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Pediatr Radiol. 2014 May 25. [Epub ahead of print]

Variation in the documentation of findings in pediatric voiding cystourethrogram.

Author information

  • 1Department of Urology, Boston Children's Hospital, 300 Longwood Ave., HU-390, Boston, MA, 02115, USA, aschaeffer78@gmail.com.

Abstract

BACKGROUND:

Few standards exist for reporting results of voiding cystourethrogram (VCUG).

OBJECTIVE:

To assess the variation in reporting of VCUG findings from different facilities using a standardized assessment tool.

MATERIALS AND METHODS:

VCUG reports were evaluated for demographic, technical, anatomical and functional information. Reports were categorized by age, gender, indication and vesicouretal reflux (VUR) status. Institutions were classified as a free-standing pediatric hospital (n = 3), pediatric hospital within a hospital (n = 11), or non-pediatric facility (n = 24) and reports were classified as having been read by a pediatric radiologist or not. Each category of outside reports (n = 152) was randomly matched with a twice-larger group of Hospital A reports from the same category (n = 304). Multivariate linear regression was used to analyze the association between the primary outcome (percentage of items described in dictated VCUG report) and the type of radiologist and institution.

RESULTS:

Of the 456 studies, 66% were in girls, 56% were in those <12 months old, and the indication was urinary tract infection (UTI) in 81%. The mean percentage of items reported was 67 ± 14% (74 ± 7% at free-standing pediatric hospitals, 61 ± 10% at pediatric hospitals within a hospital, and 48 ± 11% at non-pediatric facilities). In multivariate analysis, VCUG reports generated at non-pediatric facilities had 17% fewer items included (95% CI: 14.5-19.7%, P < 0.0001), and pediatric hospitals within a hospital had 9% fewer items included (5.9-12.5%, P < 0.0001) when compared to free-standing pediatric hospitals. Reports read by a pediatric radiologist had 12% more items included (9.1-15.3%, P < 0.0001) compared to those read by a non-pediatric radiologist.

CONCLUSION:

More complete VCUG reports were observed when generated at free-standing pediatric hospitals and when interpreted by a pediatric radiologist.

PMID:
24859357
[PubMed - as supplied by publisher]
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