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Diagnostic certainty phrases (DCPs) are common in pediatric radiology reports, showing varied use based on imaging type, patient age, and radiologist experience. This highlights a need for standardized reporting of uncertainty in pediatric imaging.

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Area of Science:

  • Medical Imaging
  • Radiology
  • Pediatric Healthcare

Background:

  • Diagnostic certainty phrases (DCPs) are used by radiologists to express confidence in interpretations.
  • Prior studies show variability in DCP use in adult radiology.
  • DCP usage in pediatric radiology remains largely uncharacterized.

Purpose of the Study:

  • To characterize the usage patterns of DCPs in pediatric radiology reports.
  • To identify factors influencing DCP frequency and variability.

Main Methods:

  • Retrospective analysis of 309,751 pediatric imaging reports (October 2023 - September 2024).
  • Random sampling of 10,000 reports for DCP identification using natural language processing (GPT-4o).
  • Evaluation of DCP occurrence across demographics, modalities, clinical settings, and radiologist seniority.

Main Results:

  • 20.9% of reports contained at least one DCP; mean frequency was 0.27 per report.
  • Higher DCP usage observed in MRI, patients aged 1-5 years, and emergency cases.
  • Mid-career and early-career radiologists used DCPs more frequently than senior radiologists.

Conclusions:

  • DCPs are frequently utilized in pediatric radiology, with significant variability.
  • Factors influencing DCP use include imaging modality, patient age, clinical context, and radiologist experience.
  • Variability in DCPs may necessitate standardized approaches for reporting diagnostic uncertainty.