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E1541. Clarifying Phrases in Emergency Radiology Reports
Authors
  1. Makoto Ogawa; Ichan School of Medicine at Mount Sinai
  2. Cheng-Han Lee; Ichan School of Medicine at Mount Sinai
  3. Barak Friedman; Ichan School of Medicine at Mount Sinai
Objective:
Interactions between radiologists and emergency physicians is often diminished as imaging volume and emphasis on turn around times has increased. Clarity in radiology reporting is just as important now as it ever has been. We explore how several commonly used phrasings are perceived by radiologists and emergency physicians in order to decrease ambiguity in reporting.

Materials and Methods:
An anonymous survey was distributed to attendings and residents at several academic radiology and emergency departments. Demographic information was collected including speciality and number of years post medical school. Open ended questions with the stem, “What is the percent chance when the radiologist says,” followed by six commonly utilized probabilistic phrasings were constructed to allow participants to quantify a level of certainty. Additional questions regarding how often the report findings are reviewed, and what makes a good radiology report were also included. Mean scores and confidence intervals were compared using an independent student T-test.

Results:
A total of 35 radiologists with a mean years of practice of 13.1 years and a total of 73 emergency physicians with a mean years of practice of 5.8 years completed 108 surveys. Radiologists and EM physicians were in agreement on 4 out of 6 probabilistic phrasings: “suspicious for”, “concerned for”, “cannot rule out”, and “possibly”. The terms in disagreement were “too small to characterize” and “compatible with.” When asked about what constitutes a good report, the radiologists frequently reported “concise”, “answers clinical questions” and “organized/structured”; while the EM cohort frequently noted “concise”, “differentials”, “definitive”, “answers clinical questions”, and “organized/structured”. In addition, there was no difference in how often the report findings are reviewed between the two cohorts.

Conclusion:
Radiologists should limit the use of ambiguous probabilistic phrases. Even phrases statistically in concordance featured a wide range suggesting potential error in interpretation. ER physicians favor reports that are concise, organized, direct and answer the clinical question. Clarifying ambiguous language in emergency radiology reporting can reduce potential for patient harm.