Framework for Extracting Critical Findings in Radiology Reports
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ORIGINAL PAPER
Framework for Extracting Critical Findings in Radiology Reports Thusitha Mabotuwana 1,2
&
Christopher S. Hall 1,2 & Nathan Cross 2
# Society for Imaging Informatics in Medicine 2020
Abstract Critical results reporting guidelines demand that certain critical findings are communicated to the responsible provider within a specific period of time. In this paper, we discuss a generic report processing pipeline to extract critical findings within the dictated report to allow for automation of quality and compliance oversight using a production dataset containing 1,210,858 radiology exams. Algorithm accuracy on an annotated dataset having 327 sentences was 91.4% (95% CI 87.6–94.2%). Our results show that most critical findings are diagnosed on CT and MR exams and that intracranial hemorrhage and fluid collection are the most prevalent at our institution. 1.6% of the exams were found to have at least one of the ten critical findings we focused on. This methodology can enable detailed analysis of critical results reporting for research, workflow management, compliance, and quality assurance. Keywords Critical results . Radiology reports . Rule-based systems . Radiology informatics
Introduction Radiology reports often contain imaging findings that are critical in nature and need to be communicated with a referring physician in a timely manner. Failure to do so could result in mortality or significant morbidity; however, timely communication of critical imaging finding is not uncommon and can lead to delayed treatment, poor patient outcomes, complications, unnecessary testing, lost revenue, and legal liability [1]. Communication of critical findings to referring providers is mandated by the Joint Commission’s National Patient Safety Goal to “Improve the Effectiveness of Communication Among Caregivers” [2]. Although critical results communication is mandated, the Joint Commission does not specify an * Thusitha Mabotuwana [email protected] Christopher S. Hall [email protected] Nathan Cross [email protected] 1
Precision Diagnosis, Philips Healthcare, Bothell, WA 98021, USA
2
Department of Radiology, University of Washington, Seattle, WA 98195, USA
exhaustive list of critical findings that need to be communicated and this decision is left up to the local treatment facility. As a result, compliance with critical findings reporting requirements is usually determined manually by radiologists performing peer-review to identify any non-compliant reports or manual text searches [3]. In an attempt to support the Joint Commission’s mandate for critical results reporting, the American College of Radiology provides practice guidelines on communicating diagnostic imaging findings, emphasizes the timely reporting of critical findings, and recommends documentation directly in the radiology report [4]. The Actionable Reporting Work Group provides further details related to using information technology to provide timely communication of critical findings and provides a fairly exhaustive list of cri
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