Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism
Abstract Background Structured reporting is an efficient and replicable method of presenting diagnostic results that eliminates variability inherent in narrative descriptive reporting and may improve clinical decisions. Synoptic element reporting can generate discrete coded data that then may inform...
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Elsevier
2022-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12801 |
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| author | Isabela A. Woller Scott C. Woller Scott M. Stevens James F. Lloyd Karen E. Conner Benjamin H. Gordon Greg L. Snow Peter Jones Joseph R. Bledsoe |
| author_facet | Isabela A. Woller Scott C. Woller Scott M. Stevens James F. Lloyd Karen E. Conner Benjamin H. Gordon Greg L. Snow Peter Jones Joseph R. Bledsoe |
| author_sort | Isabela A. Woller |
| collection | DOAJ |
| description | Abstract Background Structured reporting is an efficient and replicable method of presenting diagnostic results that eliminates variability inherent in narrative descriptive reporting and may improve clinical decisions. Synoptic element reporting can generate discrete coded data that then may inform clinical decision support and trigger downstream actions in computerized electronic health records. Objective Limited evidence exists for use of synoptic reporting for computed tomography pulmonary arteriography (CTPA) among patients suspected of pulmonary embolism. We reported the accuracy of synoptic reporting for the outcome of pulmonary embolism among patients who presented to an integrated health care system with CTPA performed for suspected pulmonary embolism. Methods Structured radiology reports with embedded synoptic elements were implemented for all CTPA examinations on March 1, 2018. Four hundred CTPA reports between January 4, 2019 and July 30, 2020 (200 reports each for which synoptic reporting recorded the presence or absence of pulmonary embolism [PE]) were selected at random. One non‐diagnostic study was excluded from analysis. We then assessed the accuracy of synoptic reporting compared with the gold standard of manual chart review. Results Synoptic reporting and manual review agreed in 99.2% of patients undergoing CTPA for suspected PE, agreed on the presence of PE in 196 of 199 (98.5%) cases, the absence of PE in 200 of 200 (100%) cases with a sensitivity of 87.6% (76.1–96.1) a specificity of 99.9% (99.7%–100%), a positive predictive value of 99.5% (98.1–100), and a negative predictive value of 98% (95.7%–99.5%). Conclusion The overall rate of agreement was 99.2%, but we observed an unacceptable false‐negative rate for clinical reliance on synoptic element reporting in isolation from dictated reports. |
| format | Article |
| id | doaj-art-4bf3032b8d4e4b82a4e412329c544792 |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-4bf3032b8d4e4b82a4e412329c5447922025-08-20T02:17:56ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-10-0135n/an/a10.1002/emp2.12801Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolismIsabela A. Woller0Scott C. Woller1Scott M. Stevens2James F. Lloyd3Karen E. Conner4Benjamin H. Gordon5Greg L. Snow6Peter Jones7Joseph R. Bledsoe8Undergraduate Education Loyola University Chicago Chicago Illinois USADepartment of Medicine Intermountain Medical Center and Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah USADepartment of Medicine Intermountain Medical Center and Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah USADepartment of Medical Informatics Intermountain Healthcare Salt Lake City Utah USADepartment of Radiology Intermountain Medical Center Salt Lake City Utah USADepartment of Radiology Intermountain Medical Center Salt Lake City Utah USAOffice of Research Intermountain Healthcare Statistical Data Center Salt Lake City Utah USAIntermountain Healthcare Enterprise Analytics Salt Lake City Utah USADepartment of Emergency Medicine Intermountain Healthcare Salt Lake City Utah USAAbstract Background Structured reporting is an efficient and replicable method of presenting diagnostic results that eliminates variability inherent in narrative descriptive reporting and may improve clinical decisions. Synoptic element reporting can generate discrete coded data that then may inform clinical decision support and trigger downstream actions in computerized electronic health records. Objective Limited evidence exists for use of synoptic reporting for computed tomography pulmonary arteriography (CTPA) among patients suspected of pulmonary embolism. We reported the accuracy of synoptic reporting for the outcome of pulmonary embolism among patients who presented to an integrated health care system with CTPA performed for suspected pulmonary embolism. Methods Structured radiology reports with embedded synoptic elements were implemented for all CTPA examinations on March 1, 2018. Four hundred CTPA reports between January 4, 2019 and July 30, 2020 (200 reports each for which synoptic reporting recorded the presence or absence of pulmonary embolism [PE]) were selected at random. One non‐diagnostic study was excluded from analysis. We then assessed the accuracy of synoptic reporting compared with the gold standard of manual chart review. Results Synoptic reporting and manual review agreed in 99.2% of patients undergoing CTPA for suspected PE, agreed on the presence of PE in 196 of 199 (98.5%) cases, the absence of PE in 200 of 200 (100%) cases with a sensitivity of 87.6% (76.1–96.1) a specificity of 99.9% (99.7%–100%), a positive predictive value of 99.5% (98.1–100), and a negative predictive value of 98% (95.7%–99.5%). Conclusion The overall rate of agreement was 99.2%, but we observed an unacceptable false‐negative rate for clinical reliance on synoptic element reporting in isolation from dictated reports.https://doi.org/10.1002/emp2.12801CTPApulmonary embolismstructured reportingsynoptic reporting |
| spellingShingle | Isabela A. Woller Scott C. Woller Scott M. Stevens James F. Lloyd Karen E. Conner Benjamin H. Gordon Greg L. Snow Peter Jones Joseph R. Bledsoe Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism Journal of the American College of Emergency Physicians Open CTPA pulmonary embolism structured reporting synoptic reporting |
| title | Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism |
| title_full | Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism |
| title_fullStr | Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism |
| title_full_unstemmed | Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism |
| title_short | Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism |
| title_sort | synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism |
| topic | CTPA pulmonary embolism structured reporting synoptic reporting |
| url | https://doi.org/10.1002/emp2.12801 |
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