Reason for Exam Imaging Reporting and Data System: Consensus Reached on Quality Assessment of Radiology Requisitions

Abstract

OBJECTIVE: The aim of this study was to reach consensus on quality assessment of clinical information in imaging requisitions using Reason for exam Imaging Reporting and Data System (RI-RADS). METHODS: A Delphi study was conducted in September 2018 with a panel of 87 radiologists with diverse levels of experience from various settings (community hospitals, private hospitals, university hospitals, and clinics), of which 74.7% completed the survey. The agreement was assessed in the following subjects: (a) presumed effect of standardization, (b) the standardized system for information, (c) the scoring system for evaluation of requisitions, and (d) the implementation of RI-RADS. The consensus threshold was set at 51% responding (strongly) agree. The rate of lawsuits preventable with clinical information was also assessed. RESULTS: Consensus was reached on all objectives of the study with a high level of agreement. Radiologists agreed on the need for standardization of imaging requisitions and attributed it to increased speed and accuracy of interpretations. Three categories of information were determined as key indicators of quality: impression, clinical findings, and clinical question. The scoring system is intended to grade requisitions based on the presence of these categories. Radiologists also agreed that RI-RADS will encourage physicians to improve requisitions. Among radiologists who responded to the survey, 12.6% had experienced at least one lawsuit potentially preventable with sufficient information in requisitions. CONCLUSIONS: Reason for exam Imaging Reporting and Data System can be used as a standard for quality assessment of requisitions. Its use may improve the quality of patient care and reduce lawsuits against radiologists.

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