Effective communication of cross-sectional imaging findings in Crohn’s disease: comparing conventional EMR reporting to a published scoring system

Autor: Joseph R. Grajo, Michael Riverso, Andrew T. Flint, Patricia P. Moser, Naueen A. Chaudhry, Angela Pham, Lazarus K. Mramba, Ellen M. Zimmermann
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Pathology
Scoring system
Adolescent
Urology
Fistula
Lumen (anatomy)
Constriction
Pathologic
Logistic regression
Severity of Illness Index
030218 nuclear medicine & medical imaging
Lesion
Cross-sectional imaging
Young Adult
03 medical and health sciences
0302 clinical medicine
Crohn Disease
Internal medicine
Intestine
Small
medicine
Electronic Health Records
Humans
Radiology
Nuclear Medicine and imaging
Aged
Retrospective Studies
Inflammation
Observer Variation
Crohn's disease
Radiological and Ultrasound Technology
business.industry
Gastroenterology
Reproducibility of Results
Middle Aged
Hepatology
medicine.disease
Magnetic Resonance Imaging
Cross-Sectional Studies
Female
030211 gastroenterology & hepatology
medicine.symptom
Tomography
X-Ray Computed
business
Zdroj: Abdominal Radiology. 43:1798-1806
ISSN: 2366-0058
2366-004X
DOI: 10.1007/s00261-017-1368-0
Popis: The purpose of the article is to compare information regarding small bowel lesions in Crohn’s disease (CD) patients communicated by a published scoring system and radiology reports from electronic medical record (EMR) of cross-sectional abdominal imaging. Two gastrointestinal radiologists (reference readers) blinded to EMR reports scored cross-sectional imaging exams using a published scoring system. Investigators compared EMR and radiologist scores based on the mentioned findings and severity documentation of each variable. Statistical analysis involved means and difference in proportions and logistic regression modeling. Seventy-three CD patients, with average age 40.6 years (± SD 14.4), having 80 small bowel lesions on imaging were included. EMR reports reliably mentioned within the consensus score included thickness (79%, p = 0.000), enhancement (70%, p = 0.000), active inflammation (86%, p = 0.000), perienteric fluid (82%, p = 0.000), and presence of stricture (62%, p = 0.002). Minimal lumen diameter (19%, p = 0.000), comb sign (19%, p = 0.000), lesion length (57%, p = 0.06), and fistula (50%, p = 1.0) were reported less often. There was a strong association between the EMR and scoring scale in noting severity of active inflammation (88%, p = 0.000), perienteric fluid (76%, p = 0.000), and internal fistula (71%, p = 0.000). The proportion matching severity values of comb sign and minimal lumen were 24% and 21%, respectively (p = 0.000). Severity matches for stricture were less likely among the non-GI radiologists (odds ratio = 0.33, SE = 0.168, p = 0.029). The odds of reporting stricture and fistula severity were 3.6 and 5.7, respectively, on MRE. Findings and severity of inflammation were communicated consistently. Stricture severity including minimal luminal diameter, was less reliably reported, though its prognostic significance impacts management.
Databáze: OpenAIRE
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