Abstract
OBJECTIVE. Few data are available on how often MRI reports provide sufficient information for clinical decision making in patients with multiple sclerosis (MS). The aim of this study is to evaluate if structured reporting of MRI in MS contain adequate information for clinical decision making compared with nonstructured reporting.
MATERIALS AND METHODS. Brain and spinal cord MRI reports of patients with suspected or known MS before and after implementation of a structured reporting template were included. Brain and spinal cord MRI reports were assessed for presence of 11 and three key features relevant for management of MS, respectively. Three neurologists evaluated reports and images to assess lesion load, presence of sufficient information for clinical decision making, and necessity to review MR images for clinical decision making. Statistical analysis included t tests and chi-square tests.
RESULTS. Thirty-two structured and 37 nonstructured reports were reviewed. Brain MRI nonstructured reports contained a mean +/- SD of 3.59 +/- 0.76 key features, and structured reports contained a mean of 10.25 +/- 1.32 key features (p < 0.001). No significant difference was observed in the number of key features in nonstructured and structured spinal cord MRI reports. All neurologists could understand lesion load significantly more often when reading structured versus nonstructured reports (p < 0.001). For two of the three neurologists, structured reports contained adequate information for clinical decision making more often than did nonstructured reports (p < 0.001 and p = 0.006). When reading nonstructured reports, two of the three neurologists needed to evaluate images significantly more often (p < 0.001).
CONCLUSION. Structured reports of MRI in patients with MS provided more adequate information for clinical decision making than nonstructured reports.
