Communicating uncertainty effectively within ultrasound reports

Uncertainty in medicine is as uncomfortable as it is inescapable. There can be no shame in admitting when we do not know things that are actually unknowable. The most difficult of post-scan report-writing skills is the challenge of faithfully transmitting the level of certainty or uncertainty that we intend so that care is optimized, risks are understood, overuse is minimized, and diagnostic error is also minimized. For sonographing professionals this means that we must first become aware that we are uncertain, understand the degree to which we are uncertain, and then find effective clear language for communicating our uncertainty effectively within the report.

Succinct formulations to accomplish this would include examples such as “This appearance suggests diagnosis x, which is felt to be the most likely possibility; however, diagnosis y must also be considered, though it is thought to be less likely because…” The use of straightforward, unambiguous language such as this has the added benefit of being equally well understood by patients, who increasingly are reading their radiology reports on electronic portals, sometimes as soon as the report receives the final signature (Bruno et al. 2017)