Analysis of Different Levels of Structured Reporting in Knee Magnetic Resonance Imaging

Abstract

Rationale and objectives: The aim of this study is to investigate the most appropriate knee MRI report template that not only provides structure and consistency, but also allows enough narrative freedom for the logical organization of findings and improved communication with the orthopedic referral base.

Materials and methods: Three fictitious knee MRI reports were created using templates with different levels of structuring: unstructured free text (FT), structured with headers (SH), and highly structured and itemized (SI). These were then distributed to clinicians in the orthopedics department at all levels of training along with a survey with numerical scoring questions on report readability, usefulness, and quality. Statistical analysis was used to evaluate the data.

Results: Fifty-three surveys were completed with responses from residents, attendings, and physician assistants. The structured format with headers had statistically significant (p value <0.001) higher mean rank score in readability, usefulness, and quality parameters compared to the unstructured FT and highly SI report templates. Most clinicians (83%) found the structured format with headers to be the most coherent report. Conversely, 53% found the unstructured FT and 43% found the highly SI templates to be the most disjointed.

Conclusion: Based on responses to surveys of knee MRI report templates, our results show that our orthopedic clinicians prefer some level of structure in the reports but not the rigorous itemization of anatomic tissues. A "middle ground" reporting structure which includes headers for different anatomic compartments and allows for grouping of relevant pathology, is shown to be the preferred format.