BJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Services
Right arrow Related articles in BJR
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by MacEneaney, P
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by MacEneaney, P
British Journal of Radiology 75 (2002),1005 © 2002 The British Institute of Radiology

Correspondence

Re: Communication of doubt and uncertainty in radiological reports

The Editor—Sir,

In their paper "Communication of doubt and certainty in radiological reports" [1], Hobby et al measured probability scores ascribed to 18 expressions, such as "consistent with", "no evidence of" etc., commonly found in radiological reports. These probability scores were the assessments, by 18 clinicians, of disease probability implied by the expression. The authors found a wide variation in probability scores and conclude that the expression used may lead to misunderstanding. They suggest the use of numerical probabilities in reports.

Calculation of a patient specific numerical probability, post-test probability, is performed with Bayes' theorem [2]. Three variables are required; sensitivity and specificity of the test/reader, and pre-test probability of disease. Pre-test probability is the clinician's estimate of disease probability given all available data. These variables are not available in almost all instances. Pre-test probability is not routinely expressed on a radiology request, in my practice at least, rather we are asked to rule pathology "in" or "out". While sensitivity and specificity estimates of radiological tests are available in the literature, these estimates do not take into account the radiologist's expertise or anatomic extent of disease [3]. Both radiologist's expertise and anatomical extent impact on sensitivity and specificity and, therefore, post-test probability. Therefore, we are some way from being able to use numerical expressions of disease probability in reports. However, a uniform vocabulary used by both requesting clinicians indicating degree of suspicion of disease, pre-test probability, and by radiologists indicating degrees of certainty of diagnosis would be a step forward.

Yours etc.,

P MacEneaney

The University of Chicago, Department of Radiology, 5841 South Maryland Avenue MC 2026, Chicago, Illinois 60637

Received for publication July 10, 2002. Accepted for publication July 30, 2002.

References

  1. Hobby JL, Tom BD, Todd C, Bearcroft PW, Dixon AK. Communication of doubt and certainty in radiological reports. Br J Radiol 2000;73:999–1001.[Abstract]
  2. MacEneaney PM, Malone DE. The meaning of diagnostic test results: a spreadsheet for swift data analysis. Clin Radiol 2000;55:227–35.[Medline]
  3. Black WC. Anatomic extent of disease: a critical variable in reports of diagnostic accuracy. Radiology 2000;217:319–20.[Free Full Text]

Related articles in BJR:

Author's reply
A K Dixon
BJR 2002 75: 1005. [Full Text]  




This Article
Right arrow Full Text (PDF)
Services
Right arrow Related articles in BJR
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by MacEneaney, P
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by MacEneaney, P

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
BJR DMFR IMAGING  ALL BIR JOURNALS