Variation in the documentation of findings in pediatric voiding cystourethrogram

Pediatr Radiol. 2014 Dec;44(12):1548-56. doi: 10.1007/s00247-014-3028-7. Epub 2014 May 25.

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.

Publication types

  • Evaluation Study

MeSH terms

  • Animals
  • Documentation / standards*
  • Female
  • Hospitals / statistics & numerical data
  • Hospitals, Pediatric / statistics & numerical data
  • Humans
  • Hydronephrosis / diagnostic imaging
  • Image Processing, Computer-Assisted / methods
  • Image Processing, Computer-Assisted / statistics & numerical data*
  • Infant
  • Kidney / diagnostic imaging
  • Male
  • Medical Records / standards*
  • Medical Records / statistics & numerical data
  • Reproducibility of Results
  • Urinary Bladder / diagnostic imaging*
  • Urinary Tract
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / diagnostic imaging*
  • Urination
  • Urography* / methods
  • Vesico-Ureteral Reflux / complications
  • Vesico-Ureteral Reflux / diagnostic imaging