Certainty Language Use in Pediatric Radiology: A Single-Institution Analysis

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.