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J Am Coll Radiol. 2017 Mar;14(3):371-379.e1. doi: 10.1016/j.jacr.2016.09.037. Epub 2016 Dec 5.

Effect of Template Reporting of Brain MRIs for Multiple Sclerosis on Report Thoroughness and Neurologist-Rated Quality: Results of a Prospective Quality Improvement Project.

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Department of Radiology, University of Michigan, Ann Arbor, Michigan. Electronic address:
Department of Radiology, University of Michigan, Ann Arbor, Michigan; Michigan Radiology Quality Collaborative, Ann Arbor, Michigan.
Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Neurology, Cleveland Clinic, Mellen Center, Cleveland, Ohio.
Department of Neurology, University of Alabama, Birmingham, Alabama.
Department of Neurology, University of Virginia Health System, Charlottesville, Virginia.
Department of Neurology, University of Michigan, Ann Arbor, Michigan.



To assess the impact of structured reporting templates on the objective and subjective quality of radiology reports for brain MRIs in patients with multiple sclerosis (MS).


A HIPAA-compliant prospective quality improvement initiative was undertaken to develop and implement a 12-item structured reporting template for brain MRI examinations in patients with known or suspected MS based on published guidelines. Reports created 1 year before implementing the template served as the baseline. A random sample of 10 template and 10 non-template reports was sent to five neurologists outside the study institution with MS expertise, who reviewed the reports for comprehensiveness and quality. The number of MS-relevant elements in template and non-template reports were compared with unpaired t tests. Proportions were compared with χ2 and Fisher exact tests.


There were 63 reports in the pre-template period and 93 reports in the post-template period. Use of the template increased over time in the post-template period (P = .04). All 12 MS-relevant findings were addressed more often and with less variability in template reports: (11.1 ± 0.7 findings versus 5.8 ± 2.2 findings in non-template reports, P < .001). Neurologists were more likely to give the template reports the highest positive rating (56% [107/190] versus 28% [56/199], P < .001) and less likely to give the template reports a lower rating (7% [13/190] versus 15% [29/199], P = .01) compared with the non-template reports.


Template reporting of brain MRI examinations increases the rate at which MS-relevant findings are included in the report. Standardized reports are preferred by neurologists with MS expertise.


Radiology templates; multiple sclerosis; quality improvement; radiology report; template reporting

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