Universität zu Köln

dos Santos, Daniel Pinto, Hempel, Johann-Martin, Mildenberger, Peter, Kloeckner, Roman ORCID: 0000-0001-5492-4792 and Persigehl, Thorsten (2019). Structured Reporting in Clinical Routine. Rofo-Fortschr. Gebiet Rontgenstrahlen Bildgeb. Verfahr., 191 (1). S. 33 - 40. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-9010

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Abstract

Background The radiology report is the key component in the communication between radiologists and referring clinicians. Traditionally, reports are written as free text. Several studies have shown that structured reporting using dedicated report templates has a number of advantages compared to conventional reports. Therefore, many radiological societies have recommended the implementation of structured reporting in clinical routine. Method In the meantime, collections of freely available templates have been presented and software solutions for structured reporting have been made commercially available. These allow for quality improvements in the written radiology report as they ensure that all relevant clinical information is included. Most vendors mainly supply proprietary report templates or allow users to create templates for their own institution. The German Radiological Society (DRG) has the goal of developing consensus-based, quality-assured report templates and providing them under a free license. Results The DRG has developed its first consensus-based report templates and provides them at www.befundung.drg.de. Further report templates will be developed in close cooperation with the respective committees of the DRG and referring clinicians. Conclusion Structured reporting allows for a significant improvement in the quality of written radiology reports. The use of report templates requires personal and technical changes to the reporting process itself. Radiology should face these challenges in its leading role in the application of modern IT-based solutions. Vendors are now encouraged to provide practical solutions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code dos Santos, Daniel Pinto UNSPECIFIED UNSPECIFIED UNSPECIFIED Hempel, Johann-Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mildenberger, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloeckner, Roman UNSPECIFIED orcid.org/0000-0001-5492-4792 UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-140626
DOI:	10.1055/a-0636-3851
Journal or Publication Title:	Rofo-Fortschr. Gebiet Rontgenstrahlen Bildgeb. Verfahr.
Volume:	191
Number:	1
Page Range:	S. 33 - 40
Date:	2019
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1438-9010
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RADIOLOGY REPORTS; REPORT TEMPLATE; MRI REPORTS; QUALITY; CT; LANGUAGE; SOCIETY; IMPACT Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14062