Can the completeness of radiological cancer staging reports be improved using proforma reporting? A prospective multicentre non-blinded interventional study across 21 centres in the UK
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Published version
Author(s)
Type
Journal Article
Abstract
Objectives: Following a diagnosis of cancer, the detailed assessment of prognostic stage by radiology is a crucial determinant of initial therapeutic strategy offered to patients. Pre-therapeutic stage by imaging is known to be inconsistently documented. We tested whether the completeness of cancer staging radiology reports could be improved through a nationally introduced pilot of proforma-based reporting for a selection of six common cancers.
Design: Prospective interventional study comparing the completeness of radiology cancer staging reports before and after the introduction of proforma reporting
Setting: Twenty-one UK NHS Hospitals
Participants: 1283 cancer staging radiology reports were submitted
Main Outcome Measures: Radiology staging reports across the six cancers types were evaluated before and after the implementation of proforma based reporting. Report completeness was assessed using scoring forms listing the presence or absence of pre-determined key staging data. Qualitative data regarding proforma implementation and usefulness was collected from questionnaires provided to radiologists and end-users.
Results: Electronic proforma based reporting was successfully implemented in 15 of the 21 centres during the evaluation period. A total of 787 pre-proforma and 496 post-proforma staging reports were evaluated. In the pre-proforma group, only 48.7% (5586/11470) of key staging items were present compared with 87.3% (6043/6920) in the post-proforma group. Thus, proforma reporting achieved an absolute improvement in staging completeness of 38.6% (95%CI,0.37-0.40%,p<0.001). An increase was seen across all cancer types and centres. The majority of respondents found proforma reporting improved report quality.
Conclusion: The implementation of proforma reporting results in a significant improvement in completeness of cancer staging reports. Proforma based assessment of radiological stage facilitates objective comparison of quality and outcomes. It should become an auditable quality standard.
Design: Prospective interventional study comparing the completeness of radiology cancer staging reports before and after the introduction of proforma reporting
Setting: Twenty-one UK NHS Hospitals
Participants: 1283 cancer staging radiology reports were submitted
Main Outcome Measures: Radiology staging reports across the six cancers types were evaluated before and after the implementation of proforma based reporting. Report completeness was assessed using scoring forms listing the presence or absence of pre-determined key staging data. Qualitative data regarding proforma implementation and usefulness was collected from questionnaires provided to radiologists and end-users.
Results: Electronic proforma based reporting was successfully implemented in 15 of the 21 centres during the evaluation period. A total of 787 pre-proforma and 496 post-proforma staging reports were evaluated. In the pre-proforma group, only 48.7% (5586/11470) of key staging items were present compared with 87.3% (6043/6920) in the post-proforma group. Thus, proforma reporting achieved an absolute improvement in staging completeness of 38.6% (95%CI,0.37-0.40%,p<0.001). An increase was seen across all cancer types and centres. The majority of respondents found proforma reporting improved report quality.
Conclusion: The implementation of proforma reporting results in a significant improvement in completeness of cancer staging reports. Proforma based assessment of radiological stage facilitates objective comparison of quality and outcomes. It should become an auditable quality standard.
Date Issued
2018-10-02
Date Acceptance
2017-11-17
Citation
BMJ Open, 2018, 8 (10)
ISSN
2044-6055
Publisher
BMJ Journals
Journal / Book Title
BMJ Open
Volume
8
Issue
10
Copyright Statement
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
NIHR
Imperial College Healthcare NHS Trust- BRC Funding
Grant Number
RDC04 79560
EME/13/122/01
NIHR BRC Royal Marsden
RDC04
Subjects
cancer staging
proforma reporting
structured reporting
synoptic reporting
Publication Status
Published
Article Number
e018499