Imaging Information Overload: Quantifying the Burden of Interpretive and Non-Interpretive Tasks for Computed Tomography Angiography for Aortic Pathologies in Emergency Radiology

Abstract

Rationale: Over the past decade, technological advances have provided new tools for radiologists. However, the effect of these technological advances on radiologist workload and detecting pathologies needs to be assessed.

Objective: The purpose of this study is to assess the workload, including non-interpretative tasks, associated with Computed Tomography Angiogram (CTA) of Aorta exams performed in the Emergency Department (ED) over a 10-year period and their relationship to detection of aortic pathology.

Materials and methods: This is a retrospective analysis of CTAs of Aorta performed on adults with suspected acute aortic pathology within the ED at an academic level I quaternary care hospital from January 1, 2005, through December 31, 2015. Data assessed included (1) Interpretive tasks: total number of images, number of reformat series, number of radiology reports with positive aortic pathologies; and (2) Non-interpretative tasks: recommendations and documentation of verbal communication with requesting providers. Statistical analyses were performed to assess temporal trends of variables. P values less than 0.05 are considered significant.

Results: A total of 4368 examinations (mean age: 69.8, M/F: 56.8%/43.2%) were performed. Studies per year increased significantly from 2005 (n = 278) to 2007 (n = 445), but not significantly after. The number of images and reformat series per scan increased from 487 to 2819 and 6.4 to 13.7, respectively (both P-value < 0.01). The proportion of exams with aortic findings did not significantly change (28.1% in 2005 and 24.9% in 2015). However, The proportions of exams with verbal communication increased from 9.3% to 24.6% and with recommendations from 1.8% to 28.9% (both P-value < 0.01).

Conclusion: During a 10-year period, CTAs performed in the ED for suspected aortic pathology were associated with a significant increase in images created, reformat series generated, recommendations, and verbal communications with ordering providers without a concomitant increase in the rate of aortic pathologies. To completely capture the complexities of CTA workloads, non-interpretive tasks such as radiologist recommendations and verbal communications should also be included.