In Reply.—Dr Amin presents important additional data regarding communication in surgical pathology reports. As feared, many modifying phrases (MPs) that appear to be commonly used by pathologists are commonly misinterpreted by clinicians. It is interesting to note that phrases many pathologists may assume to be crystal clear (“diagnostic of”) showed significant discordance between pathologists and clinicians in their data. The presence of MPs in 10% of reports is an additional interesting finding. Further work could be done to better understand the prevalence of MPs in pathology reports by subspecialty, clinical entity, institutional setting, etc. Dr Amin also acknowledges, much as we found, that clinicians do not frequently read the comments. This suggests that MPs, and their often-accompanying comments, are perhaps more meaningful to fellow pathologists than to the typical audience of the reports, and their presence and function in reports may need modification.
As such, my coauthors and I are enthusiastic about the authors' proposed “standard scheme for reporting certainty in pathology reports.” This schema has the potential to harmonize the interpretations of clinicians and encourage pathologists to use consistent diagnostic language. Furthermore, this may in turn bolster pathologist comfort in writing reports and provide a platform for teaching pathology trainees. With patients now accessing their medical reports instantly and electronically, in part because of the 21st Century Cures Act, patients routinely interpret their own pathology reports before follow-up communication with their clinician. This schema could benefit patients, giving them a framework to understand at least some of the implications of the report. Indeed, for a worried patient contemplating a cancer diagnosis, or a clinician contemplating powerful treatment modalities with dire side effects, words can mean a great deal.