Nowadays, there are so many different reporting systems: TI-RADS, PI-RADS, BI-RADS, ELCAP, Fleishner criteria, LI-RADS, and more (If you like acronyms, you are in heaven!) Sometimes, like the Fleishner criteria, LI-RADS, and ELCAP, there are multiple reporting systems for the same specialty reads. And, in our practice, we tend to use two of them for lung screenings, both the ELCAP and the Fleishner criteria. But, when you have so many systems to choose from, which ones do you choose and why? Can or should you use two different types? Here are some suggestions to make your decisions to use one reporting system over another a bit easier.
Recognize That There Is No One Right Reporting System
First of all, you need to recognize that there is no one correct answer. Each reporting system is just that, a reporting system. So, your conclusions and management can slightly differ. Even within the reporting system itself, there is a bit of wiggle room because patients don’t always follow the rule books. In my experience, I can find exceptions to almost every “rule.” For example, sometimes, you might think that they need a follow at a slightly smaller or larger interval than one year for a lung cancer screening because the patient cannot come in at a particular time. Regardless, many different systems have the potential to work for your practice. Check out all the ones that may be useful for your practice.
Decide On And Ask Your Audience
Who is referring the patients to you? Is it the pulmonologists, primary care docs, or cardiothoracic surgeons? Once you find out which is the source, then you should find out what they want. Or, at least use the type of system for which the authors have written. Why? Because they are the ones that are going to be reading your reports and deciding on patient management. Making your referrers happy is one of your top goals. If some want one type of reporting system and others wish to have another. Consider using both if your technology has the capability. It may be worth it to keep your referrers from using the practice down the street.
What Is The Simplest For You
Next, what is the most straightforward reporting system to manage? Do you have preset templates in your system that make it easier to use one reporting system over another? Or, can you do your reports freehand? What do the radiologists in your group prefer? Sometimes, these factors can be the overwhelming cause to choose one reporting system over another. Especially in the case that many of the systems could potentially work for your referrers.
Revisit The Data
Finally, once you’ve been using one or two reporting systems for a while, check how they have fared. Canvas the referrers to find out if they think the reporting and management suggestions have been reasonable. Make sure to keep up the changes within the reporting system to make sure that you are up to date. I have found that the reporting instructions for any given system have new recommendations every few years.
Also, a head-to-head comparison from time to time between the different reporting systems in terms of patient outcomes may help to decide which one to keep and which ones to chuck. This comparison can be your mini-research project or a review of the literature.
Selecting A Reporting System- The Final Decision
Arriving at a reporting system does take a bit of forethought and action. Recognize that more than one reporting system can work for you. Ask your audience and find out what works best. Utilize what makes the most sense with your system’s capabilities. And constantly check the data to make sure that your reporting systems are working as they should. Completing each of these steps will ensure that you make that you are making the right decision. Remember, reporting systems are a critical part of creating an actionable final report!
