1 Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO.
2 Washington University School of Medicine in St. Louis, St. Louis, MO.
AJR Am J Roentgenol. 2018 Jan;210(1):123-126. doi: 10.2214/AJR.17.18448. Epub 2017 Oct 12.
Despite patients' increasing interest in reading their own imaging results, little is known about how patients interpret the reporting terminology of radiologists. The purpose of this study was to survey patients and radiologists to improve understanding of how each group views commonly used phrases within the radiology report.
Patients and radiologists were asked to assign a numerical likelihood of the presence of metastatic disease based on their understanding of radiology report phrasing. Commonly used qualifying phrases, such as "likely represents," "concerning for," and "cannot exclude" were evaluated to compare differences in interpretation between patients and radiologists. Potential responses for statistical likelihoods included 0-25%, 26-50%, 51-75%, 76-99%, and 100%.
There was a significant difference between the two groups with respect to assigned statistical likelihoods for most phrases. Patients identified the phrase "probably meta-static disease" as conferring the highest likelihood of true malignancy, even though radiologists rated this phrase as conferring the sixth highest likelihood (p = 0.002). Radiologists consistently identified the phrase "diagnostic for metastatic disease" as conveying the highest likelihood of metastatic disease, whereas patients ranked this phrase as having the third highest numerical likelihood (p < 0.001). The phrase "cannot exclude cancer" was assigned the lowest numerical likelihood by both groups.
Patients and radiologists have differing perceptions of the specific semantic meaning of the language in radiology reports. A variable interpretation of the radiologist's diagnostic confidence may lead to confusion and dissatisfaction with the report. Radiologists should consider that patients read their reports and should endeavor to use strategies to convey imaging results clearly and effectively.
尽管患者越来越有兴趣阅读自己的影像检查结果,但对于患者如何解读放射科医生的报告术语却知之甚少。本研究旨在调查患者和放射科医生,以增进双方对放射科报告中常用短语的理解。
要求患者和放射科医生根据对放射科报告措辞的理解,对存在转移性疾病的可能性进行数字评估。评估了常用的限定性短语,例如“很可能代表”、“提示”和“不能排除”,以比较患者和放射科医生之间的解释差异。统计可能性的潜在反应包括 0-25%、26-50%、51-75%、76-99%和 100%。
两组之间在大多数短语的分配统计可能性方面存在显著差异。患者认为“很可能是转移性疾病”这句话最能提示真正的恶性肿瘤,尽管放射科医生将其评为第六高可能性(p = 0.002)。放射科医生始终认为“诊断为转移性疾病”这句话传达了转移性疾病的最高可能性,而患者将其列为第三高的数字可能性(p < 0.001)。“不能排除癌症”这句话被两组都赋予了最低的数字可能性。
患者和放射科医生对放射科报告中语言的具体语义理解存在差异。放射科医生诊断信心的解释差异可能导致患者对报告感到困惑和不满。放射科医生应考虑到患者会阅读他们的报告,并应努力使用策略清晰有效地传达影像结果。