title: Is terminology used effectively to convey diagnostic certainty in radiology reports?
abstract: OBJECTIVE
  This study was performed to assess the extent of agreement among radiologists and nonradiologists in perception of diagnostic certainty conveyed by words and phrases commonly used in radiology reports.
  
  
  METHODS
  The study was performed in a large academic radiology department. To determine the commonly used terminology for conveying diagnostic certainty in radiology reports, 12 randomly selected radiologists from six different subspecialties were interviewed. The authors identified the 15 most commonly used words and phrases and included these in random order in a questionnaire sent to all staff radiologists (n = 45) and to 158 referring physicians. Physicians were asked to rank the 15 phrases in order of the diagnostic certainty conveyed by each, from 1 (most certain) to 15 (least certain), using each number only once. The kappa statistic was used to assess agreement in rank order among physicians.
  
  
  RESULTS
  The questionnaire response rate was 76% (n = 34) for radiologists and 49% (n = 78) for nonradiologists. There was excellent agreement among radiologists (kappa = 0.95) and nonradiologists (kappa = 0.93) in the rank order for the phrase diagnostic of. Although there was good agreement (kappa = 0.45) among radiologists for the word unlikely, agreement among nonradiologists was poor (kappa = 0.27). There was very poor agreement among all physicians for the rank order of the other 13 phrases.
  
  
  CONCLUSIONS
  Among radiologists and nonradiologists, concordance was poor regarding the diagnostic certainty associated with phrases commonly used in radiology reports. Because poor agreement could lead to suboptimal quality of care, the standardization of terminology would benefit all parties.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
authors.forename: Ramin
authors.initials: R
authors.lastname: Khorasani
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.forename: Susan
authors.initials: S
authors.lastname: Teeger
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Rothschild
authors.forename: Douglas F
authors.initials: DF
authors.lastname: Adams
authors.forename: Steven E
authors.initials: SE
authors.lastname: Seltzer
mesh_terms: D019937:Diagnostic Techniques and Procedures / Q000592:standards*; D006801:Humans; D015588:Observer Variation; D010465:Perception; D011871:Radiology / Q000592:standards*; D011897:Random Allocation; D011795:Surveys and Questionnaires; D009626:Terminology as Topic