The clinical impact of the radiology report in wheezing and nonwheezing febrile children: a survey of clinicians.
BACKGROUND
The chest radiograph is commonly used in the diagnosis and management of patients presenting with respiratory illness. The language used to describe the findings is important to ensure appropriate communication with the referring clinician and thereby optimize patient management.


OBJECTIVE
In this study we attempted to determine how clinicians interpret specific terms commonly used in a chest radiograph report, and to assess how these terms impact the management of children with respiratory symptoms.


METHODS
An online survey was distributed to 562 pediatric practitioners asking their interpretation of the terms "peripheral airway disease (PAD)," "focal airspace consolidation," and "focal infiltrate" in a febrile child with or without wheezing.


RESULTS
There were 112 respondents. Most practitioners defined the term "PAD" as viral pneumonia (61.5%) or asthma (56.9%), "consolidation" as atelectasis (83%) followed by pneumonia (69.6%), and "infiltrate" as pneumonia (100%), followed by atelectasis (22.3%). Practitioners were more likely to treat a nonwheezing child with antibiotics if the report stated "focal airspace consolidation" (80%) or "focal infiltrate" (100%; P=0.001).


CONCLUSIONS
Some radiologic descriptors may lead to diverse and sometimes unintended diagnostic conclusions. Our findings support continued effort to structure and standardize the radiology report and our descriptive terminology.
Spottswood
Stephanie E
SE
Department of Radiology and Radiological Sciences, Monroe Carell Jr Children's Hospital, Vanderbilt University, Nashville, TN 37232, USA. Stephanie.spottswood@vanderbilt.edu
Liaw
Kevin
K
Hernanz-Schulman
Marta
M
Hilmes
Melissa A
MA
Moore
Paul E
PE
Patterson
Barron
B
Chen
Heidi
H
Kan
J Herman
JH
D004282:Documentation / Q000706:statistics & numerical data*; D005335:Fever of Unknown Origin / Q000145:classification* / Q000175:diagnosis*; D006801:Humans; D010820:Physicians / Q000706:statistics & numerical data*; D011361:Professional Competence; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D012120:Respiration Disorders / Q000145:classification* / Q000000981:diagnostic imaging*; D012135:Respiratory Sounds / Q000145:classification*; D011795:Surveys and Questionnaires; D013714:Tennessee; D009626:Terminology as Topic