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Choi, Jung, Kim, Shin, Yong, Woo, Jeong, Jin, and Choi: Status of Interchange of Medical Imaging in Korea: A Questionnaire Survey of Physicians
Original Article

J Korean Soc Radiol 2018;79(5):247-253.

Published online: 19 January 2018

DOI: https://doi.org/10.3348/jksr.2018.79.5.247

Status of Interchange of Medical Imaging in Korea: A Questionnaire Survey of Physicians

Moon Hyung Choi, MD1, Seung Eun Jung, MD1, , Sungjun Kim, MD2, Na-Young Shin, MD1, Hwan Seok Yong, MD3, Hyunsik Woo, MD4, Woo Kyoung Jeong, MD5, Kwang Nam Jin, MD4, SeonHyeong Choi, MD6

1Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

2Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

3Department of Radiology, Korea University Guro Hospital, Seoul, Korea

4Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea

5Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

6Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

∗Corresponding author: Seung Eun Jung, MD Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. Tel. 82-2-2258-1428 Fax. 82-2-599-6771 E-mail: sejung@catholic.ac.kr

Received 12 February 2018       Revised 13 June 2018       Accepted 16 June 2018

Copyright © 2018 The Korean Society of Radiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this study was to summarize the results of a survey for physicians with specialties other than radiology about imaging studies of patients referred from other institutions. The survey was promoted through individual contacts or social network service and physicians who voluntarily responded to the survey were the subjects of the study. The questionnaire consisted of 11 questions about basic information and referrals about medical imaging. A total of 160 physicians from 30 specialties participated in the survey and 95.6% of the respondents worked in tertiary care center or general hospital. Patients were frequently referred with outside medical images. The most frequently referred imaging modalities were computed tomography and magnetic resonance imaging. However, radiological reports from outside institutions were rarely referred. Most physicians thought that reinterpretation for outside imaging is necessary to acquire a secondary opinion. In conclusion, considering that outside radiological reports are frequently missing and there are high demands on reinterpretation for outside imaging, guidelines for referral of radiological reports with medical imaging, basic elements of radiological reports, and reinterpretation need to be developed.

Keywords: Diagnostic Imaging, Radiology Information Systems, Referral and Consultation

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Table 1.
Baseline Characteristics
Question Answer Respondents (n) Respondents (%)
1. What is your specialty? Family medicine 4 2.5
Internal medicine 12 7.5
Hepatology 4 2.5
Infectious disease 2 1.3
Endocrinology 6 3.8
Rheumatology 3 1.9
Gastroenterology 22 13.8
Cardiology 3 1.9
Oncology 2 1.3
Hemato-oncology 2 1.3
Pulmonology 2 1.3
Radiation oncology 6 3.8
Urology 2 1.3
Obstetrics and gynecology 6 3.8
Plastic surgery 2 1.3
Pediatrics 6 3.8
Neurology 11 6.9
Neurosurgery 9 5.6
Surgery 10 6.3
Pancreatobiliary surgery 3 1.9
Colorectal surgery 1 0.6
Gastrointestinal surgery 2 1.3
Breast surgery 2 1.3
Emergency medicine 5 3.1
Ororhinolaryngology 3 1.9
Rehabilitation medicine 5 3.1
Psychiatry 6 3.8
Orthopedic surgery 9 5.6
Spinal neurosurgery 3 1.9
Thoracic and cardiovascular surgery y 5 3.1
No response 2 1.3
2. What kind of medical institutions do you work for? Tertiary medical center 105 65.6
General hospital 48 30.0
Hospital 4 2.5
Clinic 3 1.9
Table 2.
Questions About Exchange of Medical Images
Question Answer Respondents Respondents
(n) (%)
1. How often do you meet a patient is referred with outside medical images? Very common: more than two patients per one outpatient session 95 59.4
Common: more than two patients per a week 40 25.0
Rare: less than one patient per a week 20 12.5
Very rare: less than one patient per a month 5 3.1
2. Which is the most common outside images the patients brings? (multiple choice) Plain radiography 52 32.5
Ultrasonography 68 42.5
CT 126 78.8
Magnetic resonance imaging 88 55.0
Others
  Endoscopy 11 6.9
  PET-CT 5 3.1
  Mammography 2 1.3
  Cerebral angiography 2 1.3
3. Which images do you review by yourself? (multiple choice) Plain radiography 64 40.0
Ultrasonography 61 38.1
CT 133 83.1
Magnetic resonance imaging 90 56.3
Others
  Endoscopy 12 7.5
  PET-CT 3 1.9
  Cerebral angiography 3 1.9
  Mammography 2 1.3
4. How frequent the outside radiological report is enclosed with outside images? Very common: 80–100% 10 6.3
Common: 60–80% 29 18.1
About a half: 40–60% 58 36.3
Rare: 20–40% 42 26.3
Very rare: 0–20% 21 13.1
5. How much do you trust the outside radiological report? I totally trust it 4 2.5
I trust the report to a certain degree, but judge the accuracy of it by myself 121 75.6
I have doubts about the accuracy of the report, so I only refer to it 33 20.6
I do not trust it at all 2 1.3
6. How frequent do you request reinterpretation of the outside images? Reinterpretation is very necessary, so I request reinterpretation of most outside images 62 38.8
Reinterpretation is not necessary, but I request reinterpretation of the outside images to obtain secondary opinion for surgery or treatment 78 48.8
Reinterpretation is not necessary, but I habitually request reinterpretation of the outside images 1 0.6
Reinterpretation is not necessary, but I request reinterpretation of the outside images to store the images 12 7.5
I do not request reinterpretation 7 4.4
7. Do you request reinterpretation of outside images even if the outside report contains enough information? I do not request reinterpretation when the outside report contains enough information 67 41.9
I request reinterpretation to obtain the secondary opinion 93 58.1
8. Which is the most common reason you ask for reinterpretation? Lack of the outside report 37 23.1
Low level of trust in the outside report 38 23.8
Insufficient information in the outside report 43 26.9
Trust in the report by radiologists who work in the same institution 42 26.3

CT = computed tomography, PET = positron emission tomography

Table 2.
Questions About Exchange of Medical Images (continued)
Question Answer Respondents Respondents
(n) (%)
9. Describe your opinion freely about reinterpretation and reexamination of radiological examination It is important to enclose the outside radiological report with outside images    
I hope the outside report is included in the outside images    
Reliability of the outside report depends on the size of the outside medical inst titution    
It is natural to trust a radiologist who works together    
The quality control of the radiological report is necessary    
If there is a certification system for the radiological report, reinterpretation may not be necessary    
Low image quality of outside images is frequent    
Standardization of radiological examination is necessary    
I frequently request reinterpretation to store the outside images    
Reexamination can be performed when quality of the outside images is too bad    
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