Modifying phrases in veterinary pathology diagnostic reports: The veterinary professionals’ perception on the diagnostic confidence

Pathologists use modifying phrases (MPs) to express diagnostic confidence (DC) in the diagnosis when essential features of a lesion are lacking. Although commonly used, a standardized application and shared definitions of MPs are not recognized, resulting in a discretional use in veterinary pathology reports. Through an anonymous online survey, this study explored how different groups (veterinary pathologists, general practitioners, specialists of other specialties, residents, and students) perceive selected MPs used in veterinary pathology reports, evaluated their impact on the clinical decision, and provided a possible indication on their use. Participants (<i>n</i> = 753) responded from various continents. The highest DC was generally perceived for the term "diagnostic of," in all groups. "Compatible with," "indicative of," and "consistent with" were also generally perceived with high DC. The DC was lower for the other MPs ("suggestive of," "suspicious for," and "cannot rule out"). MPs perceived as having the highest DC were more often interpreted as definitive diagnoses, while those with lower DC were more likely perceived as suggestions to perform additional diagnostic tests. Pathology reports may benefit from using the comment section to further clarify the level of certainty of the diagnosis. Limitations in the data's representativeness arise from the non-probabilistic sampling and a predominance of a single nation's participants. Despite this, our study provides valuable insights into the perception and clinical impact of MPs, providing a foundation for discussions aimed in standardizing their use in veterinary pathology reports. Adopting consistent and uniform MPs could improve communication between pathologists and clinicians and patient care.