Computer processing of neuroradiologic reports by variable-field-length format. II. Utilization of the technic to evaluate cerebral angiograms in a series of patients with head trauma.

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The variable-field-length format is a data-recording technic which allows the reporting of narrative radiologic data in a form acceptable for computer storage and retrieval. Most methods that apply computer technics to verbal medical data utilize inputs into the computer by means of punch cards and check lists. These “fixed-field” methods are time-consuming, incomplete, and restricted in terms of data which may be stored. The variable-field technic enables the radiologist to dictate reports in his own words without altering his usual word patterns. The entire report is then stored in the computer and is available for subsequent analysis and retrieval. There is theoretically no limit to the amount or type of data that can be included in the report. Data Collection The method of data collection has been previously described in detail (1–4). The radiologist designs a “master” format consisting of several paragraph headings to be followed in sequence (Fig. 1). A typist uses a special punched paper tape in a paper tape typewriter, which superimposes the master format on the dictated report. The typewriter produces readable printed copy and another punched paper tape containing both the dictated report and the superimposed master format. The variety of format designs is unlimited. Formats may also be modified at a later date as a need for such modification develops. There has been ready acceptance by radiologists to dictate in the prescribed manner. It may take a few days to become familiar with the format; however, one soon becomes accustomed to the sequence of reporting. Furthermore, a logical sequential approach to reporting of cases is a valuable addition to resident training. Careful editing of reports is currently more difficult than with standard reports. Misspelled words may occur, and thus data may be unavailable for retrieval with existing programs. Developments to be considered include programs for phonetic retrieval which will allow the computer to retrieve misspelled words. In addition, new editing controls on the typewriter to simplify corrections on paper tapes are now on the market. Storage, Analysis, and Retrieval A series of programs have been produced which allow the information on the punched paper tape to be transferred to magnetic tape for eventual analysis and retrieval. This is undertaken in two stages. The first stage is one of reformation and storage; the second, interrogation of data. The first program, called FLEXTT, transfers the information from paper tape with 10 characters per inch to magnetic tape containing 556 characters per inch without reforming it. One reel of magnetic tape can accommodate approximately 3,000 to 4,000 full pages of narrative data, or 10 million characters. We have calculated this to be more than the yearly output of the average typist. The next program, called DIRECTRY, begins the actual reformation process.