Department of Radiology, Brigham and Women's Hospital, 20 Kent Street, 2nd flr, Boston, MA 02445; Harvard Medical School, Boston, MA.
Department of Radiology, Brigham and Women's Hospital, 20 Kent Street, 2nd flr, Boston, MA 02445.
Acad Radiol. 2019 Sep;26(9):1229-1234. doi: 10.1016/j.acra.2018.10.017. Epub 2018 Nov 28.
To quantify the use of Diagnostic Certainty Phrases (DCP) in radiology reports, including DCPs with good agreement (including "diagnostic of," "unlikely" and "represents") in connoting degree of certainty between providers based on previous studies; and to assess whether modality, presence of a trainee, radiologic subspecialty, and individual radiologists are associated with the usage of DCPs with good agreement.
This retrospective, IRB-approved study was conducted at an academic medical center. Radiology reports that contain DCPs were identified using information retrieval from all reports generated in 2016, excluding mammograms, obstetrical ultrasound, bone densitometry, and interventional studies. DCPs connoting good agreement were further noted. Of the reports that contained DCPs, a two-level hierarchical generalized linear model with attending as the level-two variable was performed comparing the use of DCP with good agreement while considering trainee involvement, modality, and subspecialty.
A total of 159,151 reports out of 370,881 were found to have at least one DCP (43%). Reports of CT scans had the most number of DCP (68% of all CT reports). Breast and abdomen subspecialties were associated with use of DCP with good agreement. There was significant variation in use of DCP with good agreement between physicians that could not be explained by modality, trainee presence, and subspecialty.
Phrases to convey diagnostic certainty were commonly used in radiology reports. There is wide variation in usage of DCP with good agreement. Future interventions to reduce variation in use of DCPs may reduce ambiguity and improve quality of radiology reports.
通过之前的研究，对放射学报告中的诊断确定性短语（DCP）进行量化，包括在表示提供者之间的确定性程度方面具有良好一致性的 DCP（包括“诊断为”、“不太可能”和“代表”）；并评估模态、是否有受训者、放射学亚专业和个别放射科医生是否与使用具有良好一致性的 DCP 相关。
本回顾性、IRB 批准的研究在一家学术医疗中心进行。使用从 2016 年生成的所有报告中进行信息检索来识别包含 DCP 的放射学报告，不包括乳房 X 光、产科超声、骨密度测定和介入研究。进一步注意到表示良好一致性的 DCP。在包含 DCP 的报告中，对包含受训者的参与、模态和亚专业的两级层次广义线性模型进行了分析，以比较使用具有良好一致性的 DCP。
在 370881 份报告中，共有 159151 份报告至少有一个 DCP（43%）。CT 扫描报告的 DCP 数量最多（所有 CT 报告的 68%）。乳腺和腹部亚专业与使用具有良好一致性的 DCP 相关。医生之间使用具有良好一致性的 DCP 的差异很大，无法用模态、受训者的存在和亚专业来解释。
传达诊断确定性的短语在放射学报告中经常使用。具有良好一致性的 DCP 的使用存在很大差异。未来减少 DCP 使用差异的干预措施可能会减少歧义并提高放射学报告的质量。
