Documentation of Nonroutine Communications of Critical or Significant Radiology Results: A Multiyear Experience at a Tertiary Hospital

Abstract

The aim of this study was to determine the frequency of radiology reports that contain nonroutine communications of results and categorize the urgency of such communications. A rule-based text-query algorithm was applied to a database of 2.3 million radiology reports, which has an accuracy of 98% for classifying reports containing documentation of communications. The frequency of such communications by year, modality, and study type was then determined. Finally, 200 random reports selected by the algorithm were analyzed, and reports containing critical results were categorized according to ascending levels of urgency. Critical or noncritical results to health care providers were present in 5.09% of radiology reports (116,184 of 2,282,923). For common modalities, documentation of communications were most frequent in CT (14.34% [57,537 of 402,060]), followed by ultrasound (9.55% [17,814 of 186,626]), MRI (5.50% [13,697 of 248,833]), and chest radiography (1.57% [19,840 of 1,262,925]). From 1997 to 2005, there was an increase in reports containing such communications (3.04% in 1997, 6.82% in 2005). More reports contained nonroutine communications in single-view chest radiography (1.29% [5,533 of 428,377]) than frontal/lateral chest radiography (0.80% [1,815 of 226,837]), diagnostic mammography (9.42% [3,662 of 38,877]) than screening mammography (0.47% [289 of 61,114]), and head CT (26.21% [20,963 of 79,985]) than abdominal CT (15.05% [19,871 of 132,034]) or chest CT (5.33% [3,017 of 56,613]). All of these results were statistically significant (P < .00001). Of 200 random radiology reports indicating nonroutine communications, 155 (78%) had critical and 45 (22%) had noncritical results. Regarding level of urgency, 94 of 155 reports (60.6%) with critical results were categorized as high urgency, 31 (20.0%) as low urgency, 26 (16.8%) as medium urgency, and 4 (2.6%) as discrepant. From 1997 to 2005, there was a significant increase in documentation of nonroutine communications, which may be due to increasing compliance with ACR guidelines. Most reports with nonroutine communications contain critical findings.