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Ellesmere Radiology Associates Scarborough, ON M4T 1R8 Canada
Communication is one of the keystones of our profession, and we must constantly critically appraise our use of it. This is paramount when we are training residents and fellows because the positive and negative effects will be propagated.
Thus, I was disappointed to see a style guide recommend the passive voice in its guidelines [1]. Would not "left hydroureteronephrosis can be traced to the level of a 6-mm stone" read better as "there is a 6-mm stone at the left ureterovesical junction with proximal hydroureteronephrosis?"
I was most disappointed to see a style guide recommend (or passively accept) the vague term "impression" [2]. I do not give impressions. I strive to be definitive and to give interpretations, conclusions, or opinions.
The modern mantra "continuous quality improvement" applies to all aspects of practice including style guides.
References
University of California San Francisco, CA 94143-0628
My coauthors and I welcome Dr. Clark's comments on our opinion article [1]. As noted, we do not regard our proposed guidelines as written in stone but rather as a collection of suggestions that we have found helpful. When we wrote this article, we were aware that others may have different opinions. Therefore, we have objectively investigated the use of our guidelines and shown an improvement in the perceived quality of reports edited in accordance with these guidelines, as scored by interpreting physicians [2]. Although many authorities have put forward various suggestions as to how reports should be worded, we are unaware of previous studies that have validated such edicts by showing an improvement in report quality. If others have alternative approaches, we suggest that their approaches be evaluated in a systematic appraisal.
With respect to two specific points in Clark's letter, we deliberately avoid beginning sentences with "there is" or "there are" because such sentences can usually be reworded into a more concise form; moreover, reading a string of sentences beginning with "there is" and "there are" is mind-numbing. We are happy to use the heading "Impression" for the conclusion of our reports. I suspect that the physicians who interpret our reports are far more concerned with the content of this section rather than the title. We are in complete agreement with Clark that style guidelines, like all aspects of medical practice, should be subjected to continuous quality improvement. We hope that our suggestions further the dialogue on style guidelines for radiology reporting and would welcome any appropriately researched improvement on our offerings.
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