Jaber Omar, Ammar Khawla, Sughayer Maher
Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, 202 Queen Rania Al Abdullah St., P.O. Box 1269, Amman, 11941 Jordan.
Survey Research Unit, Center of Research Shared Resources, King Hussein Cancer Center, 202 Queen Rania Al Abdullah St., P.O. Box 1269, Amman, 11941 Jordan.
Acad Pathol. 2024 Feb 26;11(1):100109. doi: 10.1016/j.acpath.2024.100109. eCollection 2024 Jan-Mar.
Pathologists use certain terminologies to communicate uncertainty in pathology reports. The message conveyed in pathology reports may be interpreted differently by clinicians leading to possible miscommunication. We aimed to compare the interpretation and impact of uncertainty phrases between pathologists and clinicians. A survey with examples of uncertain diagnoses containing ("suspicious for", "indefinite for", "favor", "cannot exclude", "suggestive of", "compatible with", "cannot rule out", "highly suspicious for" and "consistent with") was sent to pathologists and clinicians. For each diagnosis, participants assigned a level of certainty from 1 to 10 and were asked whether they would recommend treatment based on such phraseology. Thirty-six responses (from 7 pathologists, 10 surgeons, 8 pediatric oncologists, 8 medical oncologists, 2 radiation oncologists and 1 diagnostic radiologist) were received. Pathologists had a narrower range of uncertainty compared to clinicians. Wide variation between both groups was seen for all phrases except "compatible with" and "highly suspicious for". 'Indefinite for' showed the lowest mean of certainty (4.67 for pathologists; 4.00 for clinicians) whereas 'consistent with' had the highest (8.83 for pathologists and 9.38 for clinicians). There was a significant difference in the degree of certainty between both groups for "compatible with" (7.83 for pathologists and 9.06 for clinicians, = .009). For treatment decisions, pathologists and clinicians agreed on initiating treatment when "consistent with" and "compatible with" were used and gave variable responses for the other terms. They proposed opposing treatment recommendations for "favor". Pathologists and clinicians varied in interpretation of uncertainty phrases which may impact treatment.
病理学家使用特定术语来传达病理报告中的不确定性。临床医生对病理报告中传达的信息可能会有不同的解读，从而导致可能的沟通不畅。我们旨在比较病理学家和临床医生对不确定性短语的解读及其影响。一项包含不确定诊断示例（如“怀疑为”“不确定为”“倾向于”“不能排除”“提示”“与……相符”“不能排除”“高度怀疑为”和“与……一致”）的调查被发送给病理学家和临床医生。对于每个诊断，参与者从1到10分配一个确定程度，并被问及他们是否会基于这样的措辞推荐治疗。共收到36份回复（来自7名病理学家、10名外科医生、8名儿科肿瘤学家、8名医学肿瘤学家、2名放射肿瘤学家和1名诊断放射科医生）。与临床医生相比，病理学家的不确定性范围更窄。除了“与……相符”和“高度怀疑为”之外，两组对所有短语的看法都存在很大差异。“不确定为”的确定性均值最低（病理学家为4.67；临床医生为4.00），而“与……一致”的确定性均值最高（病理学家为8.83，临床医生为9.38）。两组对于“与……相符”的确定性程度存在显著差异（病理学家为7.83，临床医生为9.06，P = 0.009）。对于治疗决策，当使用“与……一致”和“与……相符 ”时，病理学家和临床医生都同意开始治疗，而对于其他术语则给出了不同的回复。他们对于“倾向于”提出了相反的治疗建议。病理学家和临床医生对不确定性短语的解读存在差异，这可能会影响治疗。
