Evidence map›Paper›PMID 37307897›Full record

ArticleJournal of the American College of Radiology : JACR2023

Impact of an Automated Closed-Loop Communication and Tracking Tool on the Rate of Recommendations for Additional Imaging in Thoracic Radiology Reports.

Ariadne K DeSimone, Neena Kapoor, Ronilda Lacson, Elvira Budiawan, Mark M Hammer, Sonali P Desai, Sunil Eappen, Ramin Khorasani

Abstract read
In one paragraph

Article in Journal of the American College of Radiology : JACR, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ariadne K DeSimoneDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: adesimone@bwh.harvard.edu.
Neena KapoorDirector of Diversity, Inclusion, and Equity and Quality and Patient Safety Officer, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Ronilda LacsonDirector of Education, Center for Evidence-Based Imaging, Brigham and Women's Hospital, and Director of Clinical Informatics, Harvard Medical School Library of Evidence, Boston, Massachusetts.
Elvira BudiawanCenter for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Mark M HammerCardiothoracic Fellowship Program Director, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Sonali P DesaiSenior Vice President and Chief Quality Officer, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Sunil EappenSenior Vice President, Medical Affairs, and Chief Medical Officer, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Ramin KhorasaniVice Chair of Radiology Quality and Safety, Mass General Brigham; Director of the Center for Evidence-Based Imaging and Vice Chair of Quality/Safety, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Funding

DECODE: Diagnostic Excellence Center on Diagnostic ErrorR18HS029348 · AHRQ · BRIGHAM AND WOMEN'S HOSPITAL · PI KHORASANI, RAMIN, LACSON, RONILDA · 2022 to 2025
$4.0M
AHRQ HHS R18 HS029348
6 · The paper itself

Abstract

objectiveAssess the effects of feedback reports and implementing a closed-loop communication system on rates of recommendations for additional imaging (RAIs) in thoracic radiology reports.

methodsIn this retrospective, institutional review board-approved study at an academic quaternary care hospital, we analyzed 176,498 thoracic radiology reports during a pre-intervention (baseline) period from April 1, 2018, to November 30, 2018; a feedback report only period from December 1, 2018, to September 30, 2019; and a closed-loop communication system plus feedback report (IT intervention) period from October 1, 2019, to December 31, 2020, promoting explicit documentation of rationale, time frame, and imaging modality for RAI, defined as complete RAI. A previously validated natural language processing tool was used to classify reports with an RAI. Primary outcome of rate of RAI was compared using a control chart. Multivariable logistic regression determined factors associated with likelihood of RAI. We also estimated the completeness of RAI in reports comparing IT intervention to baseline using χ

resultsThe natural language processing tool classified 3.2% (5,682 of 176,498) reports as having an RAI; 3.5% (1,783 of 51,323) during the pre-intervention period, 3.8% (2,147 of 56,722) during the feedback report only period (odds ratio: 1.1, P = .03), and 2.6% (1,752 of 68,453) during the IT intervention period (odds ratio: 0.60, P < .001). In subanalysis, the proportion of incomplete RAI decreased from 84.0% (79 of 94) during the pre-intervention period to 48.5% (47 of 97) during the IT intervention period (P < .001). DISCUSSION: Feedback reports alone increased RAI rates, and an IT intervention promoting documentation of complete RAI in addition to feedback reports led to significant reductions in RAI rate, incomplete RAI, and improved overall completeness of the radiology recommendations.

Indexed as

RadiologyTeach-Back CommunicationCommunicationRadiographyRadiography, ThoracicRetrospective StudiesClosed-loop communicationfollow-up imaging recommendationphysician feedbackquality improvement

Identifiers

PMID37307897
PMCPMC12911512

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.