Free Text Versus Structured Format: Information Transfer Efficiency of Radiology Reports

We discuss the effect of radiology report format on the accuracy and speed with which reviewers can extract case-specific information. A Web-based testing mechanism was used to present radiology reports to each of 16 senior medical students and record their answers to 10 multiple choice questions about specific medical content for each of 12 cases. Subjects were randomly assigned to view the reports in either free text or structured format. In addition to number of answers correct for each case, we recorded the time taken for each case and an efficiency score (correctly answered questions per minute). These three outcomes were tested for differences on report format using multifactorial analysis of variance. A postexperimental questionnaire and a mediated focus group elicited subject preference as to radiology report format. There were no significant differences in the three outcomes (score, time, and efficiency) between the free text and structured format conditions. The power of the experiment was sufficient to detect small differences in these outcomes by format. Subjects strongly and consistently expressed a preference for the structured version. We assert that free text and itemized (structured) forms of radiology reports are equally efficient and accurate for transmitting case-specific interpretative content to reviewers of the document.