A taxonomy of anatomical and pathological entities to support commenting on radiographs (preliminary clinical evaluation)

It has been shown that radiographers have a lot to offer the patient by providing their expert opinion in a timely intervention; including the possibility of Radiographer Led Discharge. Some excellent paper based ‘commenting’ systems have been developed locally and the Society and College of Radiographers has issued national guidance with a pro-forma to support implementation. However, delivery and audit of the PCE service can be burdensome. There is also an ongoing training need linked in to annual reviews.This paper provides a brief introduction to the field of controlled vocabularies and ontologies in radiology and serves to identify their potential for PCE systems. The current work has constructed a prototype taxonomy and accompanying ontology (list of relationships) that enable the generation of radiographer comments using an electronic, fast, and structured web based interface. For example, in the current implementation any one of thousands of possible unique comments could be constructed by making just six selections from filtered lists of terms.The prototype taxonomy has been tested to refine and validate the concept. The resulting taxonomy and its evolution is described here. Finally, the taxonomy was trialled by 23 participants who generated structured PCE's after reviewing 27 cases on DICOM workstations. An analysis of agreement between participants and the ‘gold standard’ is presented.In conclusion, a taxonomy has been created that would provide for: a standardised framework for training staff and students, efficient and robust delivery of the service, and audit of individual practice.