example:
rewrite:
1. Stable disease*. No metabolically active tumor.
2. Mild ascites, decreased since mm/dd/yy. Decreased omental nodules.
3. Likely inflammatory FDG-avid hilar lymph nodes. Tiny, ametabolic pulmonary and subcutaneous nodules are indeterminate. (any recommendations???)
4. Mild, stable slenomegaly.
5. Stable left inguinal hernia and left hydrocele as described.
*could be partial response depending on criteria
Example: “There is no significant FDG avidity in the left breast to suggest residual FDG avid malignancy. There is no evidence of abnormal FDG uptake or lymphadenopathy in the left axilla to suggest FDG avid lymphadenopathy.”
Flesch-Kincaid reading level = 13.8; reading ease score = 27.1
Possible rewrite: “No significant abnormal FDG activity in the left breast or axilla. No enlarged lymph nodes.”
Flesch-Kincaid reading level = 7.7; reading ease score = 52.5
The example mixes findings and impressions making the sentence more complicated by duplicating information that should be in the report impression, ex.”Impression: No FDG avid residual, recurrent or metastatic tumor.” Or more simply “No FDG avid tumor.”
Example: “On bone windows, atherosclerotic calcifications are present at the skull base.”
It’s not necessary to report “on bone windows.” It adds no relevant information regarding athersclerotic calcification. It’s analogous to us getting the following history for a chest radiograph: “On auscultation left lower lobe rales are present.” It doesn’t matter how the physical finding was made. It’s only the finding itself that matters. The other information is extraneous.
The words “are present” do not carry useful information and should be omitted from the example. With these proposed edits the example would read “Atherosclerotic calcifications at the skull base.”
“At the skull base” is a vague description. Furthermore, the example sentence gives no idea of severity. If I felt compelled to report vascular calcification in this region, I’d say where and how bad: “Mildly calcified distal cervical internal carotid arteries.”
Example: “On bone windows, atherosclerotic calcifications are present at the skull base.”
Possible rewrite: “Mildly calcified distal cervical ICAs.”