Radiologists, emergency physicians see eye-to-eye when using common reporting language

Imaging reports are the primary means of communication between radiologists and referring providers. But sometimes, the wide variety of language used in these documents can leave one side, or both, scratching their heads.

A new survey of rads and emergency medicine physicians at Madigan Army Medical Center in Tacoma, Washington, however, found that these providers may be more in sync than previously thought. In fact, out of 18 commonly used reporting phrases, both provider groups only had communication problems when using one term, researchers reported Thursday in AJR.

“This result suggests that, while a standardized and study-specific lexicon is being further explored, ordinary professional language has the potential to reliably communicate diagnostic certainty as well,” Matthew D. Grant, MD, an Army radiologist at Joint Base Lewis-McChord, and colleagues explained in the study. “The only phrase that showed a significant difference was ‘compatible with,’ to which more radiologists assigned a higher degree of diagnostic probability than did EM physicians.”

Exploring the topic, Grant et al. found that miscommunication is a top contributor to medical errors and the primary factor in 80% of malpractice cases. And with past research revealing that vague reporting can lead to negative downstream consequences, the authors wanted to better understand the terminology divide.

To do this, they sent a survey to rads and emergency physicians asking each to select the degree of diagnostic probability they thought was conveyed by 18 common radiology phrases. Respondents were given a choice of five diagnostic probabilities: less than 10%, about 25%, 50%, 75%, and more than 90%.

Overall, 42 EM fellows and attendings completed the survey along with 32 radiology residents and attendings.

Both provider groups shared a “high degree” of understanding for most of the phrases, the authors explained. Also, “most likely,” “likely” and “probable” ranked among the most precise phrases, according to responses. Residents reported a lower diagnostic probability with the term “probable” than staff and fellows.

The authors did note a number of limitations of their study, including a small sample size and single-center design, which may limit its generalizability. Despite these concerns, Grant and colleagues said radiologists can use these results to enhance their reporting.

“The results of our study show a high degree of shared understanding for most phrases (17/18) surveyed between radiologists and EM physicians,” the group concluded. “These results can be used to create a list of suggested phrases to convey the degree of diagnostic probability when generating radiology reports for the ED.”

Read the entire study published in the American Journal of Roentgenology here.