Report Template Research Articles

Abstract 248: Current Status Of In-hospital Cardiac Arrest And Issues Of Collecting Data Using The Latest In-hospital Utstein-style Reporting Templates

[Background]: The outcome of in-hospital cardiac arrest has improved over the past decade, although the survival rate is still approximately 25%. The in-hospital Utstein-style reporting templates were international standard template for in-hospital cardiac arrest, with items to be substantially revised in 2019, with recommendations for standardization of records to allow objective comparisons. The aim of this study is to analyze the current status of in-hospital cardiac arrest in our hospital, and to clarify the issues in collecting the data using the in-hospital Utstein-style reporting templates. [Methods]: We collected the reports of 3 years in-hospital cardiac arrests occurred between April 2019 and March 2022 in our hospital. We described all reported items and their proportion (Patient, Pre-event, Cardiac arrest process, Post-resuscitation process, and Outcome), and calculated the missing rate of each item. [Results]: A total of 106 cases during the study period, and all reports were submitted by nurses. The median age was 74 years old (IQR: 64-81), 60.4% were male, 76.4% of cases were witnessed, chest compressions were 67.9%, and shock delivered were in 5.9%. The initial shockable rhythm was in 15.1% of cases (Table). Some items had missing data or invalid responses. Date and time of event, initial rhythm, the time of first shock delivered, and 30 days outcome had missing data (rate of missing 33%, 13.2%, 44.4%, and 80.7%, respectively), which were core items of the latest in-hospital Utstein-style reporting templates. Patient category, post-resuscitation process, reason for CPR stopped, and neurological outcome at 30 days were not measured. [Conclusions]: The high rate of missing data is considered that the nurses may not understand the meaning of the items, and suggested the need for education of nurses who submit reports.

Co-design, implementation, and evaluation of plain language genomic test reports

Understanding and communicating genomic results can be challenging for families and health professionals without genetic specialty training. Unlike modifying existing laboratory reports, plain language genomic test reports provide an opportunity for patient/family-centered approaches. However, emerging examples generally lack co-design and/or evaluation in real-world settings. Through co-design involving patient groups, plain language experts, educators, and genetic health professionals, plain language genomic test report templates were produced for common test outcomes in rare diseases. Eight plain language genomic test report templates were developed. These reports were piloted and evaluated as part of a national pediatric ultra-rapid genomic testing program. Family and genetic health professional experiences with report layout, content, and use were explored using surveys. Of 154 families and 107 genetic health professionals issued with reports, 51 families and 57 clinicians responded (RR = 33% and 53%, respectively). Most families (82%) found their report helpful in understanding the result. Reports were shared by 63% of families, predominantly with family members (72%), or health professionals (68%). Clinicians (15%) adapted the reports for other settings. Through co-design, plain language genomic test reports implemented in a real-world setting can facilitate patient/family and caregiver understanding and communication of genomic test purpose, outcome, and potential clinical implications.

Technical standards for pulmonary function tests: impulse oscillometry

Impulse oscillometry (IOS) is a method for measuring respiratory impedance based on the forced oscillation technique (FOT). The IOS measurement requires only quiet tidal breathing, which is simple, suitable for a wide range of people and provides various respiratory physiological parameters. For promoting the standardization and clinical application of IOS measurement in China, based on the relevant research evidence and the updated technical standards by European Respiratory Society, this article provided a brief introduction to the background of IOS technique and the current situation of its clinical application in China, as well as the recommendations and interpretations on the indications and contraindications, device calibration, testing protocols, quality control requirements including acceptability and repeatability criteria, measurement parameters and graphs, testing results interpretation, references values and normal limits, report template, clinical application including assessment of airway patency, airway reversibility and responsiveness, small airway function and so on. It also offered recommendations on the relevant thresholds of diagnosis and evaluation.

Gastroenteropancreatic neuroendocrine neoplasm imaging: standard reporting templates.

Standardized reporting in radiology has an established role in numerous disease processes, with added benefits in oncology of reduced variability, and generation of a thorough and pertinent report with a focused and relevant conclusion. Many radiologists are not familiar with the imaging patterns of neuroendocrine neoplasm (NEN) spread and recurrence. This paper will present standardized CT, MRI, and PET templates for reporting gastroenteropancreatic (GEP) NENs and explain the rationale for including specific pertinent positive and negative findings, at various stages of disease management, based on site of origin. Basic templates for initial and follow-up anatomic and molecular GEP NEN imaging were created with input from the multidisciplinary Society of Abdominal Radiology (SAR) Neuroendocrine Tumor Disease Focused Panel (NET-DFP). The templates were further modified and finalized after several iterations. Four main report templates were generated for (i) initial anatomic CT or MR imaging studies, (ii) follow-up anatomic CT or MR imaging studies, (iii) initial Somatostatin Receptor (SSTR) or FDG PET imaging studies, and (iv) follow-up SSTR or FDG PET imaging studies. Each study template was formatted to allow its integration into a dictation software directly and be modified as needed, with internalized instructions indicating where a drop-down menu or macro may be used to personalize the template as necessary. These templates were created through a combination of multidisciplinary expert opinion discussion supported by literature review and provide basic structured reporting standards for GEP NEN anatomic and molecular imaging studies.

Development of an Electronic Health Record Registry to Facilitate Collection of Commission on Cancer Metrics for Patients Undergoing Surgery for Breast Cancer.

Accurate and efficient data collection is a challenge for quality improvement initiatives and clinical research. We describe the development of a custom electronic health record (EHR)-based registry to automatically extract structured Commission on Cancer axillary surgery-specific metrics from a custom synoptic note template included in the operative reports for patients with breast cancer undergoing surgery. The smart functionality of our enterprise-based EHR system was leveraged to create a custom smart phrase to capture axillary surgery-specific variables. A multidisciplinary team developed structured data elements correlating to each axillary surgery-specific variable. These data elements were then included in a note template for the operative report. Each variable could be aggregated and converted into a single flat database through the EHR's reporting workbench and serve as a live, prospective registry for all users within the EHR. The final axillary surgery-specific note template in a synoptic format allowed for efficient and easy entry and automatic collection of breast cancer-specific metrics. From initial adoption in February 2021-December 2021, there were 1,254 patients who underwent breast surgery with axillary surgery. The operative notes allowed for automatic capture of metrics from 60.5% (n = 759) of patients. Data capture improved from 37.6% in the initial adoption period of 6 months to 86.2% in the last 5 months. We were able to demonstrate successful implementation of provider-driven structured data entry into EHR systems that permits automatic data capture. The end result is a custom synoptic note template and a real-time, prospective registry of breast cancer-specific Commission on Cancer metrics that are robust enough to use for quality improvement initiatives and clinical research.

Association of Artificial Intelligence–Aided Chest Radiograph Interpretation With Reader Performance and Efficiency

The efficient and accurate interpretation of radiologic images is paramount. To evaluate whether a deep learning-based artificial intelligence (AI) engine used concurrently can improve reader performance and efficiency in interpreting chest radiograph abnormalities. This multicenter cohort study was conducted from April to November 2021 and involved radiologists, including attending radiologists, thoracic radiology fellows, and residents, who independently participated in 2 observer performance test sessions. The sessions included a reading session with AI and a session without AI, in a randomized crossover manner with a 4-week washout period in between. The AI produced a heat map and the image-level probability of the presence of the referrable lesion. The data used were collected at 2 quaternary academic hospitals in Boston, Massachusetts: Beth Israel Deaconess Medical Center (The Medical Information Mart for Intensive Care Chest X-Ray [MIMIC-CXR]) and Massachusetts General Hospital (MGH). The ground truths for the labels were created via consensual reading by 2 thoracic radiologists. Each reader documented their findings in a customized report template, in which the 4 target chest radiograph findings and the reader confidence of the presence of each finding was recorded. The time taken for reporting each chest radiograph was also recorded. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were calculated for each target finding. A total of 6 radiologists (2 attending radiologists, 2 thoracic radiology fellows, and 2 residents) participated in the study. The study involved a total of 497 frontal chest radiographs-247 from the MIMIC-CXR data set (demographic data for patients were not available) and 250 chest radiographs from MGH (mean [SD] age, 63 [16] years; 133 men [53.2%])-from adult patients with and without 4 target findings (pneumonia, nodule, pneumothorax, and pleural effusion). The target findings were found in 351 of 497 chest radiographs. The AI was associated with higher sensitivity for all findings compared with the readers (nodule, 0.816 [95% CI, 0.732-0.882] vs 0.567 [95% CI, 0.524-0.611]; pneumonia, 0.887 [95% CI, 0.834-0.928] vs 0.673 [95% CI, 0.632-0.714]; pleural effusion, 0.872 [95% CI, 0.808-0.921] vs 0.889 [95% CI, 0.862-0.917]; pneumothorax, 0.988 [95% CI, 0.932-1.000] vs 0.792 [95% CI, 0.756-0.827]). AI-aided interpretation was associated with significantly improved reader sensitivities for all target findings, without negative impacts on the specificity. Overall, the AUROCs of readers improved for all 4 target findings, with significant improvements in detection of pneumothorax and nodule. The reporting time with AI was 10% lower than without AI (40.8 vs 36.9 seconds; difference, 3.9 seconds; 95% CI, 2.9-5.2 seconds; P < .001). These findings suggest that AI-aided interpretation was associated with improved reader performance and efficiency for identifying major thoracic findings on a chest radiograph.

Performance of a Chest Radiography AI Algorithm for Detection of Missed or Mislabeled Findings: A Multicenter Study.

Purpose: We assessed whether a CXR AI algorithm was able to detect missed or mislabeled chest radiograph (CXR) findings in radiology reports. Methods: We queried a multi-institutional radiology reports search database of 13 million reports to identify all CXR reports with addendums from 1999–2021. Of the 3469 CXR reports with an addendum, a thoracic radiologist excluded reports where addenda were created for typographic errors, wrong report template, missing sections, or uninterpreted signoffs. The remaining reports contained addenda (279 patients) with errors related to side-discrepancies or missed findings such as pulmonary nodules, consolidation, pleural effusions, pneumothorax, and rib fractures. All CXRs were processed with an AI algorithm. Descriptive statistics were performed to determine the sensitivity, specificity, and accuracy of the AI in detecting missed or mislabeled findings. Results: The AI had high sensitivity (96%), specificity (100%), and accuracy (96%) for detecting all missed and mislabeled CXR findings. The corresponding finding-specific statistics for the AI were nodules (96%, 100%, 96%), pneumothorax (84%, 100%, 85%), pleural effusion (100%, 17%, 67%), consolidation (98%, 100%, 98%), and rib fractures (87%, 100%, 94%). Conclusions: The CXR AI could accurately detect mislabeled and missed findings. Clinical Relevance: The CXR AI can reduce the frequency of errors in detection and side-labeling of radiographic findings.

Breast ultrasound in Chinese hospitals: A cross-sectional study of the current status and influencing factors of BI-RADS utilization and diagnostic accuracy

SummaryBackgroundWith the growing demand for breast screening in public health services and clinical care, ultrasound departments in China are facing tremendous challenges.MethodsA cross-sectional nationwide survey was conducted in 5,460 departments providing ultrasound diagnoses in mainland China from 2020 to 2021. The survey included general information about the ultrasound department, the characteristics of sonologists, the use of Breast Imaging Reporting and Data System (BI-RADS) templates, and the diagnostic accuracy rate of breast cancer ultrasound.FindingsThere were on average 2.25 sonologists per 10,000 patients in mainland China per year. The average utilization rate of BI-RADS in Chinese hospitals was 87.02%. The GDP per capita of the province (P = 0.008), whether the hospital was specialized (P = 0.002) or a Tier 3 facility (P < 0.001), the percentage of doctors with master's and doctoral degrees (P < 0.001) and doctors ≤35 years (P = 0.005) were significantly and independently associated with the utilization rate of BI-RADS. The average diagnostic accuracy rate of breast cancer ultrasound in Chinese hospitals was 73.64%, and we observed significant positive associations between GDP per capita (P = 0.02), BI-RADS utilization rate (P = 0.019), and breast cancer ultrasound diagnostic accuracy.InterpretationThe utilization of BI-RADS templates effectively improved the diagnostic accuracy of ultrasound. Moreover, the survey summarized the current situation of departments and sonologists providing breast ultrasound diagnosis in mainland China, which helped monitor the development of the discipline and provide information for administrators to meet the growing demand.FundingThis work was supported by Natural Science Foundation of Beijing (7202156) and Foundation of ihecc (2019-C-0646-2).

A proposed approach for standardized reporting of data linkage processes and results.

ObjectivesPopulation Data BC (PopData) is an agency in British Columbia, Canada, that routinely performs linkages of various administrative and researcher-collected data to a population spine. We developed a linkage report template in order to increase transparency of linkage process and outcome for end users and data providers. ApproachPopData performs probabilistic and deterministic data linkage using an in-house software. A literature review identified existing guidelines and examples of linkage reporting. A survey collected input from a wide range of end users about their interest in receiving linkage reports and specific information that is important to their work. A draft template was developed by PopData’s linkage experts and data scientists which then was reviewed by PopData staff and external partners. Privacy requirements, mode of delivery, readability to the intended audience and operational feasibility were carefully considered. ResultsThe resulting template built on our existing internal linkage summaries. The report follows a framework suggested in the literature with three key components: 1) information on the data source and linkage fields, 2) data pre-processing and linkage methodology, and 3) linkage results, presented in tables and figures, including overall linkage rates, detail on matched fields, and the distribution of linkage weights of linked and unliked pairs. In addition, an appendix describes the linkage methods and population spine in detail, and supplementary notes will comment on unique issues related to the data, when those are applicable. Educational materials to aid understanding of linkage methodologies and reporting are also under development. ConclusionLinked data are increasingly used in research, making it important to provide information on linkage process and performance to the research community. Rigorous and standardized linkage reports produced by data centres can facilitate evaluation of the impact of linkage performance on research findings and enable transparent reporting in peer-reviewed research.

Impact of a Structured Report Template on the Quality of Multislice Spiral Computed Tomography Scan Reports for Small Bowel Diseases: A Preliminary Study

Background: The application of multislice spiral computed tomography (MSCT) scan has improved the diagnosis of small bowel diseases (SBDs). Objectives: This study aimed to develop a structured report (SR) template for SBDs based on MSCT scans and to compare its value with free-text reports (FTRs) by radiologists with different levels of seniority in radiology. Patients and Methods: A total of 120 SBD cases were confirmed based on the clinical manifestations, surgery, colonoscopy, and pathology. An SR template for small bowel imaging was developed, and six radiologists were divided into inexperienced and experienced groups. Sixty cases with small intestinal MSCT data were available for FTRs and another 60 cases for SRs after training. The report accuracy, satisfaction, and completion time were compared between the two reporting methods. Results: The writing time of SRs was significantly shorter than that of FTRs. By using FTRs, the experienced group showed higher levels of sensitivity for all diseases (i.e., intestinal wall, intestinal peripheral artery, blood vessel, bone, and other abdominal organ diseases) (P &lt; 0.05). The experienced group showed a low misdiagnosis rate for all diseases (P &lt; 0.05), except for bone disease (P = 0.161). By using SRs, the experienced group only showed a low misdiagnosis rate for the intestinal wall disease (P &lt; 0.05). High sensitivity for the intestinal wall disease (P &lt; 0.05) and intestinal peripheral artery disease (P = 0.024), along with improved sensitivity for bone lesions (P &lt; 0.05), was reported in this group. In the inexperienced group, SRs improved sensitivity for all diseases (P &lt; 0.05), except for intestinal wall disease (P &gt; 0.05). The satisfaction scores for both inexperienced and experienced groups improved by using SRs (4 vs. 2.6 for the inexperienced group and 4.1 vs. 3.2 for the experienced group; P &lt; 0.05 for both). Conclusion: The SRs were superior to FTRs in terms of writing efficiency, accuracy, and satisfaction. They could improve the accuracy of inexperienced radiologists in diagnosis and help detect SBDs.

Paper 2: Performing rapid reviews

BackgroundHealth policy-makers must often make decisions in compressed time frames and with limited resources. Hence, rapid reviews have become a pragmatic alternative to comprehensive systematic reviews. However, it is important that rapid review methods remain rigorous to support good policy development and decisions. There is currently little evidence about which streamlined steps in a rapid review are less likely to introduce unacceptable levels of uncertainty while still producing a product that remains useful to policy-makers.MethodsThis paper summarizes current research describing commonly used methods and practices that are used to conduct rapid reviews and presents key considerations and options to guide methodological choices for a rapid review.ResultsThe most important step for a rapid review is for an experienced research team to have early and ongoing engagement with the people who have requested the review. A clear research protocol, derived from a needs assessment conducted with the requester, serves to focus the review, defines the scope of the rapid review, and guides all subsequent steps. Common recommendations for rapid review methods include tailoring the literature search in terms of databases, dates, and languages. Researchers can consider using a staged search to locate high-quality systematic reviews and then subsequently published primary studies. The approaches used for study screening and selection, data extraction, and risk-of-bias assessment should be tailored to the topic, researcher experience, and available resources. Many rapid reviews use a single reviewer for study selection, risk-of-bias assessment, or data abstraction, sometimes with partial or full verification by a second reviewer. Rapid reviews usually use a descriptive synthesis method rather than quantitative meta-analysis. Use of brief report templates and standardized production methods helps to speed final report publication.ConclusionsResearchers conducting rapid reviews need to make transparent methodological choices, informed by stakeholder input, to ensure that rapid reviews meet their intended purpose. Transparency is critical because it is unclear how or how much streamlined methods can bias the conclusions of reviews. There are not yet internationally accepted standards for conducting or reporting rapid reviews. Thus, this article proposes interim guidance for researchers who are increasingly employing these methods.

Structured Reporting in Multiple Sclerosis - Consensus-Based Reporting Templates for Magnetic Resonance Imaging of the Brain and Spinal Cord.

As a result of technical developments and greater availability of imaging equipment, the number of neuroradiological examinations is steadily increasing [1]. Due to improved image quality and sensitivity, more details can be detected making reporting more complex and time-intensive. At the same time, reliable algorithms increasingly allow quantitative image analysis that should be integrated in reports in a standardized manner. Moreover, increasing digitalization is resulting in a decrease in the personal exchange between neuroradiologists and referring disciplines, thereby making communication more difficult. The introduction of structured reporting tailored to the specific disease and medical issue [2, 3] and corresponding to at least the second reporting level as defined by the German Radiological Society (https://www.befundung.drg.de/de-DE/2908/strukturierte-befundung/) is therefore desirable to ensure that the quality standards of neuroradiological reports continue to be met.The advantages of structured reporting include a reduced workload for neuroradiologists and an information gain for referring physicians. A complete and standardized list with relevant details for image reporting is provided to neuroradiologists in accordance with the current state of knowledge, thereby ensuring that important points are not forgotten [4]. A time savings and increase in efficiency during reporting were also seen [5]. Further advantages include report clarity and consistency and better comparability in follow-up examinations regardless of the neuroradiologist's particular reporting style. This results in better communication with the referring disciplines and makes clinical decision significantly easier [6, 7]. Although the advantages are significant, any potential disadvantages like the reduction of autonomy in reporting and inadequate coverage of all relevant details and any incidental findings not associated with the main pathology in complex cases or in rare diseases should be taken into consideration [4]. Therefore, studies examining the advantages of structured reporting, promoting the introduction of this system in the clinical routine, and increasing the acceptance among neuroradiologists are still needed.Numerous specific templates for structured reporting, e. g., regarding diseases in cardiology and oncology, are already available on the website www.befundung.drg.de . Multiple sclerosis (MS) is an idiopathic chronic inflammatory and neurodegenerative disease of the central nervous system and is the most common non-trauma-based inflammatory neurological disease in young adults. Therefore, it has significant individual and socioeconomic relevance [8]. Magnetic resonance imaging (MRI) plays an important role in the diagnosis, prognosis evaluation, and follow-up of this disease. MRI is established as the central diagnostic method in the diagnostic criteria. Therefore, specific changes are seen on MRI in almost all patients with a verified MS diagnosis [9]. Reporting of MRI datasets regarding the brain and spinal cord of patients with MS includes examination of the images with respect to the relevant medical issue in order to determine whether the McDonald criteria, which were revised in 2017 [10] and define dissemination in time and space clinically as well as with respect to MRI based on the recommendations of the MAGNIMS groups [11, 12], are fulfilled. A more precise definition of lesion types and locations according to the recommendations of an international expert group [13] is discussed in the supplementary material. Spinal cord signal abnormalities are seen in up to 92 % of MS patients [14-16] and are primarily located in the cervical spine [15]. The recommendations of the MAGNIMS-CMSC-NAIMS working group published in 2021 [11] explicitly recommend the use of structured reporting for MS patients.Therefore, a reporting template for evaluating MRI examinations of the brain and spinal cord of patients with MS was created as part of the BMBF-funded DIFUTURE consortium in consensus with neuroradiological and neurological experts in concordance with the recommendations mentioned above [11] and was made available for broad use (https://github.com/DRGagit/ak_befundung). The goal is to facilitate efficient and comprehensive evaluation of patients with MS in the primary diagnostic workup and follow-up imaging. These reporting templates are consensus-based recommendations and do not make any claim to general validity or completeness. The information technology working group (@GIT) of the German Radiological Society and the German Society for Neuroradiology strive to keep the reporting templates presented here up-to-date with respect to new research data and recommendations of the MAGNIMS-CMSC-NAIMS group [11]. KEY POINTS:: · consensus-based reporting templates. · template for the structured reporting of MRI examinations of patients with multiple sclerosis. · structured reporting might facilitate communication between neuroradiologists and referring disciplines. CITATION FORMAT: · Riederer I, Mühlau M, Wiestler B et al. Structured Reporting in Multiple Sclerosis - Consensus-Based Reporting Templates for Magnetic Resonance Imaging of the Brain and Spinal Cord. Fortschr Röntgenstr 2023; 195: 135 - 138.

New sustainability report template complements Structural Plan of Work

To help engineers design sustainably and communicate this to their clients, the IStructE Sustainability Panel and Climate Emergency Task Group have worked together to publish a sustainability report template and sustainability checklist under wider updates to the Structural Plan of Work.

Abstract 6310: Designing genomic test reports using a user-centered approach for clinicians in Pakistan

Abstract In the developed world, precision medicine and genomics are transforming traditional healthcare approaches. In spite of rapid technological progress being made in genomics, a 'genomic divide' is emerging between developed and developing countries. This is partly because of the limited genomic literacy of healthcare professionals and a scarcity of available genomics workforce that reportedly deters them from proposing genomic testing. We aim to help reduce this 'genomic divide' by proposing a genomic test report design for clinicians in Pakistan, that incorporates user-centered design principles. We tested two commonly used genomic reportswiththat varied in language, content and layout. Report A was a one-page genomic report from the Laboratory for Molecular Medicine, of a patient with suspected hypertrophic cardiomyopathy. Report B was a report from FoundationOneCDx, of a breast carcinoma specimen with confirmed findings mentioned. We employed a qualitative descriptive study design, including a survey for trainees, non-specialists, and specialists. The parameters recorded were: subject comprehension, overall visual impression, level of difficulty of the language, and ease of understanding, along with, actionability and degree of trust. A total of 49 medical professionals across 11 institutes in Pakistan participated in the survey, of which 11 were specialists and 38 were non-specialists. We extracted 19 recommendations from the survey and broadly grouped them into three categories: communication style, report content, and layout. About 25% of the respondents commented that they would prefer a short and concise report, 20.8% wanted the language to be ‘doctor-friendly’ and 8.3% preferred data to be presented in tables. All recommendations were incorporated into our proposed genomic test report template. The template displays the results and what they mean for the patient (in layman's terms for ease of access to non-specialists), what possible action is to be taken by the doctor, and details of further information and support regarding the results. We propose the addition of a box on technical methodology at the end of the report template that may help in assisting with refreshing the genomic knowledge of non-specialists. Our findings have shown that in order to design impactful genomic reports for clinicians in Pakistan, we will have to start with a user-centered design approach. This can be instrumental in helping us improve the adoption of genomic testing in clinics around Pakistan. Citation Format: Momal Agha, Faisal Khan. Designing genomic test reports using a user-centered approach for clinicians in Pakistan [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6310.

FELASA-AALAS Recommendations for Monitoring and Reporting of Laboratory Fish Diseases and Health Status, with an Emphasis on Zebrafish (Danio Rerio).

The exchange of fish for research may expose an aquatic laboratory to pathogen contamination as incoming fish can introduce bacteria, fungi, parasites, and viruses capable of affecting both experimental results and fish and personnel health and welfare. To develop risk mitigation strategies, FELASA and AALAS established a joint working group to recommend good practices for health monitoring of laboratory fish. The recommendations address all fish species used for research, with a particular focus on zebrafish (Danio rerio). First, the background of the working group and key definitions are provided. Next, fish diseases of high impact are described. Third, recommendations are made for health monitoring of laboratory fishes. The recommendations emphasize the importance of daily observation of the fish and strategies to determine fish colony health status. Finally, report templates are proposed for historical screening data and aquatic facility description to facilitate biohazard risk assessment when exchanging fish.

Development of an electronic health record registry to facilitate collection of Commission on Cancer (CoC) metrics for patients undergoing surgery for breast cancer.

1549 Background: Accurate and efficient data collection is a challenge for quality improvement initiatives and clinical research. We describe the development of a custom electronic health record (EHR) based registry to automatically extract structured Commission on Cancer (CoC) axillary surgery specific metrics from a custom synoptic note template included in the operative reports for breast cancer patients undergoing surgery. Methods: The “Smart” functionality of our enterprise-based EHR system was leveraged to create a custom Smart phrase to capture axillary surgery specific variables. A multidisciplinary team developed structured data elements correlating to each axillary surgery-specific variable. These data elements were then included in a note template for the operative report. Each variable could be aggregated and converted into a single flat database through the EHR’s reporting workbench and serve as a live, prospective registry for all users within the EHR. Results: The final axillary surgery-specific note template in a synoptic format allowed for efficient and easy entry and automatic collection of breast cancer specific metrics. From initial adoption in February 2021 through December 2021, there were 1,254 patients who underwent breast surgery with axillary surgery. The operative notes allowed for automatic capture of metrics from 60.5% (n = 759) of patients. Data capture improved from 37.6% in the initial adoption period of six months to 86.2% in the last five months. Capture rate in December 2021 was 98%. Conclusions: We were able to demonstrate successful implementation of provider driven structured data entry into EHR systems that permits automatic data capture. The end result is a custom synoptic note template and a real-time, prospective registry of breast cancer-specific CoC metrics that are robust enough to use for quality improvement initiatives and clinical research.

Assessment of functioning in Dutch primary care: Development study of a consultation tool for patients with chronic conditions and multimorbidity.

BackgroundIn primary care, a shift from a disease‐oriented approach for patients with multimorbidity towards a more person‐centred approach is needed.AimTo transform a self‐report questionnaire for patients with chronic conditions in primary care, the Primary Care Functioning Scale (PCFS), into an understandable, visually attractive and feasible consultation tool for patients and health care providers. The consultation tool consists of a web‐based version of the PCFS, which is filled in by the patient and is processed to a feedback report that summarizes and visualizes the main findings. The feedback report can be discussed with the patient to facilitate a more person‐centred conversation for patients with chronic conditions and multimorbidity in general practice.Design and SettingIn this qualitative study, we developed the consultation tool by using design thinking in a participatory developmental process.MethodsIn the first phase, we constructed five different feedback report templates to summarize and display the results of a completed PCFS questionnaire in a series of two expert meetings with patients and general practitioners (GPs). In the second phase, we performed an exploratory qualitative interview study involving dyads of patients with chronic conditions and their practice nurses. In an iterative process, we explored their experiences with the consultation tool.ResultsPatients, as well as GPs, preferred a clear manner of presenting the results of the questionnaire in a feedback report. In 18 interviews with patients and practice nurses during three different interview rounds, we adjusted the feedback report and consultation tool based on the input from patients and practice nurses. After the final interview round, patients and practice nurses consented that the consultation tool was useful for having a more in‐depth consultation about functioning and patients' preferences when integrated into the regularly scheduled consultations.ConclusionWe were able to develop an understandable and feasible consultation tool that is applicable in already existing chronic disease management programmes in general practice in the Netherlands.Patient or Public ContributionTo increase the understandability and feasibility of the consultation tool, we collaborated with end‐users and actively involved patients, GPs and practice nurses in a participatory development process.

Development and Implementation of a Multisite Registry Using Structured Templates for Actionable Findings in the Kidney.

The aim of this study was to scale structured report templates categorizing actionable renal findings across health systems and create a centralized registry of patient and report data. In January 2017, three academic radiology departments agreed to prospectively include identical structured templates categorizing the malignant likelihood of renal findings in ≥90% of all adult ultrasound, MRI, and CT reports, a new approach for two sites. Between November 20, 2017, and September 30, 2019, deidentified HL7 report data were transmitted to a centralized ACR registry. An automated algorithm extracted categories. Radiologists were requested to addend reports with missing or incomplete templates after the first month. Separately, each site submitted patient sociodemographic and clinical data 12 months before and at least 3 months after enrollment. A total of 164,982 eligible radiology reports were transmitted to the registry; 4,159 (2.5%) were excluded because of missing categories or radiologist names. The final cohort included 160,823 examinations on 102,619 unique patients. Mean template use before and after addendum requests was 99.3% and 99.9% at SITE1, 86.5% and 94.6% at SITE2, and 91.4% and 96.0% at SITE3. Matching patient sociodemographic and clinical data were obtained on 96.9% of reports from SITE1, 94.2% from SITE2, and 96.0% from SITE3. Regulatory, cultural, and technology barriers to the creation of a multisite registry were identified. Barriers to the adoption of unified structured report templates for actionable kidney findings can be addressed. Deidentified report and patient data can be securely transmitted to an external registry. These data can facilitate the collection of diverse evidence-based population imaging outcomes.

511 Automation of Home Food Inventory Scoring to Standardize Reporting, Enhance Clinical Utility, and Operationalize Delivery of Personalized Behavioral Targets

OBJECTIVES/GOALS: The Fulkerson Home Food Inventory (HFI) is widely used to assess the home food environment, a key target of behavioral weight loss trials. However, no standardized report is available. We created publicly available procedures to automate and standardize HFI reporting, yielding a personalized report to enhance this measures clinical utility. METHODS/STUDY POPULATION: Parents in the TEENS adolescent behavioral weight loss trial complete the HFI at 0-, 2-, 4-, 8-, and 12m and receive personalized reports at each timepoint. In REDCap, participants identify foods available in their home. HFI syntax is applied to calculate the obesogenic home food availability score. Categories of foods found are identified, with specific guidance provided to enhance their home food environment. Prior to automation, procedures were time intensive and error prone. To address this, HFI data are exported into Excel by a PowerShell (v7.2) command-line script using Python (v3.10) with the REDCap API. Results are calculated with F# (v6.0) using Microsoft Excel Interop API and inserted into a report template with F# using the Microsoft Publisher Interop API. This process is repeated at each timepoint. RESULTS/ANTICIPATED RESULTS: The new automated procedures significantly reduce time to generate reports and enhance accuracy. Procedures yield a 2-page individualized report that includes the obesogenic home food environment score and identifies categories of healthy items found (e.g., fruits, vegetables, whole grains) as well as areas of improvement (e.g., high-fat dairy products, processed meats). Specific items found in each category are identified. The report identifies food found in the home (e.g., chicken nuggets) with suggested healthier substitutions (e.g., lean chicken breast). This syntax and commands will be made publicly available for use in the scientific and clinical community. DISCUSSION/SIGNIFICANCE: These publicly available procedures optimize, automate, and standardize reporting for the HFI. Procedures improve efficiency within large-scale clinical trials and yield a personalized report to enhance the clinical utility of this measure and empower participants to make informed decisions about their health behaviors.

Automated Generation of Synoptic Reports from Narrative Pathology Reports in University Malaya Medical Centre Using Natural Language Processing.

Pathology reports represent a primary source of information for cancer registries. University Malaya Medical Centre (UMMC) is a tertiary hospital responsible for training pathologists; thus narrative reporting becomes important. However, the unstructured free-text reports made the information extraction process tedious for clinical audits and data analysis-related research. This study aims to develop an automated natural language processing (NLP) algorithm to summarize the existing narrative breast pathology report from UMMC to a narrower structured synoptic pathology report with a checklist-style report template to ease the creation of pathology reports. The development of the rule-based NLP algorithm was based on the R programming language by using 593 pathology specimens from 174 patients provided by the Department of Pathology, UMMC. The pathologist provides specific keywords for data elements to define the semantic rules of the NLP. The system was evaluated by calculating the precision, recall, and F1-score. The proposed NLP algorithm achieved a micro-F1 score of 99.50% and a macro-F1 score of 98.97% on 178 specimens with 25 data elements. This achievement correlated to clinicians’ needs, which could improve communication between pathologists and clinicians. The study presented here is significant, as structured data is easily minable and could generate important insights.