Assessment of Reason for Exam Imaging Reporting and Data System (RI-RADS) in inpatient diagnostic imaging referrals.

IF 4.1 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Insights into Imaging Pub Date : 2024-11-08 DOI:10.1186/s13244-024-01846-x
Marco Parillo, Federica Vaccarino, Daniele Vertulli, Gloria Perillo, Edoardo Montanari, Carlo Augusto Mallio, Carlo Cosimo Quattrocchi
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Abstract

Objectives: To test the Reason for Exam Imaging Reporting and Data System (RI-RADS) in assessing the quality of radiology requests in an Italian cohort of inpatients; to evaluate the interobserver reliability of RI-RADS.

Methods: A single-center quality care study was designed to retrospectively identify consecutive radiology request forms for computed tomography, magnetic resonance imaging, and conventional radiography examinations. One radiologist scored the requests using the RI-RADS. The association between RI-RADS and clinical request variables (urgent request, on-call requests, indication for imaging, requesting specialty, imaging modality, and body region) was evaluated. We calculated interobserver agreement between four readers in a subset of 450 requests.

Results: We included 762 imaging requests. RI-RADS grades A (adequate request), B (barely adequate request), C (considerably limited request), D (deficient request), and X were assigned to 8 (1%), 49 (7%), 237 (31%), 404 (53%), and 64 (8%) of cases, respectively. In the multivariate analysis, the indication for imaging, body region, and requesting specialty significantly influenced the RI-RADS. Indications for imaging with a high risk of poor RI-RADS grade were routine preoperative imaging and device check requests. The upper extremity was the body region with the highest risk of poor RI-RADS grade. Requesting specialties with a high risk of poor RI-RADS grade were cardiovascular surgery, intensive care medicine, and orthopedics. The analysis of the interobserver agreement revealed substantial agreement for the RI-RADS grade.

Conclusion: The majority of radiology exam requests were inadequate according to RI-RADS, especially those for routine imaging. RI-RADS demonstrated substantial reliability, suggesting that it can be satisfactorily employed in clinical settings.

Critical relevant statement: The implementation of RI-RADS can provide a framework for standardizing radiology requests, thereby enabling quality assurance and promoting a culture of quality improvement.

Key points: RI-RADS aims to grade the completeness of radiology requests. Over half of the imaging requests were RI-RADS D grade; RI-RADS demonstrated substantial reliability. Most radiology requests were inadequate and RI-RADS could classify them in clinical practice.

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评估住院病人诊断成像转诊中的检查成像报告和数据系统(RI-RADS)原因。
目的测试 "检查原因成像报告和数据系统"(RI-RADS)在评估意大利住院患者放射检查申请质量方面的作用;评估 RI-RADS 的观察者间可靠性:方法:设计了一项单中心质量护理研究,以回顾性方式确定连续的计算机断层扫描、磁共振成像和传统放射学检查的放射学申请表。一名放射科医生使用 RI-RADS 对申请表进行评分。我们评估了 RI-RADS 与临床申请变量(紧急申请、随叫随到申请、成像指征、申请专业、成像方式和身体部位)之间的关联。我们计算了 450 份请求子集中四位阅读者之间的观察者间一致性:结果:我们纳入了 762 份成像申请。8例(1%)、49例(7%)、237例(31%)、404例(53%)和64例(8%)分别被评为RI-RADS A级(请求充分)、B级(请求勉强充分)、C级(请求相当有限)、D级(请求不足)和X级。在多变量分析中,成像适应症、身体部位和申请专业对 RI-RADS 有显著影响。RI-RADS分级较差风险较高的成像适应症是常规术前成像和设备检查请求。上肢是 RI-RADS 分级风险最高的身体部位。RI-RADS分级不良风险较高的申请专科是心血管外科、重症监护医学科和骨科。对观察者间一致性的分析表明,RI-RADS分级的一致性非常高:结论:根据 RI-RADS 标准,大多数放射科检查申请都是不充分的,尤其是常规成像检查。RI-RADS显示出很高的可靠性,表明它可以在临床环境中得到满意的应用:关键相关声明:RI-RADS 的实施可以为放射学请求的标准化提供一个框架,从而实现质量保证并促进质量改进文化:RI-RADS旨在对放射请求的完整性进行分级。半数以上的成像申请为 RI-RADS D 级;RI-RADS 证明了其高度可靠性。大多数放射学申请不充分,RI-RADS 可在临床实践中对其进行分类。
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来源期刊
Insights into Imaging
Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
7.30
自引率
4.30%
发文量
182
审稿时长
13 weeks
期刊介绍: Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.
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