Abstract
Background
Written communication can convey one’s emotions, personality, and sentiments. Radiology reports employ medical jargon and serve to document a patients’ condition. Patients might misinterpret this medical jargon in a way that increases their anxiety and makes them feel unwell. We were interested whether linguistic tones in MRI reports vary between radiologists and correlate with the severity of pathology.
Questions/Purposes
(1) Is there variation in linguistic tones among different radiologists reporting MRI results for rotator cuff tendinopathy? (2) Is the retraction of the supraspinatus tendon in millimeters associated with linguistic tones?
Methods
Two hundred twenty consecutive MRI reports of patients with full-thickness rotator cuff defects were collected. Supraspinatus retraction was measured on the MRI using viewer tools. Using Kruskal–Wallis H tests, we measured variation between 11 radiologists for the following tones: positive emotion, negative emotion, analytical thinking, cause, insight, tentativeness, certainty, and informal speech. We also measured the correlation of tones and the degree of tendon retraction. Multilevel mixed-effects linear regression models were constructed, seeking factors associated with the tone, accounting for retraction, the presence of prior imaging, and for the effects of each radiologist (nesting).
Results
There were statistically significant differences for all of the tones by radiologist. In bivariate analysis, greater retraction of the supraspinatus muscle in millimeters was associated with more negative emotion and certainty, and with less tentativeness. In multilevel mixed-effects linear regression, more negative tones were associated with greater retraction and absence of prior imaging. Greater tentativeness was associated with the absence of prior imaging, but not with retraction.
Conclusions
Radiology reports have emotional content that is relatively negative, varies by radiologist and is affected by pathology. Strategies for more hopeful, positive, optimistic descriptions of pathology have the potential to help patients feel better without introducing inaccuracies even if unlikely.
Level of Evidence
Level III, Diagnostic.
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Acknowledgements
We would like to thank Dr. Jarrod Dale for providing access to the data to make this study possible.
Funding
The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.
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No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. One of the authors (DR) received royalties from Wright Medical (Memphis, TN, USA) for elbow plates in the amount of less than USD 10,000 per year and from Skeletal Dynamics for an internal joint stabilizer elbow in the amount of between 10,000 and 100,000 USD per year. One of the authors certifies that he (DR) is a Deputy Editor for Hand and Wrist, Journal of Orthopaedic Trauma, and Clinical Orthopaedics and Related Research® and has received or may receive payments or benefits in the amount of USD 5000 per year. One of the authors certifies that he (DR) received honoraria from meetings of the AO North America (Wayne, PA, USA), AO International (Davos, Switzerland), and various hospitals and universities. The rest of the authors have no relevant financial or nonfinancial interests to disclose. The rest of the authors have no conflicts of interest to declare that are relevant to the content of this article. The rest of the authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript. The rest of the authors have no financial or proprietary interests in any material discussed in this article.
Ethical approval
This study received approval from the Institutional Review Board of the University of Texas at Austin. This study has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. This study has been carried out in accordance with relevant regulations of the US Health Insurance Portability and Accountability Act (HIPAA). The study number assigned to this study is 2019-01-0148.
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Kim, E., Table, B., Ring, D. et al. Linguistic tones in MRI reports correlate with severity of pathology for rotator cuff tendinopathy. Arch Orthop Trauma Surg 143, 3753–3758 (2023). https://doi.org/10.1007/s00402-022-04543-w
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DOI: https://doi.org/10.1007/s00402-022-04543-w