Abstract
Rationale and Objectives. To determine the amount of formal instruction and evaluation about reporting given
to radiology residents in the U.S.A., to document report generation methods and to
quantify the performance of physician coding.
Materials and Methods. E-mail requests with links to a web-based, anonymous survey were sent to program
directors of all accredited radiology residencies in the USA. Demographic questions
included university or private affiliation, number of residents, geographic location,
and number of hospitals covered. Subject-specific items covered the amount of didactic
instruction, formal evaluation of reports, and use of structured reports. A didactic
activity index (DAI) was calculated as the sum of answers to domain-specific questions
and tested for relation to demographic variables. We also asked about dictation methods
and International Classification of Diseases (ICD) or Common Procedural Terminology
(CPT) coding of examinations by radiologists.
Results. Of the 191 active radiology residencies, 151 (79%) completed the survey. Responses
for hours of didactic instruction in reporting given more than a 4-year residency
were distributed as follows: 0–1 = 40%, 2–4 = 46%, >4 = 14%. The percentage of resident
reports formally graded was distributed as follows: 0–1 = 82%, 2–4 = 8%, >4 = 10%.
The extent to which faculty-designed, structured reports were used by residents was
distributed as follows: none = 16%, minimal = 25%, few = 17%, some = 33%, most = 9%.
The DAI was normally distributed with a mean of 14.8 and a standard deviation of 2.4.
Military programs had higher DAIs than university residencies (P = .03). There was no significant relation between any other program demographic variables
and the DAI (P > .05). A substantial number of programs reported that physicians performed coding
for some or most studies: ICD-9 = 30%, CPT = 26%. The dominant method for report generation
was human transcription in 79% followed by speech recognition at 19%. Speech recognition
penetration (departments reporting use of the technology for at least some dictation)
was estimated to be 38%.
Conclusion. In 86% of sampled radiology residencies, trainees receive no more than one hour of
didactic instruction in radiology reporting per year. An aggregate measure of didactic
activity about interpretative reporting was identical across all program demographic
variables except that military residencies seemed to do slightly more than those located
at universities.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Standardization of roentgen-ray reports.AJR Am J Roentgenol. 1922; 9 (442–425)
- Radiology reporting.Radiology. 1988; 169: 825-826
- The radiological report.Can Assoc Radiol J. 1988; 39: 140-143
- Radiology reports.AJR Am J Roentgenol. 1995; 165: 803-806
- The evolution of the X-ray report.AJR Am J Roentgenol. 1995; 164: 501-502
- Radiology reports.AJR Am J Roentgenol. 2001; 176: 591-598
- Medical cost containment.J Trauma. 1995; 38: 220-222
- Comparative analysis of radiographic interpretation of orthopedic films.J Trauma. 1995; 39: 720-721
- Clinical value of radiologists’ interpretations of perioperative radiographs of orthopedic patients.Orthopedics. 1996; 19: 1003-1007
- The clinical utility of duplicate readings for musculoskeletal radiographs.Orthopedics. 1997; 20: 1015-1019
- Is a routine radiological consultation cost-effective for pediatric orthopedic radiographs?.J Pediatr Orthop. 1998; 18: 549-551
- Idiopathic scoliosis. The clinical value of radiologists’ interpretation of pre- and postoperative radiographs with interobserver and interdisciplinary variability.Spine. 1999; 24: 2007-2009
- U.S.General Accounting Office.Mammography services. 1997 (GAO/HEHS-98-11)
- Breast Imaging Reporting and Data System.AJR Am J Roentgenol. 2000; 174: 1769-1777
- Breast imaging reporting and data system standardized mammography lexiconobserver variability in lesion description.AJR Am J Roentgenol. 1996; 166 ([see comments]): 773-778
- Variability and accuracy in mammographic interpretation using the American College of Radiology Breast Imaging Reporting and Data System.J Natl Cancer Inst. 1998; 90: 1801-1809
- Effect of training with the american college of radiology breast imaging reporting and data system lexicon on mammographic interpretation skills in developing countries.Acad Radiol. 2001; 8: 647-650
- Does training in the Breast Imaging Reporting and Data System (BI-RADS) improve biopsy recommendations or feature analysis agreement with experienced breast imagers at mammography?.Radiology. 2002; 224: 871-880
- Learning to report.Acad Radiol. 2002; 9: 817-820
- A curriculum in chest radiology for diagnostic radiology residency, with goals and objectives.Acad Radiol. 2000; 7: 730-743
- ACR standard for communication.in: American College of Radiology, editor. Standards. American College of Radiology, Reston, VA2002: 3-5
- Assessing radiology resident reporting skills.Radiology. 2002; 225: 719-722
- The film-reporting session as a qualifying examination in diagnostic radiology.Can Assoc Radiol J. 1990; 41: 186-190
- Resident film interpretations and staff review.AJR Am J Roentgenol. 1981; 137: 129-133
- Educational impact of faculty review on radiology residents’ radiographic interpretations.Invest Radiol. 1984; 19: 61-64
- Routine editing of trainee-generated radiology reports.Acta Radiol. 2003; 10: 289-294
- Qualities of a good radiology report.AJR Am J Roentgenol. 1998; 170: 1110
- Report generation using digital speech recognition in radiology.Eur Radiol. 2000; 10: 1976-1982
- Quality-of-service improvements from coupling a digital chest unit with integrated speech recognition, information, and picture archiving and communications systems.J Digit Imaging. 1999; 12: 191-197
- Speech recognition cuts report turnaround time.Diagn Imaging. 1991; 13 (201): 196-198
- Impact of speech recognition on radiologist productivity.J Digit Imaging. 2002; 15: 203-209
- Speech processing in radiology.Eur Radiol. 1999; 9: 1451-1456
- Experience with implementation of a radiology speech recognition system.J Digit Imaging. 2000; 13: 124-128
- Coding and reimbursement issues for the radiologist.Radiology. 2001; 220: 7-11
- Networked ICD-9 coding system for a radiology department.AJR Am J Roentgenol. 2001; 176: 335-339
Article info
Publication history
Accepted:
September 23,
2003
Received in revised form:
August 28,
2003
Received in revised form:
September 22,
2003
Received:
August 21,
2003
Identification
Copyright
© 2004 AUR. Published by Elsevier Inc. All rights reserved.
