Communicating Diagnostic Uncertainty in Surgical Pathology Reports: Disparities between Sender and Receiver
Sarah W Lindley, Lewis A Hassell, Elizabeth M Gillies. University of Oklahoma, Health Sciences Center, Oklahoma City, OK
Background: Conveying diagnostic uncertainty in surgical pathology is a daily practice however there is no standardized wording for communication of uncertainty to clinicians.
Design: Attendees at multi-disciplinary tumor boards completed an anonymous survey that asked them to estimate the degree of certainty associated with eight diagnoses. One diagnosis contained no expression of uncertainty while the other seven contained the following phrases: cannot rule out; consistent with; highly suspicious; favor; indefinite for; suggestive of; and worrisome for. A total of 57 responses were received.
Results: For analysis the respondents were divided into the following groups: medical students, residents, fellows, attendings, medicine/medical subspecialties, pathologists/radiologists, and surgeons. The variations in the level of perceived certainty is quantified by the standard deviations from the means (table 1) and shown graphically (Figure 1).
|Cannot rule out||18||25||25||27||31||21||30|
|No uncertainty terms||8.3||8.1||30||15||30||6||13|