title: A default normal chest CT structured reporting field for coronary calcifications does not cause excessive false-negative reporting.
abstract: OBJECTIVE
  The aim of this study was to compare the accuracy of coronary atherosclerosis reporting before and after the implementation of a structured reporting chest CT template.
  
  
  METHODS
  A noncardiac, noncontrast chest CT structured reporting template was developed and mandated for department-wide use at a large academic center. The template included the statement "There are no coronary artery calcifications." All noncardiac, noncontrast chest CT examinations reported over 3 days, 1 month after template implementation (structured template group), and from a 3-day period 1 year prior (control group) were retrospectively collected. Final radiology reports were reviewed and designated positive or negative for coronary calcifications. CT images were reviewed in consensus by 2 radiologists, who scored each case for the presence or absence of coronary calcifications, blinded to the original report. Statistical analysis was performed using Pearson χ(2) and Fisher exact tests.
  
  
  RESULTS
  Sixty-five percent (69 of 106) of structured template group and 58% (62 of 106) of control group cases had coronary calcifications. Reports from the structured template group were more likely to correctly state the presence or absence of coronary atherosclerosis compared with those from the control group (96.2% vs 85.8%; odds ratio, 4.2; 95% confidence interval, 1.3-13.1; P = .008). Structured template group reports were less likely to be falsely negative compared with control group reports (3.8% vs 11.7%; odds ratio, 3.4; 95% confidence interval, 1.0-10.8; P = .03).
  
  
  CONCLUSIONS
  Implementing a structured reporting template improves reporting accuracy of coronary calcifications.
authors.affiliation: Department of Radiology, Montefiore Medical Center, Bronx, New York.
authors.forename: William R
authors.initials: WR
authors.lastname: Walter
authors.affiliation: Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Shlomit
authors.initials: S
authors.lastname: Goldberg-Stein
authors.affiliation: Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Levsky
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.affiliation: Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address: mscheinf@montefiore.org.
authors.forename: Meir H
authors.initials: MH
authors.lastname: Scheinfeld
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004282:Documentation; D005188:False Negative Reactions; D019983:Guideline Adherence / Q000706:statistics & numerical data; D017408:Guidelines as Topic; D006801:Humans; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D013902:Radiography, Thoracic / Q000592:standards* / Q000706:statistics & numerical data; D011873:Radiology Information Systems / Q000592:standards / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000706:statistics & numerical data; D014481:United States
keywords: Structured reporting; coronary calcifications; report quality