title: Reporting of central airway obstruction on radiology reports and impact on bronchoscopic airway interventions and patient outcomes.
abstract: BACKGROUND
  Central airway obstruction (CAO) is a serious condition that affects patients with both benign and malignant diseases. Timely recognition of CAO is crucial for prompt intervention aimed at improving the symptoms and quality of life of these patients. The aim of this study is to evaluate the formal radiology reporting of CAO and its impact on patients' outcomes.
  
  
  METHODS
  The medical records of patients who underwent advanced therapeutic bronchoscopy for CAO from August 2013 to September 2014 were retrospectively reviewed. Three researchers each reviewed 14 of the 42 formal radiology reports that were performed at 16 different medical and radiology centers.Patient characteristics were reported as means, medians, and standard deviations for continuous variables, and as frequencies and relative frequencies for categorical variables.
  
  
  RESULTS
  Out of 42 patients who underwent advanced bronchoscopy for planned therapeutic intervention, only 30 had radiology and pulmonology concordance about the airway findings of CAO. This is an agreement rate of 71.4% [95% confidence interval (CI): 56.7-83.3%] or a disagreement rate of 28.6% (95% CI: 16.7-43.3%). The radiology reports did not mention 31% of CAO on CT scans. The median time from CT imaging to bronchoscopy was significantly longer in patients with CAO not reported by the radiologists (21 versus 10 days; p = 0.011). Most patients improved postoperatively with no significant difference between the two groups.
  
  
  CONCLUSIONS
  Findings of CAOs were not described in a significant proportion of radiology reports. This results in significant delay in bronchoscopic airway management.
authors.affiliation: Roswell Park Cancer Institute, Department of Medicine, Interventional Pulmonary Section University at Buffalo, State University of New York, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Elm and Carlton streets, Buffalo, NY 14623, USA kassem.harris@roswellpark.org.
authors.forename: Kassem
authors.initials: K
authors.lastname: Harris
authors.affiliation: Roswell Park Cancer Institute, Department of Medicine, Interventional Pulmonary Section University at Buffalo, State University of New York, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York, USA.
authors.forename: Abdul Hamid
authors.initials: AH
authors.lastname: Alraiyes
authors.affiliation: Roswell Park Cancer Institute, Department of Biostatistics and Bioinformatics.
authors.forename: Kristopher
authors.initials: K
authors.lastname: Attwood
authors.affiliation: University at Buffalo, State University of New York, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York, USA.
authors.forename: Kush
authors.initials: K
authors.lastname: Modi
authors.affiliation: Roswell Park Cancer Institute, Department of Medicine, Interventional Pulmonary Section University at Buffalo, State University of New York, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York, USA.
authors.forename: Samjot S
authors.initials: SS
authors.lastname: Dhillon
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011873:Radiology Information Systems; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: airway obstruction; interventional pulmonology; radiology report