Abstract
Purpose Evaluation of the diagnostic accuracy of a checklist-style structured reporting template
in the setting of whole-body multislice computed tomography in major trauma patients
depending on the level of experience of the reporting radiologist.
Materials and Methods A total of 140 major trauma scans with the same protocol were included in this retrospective
study. In a purely trial-intended reading, the trauma scans were analyzed by three
radiologists with different levels of experience (resident, radiologist with 3 years
of experience after board certification, and radiologist with 7 years of experience
after board certification). The aim was to fill in the checklist 1 template within
one minute to immediately diagnose management-altering findings. Checklist 2 was intended
for the analysis of important trauma-related findings within 10 minutes. Reading times
were documented. The final radiology report and the documented injuries in the patient’s
medical record were used as gold standard.
Results The evaluation of checklist 1 showed a range of false-negative reports between 5.0 %
and 11.4 % with the resident showing the highest accuracy. Checklist 2 showed overall
high diagnostic inaccuracy (19.3–35.0 %). The resident's diagnostic accuracy was statistically
significantly higher compared to the radiologist with 3 years of experience after
board certification (p = 0.0197) and with 7 years of experience after board certification
(p = 0.0046). Shorter average reporting time resulted in higher diagnostic inaccuracy.
Most of the missed diagnoses were fractures of the spine and ribs.
Conclusion By using a structured reporting template in the setting of major trauma computed
tomography, less experienced radiologists reach a higher diagnostic accuracy compared
to experienced readers.
Key Points:
In the setting of a pure trial reading, the diagnostic inaccuracy of template-based
reporting of major trauma CT examinations is high.
Fractures in general and especially of the vertebral bodies and ribs were the most
commonly missed diagnoses.
In a study setting, less experienced radiologists seem to reach a higher diagnostic
accuracy when using a structured reporting approach.
Citation Format
Dendl LM, Pausch AM, Hoffstetter P et al. Structured Reporting of Whole-Body Trauma
CT Scans Using Checklists: Diagnostic Accuracy of Reporting Radiologists Depending
on Their Level of Experience. Fortschr Röntgenstr 2021; 193: 1451 – 1460
Key words structured reporting - CT - trauma
