Patients’ Interpretations of Radiology Reports

May 19, 2016

The language used in radiology reports can be ambiguous, leading patients to misunderstand the results, according to a study at ACR 2016.

More patients are reading their own radiology reports and radiologists could help reduce confusion and anxiety by using unambiguous terms to communicate results, according to a presentation at the 2016 annual meeting of the American College of Radiology.

Researchers from the Mallinckrodt Institute of Radiology at the Washington University in St. Louis, St Louis, MO, surveyed 115 patients to better understand how they view commonly used phrases within the radiology report.

The patients were waiting for outpatient radiologic examinations when they were asked to assign their own statistical likelihood of the presence of metastatic disease based upon the terminology used within a hypothetical radiology report. Common report terminology included:

Likely represents cancer

Compatible with cancer

Consistent with cancer

Concerning for cancer

May represent cancer

Suspicious for cancer

Cannot exclude cancer

Diagnostic for cancer

Probably represents cancer

Represents cancer

Potential responses for the statistical likelihoods included: 0% to 25%, 26% to 50%, 51% to 75%, 76% to 99%, and 100%. For statistical analysis, responses were given a numeric value by the authors on a 1 to 5 scale: 1 = 0% to 25%; 2 = 26% to 50%; 3 = 51% to 75%; 4 = 76% to 99%; 5 = 100 percent.

The results showed that most patients saw the highest statistical likelihood if they read:

Probably represents cancer (mean = 4.16)

Represents cancer (mean = 3.51)

Diagnostic for cancer (mean = 3.33)

The lowest statistical likelihood resulted from reading “cannot exclude metastatic disease” (mean = 2.23) and “suspicious for cancer” (mean = 2.41).

The researchers conclude that patients’ perceptions of diagnostic certainty based upon report terminology are variable, which could lead to confusion and anxiety. Radiologists should consider that patients are increasingly reading their own reports and therefore strive to use unambiguous terms that communicate the results of an examination more clearly and effectively.