Johnston Michael G, Burke Skyler, Brock Chance M, Beckius Saralyn, King Scott
Medicine, Washington State University, Spokane, USA.
Radiology, Providence Sacred Heart Medical Center, Spokane, USA.
Cureus. 2023 Jun 22;15(6):e40828. doi: 10.7759/cureus.40828. eCollection 2023 Jun.
Introduction The objective of this quality improvement study was to assess radiology report follow-up recommendation trends upon detection of incidental renal lesions before and after instituting standardized follow-up macros. Materials and methods A retrospective review was performed in 2019 of multiphase imaging workups on renal lesions (n = 396), including the following imaging modalities: ultrasound, CT with and without contrast, and spine MRI. Utilizing the same collection methods, a similar retrospective set of cases was collected in 2021, 12 months following the creation of the renal follow-up macros (n = 501). After exclusions, the second set was left with 98 cases of newly characterized incidental renal lesions. For both sets, we assessed the reports of the exams that initially detected the incidental renal lesion. We evaluated the incident reports for the presence of a follow-up recommendation, recommendation completeness, and alignment with the American College of Radiology (ACR) white paper suggestions for renal lesion follow-up. Results Before the implementation of the standardized renal follow-up macros, initial follow-up recommendations were in concordance with the ACR white paper recommendations in 33 of 98 cases (33.7%), incomplete or discordant in 49 of 98 (50.0%), and absent in 16 of 98 cases (16.3%). Following the institution of our macros, there was an improvement in concordant follow-up recommendations (51/98; 52.0%) (p = 0.009), a decrease in the number of incomplete or discordant recommendations (37/98; 37.8%), and a decrease in the number of reports lacking a follow-up recommendation (10/98; 10.2%). Conclusion Utilization of standard language renal lesion follow-up macros improves the rate of appropriate follow-up recommendations in radiology reports when encountering a previously unknown incidental renal lesion.
引言 本质量改进研究的目的是评估在制定标准化随访宏指令前后，检测到偶然发现的肾脏病变时放射学报告随访建议的趋势。材料与方法 2019年对肾脏病变的多期成像检查（n = 396）进行了回顾性分析，包括以下成像方式：超声、有或无对比剂的CT以及脊柱MRI。采用相同的收集方法，在肾脏随访宏指令创建后的12个月，即2021年收集了一组类似的回顾性病例（n = 501）。排除后，第二组留下98例新发现的偶然肾脏病变病例。对于这两组病例，我们评估了最初检测到偶然肾脏病变的检查报告。我们评估了这些病例报告中是否存在随访建议、建议的完整性以及是否符合美国放射学会（ACR）关于肾脏病变随访的白皮书建议。结果 在实施标准化肾脏随访宏指令之前，98例病例中有33例（33.7%）的初始随访建议与ACR白皮书建议一致，49例（50.0%）不完整或不一致，16例（16.3%）无随访建议。在我们的宏指令实施后，一致的随访建议有所改善（51/98；52.0%）（p = 0.009），不完整或不一致建议的数量减少（37/98；37.8%），缺乏随访建议的报告数量减少（10/98；10.2%）。结论 当遇到先前未知的偶然肾脏病变时，使用标准语言的肾脏病变随访宏指令可提高放射学报告中适当随访建议的比例。
