Quantifying the characteristics of unambiguous chest radiography reports in the context of pneumonia

Rationale and Objectives. The purpose of this study was to statistically id entify some characteristics of unambiguous tie, clear) chest radiography re ports in the context of acute bacterial pneumonia. Materials and Methods. Seven physicians individually read 292 chest radiogr aphy reports to determine if they contained radiologic evidence of pneumoni a. Unambiguous reports were defined as those that physicians unanimously cl assified as supporting or not supporting the diagnosis of pneumonia. Ambigu ous reports were assigned degrees of ambiguity on the basis of how much dis agreement they caused among the physicians. Characteristics of unambiguous reports as described in the literature were manually quantified and assigne d to every report, To identify characteristics that statistically distingui shed unambiguous from ambiguous reports, the authors performed an ordinal l ogistic regression analysis for which the dependent variable was the number of dissenting votes the report received and the independent variables were the quantified characteristics of the report. Results. Six independent variables were statistically significantly associa ted with unambiguous reports (P < .05). Three were positively associated: a n interpretation of whether findings supported the diagnosis of pneumonia i n reports with pneumonia-related observations, short sentences, and redunda ncy of pneumonia-related observations. Three were negatively associated: hi gh use of uncertainty modifiers for pneumonia-related observations, use of only descriptive terms to describe pneumonia-related observations, and insu fficient amount of pneumonia-related information. Conclusion. The most influential characteristic of an unambiguous chest rad iography report was an interpretation of whether the radiograph supported t he diagnosis of pneumonia when findings could be indicative.