P2653 - A Quality Improvement Program to Standardize Enterography Reports for Patients With Inflammatory Bowel Disease

Ryan Bailey, MD, Francis A. Farraye, MD, MSc, Michael Picco, MD, PhD, Joseph Cernigliaro, MD, Candice Bolan, MD
Mayo Clinic, Jacksonville, FL

Introduction: Radiology reports are inherently variable as they are read by different radiologists with differing levels of focus in inflammatory bowel disease. This may result in a report which is more difficult to interpret and may overlook salient findings. In the setting of inflammatory bowel disease, magnetic resonance (MRE) and computed tomography enterography (CTE) provide important information for clinical decision making. We sought to standardize enterography reports at our institution in a collaborative effort between radiology and gastroenterology to ensure that diagnostic criteria utilized to guide clinical management were consistently and clearly communicated to the referring clinician.

Methods: We developed a scoring questionnaire which included both subjective and objective measures of report clarity, efficacy, and inclusion of pertinent findings. Subsequently, 50 consecutive patients who underwent CTE and 30 consecutive patients who underwent MRE from 2/1/2020-3/15/2020 were identified. The deidentified original reports were reviewed by the gastroenterologists on our team and scored with the questionnaire. We then reviewed the available literature, and collaboratively developed a structured reporting template. Two blinded experienced gastrointestinal radiologists re-interpreted these studies utilizing the new template. The new reports were reviewed by the same three gastroenterologists. Scores for both the old and new reports were recorded in a secure internal database.

Results: At baseline, 40 reports (50%) were missing clinically significant findings. Subjective scores of referring clinician satisfaction regarding report clarity and efficiency varied widely averaging 7.6/10 and 7.1/10, respectively. Following implementation of the standardized reporting template, inclusion of all clinically pertinent data was achieved in 77 reports (96.3%). Subjective measures of referring clinician satisfaction also improved significantly, scoring 9.9/10 for both report clarity and efficiency (p< 0.0001 for both). Perhaps most importantly, new information included in the standardized reports would have altered clinical management for 20 patients (25%).

Discussion: Standardization of radiological reports for CTE and MRE resulted in improved provider satisfaction and consistent inclusion of relevant data. As this intervention would have altered clinical management for 25% of patients retrospectively, we plan to implement this intervention in our practice, and anticipate significant benefit.


Figure: Questionnaire utilized to score both the original and revised reports.

Question	Original Report	New Report	p value
How clearly were the findings communicated?	7.72	9.84	< 0.001
How efficiently was the pertinent information extracted?	7.28	9.85	< 0.001
Number of Reports with Omitted Information	40	3
Reports Missing Information	50%	4%
Reports Including All Information	50%	96%
Omitted Information
Disease Location/Length/# of Segments	18
Enhancement Pattern	2
Bowel wall thickening	8
Ulcerations	7
Inflammatory Change	5
Stricture	9
Bowel Dilation	3
Penetrating Disease	3
Perianal Disease	18
Mesenteric/Perienteric Findings	5
Extra-intestinal Findings	3
Other	2

Table: Data Summary
Scores for efficiency and clarity reflect the average score from 1-10 with 10 being the highest.


Disclosures:
Ryan Bailey indicated no relevant financial relationships.
Francis Farraye indicated no relevant financial relationships.
Michael Picco indicated no relevant financial relationships.
Joseph Cernigliaro indicated no relevant financial relationships.
Candice Bolan indicated no relevant financial relationships.


Ryan Bailey, MD, Francis A. Farraye, MD, MSc, Michael Picco, MD, PhD, Joseph Cernigliaro, MD, Candice Bolan, MD. P2653 - A Quality Improvement Program to Standardize Enterography Reports for Patients With Inflammatory Bowel Disease, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.