title: Structured reporting of CT enterography for inflammatory bowel disease: effect on key feature reporting, accuracy across training levels, and subjective assessment of disease by referring physicians.
abstract: To compare the content and accuracy of structured reporting (SR) versus non-structured reporting (NSR) for computed tomographic enterography (CTE) of inflammatory bowel disease (IBD).
  
  
  
  This IRB-approved, HIPAA-compliant, retrospective study included 30 adult subjects (15 male, 15 female; mean age 41.9 years) with IBD imaged with CTE. Nine radiologists (3 faculty, 3 abdominal imaging fellows, and 3 senior radiology residents) independently interpreted all examinations using both NSR and SR, separated by four weeks. Reports were assessed for documentation of 15 key reporting features and a subset of 5 features was assessed for accuracy. Thirty faculty reports (15 NSR [5 per reader] and 15 SR [5 per reader]) were randomly selected for review by three referring physicians, who independently rated quality metrics for each report.
  
  
  
  NSR documented the presence or absence of 8.2 ± 2.2 key features, while SR documented 14.6 ± 0.5 features (p < 0.001). SR resulted in increased documentation of 13 of 15 features including stricture (p < 0.001), fistula (p < 0.001), fluid collection (p = 0.003), and perianal disease (p < 0.001). Among a subset of five features, accuracy for diagnosing multifocal disease was minimally increased when using SR (76% NSR vs. 83% SR; p = 0.01), but accuracy for other features was not affected by report type. Referring physicians significantly preferred SR based on ease of information extraction (p < 0.01).
  
  
  
  Structured reporting of CTE for IBD improved documentation of key reporting features for trainees and faculty, though there was minimal impact on accuracy. Referring physicians subjectively preferred the structured reports.
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA. benjamin.wildman-tobriner@duke.edu.
authors.forename: Benjamin
authors.identifier: 0000-0002-7311-5947
authors.initials: B
authors.lastname: Wildman-Tobriner
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Allen
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.|Center for Advanced Magnetic Resonance Development, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Mustafa R
authors.initials: MR
authors.lastname: Bashir
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Morgan
authors.initials: M
authors.lastname: Camp
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Miller
authors.affiliation: Department of Radiology, Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Columbus, OH, 43210, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Fiorillo
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Cubre
authors.affiliation: Department of Radiology, University of Texas MD Anderson, 1400 Pressler Street, Unit 1459, Houston, TX, 77030, USA.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Javadi
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Alex D
authors.initials: AD
authors.lastname: Bibbey
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Ehieli
authors.affiliation: Department of Gastroenterology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: McGreal
authors.affiliation: Department of Gastroenterology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Quevedo
authors.affiliation: Department of Surgery, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Julie K
authors.initials: JK
authors.lastname: Thacker
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Maciej
authors.initials: M
authors.lastname: Mazurowski
authors.affiliation: Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Jaffe
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D004282:Documentation / Q000592:standards*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: CT; Enterography; Inflammatory bowel disease; Standardized report; Structured report