| 427446c1-881f5cce-85191ce1-91a58ba9-0a57d3f5, abea5eb9-b7c32823-3a14c5ca-77868030-69c83139 | 50051329 | 10046166 | Findings: Lateral view somewhat limited due to overlying motion artifact. The lungs are low in volume. There is no focal airspace consolidation to suggest pneumonia. A 1.2-cm calcified granuloma just below the medial aspect of the right hemidiaphragm is unchanged from prior study. No pleural effusions or pulmonary edema. There is no pneumothorax. The inferior sternotomy wire is fractured but unchanged. Surgical clips and vascular markers in the thorax are related to prior CABG surgery. Impression: No evidence of acute cardiopulmonary process. | Findings: Latral view somewhat limited due to overlying motion artifact. The lungs are low in volumen. There is no focal airspace consolidation to suggest pneumonia. A 2.3-cm calcified granuloma just below the medial aspect of the right hemidiaphragm is unchanged from prior study. No pleural effusions or pulmonary edema. There is no pneumothorax. The inferior sternotomy wire is fractured but unchanged. Surgical clips, pacemaker, and vascular markers in the thorax are related to prior CABG surgery. Impression: No evidence of acute cardiopulmonary process. | ['Change measurement', 'Add typo', 'Add medical device'] |
| 3a8a17fc-3cd357d9-83466363-91dc5a06-a401e5ed, 6130440f-929f5fae-e4b47406-634aedcb-3dd112ec | 51738740 | 10046166 | Impression: No acute intrathoracic process. | Impression: No acute intrathoracic process. There is mild pulmonary edema. Impression: Acute intrathoracic findings with no evidence of edema. New right-sided pleural effusion is noted. Pacemaker in a stable position. | ['False prediction', 'Add contradiction', 'Add medical device'] |
| 18f0fd6d-f513afc9-e4aa8de2-bc5ac0d6-ea3daaff, 7d5ef12b-34d86e32-207566d6-d5ed6f02-cd868f2c | 53492798 | 10046166 | Findings: Frontal and lateral radiographs of the chest redemonstrate a round calcified pulmonary nodule in the posterior right lung base, unchanged from multiple priors and consistent with prior granulomatous disease. A known enlarged right hilar lymph node seen on CT of ___ likely accounts for the increased opacity at the right hilum. A known right mediastinal lymph node conglomerate accounts for the fullness at the right paratracheal region. No pleural effusion, pneumothorax or focal consolidation is present. The patient is status post median sternotomy and CABG with wires intact. The cardiac silhouette is normal in size. The mediastinal and hilar contours are unchanged from the preceding radiograph. Impression: No acute cardiopulmonary process. | Findings: Frontal and lateral radiographs of the chest redemonstrate a round calcified pulmonary nodule in the posterior left lung base, unchanged from multiple priors and consistent with prior granulomatous disease. A known enlarged right hilar lymph node scene on CT of ___ likely accounts for the increased opacity at the right hilum. A known right mediastinal lymph node conglomerate accounts for the fullness at the right paratracheal region. No pleural effusion, pneumothorax or focal consolidation is present. The patient is status post median sternotomy and CABG with wires intact. The cardiac silhouette is normal in size. The mediastinal and hilar contours are unchanged from the preceding radiograph. There is also the presence of a central venous line. Impression: No acute cardiopulmonary process. | ['Change location', 'Change to homophone', 'Add medical device'] |
| 6e511483-c7e1601c-76890b2f-b0c6b55d-e53bcbf6, e5ba5704-ce2f09d3-e28fe2a2-8a9aca96-86f4966a | 57379357 | 10046166 | Findings: Frontal and lateral views of the chest were obtained. Rounded calcified nodule in the region of the posterior right lung base is seen and represents calcified granuloma on CTs dating back to ___, likely secondary to prior granulomatous disease. Previously seen pretracheal lymph node conglomerate and right hilar lymph nodes are better seen/evaluated on CT. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable with possible slight decrease in right paratracheal prominence. Impression: No radiographic findings to suggest pneumonia. | Findings: Frontal and lateral views of the chest were obtained. Rounded calcified nodule in the region of the anterior right lung base is seen and represents calcified granuloma on CTs dating back to ___, likely secondary to prior granulomatous disease. Previously seen pretracheal lymph node conglomerate and right hilar lymph nodes are better seen/evaluated on CT. Previously seen pretracheal lymph node conglomerate and right hilar lymph nodes are better seen/evaluated on CT. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable with possible slight decrease in right paratracheal prominence. Impression: No calcified nodules. | ['Change location', 'Add repetitions', 'False negation'] |
| e2856783-ffa5ec26-043b0303-21aeddc6-b11b2876 | 57977208 | 10046166 | Findings: In comparison with the study of ___, there is no evidence of pneumothorax. Continued low lung volumes with substantial mass in the right paratracheal region. | Findings: In comparison with the study of ___, there is no evidence of pneumothorax. Continued low lung volumes with substantial mass in the left paratracheal region. There is no mass noted in the left paratracheal region. | ['Change location', 'Add contradiction', 'False negation'] |
| 7f6d7289-9941e757-2663be13-0dde50f8-5d2670aa | 52835225 | 10183775 | Impression: 1. Status post median sternotomy for CABG with stable cardiac enlargement and calcification of the aorta consistent with atherosclerosis. Relatively lower lung volumes with no focal airspace consolidation appreciated. Crowding of the pulmonary vasculature with possible minimal perihilar edema, but no overt pulmonary edema. No pleural effusions or pneumothoraces. | Impression: 1. Status post median sternotomy for CABG with stable cardiac enlargement and calcification of the aorta consistent with atherosclerosis. Relatively lower lung volumes with no focal airspace consolidation appreciated. Crowding of the pulmonary vasculature with possible moderate perihilar edema, but no overt pulmonary edema. No pleural effusions or pneumothoraces. Mild pulmonary edema noted. | ['Change severity', 'Add contradiction', 'False negation'] |
| 4c3c1335-0fce9b11-027c582b-a0ed8d89-ca614d90 | 50042142 | 10268877 | Findings: The ET tube is 3.5 cm above the carina. The NG tube tip is off the film, at least in the stomach. Right IJ Cordis tip is in the proximal SVC. The heart size is moderately enlarged. There is ill-defined vasculature and alveolar infiltrate, right greater than left. This is markedly increased compared to the film from two hours prior and likely represents fluid overload. | Findings: The ET tube is 4.2 cm above the carina. The NG tube tip is of the film, at least in the stomach. Right IJ Cordis tip is in the proxomal SVC. The heart size is moderately enlarged. There is ill-defined vasculature and no alveolar infiltrate. This is markedly increased compared to the film from two hours prior and likely represents fluid overload. | ['Change measurement', 'Add typo', 'False negation'] |
| 0c69d156-6f5f3a89-7d361367-57f8c979-583ef198 | 50239281 | 10268877 | Findings: Left PICC tip is seen terminating in the region of the distal left brachiocephalic vein. Tracheostomy tube is in unchanged standard position. The heart is moderately enlarged. Marked calcification of the aortic knob is again present. Mild pulmonary vascular congestion is similar. Bibasilar streaky airspace opacities are minimally improved. Previously noted left pleural effusion appears to have resolved. No pneumothorax is identified. Percutaneous gastrostomy tube is seen in the left upper quadrant. Impression: 1. Left PICC tip appears to terminate in the distal left brachiocephalic vein. 2. Mild pulmonary vascular congestion. 3. Interval improvement in aeration of the lung bases with residual streaky opacity likely reflective of atelectasis. Interval resolution of the left pleural effusion. | Findings: Left Left-sided AICD device is noted with single lead terminating in unchanged position in the right atrium. Tracheostomy tube is in unchanged standard position. The heart is moderately enlarged. Marked calcification of the aortic knob is again present. Mild pulmonary vascular congestion is similar. Bibasilar streaky airspace opacities are minimally improved. Previously noted left sided heart failure is evident. Previously noted left pleural effusion appears to have resolved. No pneumothorax is identified. Percutaneous gastrostomy tube is seen in the left upper quadrant. Impression: 1. Left PICC tip appears to terminate in the distal left brachiocephalic vein. 2. Mild pulmonary vascular congestion. 1. Left PICC tip appears to terminate in the distal left brachiocephalic vein. 3. Interval improvement in aeration of the lung bases with residual streaky opacity likely reflective of atelectasis. Interval resolution of the left pleural effusion. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| 053e0fdd-17dbee89-17885e49-08249a30-7f829c9c | 51513702 | 10268877 | Findings: Single AP portable view of the chest. No prior. The lungs are clear of large confluent consolidation. Cardiac silhouette enlarged but could be accentuated by positioning and relatively low inspiratory effort. Calcifications noted at the aortic arch. Degenerative changes noted at the glenohumeral joints bilaterally. Osseous and soft tissue structures otherwise unremarkable. Impression: No definite acute cardiopulmonary process. Enlarged cardiac silhouette could be accentuated by patient's positioning. | Findings: Single AP praotable view of the chest. No proir. The lungs are clear of moderate confluent consolidation. Cardiac silhouette enlarged but could be accentuated by positioning and relatively low inspiratory effort due to faint ET tube placement. Calcifications noted at the aoritc arch. Degenerative changes noted at the glenohumeral joints bilaterally. Osseous and soft tissue structures otherwise unremarkable. Impression: No definitive acute cardiopulmonary process. Enlarged cardiac silhouette could be accentuated by patient's positioning. | ['Change severity', 'Add typo', 'Add medical device'] |
| 9dcbd7ac-9d6ca173-f7e669fd-bb419597-97f58083 | 51623828 | 10268877 | Impression: Increased mild pulmonary edema and left basal atelectasis. | Impression: Increased moderate pulmonary edema and left basal atelectasis. | ['Change severity', 'Add typo', 'False negation'] |
| 1b966ed7-06a3bfa3-fee1b692-81c9a0b7-7678b5ec | 51715880 | 10268877 | Findings: As compared to the previous radiograph, there is marked improvement in extent and severity of the pre-existing parenchymal opacities. Unchanged borderline size of the cardiac silhouette. No pleural effusions. The nasogastric tube has been removed. Endotracheal tube and the right internal jugular vein introduction sheath are in constant position. | Findings: As compared to the previous radiograph, there is a large mass in the left upper lobe. Unchanged borderline size of the cardiac silhouette. No pleural effusions. The nasogastric tube has been removed. The nasogastric tube has been removed. Endotracheal tube and the left internal jugular vein introduction sheath are in constant position. | ['Change location', 'Add repetitions', 'False prediction'] |
| f1b12ac7-37699f77-a605ccbb-0eee65fd-e2f0351d | 52199665 | 10268877 | Findings: Indwelling support and monitoring devices are unchanged in position, and cardiomediastinal contours are stable allowing for positional differences. Left retrocardiac atelectasis has improved, but an area of confluent increased opacity in the right infrahilar region is new. The latter may reflect atelectasis, aspiration, or developing infection. | Findings: Indwelling support and monitoring devices are unchanged in position, and cardiomediastinal counters are stable allowing for positional differences. Right retrocardiac atelectasis has improved, but an area of confluent increased opacity in the right infrahilar region is new. The latter may reflect atelectasis, aspiration, or developing infection. A small pleural effusion is noted at the left lung base. | ['Change location', 'Change to homophone', 'False prediction'] |
| 046bbbe6-823f11ab-c43a868b-b3342241-8cf3254b | 53021891 | 10268877 | Impression: 1. Decreased left basilar consolidation with mild pulmonary edema. 2. Possible pulmonary arterial hypertension. | Impression: 1. Decreased right basilar consolidation with mild pulmonary edema. 2. Possible pulmonary arterial hypertension. However, there is no evidence of pulmonary arterial hypertension. Additionally, there is an incidental note of an implanted pacemaker. | ['Change location', 'Add contradiction', 'Add medical device'] |
| aebc8b32-83f9db36-e7859808-602b3b39-66bb2765 | 53368667 | 10268877 | Impression: AP chest compared to ___: ET tube in standard placement. Nasogastric tube passes into the stomach and out of view. No pneumothorax. Leftward mediastinal shift suggests a new opacification at the base of the left lung is atelectasis. The right lung is clear. Left jugular line ends at the origin of the SVC. | Impression: AP chest compared to ___: ET tube terminates 2.5 cm above the carina. Nasogastric tube is coiled in the esophagus. No pneumothorax. Leftward mediastinal shift suggests a new opacification at the base of the left lung is atelectasis. The right lung is clear. Left jugular line ends in the right atrium. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| e35d7c70-3f278882-4f133ee9-184f4d7e-fa32a4d7 | 53452091 | 10268877 | Findings: A hazy opacity is present in the right lung which may represent aspiration, pleural effusion or hemorrhage. Retrocardiac opacity at the left base is unchanged. Moderate cardiomegaly is stable. Slight prominence of the pulmonary vasculature with cephalization and enlarged pulmonary arteries are consistent with mild pulmonary edema. Tracheostomy tube is in place. There are no displaced rib fractures. Impression: 1. Hazy opacity in the right lung which may represent aspiration versus pleural effusion or hemorrhage. 2. Mild pulmonary edema. 3. No displaced rib fractures. | Findings: A hazy opacity is present in the rigth lung which may represent aspiration, pleural effusion or hemorrhage. Retrocardiac opacity at the left base is unchanged. Moderate cardiomegaly is stabel. Slight prominence of the pulmonary vasculature with cephalization and enlarged pulmonary arteries are consistent with moderate pulmonary edema. Tracheostomy tube is in place. There are no displaced rib fractures. A central venous line is noted in the superior vena cava. Impression: 1. Hazy opacity in the right lung which may represent aspiration versus pleural effusion or hemorrhage. 2. Moderate pulmonary edema. 3. No displaced rib fraktures. | ['Change severity', 'Add typo', 'Add medical device'] |
| 878341cc-7587aff2-e1f70246-3a29413e-36f37ddb | 53883066 | 10268877 | Impression: The patient is markedly rotated to his left limiting evaluation of the cardiac and mediastinal contours. The heart remains enlarged. There has been interval removal of the endotracheal tube with placement of a tracheostomy tube, which has its tip at the thoracic inlet. The right subclavian PICC line still has its tip in the distal SVC. A nasogastric tube is seen coursing below the diaphragm with the tip projecting over the expected location in the stomach. Patchy opacity in the retrocardiac region may reflect an area of atelectasis, although pneumonia cannot be entirely excluded. No evidence of pulmonary edema. No pneumothorax. Probable small layering left effusion. | Impression: The patient is markedly rotated to his left limiting evaluation of the cardiac and mediastinal contours. The heart is normal in size. There has been interval removal of the endotracheal tube with placement of a Foley catheter, which has its tip at the thoracic inlet. The right subclavian chest tube still has its tip in the distal SVC. A nasogastric tube is seen coursing below the diaphragm with the tip projecting over the expected location in the stomach. Patchy opacity in the retrocardiac region may reflect an area of atelectasis, although pneumonia cannot be entirely excluded. No evidence of pulmonary edema. No pneumothorax. No effusion. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 46258faf-c930aa13-1b09c523-4972126b-47bba114 | 54103072 | 10268877 | Findings: Bedside upright AP radiograph of the chest demonstrates little interval change when compared to prior study performed 24 hours ago. There is minimal, stable enlargement of the cardiomediastinal contours consistent with mild chronic heart failure. Persistent obscuration of the pulmonary vascular markings in the right lung base is consistent with trace pulmonary edema. Bibasilar atelectasis is still present. The lungs are otherwise clear. There is no pneumothorax or pleural effusion. A left internal jugular central venous catheter, an endotracheal tube, and an orogastric tube are unchanged and appropriately positioned. The chronic findings of atherosclerotic calcification of the aortic arch and bilateral glenohumeral joint degenerative changes are once again noted. Impression: 1. Mild chronic congestive heart failure with stable trace pulmonary edema at the right lung base. 2. Stable bibasilar atelectasis. | Findings: Bedside upright AP radiograph of the chest demonstrates little interval change when compared to prior study performed 24 hours ago. There is minimal, stable enlargement of the cardiomediastinal contours consistent with mild chronic heart failure. Persistent obscuration of the pulmonary vascular markings in the rite lung base is consistent with trace pulmonary edema. Bibasilar atelectasis is still present. The lungs show increased bronchovascular markings bilaterally. There is no pneumothorax or pleural effusion. A left internal jugular dialysis catheter, an endotracheal tube, and an orogastric tube are unchanged and appropriately positioned. The chronic findings of atherosclerotic calcification of the aortic arch and bilateral glenohumeral joint degenerative changes are once again noted. Impression: 1. Mild chronic congestive heart failure with stable trace pulmonary edema at the right lung base. 2. Moderate bibasilar atelectasis. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| e279d10a-22b3d14a-0527c87a-bbd31c9b-de232422 | 54137212 | 10268877 | Findings: Single portable view of the chest is compared to previous exam from ___. Tracheostomy tube is again noted. Left PICC tip is not clearly delineated on the current exam. Again there is mild pulmonary vascular congestion. Streaky opacities at the lung bases suggestive of atelectasis; however infection cannot be excluded. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. Impression: No significant interval change since prior. Pulmonary vascular congestion. Bibasilar opacities potentially due to atelectasis; however, infection is not excluded. | Findings: Single portable view of the chest is compared to previous exam from ___. Tracheostomy tube is again noted. Left chest wall catheter tip is not clearly delineated on the current exam. Again there is mild pulmonary vascular congestion. Streaky opacities at the lung bases suggestive of atelectasis; however infection cannot be excluded. There is mild pulmonary vascular congestion. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. A right-sided central venous line terminates in the superior vena cava. Impression: No significant interval change since prior. Pulmonary vascular congestion. Bibasilar opacities potentially due to atelectasis; however, infection is not excluded. | ['Change name of device', 'Add repetitions', 'Add medical device'] |
| 672a57a9-30dbdb02-4e0a1676-fbf127b4-e2f52011 | 54558182 | 10268877 | Findings: There are no old films available for comparison. The heart is moderately enlarged. There is a right IJ Cordis with tip in the upper SVC. There is mild pulmonary vascular re-distribution, but no definite infiltrates or effusion. | Findings: There are no old films available for comparison. The heart is severely enlarged. There is a right IJ Cordis with tip in the upper SVC. There is mild pulmonary vascular re-distribution, but no definite infiltrates or effusion. There is a right IJ Cordis with tip in the upper SVC. A permanent pacemaker is present. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| b0cabafd-224d8d46-c113bb88-27e041f4-2ecf273b | 54658698 | 10268877 | Findings: In comparison with study of ___, the tip of the endotracheal tube now measures approximately 6.5 cm above the carina. Nasogastric tube again courses beyond the lower margin of the image in the distal stomach. The left hemidiaphragm is not as sharply seen and there is increased opacification in the retrocardiac region, consistent with volume loss in the left lower lobe and areas of plate-like atelectasis. Continued mild pulmonary vascular congestion. | Findings: In comparison with study of ___, the tip of the endotracheal tube now measures approximately 6.5 mm above the carina. Nasogastric tube again courses beyond the lower margin of the image in the distal stomach. The left hemidiaphragm is not as sharpl seen and there is increased opacification in the retrocardiac region, consistent with volume loss in the left lower lobe and areas of plate-like atelectasis. Continued mild pulmonary vascular congestion. There is a subtle nodular opacity in the right upper lobe, which may represent an early infectious process. | ['Change measurement', 'Add typo', 'False prediction'] |
| 2c047cc5-4f33acea-462ae2cb-0d9a48d2-8906e8f9, 2d0d0dd1-758ad05c-5f33e8fa-08a1e0dc-63d862be | 54934220 | 10268877 | Findings: Comparison is made to previous study from ___. There is an endotracheal tube whose distal tip is 6.2 cm above the carina appropriately sited. There is a left-sided IJ line with distal lead tip in the mid SVC. There is a nasogastric tube whose tip and sideport are below the GE junction. There is a persistent left retrocardiac opacity. There is some atelectasis at the left lung base. There is improved aeration at the right lung base. No pneumothoraces are seen. | Findings: Comparison is made to previous study from ___. There is an endotracheal tube whose distal tip is 7.2 cm above the carina appropriately sited. Their is a left-sided IJ line with distal lead tip in the mid SVC. There is a nasogastric tube whose tip and sideport are below the GE junction. There is a persistent left retrocardiac opacity. There is some atelectasis at the left lung bass. There is improved aeration at the right lung base. No pneumothoraces are seen. There is a pacemaker lead present in the left chest. | ['Change measurement', 'Change to homophone', 'Add medical device'] |
| 14ff31ea-afb9a3f3-fca0fe57-1fb4e5d4-9f537945, befa8b27-2bfd96b0-d50f7eda-deffa4f9-dd7e7314 | 55430988 | 10268877 | Findings: As compared to the previous radiograph, there is no relevant change. Monitoring and support devices are constant. Constant cardiomegaly with relatively extensive retrocardiac atelectasis and the potential presence of a small left pleural effusion. Mild pulmonary edema. Areas of atelectasis at the right lung base. No newly occurred parenchymal opacities. No pneumothorax. | Findings: As compared to the previous radiograph, there is no relevant change. Monitoring and support devices are constant. Constant cardiomegaly with relatively extensive retrocardiac atelectasis and the potential presence of a small left pleural effusion. No pulmonary edema. Areas of atelectasis at the right lung base. No newly occurred parenchymal opacities. No pneumothorax. | ['Change severity', 'Change to homophone', 'False negation'] |
| 2b68ac0e-611f3a5f-ddd4047f-97ef55a1-538b75df | 55785509 | 10268877 | Findings: In comparison with study of ___, the PICC extends only to the left brachiocephalic vein before its junction with the superior vena cava. Continued low lung volumes may account for some of the prominence of the transverse diameter of the heart. Bibasilar opacification most likely reflects atelectatic changes. Possibility of supervening pneumonia would have to be considered in the appropriate clinical setting. The pulmonary vascular congestion is less prominent than on the prior study. | Findings: In comparison with study of ___, the PICC extends only to the lower superior vena cava before its junction with the right atrium. Continued low lung volumes may account for some of the prominence of the transverse diameter of the heart. Bibasilar opacification most likely reflects atelectatic changes. Possibility of supervening pneumonia would have to be considered in the appropriate clinical setting. Continued low lung volumes may account for some of the prominence of the transverse diameter of the heart. There is evidence of mild pleural effusion in both lungs. The pulmonary vascular congestion is less prominent than on the prior study. | ['Change position of device', 'Add repetitions', 'False prediction'] |
| 2f8ca5e2-5a1e02ab-e84f7547-069743e9-0f08d9e0 | 57765703 | 10268877 | Findings: Portable AP chest radiograph is obtained with the patient in the semi-erect position. Tracheostomy noted. Cardiomediastinal silhouette is unchanged; bulging of the pulmonary outflow tract reflects enlargement of pulmonary arteries and suggests underlying pulmonary arterial hypertension. Pulmonary edema has slightly improved compared to the prior study. Small right pleural effusion is unchanged. Again bibasilar opacifications are noted and are suggestive of atelectasis or consolidation. Impression: 1. Unchanged bibasilar opacities are consistent with atelectasis or consolidation and pneumonia should be considered in the appropriate clinical context. 2. Improved pulmonary edema. | Findings: Portable AP chest radiogrpah is obtained with the patint in the semi-erect position. Tracheostomy noted. Cardiomediastinal silhouette is unchanged; bulging of the pulmonary outflow tract reflects slight enlargement of pulmonary arteries and suggests underlying pulmonary arterial hypertension. Pulmonary edema has markedly improved compared to the prior study. Small right pleural effusion is unchanged. Again bibasilar opacifications are noted and are suggestive of atelectasis or consolidation with a small pneumothorax on the left side. Impression: 1. Unchanged bibasilar opacities are consistent with atelectasis or consolidation and pneumonia should be considered in the appropriate clinical context. 2. Moderately improved pulmonary edema. | ['Change severity', 'Add typo', 'False prediction'] |
| 28c17b79-14a8e7a1-14591313-2a68d678-39106288, f8e1f272-c87c4a00-60025a33-09d9a7ea-c1125ac6 | 57873452 | 10268877 | Findings: As compared to the previous radiograph, the monitoring and support devices are constant in position. The pre-existing right basal opacity, with maximum in the infrahilar area, is not substantially changed. On the left, there is decreased visibility of the left hemidiaphragm, suggesting the appearance of either atelectasis or small left pleural effusion. Unchanged moderate cardiomegaly. The right costophrenic sinus is unremarkable. | Findings: As compared to the previous radiograph, the monitoring and support devices are constant in position. The pre-existing left basal opacity, with maximum in the infrahilar area, is not substantially changed. On the left, there is decreased visibility off the left hemidiaphragm, suggesting the appearance of either atelectasis or small left pleural effusion. There is an ET tube in place. The right moderate cardiomegaly. The left costophrenic sinus is unremarkable. | ['Change location', 'Change to homophone', 'Add medical device'] |
| d6010cbd-efa41b72-2fbc0daf-8fa1dc40-bdd4fe35 | 57976739 | 10268877 | Findings: An endotracheal tube, NG tube, and right upper extremity PICC with its tip at the cavoatrial junction are unchanged. There is no change in left lower lobe opacity. There is no large pleural effusion, or pneumothorax. The cardiac silhouette remains moderately enlarged, mediastinal contours are notable for calcification of the aortic arch. Impression: Mild residual retrocardiac opacification remains, pneumonia vs. atelectasis. | Findings: An endotracheal tube, NG tube, and right upper extremity PICC with its tip at the mid SVC are unchanged. There is no change in left lower lobe opacity. There is no large pleural effusion, or pneumothorax. The cardiac silhouette remains moderately enlarged, mediastinal contours are notable for calcification of the aortic ark. Impression: Mild residual retrocardiac opacification remains. | ['Change position of device', 'Change to homophone', 'False negation'] |
| 95efb462-e05c1ac9-3c5319d6-bafdcede-df6db042 | 58267855 | 10268877 | Findings: Comparison is made to the prior study performed two hours earlier. Interval placement of a nasogastric tube, whose distal tip and sideport are below the gastroesophageal junction. Endotracheal tube and right IJ central line are in unchanged position. There is persistent cardiomegaly. There is a left retrocardiac opacity. There is prominence of the pulmonary vascular markings, consistent with mild pulmonary edema. There is some atelectasis at the left lung base. | Findings: Comparison is made to the prior study performed too hours earlier. Interval placement of a Foley catheter, whose distal tip and sideport are below the gastroesophageal junction. Endotracheal tube and right subclavian line are in unchanged position. There is moderate pleural effusion in the left lung. There is a left retrocardiac opacity. There is prominence of the pulmonary vascular markings, consistent with mild pulmonary edema. There is some atelectasis at the right lung base. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| f2ea048e-52ada468-199a5a64-06f14cb3-76e57312 | 59301985 | 10268877 | Findings: Single AP portable chest radiograph is obtained. Tracheostomy tube is present. There is no pneumothorax or pleural effusion. There is a hazy veil-like opacity in the right upper lung zone which may be consolidation, atelectasis or artifact. Heart size appears enlarged; however, this may be technical due to AP view. Bony structures are intact. Impression: Limited study with hazy opacity in the right upper and mid lungs which may be infectious in etiology, atelectasis or artifact. | Findings: Single AP portable chest radiograph is obtaned. Tracheostomy ultrasound is present. There is no pneumothorax or pleural effusion. There is no veil-like opacity in the lung. Heart size appears enlarged; however, this may be technical due to AP view. Bony sturctures are intact. Impression: Limited study with hazy opacity in the right upper and mid lungs which may be infectious in etiology, atelectasis or artifact. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 4a0397d2-1c7cac8d-bd1e1991-d3459191-3e510506, 4e60f3da-37ed157d-a469a568-0b2ee907-4b01c924 | 53356050 | 10274145 | Findings: Chest PA and lateral radiograph demonstrates unchanged cardiomediastinal and hilar contours. No overt pulmonary edema is evident though chronic mild interstitial abnormalities are stable. Faint opacification projecting over the left mid lung may represent developing infectious process. There is no definitive correlate on the lateral radiograph. No pleural effusion or pneumothorax present. Mild separation of superior aspect of sternotomy line with intact sternotomy sutures. Impression: Faint increased opacification in left mid lung may indicate developing infectious process. Could further evaluate with right anterior oblique view to further evaluate lung. | Findings: Chest PA and lateral radiograph demonstrates unchanged cardiomediastinal and hilar contours. No overt pulmonary edema is evident though chronic mild interstitial abnormalities are stable. Moderate opacification projecting over the left mid lung may represent developing infectious process. There is no overt pulmonary edema is evident though chronic mild interstitial abnormalities are stable. There is no definitive correlate on the lateral radiograph. No pleural effusion or pneumothorax present. A central venous line is seen in the right subclavian vein. Impression: Faint increased opacification in left mid lung may indicate developing infectious process. Could further evaluate with right anterior oblique view to further evaluate lung. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| 7b43b8ff-190d3ca9-03cfbbd3-45ad3d0d-72d06c1c | 56140866 | 10274145 | Findings: Two images of the chest shows a small consolidation at the right base, most consistent with pneumonia. There are no other consolidations. There is no evidence of interstitial edema. There are no pleural effusions. The heart size is at the upper limits of normal. The mediastinal contours are normal. There are sternotomy wires in place. Impression: Consolidation in the right base is most consistent with pneumonia. Results were communicated with Dr. ___ at 11:10 a.m. on ___ via telephone by Dr. ___. | Findings: Two images of the chest shows a large consolidation at the right base, most consistent with pneumonia. There are no other consolidations. There is no evidence of interstitial edema. There are no pleural effusions. The heart size is at the upper limits of normal. The mediastinal contours are normal. There are sternotomy wires in place. There are sternotomy wires in place. Impression: No consolidation seen. Results were communicated with Dr. ___ at 11:10 a.m. on ___ via telephone by Dr. ___. | ['Change severity', 'Add repetitions', 'False negation'] |
| 638f2c7f-1ddfe2c3-062f8057-b3e8a5aa-17b03955, b863ce69-7e0670b3-3c5a3a29-b96b7248-a616113c | 58307391 | 10274145 | Impression: No acute intrathoracic process. | Impression: There is a small pleural effusion. | ['False negation', 'Change to homophone', 'False prediction'] |
| 2cc38dd6-d1f5970f-055155bc-e9e8fccd-8ec98168 | 59166131 | 10274145 | Findings: The previously seen right lower lobe opacification has decreased substantially. There has also been a mild decrease in the amount of vascular engorgement suggesting improvement in mild biventricular heart failure. In retrospect, given the rapid change, the opacification likely represented fluid overload. The heart size is at the upper limits of normal. The sternal wires are intact and midline. There is longstanding midline lucency in the manubrium and upper body is due to incomplete sternal fusion; there is no evidence of other incision complications. A PICC can be traced to the mid SVC. Impression: 1. Mild improvement of pulmonary vascular congestion. 2. Less opacification at the right lower; no evidence of pneumonia on today's radiograph. Results were communicated with the surgery team by Dr. ___. | Findings: The previously seen right lower lobe opacification has decreased substantially. There has also been a mild decrease in the amount of vascular engorgement suggesting improvement in mild biventricular heart failure. In retrospect, given the rapid change, the opacification likely represented fluid overload. The heart size is at the upper limits of normal. The sternal wires are intact and midline. There is longstanding midline lucency in the manubrium and upper body is due to incomplete sternal fusion; there is no evidence of other incision complications. A central line can be traced to the mid SVC. Impression: 1. Mild improvement of pulmonary vascular congestion. 2. No opacification. Results were communicated with the surgery team by Dr. ________. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 09bcae55-47d8afaa-5cd21ca4-2cc83c46-d432bd6d | 50879902 | 10402372 | Findings: As compared to the previous radiograph, there is a subtle but new opacity at the right lung base, in the medial aspect of the lung. The opacities located in an area of bronchiectasis. Given the clinical presentation, pneumonia must be suspected. The referring physician, ___. ___ was paged for notification at the time of dictation, 3:18 p.m. on ___ and the findings were discussed over the telephone. Otherwise, the radiograph is unchanged, extensive overinflation with bronchiectasis but no pleural effusions or other parenchymal changes. Normal size of the cardiac silhouette. Unchanged position of the nasogastric tube. | Findings: As compared to the previous radiograph, there is a subtle but new opacity at the left lung base, in the medial aspect of the lung. The opacities located in an area of bronchiectasis. Given the clinical presentation, pneumonia must be suspected. The referring physician, ___. The opacities located in an area of bronchiectasis. ___ was paged for notification at the time of dictation, 3:18 p.m. on ___ and the findings were discussed over the telephone. Otherwise, the radiograph is unchanged, extensive overinflation with bronchiectasis but no pleural effusions or other parenchymal changes. There is a small left pleural effusion. Unchanged position of the nasogastric tube. | ['Change location', 'Add repetitions', 'False prediction'] |
| 8797515b-595dfac0-77013a06-226b52bd-65681bf2, b5da9d38-5e0c570b-e88b17c1-029654a9-a4f8a0b3 | 51966612 | 10402372 | Findings: Frontal and lateral views of the chest are obtained. The lungs remain hyperinflated, suggesting chronic obstructive pulmonary disease. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Hilar contours are also stable. Impression: No acute cardiopulmonary process. No significant interval change. Please note that peribronchovascular ground-glass opacities at the left greater than right lung bases seen on the prior chest CT of ___ were not appreciated on prior chest radiography on the same date and may still be present. Additionally, several pulmonary nodules measuring up to 3 mm are not not well appreciated on the current study-CT is more sensitive. | Findings: Frontal and lateral views of the chest are obtaned. The lungs remain hyperinflated, suggesting chronic obstructive pulmonary disease. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Hilar contours are also stable. Multiple scatter nodular lesions are noted in bilateral lung fields. Impression: No acute cardiopulmonary process. No significant interval change. Please note that peribronchovascular ground-glass opacities at the left greater than right lung bases seen on the prior chest CT of ___ were not appreciated on prior chest radiography on the same date and may still be present. Additionally, several pulmonary nodules measuring up to 4 mm are not not well appreciated on the current study-CT is more sensitive. | ['Change measurement', 'Add typo', 'False prediction'] |
| 917859c3-e459ee3b-965451a4-1d4a3e3b-cdbac544 | 52241282 | 10402372 | Impression: AP chest compared to ___: Bronchial wall thickening or peribronchial infiltration in the lower lungs where most pronounced bronchiectasis is have worsened since ___ consistent either with a flare of bronchiectasis or development of peribronchial pneumonia. Heart size is normal. There is no pleural effusion, no pneumothorax. Feeding tube ends in the upper stomach. | Impression: AP chest compared to ___: Bronchial wall thickening or peribronchial infiltration in the lower lungs where most pronounced bronchiectasis is have worsened since ___ consistent either with a flare of bronchiectasis or development of peribronchial pneumonia. Heart size is normal. There is no pleural effusion, no pneumothorax. There is no pleural effusion, no pneumothorax. Feeding tube ends in the lower esophagus. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 1bfd4f62-e1254bfb-54b0a6ac-29453546-2c0e7100 | 52824884 | 10402372 | Impression: 1. Dobbhoff feeding tube is seen coursing below the diaphragm with the tip not completely identified but positioned within the stomach proximally. It does not appear to be significantly changed. Bilateral lower lobe bronchiectasis is stable. No focal airspace consolidation is seen to suggest an acute pneumonia. No pleural effusions or pneumothoraces. Overall, cardiac and mediastinal contours are unchanged. Lungs remain hyperinflated. | Impression: 1. Dobbhoff feeding tube is seen coursing below the diaphragm with the tip not identified but positioned near the stomach proximally. It does not appear to be significantly changer. No bronchiectasis is seen. No focal airspace consolidation is seen to suggest an acute pneumonia. No pleural effusions or pneumothoraces. Overall, cardiac and mediastinal contours are unchanged. Lungs remain hyperinglated. | ['Change position of device', 'Add typo', 'False negation'] |
| b4220d24-884a0275-1552d547-a339b365-4417b9d5 | 54715839 | 10402372 | Impression: PA and lateral chest compared to ___ through ___, extent of peribronchial thickening and impaction of extensive bibasilar bronchiectasis may have increased slightly since the most recent prior lateral chest radiograph, ___. There is really no change in the appearance of the frontal views as recently as ___. Generalized hyperinflation is due to emphysema. Heart size is normal. There is no pulmonary edema, consolidation. A tiny right pleural effusion may be new, but probably not clinically significant. Findings would therefore be attributed to decompensation of emphysema and bronchiectasis. | Impression: PA and lateral chest compared to ___ through ___, extent of peribronchial thickening and impaction of extensive bibasilar bronchiectasis may have increased moderately since the most recent prior lateral chest radiograph, ___. There is really no change in the appearance of the frontal views as recently as ___. Mild hyperinflation is due to emphysema. Heart size is normal. There is no pulmonary edema, consolidation. A tiny right pleural effusion may be new, but probably not clinically significant. Findings would therefore be attributed to decompensation of emphysema and no bronchiectasis. | ['Change severity', 'Add contradiction', 'False negation'] |
| 510e2767-2a04a9c8-afb492f8-57d38e8e-75d5d488, 5db0c1c9-ed5d119d-aaad1f9a-7c0edc05-e53df1c9 | 56446284 | 10402372 | Findings: Review of frontal and lateral views were remarkable for bilateral lower lung bronchiectasis with peribronchial opacities. In the right lower and medial lung, peribronchial opacities have improved since ___. There are no new opacities. Lungs are mildly hyperinflated. Heart size, mediastinal and hilar contours are normal. No pleural effusion. Impression: Bilateral lower lobe bronchiectasis with improved right lower medial lung peribronchial consolidation. | Findings: Review of frontal and laterel views were remarkable for bilateral lower lung bronchiectasis with peribronchial opacities. No bronchiectasis seen. Ther are no new opacities. Lungs are mildly hyperinflated. Heart size, mediastinal and hilar contours are normal. No pleural effusion. Impression: No bronchiectasis. | ['Change location', 'Add typo', 'False negation'] |
| 416b3f78-42417756-a0ba04e9-a8248885-a0e040a9, 840febf0-f7f07a57-33f1bfa8-6a02494a-8dc4cb09 | 56711198 | 10402372 | Findings: As compared to the previous radiograph, there is no relevant change. Moderate-to-severe overinflation with known areas of bronchiectasis and perifocal parenchymal opacities. The opacities are unchanged in distribution and severity. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No newly appeared focal parenchymal changes. | Findings: As compared to the previous radiograph, there is no relevant change. Mild-to-moderate overinflation with known areas of bronchiectasis and perifocal parenchymal opacities. The opacities are unchanged in distribution and severity. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No newly appeared focal parenchymal changes. As compared to the previous radiograph, there is no relevant change. Placement of central venous line noted. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| 080eb78a-c3c3f369-1eaacd39-7f6cc416-8810586c | 57949791 | 10402372 | Impression: AP chest compared to ___: Feeding tube, now without the wire stylet ends in the same place, upper stomach. The apex and lateral right lower hemithorax are excluded from this examination. Remaining pleural surfaces are normal and the imaged lungs show no pneumonia or edema, but there are several small nodules and bronchiectasis in the right lower lobe. | Impression: AP chest compared to ___: Feeding tube, now without the wire stylet ends in the same place, upper esophagus. The apex and lateral right lower hemithrox are excluded from this examination. Remaining pleural surfaces are normal and the imaged lungs show no pneumonia or edema, but there are several small nodules and bronchiectasis in the right lower lobe. A peripherally inserted central catheter (PICC) is noted with the tip in the right atrium. | ['Change position of device', 'Add typo', 'Add medical device'] |
| 34fcf711-355f24f3-53a8dbc6-97730735-1d046d5a, d9178fb7-5642042d-3553ab93-d4002d32-a1a9a012 | 58117612 | 10402372 | Impression: PA and lateral chest compared to ___: Slight hyperinflation, chest CTA prior to surgery did not show emphysema. It did show mild to moderately severe bronchiectasis, particularly in the left lower lobe. Postoperatively, left lower lobe consolidation is probably due to atelectasis, stable since ___. There is new peribronchial opacification on the right, conceivably aspiration. Exacerbation of bronchiectasis is another possibility. There is no pulmonary edema, and the upper lungs are clear. Tiny left pleural effusion is of no clinical significance. Heart size is normal. | Impression: PA and lateral chest compared to ___: Slight hyperinflation, chest CTA prior to surgery did not show emphysema. It did show mild to severe bronchiectasis, particularly in the left lower lobe. Postoperatively, left lower lobe consolidation is probably due to atelectasis, stable since ___. There is new perihilar opacification on the right, conceivably aspiration. Exacerbation of bronchiectasis is another possibility. There is no pulmonary effusion, and the upper lungs are clear. Tiny left pleural effusion is of no clinical significance. Heart size is large. | ['Change severity', 'Change to homophone', 'False prediction'] |
| c09a6b81-3118c102-3127bf27-987bd433-7114e2d1, c4713b43-d31ad200-30f7309b-ba7d87e3-b69db479 | 58736291 | 10402372 | Findings: No focal consolidation, pleural effusion, or pneumothorax is seen. Heart and mediastinal contours are within normal limits. Lungs are again noted to be hyperinflated. Impression: Stable chest radiographs without acute change. | Findings: Know focal consolidation, pleural effusion, or pneumothorax is scene. Heart and mediastinal contours are within normal limts. Lungs are again noted to be hyperinflated. A central venous line is present. Impression: Stable chest radiographs without aacute change. | ['Change to homophone', 'Add typo', 'Add medical device'] |
| 2ae8ec41-067f24d2-3f3ea6b7-113cb63b-aa3cc9e0, 3a482f4e-16d6aea0-57ca6763-e23182b9-ae66b9e9 | 59239338 | 10402372 | Findings: In comparison with the study of ___, there is little overall change in the peribronchial thickening and impaction with extensive bibasilar bronchiectasis. This is again extremely well seen on the lateral radiograph. Hyperexpansion of the lungs is consistent with emphysema and the cardiac size is normal. No evidence of pulmonary edema. No evidence of acute focal pneumonia. Impression: Little change in the severe bronchiectasis and emphysema. | Findings: In comparison with the study of ___, there is little overall change in the peribronchial thickening and impaction with extensive bibasilar bronchiectasis. This is again extremely well seen on the lateral radiograph. Hyperexpansion of the lungs is consistent with severe emphysema and the cardiac size is normal. No evidence of pulmonary edema. No evidence of acute focal pneumonia. The presence of a right-sided central venous line is noted. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| 20f54ecb-20a32ed8-5f27bfe6-e9d07de1-ce76357e, 271ab9c9-419a0db3-215b585b-1c874aad-7c04a49d | 53850317 | 10410641 | Findings: PA and lateral views of the chest are compared to previous chest x ray from ___ and chest ct from ___. There is a large right lower lung opacity, compatible with pleural effusion. Given relatively mild mediastinal shift to the left, there must be components of atelectasis in the right lower and right middle lobes with possible superimposed consolidation. The right upper lobe is grossly clear. Small left pleural effusion is also seen; however, the left lung remains grossly clear. There is a rounded density projecting in the retrosternal clear space on the lateral. Cardiomediastinal silhouette is difficult to assess, however, is slightly shifted towards the left. Osseous and soft tissue structures are unremarkable. Impression: New large right-sided pleural effusion with underlying atelectasis and possible consolidation in the middle and lower lobes. CT scan may offer additional detail of underlying parenchymal abnormalities. Small left-sided pleural effusion. | Findings: PA and lateral views of the chest are compared to previous chest x ray from ___ and chest ct from ___. There is a large right lower lung opacity, compatible with pleural effusion. Given relatively severe mediastinal shift to the left, there must be components of atelectasis in the right lower and right middle lobes with possible superimposed consolidation. The right upper lobe is grossly clear. Small left pleural effusion is also seen; however, the left lung remains diffusely clear. There is a rounded density projecting in the retrosternal clear space on the lateral. Cardiomediastinal silhouette is difficult to assess, however, is slightly shifted towards the right. Osseous and soft tissue structures show the presence of a central venous line. Impression: New small right-sided pleural effusion with underlying atelectasis and possible consolidation in the middle and lower lobes. CT scan may offer additional detail of underlying parenchymal abnormalities. Small left-sided pleural effusion. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| 74ab0576-165250aa-5fedc1a0-3f75f2c6-9f87fa70 | 56031350 | 10410641 | Findings: There is a right pleural effusion, the size of which is difficult to ascertain. There is unchanged bilateral lower lobe and right middle lobe collapse. The small left pleural effusion is unchanged. There is no pulmonary vascular congestion or pneumothorax. The cardiac and mediastinal contours are not well visualized. Impression: Stable large right pleural effusion and increasing left pleural effusion. Feasibility of of thoracentesis would best be evaluated with decubitus films. Ultrasound guidance can also be considered. | Findings: There is a right pleural effusion, the size of which is difficult to ascertain. There is unchanged bilateral lower lobe and right middle lobe collapse. The large left pleural effusion is unchanged. There is no pulmonary vascular congestion or pneumothorax. The cardiac and mediastinal contours are not well visualized. A central venous line is present. Impression: Stable small right pleural effusion and increasing left pleural effusion. Feasibility of of thoracentesis would best be evaluated with decubitus films. Ultrasound guidance can also be considered. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| 5644c5de-1ae5b48c-edb63079-e8230bfa-79dfbf13 | 56839020 | 10410641 | Findings: Single portable view of the chest is compared to previous exam from ___. When compared to prior, there has been significant interval enlargement of bilateral pleural effusions which are now moderate in size. Underlying airspace disease is also possible. Superiorly, however, the lungs are grossly clear. Cardiac silhouette is difficult to assess given the size of effusions. Osseous and soft tissue structures are unchanged. Impression: Significant interval increase in the bilateral pleural effusions since prior exam with possible underlying airspace disease not excluded. | Findings: Single portable view of the chest is compared to previous exam from ___. When compared to prior, there has been significant interval enlargement of bilateral pleural effusions which are now moderate in size. Underlying airspace disease is also possible. Superiorly, however, the lungs are grossly clear. Cardiac silhouette is difficult to assess given the size of effusions. A central venous line is noted in situ.Osseous and soft tissue structures are unchanged. Impression: Significant interval increase in the bilateral pleural effusions since prior exam with possible underlying airspace disease not eluded. | ['Change location', 'Change to homophone', 'Add medical device'] |
| d471efcd-b9883de0-61154002-0ed78c74-1fe5a5e5 | 57107868 | 10410641 | Impression: Reoccurrence of right-sided pleural effusion in patient with history of pancreatic carcinoma. No radiographic evidence of CHF, cardiac enlargement or fluid overload. | Impression: Reoccurrence of left-sided pleural effusion in patient with history of pancreatic carcinoma. No radiograhic evidence of CHF, cardiac enlargement or fluid overload. No pleural effusion. | ['Change location', 'Add typo', 'False negation'] |
| 05dad5f1-e33191fc-c4063ab8-15fcf471-3f82205d | 59146650 | 10410641 | Findings: In comparison with study of ___, there is a Pleurx catheter in place. No evidence of pneumothorax. Bibasilar opacification is consistent with atelectasis and effusion. Indistinctness of pulmonary vessels is consistent with elevated pulmonary venous pressure. | Findings: In comparison with study of ___, there is a Pleurx catheter terminating at the left pleural space. No evidence of pneumothorax. No opacification is seen. Indistinctness of pulmonary vessels is consistent with elevated pulmonary venial pressure. | ['Change position of device', 'Change to homophone', 'False negation'] |
| 380fda55-d2283afd-511dcad7-803d3b6a-ed8c6b64, 8710a9ad-589288a8-7983c163-56388801-14daa160 | 59980986 | 10410641 | Findings: There is a mild-to-moderate left pneumothorax with rightward mediastinal shift more apparent than on portable chest radiograph at 2:26 p.m. The small right pneumothorax is stable. There is also a moderate left pleural effusion. Bilateral pigtail catheters are in place. The heart size remains normal. There is no focal consolidation. Impression: 1. New mild-to-moderate left pneumothorax with mild rightward shift of the mediastinum. 2. Stable right pneumothorax. 3. Moderate left pleural effusion. The case was discussed by Dr. ___ with Dr. ___. | Findings: There is a mild-to-moderate left pneumothorax with rightward mediastinal shift more apparent than on portable chest radiograph at 2:26 p.m. The small right pneumothorax is stable. There is also a moderate left pleural effusion. Bilateral pigtail catheters are in place. The heart size remains normal. There is no focal constipation. Impression: 1. New mild-to-moderate right pneumothorax with mild rightward shift of the mediastinum. 2. Stable right pneumothorax. 3. Moderate left pleural effusion. The case was discussed by Dr. ___ with Dr. ___. A central venous line is noted. | ['Change location', 'Change to homophone', 'Add medical device'] |
| 397252c6-f7b6111e-367341df-b8fc523c-599cfcbd | 50277921 | 10439781 | Impression: AP chest compared to ___ through ___: Feeding tube with a wire stylet in place passes into the stomach and out of view. Comparing today's examination with many chest radiographs since ___, it looks like there is a mild degree of pulmonary edema superimposed on chronic interstitial lung disease. Specifically, on ___ the interstitial abnormality is comparable to that on ___, whereas at other times there has been at least a component of acute pulmonary edema. Today, the findings are very similar to ___. Severe cardiomegaly and pulmonary vascular plethora are chronic. Left subclavian infusion port ends in the mid-to-low SVC. Pleural effusion, if any, is minimal and there is no pneumothorax. | Impression: AP chest compared to ___ through ___: Feeding tube with a wire stylet in place passes into the stomach and out of view. Comparing today's examination with many chest radiographs since ___, it looks like there is a mild degree of pulmonary edema superimposed on chronic interstitial lung disease. Specifically, on ___ the interstitial abnormality is comparable to that on ___, whereas at other times there has been at least a component of acute pulmonary edema. Today, the findings are very similar to ___. Cardiomegaly and pulmonary vascular plethora are chronic. Left subclavian infusion port ends in the mid-to-low SVC. Pleural effusion, if any, is minimal and there is no pneumothorax. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 58c735ba-cc7d2492-f290f622-154bc6f2-5fdc853c, 91623d3d-e82bd37b-a89a94ab-6a69e4ac-8e679081 | 50501762 | 10439781 | Findings: AP upright and lateral chest radiographs were obtained. Known interstitial lung disease contributes to a bilateral perihilar interstitial abnormality. In addition to the chronic findings there is bilateral ground-glass opacity and interstitial thickening, predominantly radiating from the hila. Cardiomegaly remains moderate. Aortic arch calcifications are unchanged. A right-sided PICC line terminates in the low SVC. A left chest Port-A-Cath terminates in the right atrium. Vertebroplasty changes are stable. Impression: New pulmonary parenchymal abnormalities on top of chronic pulmonary fibrosis most likely represents pulmonary edema. Infection is less likely. | Findings: AP upright and lateral chest raidiographs were obtained. Known interstitial lung disease contributes to a bilateral perihilar interstitial abnormality. In addition to the chronic findings there is bilateral ground-glass opacity and interstitial thickening, predominantly radiatnig from the hila. Cardiomegaly remains modrate. Aortic arch calcifications are unchanged. A right-sided PICC line terminates in the intenal jugular vein. A left chest Port-A-Cath terminates in the lower SVC. Vertebroplasty changes are stable with small right pleural effusion. Impression: New pulmonary parenchymal abnormalities on top of chronic pulmonary fibrosis most likely represents pulmonary edema. Right lower lobe consolidation is present, infection is less likely. | ['Change position of device', 'Add typo', 'False prediction'] |
| 1d74ca1d-12ac2785-bd84a322-376f04bc-b9fdaa99 | 51129150 | 10439781 | Impression: Superimposed pulmonary edema on a background of pulmonary fibrosis. Low lung volumes limit assessment for basilar consolidation. | Impression: No pulmonary fibrosis. Low lung volmes limit assessment for basilar consolidation. There is a probable right-sided pleural effusion. | ['False negation', 'Add typo', 'False prediction'] |
| 3d0754cf-6b313d54-5c41bc32-9f042b6f-4f2f7051 | 51441976 | 10439781 | Findings: In comparison with study of ___, there is little overall change. Substantial cardiomegaly with bilateral opacifications most likely reflecting pulmonary edema. The possibility of supervening pneumonia would have to be raised in the appropriate clinical setting. Central catheter remains in place. Slight impression on the lower cervical trachea on the right could possibly represent a small thyroid mass. | Findings: In comparison with study of ___, there is little overall change. Severe cardiomegaly with bilateral opacifications most likely reflecting pulmonary edema. The possibility of supervening pneumonia would have to be raised in the appropriate clinical setting. Central catheter remains in place. Slight impression on the lower cervical trachea on the right could possibly represent a small thyroid mass. Central catheter remains in place. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| 5fb4fd93-f41ffe10-432dff5b-080386a2-de609585 | 52077644 | 10439781 | Findings: As compared to the previous radiograph, there is unchanged evidence of moderate-to-severe pulmonary edema. However, the interstitial component of the edema is more prominent on the current image. The presence of a small pleural effusion cannot be excluded. Unchanged mild cardiomegaly. Unchanged position of the left pectoral Port-A-Cath. | Findings: As compared to the previous radiograph, there is unchanged evidence of moderate-to-severe pulmonary edema. However, the interstitial component of the edema is more prominent on the current image. The presence of a small pleural effusion is seen. Unchanged mild cardiomegaly. Unchanged position of the left pectoral Port-A-Cath. The endotracheal tube is in place with its tip located approximately 5 cm above the carina. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| d7aa2bc3-c5a89fbe-b2bb2639-e86d470f-036506f5, da9141f6-6ff1eb67-eb4df992-68b342ae-4a15b62d | 52737492 | 10439781 | Findings: Moderate to severe pulmonary edema is increased from the prior examination. No focal consolidation to suggest pneumonia is seen. No significant pleural effusion or pneumothorax is present. There is moderate cardiomegaly. A left-sided port is unchanged. There are multiple vertebroplasties. | Findings: Mild to severe pulmonary edema is increased from the prior examination. No focal consolidation to suggest pneumonia is seen. No significant pleural effusion or pneumothorax is present. No cardiomegaly. A left-sided port is unchanged. There are multiple vertebroplasties. There are multiple vertebroplasties. | ['Change severity', 'Add repetitions', 'False negation'] |
| d43639b5-bec0c47c-8415bea0-3a2f74e5-627c89d4 | 52831202 | 10439781 | Findings: In comparison with the study of ___, there is little overall change. Again there is substantial cardiomegaly with bilateral opacifications that most likely represent pulmonary edema. More focal opacification at the right base medially could represent a developing consolidation. | Findings: In comparison with the study of ___, there is little overall change. Again there is substantial cardiomegaly with bilateral opacifications that most likely represent pulmonary edema. More focal opacification at the left base medially could represent a developing consolidation. Overall, the heart size is within normal limits. | ['Change location', 'Add contradiction', 'False negation'] |
| 14e120dd-c09a8900-5ff950e9-0e2fe5bc-17cb2b3e, 86d7a0e2-a6e5e874-ed2fed4c-1c2ffbf1-4f1621e3 | 53479699 | 10439781 | Impression: PA and lateral chest compared to ___: Heterogeneous pulmonary opacification has worsened in both lungs. This is largely pulmonary edema, but more focal abnormalities in the axillary portion of the left lung and at the right lung base could be concurrent pneumonia. In addition, chest radiographs from ___ suggest concurrent substantial interstitial lung disease. Mild-to-moderate cardiomegaly is stable. Endotracheal tube is no less than 2 cm from the carina, with the chin in neutral position. Care must be taken that it not advance inadvertently. A left subclavian infusion port ends in the right atrium. Dr. ___ was paged at the time of dictation. | Impression: PA and lateral chest compared to ___: Heterogeneous pulmonary opacification has worsened in both lungs. This is largely pulmonary edema, but more focal abnormalities in the axillary portion of the left lung and at the right lung base could be concurrent pneumonia. In addition, chest radiographs from ___ suggest concurrent substantial interstitial lung disease. Mild-to-moderate cardiomegaly is stable. Dual-chamber pacemaker is no less than 2 cm from the carina, with the chin in neurtal position. Care must be taken that it not advance inadvertently. A left subclavian picc line ends in the right atrium. Dr. ___ was paged at the time of dictation. | ['Change name of device', 'Add typo', 'False negation'] |
| 5eae8395-ea7af71c-6d518498-6d193886-1c2d0853 | 53567394 | 10439781 | Findings: As compared to previous radiograph, the patient has been extubated. Otherwise, there is no relevant change. The bilateral massive parenchymal opacities are constant, constant moderate cardiomegaly. | Findings: As compared to previous radiograph, the patient has been extubated. Otherwise, there is no relevant change. The bilateral massive parenchymal opacities are constant, constant massive cardiomegaly. There is a pacemaker in situ. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| 2e5ac89a-e2d5d8c6-8cbf02bc-ec6e4725-9339a9cc | 55725911 | 10439781 | Findings: In comparison with the study of ___, the degree of pulmonary vascular congestion may have slightly decreased in this patient with continued substantial enlargement of the cardiac silhouette. The possibility of supervening interstitial lung disease is difficult to assess on plain radiograph, but was apparent on the CT study of ___. No acute focal pneumonia. Central catheter remains in place. Impression: Some improvement in still prominent pulmonary vascular congestion. | Findings: In comparison with the study of ___, the degree of pulmonary vascular congestion may have slightly decreased in this patient with continued substantial enlargement of the cardiac silhouette. The possibility of supervening interstitial lung disease is difficult to assess on plain radiograph, but was apparent on the CT study of ___. No acute focal pneumonia. Central catheter extends into the right ventricle. Central catheter remains in place. Impression: Some improvement in still prominent pulmonary vascular congestion. Pacemaker is present. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 3ea6406a-214fd5a4-1e6e4b0e-195445b8-1ea913b3, 8213973a-4ae791c1-ff080394-69e53e74-8e6d3813 | 55811525 | 10439781 | Findings: Frontal and lateral views of the chest were obtained. Left-sided Port-A-Catheter is similar in position, terminating at the cavoatrial/right atrial junction. Patient has diffuse increase in interstitial markings bilaterally consistent with patient's underlying history of chronic interstitial lung disease with likely overlying pulmonary edema improved since ___, but similar in appearance as compared to ___. No definite focal consolidation or pleural effusion. Multilevel vertebroplasties are seen along the thoracic spine, similar to prior. Impression: Pulmonary edema superimposed on known lung fibrosis. | Findings: Frontal and lateral views of the chest were obtained. Left-sided Port-A-Catheter terminates in the mid SVC. Patient has a sharp decrease in interstitial markings bilaterally consistent with patient's underlying history of chronic interstitial lung disease with likely overlying pulmonary edema improved since ___, but similar in appearance as compared to ___. Bibasilar subsegmental atelectasis is noted. Multilevel vertebroplasties are seen along the thoracic spine, similar to prior. Impression: No evidence of pulmonary edema superimposed on known lung fibrosis. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| fd8df0f3-08320e37-c337efdf-505d4348-76e89a9e | 56140154 | 10439781 | Findings: There has been improvement in mild-to-moderate pulmonary edema with decreased interstitial markings compared to most recent prior study. Small bilateral pleural effusions have resolved. There is no focal consolidation or pneumothorax. Heart size is moderately enlarged and stable. A left chest wall Port-A-Cath terminates in the RA. The patient is status post multiple vertebroplasties. Impression: Improved but not resolved mild-to-moderate pulmonary edema. | Findings: There has been improvement in mild-to-moderate pulmonary edema with decreased interstitial markings compared to most recent prior study. Small bilateral pleural effusions have resolved. There is no focal consolidation or pneumothorax. Heart size is moderately enlarged and stable. A left chest wall Port-A-Cath terminates in the mid SVC. A left chest wall Port-A-Cath terminates in the mid SVC. A new pacemaker is in place. The patient is status post multiple vertebroplasties. Impression: Improved but not resolved mild-to-moderate pulmonary edema. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| cbf70dce-197f82f4-7b8613a7-c0b0b099-d1de4726, ffa27b68-fa32bc2b-9197ec90-33bf30ae-8bea837b | 56498272 | 10439781 | Findings: Frontal and lateral views of the chest were obtained. Cardiomegaly is mild, similar to prior. Prominent interstitial lung markings are compatible with known lung fibrosis. Indistinct pulmonary vascular markings are similar to prior and compatible with mild pulmonary edema. No focal consolidation, pleural effusion, or pneumothorax. The catheter of the left chest wall port terminates in the right atrium. Multiple vertebroplasties are similar to prior. No displaced rib fracture is identified. Impression: Mild pulmonary edema superimposed on known lung fibrosis. Severe chronic cardiomegaly and pulmonary hypertension. No displaced rib fracture. Multiple vertebroplasties, similar to prior. | Findings: Frontal and lateral views of the chest were obtained. Cardiomegaly is mild, similar to prior. Prominent interstitial lung markings are compatible with known lung fibrosis. Indistinct pulmonary vascular markings are similar to prior and compatible with mild pulmonary edema. No focal consolidation, pleural effusion, or pneumothorax. The chest tube of the left chest wall port terminates in the right atrium. Multiple vertebroplasties are similar to prior. No displaced rib fracture is identified.Clinical note: An NG tube is present with its tip in the stomach.Impression: Mild pulmonary edema superimposed on known lung fibrosis. Severe chronic cardiomegaly and pulmonary hypertension. No displaced rib fracture. Multiple vertebroplasties, similar to prior. Findings indicative of significant acute cardiomegaly. | ['Change name of device', 'Add contradiction', 'Add medical device'] |
| 2883541d-6a242b68-0838ecc7-5cd20cbf-133ec77b, 2bd79f61-da184ac4-7311c0ac-3f0af71f-65418141 | 56925922 | 10439781 | Findings: A Port-A-Cath terminates in the upper right atrium. The cardiac, mediastinal and hilar contours appear unchanged. Fine reticulation associated with pulmonary fibrosis appears very similar within each lung in extent and distribution with no significant superimposed change. The lung volumes are low. There is no pleural effusion or pneumothorax. Multiple compression deformities including lower thoracic vertebroplasties appear unchanged. Impression: No evidence of acute disease. Severe pulmonary fibrosis, not significantly changed. | Findings: A Port-A-Cath terminates in the upper right atrium. The cardiac, mediastinal and hilar contours appear unchanged. Fine reticulation associated with pulmonary fibrosis appears very similar win each lung in extent and distribution with no significant superimposed change. The lung volumes are low. There is no pleural effusion or pneumothorax. Multiple compression deformities including lower thoracic vertebroplasties appear unchanged. Presence of a central venous line with tip in the superior vena cava. Impression: No evidence of acute disease. Severe pulmonary fibrosis, not significantly changed. | ['Change name of device', 'Change to homophone', 'Add medical device'] |
| 609ca0e0-3dcbf65f-38322c64-03e4fea0-3faa3a90, ca9c23fa-7ce50ff3-f17c9e8e-6e334bd7-76fea55e | 52837403 | 10449297 | Findings: AP upright and lateral views of the chest were obtained. Elevated right hemidiaphragm is again noted. Mild cardiomegaly is also stable. There is no focal consolidation, effusion, or overt signs of CHF. Mediastinal contour is stable. Bony structures are intact. A mild scoliosis is again noted with a superior end plate compression deformity at the thoracolumbar junction. Impression: No acute intrathoracic process. | Findings: AP upright and lateral views of the chest were obtained. Elevated right hemidiaphragm is again noted. Mild cardiomegaly is also stable. There is no focal consolidation, effusion, or overt signs of CHF. Mediastinal contour is stable. Bony structures are intact. A mild scoliosis is again noted with a superior end plate compression deformity at the thoracolumbar junction. PA upright and lateral views of the chest were obtained. Impression: Left lower lobe consolidation noted. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| 144841f5-0126909a-cde81d66-1db1375d-b3ed7127 | 56486000 | 10449297 | Findings: Lung volumes are low. Elevation of the right hemidiaphragm appears similar. Cardiomegaly is again noted. Minimal linear left basilar opacity appears similar and likely represents atelectasis. Of note, evaluation is slightly limited in the absence of lateral view. No pleural effusion or pneumothorax is seen on this single view. No focal consolidation is seen on this single view. Aortic calcifications are again noted. Radiopaque material in the left abdomen may represent previously ingested oral contrast. Impression: Stable frontal chest radiograph. Limited evaluation in the setting of single frontal view; lateral view would be helpful for more thorough evaluation. This was discussed with Dr. ___ by Dr. ___ by phone at 12:45 p.m. on ___. | Findings: Lung volumes are normal. Elevation of the right hemidiaphragm appears similar. Cardiomegaly is again notedd. Minimal linear left basilar opacity appears similar and likely represents a pleural effusion. Of note, evaluation is slightly limited in the absence of lateral view. No pleural effusion or pneumothorax is seen on this single view. Right basal consolidation is noted on this single view. Aortic calcifications are again noted. Radiopaque material in the left abdomen could indicate bowel obstruction. Impression: Progressing frontal chest radiograph. Limited evaluation in the setting of single frontal view; The left lower lobe appears consolidated; lateral view would be helpful for more thorough evaluation . This was discussed with Dr. ___ by Dr. ___ by phone at 1:45 p.m. on ___. | ['Change severity', 'Add typo', 'False prediction'] |
| 5c549479-dcb2c159-300ce6a6-b8362dc7-c43d8f1d, 655d3207-d13024d7-c94b6261-b2f2448d-6d4f566f | 56078456 | 10523725 | Findings: Frontal and lateral views of the chest. The lungs are clear of consolidation or effusion. Right pleural based thickening at the base laterally is again seen. There is no evidence of pulmonary vascular congestion. Cardiomediastinal silhouette is stable in. No acute osseous abnormality detected. Impression: No acute cardiopulmonary process. | Findings: Frontal and medial views of the chest. The lungs are clear of consolidation or effusion. Right pleural based thickening at the base laterally is again seen. There is no evidence of pulmonary vascular congestion. Cardiomediastinal silhouette is stable in. No acute osseous abnormality detected. The lungs are clear of consolidation or effusion. Impression: No pleural based thickening. | ['Change location', 'Add repetitions', 'False negation'] |
| 15021246-7240defd-a21246de-0fed22d9-fe09d00e, 8553b174-2aa2d55b-4b3dbe15-7655300b-ea62c5ae | 59223989 | 10523725 | Findings: The cardiomediastinal and hilar contours are stable. The aorta is again noted to be tortuous. The patient is status post CABG with median sternotomy wires in place. The second most superior median sternotomy wires again noted to be fractured. There is no pleural effusion or pneumothorax. The lungs are well-expanded with stable scarring at the right costophrenic angle. There is no new focal consolidation concerning for pneumonia. There is no overt pulmonary edema. The upper abdomen is unremarkable aside from surgical clips. Impression: No acute cardiopulmonary process. | Findings: The cardiomediastinal and hilar contours are stable. The aorta is again noted to be tortuous. The patient is status post CABG with median sternotomy wires in place. NG tube is seen in the lower esophagus The second most superior median sternotomy wires again noted to bee fractured. There is no pleural effusion or pneumothorax. The lungs are well-expanded with stable scarring at the right costophrenic angle. There is know new focal consolidation concerning for pneumonia. There is no overt pulmonary edema. The upper abdomen is unremarkable aside from surgical clips. Impression: No acute cardiopulmonary process. | ['Change position of device', 'Change to homophone', 'Add medical device'] |
| ef191125-3db31590-77881dc9-a6302910-7a35821f | 51742525 | 10532326 | Findings: The nasogastric tube is in adequate position and there is a resolution of the gastric distention. There is still mild bibasilar atelectasis. There are no pneumothorax no pleural effusion. The cardiac and mediastinal contour are unchanged. Impression: The nasogastric tube is in adequate position and there is resolution of the gastric distention. | Findings: The nasogastric pump is in adequate position and there is a resolution of the gastric distention. There is steel mild bibasilar atelectasis. A right-sided central venous line is in place. There are no pneumothorax no pleural effusion. The cardiac and mediastinal contour are unchanged. Impression: The nasogastric tube is in adequate position and there is resolution of the gastric distention. | ['Change name of device', 'Change to homophone', 'Add medical device'] |
| 445fdcdb-f4896587-4f3f5bf8-e3a051ad-290f10ae | 52195893 | 10532326 | Impression: Mild pulmonary edema with increased size of small to moderate right pleural effusion and right basilar opacity, possibly reflecting atelectasis but infection is not excluded. | Impression: Mild pulmonary edema with increased size of small to moderate left pleural effusion and right basilar opacity, possibly reflecting atelectasis but infection is not excluded. | ['Change severity', 'Add repetitions', 'False prediction'] |
| 0df9bbe7-ea299297-6717c3a6-4faece0e-15ca4a73, 83d40298-284d7832-cb39f63b-f6426b53-6ac3f6a7 | 53897449 | 10532326 | Findings: PA and lateral chest radiographs demonstrate low lung volumes and distended bowel as described on concurrent CT abdomen/pelvis. There are patchy opacities suggesting minor dependent bibasilar atelectasis. There is persistent cardiomegaly. There is no pneumothorax or pleural effusion. Suggestion of pulmonary venous hypertension is unchanged from prior radiograph. | Findings: PA and lateral chest radiographs demonstrate low lung volumes and distended bowel as described on concurrent CT abdomen/pelvis. There are patchy opacitites suggesting minor dependent bibasilar atelectasis. There is persistent cardiomegaly. There is no pneumothorax or pleural effusion. Suggestion of pulmonary arterial hypertension is unchanged from prior radiograph. An ET tube is noted in the trachea. | ['Change location', 'Add typo', 'Add medical device'] |
| d80a6738-8d88d0fb-04d18b57-35d87a21-0ec6ff6a | 59775769 | 10532326 | Impression: 1. Interval placement of a feeding tube, which courses below the diaphragm with the tip likely within the stomach. The patient is markedly rotated to the right, limiting evaluation of the cardiac and mediastinal contours. Overall, however, there is a more focal airspace opacity in the left mid and lower lung, which may reflect asymmetric pulmonary edema or an infectious process, less likely atelectasis. Clinical correlation is advised. Possible layering left effusion. | Impression: 1. Interval placement of a feedding tube, which courses below the diaphragm with the tip likely within the stomach. The patient is markedly rotated to the right, limiting evaluation of the cardiac and mediastinal contours. Overall, however, there is a more focal airspace opacity in the right mid and lower lung, which may reflect asymmetric pulmonary edema or an infectious process, less likely atelectasis. No evidence of layering effusion. Clinical correlation is advised. Possible layering left effusion. | ['Change location', 'Add typo', 'False negation'] |
| 3878f00f-4b737c96-dff939c5-2f24a10d-23db2293 | 50124332 | 10650001 | Findings: Portable upright view of the chest demonstrates low lung volumes. There is no pleural effusion or pneumothorax. Heart size is top normal. Hilar and mediastinal silhouettes are unchanged. There is perihilar vascular congestion. Interstitial markings are prominent, suggest possible mild interstitial pulmonary edema. Right-sided Port-A-Cath is stable position projecting over cavoatrial junction. | Findings: Portable upright view of the chest demonstrates low lung volumes. There is no pleural effusion or pneumothorax. Heart size is top normal. Hilar and mediastinal silhouettes are unchanged. There is perihilar vascular congestion. Interstitial markings are prominent, suggest possible mild interstitial pulmonary edema. Right-sided Port-A-Cath is stable position projecting over superior vena cava. An endotracheal (ET) tube terminates 3 cm above the carina. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| 6bad4c60-b2e3becf-a99801f7-aac3757c-2b669f35 | 55609649 | 10650001 | Findings: Pulmonary edema is mild and new since ___. Increased opacity at left lung base is either atelectasis and/or combination of atelectasis and edema. Left pleural effusion is presumed and small and is also new since ___. Heart size is normal. Cardiomediastinal silhouette is unremarkable. Mild-to-moderate atherosclerotic calcification is present in the aortic arch. Impression: Mild pulmonary edema and presumed small left pleural effusion, new since ___. | Findings: Pulmonary edema is mild and new since ___. Increased opacity at right lung base is either atelectasis and/or combination of atelectasis and edema. Left pleural effusion is presumed and small and is also new since ___. Heart size is normal. Cardiomediastinal silhouette is unremarkable. Mild-to-moderate atherosclerotic calcification is present in the aortic arch. Mild hyperinflation of the lungs is noted. Impression: Mild pulmonary edema and presumed small left pleural effusion, new since ___. Cardiomediastinal silhouette is unremarkable. | ['Change location', 'Add repetitions', 'False prediction'] |
| edfd806e-5c672eea-1119d9d0-44c282a8-7c3d9730 | 56172325 | 10650001 | Findings: As compared to the previous radiograph, there is complete resolution of the pre-existing pleural effusions. Unchanged moderate cardiomegaly without evidence of pulmonary edema. Small basal parenchymal scars but no evidence of recent pneumonia. Moderate tortuosity of the thoracic aorta. Calcified bronchial walls . | Findings: As compared to the previous radiographic, there is complete resolution of the pre-existing pleural effusions. Unchanged mild cardiomegaly without evidence of pulmonary edema. Small basal parenchymal scars but no evidence of recent pneumonia. Moderate tortuosity of the thoracic aorta. Calcified bronchial walls. A central venous line is noted in the subclavian vein. | ['Change severity', 'Add typo', 'Add medical device'] |
| 8671643b-f06c27c8-91a43c5d-85161fe5-a1eb95b0 | 50563564 | 10715477 | Findings: In comparison with the study of ___, there is little change in the substantial enlargement of the cardiomediastinal silhouette and moderate pulmonary edema with bilateral pleural effusions. Monitoring and support devices remain in place. | Findings: In comparison with the study of ___, there is little change in the substantial enlargement of the cardiomediastinal silhouette and moderate pulmonary edema with bilateral pleural effusions. In comparison with the study of ___, there is little change in the substantial enlargement of the cardiomediastinal silhouette and moderate pulmonary edema with bilateral pleural effusions. Monitoring and support devices remain in place. A central venous line is present. | ['Change location', 'Add repetitions', 'Add medical device'] |
| b079d6bd-55655ce2-25867c4e-0deba6a1-8a159d08 | 51185902 | 10715477 | Findings: Right internal jugular sheath ends at upper SVC. A single mediastinal drain tube is present on the right side. The appearance of the post operative widened mediastinum is unchanged since ___. Bilateral, confluent, lung opacities suggesting moderate pulmonary edema has improved asymmetrically on the left side, but unchanged on the right. Pleural effusions, if any, is mild bilaterally. | Findings: Right internal jugular sheath ends at upper SVC. A single mediastinal drain tube is present on the write side. The appearance of the post operative widened mediastinum is unchanged since ___. Bilateral, confluent, lung opacities suggesting severe pulmonary edema has improved asymmetrically on the left side, but unchanged on the right. Pleural effusions, if any, is mild bilaterally. There is evidence of a small right apical pneumothorax. | ['Change severity', 'Change to homophone', 'False prediction'] |
| 701d2394-b800427d-91a53aa7-5fb33fd1-663b37c1 | 52363927 | 10715477 | Findings: Indwelling support and monitoring devices are in standard position. Cardiac silhouette remains enlarged, and pulmonary edema continues to improve, with residual asymmetrical edema worse on the right than the left. Small pleural effusions are not substantially changed. | Findings: Indwelling support and monitoring devices are in standard position. Cardiac silhouette remains severely enlarged, and pulmonary edema continues to improve, with residual asymmetrical edema worse on the right than the left. Snall pleural effusions are not substantially changed. Pulmonary nodules are noted in the lower lobes. | ['Change severity', 'Add typo', 'False prediction'] |
| a4cc4fce-403bca64-3d69bd14-402f40af-28edbebd, fbaf1e44-468cb5b9-2cd8fc25-a7f7e778-1dde8b89 | 52467293 | 10715477 | Findings: PA and lateral views of the chest were obtained. Midline sternotomy wires are again noted. The left IJ central venous catheter has been removed. There is improved aeration in the lung bases as compared with the prior exam. The heart is markedly enlarged, which appears grossly stable compared with prior exam. There is no sign of pneumonia or overt CHF. Bony structures are intact. Aortic calcifications noted. Impression: Stable cardiomegaly without signs of pneumonia or CHF. | Findings: PA and lateral views of the chest were obtained. Midline sternotomy wires are again noted. The left IJ endotracheal tube has been removed. There is improved aeration in the lung bases as compared with the prior exam. The hart is markedly enlarged, which appears grossly stable compared with prior exam. There is no sign of pneumonia or overt CHF. Bony structures are intact. No aortic calcifications noted. Impression: Stable cardiomegaly without signs of pneumonia or CHF. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 264b773c-cd573e36-8b42c4fd-971c4302-1946ed5a | 53818026 | 10715477 | Findings: Since prior radiograph from ___, the mediastinal drain tube has been removed. There is no pneumothorax. Both lung volumes are very low. Bilateral, right side more than left side, moderate pulmonary edema has improved. Widened cardiomediastinal silhouette is more than it was on ___; however, this appearance could be exacerbation from low lung volumes. Patient is status post median sternotomy with intact sternal sutures. | Findings: Since prior radiograph from ___, the mediastinal drain tube is now positioned at the apex of the left lung. There is no new pneumothorax. Both lung volumes are normal. Bilateral, right side more than left side, moderate pulmonary edema has persisted. Widened cardiomediastinal silhouette is less than it was on ___; however, this appearance could be exacerbation from low lung volumes. Patient is status post median sternotomy with intact sternal sutures. | ['Change position of device', 'Add contradiction', 'False negation'] |
| 9197e8a6-688e955b-b870d598-a611016b-66ef0b8e | 55183572 | 10715477 | Impression: AP chest compared to ___: Large cardiomediastinal silhouette has not changed appreciably since at least ___, early postoperatively. Moderate-to-severe cardiomegaly is comparable to the preoperative appearance. Small bilateral pleural effusions persist. There is no longer any pulmonary edema. ET tube and left internal jugular line are in standard placements and a nasogastric tube passes into the stomach and out of view. No pneumothorax. | Impression: AP chest compared to ___: Large cardiomediastinal sylowette has not changed appreciably since at least ___, early postoperatively. Moderate-to-mild cardiomegaly is comparable to the preoperative appearance. Moderate bilateral pleural effusions persist. There is no longer any pulmonary edema. ET tube and left internal jugular line are in standard placements and a nasogastric tube passes into the stomach and out of view. No pneumothorax. A pacemaker is in place. | ['Change severity', 'Change to homophone', 'Add medical device'] |
| 77961fbc-766a38fd-e7b726ed-43313009-06ed55d4, 989b6a15-ba84ab43-d60ebb5a-c7681741-c34f140f | 55878458 | 10715477 | Findings: New PICC line on the right is projecting with its tip somewhere in the mediastinum. Appears to cross the midline, there is concern for potential arterial location. The initial line concerns were communicated over the telephone at the time of the wet read. Repeat PA and lateral radiograph, taken approximately an hour after the radiograph demonstrated the PICC line in the mid SVC. Potential small right pleural effusion. Stable moderate cardiomegaly. | Findings: New PICC line on the left is projecting with its tip somewhere in the mediastinum. Appears to cross the midline, there is concern for potential arterial location. The initial line concerns were communicated over the telephone at the time of the wet reaad. Repeat PA and lateral radiograph, taken approximately an hour after the radiograph demonstrated the PICC line in the mid SVC. No pleural effusion. Stable moderate cardiomegaly. | ['Change location', 'Add typo', 'False negation'] |
| 0cdeff10-c7e75e12-5c067cb6-eab4e635-50d1144c | 59089311 | 10715477 | Findings: In comparison with the earlier study of this date, there has been placement of a left IJ catheter that extends to the upper portion of the SVC. No evidence of pneumothorax. Otherwise, little change. | Findings: In comparison with the earlier study of this date, there has been placement of a left IJ catheter that extends to the upper pirtion of the SVC. No evidence of pneumothrax. Otherwise, little change. A right-sided vascular stent is noted ending in the mid SVC. | ['Change name of device', 'Add typo', 'Add medical device'] |
| 74501968-2251dd66-a1905203-8ff7c470-9c45dcb6 | 59170987 | 10715477 | Impression: Mild acute congestive heart failure. | Impression: Severe acute congestive heart failure. | ['Change severity', 'Change to homophone', 'False prediction'] |
| 2eb05c0b-30b37945-71fb6374-45cab675-82128ecc, 47860d0e-7714c59f-fbe13df2-5e581eb8-60b60826 | 51837636 | 10754184 | Findings: Dual-lead pacer is seen with leads in the right atrium and ventricle as before. There is no pneumothorax or pleural effusion. Hyperinflation is again seen compatible with preexisting chronic pulmonary disease. Right middle and lower lobe opacities are redemonstrated without new lesions. There is a slight change in morphology with increased lucency of one of the more medial opacities. They are overall unchanged in distribution and as a whole slightly decreased in size. Cardiomediastinal silhouette and hilar contours are unchanged. Impression: Right basal nodules as a whole minimally decreased since the prior study. Differential for these lesions includes amiodarone toxicity and cryptogenic organizing pneumonia. While chest radiographs are likely suitable for monitoring for change over time, a baseline CT examination can be obtained to allow for better characterization. | Findings: Dual-lead AICD is seen with leads in the right atrium and ventricle as before. There is no pneumothorax or pleural effusion. Hyperinflation is again seen compatible with preexisting chronic pulmonary disease. Right middle and lower lobe opacities are redemonstrated without knew lesions. There is a slight change in morphology with increased lucency of one of the more medial opacities. A small left-sided pleural effusion is noted. They are overall unchanged in distribution and as a whole slightly decreased in size. Cardiomediastinal silhouette and hilar contours are unchanged. Impression: Right basal nodules as a whole minimally decreased since the prior study. Differential for these lesions includes amiodarone toxicity and cryptogenic organizing pneumonia. While chest radiographs are likely suitable for monitoring for change over time, a baseline CT examination can be obtained to allow for better characterization. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| 36d187c2-a2f1c238-25e77d89-19d5e8b8-ca837472, 9065147e-4fa65619-480eba86-8e159f3d-3d96acd4 | 54594848 | 10754184 | Impression: New multifocal parenchymal opacities in the lower and middle lobes bilaterally, which given concurrent increased hepatic density from ___ to ___, could represent amiodarone-induced pulmonary toxicity. Differential would includes infectious processes in the proper clinical setting or organizing pneumonia. CT could be considered for further evaluation. This was discussed with Dr ___ at noon by Dr ___ on ___ via phone. | Impression: New multifocal parenchymal opacities in the lower and middle lobes bilaterally, which given concurrent increased gastric density from ___ to ___, could represent amiodarone-induced pulmonary toxicity. Differential would inclues infectious processes in the proper clinical setting or organizing pneumonia. CT could be considered for further evaluation. This was discussed with Dr ___ at noon by Dr ___ on ___ via phone. A central venous line is visualized. | ['Change location', 'Change to homophone', 'Add medical device'] |
| c979aaaa-4bb31072-c9884178-6e3ced8b-edf531fa, e88fa460-a2901f48-730373f3-89be4f0a-89e6e2a9 | 56348027 | 10754184 | Findings: The lungs are clear of consolidation, effusion, or pneumothorax. Left chest wall dual lead pacing device is again seen. Moderate cardiomegaly is again noted. Upper thoracic dextroscoliosis is seen. No acute fracture identified based on this nondedicated exam. Surgical clips seen in the upper abdomen. Impression: Cardiomegaly without acute cardiopulmonary process. | Findings: The lungs are clear of consolidation, effusion, or pneumothorax. Left chest wall dual lead pacing device is again seen. Severe cardiomegaly is again noted. Upper thoracic dextroscoliosis is seen. No acute fracture identified based on this nondedicated exam. Surgical clips seen in the upper abdomen. Impression: Cardiomegaly without acute cardiopulmonary process. Severe cardiomegaly is again noted. | ['Change severity', 'Add repetitions', 'False negation'] |
| e12e1dd7-9b6e4d27-63a06a72-937c9716-451f2db8 | 56625924 | 10754184 | Findings: A dual-lead pacemaker implanted in the left chest wall has two leads terminating in the expected location of the right atrium and right ventricle respectively. Mild hyperexpansion is unchanged. A small right pleural effusion is new. There are no focal opacities to suggest pneumonia. Mild cardiomegaly is stable. The hilar contours and pulmonary vasculature appear normal. The mediastinal silhouette is unchanged. Tortuosity of the thoracic aorta is re-demonstrated. Impression: 1. Small right pleural effusion is new; however, there is no evidence of pneumonia and no other significant appreciable change. 2. Mild cardiomegaly is unchanged. The above results were communicated via telephone by Dr. ___ to Dr. ___ ___ at 2:45 p.m. as requested. | Findings: A dual-lead ICD implanted in the left chest wall has two leads terminating in the expected location of the right atrium and right ventricle respectively. Mild hyperexpansion is unchanged. A small right pleural effusion is new. There are no focal opacities to suggest pneumonia. Mild cardiomegaly is stable. The hilar contours and pulmonary vasculature appear abnormal. The mediastinal silhouette is unchanged. Tortuosity of the thoracic aorta is re-demonstrated. A NG tube is noted with the tip in the stomach. Impression: 1. Small right pleural effusion is new; however, there is no evidence of pneumonia and no other significant appreciable change. 2. Mild cardiomegaly is unchanged. Moderate cardiomegaly is also noted. The above results were communicated via telephone by Dr. ___ to Dr. ___ ___ at 2:45 p.m. as requested. | ['Change name of device', 'Add contradiction', 'Add medical device'] |
| 1bc3d3de-cd13c1cd-ce13e61d-5191632c-e3ae7b5c, 46bd0776-78bcff84-5e4494eb-6f9c877a-a356af25 | 58393560 | 10850815 | Findings: Frontal and lateral views of the chest are obtained. Dual lead of left-sided pacemaker is again seen with leads extending to the expected positions of the right atrium and right ventricle, unchanged. Patient is status post median sternotomy and aortic valve replacement, grossly stable. Again seen is blunting of the left costophrenic angle suggesting pleural effusion with overlying atelectasis. Underlying consolidation cannot be excluded. There is slight increase in opacity at the right lung base which may be due to atelectasis, although the appropriate clinical setting, early aspiration or pneumonia are not excluded. Surgical clips are again seen projecting over the lateral right upper hemithorax. | Findings: Frontal and lateral views of the chest are obtained. Dual lead of left-sided pacemaker is again seen with leads extending to the expected positions of the right atrium and left ventricle, unchanged. Patinet is status post median sternotomy and aortic valve replacement, grossly stable. Again seen is no blunting of the left costophrenic angle. Underlying consolidation cannot be excluded. There is slight increase in opacity at the right lung base which may be due to atelectasis, although the appropriate clinical setting, early aspiration or pneumonia are not excluded. Surgical clips are again seen projecting over the lateral rigth upper hemithorax. | ['Change name of device', 'Add typo', 'False negation'] |
| 13b3f835-9d35e2fb-bef55a2d-4bf1a470-21b7626c | 50482798 | 10867202 | Findings: Lung volumes remain low. Heart size is mildly enlarged but unchanged. The aortic knob is calcified. Diffuse parenchymal opacities with architectural distortion and bronchiectasis is re- demonstrate compatible with known chronic fibrotic lung disease, overall similar compared to the prior exam. No new areas of focal consolidation, pleural effusion or pneumothorax is seen. No pulmonary edema is demonstrated. Impression: Relatively similar appearance of diffuse chronic chronic lung disease. No new gross focal consolidation identified. | Findings: Lung volumes remain low. Heart size is mildly enlarged but unchanged. The aortic knob is calcified. Diffuse parenchymal opacities with architectural distortion and bronchiectasis is re- demonstrate compatible with known chronic fibrotic lung disease, overall similar compared to the prior exam. No new areas of focal consolidation, pleural effusion or pneumothorax is seen. No pulmonary edema is demonstrated. Endotracheal (ET) tube in place. No new gross focal consolidation identified. | ['Add medical device', 'Add repetitions', 'False negation'] |
| 15941772-4cd5498f-ccdb2ccb-80f7a7f0-af9b87e9, bb795051-0e639ffa-dbded494-287ec2f7-1a213bd1 | 51707133 | 10867202 | Findings: AP and lateral views of the chest. Low lung volumes are seen compatible with patient's history of fibrosis. Diffusely increased interstitial markings are seen throughout the lungs, but these appear overall slightly worse when compared to prior. Cardiomediastinal silhouette is grossly unchanged. No acute osseous abnormality is detected. Impression: Findings compatible with pulmonary fibrosis with likely superimposed edema. Please note that infection cannot be excluded and clinical correlation is necessary. | Findings: AP and lateral views of the chest. Low lung volumes are seen compatible with patient's history of fibrosis. Diffusely increased interstitial markings are seen throughout the lungs, but these appear overall slightly worse when compared to prior. Cardiomediastinal silhouette is grossly unchanged. No acute osseous abnormality is detected. Impression: Findings compatible with moderately clear lungs without significant fibrosis. Please note that infection cannot be excluded and clinical correlation is necessary. | ['Change location', 'Add contradiction', 'False prediction'] |
| bcb5e90b-c7d3f928-7bd202ee-4e772a8f-e2240e90 | 51723789 | 10867202 | Findings: Lung volumes are low. Extensive bilateral opacities are unchanged from the prior examination and likely reflect the patient underlying severe interstitial lung disease. There is possibly increased opacification of the right lower lung, which may represent mild edema. Hilar and cardiomediastinal contours are unchanged. Calcification of the aortic arch is noted. There is no pneumothorax. There is no pleural effusion. Impression: Minimally increased opacification of the right lower lung may reflect mild edema superimposed on chronic severe interstitial lung disease. | Findings: Lung volumes are low. Extensive bilateral opacities are unchenged from the prior examination and likely reflect the patient underlying severe interstitial lung disease. There is possibly increased opacification of the left lower lung, which may represent mild edema. Hilar and cardiomediastinal contours are unchanged. Pacemaker is visible in the right chest. Calcification of the aortic arch is noted. There is no pneumothorax. There is no pleural effusion. Impression: Minimally increased opacification of the left lower lung may reflect mild edema superimposed on chronic severe interstitial lung disease. | ['Change location', 'Add typo', 'Add medical device'] |
| 6a0e1f5d-e6e23298-495f2580-9ef21652-d843b243 | 53652133 | 10867202 | Findings: Low lung volumes are again demonstrated. Chronic interstitial abnormality is again seen as well as more focal opacities within the left lung base, left perihilar region, and right upper lobe which are not significantly changed when compared to the prior exam. The cardiac, mediastinal and hilar contours are relatively unchanged with marked calcification of the aortic knob. No pneumothorax or large pleural effusion is demonstrated. The right PICC has been removed. Assessment of the pulmonary vascularity is limited. Impression: Relatively unchanged appearance of the chest compared to prior exam. Persistent opacities within the right upper lobe, left lung base and left perihilar region are redemonstrated on a background of chronic interstitial lung disease which on the prior chest CT was thought to reflect UIP or fibrosing NSIP. As before, these more focal opacities may reflect progression of chronic interstitial lung disease, acute exacerbation of interstitial lung disease, or possibly infection. | Findings: Low lugn volumes are again demonstrated. Chronic interstitial abnormality is agian seen as well as more focal opacities within the left lung base, left perihilar region, and right upper lobe which are not significantly changed when compared to the prior exam. The cardiac, mediastinal and hilar contours are relatively unchanged with marked calcification of the aortic knob. No pneumothorax or large pleural effusion is demonstrated. The right PICC si terminated in the mid SVC. Assessment of the pulmonary vascularity is limited. A pacemaker is present. Impression: Relatively unchanged appearance of the chest compared to prior exam. Persistent opacities within the rigth upper lobe, left lung base and left perihilar region are redemonstrated on a background of chronic interstitial lung disease which on the prior chest CT was thought to reflect UIP or fibrosing NSIP. As before, these more focal opacities may reflect progression of chronic interstitial lung disease, acute exacerbation of interstitial lung disease, or possibly infection. | ['Change position of device', 'Add typo', 'Add medical device'] |
| b7af070d-78068621-15eff16b-a70624dd-db393d15 | 57033562 | 10867202 | Impression: There are low lung volumes. Cardiomegaly and widened mediastinum are stable. Extensive interstitial reticular abnormalities larger in the left perihilar and left lower lobe region are grossly unchanged allowing the difference in inspiratory effort of the patient without evidence of new abnormalities pneumothorax or effusion. . | Impression: There are moderate lung volumes. Cardiomegaly and widened mediastinum are stable. Extensive interstitial reticular abnormalities larger in the left perihilar and left lower lobe region are grossly unchanged allowing the difference in inspiratory effort of the patient without evidence of new abnormalities pneumothorax or effusion. Cardiomegaly and widened mediastinum are stable. . No interstitial reticular abnormalities. . | ['Change severity', 'Add repetitions', 'False negation'] |
| 97a5f522-bb4f6eac-5f7d4736-30880e7b-872ea26f | 57163975 | 10867202 | Findings: AP, lateral, and oblique radiographs of the chest are somewhat limited in the determination of the exact termination point of the right PICC, which is difficult to visualize amongst the mediastinal structures. However, it appears to terminate in the lower portion of the SVC. There has been marked improvement in the bilateral effusions and heterogeneous opacities when compared to the prior study. Prominent interstitial lung markings reflect the patient's baseline pulmonary fibrosis. There is no pneumothorax. The aorta is stably tortuous with atherosclerotic calcifications in the arch. Impression: 1. New right PICC is difficult to visualize but likely ends within the lower SVC. 2. Marked interval improvement in what was likely multifocal pneumonia as well as near complete clearance of the bilateral pleural effusions compared to ___. 3. Stable interstitial lung markings consistent with chronic pulmonary fibrosis. | Findings: AP, lateral, and oblique radiographs of the chest are somewhat limited in the determination of the exact termination point of the left PICC, which is difficult to visualize amongst the mediastinal structures. However, it appears to terminate in the lower portion of the SVC. There has been marked improvement in the bilateral effusions and heterogeneous opacities when compared to the prior study. Prominent interstitial lung markings reflect the patient's baseline pulmonary fibrosis. There is no pneumothorax. The aorta is stably tortuous with atherosclerotic calcifications in the arch. A central venous line is present. However, it appears to terminate in the lower portion of the SVC. Impression: 1. New right PICC is difficult to visualize but likely ends within the lower SVC. 2. Marked interval improvement in what was likely multifocal pneumonia as well as near complete clearance of the bilateral pleural effusions compared to ___. 3. Stable interstitial lung markings consistent with chronic pulmonary fibrosis. | ['Change location', 'Add repetitions', 'Add medical device'] |
| a4d62fc4-613c998d-9a906778-5703a1a3-21507e30 | 57513198 | 10867202 | Impression: In comparison with the study of ___, there are somewhat better lung volumes. Continued enlargement of the cardiac silhouette with extensive parenchymal opacities bilaterally consistent with known fibrotic lung disease. | Impression: In comparison with the study of ___, there are somewhat better lung volumes. Continued enlargement of the cardiac silhouette with extensive parenchymal opaciteis bilaterally. No fibrotic lung disease. | ['Change severity', 'Add typo', 'False negation'] |
| 46b5b999-bd0dd08a-4756e4ca-de3d7098-494c0126, 62cd4342-77a1737e-da11be7c-6914655a-20dc273b | 57761141 | 10867202 | Findings: Lung volumes are reduced. Diffuse interstitial opacities most pronounced within the periphery and lung bases with architectural distortion are unchanged compared to the previous chest CT and compatible with chronic interstitial lung disease, previously characterized as UIP or fibrosing NSIP. Previously noted hazy opacities in both lungs has resolved. No new areas of focal consolidation are demonstrated. There is no pulmonary vascular congestion, pleural effusion or pneumothorax. Mild degenerative changes are noted in the thoracic spine. The cardiac and mediastinal contours are unchanged. Impression: Findings compatible chronic interstitial lung disease, previously characterized on chest CT as UIP or fibrosing NSIP. No new areas of focal consolidation or pulmonary edema. | Findings: Lung volumes are reduced. Diffuse interstitial opacities most pronounced within the periphery and lung bases with architectural distortion are unchanged compared to the previous chest CT and compatible with chronic interstitial lung disease, previously characterized as UIP or fibrosing NSIP. Previously noted hazy opacities in both lungs has resolved. No new areas of focal consolidation are demonstrated. There is no pulmonary vascular congestion, pleural effusion or pneumothorax. Severe degenerative changes are noted in the thoracic spine. The cardiac and mediastinal contours are unchanged. Impression: Findings compatible chronic interstitial lung disease, previously characterized on chest CT as UIP or fibrosing NSIP. No new areas of focal consolidation or pulmonary edema. | ['Change severity', 'Change to homophone', 'False negation'] |
| d1476c64-942c69d1-01468aa0-5ba156c1-07f5abb4, da5580a4-d85e8eac-795ffec6-41e6d24b-273b3747 | 59071382 | 10867202 | Findings: In the background of severe interstitial lung disease, which is predominantly reflected in fine reticulation of the lung periphery on each side, there are patchy superimposed opacities in the right upper lung as well as the left mid and lower lung worrisome for superimposed pneumonia. There is no pleural effusion or pneumothorax. The lung volume are again low. The cardiac, mediastinal and hilar contours appear unchanged, allowing for differences in technique. Impression: Multifocal opacities worrisome for pneumonia superimposed on severe underlying interstitial lung disease; although recent prior radiographs are not available for comparison and progression of chronic lung disease could be considered as an alternative, acute superimposed pneumonia seems most likely. | Findings: In the background of severe interstitial lung disease, which is predominantly reflected in fine reticulation of the lung periphery on each side, there are patchy superimposed opacities in the right upper lung as well as the left mid and lower lung worrisome for superimposed pneumonia. No patchy opacities are seen. The lung volume are again low. The cardiac, mediastinal and hilar contours appear unchanged, allowing for differences in technique. The lung volume are again low. Impression: Multifocal opacities worrisome for pneumonia superimposed on severe underlying interstitial lung disease; although recent prior radiographs are not available for comparison and progression of chronic lung disease could be considered as an alternative, acute superimposed pneumonia seems most likely. | ['Change location', 'Add repetitions', 'False negation'] |
| bea5fb24-e1d13af2-d70b5be5-fb32e7b8-15828f56 | 59191972 | 10867202 | Impression: AP chest compared to ___ through ___: Interval improvement in the severity of severe interstitial lung abnormality, at least in the left lung, is due to recent decrease in the component of reversible pulmonary edema, aside from severe pulmonary fibrosis. Right lung has not appreciably improved. Pleural effusions small if any. Moderate-to-severe cardiomegaly stable. No pneumothorax. | Impression: AP chest compared to ___ through ___: Interval improvement in the severity of moderate interstitial lung abnormality, at least in the left lung, is due to recent decrease in the component of reversible pulmonary edema, aside from severe pulmonary fibrosis. Right lung has not appreciably improved. Pleural effusions large if any. Moderate-to-severe cardiomegaly stable. Right-sided pneumothorax noted. | ['Change severity', 'Add contradiction', 'False prediction'] |
| 38ea1228-340e5c29-16578c7c-9c80eaed-1bb35307 | 59535316 | 10867202 | Findings: Single portable view of the chest. Low lung volumes are again noted. Chronic changes compatible with patients pulmonary fibrosis are noted. More severely affected areas seen at the bases, left greater than right. Cardiomediastinal silhouette is stable. No acute osseous abnormalities identified. Impression: Findings again compatible with patient's known pulmonary fibrosis without definite superimposed acute process, noting that subtle change would be difficult to detect based on a portable film. | Findings: Single portable view of the chest. Low lung volumes are again noted. Chronic changes compatible with patients pulmonary fibrosis are noted. More severely affected areas seen at the apices, left greater than right. Cardiomediastinal silhouette is enlarged. No acute osseous abnormalities identified. Impression: Findings again compatible with patient's known pulmonary fibrosis without definite superimposed acute process, noting that subtle change would be difficult to detect based on a portable film. Findings reveal no signs of pulmonary fibrosis. | ['Change location', 'Add contradiction', 'False negation'] |
| b83a98a1-69ae5692-5fc5b2eb-140a525a-abf289ab | 51545557 | 10885696 | Impression: AP chest compared to ___ through ___: Moderate right pleural effusion is new, obscuring some of the right lower lung, but changing the contour of the lung base substantially since ___. Postoperative left hemithorax is unchanged following left upper lobectomy. Heart is partially obscured by postoperative contour changes. Right middle lobe collapse seen on lateral chest films, ___ and ___ and on chest CT, ___, presumably unchanged. | Impression: AP chest compared to ___ through ___: Small right pleural effusion is new, obscuring some of the right lower lung, but changing the contour of the lung base substantially since ___. Postoperative left hemithorax is unchanged following left upper lobectomy. Heart is partially obscured by postoperative contour changes. Right middle lobe collapse scene on lateral chest films, ___ and ___ and on chest CT, ___, presumably unchanged. A prominent pacemaker is noted in the left upper chest. | ['Change severity', 'Change to homophone', 'Add medical device'] |
| eee70ea1-a4bb5ad0-eb92e7e6-ac788ab6-922f880b | 52654095 | 10885696 | Findings: As compared to the previous radiograph, there is no relevant change. Unchanged appearance of the left postoperative lung with decrease in size of the hemithorax. Unchanged opacities at the right lung base, potentially caused by atelectasis or, possibly, aspiration. Short-term further radiographic followup should be performed. No larger pleural effusions. | Findings: As compared to the previous radiograph, there is no relevant change. Unchanged appearance of the left postoperative lung with decrease in size of the hemithorax. Unchanged opacities at the left lung base, potentially caused by atelectasis or, possibly, aspiration. Short-term further radiographic followup should be performed. No larger pleural effusions. Unchanged opacities at the left lung base, potentially caused by atelectasis or, possibly, aspiration. Presence of pacemaker noted. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 91612855-728b71c5-52138016-9cb33506-c5fc594e | 52894975 | 10885696 | Impression: 1. Postoperative appearance to left hemithorax is stable. There is a patchy opacity at the right base which could reflect a combination of a layering effusion with atelectasis, although an acute infectious process cannot be excluded. Overall, however, there is not significant interval change since ___. No pneumothorax. Cardiac and mediastinal contours is difficult to assess due to the postoperative state of the patient as well as patient positioning on the current examination. No evidence of pulmonary edema. | Impression: 1. Postoperative appearance to left hemithorax is stable. There is a patchy opacity in the right middle lobe which could reflect a combination of a layering effusion with atelectasis, although an acute infectious process cannot be excluded. Overall, howevr, there is not significant interval change since ___. No pneumothorax. Cardiac and mediastinal contours is difficult to assess due to the postoperative state of the patient as well as patient positioning on the current examination. A small pleural effusion is noted. No evidence of pulmonary edema. | ['Change location', 'Add typo', 'False prediction'] |
| e7842e08-9ac5d312-a9c14d39-62df9f23-c7a94a70, f1e6712c-61dabae0-6691539a-039dcbb7-6c467216 | 52937462 | 10885696 | Impression: Right lower lobe opacity with volume loss, likely atelectasis, unchanged since the earlier study of ___. | Impression: Left lower lobe opacity with volume loss, likely atelectasis, unchanged since the earlier study of ___. There is no evidence of left lower lobe opacity. | ['Change location', 'Add contradiction', 'False negation'] |
| f50a6967-0c476fd1-f6b7ff3a-5cdaaa5f-c072b628 | 56441444 | 10885696 | Impression: AP chest compared to ___: Pulmonary vascular engorgement has improved. There is no mediastinal widening. The heart is unchanged in size, probably mildly enlarged, but obscured by mediastinal fat deposition. The postoperative appearance of the left hemithorax including bulbous left hilus is also longstanding. Large scale atelectasis in the right lower lobe has also been a feature since mid ___, probably progressed to complete collapse. Tracheostomy tube in standard placement. | Impression: AP chest compared to ___: Pulmonary vascular engorgement have improved. There is no mediastinal widening. The heart is unchanged in size, probably mildly enlarged, but obscured by mediastinal fat deposition. The postoperative appearance of the left hemithorax including bulbous left hilus is also longstanding. Large scale atelectasis in the right lower lobe has also been a feature since mid ___, probably progressed to complete collapse. Tracheostomy tube 1 cm above the carina. | ['Change position of device', 'Change to homophone', 'False prediction'] |
| 5b429228-9769c874-369577de-11d25077-c9ad1f2b, 747bf134-95cc6d92-0fb6f30d-863827b7-3042900e | 56443683 | 10885696 | Findings: There is persistent opacification of the medial right lower lung. There is a small right pleural effusion. No pneumothorax is detected. There is no evidence for pulmonary edema. The aorta is tortuous. The patient is status post left upper lobectomy; surgical changes with volume loss are evident. Impression: Right lower lobe pneumonia, which has not cleared, and small right pleural effusion. | Findings: There is persistent opacification of the medial right lower lugn. There is a moderate right pleural effusion. No pneumotoerax is detected. There is no evidence for pulmonary edema. The aorta is tortuous. The patient is status post left upper lobectomy; surgical chnages with volume loss are evident. A central venous line is in place. Impression: Right lower lobe pneumonia, which has not cleared, and moderate right pleural effusion. | ['Change severity', 'Add typo', 'Add medical device'] |
| a7fdae9e-97d1a4d6-df3c7f40-29a51d88-39463d76, ce354924-31b789c8-efd39b27-f2708902-84e7f064 | 57959841 | 10885696 | Impression: Post left upper lobectomy changes, with no superimposed acute intrathoracic process detected. | Impression: Post right upper lobectomy changes, with no superimposed acute intrathoracic process detected. Moderate intrathoracic process is revealed. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 33cbca42-cc8136d7-714fe7b7-c6fd6342-7bfbd4f1 | 59532499 | 10885696 | Findings: Single portable view of the chest is compared to previous exam from ___. Tracheostomy tube and postoperative changes of left upper lobectomy are again seen. Right basilar opacity silhouettes the right hemidiaphragm. Superiorly, the right lung is clear and appearance of the left lung is stable. Cardiomediastinal silhouette remains stable as do the osseous and soft tissue structures. Impression: Right basilar opacity silhouetting the hemidiaphragm, possibly due to any combination of effusion, atelectasis or consolidation. Clinical correlation recommended. Two-view chest x-ray may also offer additional detail. | Findings: Single portable view of the chest is compared to previous exam from ___. Tracheostomy tube and postoperative changes of right upper lobectomy are again seen. Right basilar opacity silhouettes the right hemidiaphragm. Superiorly, the left lung is clear and appearance of the left lung is stable. Cardiomediastinal silhouette remains stable as do the osseous and soft tissue structures. Impression: Right basilar opacity silhouetting the hemidiaphragm, possibly due to any combination of effusion, atelectasis or consolidation. Clinical correlation recommended. No opacity detected in the right basilar region. Two-view chest x-ray may also offer additional detail. Findings are highly suggestive of a small pleural effusion on the left side. | ['Change location', 'Add contradiction', 'False prediction'] |
| 104737c6-53b91029-bb16816d-13bbcdb8-0564caa2, 60c60c6e-1471b41d-d8ae011a-299592ea-7c39d5e7 | 50301215 | 10886362 | Findings: The endotracheal tube is too high, at the thoracic inlet. This finding was called to the CCU nurse, ___ at 5:00 p.m. at the time of dictating this report by Dr. ___. Otherwise, the appearance of the lungs is unchanged. Pacemaker and left IJ line are unchanged. | Findings: The nasogastric tube is too high, at the thoracic inlet. This finding was called to the CCU nurse, ___ at 5:00 p.m. at the time of dithcting this report by Dr. ___. Otherwise, the presence of a right pleural effusion is noted. Dual-chamber pacemaker and left IJ line are unchanged. | ['Change name of device', 'Add typo', 'False prediction'] |
| 9192ac1a-8d64bbf3-4b035831-96f59abc-903b2aaa | 51423353 | 10886362 | Findings: The ET tube is now 7 cm above the carina. There continues to be pulmonary vascular redistribution and areas of alveolar infiltrate consistent with fluid overload. Swan-Ganz catheter tip is in the pulmonary outflow tract. Cardiac pacemaker is unchanged. The left IJ line tip is in the SVC. | Findings: The ET tube is now 5 cm above the carina. There continues to be pulmonary vascular redistribution and areas of alveolar infiltrate consistent with flued overload. Swan-Ganz catheter tip is in the pulmonary outflow tract. Cardiac pacemaker is unchanged. No left IJ line tip is seen. | ['Change measurement', 'Add typo', 'False negation'] |
| 5fd6fa4a-2108246f-d9199b99-e14370ae-0eea894d | 52555178 | 10886362 | Impression: Cardiomegaly and venous congestion. | Impression: No cardiomegaly. Venous congestion. | ['False negation', 'Add repetitions', 'Add medical device'] |
| b4391db8-8076224b-e326c566-f0ee0cd4-94341441 | 53460154 | 10886362 | Impression: AP chest compared to ___ at 9:59 a.m.: Mild pulmonary edema worsened slightly since earlier in the day. No pneumothorax. Small left pleural effusion and moderate left basal atelectasis are unchanged. Pulmonary artery catheter ends in the right pulmonary artery. Transvenous right atrial and right ventricular pacer leads are unchanged in longstanding locations including the more medial than usual positioning of the tip of the right atrial lead. Mild-to-moderate cardiomegaly comparable to the preoperative appearance. | Impression: AP chest compared to ___ at 9:59 a.m.: Mild pulmonary edema worsened slightly since earlier in the day. No pneumothorax. Moderate left pleural effusion and moderate left basal atelectasis are unchanged. Pulmonary artery catheter ends in the left pulmonary artery. Transvenous right atrial and right ventricular pacer leads are unchanged in longstanding locations including the more medial than usual positioning of the tip of the right atrial lead. Mild-to-moderate cardiomegaly comparable to the preoperative appearance. No evidence of cardiomegaly. | ['Change name of device', 'Add contradiction', 'False prediction'] |
| 9189763d-c3b6ee12-d0d89f14-29a0cb1f-e3dee331 | 54849848 | 10886362 | Findings: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding portable chest examination with the patient in supine position as of ___. Again noted is status post sternotomy and significant enlargement of the cardiac silhouette. Previously described permanent pacer in left axillary position with two intracavitary electrodes in unchanged location. Unchanged position of left internal jugular approach central venous line terminating in upper portion of SVC. No pneumothorax has developed. Diffuse haze over both lung bases as before obliterating the diaphragmatic contours and indicative of bilateral pleural effusions partially layering posteriorly. The pulmonary venous congestive pattern persists. An intra-aortic balloon pump device is seen to terminate in the descending thoracic aorta about 3 cm below the level of the lower thoracic arch contour. This is unchanged. Impression: No significant interval changes during the last 24 hours interval. The described changes with postoperative status, CHF, pleural effusion and intra-aortic balloon pump device in place is of course compatible with the patient's hypoxia. | Findings: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding portable chest examination with the patient in supine position as of ___. Again noted is status post sternotomy and significant enlargement of the cardiac silhouette. Previously described permanent pacer in left axillary position with two intracavitary electrodes in unchanged location. Unchanged position of left internal jugular approach central venous line terminating in mid SVC. No pneumothorax has developed. Diffuse haze over both lung bases as before obliterating the diaphragmatic contours and indicative of bilateral pleural effusions partially layering posteriorly. The pulmonary venous congestive pattern persists. An intra-aortic balloon pump device is seen to terminate in the descending thoracic aorta about 5 cm below the level of the lower thoracic arch contour. This is unchanged. Impression: No significant interval changes during the last 24 hours interval. The described changes with postoperative status, CHF, pleural effusion and intra-aortic balloon pump device in place is of course compatible with the patient's hypoxia. Previously described permanent pacer in left axillary position with two intracavitary electrodes in unchanged location. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 51dc7b8e-860b2222-aad3c79e-02a2a9d0-085ebd6d, 68ea99a4-bd75cd2b-df54e0c2-ae1f3e13-c5a9bca4 | 54962274 | 10886362 | Findings: Compared to the film from earlier the same day, there is no significant interval change. | Findings: Compared to the film from earlier the same day, there is no significant interval change. Compared to the film from earlier the same day, there is no significant interval change. There is a small right pleural effusion. | ['Change severity', 'Add repetitions', 'False prediction'] |
| 10de7e37-6e13bc83-6797db44-6cac4fdb-8bcba198, b2b5a3a4-24b4dc24-84c9e1a5-98f8a217-8c89ba2a | 55957472 | 10886362 | Impression: AP chest compared to ___ at 9:19 a.m.: No appreciable pneumothorax or right pleural effusion following removal of the right basal pleural drain. Mild pulmonary edema collected in the right lower lung. Left lower lobe atelectasis is moderate-to-severe and small left pleural effusion is stable. Normal post-operative cardiomediastinal silhouette including mild-to-moderate cardiomegaly, improved since pre-operative chest radiograph. Nasogastric tube passes below the diaphragm and out of view. Transvenous right atrial and right ventricular pacer leads are unchanged in their longstanding positions, including a more medial location than generally seen for the tip of the right atrial lead. Swan-Ganz or other pulmonary arterial line ends in the right pulmonary artery. No pneumothorax. | Impression: AP chest compared to ___ at 9:19 a.m.: No appreciable pneumothorax or right pleural efsuion following removal of the right basal pleural drain. Mild pulmonary edema collected in the right lower lung. No atelectasis observed. Normal post-operative cardiomediastinal silhouette including mild-to-moderate cardiomegaly, improved since pre-operative chest radiograph. Nasogastric tube passes above the diaphragm and out of view. Transvenous right atrial and right ventricular pacer leads are unchanged in their longstanding positions, including a more superior location than generally seen for the tip of the right atrial lead. Swan-Ganz or other pulmonary arterial line ends in the left pulmonary artery. No pneumothorax. | ['Change position of device', 'Add typo', 'False negation'] |
| fdd8adcf-96e61323-ef98915c-c91ab8b9-7bf45f5e | 56034024 | 10886362 | Findings: On the prior study, there was a femoral Swan-Ganz catheter that is no longer visualized. It is off the film. It has likely been pulled back. Left IJ line tip is in the SVC. Cardiac pacer with wires is again visualized. ET tube is unchanged. Bilateral pleural effusions have increased in size compared to the prior study. The heart size is moderately enlarged and is larger than on the prior exam. There is pulmonary vascular redistribution with perihilar haze. The overall impression is that of worsening CHF. | Findings: On the prior study, there was a femoral Swan-Ganz catheter that is no longer visualized. It is off the film. It is likely bean pulled back. Left IJ line tip is in the mid SVC. Cardiac pacer with wires is again visualized. ET tube is unchanged. Bilateral pleural effusions have increased in size compared to the prior study. The heart size is moderately enlarged and is larger than on the prior exam. There is pulmonary vascular redistribution with perihilar haze. A nasogastric (NG) tube is seen with its tip in the stomach. The overall impression is that of worsening CHF. | ['Change position of device', 'Change to homophone', 'Add medical device'] |
| c5317373-5acdf384-4d5fee0f-423f29ef-22858502 | 57211901 | 10886362 | Findings: In comparison with study of ___, the mediastinal and left chest tube has been removed and there is no evidence of pneumothorax. The overall appearance of the heart and lungs is essentially unchanged. Persistent pulmonary vascular congestion with opacification, especially at the left base consistent with effusion and volume loss in the lower lobe. Less prominent changes are seen at the right base. | Findings: In comparison with study of ___, the mediastinal and left chest tube ends in the mid SVC and there is no evidence of pneumothorax. The overall appearance of the heart and lungs is essentially unchanged. Persistent pulmonary vascular congestion with opacification, especially at the left base, consistent with bilateral interstitial infiltration and volume loss in the lower lobe. Less prominent changes are seen at the right base. Findings: In comparison with study of ___, the mediastinal and left chest tube ends in the mid SVC and there is no evidence of pneumothorax. | ['Change position of device', 'Add repetitions', 'False prediction'] |
| 0b7ab545-c2af9860-5aae88b7-7e27fa66-b0c115db, 22626212-038a564e-86e62d8b-9d61ea9c-daa48afc | 58072789 | 10886362 | Impression: AP chest compared to ___ at 2:29 p.m.: Lateral aspect left lower chest is excluded from the examination. Remaining pleural surfaces show no pneumothorax and minimal if any pleural effusion. Nasogastric tube passes into the stomach and out of the field of view. Swan-Ganz catheter tip is partially obscured by cardiac motion, but is probably in the right pulmonary artery in standard placement. Right pleural, left pleural, midline drains in place. Pulmonary vascular congestion and moderate postoperative widening of the cardiomediastinal silhouette are unchanged. There is more atelectasis in the right lower lobe, left lower lobe atelectasis is mild-to-moderate. There is probably no pulmonary edema. | Impression: AP chest compared to ___ at 2:29 p.m.: Lateral aspect left lower chest is excluded from the examination. Remaining pleural surfaces show no pneumothorax and no pleural effusion. Nasogastric tube passes into the stomach and out of the field of view. Swan-Ganz catheter tip is partially obscured by cardiac motion, but is probably in the right atrium. Right pleural, left pleural, midline drains in place. Pulmonary vascular congestion and mild postoperative widening of the cardiomediastinal silhouette are unchanged. There is more atelectasis in the right lower lobe, left lower lobe atelectasis is severe. There is probably mild pulmonary edema. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| 5df8c586-2f6adf15-722e6f13-ffa8a117-acd92b9a | 50205123 | 10933609 | Findings: The heart size is normal. Lung volumes are low. Biapical fibrotic changes with traction bronchiectasis is re- demonstrated. Minimal blunting of the left costophrenic angle suggests a trace left pleural effusion. Streaky bibasilar airspace opacities likely reflect atelectasis. No pneumothorax is identified. Known fracture of the left 11th rib is not clearly delineated on this exam. Clips are seen projecting over the left upper quadrant. No new fractures are seen. There is crowding of the bronchovascular structures but no overt pulmonary edema is demonstrated. Impression: Chronic fibrotic changes within both lung apices. Low lung volumes with probable bibasilar atelectasis, though infection or aspiration cannot be excluded. Small left pleural effusion. Known left 11th rib fracture is not clearly seen on the current exam. | Findings: The heart size is normal. Lung volumes are low. Biapical fibrotic changes with traction bronchiectasis is re-demonstrated. Minimal blunting of the right costophrenic angle suggests a trace left pleural effusion. Streaky bibasilar airspace opacities likely reflect atelectasis. No pneumothorax is identified. Known fracture of the left 11th rib is clearly delineated on this exam. Clips are seen projecting over the left upper quadrant. No new fractures are seen. There is crowding of the bronchovascular structures but no overt pulmonary edema is demonstrated. Impression: Chronic fibrotic changes within both lung apices. Low lung volumes with probable bibasilar atelectasis, though infection or aspiration cannot be excluded. Small left pleural effusion. Known left 11th rib fracture is not clearly seen on the current exam. A central venous line terminates at the superior vena cava. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 57c03361-059aa6a2-9f7028da-423292f4-3b134303, add88ac4-2338dc16-a58a1ae9-57b1ecae-0a8f018a | 50289849 | 10933609 | Findings: Frontal and lateral views of the chest were obtained. There is interval increase in bilateral upper lobe opacities, right greater than left. Evidence of scarring is again seen with retraction of the hila bilaterally. No large pleural effusion or pneumothorax is seen. Evidence of a left-sided rib fracture is again seen, although not well evaluated. Cardiac and mediastinal silhouettes are stable. Impression: Interval increase in bilateral upper lobe, right greater than left opacities raises concern for infectious process superimposed on chronic changes. | Findings: Frontal and lateral views of the chest were obtained. There is interval increase in bilateral upper lobe opacities, left greater than right. No scarring is seen with retraction of the hila bilaterally. No large pleural effusion or pneumothorax is seen. No rib fracture is seen. Cardiac and mediastinal silhouettes are stable. Frontal and lateral views of the chest were obtained.Impression: Interval decrease in bilateral upper lobe, right greater than left opacities raises concern for infectious process superimposed on chronic changes. | ['Change severity', 'Add repetitions', 'False negation'] |
| 000ffbff-3d93bcef-da8b17cd-fbcede53-51728df9, f576c221-e516f6b2-ee125faa-a1af8c31-ed2991b8 | 50290463 | 10933609 | Findings: AP and lateral views of the chest were provided. Lung volumes are low, similar to the prior study. The previously noted dense consolidation of the right upper lobe has improved with diffuse streaky opacities remaining. There are findings consistent with chronic lung disease such as sarcoidosis. Prominence of the pulmonary interstitial markings is due to mild heart failure. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is notable for a tortuous aorta. Bones are slightly osteopenic. Impression: 1. Improving right upper lobe consolidation. 2. Mild heart failure. 3. Findings of chronic lung disease, most likely sarcoidosis. | Findings: AP and lateral views of the chess were provided. Lung volumes are low, similar to the prior study. The previously noted dense consolidation of the right upper lobe has improved with diffuse streaky opacities remaining. There are findings consistent with chronic lung disease such as sarcoidosis. Prominence of the pulmonary interstitial markings is due to moderate heart failure. There is bilateral mild pleural effusion. The cardiomediastinal silhouette is notable for a tortuous aorta. Bones are slightly osteopenic. Impression: 1. Improving right upper lobe consolidation. 2. Moderate heart failure. 3. Findings of chronic lung disease, most likely sarcoidosis with associated calcified granulomas. | ['Change severity', 'Change to homophone', 'False prediction'] |
| 0f7b9130-cdf81a79-d3e0a0cc-4e06df3c-dfc97cab, 2b34055b-5ae8bcf1-5a188ee8-135d064b-19c2f6ce | 50380704 | 10933609 | Impression: Stable exam with no acute intrathoracic process. Unchanged linear densities in the upper lungs likely reflective of scarring. | Impression: Stable exam with no acute intrathoracic process. Unchanged linear densities in the lower lungs likely reflective of scarring. A pacemaker is present. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 8452bd2c-ba775d23-e46872fa-f0e9c5bd-63897743 | 50636786 | 10933609 | Findings: Endotracheal tube tip terminates approximately 3.8 cm from the carina. An orogastric tube tip is noted within the distal stomach. Lung volumes are low. Heart size is normal. Mediastinal contours are unremarkable. Crowding of the bronchovascular structures is noted, and mild pulmonary vascular congestion is likely present. Additionally, more focal somewhat linear opacities within both upper lobes appear to be associated with fibrotic changes. No pleural effusion or pneumothorax is identified, although the right costophrenic angle is excluded from the field of view. Diffuse gaseous distention of the bowel loops are noted within the upper abdomen. No acute osseous abnormality seen. Surgical anchors are noted projecting over the right shoulder. Impression: 1. Standard positions of the endotracheal and orogastric tubes. 2. Focal, somewhat linear opacities within both upper lobes which may be due to a chronic interstitial process. Correlation with prior imaging is recommended. Aspiration or infection, however, cannot be completely excluded. 3. Mild pulmonary vascular congestion in the setting of low lung volumes. | Findings: Endotracheal tube tip terminates approximately 1.2 cm from the carina. An orogastric tube tip is noted within the distal stomach. Lung volumes are low. Heart size is normal. Mediastinal counters are unremarkable. Crowding of the bronchovascular structures is noted, and mild pulmonary vascular congestion is likely present. Additionally, more focal somewhat linear opacities within both upper lobes appear to be associated with fibrotic changes. No pleural effusion or pneumothorax is identified, although the right costophrenic angle is excluded from the field of view. Diffuse gaseous distention of the bowel loops is noted within the upper abdomen. No acute osseous abnormality scene. Surgical anchors are noted projecting over the right shoulder. Bilateral pleural effusions noted. Impression: 1. Standard positions of the endotracheal and orogastric tubes. 2. Focal, somewhat linear opacities within both upper lobes which may be due to a chronic interstitial process. Correlation with prior imaging is recommended. Aspiration or infection, however, cannot be completely excluded. 3. Bilat pulmonary vascular congestion in the setting of low lung volumes. | ['Change position of device', 'Change to homophone', 'False prediction'] |
| c9cd6c49-2bebaea2-82c0c5dc-c3d2e9a7-560599b0 | 51002383 | 10933609 | Findings: PA and lateral views of the chest. Bilateral upper lobe scarring is seen with superior retraction of the hila. The lung volumes are relatively low. There is no evidence of superimposed acute process. Cardiomediastinal silhouette is stable. Surgical clips in the upper abdomen again noted. Osseous structures are essentially unremarkable noting probable right glenoid orthopedic hardware. Impression: Bilateral upper lobe scarring unchanged without evidence of superimposed acute process. | Findings: PA and lateral views of the chest. Bilateral upper lobe scarring is seen with superior retraction of the hila. The lung volumes are relatively low. There is no evidence of superimposed acute process. Cardiomediastinal silhouette is stable. Surgical clips in the upper abdomen again noted. Osseous structures are essentially unremarkable noting probable right glenoid shunt. Impression: Bilateral upper lobe scarring unchanged without evidence of superimposed acute process. A left-sided central venous line is present. | ['Change name of device', 'Add repetitions', 'Add medical device'] |
| 16cf598d-2b1a30e2-627a4c64-25720237-cab9c186 | 51115198 | 10933609 | Findings: There is increase in moderate left loculated pleural effusion. The left lung opacification has also increased, concerning for worsening infection. Right upper lobe scarring is unchanged. There is no pneumothorax. The mediastinal and cardiac contours are normal. By reviewing the initial chest x-ray of ___, there was scarring in bilateral upper lobes which could either reflect scarring from previous aspiration, but sarcoid could also be a possibility. Impression: 1. Increase in moderate left loculated pleural effusion. 2. Worsening of left lung pneumonia. Wet read was done by Dr. ___ at 6:14 p.m., ___. | Findings: There is increase in severe left loculated pleural effusion. The left lung opacification has also increased, concerning for worsening infection. Right upper lobe scarring is unchanged. There is no pneumothorax. The mediastinal and cardiac contours are normal. By reviewing the initial chest x-ray of ___, there was scarring in bilateral upper lobes which could either reflect scarring from previous aspiration, but sarcoid could also be a possibility. Impression: 1. Increase in severe left loculated pleural effusion. 2. Worsening of left lung pneumonia. Wet read was done by Dr. ___ at 6:14 p.m., ___.An ET tube is placed in the upper trachea. Wet read was done by Dr. ___ at 6:14 p.m., ___. Findings: There is increase in moderate left loculated pleural effusion. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| b6958192-e9ba61f7-b0d3e5ab-5562c733-a0ad2714 | 51816597 | 10933609 | Findings: Interval placement of right internal jugular central venous catheter, with tip terminating in the body of the right atrium, with no visible pneumothorax. Low lung volumes accentuate the cardiac silhouette and bronchovascular structures. Even allowing for this factor, there are apparent new perihilar opacities, particularly in the right infrahilar region. This is concerning for acute aspiration given rapidity of development. Bilateral upper lobe fibrosis is again demonstrated and may be due to sarcoid or other granulomatous process. | Findings: Interval placement of right PICC line, with tip terminating in the body of the right atrium, with no visible pneumothorax. Low lung volumes accentuate the cardiac silhouette and bronchovascular structures. Even allowing for this factor, there are no new perihilar opacities. This is concerning for acute aspiration given rapidity of development. Bilateral upper lobe fibrosis is again demonstrated and may be due to sarcoid or other granulomatous process. There is moderate pleural effusion on the left side. Impression: Right-sided pneumothorax. | ['Change name of device', 'Add contradiction', 'False prediction'] |
| 318975e1-0f1046f7-331e3d92-185e4805-d5ac3b65, c0023bba-56efba28-c654ac42-24227b01-0157a8c2 | 52402828 | 10933609 | Impression: Improved aeration of the left lower lobe suggesting resolving pneumonia. | Impression: Improved aeration of the right lower lobe suggesting resolving pneumonia. | ['Change location', 'Change to homophone', 'False negation'] |
| 225164ad-9f7e5e4f-b9c9e387-2b07cdd5-10488e8b, c89c7ca8-466643b7-e8480932-1b791a6f-4ae17f31 | 52624179 | 10933609 | Findings: PA and lateral images of the chest. The lungs well expanded. Bilateral upper lobe opacities consistent with chronic fibrosis are again seen, unchanged from prior exam. The lungs are otherwise clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. Impression: No acute cardiopulmonary process. Stable fibrotic changes in the upper lungs. | Findings: PA and lateral images of the chest. The lungs well expanded. Bilateral upper lobe opacities consistent with chronic fibrosis are again seen, unchanged from prior exam. The lungs are otherwise clear. There is a small right pleural effusion. The cardiomediastinal silhouette is unremarkable. Impression: No acute cardiopulmonary process. Stable fibrotic changes in the lower lungs. | ['Change location', 'Add typo', 'False prediction'] |
| 9587ec7a-e6b7082f-0b22b670-b924b608-674375e2, fa29a6c8-729bdd50-764451b7-b92da9bc-daf265ee | 52935265 | 10933609 | Findings: PA and lateral views of the chest were provided. Areas of streaky opacity are again seen in the upper lobes, minimally changed from ___, likely reflects residua of recent pneumonia vs. scarring. Effusion is seen. No pneumothorax. No signs of pulmonary edema. The heart appears stable in size. The mediastinal contour is unchanged. Bony structures are intact. Anchors are partially imaged at the right glenoid. Impression: Resolving b/l upper lobe pneumonia. | Findings: PA and lateral views of the chest were provided. Areas of streaky opacity are again seen in the lower lobes, minimally changed from ___, likely reflects residua of recent pneumonia vs. scarring. Diffuse bilateral opacities suggest pulmonary edema. No pneumothorax. Mild pulmonary edema is seen. The heart appears enlarged. The mediastinal contour is unchanged. Substantial bony deformities are noted. Anchors are partially imaged at the left glenoid. Impression: Resolving b/l upper lobe pneumonia. No evidence of recent pneumonia. | ['Change location', 'Add contradiction', 'False prediction'] |
| 3e25d193-509147d7-b305908a-51e0da17-7cb23fda | 53512860 | 10933609 | Impression: Some clearing of aspiration pneumonia. | Impression: Some clearing of aspiration pneumonia. No evidence of aspiration pneumonia. | ['Add contradiction', 'Add repetitions', 'False negation'] |
| 21f6f51a-c6b2fab8-8c228bb8-1a8f8c46-d568b413, 962a470a-df0275b5-6b8e2125-e3cc9c90-bf7e0a66 | 54300688 | 10933609 | Findings: The cardiac, mediastinal, and hilar contours appear unchanged. Multifocal opacities which persist in the upper lungs with volume loss suggest chronic scarring without definite superimposed disease. Blunting of the left posterior costophrenic sulcus is unchanged, suggesting either trace pleural effusion or pleural thickening. Bony structures are unremarkable. Impression: Stable appearance of the chest. | Findings: The cardiac, mediastinal, and hilar contours appear unchanged. Multifocal opacities which persist in the upper lobe with volume loss suggest chronic scarring without definite superimposed disease. Trace pleural thickening observed, suggesting either trace pleural effusion or pleural thickening. Bony structures appear normal. Impression: Stable appearance of the chest. Basilar opacities are reduced significantly. | ['Change location', 'Add contradiction', 'False negation'] |
| 53c18304-54fac49c-cabe4615-c2a37b60-8555c705, 72a3f5c1-9ff27189-d2d045aa-ee3f3b3b-8d4f144f | 54422699 | 10933609 | Findings: AP and lateral views of chest demonstrate a right upper lobe consolidation with some areas of air bronchogram. Background multifocal opacities with volume loss and chronic scarring are unchanged. There is no large pleural effusion. Cardiac size is normal. Impression: New right upper lobe consolidation worrisome for infection on background chronic scarring. | Findings: AP and lateral views of chest demonstrate a right upper lobe consolidation with moderate areas of air bronchogram. Background multifocal opacities with volume loss and chronic scarring are unchanged. There is no large pleural effusion. Cardiac size is mildly enlarged. There is also the presence of a right-sided PICC line. Impression: New right upper lobe consolidation worrisome for infection on background chronic scarring. Mild right upper lobe consolidation noted, consistent with infection on background chronic scarring. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| 406539e1-fd9fe3f2-6192f2a5-e24d2d07-5ff88d1d | 54537700 | 10933609 | Impression: 1) Equivocal slight worsening of the opacity in the right upper zone. Otherwise, no interval change identified. 2) Compared to a radiograph from ___, the opacity in the right upper zone has improved, as have changes at the right cardiophrenic region. | Impression: 1) Equivocal slight worsening of the opacity in the right lower zone. Otherwise, npo interval change identified. 2) No opacity. | ['Change location', 'Add typo', 'False negation'] |
| 4778cb0a-f3b1679a-db7c043c-cfdd71ef-5b2da652, ff86990a-2b9b1ae4-abec4188-55d0170a-72142dca | 54694185 | 10933609 | Findings: PA and lateral chest radiographs were obtained. A right upper lobe consolidation with air bronchograms is similar to ___. Focal tubular lucency within the opacity is new and may reflect cavitation, dilated airways or spared lung parenchyma. Opacity in the right lower lobe has progressed since the prior study. There is no effusion or pneumothorax. Cardiac and mediastinal contours are normal. There is mild thickening of the left major fissure. Impression: Non-resolving right upper lobe pneumonia superimposed on bilateral juxtahilar scarring which could be due to prior granulomatous process such as TB or sarcoid. Consider CT to further evaluate the right upper lobe and to exclude central necrosis, as well as to further characterize for causes of non-resolving pneumonia. | Findings: PA and lateral chest radiographs were obtained. A right lower lobe consolidation with air bronchograms is similar to ___. No focal tubular lucency is seen and cavitation, dilated airways or spared lung parenchyma is not suggested. Opacity in the left lower lobe has progressed since the prior study. There is no effusion or pneumothorax. Cardiac and mediastinal contours are normal. There is mild thickening of the left major fissure. Impression: Mild right upper lobe pneumonia superimposed on bilateral juxtahilar scarring which could be due to prior granulomatous process such as TB or sarcoid. Consider CT to further evaluate the right upper lobe and to exclude central necrosis, as well as to further characterize for causes of non-resolving pneumonia. No significant right upper lobe abnormalities identified. | ['Change location', 'Add contradiction', 'False negation'] |
| 7acf30bd-0ed39a38-bb6159dd-2ed09689-dd05ba98, 95527da6-78fdab9e-2d3b3782-9aa97e06-a3e69c13 | 54870311 | 10933609 | Findings: PA and lateral views of the chest were provided. When compared with multiple prior studies, there is bilateral upper lung scarring with slight retraction of the bronchovasculature. There is no definite sign of new consolidation with relative opacity at the right heart border on the frontal view, not convincing for pneumonia. Lung volumes are low. Heart and mediastinal contours appear stable. No effusion or pneumothorax. Impression: Stable chest radiograph with upper lung scarring. Subtle opacity in the right lower lung, likely crowding of bronchovasculature. | Findings: PA and lateral views of the chest weer provided. When compared with multiple prior studies, there is bilateral lower lung scarring with slight retraction of the bronchovasculature. There is no definite sign of new consolidation with relative opacity at the rigth heart border on the frontal view, not convincing for pneumonia. Lung volumes are low. Heart and mediastinal contours appear stable. No effusion or pneumothorax. Impression: Stable chest radiograph with no lung scarring. Subtle opacity in the right lower lung, likely crowding of bronchovasculature. | ['Change location', 'Add typo', 'False negation'] |
| 4a706f94-eae311b0-de845977-dcc52bde-4615615e, 75869cde-a41c0128-bd418fb5-b3e4f46b-8f003c99 | 55438657 | 10933609 | Findings: Persistent largely unchanged left upper lobe, right upper lobe and left lower lobe peribronchial consolidation. There are stable low lung volumes. No pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable within normal limits. The pleural surfaces are unremarkable. Impression: Persistent bilateral peribronchial consolidations which might represent post-pneumonic fibrosis/inflammation, organizing pneumonia, Wegener's granulomatosis, or less likely residual infection. Followup examination as clinically warranted is recommended. | Findings: Persistent largely unchanged left upper lobe, right middle lobe and left lower lobe peribronchial consolidation. There are stable low lung volumes. The cardiomediastinal silhouette is stable within normal limits. The pleural surfaces are unremarkable. Impression: Persistent bilateral peribronchial consolidations which might represent post-pneumonic fibrosis/inflammation, organizing pneumonia, Wegener's granulomatosis, or less likely residual infection. There is a small pleural effusion. Followup examination as clinically warranted is recommended. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 67046a75-310cfff1-2dd57e2f-6208c141-d18736f5, 92fe0d65-6cd5e4b6-22dbcaec-949cb8bd-1c28d956 | 55447530 | 10933609 | Findings: PA and lateral views of the chest were obtained. Linear opacities in the upper lungs are noted with associated retraction of the hila likely reflecting scarring in this patient with prior pneumonia. Subtle opacity in the left lower lobe retrocardiac region is of unclear etiology. No large effusion or pneumothorax. Old left lower rib fractures are noted. Impression: Areas of scarring in the upper lungs. Subtle opacity in left lower lobe. Please correlate with CT chest performed earlier same day for further details. | Findings: PA and lateral views of the abdomen were obtained. Linear opacities in the lower lungs are noted with associated retraction of the hila likely reflecting scarring in this patient with prior pneumonia. A subtle opacity in the right lower lobe retrocardiac region is of unclear etiology. No large effusion or pneumothorax. Old left lower rib fractures are noted, with a newly placed central venous line in the right subclavian vein. Impression: Areas of scarring in the lower lungs. Subtle opacity in right lower lobe. Unremarkable study without significant findings. Please correlate with CT chest performed earlier same day for further details. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 1e31fec1-1f4cbc01-4583b395-5127c6f7-43b9a7e7, e26fdf14-791d85bf-3beaee42-3ec8bcee-4a05efee | 55646831 | 10933609 | Findings: Frontal and lateral views of the chest were obtained. There are low lung volumes. Right upper lobe scarring/chronic fibrosis in the right greater than left upper lobes are again seen. New since the prior study, there is left mid lung streaky opacity and to a lesser extent in the left lower lobe. No pleural effusion is seen. The cardiac and mediastinal silhouettes are stable. Impression: Stable right greater than left upper lobe fibrotic changes. New opacity in the left mid-to-lower lung raises concern for infectious process versus possibly asymmetric edema. Recommend followup to resolution. | Findings: Frontal and lateral views of the chest were obtaied. There are low ling volumes. Left upper lobe scarring/chronic fibrosis in the left greater than right upper lobes are again seen. No streaky opacity is seen. No pleural effusion is seen. The cardiac and mediastinal silhouettes are stable. Impression: Stable left greater than right upper lobe fibrotic changes. No opacity in the mid-to-lower lung raises concern for infectious process versus possibly asymmetric edema. Recommend followup to resolution. | ['Change location', 'Add typo', 'False negation'] |
| 1a734389-4bcb9234-220a253e-c22386fd-4f018ada, 4b842f9a-e380a620-f62f355a-f706be25-95150ec3 | 55736427 | 10933609 | Findings: Lung volumes are reduced. The left internal jugular central venous catheter has been removed. The heart size is borderline enlarged, but accentuated due to low inspiratory lung volumes. There is crowding of the bronchovascular structures with probable mild pulmonary vascular congestion. Worsening consolidative opacity in the right upper lung field as well as focal opacities within the left upper and bilateral lower lung fields are concerning for multifocal pneumonia. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities visualized. Clips are demonstrated within the left upper quadrant of the abdomen. Impression: Worsening multifocal opacities concerning for pneumonia. Probable mild pulmonary vascular congestion. Low lung volumes. | Findings: Lung volumes are mildly reduced. The left internal jugular central venous catheter has been removed. The heart size is borderline enlarged, but accentuated due to low inspiratory lung volumes. There is crowding of the bronchovascular structures with probable mild pulmonary vascular congestion. Worsening consolidative opacity in the right upper lung field as well as focal opacities within the left upper and bilateral lower lung fields are concerning for multifocal pneumonia. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities visualized. Short segment of lower lobe atelectasis is noted. Clips are demonstrated within the left upper quadrant of the abdomen. Impression: Worsening multifocal opacities concerning for pneumonia. Probable mild pulmonary vascular congestion. Lung volumes are mildly reduced. | ['Change severity', 'Add repetitions', 'False prediction'] |
| 16fbacce-c16d2bb4-ab113b1b-2956fc48-9f78a96d, 67106e2c-168fd4e2-52fbcc7d-4c4b2f27-5499c157 | 56058164 | 10933609 | Findings: Basilar opacity seen on the lateral view best corresponds to a retrocardiac opacity suspicious for developing left lower lobe pneumonia or aspiration event in the setting of altered mental status. Chronic peribronchiolar opacities seen bilaterally are similar in distribution and slightly more apparent due to lower lung volumes and AP technique. There is no pleural effusion or pneumothorax. The heart size is normal with normal cardiomediastinal silhouette. Impression: Left lower lobe opacity likely reflects pneumonia or aspiration. | Findings: Basilar opacity seen on the lateral view best corresponds to a retrocardiac opacity suspicious for developing right lower lobe pneumonia or aspiration event in the setting of altered mental status. Chronic peribronchiolar opacities seen bilaterally are similar in distribution and slightly more apparent due to lower lung volumes and AP technique. There is no pleural effusion or pneumothorax. The heart size is normal with normal cardiomediastinal silhouette. Impression: No opacity reflects pneumonia or aspiration. | ['Change location', 'Change to homophone', 'False negation'] |
| 157aae90-df977bc0-da3b3a41-87cc0fcb-438b3e17, dc460b17-20bafc45-b91e6c92-311eb0ad-7ea1a883 | 56267214 | 10933609 | Impression: AP chest compared to ___: Previous mild but asymmetric pulmonary edema continues to improve. The residual opacification in the right upper lobe raises concern for pneumonia. Heart size is normal. There is no pleural effusion. | Impression: AP chest compared to ___: Previous moderate but asymmetric pulmonary edema continues to improve. The residual opacification in the right upper lobe raises concern for pneumonia. Heart size is normal. There is no pleural effusion. No significant pulmonary opacification is present. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| b9c18cbb-323135fb-0118b586-6d8846f0-a1099863 | 56304327 | 10933609 | Impression: 1) PICC line tip over SVC/RA junction or upper right atrium. If clinically indicated, this could be retracted by approximately 2 cm. 2) Chronic patchy interstial opacities both upper lobes, unchanged. 3) No new infiltrate identified. | Impression: 1) PICC line tip over mid SVC or upper right atrium. If clinically indicated, this could be retracted by approximately too cm. 2) No interstial opacities. 3) No new infiltrate identified. | ['Change position of device', 'Change to homophone', 'False negation'] |
| 5740ef70-f0368542-f6ff1baf-09a39fdc-33e82710, fa80d52e-25c85b24-0302d3d0-f2052c45-6faebca9 | 56535476 | 10933609 | Findings: Low lung volumes are present. The heart size is normal. The mediastinal contours are unremarkable. The right PICC has been removed. As before, there is continued upward retraction of the hila with bilateral upper lobe scarring, similar when compared to the prior study. Findings may reflect prior sarcoidosis or tuberculosis. Patchy opacity in the right lung base may reflect atelectasis. Infection cannot be excluded. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Projecting over previous left upper quadrant of the abdomen is a surgical clip. Impression: Bilateral upper lobe scarring with upward retraction of hila suggestive of sarcoidosis or prior tuberculosis which is similar compared to prior studies. Patchy opacity in the right lung base may reflect atelectasis but infection cannot be excluded. | Findings: Low lung volumes are present. The heart size is normal. A left-sided central venous line is in place. The right PICC remains in place ending at the SVC. As before, there is continued upward retraction of the hila with bilateral upper lobe scarring, similar when compared to the prior study. Findings may reflect prior sarcoidosis or tuberculosis. Patchy opacity in the right lung base may reflect atelectasis. Infection cannot be excluded. Low lung volumes are present. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Projecting over previous left upper quadrant of the abdomen is a surgical clip. Impression: Bilateral upper lobe scarring with upward retraction of hila suggestive of sarcoidosis or prior tuberculosis which is similar compared to prior studies. A right-sided central venous line is present. Patchy opacity in the right lung base may reflect atelectasis but infection cannot be excluded. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 2a78a082-bf1c63ea-400d5e85-edf9eacf-5ede056d, 7699bdde-b4b344e6-8109dc76-dd9e5dc5-2f06b11a | 57053258 | 10933609 | Impression: AP chest compared to ___: By ___, the patient has largely cleared the extensive consolidation affecting all of the left lung and the right upper lung at the beginning of ___. Residual peribronchial opacification in the upper lungs was probably scarring, and persists. There may be a very slight increase in the pleural perfusion of abnormality in the left upper lung, but not enough to call pneumonia, and the lower lungs are essentially clear. Heart size is normal. Mediastinal and hilar silhouettes are unremarkable and no pleural abnormality. Feeding tube follows the same course through either a medially displaced stomach or postoperative gastric remnant. No pleural abnormality. | Impression: AP chest compared to ___: By ___, the patient has largely cleared the consolidation affecting all of the right lung and the left upper lung at the beginning of ___. Residual peribronchial opacification in the upper lungs was probably scarring, and persists. There may be a very slight increase in the pleural perfusion of abnormality in the left upper lung, but not enough to call pneumonia, and the lower lungs are essentially clear. Heart size is enlarged. Mediastinal and hilar silhouettes are unremarkable and no pleural abnormality. Feeding tube follows the same course through either a medially displaced colon or postoperative gastric remnant. No pleural abnormality. Additional minimal basal atelectasis is noted. There is no pleural effusion. | ['Change name of device', 'Add contradiction', 'False prediction'] |
| 9d8483b4-460ba2c2-3a8322ea-4d7df3ca-e1789d06, ba684a87-3ecff165-b646c20d-ce6363d4-5a11761e | 57290683 | 10933609 | Findings: Frontal and lateral views of the chest are compared to previous exam from ___. Again seen is biapical fibrotic changes. Previously seen perihilar and right basilar opacities, have resolved. There is no effusion or new consolidation. The cardiomediastinal silhouette is stable. Orthopedic hardware projects over the right glenoid fossa. Impression: Persistent biapical fibrosis without superimposed acute consolidation. | Findings: Frontal and lateral views of the chest are compared to previous exam from ___. Again seen is biapical fibrotic changes . Previously seen perihilar and right basilar opacities have resolved. There is no effusion or new consolidation in the left lung. The cardiomediastinal silhouette is stable. Orthpedic hardwrae projects over the right glenoid fossa. There are scattered nodula in the left upper lobe. Impression: Persistent biapical fibrosis without superimposed acute consolidation. | ['Change location', 'Add typo', 'False prediction'] |
| 68fe8811-11486a87-1a63faec-cbde0858-b889b677, 93894f42-2000f601-7b1944a8-7c4c0711-3d3a2a9b | 57629869 | 10933609 | Findings: Single frontal radiograph of the chest was performed and reveals no acute cardiopulmonary process. The cardiomediastinal and pleural structures are unremarkable. There is scarring in the upper lungs with superior traction of the hila. There is no pleural effusion or pneumothorax. Heart size is normal. Surgical hardware is seen at the right glenohumeral joint and ___ are seen within the abdomen with cardiophrenic angle may represent a small left pleural effusion as was previously seen approximately one month prior. Impression: No acute cardiopulmonary process. | Findings: Single frontal radiograph of the chest was performed and reveals no acute cardiopulmonary process. The cardiomediastinal and pleural structures are unremarkabel. There is scarring in the lower lungs with superior traction of the hila. There is no pleural effusion or pneumothorax. Heart size is mildly increased. Surgical hardware is seen at the right glenohumeral joint and ___ are seen within the abdomen with cardiophrenic angle may represent a small left pleural effusion as was previously seen approximately one week prior. Impression: Slight pulmonary vascular congestion is noted. | ['Change severity', 'Add typo', 'False prediction'] |
| c11514bb-319a3161-c0c85326-68094c62-0220f4f4 | 57695180 | 10933609 | Findings: The heart size is within normal limits. Mediastinal and hilar contours are normal. The previously described resolving right upper lobe pneumonia has improved. There is increasing density over most of the left lung with a small left-sided pleural effusion. There is no pneumothorax. Anchors are present within the right glenoid. Impression: Improving right upper lobe pneumonia and increasing left lung opacity concerning for worsening or new pneumonia. | Findings: The heart size is within normal limits. Mediastinal and hilar contours are normal. No right upper lobe pneumonia is found. There is increasing density over most of the left lung with a large left-sided pleural effusion. There is no pneumothorax. Anchors are present within the right glenoid. Anchors are present within the right glenoid. Impression: Improving right upper lobe pneumonia and increasing left lung opacity concerning for worsening or new pneumonia. | ['Change severity', 'Add repetitions', 'False negation'] |
| 282d803b-7e9e211b-ccf6ccf5-f3885dec-b8b9f76b, a603cd8b-deb5791e-0af13e1c-291d022f-105c7d5c | 58929044 | 10933609 | Findings: PA and lateral views of the chest are compared to multiple prior exams including CT torso from ___ with most recent x-ray from ___. When compared to most recent exam, there has been near complete resolution of the right upper lung opacity. There is evidence of scarring at the upper lobes bilaterally with retraction of the hila and some nodular densities, particularly in the left upper lung. These have been seen on multiple prior exams. Minimal blunting of the left posterior costophrenic angle may represent trace effusion. There is no large confluent consolidation. Cardiomediastinal silhouette is stable as are the osseous structures, noting multiple orthopedic screws projecting over the right glenoid. Impression: Essentially complete resolution of the right upper lobe opacity seen on prior. Findings suggestive of underlying chronic upper lobe scarring, although superimposed acute infectious process, particularly on the left, is not completely excluded. | Findings: PA and lateral views of the chest are compared to multiple prior exams including CT torso from ___ with most recent x-ray from ___. When compared to most recent exam, there has been complete resolution of the right upper lung opacity. There is evidence of scarring at the upper lobes bilaterally with retraction of the hila and some nodular densities, particularly in the left upper lung. These have not been seen on multiple prior exams. Severe blunting of the left posterior costophrenic angle may represent moderate effusion. There is large confluent consolidation. Right IJ central venous catheter projects over the left atrium. Cardiomediastinal silhouette is stable as are the osseous structures, noting multiple orthopedic screws projecting over the right glenoid. Impression: Essentially complete resolution of the right upper lobe opacity seen on prior. Findings suggestive of underlying chronic upper lobe scarring, although superimposed acute infectious process, particularly on the left, is not completely excluded. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| ca5edfd1-791faa24-0e6c7747-b17088d0-d90a8fc2 | 59018975 | 10933609 | Findings: Comparison is made to prior study from ___. Endotracheal tube has been removed. There remains a left IJ central venous line with the distal lead tip at the cavoatrial junction. Cardiac silhouette is enlarged. There are diffuse airspace opacities bilaterally, more confluent within the right lung. Findings are consistent with pulmonary edema, although multifocal pneumonia should also be considered. | Findings: Comparison is made to prior study from ___. Endotracheal tube has been removed. There remains a left IJ central venous line with the distal catheter tip at the cavoatrial junction. Cardiac silhouette is enlarged. There are diffuse airspace opacities bilaterally, more confluent within the right lung. Findings are consistent with pulmonary edema, although multifocal pneumonia should also be considered. There is no evident pleural effusion or pneumothorax. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| 7491ba73-b81aa431-0b41a7cb-733d87f1-4523ba29, f67b2368-01c7950b-b586b58b-6d8c66a4-c8b17db2 | 59225625 | 10933609 | Findings: Frontal and lateral views of the chest are compared to previous exam from ___. There is new multifocal consolidation in the right upper lobe, within the right perihilar region and possibly in the retrocardiac region as well. Lungs are otherwise notable for parenchymal architectural distortion at the upper lungs bilaterally. There is no effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. Impression: Multifocal regions of consolidation, new since exam from two weeks prior, compatible with pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. | Findings: Frontal and lateral views of the chest are compared to previous exam from ___. There is new multifocal consolidation in the left lower lobe, within the right perihilar region and possibly in the retrocardiac region as well. There is upper lung architectural distortion at the upper lungs bilaterally. There is mild bilateral pleural effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are notable for possible rib fractures. Impression: Lungs are clear without evidence of consolidation. Recommend repeat after treatment to document resolution. | ['Change location', 'Add contradiction', 'False prediction'] |
| 56d68575-e620ef2b-9e25dbcd-faa3f9d8-2f61e0ca, bb067a71-304abf94-bb1611d4-e8ac9115-189005f3 | 59243134 | 10933609 | Findings: The lung volumes are low and there is chronic lung disease, which is relatively unchanged since ___. No new focal opacities are seen compared to the ___ chest radiograph; however, right upper lobe consolidation is unchanged and may represent old pneumonia. There is no pleural effusion or pneumothorax. The heart and mediastinal contours are normal. Impression: No new focal opacities are seen. Right upper lobe consolidation was present on ___ and could represent an old pneumonia or chronic changes. The lung volumes remain low. COMMENT: ___ discussed with ___. | Findings: The lung volumes are low and there is chronic lung disease, which is relatively unchanged since ___. No new focal opacities are seen compared to the ___ chest radiograph; however, left upper lobe consolidation is unchanged and may represent old pneumonia. No pleural effusion or pneumothorax is sen. The heart and mediastinal contours are normal. Mild basilar atelectasis is also noted. Impression: New moderate right lower lobe opacities were present on ___ and could represent pneumonia or chronic changes. The lung volumes remain low. CCOMMENT: ___ disscussed with ___. | ['Change location', 'Add typo', 'False prediction'] |
| f52047f3-b0ba5171-755f7044-afcf59b8-62848096 | 59885828 | 10933609 | Findings: As compared to the previous radiograph, the lung volumes have slightly increased. The pre-existing, predominantly perihilar opacities have substantially decreased in extent and severity. The remaining opacities are now predominating in the upper lobes and are located around the upper aspects of the left and right hilus. No newly appeared opacities. The left internal jugular vein catheter has been removed, the lateral radiograph shows evidence of a small left effusion, obliterating the dorsal aspects of the costophrenic sinus. | Findings: As compared to the previous radiograph, the lung volumes have slightly increased. No pre-existing, predominantly perihilar opacities detected. The remaining opacities are now predominating in the upper lobes and are located around the upper aspects of the right and left hilus. No newly appeared opacities. The left internal jugular vein catheter has been removed, the latter radiograph shows evidence of a small right effusion, obliterating the dorsal aspects of the costophrenic sinus. | ['Change location', 'Change to homophone', 'False negation'] |
| ca220440-2b8510e6-fd0298b7-ab4fc422-434e558f | 50128467 | 10959054 | Findings: Since the prior examination there is little change. There is no evidence of pneumothorax. There is a moderate subpulmonic pleural effusion as better demonstrated on the prior lateral radiograph. There is a new small left layering pleural effusion. There are no new focal opacities concerning for pneumonia. Cardiomediastinal and hilar contours are stable demonstrating mild tortuosity of the thoracic aorta. Heart size is within normal limits. Pulmonary vascularity is normal. Impression: No evidence of pneumothorax. Little change in subpulmonic right pleural effusion as better demonstrated on radiographs from ___ a.m.. | Findings: Since the prior examination there is little change. There is no evidence of pneumothorax. There is a mild subpulmonic pleural effusion as better demonstrated on the prior lateral radiograph. There is a new small left layering pleural effusion. There are no new focal opacities concerning for pneumonia. Cardiomediastinal and hilar contours are stable demonstrating normal thoracic aorta. Heart size is within normal limits. No pleural effusion. Impression: No evidence of pneumothorax. Significant worsening in subpulmonic right pleural effusion as better demonstrated on radiographs from ___ a.m. | ['Change severity', 'Add contradiction', 'False negation'] |
| 32ec8188-8c334483-81cb6b13-428e8019-c0db3517 | 53881360 | 10959054 | Findings: There relatively low lung volumes. There is increased opacity projecting over the right hemi thorax likely due to increased right pleural effusion with overlying atelectasis, underlying infectious process not excluded. Possible trace left pleural effusion. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are unremarkable. No pneumothorax is seen. Impression: Increased opacity projecting over the right hemi thorax likely due to increased right pleural effusion with overlying atelectasis, underlying infectious process not excluded. | Findings: There relatively low lung volumes. There is increased opacity projecting over the left hemi thorax likely due to increased right pleural effusion with overlying atelectasis, underlying infectious process not excluded. Posible trace left pleural effusion. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are unremarkable. Thickening of the bronchial walls is noted. No pneumothorax is seen. Impression: Increased opacity projecting over the right hemi thorax likely due to increased right pleural effusion with overlying atelectasis, underlying infectious process not excluded. | ['Change location', 'Add typo', 'False prediction'] |
| 21895b3c-f3dac4a2-da11d756-cf67ed5c-9c175d9a, 47aa8fda-9852d351-ef7343e7-38ee20f2-b982b15d | 59281953 | 10959054 | Findings: Since the examination from ___, right basilar nodular opacification is improved. There is a persistence of a moderate layering pulmonary effusion on the right. In addition, there is increased opacification in the right lower lobe, improved since ___. There are no new focal opacities concerning for pneumonia. There is no pneumothorax. The cardiomediastinal and hilar contours are stable, with mild cardiomegaly. Pulmonary vascularity is not increased. Impression: Moderate layering right subpulmonic pleural effusion. Otherwise, mild improvement in right basilar atelectasis. | Findings: Since the examination from ___, left basilar nodular opacification is improved. There is a persistence of a moderate layering pulmonary effusion on the right. In addition, there is increased opacification in the right lower lobe, improved since ___. There are no new focal opacities concerning for pneumonia. There is no pneumothorax. No cardiomegaly. Pulmonary vascularity is not increased. Impression: Moderate layering right subpulmonic pleural effusion. Otherwise, mild improvement in right basilar atelectasis. Otherwise, mild improvement in right basilar atelectasis. | ['Change location', 'Add repetitions', 'False negation'] |
| bdaf4a42-459ff19b-d725de79-5f824931-917dc689, d6ee29da-bcb41124-a58ef710-c184f244-9d677f90 | 59557609 | 10959054 | Findings: Frontal and lateral views of the chest were obtained. There is a small right pleural effusion with some fluid seen tracking in the minor fissure and which may be partially loculated. Scattered patchy opacities projecting predominantly over the right lung raises concern for an infection, less likely asymmetric edema. There is left basilar atelectasis. The lungs are relatively hyperinflated with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. The cardiac and mediastinal silhouettes are relatively stable. | Findings: Frontal and lateral views of the chest were obtained. There is a large right pleural effusion with some fluid seen tracking in the minor fissure and which may be partially loculated. Scattered patchy opacities projecting predominantly over the right lung raises concern for an infection, less likely asymmetric edema. There is left basilar atelectasis. ET tube is noted in the trachea. The lungs are relatively hyperinflated with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. The cardiac and mediastinal silhouettes are severely distorted. No acute cardiopulmonary process. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| d25f054a-e8199cdc-c669cb2e-ebcfb082-54c205b7 | 50572011 | 10975446 | Findings: Cardiac silhouette is mildly enlarged, and accompanied by pulmonary vascular congestion and mild interstitial edema. Patchy opacities persist at the bases, and likely reflect atelectasis. Followup radiographs may be helpful to exclude pneumonia in the appropriate clinical setting. | Findings: Cardiac silhouette is severely enlarged, and accompanied by pulmonary vascular congestion and mild interstitial edema. Patchy opacities persist at the bases, and likely reflect atelectasis. Followup radiographs may be helpful to confirm pneumonia in the appropriate clinical setting. There is a small left pleural effusion. | ['Change severity', 'Add contradiction', 'False prediction'] |
| e0f5b52f-7723f470-e1b422a4-73ef70cb-2a76d9c3 | 51473674 | 10975446 | Findings: There is mild cardiomegaly. The aorta is tortuous and calcified. The mediastinal and hilar contours appear unchanged. There is a similar mild interstitial abnormality with prominence of central pulmonary vascularity, suggesting mild vascular congestion. In addition, patchy streaky opacities in the right mid and lower lung suggest a background of minor scarring or atelectasis. Although evaluation is limited, there is no definite pleural effusion. No pneumothorax is demonstrated, although it is noted that the left lung apex is obscured by a flexed chin. Impression: Essentially stable findings suggesting mild pulmonary vascular congestion. | Findings: There is mild cardiomegaly. The aorta is tortuous and calcified. The mediastinal and hilar contours appear unchanged. No interstitial abnormality is noted. In addition, patchy streaky opacities in the right mid and lower lung suggest a background of minor scarring or atelectasis. Although evaluation is limited, there is no definite pleural effusion. No pneumothorax is demonstrated, although it is noted that the right lung apex is obscured by a flexed chin. Impression: Essentially stable findings suggesting mild pulmonary vascular congestion. No evidence of pulmonary vascular congestion. | ['Change location', 'Add contradiction', 'False negation'] |
| d093e190-64d95289-7b99a592-ca302be2-6987d800 | 53829371 | 10975446 | Impression: AP chest compared to ___: Pulmonary vascular congestion, hilar enlargement and moderate cardiomegaly are longstanding. There is no pulmonary edema. Pleural effusions are small if any. Thoracic aorta is heavily calcified, tortuous and generally large, but there is no evidence of focal aneurysm or interval change. No pneumothorax. | Impression: AP chest compared to ___: Pulmonary vascular congestion, hilar enlargement and severe cardiomegaly are longstanding. Mild pulmonary edema. Pleural effusions are large if any. Thoracic aorta is heavily calcified, tortuous and generally large, but there is no evidence of focal aneurysm or interval change. There is an endotracheal (ET) tube in place. No pneumothorax. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| 32ddd325-e5d324e2-d240150b-5c00c3f0-fadd7c83 | 53835190 | 10975446 | Findings: As compared to the previous radiograph, there is unchanged evidence of bilateral parenchymal opacities, constant on the right and minimally improving on the left. Unchanged cardiomegaly and small bilateral pleural effusions. Subsequent areas of basal atelectasis. Unchanged position of the endotracheal tube and right-sided central venous access line. | Findings: As compared too the previous radiograph, there is unchanged evidence of bilateral parenchymal opacities, constant on the right and minimally improving on the left. Cardiomegaly and small bilateral pleural effusions. Persistent areas of basal atelectasis. Unchanged position of the endotracheal tube and lower right-sided central venous access line. | ['Change position of device', 'Change to homophone', 'False prediction'] |
| f5694e30-74276190-ca787eed-b4262479-f73aec86 | 53843466 | 10975446 | Findings: The ET tube is low, 1.5 cm above the carina. There are increased lung markings bilaterally in this patient with known bilateral basilar atelectasis/infiltrate/aspiration. An IJ line tip is at the cavoatrial junction. | Findings: The ET tube is low, 1.7 cm above the carina. Their are increased lung markings bilaterally. No IJ line tip is seen. | ['Change measurement', 'Change to homophone', 'False negation'] |
| 0d768fcf-0bb1bca1-eb1fe1d6-686b876b-675a2e95 | 55185117 | 10975446 | Impression: AP chest compared to ___: Moderately severe pulmonary edema is worsening, accompanied by increasing small-to-moderate bilateral pleural effusions and progressive moderate-to-severe cardiomegaly. Right jugular line ends in the upper right atrium. ET tube is in standard placement. No pneumothorax. Thoracic aorta is heavily calcified and at least tortuous if not dilated, but probably not acutely changed. | Impression: AP chest compared to ___: Moderately severe pulmonary edema is worsening, accompanied by increasing small-to-moderate bilateral pleural effusions and progressive moderate-to-severe cardiomegaly. Left jugular line ends in the upper right atrium. ET tibe is in standard placement. Multiple small nodular opacities are seen in the right lung field. No pneumothorax. Thoracic aorta is heavily calcified and at least tortuous if not dilated, but probably not acutely changed. | ['Change location', 'Add typo', 'False prediction'] |
| 520be031-be2101c2-d3c096ac-08925edb-0177dee8 | 55747813 | 10975446 | Findings: The ET tube is still slightly low, 1.7 cm above the carina. Right IJ line tip is at the cavoatrial junction. There are bilateral pleural effusions, vascular plethora, patchy areas of alveolar edema. The overall impression is that of CHF and underlying infectious infiltrate cannot be excluded. Compared to the prior study, the fluid status is slightly worse. | Findings: The ET tube is still slightly low, 1.5 cm above the carina. Right IJ line tip is at the cavoatrial junction. No pleural effusions noted, but vascular plethora, patchy areas of alveolar edema are seen. The overall impression is that of CHF and underlying infectious infiltrate cannot be excluded. Compared to the prior study, the fluid status is slightly improved. | ['Change measurement', 'Add contradiction', 'False negation'] |
| f64708b2-5173902f-9397bc55-1a8502c8-8be61ec4 | 55911959 | 10975446 | Findings: As compared to the previous radiograph, there is no major change. The monitoring and support devices are in unchanged position. Small bilateral pleural effusions with evidence of relatively extensive bilateral probably atelectatic consolidations. Mild-to-moderate fluid overload. No newly appeared focal parenchymal opacities. Extensive calcifications and tortuosity of the thoracic aorta. | Findings: As compared to the previous radiograph, there is no major change. The monitoring and support devices are in their previous location. Small bilateral pleural effusions with evidence of relatively extensive left probably atelectatic consolidations. Mild-to-moderate fluid overload. Newly appeared focal parenchymal opacities. Extensive calcifications and tortuosity of the thoracic aorta with a large aneurysm. | ['Change location', 'Add contradiction', 'False prediction'] |
| 71472bea-4861bb4b-57725cca-447baed5-d7d18080 | 56122911 | 10975446 | Findings: As compared to the previous radiograph, there is no relevant change. The extensive bilateral parenchymal opacities, bilateral pleural effusions, cardiomegaly, and basal atelectasis are unchanged. No new opacities. Unchanged monitoring and support devices. | Findings: As compared to the prvious radiograph, there is no relevant change. The mild bilateral parenchymal opacities, moderate bilateral pleural effusions, cardiomegaly, and bibasilar atelectasis are unchanged. Bibasilar nodules seen. Unchanged monitoring and support devices. | ['Change severity', 'Add typo', 'False prediction'] |
| 0baf5e16-bb057c79-97a74dac-e4631d48-f99f01d7 | 56390608 | 10975446 | Findings: Again seen is low position of the ET tube, 1.4 cm above the carina. The appearance of the lungs is unchanged. Right IJ line tip at cavoatrial junction is unchanged. | Findings: Again seen is low position of the ET tube, 2.5 cm above the carina. The appearance of the lungs is unchanged. There is bibasilar opacities suggesting pneumonia. Right IJ line tip at mid SVC is unchanged. Impression: Endotracheal tube is appropriately placed. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| f76c2a78-65248647-1c1b4bdf-9896fb2b-f5c2ab8d | 56616764 | 10975446 | Impression: AP chest compared to ___. ET tube and right internal jugular line are in standard placements. Mild pulmonary edema has improved since ___. Moderate bilateral pleural effusion and moderate cardiomegaly are stable. No pneumothorax. | Impression: AP chets compared to ___. ET tube and right internal jugular line are terminaing at mid SVC. Mild pulmonary edema has improved snice ___. Moderate bilateral pleural effusion and moderate cardiomegaly are stable. No pneumothorax. A left-sided pacemaker is present. | ['Change position of device', 'Add typo', 'Add medical device'] |
| 28a61df7-4fa64f79-11a7bc9c-789dd22b-171b52b3 | 56820999 | 10975446 | Findings: There are lower lung volumes with secondary mild widening of cardiomediastinal silhouette. There is no pleural effusion, pneumothorax or focal lung consolidation. There are bibasilar opacities which are better seen on the subsequent CT abd, may represent aspiration or atelectasis. | Findings: There are lower lung volumes with secondary mild widening of the cardiomediastinal silhouette. There is no pleural effusion, pneumothorax or focal ling consolidation. There are bibasilar opacities which are better seen on the subsequent CT abd, may represent aspiration or atelectasis. Diffuse interstitial markings may be suggestive of chronic interstitial lung disease. | ['Change location', 'Add typo', 'False prediction'] |
| 34058be0-81c50b36-9b2c0874-23eca60a-7789a943 | 58917552 | 10975446 | Findings: Cardiac silhouette remains enlarged and is accompanied by persistent pulmonary vascular congestion and interstitial edema. Patchy bibasilar atelectasis also appears similar compared to the prior study. | Findings: Cardiac silhouette remains normal and is accompanied by persistent pulmonary vascular congestion and interstitial edema. Patchy bibasilar atelectasis also appears simlar compared to the prior study. Lungs appear clear and there is no sign of pulmonary vascular congestion. | ['Add contradiction', 'Add typo', 'False negation'] |
| 234437dc-32485521-78bd0c1a-5997bd43-47401378, 66cab843-95809cae-6a67db82-36faecab-8a75c30e | 59969148 | 10975446 | Findings: There is a somewhat heterogeneous but generally diffuse mild interstitial abnormality suggesting slight pulmonary congestion. One of two views shows a slightly more confluent right upper lobe opacity of uncertain significance, quite vague, and there is also focal left infrahilar opacity. There is no definite pleural effusion or pneumothorax. Impression: Findings suggesting mild vascular congestion. More focal patchy right upper lobe and left infrahilar opacities of uncertain significance but possibly due to coinciding atelectasis or scarring. If developing infection is a clinical consideration then short-term followup radiographs could be considered. | Findings: There is a somewhat heterogeneous but generally diffuse mild interstitial abnormality suggesting slight bronchial congestion. One of two views shows a slightly more confluent right upper lobe opacity of uncertain significance, quite vague, and there is also focal right infrahilar opacity. There is a somewhat heterogeneous but generally diffuse mild interstitial abnormality suggesting slight bronchial congestion. There is no definite pleural effusion or pneumothorax. Also noted is a right middle lobe consolidation. Impression: Findings suggesting mild vascular congestion. More focal patchy right upper lobe and right infrahilar opacities of uncertain significance but possibly due to coinciding atelectasis or scarring. If developing infection is a clinical consideration then short-term followup radiographs could be considered. | ['Change location', 'Add repetitions', 'False prediction'] |
| 7e26f6a7-ec126822-1bcdc587-a3f5d439-b4715eae | 51683155 | 11016935 | Findings: PA and lateral views of the chest provided. Patient is status post CABG with median sternotomy and aortic valve replacement. Moderate-to-severe emphysema with apical predominance. 7 mm nodular opacity in the right upper lobe has not changed. Heart is top-normal in size. No focal consolidation, pleural effusion or pneumothorax. Vertebroplasty changes are seen in the mid-thoracic spine. Impression: No acute intrathoracic process. | Findings: PA and lateral views of the chest provided. Patient is status post CABG with median sternotomy and aortic valve replacement. Moderate-to-severe emphysema with apical predominance. 7 cm nodular opacity in the right upper lobe has not changed. Heart is top-normal in size. No focal consolidation, pleural effusion or pneumothorax. Vertebroplasty changes are seen in the mid-thoracic spine. Bibasilar atelectasis is noted. Impression: No acute intrathoracic process. | ['Change measurement', 'Add repetitions', 'False prediction'] |
| d7455c33-4a0f90a6-565ee283-906f14b4-c737ba31, ffe111af-f37e2ddf-0a7424d4-4b1cd736-be3f6e66 | 54381763 | 11016935 | Impression: PA and lateral chest compared to ___: Patient has had median sternotomy and aortic valve replacement. Sternal wires are aligned. Cardiomediastinal silhouette is normal. Emphysema is moderate to severe and apical predominant. A 6 mm nodular opacity projecting over the right second anterior rib could be a pleural calcification shown on the ___ chest CT, 4:20 or a new lung nodule A lordotic view might be definitive. Lungs are otherwise clear of focal opacities. There is no pleural effusion or evidence of central adenopathy. Cement and fusions are present in two lower thoracic vertebral bodies, with only minimal loss of height, unchanged since ___. Findings were posted to the online record of critical radiology findings for direct notification of the referring physician, at the time of this dictation. | Impression: PA and lateral chest compared to ___: Patient has had median sternotomy and aortic valve replacement. Sternal wires are aligned. Cardiomediastinal silhouette is normal. Emphysema is moderate to severe and apical predominant. A 5 cm nodular opacity projecting over the right second anterior rib could be a pleural calcification shown on the ___ chest CT, 4:20 or a new lung nodule. Lungs are otherwise clear of focal opacities. There is no pleural effusion or evidence of central adenopathy. No cement and fusions present in thoracic vertebral bodies. Findings were posted to the online record of critical radiology findings for indication of the referring physician, at the time of this dictation. Moderate emphysema and possible lung nodule noted. Cement and fusions are present in two lower thoracic vertebral bodies, with only minimal loss of height, unchanged since ___. | ['Change measurement', 'Add contradiction', 'False negation'] |
| 70ee568a-e2a70b5f-9f73d45e-c3015d3a-2a6bf3c0, 816f21ae-13fa33ff-7a4ea5d9-e246fa18-f09a32ff | 50078440 | 11022245 | Findings: Portable frontal chest radiographs demonstrate intubated patient, the tip of the endotracheal tube is positioned 4.1 cm from the level of the carina. An orogastric tube is in place and is coiled within the fundus of the stomach. There is airspace opacification of the right lung with relative sparing of the apex, as well as basilar left lung opacity. Linear atelectasis is seen in the right mid lung. The left lung is relatively clear. A focal nodular opacity is seen in the left upper lung measuring 8 mm. There is linear atelectasis in the left lower lung. There is no definite effusion. There is no pneumothorax. The heart size is enlarged, the mediastinal contours appear grossly unremarkable on this portable film. Impression: 1. Bilateral airspace opacity consistent with lobar pneumonia. 2. Nodular opacity in the left lung apex, recommend attention on followup. 3. Moderate cardiomegaly. | Findings: Portable frontal chest radiographs demonstrate intubated patient, the tip of the endotracheal tube is positioned 5 cm from the level of the carina. An orogastric tube is in place and is coiled within the fund us of the stomach. There is airspace opacification of the right lung with relative sparing of the apex, as well as basilar left lung opacity. Linear atelectasis is seen in the right mid lung. The left lung is relatively clear, and a central venous line is in place. A focal nodular opacity is seen in the left upper lung measuring 8 cm. There is linear atelectasis in the left lower lung. There is no definite effusion. There is no pneumothorax. The heart size is enlarged, the mediastinal contours appear grossly unremarkable on this portable film. Impression: 1. Bilateral airspace opacity consistent with lobar pneumonia. 2. Nodular opacity in the left lung apex, recommend attention on followup. 3. Moderate cardiomegaly. | ['Change measurement', 'Change to homophone', 'Add medical device'] |
| 0ae07ada-41d03c2a-ec74ae48-d0c17cec-343ae6fa | 50126222 | 11022245 | Findings: Right-sided Port-A-Cath tip terminates at the junction of the SVC and right atrium. Patient is status post median sternotomy and aortic valve replacement. Lung volumes are low with mild enlargement of the cardiac silhouette, unchanged. Mediastinal and hilar contours are similar. There is mild pulmonary edema, slightly improved in the interval. Patchy opacities in the lung bases may reflect areas of atelectasis, but infection particularly in the left lung base cannot be completely excluded. No pleural effusion or pneumothorax is demonstrated. Elevation of the left hemidiaphragm is again noted. No acute osseous abnormality is visualized. Impression: Slight improvement in mild pulmonary edema. Patchy opacities in the lung bases may reflect atelectasis, but infection particularly in the left lung base cannot be completely excluded. | Findings: Right-sided Port-A-Cath tip terminates at the junction of the SVC and right atrium. Patient is status post median sternotomy and aortic valve replacement. Lung volumes are low with mild enlargement of the cardiac silhouette, unchanged. Mediastinal and hilar contours are similar. There is moderate pulmonary edema, slightly improved in the interval. Patchy opacities in the lung bases may reflect areas of atelectasis, but infection particularly in the left lung base cannot be completely excluded. No pleural effusion or pneumothorax is demonstrated. Elevation of the left hemidiaphragm is again noted. No pulmonary edema is visualized. Impression: Slight improvement in mild pulmonary edema. Patchy opacities in the lung bases may reflect atelectasis, but infection particularly in the left lung base cannot be completely excluded. Slight improvement in mild pulmonary edema. | ['Change severity', 'Add repetitions', 'False negation'] |
| b418d709-571d80f6-35f680e3-16a938ff-bde93b89 | 50146341 | 11022245 | Findings: The endotracheal tube tip sits 5 cm above the carina. A left-sided IJ central venous catheter tip sits in the left brachiocephalic vein. The right-sided IJ central venous catheter tip sits in the upper SVC. The heart size is large but stable. The mediastinal contours are within normal limits. There continue to be bibasilar and perihilar opacities as well as a more rounded confluent opacity in the right upper lung. These findings likely represent increased pulmonary edema as well as right upper and lower lobe consolidations. Retrocardiac opacity is also compatible with a left lower lobe consolidation. The costophrenic angles are excluded from the study limiting assessment for subtle pleural effusion. There is no large pneumothorax. Impression: 1. Lines and tubes in place. 2. Increased pulmonary edema with right upper lobe and bibasilar consolidations. | Findings: The endotracheal tube tip sites 5 cm above the carina. A left-sided IJ central intravenous catheter tip sits in the left brachiocephalic vein. The right-sided IJ PICC line tip sits in the upper SVC. The heart size is large but stable. The mediastinal contours are within normal limits. There are no bibasilar and perihilar opacities or a confluent opacity in the right upper lung. These findings likely represent increased pulmonary edema as well as right upper and lower lobe consolidations. Retrocardiac opacity is also compatible with a left lower lobe consolidation. The costophrenic angles are excluded from the study limiting assessment for subtle pleural effusion. There is no large pneumothorax. Impression: 1. Lines and tubes in place. 2. Increased pulmonary edema without consolidations. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 24754e52-7336ea34-603896e1-a86b2dd6-17909981, 64988a4a-7c2cfce5-4e93b5ca-d55602d6-94c83006 | 51656138 | 11022245 | Findings: One portable AP view of the chest. The Swan-Ganz catheter through a right internal jugular approach ends in the region of the main pulmonary artery. The left internal jugular catheter ends in the left brachiocephalic vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The previously seen moderate-to-severe pulmonary edema has slightly improved. The right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is stable. Mediastinal and hilar contours are normal. No pneumothorax. Impression: 1. Slightly decreased pulmonary edema compared to most recent study, however right upper and lower lobe parenchymal opacities are more prominent and may represent pneumonia. 2. Lines and tubes are in standard position. | Findings: One portable AP view of the chest. The Swan-Ganz catheter through a right internal jugular approach ends in the region of the right atrium. The left internal jugular catheter ends in the left brachiocephalic vein just before the svc. Endotracheal tube ends 2 cm from the carina. No pulmonary edema. The right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is stable. Mediastinal and hilar contours are normal. No pneumothorax. Impression: 1. Slightly decreased pulmonary edema compared to most recent study, however right upper and lower lobe parenchymal opacities are more prominent and may represent pneumonia. 2. Lines and tubse are in standard position. | ['Change position of device', 'Add typo', 'False negation'] |
| df81aa63-051ce829-f15a7ba0-391d8fb4-f81549e5 | 52391187 | 11022245 | Findings: No significant change within the airspace opacity at the left mid lung zone. Again seen medial right base airspace opacity, unchanged Right IJ Port-A-Cath is unchanged in position. Sternotomy wires. Cardiac valve replacement is noted. Heart is enlarged, unchanged. Again seen prominent bilateral hilar in haziness the pulmonary vascular consistent pulmonary vascular congestion. This preliminary report was reviewed with Dr. ___, ___ radiologist. Impression: No change in the left midlung airspace opacity or in the airspace opacity at the right medial lung base | Findings: No significant change within the airspace opacity at the left mid lung zone. Again seen medial right bass airspace opacity, unchanged Right IJ dialysis catheter is unchanged in position. Sternotomy wires. No cardiac valve replacement is noted. Heart is enlarged, unchanged. Again seen prominent bilateral hilar in haziness the pulmonary vascular consistent pulmonary vascular congestion. This preliminary report was reviewed with Dr. ___, ___ radiologist. Impression: No change in the left midlung airspace opacity or in the airspace opacity at the right medial lung base | ['Change name of device', 'Change to homophone', 'False negation'] |
| 957e4fa0-2b741119-9fb1f79c-62130589-86d6cbed | 53978610 | 11022245 | Findings: Rounded right midlung opacity compatible with previously described septic embolus is decreased in size from the prior study. Left midlung rounded consolidation is more conspicuous than previously seen. Potential etiologies include developing pneumonia, additional septic embolus or collection of fissural fluid, though the lateral argues against the latter. Small left pleural effusion is noted along with left greater than right bibasilar atelectasis. Marked enlargement of the cardiac silhouette is similar to the study from ___ though notably larger than the immediate post-procedure study from ___. Left PICC is in satisfactory position in the superior cavoatrial junction. Median sternotomy wires and aortic valve replacement are also noted. Impression: 1. More conspicuous left midlung opacity concerning for developing pneumonia or septic embolus. 2. Improved small left pleural effusion and left greater than right bibasilar atelectasis. Findings were discussed by telephone with ___, NP, by Dr. ___ on ___ at ___. | Findings: Rounded right midlung opacity compatible with previously described septic embolus is increased in size from the prior study. Left midlung rounded consolidation is more conspicuous thna previously seen. Potential etiologies include developing pneumonia, additional septic embolus or collection of fissural fluid, though the lateral argues against the latter. No pleural effusion is noted along with left greater than right bibasilar atelectasis. Marked enlargement of the cardiac silhouette is similar to the study from ___ though notably smallter than the immediate post-procedure study from ___. Left PICC is in satisfactory position in the superior cavoatrial junction. Median sternotomy wires and aortic valve replacement are also noted. Impression: 1. More conspicuous left midlung opacity concerning for developing pneumonia or septic embolus. 2. Improved large left pleural effusion and left greater than right bibasilar atelectasis. Findings were discussed by telephone with ___, NP, by Dr. ___ on ___ at ___. | ['Change severity', 'Add typo', 'False negation'] |
| 9ca1e240-842fe6d2-5b26c6f5-a9523752-6603498e | 55490259 | 11022245 | Findings: AP portable upright view of the chest. There has been interval intubation with the tip of the endotracheal tube positioned 3.3 cm above the carina. The right upper extremity access PICC line is unchanged. There is increasing bibasilar atelectasis. Impression: As above. | Findings: AP portable upright view of the chest. There has been interval intubation with the tip of the endotracheal tube positioned 4.2 cm above the carina. The right upper extremity access PICC line is unchagned. There is increasing bibasilar atelectasis with a new left pleural effusion. Impression: As above. | ['Change measurement', 'Add typo', 'False prediction'] |
| 848b0d7f-e95a86d4-0c40c933-7b2dc937-ac3d74c6 | 56258422 | 11022245 | Findings: As compared to the previous radiograph, the right venous introduction sheath has been removed and a left PICC line has been inserted. The course of the line is unremarkable, the tip of the line projects over the mid SVC. There is no evidence of complications, notably no pneumothorax. The pre-existing bilateral parenchymal opacities, mostly caused by pleural effusions and subsequent atelectasis, have decreased in extent. | Findings: As compared to the previous radiograph, the right venous introduction sheath has been removed and a left central venous catheter has been inserted. The coarse of the line is unremarkable, the tip of the line projects over the mid SVC. There is subtle left lower lobe consolidation. There is no evidence of complications, notably no pneumothorax. The pre-existing bilateral parenchymal opacities, mostly caused by pleural effusions and subsequent atelectasis, have decreased in extent. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| 777626de-a55fbd7d-e30f8359-db74c619-80afa62d | 56603583 | 11022245 | Findings: As compared to the previous exam, the patient has been extubated and the nasogastric tube has been removed. The extent of the pre-existing pleural effusions have bilaterally increased. There is moderate-to-extensive cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate fluid overload. No focal parenchymal opacity suggest pneumonia. | Findings: As compared to the previous exam, the patient has been extubated and the nasogastric tube has been removed. The extent of the pre-existing pleural effusions have bilaterally increased. There is a newly placed central venous catheter with its tip in the lower SVC. There is moderate-to-extensive cardiomegaly with bilateral extensive areas of atelectasis. Findings: As compared to the previous exam, the patient has been extubated and the nasogastric tube has been removed. Mild-to-moderate fluid overload. No focal parenchymal opacity suggest pneumonia. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| a3539c79-41479e80-4150d89e-96e86692-6876133e, c2ace888-d3f68f82-2d5b5dd6-07dc85c9-327c4bce | 57185571 | 11022245 | Findings: As compared to the previous radiograph, the right-sided pleural effusion has minimally decreased. On the left, however, the effusion has substantially increased and leads to a near total opacification of the left hemithorax. Subsequently, severe atelectatic changes are present. The Swan-Ganz catheter has been removed, the right internal jugular vein catheter has also been removed, a nasogastric tube, the endotracheal tube and a venous introduction sheath remains in situ. | Findings: As compared to the previous radiograph, the right-sided pleural effusion has minimally decreased. On the left, however, the effusion has substantially increased and leads to a near total opacification of the left hemithorax. Subsequently, severe atelectatic changes are present. The Swan-Ganz catheter has been removed, the right internal jugular vein catheter is still in place, a nasogastric tube, the endotracheal tube and a venous introduction sheath remains in situ. The cardiac silhouette remains stable in appearance. | ['Change name of device', 'Add contradiction', 'False prediction'] |
| 7c113cab-8f9bee61-2b8ef272-d3fb769c-21b9dd1c | 57732352 | 11022245 | Impression: Comparison to ___, 18:21. The position of the right PICC line and of the endotracheal tube are stable and correct. The tip of the endotracheal tube projects approximately 5 cm above the carina. Increasing areas of right basal and left retrocardiac atelectasis. Otherwise unchanged radiographic appearance of the lung and of the heart. | Impression: Comparison to ___, 18:21. The position of the right PICC line and of the endotracheal tube are stable and correct. The tip of the endotracheal tube projects approximately 5 mm above the carina. Increasing areas of right basal and left retrocardiac atelectasis. Otherwise unchanged radiographic appearance of the lung and of the hart. | ['Change measurement', 'Change to homophone', 'False negation'] |
| f7ba6691-53545537-20c8b2dc-79dbd392-36f05d15 | 58274962 | 11022245 | Findings: Rounded bilateral mid lung opacities are again seen, grossly unchanged and likely reflect consolidative infectious process given history of septic emboli. There is unchanged bibasilar opacification, which is likely atelectasis with left greater than right effusions. Cardiac silhouette is markedly enlarged, similar to the most recent prior. Left PICC terminates in the cavoatrial junction. Median sternotomy wires are intact. Impression: 1. Unchanged bilateral mid lung opacities likely reflect infectious process given history of septic emboli. 2. Unchanged or slightly increased left greater than right pleural effusion and associated atelectasis. | Findings: Rounded bilateral mid lung opacitise are again seen, grossly unchanged and likely reflect consolidative infectious process given history of septic emboli. There is unchanged bibasilar opacification, which is likely atelectasis without effusions. Cardiac silhouette is markedly enlarged, similar to the most recent prior. Left pacemaker terminates in the cavoatrial junction. Median sternotomy wires are intact. Impression: 1. No bilateral mid lung opacities. 2. Unchanged or slightly increased left greater than right pleural effusion and associated atelectasis. | ['Change name of device', 'Add typo', 'False negation'] |
| 8d3d599d-c63f3e85-fcd2ddbe-2e931945-482b1161 | 58402174 | 11022245 | Findings: AP portable semi upright view of the chest. Lung volumes are low limiting assessment. There is increased bibasilar atelectasis and bronchovascular crowding. Overall cardiomediastinal silhouette is unchanged. The right upper extremity access PICC line appears in unchanged position extending to the level of the cavoatrial junction. Mild congestion is difficult to exclude in the correct clinical setting. No overt signs of edema. Impression: Increasing bibasilar atelectasis. Possible mild pulmonary vascular congestion. | Findings: AP portable semi upright view of the chest. Lung volumes are low limiting assessment. There is increased left basilar atelectasis and bronchovascular crowding. Overall cardiomediastinal silhouette is unchanged. The right upper extremity access PICC line appears in unchanged position extending to the level of the cavoatrial junction. Mild congestion is difficult to exclude in the correct clinical setting. No overt signs of edema. There is a right internal jugular central venous catheter in place. Impression: Increasing bibasilar atelectasis. Possible mild pulmonary vascular congestion. No evidence of increasing atelectasis. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 833353ab-ca676eba-dc9127a5-675bc9a1-79e5737d | 52056685 | 11052273 | Impression: In comparison with the study of ___, there is again some enlargement of the cardiac silhouette without definite vascular congestion, pleural effusion, or acute focal pneumonia. | Impression: In comparison with the study of ___, there is again some enlargement of the cardiac silhouette without definite vascular congestion, pleural effusion, or acute focal pneumonia. A central venous line is in place. | ['Add medical device', 'Add repetitions', 'False prediction'] |
| e8da4f53-f62c1459-cc4b5add-8a21431c-c2395de1 | 53407845 | 11052273 | Impression: Overall, cardiac and mediastinal contours are stable. Interval appearance of patchy opacity at the left base could represent early pneumonia, although aspiration or patchy atelectasis would also be in the differential. Clinical correlation is advised. No evidence of pulmonary edema, pneumothorax or pleural effusions. No acute bony abnormality. | Impression: Overall, cardiac and mediastinal contours are stable. Overall, cardiac and mediastinal contours are stable. Interval appearance of patchy opacity at the right base could represent early pneumonia, although aspiration or patchy atelectasis would also be in the differential. Clinical correlation is advised. No evidence of pulmonary edema, pneumothorax or pleural effusions. No acute bony abnormality. A central venous line is present. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 806524e4-d5ed7e9b-1ac2dada-ba9c4a48-68216237, f9f7d4af-2d90cb81-2541b729-6aab0e3f-06acb455 | 53537165 | 11052273 | Impression: No definite evidence for congestive heart failure. Patchy streaky opacity in the right lung base likely reflects atelectasis though infection is difficult to exclude. | Impression: No definite evidence for congestive heart failure. Patchy streaky opacity in the left lung base likely reflects atelectasis though infection is difficult to exclude. | ['Change location', 'Change to homophone', 'False negation'] |
| 23eb46d8-6ba45d7f-fa02d462-a31da493-b8b7e5af, e35b1970-3dfc9412-ec657374-09990870-561ca892 | 53702175 | 11052273 | Findings: AP and lateral views of the chest. Thereis hyperinflation, consistent with background COPD. There is increased diffuse parenchymal opacities bilaterally, more prominent at the bases consistent with mild pulmonary edema. There are small bilateral pleural effusions layering posteriorly, left greater than right. There is fluid in the major fissure seen on the lateral view. There is moderate cardiomegaly. No pneumothorax. The left hemidiaphragm is elevated laterally. Impression: Moderate cardiomegaly, mild pulmonary edema and small bilateral pleural effusions consistent with CHF. | Findings: AP and lateral views of the chest. Thereis hyperinflation, consistent with background COPD. There is increased diffuse parenchymal opacities bilaterally, more prominent at the bases consistent with moderate pulmonary edema. There are small bilateral pleural effusions layering posteriorly, left greater tgan right. There is fluid in the major fissure seen on the lateral view. There is mild cardiomegaly. No pneumothorax. The left hemidiaphragm is elevated laterally. Impression: Moderate cardiomegaly, mild pulmonary edema and small bilateral pleural effusions consistent with CHF. There is a central venous line in place. | ['Change severity', 'Add typo', 'Add medical device'] |
| d7395617-98bb6ef8-6f0187e5-2c3df909-6f3a57c4 | 54389393 | 11052273 | Findings: Single portable view of the chest. Bibasilar opacities with blunting of the costophrenic angles which could be due to effusions. There are indistinct pulmonary vascular markings. Relatively lentiform-shaped opacity over the right mid lung is suggestive of fluid within the fissure. The cardiac silhouette is enlarged, similar to prior. Atherosclerotic calcifications are noted. Impression: Pulmonary vascular congestion, small effusions with probable fluid in the right fissure. | Findings: Single portable view of the chest. Bilateral mid-lung opacities with blunting of the costophrenic angles which could be due to effusions. There are indistinct pulmonary vascular markings. Relatively lentiform-shaped opacity over the left mid lung is suggestive of fluid within the fissure. The cardiac silhouette is enlarged, similar to prior. Atherosclerotic calcifications are noted. Central venous line is in place. Impression: Pulmonary vascular congestion, small effusions with probable fluid in the right fissure. Relatively clear lung fields with no significant effusions. | ['Change location', 'Add contradiction', 'Add medical device'] |
| f0f60c0b-52abfabd-2b92739a-f825fa77-74c719e9 | 57433211 | 11052273 | Impression: Heart size and mediastinum are stable. No change in mild cardiomegaly and prominence of the main pulmonary arteries present. Mild vascular congestion is present but there is no overt pulmonary edema. No appreciable pleural effusion or pneumothorax. | Impression: Heart size and mediastinum are stable. No change in severe cardiomegaly and prominence of the main pulmonary arteries present. Mild vascular congestion is present but there is no overt pulmonary edema. Mild pulmonary edema. No appreciable pleural effusion or pneumothorax. | ['Change severity', 'Add contradiction', 'False negation'] |
| 97cfb5fb-f151949c-ec5357b7-3b5b1046-5ef2a77c | 58377417 | 11052273 | Impression: Moderate cardiomegaly is comparable, but pulmonary vascular congestion and upper lobe redistribution of blood flow have developed. There is no pulmonary edema or appreciable pleural effusion. No pneumothorax. No focal consolidation to suggest pneumonia. | Impression: Mild cardiomegaly is comparable, but pulmonary vascular congestion and upper lobe redistribution of blood flow have develeped. There is no pulmonary edema or appreciable pleural effusion. No pneumothorax. No focal consolidation. | ['Change severity', 'Add typo', 'False negation'] |
| 1d1ad085-bc04d368-4062c6ff-8388f25c-c9acb192, 9b4fdd07-1f45d8dc-4890ea49-e3f06306-639cb645 | 59032183 | 11052273 | Findings: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable and top-normal in size. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process. | Findings: PA and lateral views of the chest privded. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable and top-normal in size. Multiple bilateral pulmonary nodules are seen. Imaged osseous structures are intact. No free air below the left hemidiaphragm is seen. Impression: No acute intrathoracic process. | ['Change location', 'Add typo', 'False prediction'] |
| 2876892c-9a38069a-e2cf1491-82ef0d5f-a4935ae3, 43b6f8f9-f0d77b57-b2603100-48f5611a-a7405f03 | 50367895 | 11052935 | Findings: There is ill-defined opacity in the left upper lobe. There has been interval resolution of the left lower lobe consolidation. Heart and mediastinal contours are within normal limits. No pneumothorax is seen. Biapical pleural thickening is present. Underlying emphysematous changes are noted. Impression: Left upper lobe pneumonia. Recurrent infection in an area that is chronically abnormal may be due to atypical mycobacterial infection. Findings discussed with Dr. ___ by Dr. ___ by telephone at 11:30 p.m. on ___ at the time of discovery of these findings and at the time of wet read request. Additional diagnostic consideration of atypical mycobacterical infection was discussed with Dr. ___ by Dr. ___ by phone at 8:03 a.m. on ___ after attending radiologist review. | Findings: There is ill-defined opacity in the left upper lobe. There has been interval resolution of the right lower lobe consolidation. Heart and mediastinal contours are within normal limits. No pneumothorax is seen. No pleural thickening is present. Underlying emphysematous changes are noted. Impression: No left upper lobe pneumonia. Recurrent infection in an area that is chronically abnormal may be due to atypical mycobacterial infection. Findings discussed with Dr. ___ by Dr. ___ by telephone at 11:30 p.m. on ___ at the time of discovery of these findings and at the time of wet read request. Additional diagnostic consideration of atypical mycobacterical infection was discussed with Dr. ___ by Dr. ___ by phone at 8:03 a.m. on ___ after attending radiologist review. | ['Change location', 'Add contradiction', 'False negation'] |
| 523db987-d0978a19-c8725d72-5e091b8d-9564d8d9, f3686ece-bb54acba-7f3b1ce4-b9166b5f-cd9b52c2 | 50457087 | 11052935 | Findings: A new area of consolidation has developed in the left lower lobe, and is concerning for developing pneumonia considering the clinical suspicion for this entity. Additional nonspecific patchy opacity at the periphery of the right lung base could reflect focal atelectasis, or an additional site of infection. Severe upper lobe predominant emphysema is again demonstrated. Cardiomediastinal contours are normal. No pleural effusion or pneumothorax is evident. | Findings: A new area of consolidation has developed in the left lower lobe, and is concerning for developing pneumonia considering the clinical suspicion for this entity. Additional nonspecific patchy opacity at the periphery of the right lung base could reflect focal atelectasis, or an additional site of infection. Mild upper lobe predominant emphysema is again demonstrated. Cardiomediastinal contours are abnormal. No pleural effusion or pneumothorax is evident. Mild perihilar infiltrates in the upper lobes. | ['Change severity', 'Add contradiction', 'False prediction'] |
| 4349ed2f-1f67b94b-ea3230e8-7aa7e2a9-e04dd888, c8913af9-734e331d-173b2e64-3bd029ab-fb2771ae | 51137224 | 11052935 | Findings: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs appear hyperexpanded, in keeping with known emphysema. Previously seen left lower lobe opacity has resolved on the frontal view but may persist on lateral view obscuring the posterior costophrenic angle, which could represent a component of residual infection and/or atelectasis. There is trace basilar atelectasis on the right. There is no large effusion. Eventration is seen on the right, unchanged. Impression: Bibasilar dependent atelectasis. Persistent probable left lower lobe posterior opacity which could represent atelectasis or a component of residual infection, to be clinically correlated. Followup after treatment recommending to document resolution. | Findings: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs appear hyperexpanded, in keeping with known emphysema. Previously seen right lower lobe opacity has resolved on the frontal view but may persist on lateral view obscuring the posterior costophrenic angle, which could represent a component of residual infection and/or atelectasis. There is trace basilar atelectasis on the right. There is no large effusion. Eventration is seen on the right, unchanged. There are multiple rib fractures. Impression: Bibasilar dependent atelectasis. Bibasilar dependent atelectasis. Persistent probable left lower lobe posterior opacity which could represent atelectasis or a component of residual infection, to be clinically correlated. Followup after treatment recommending to document resolution. | ['Change location', 'Add repetitions', 'False prediction'] |
| 60ac55ad-b8bf8c04-356991fb-91f18417-83b359fa, 727f555b-ca31baa2-5a5d16fd-ca9b8960-5a9ce4e0 | 51882937 | 11052935 | Findings: PA and lateral chest radiographs were provided. There is a subtle opacity in the right lower lobe that is concerning for early pneumonia. There is linear scarring in the left upper lobe from area of prior pneumonia that has resolved. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. There is no free air under the right hemidiaphragm. There are no acute osseous lesions. Impression: 1. Possible early right lower lobe pneumonia. 2. Left upper lobe scarring from prior pneumonia. 3. Findings consistent with COPD. | Findings: PA and lateral chest radiographs were provided. There is a subtle opacity in the left lower lobe that is concerning for early pneumonia. There is linear scarring in the left upper lobe from area of prior pneumonia that has resolved. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is no pleural effusion or pneumothorax. There is linear scarring in the left upper lobe from area of prior pneumonia that has resolved. There is no free air under the right hemidiaphragm. There are no acute osseous lesions. Impression: 1. No pneumonia. 2. Left upper lobe scarring from prior pneumonia. 3. Findings consistent with COPD. | ['Change location', 'Add repetitions', 'False negation'] |
| f1af4079-d3abad02-2bdd2d45-9f43ee98-bb00dc90 | 53792271 | 11052935 | Findings: Residual stellate left upper lobe opacity is most compatible with scarring. Left mid lung granuloma is unchanged. Otherwise, the lungs remain hyperexpanded compatible with chronic obstructive pulmonary disease without new opacity. There is no pleural effusion or pneumothorax. The heart is normal in size and cardiomediastinal contours. Impression: Residual left upper lobe stellate opacity may reflect scarring after pneumonia. However, followup radiograph in ___ weeks is recommended. Findings were entered in the radiology department's online record for notification of critical results on ___. | Findings: Residual stellate left lower lobe opacity is most compatible with scarring. Left mid lung granuloma is still unchanged. Otherwise, the lungs remain hyperexpanded compatible with chronic obstructive pulmonary disease with new opacities. There is no pleural effusion or pneumothorax. The heart is normal in size and cardiomediastinal contours. A left-side pacemaker is in place. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 50ca584b-f859bda7-fd523d01-28a67cc1-ac2b5c55, b7e54cea-2a3fc10b-f21fa55c-64fe5b63-5306646b | 53884408 | 11052935 | Impression: Slight interval improvement in ill-defined patchy opacity within the right lower lobe likely representing pneumonia. Patchy opacity in the left lower lobe may be reflective of atelectasis, though infection in this region also cannot be excluded, but appears relatively unchanged compared to the prior study. | Impression: Slight interval improvement in ill-defined patchy opacity within the left lower lobe likely representing pneumonia. Patchy opacity in the left lower lobe may be reflective of atelectasis, though infection in this region also cannot be excluded, but appears relatively unchanged compared to the prior study. A central venous line is noted in the right subclavian vein. Patchy opacity in the left lower lobe may be reflective of atelectasis, though infection in this region also cannot be excluded, but appears relatively unchanged compared to the prior study. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 92c1d255-50a94318-0d4def6d-64a46468-3233bb79, d4800b11-08ea5ece-04ba7667-a463e711-378c3893 | 55372843 | 11052935 | Findings: Frontal and lateral views of the chest were obtained. The lungs are hyperinflated. There is no focal consolidation, pleural effusion or pneumothorax. Small focal opacity projects over the lateral right lower hemithorax, may represent overlapping structures, but further evaluation is recommended with shallow obliques to assess for possible pulmonary nodule. Heart size is normal. Mediastinal silhouette and hilar contours are normal. Impression: 1. No acute intrathoracic process. 2. Small focal opacity projects over the lateral right lower hemithorax. Shallow obliques off the frontal view are recommended for further evaluation. Findings and recommendations discussed with Dr. ___ (covering for Dr. ___, ___ by phone at ___:___pm ___. | Findings: Frontal and lateral views of the abdomen were obtained. The lungs are hyperinflated. There is no focal consolidation, pleural effusion or pneumothorax. Small focal opacity projects over the lateral right lower hemithorax, may represent overlapping structures, but further evaluation is recommended with shallow obliques to assess for possible pulmonary nodule. Heart size is normal. Mediastinal silhouette and hilar contours are normal. Impression: 1. No acute intrathoracic process. 2. Mild pulmonary congestion. 3. Small focal opacity projects over the lateral right lower hemithorax. Shallow obliques off the frontal view are recommended for further evaluation. Findings and recommendations discussed with Dr. ___ (covering for Dr. ___, ___ by phone at ___:___pm ___. Additionally, right IJ central venous catheter is noted. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 9870d11d-3a0d9c78-f49f71c6-58644dd5-ce1b85fb | 56129930 | 11052935 | Findings: There is increased opacification in the left lung base with obscuration of the left hemidiaphragm when compared to ___. Again noted is hyperinflation and flattening of the diaphragms suggesting emphysema. The cardiomediastinal silhouette is within normal limits. Impression: Left lower lobe pneumonia, more apparent than on ___. | Findings: There is increased opacification in the right lung base with obscuration of the left hemidiaphragm when compared to ___. Again noted is hyperinflation and flattening of the diaphragms suggesting emphysema. The cardiomediastinal silhouette is within normal limits. There is a small right pleural effusion. Impression: Left lower lobe pneumonia, more apparent than on for ___. | ['Change location', 'Change to homophone', 'False prediction'] |
| ab104077-b39a8fcb-8c1d8fd5-5a8badb0-be5353a1 | 56673612 | 11052935 | Findings: In comparison with the study of ___, the increased opacification at the left base has substantially cleared. The suspected area of opacification at the right base laterally is barely perceptible at this time. Substantial hyperexpansion of the lungs with upper lobe predominant emphysema is again noted and there is little change in the appearance of the cardiomediastinal silhouette. | Findings: In comparison with the study of ___, the increased opacification at the right base has substantially cleared. The suspected area of opacification at the right base laterally is barely perceptible at this time. Substantial hyperexpansion of the lungs with upper lobe predominant emphysema is gain noted and there is little change in the appearance of the cardiomediastinal silhouette. There is a small right pleural effusion present. | ['Change location', 'Change to homophone', 'False prediction'] |
| 1de015eb-891f1b02-f90be378-d6af1e86-df3270c2 | 57171514 | 11052935 | Findings: Single portable view of the chest. The lungs are hyperinflated but clear of consolidation. The cardiomediastinal silhouette is within normal limits. Osseous structures are unremarkable. Impression: No acute cardiopulmonary process. | Findings: Single portable view of the chest. The lungs are clear of consolidation. The lungs are clear of consolidation. The cardiomediastinal silhouette is within normal limits. There is a left lower lobe infiltrate. Osseous structures are unremarkable. Impression: No acute cardiopulmonary process. | ['False negation', 'Add repetitions', 'False prediction'] |
| 4859ca51-f9aec9f3-e0959b5c-a6342b33-28811875 | 57214202 | 11052935 | Impression: Moderate COPD. Probable left lower lobe pneumonia. | Impression: Moderate COPD. Probable right lower lobe pneumonia. Probable right lower lobe pneumonia. | ['Change location', 'Add repetitions', 'False negation'] |
| 2f142040-3d2b5cf2-a37622c9-4909cb67-92fad10f, cd80755e-af71f75a-2e48e700-630387b9-5c322a17 | 57502393 | 11052935 | Findings: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vascularity is normal. The lungs are hyperinflated with severe emphysema. Punctate calcified granulomas are seen within the lung bases. Linear opacities in the lung bases likely reflect scarring or subsegmental atelectasis. Residual patchy opacity within the left upper lobe likely reflects scarring, as seen on the prior chest CT. No new consolidation, pleural effusion or pneumothorax is identified. Scarring within the lung apices is again noted. There is diffuse demineralization of the osseous structures. Impression: No acute cardiopulmonary abnormality. Severe emphysema. Residual left upper lobe opacity likely reflects scarring, as seen on the prior chest CT, with bibasilar linear opacities either reflecting subsegmental atelectasis or scarring. | Findings: Heart size is normal. Mediastinal and hilar contours are remarkable. Pulmonary vascularity is abnormal. The lungs are hyperinflated with severe emphysema. Punctate calcified granulomas are seen within the lung bases. Linear opacities in the lung bases likely reflect scarring or subsegmental atelectasis. Residual patchy opacity within the left upper lobe likely reflects an infection, as seen on the prior chest CT. No new consolidation, pleural effusion or pneumothorax is identified besides a small right-sided effusion. Scarring within the lung apices is again noted. There is diffuse demineralization of the osseous structures. Impression: No acute cardiopulmonary abnormality. Moderate emphysema. Residual left upper lobe opacity likely reflects scarring, as seen on the prior chest CT, with bibasilar linear opacities either reflecting subsegmental atelectasis or scarring. | ['Change severity', 'Change to homophone', 'False prediction'] |
| 2528f6e5-586bb3a0-e00e7283-5c594954-fe27b052 | 58831403 | 11052935 | Findings: AP portable upright chest radiograph was provided. The lungs are hyperinflated with upper lobe lucency compatible with emphysema. No focal consolidation, effusion, or pneumothorax seen. Cardiomediastinal silhouette is normal. Bony structures are intact. Impression: Severe emphysema without superimposed consolidation. | Findings: AP portable upright chest radiograph was provided. The lungs are hyperinflated with upper lobe lucency compatible with emphysema. No vocal consolidation, effusion, or pneumothorax seen. The cardiomediastinal silhouette is normal with mild aortic tortuosity. Bony structures are intact with multiple bilateral rib fractures. Impression: Mild emphysema without superimposed consolidation. | ['Change severity', 'Change to homophone', 'False prediction'] |
| 146e8390-fd657795-492c6a0b-7aaa1bef-06c08c00 | 59503672 | 11052935 | Findings: Single portable view of the chest is compared to previous exam from ___. As on prior, the lungs are hyperinflated with parenchymal changes suggestive of emphysema, particularly at the left lung apex. Increased interstitial markings are identified at the left lung base. Elsewhere, the lungs are grossly clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. Linear patchy at the right lung base is compatible with atelectasis versus scarring. Impression: Increased interstitial markings at the left lung base, potentially due to chronic changes; however, in the proper clinical setting, component of infection is also possible. Two views of the chest may help further characterize. | Findings: Single portable view of the chest is compared to previous exam from ___. As on prior, the lungs are hyperinflated with parenchymal changes suggestive of emphysema, particularly at the right lung apex. Increased interstitial markings are identified at the left lung base. Elsewear, the lungs are grossly clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. Linear patchy at the right lung base is compatible with atelectasis versus scarring. A central venous line is present. | ['Change location', 'Change to homophone', 'Add medical device'] |
| d6fbe6a9-57f6ae9d-07f24e69-1c032794-76d80d8f | 50533006 | 11204646 | Findings: The heart size is enlarged. The mediastinal contours demonstrate engorgement of the central venous vasculature. Additionally small bilateral pleural effusions are present with basilar atelectasis. There does not appear to be appreciable interstitial edema. There is no pneumothorax. Impression: Cardiomegaly and small bilateral pleural effusions but no evidence of CHF. | Findings: The heart size is moderately enlarged. The mediastinal contours demonstrate severe engorgement of the central venous vasculature. Additionally large bilateral pleural effusions are present with basilar atelectasis. There does not appear to be appreciable interstitial edema. There is no pneumothorax. Impression: Cardiomegaly and no pleural effusions but no evidence of CHF. | ['Change severity', 'Add contradiction', 'False negation'] |
| 53f16e4e-347b6971-9312cbfa-d05f1ca8-6046ec2f | 51807337 | 11204646 | Impression: AP chest compared to ___: Severe cardiomegaly is chronic and mediastinal veins are generally dilated. Moderate right pleural effusion increased in ___ compared to ___, moderate in size and subsequently unchanged. Left lung is grossly clear. ET tube in standard placement. Nasogastric tube passes below the diaphragm and out of view. A right subclavian PICC line can be traced into the right atrium, but the tip is quite indistinct. No pneumothorax. | Impression: AP chest compared to ___: Severe cardiomegaly is chronic and mediastinal veins are generally dilated. Moderate right pleural effusion increased in ___ compared to ___, significant in size and subsequently unchanged. Left lung is grossly clear. Left-sided dual chamber pacemaker in standard placement. Nasogastric tube passes below the diaphragm and out of view. A right subclavian PICC line can be traced into the right atrium, but the tip is quite indistinct. No pneumothorax. A central venous line is also present. | ['Change name of device', 'Add contradiction', 'Add medical device'] |
| 87c43c95-278ced86-fb0beb94-95ff11a9-8e8a8c3f, ae0ca9f1-a6aa65c0-b8754692-be29d5b4-8ce0e6ff | 51866834 | 11204646 | Findings: Comparison is made to previous study from ___. The endotracheal tube and right-sided IJ central venous line are unchanged in position and appropriately sited. There is also a left-sided subclavian catheter with distal lead tip in the proximal SVC. There is stable cardiomegaly. There are again seen bilateral pleural effusions and a left retrocardiac opacity. There are no signs for overt pulmonary edema. There are no pneumothoraces. | Findings: Comparison is made to previous study from ___. The bronchoscopic tube and right-sided IJ central venous line are unchanged in position and appropriately sited. There is also a left-sided subclavian catheter with distal lead tip in the proximal SVC. There is stable cardiomegaly. There are again seen bilateral pleural effusions and a left retrocardiac opacity. There are streaky opacities suggestive of atelectasis in the lung bases. There are no pneumothoraces. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| 3ed3a641-a4156d57-ea055912-baebd6d1-30ae3af9 | 52079096 | 11204646 | Findings: As compared to the previous radiograph, there is no change in position of the monitoring and support devices. Unchanged volume loss at the right lung base. Unchanged disruption of the right bronchial air column, suggesting mucoid impaction. Unchanged borderline size of the cardiac silhouette. No pneumothorax. No pulmonary edema. No evidence of pneumonia. | Findings: As compared to the previous radiograph, there is no change in position of the monitoring and support devices. Unchanged volume loss at the left lung base. Unchanged disruption of the right bronchial air column, suggesting mucoid impaction. Unchanged bordeline size of the cardiac silhouette. No pneumothorax. No pulmonary edema. No evidence of pneumonia. A central venous line is present. | ['Change location', 'Add typo', 'Add medical device'] |
| 799b532b-5d5f4a41-fe352b84-83e78fa1-73e7b283 | 52842984 | 11204646 | Findings: Right internal jugular line ends at lower SVC whereas the dialysis catheter through the left subclavian approach ends at mid SVC. Moderate right pleural effusion and bilateral lower lung atelectasis are unchanged. Mild pulmonary vascular congestion is stable. Enlarged heart size, mediastinal and hilar contours are unchanged. No pneumothorax. | Findings: Right internal jugular line ends at lower SVC whereas the dialysis catheter through the left subclavian approach ends at mid SVC. Large right pleural effusion and bilateral lower lung atelectasis are unchanged. Severe pulmonary vascular congestion is stable. Enlarged heart size, mediastinal and hilar contours are unchanged. No pneumothorax and significant left pleural effusion. Cardiac pacemaker is present. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| d31b7429-f370f8c7-ceb83fb9-f7188520-153ffb88 | 52989952 | 11204646 | Findings: As compared to the previous radiograph, the cardiac silhouette is unchanged. There is increasing opacity at the right lung base. As previously noted, there is volume loss. This volume loss could now be accompanied by a small right pleural effusion. The left hemidiaphragm is also less visible, suggesting the potential for a small left pleural effusion. The monitoring and support devices, in particular the position of the endotracheal tube is constant. At the time of observation and dictation, 8:41 a.m., on ___, the referring physician ___. ___ was paged for notification. | Findings: As compared to the previous radiograph, the cardiac silhouette is unchanged. There is increasing opcaity at the right lung base. As previously noted, there is volume loss. This volume loss could now be accompanied by a small right pleural effusion. The left hemidiaphragm is also less visible, suggesting the potential for a small left pleural effusion. The monitoring and support devices, in particular the position of the central venous catheter is constant. There is moderate right-side heart enlargement. At the time of observation and dictation, 8:41 a.m., on ___, the referring physician ___. ___ was paged for notification. | ['Change name of device', 'Add typo', 'False prediction'] |
| fc346a9c-a6343b2b-98bdb36b-5a813740-aa659cba | 53737003 | 11204646 | Findings: A right internal jugular central venous catheter tip terminates in the mid SVC. No pneumothorax is identified. Moderate to severe cardiomegaly persists. Mediastinal and hilar contours are unchanged. A septal closure device is noted again. There is a small right pleural effusion with atelectatic changes in the right lung base. Left lung remains clear. | Findings: A right internal jugular tracheostomy tube tip terminates in the mid SVC. No pneumothorax is identified. Moderate to severe cardimoegaly persists. Mediastinal and hilar contours are unchanged. A septal closure device is noted again. There is a small right pleural effusion with atelectatic changes in the right lung base. Left lung has scattered opacities. | ['Change name of device', 'Add typo', 'False prediction'] |
| 4f7d591a-e6d9f7a8-05c5e886-421a776a-66a7a9eb | 54351633 | 11204646 | Findings: As compared to the previous radiograph, the previously visible right internal jugular vein catheter has been removed. The patient is still intubated, with an unchanged position of the endotracheal tube, nasogastric tube and the right PICC line. Unchanged moderate cardiomegaly. Unchanged mild-to-moderate right pleural effusion, unchanged mild fluid overload and areas of moderate retrocardiac atelectasis. There is no newly occurred focal parenchymal opacity. | Findings: As compared to the previous radiograph, the previously visible right IJ central venous catheter has been removed. The patient is still intubated, with an unchanged position of the endotracheal tube, nasogastric tube and the right IJ central venous catheter. Unchanged moderate cardiomegaly. Unchanged mild-to-moderate right pleural effusion, unchanged mild fluid overload and areas of moderate retrocardiac atelectasis. There is no newly occurred focal parenchymal opacity. There is the presence of a left-sided dual-chamber pacemaker device. | ['Change name of device', 'Add contradiction', 'Add medical device'] |
| ea99a6c6-34280d75-9f1ddc1c-837b3a69-a94986ea | 55470597 | 11204646 | Impression: AP chest compared to ___: Tip of the endotracheal tube at the upper margin of the clavicles is no less than 5 cm from the carina, with the chin in neutral or elevation. It could be advanced safely 15 mm to achieve better seating. Moderate right pleural effusion stable. Moderate-to-severe cardiomegaly stable. Upper lobe pulmonary vasculature mildly engorged, but no appreciable pulmonary edema. Right PIC line tip ends in the right atrium. Right internal jugular dual-channel catheter ends in the upper SVC. | Impression: AP chest compared to ___: Tip of the endotracheal tube at the upper margin of the clavicles is no less than 6 cm from the carina, with the chin in neutral or elevation. It could be advanced safely 2 cm to achieve better seating. No pleural effusion. Mild cardiomegaly stable. Upper lobe pulmonary vasculature mildly engorged, with evidence of mild pulmonary edema. Right PIC line tip ends in the right atrium. Right internal jugular dual-channel catheter ends in the upper SVC. | ['Change measurement', 'Add contradiction', 'False negation'] |
| 1aaf0cfe-67aa23d3-b5403e61-1b88698f-a6bf329b, a4849658-ce9b054b-b59e436d-df3b5ab8-80025982 | 55611611 | 11204646 | Findings: The study is somewhat limited due to patient rotation. The heart remains moderate to severely enlarged. Mediastinal widening is unchanged compared to the prior studies. The pulmonary vascularity is normal. Small right pleural effusion has decreased in the interval. Left lung is clear. There is minimal atelectasis in the right lung. No pneumothorax is present. No acute osseous abnormality is seen. Impression: Interval decrease in size of small right pleural effusion with mild right basilar atelectasis. | Findings: The study is somewha limited due to patient rotation. The heart remains mild to moderately enlarged. Mediastinal widening is unchanged compared to the prior studies. The pulmonary vascularity is normla. No pleural effusion is present. Left lung is clear. There is minimal atelectasis in the right lung. No pneumothorax is present. No acute osseous abnormality is seen. Impression: Interval decrease in size of small right pleural effusion with moderate right basilar atelectasis. | ['Change severity', 'Add typo', 'False negation'] |
| ae38c715-8eeb617e-ad8ab0a9-9f23fdef-9e43fccf | 57844625 | 11204646 | Findings: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 2.8 cm above the carina. The patient has also received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube is not visible on the current image. The right internal jugular vein catheter is in unchanged position. The atelectatic opacity at the right lung base is slightly increasing. There also is a disruption in the air column of the right main bronchus, so that bronchoscopic evaluation or clearance of potentially present mucus might be indicated. | Findings: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 4.1 cm above the carina. The patient has also received a nasogastric tube. The course of the tube is unremarkable, and the tip of the tube extends into the stomach on the current image. The right internal jugular vein catheter is malpositioned and needs adjustment. The atelectatic opacity at the right lung base is slightly improved. There also is a disruption in the air column of the right main bronchus, so that bronchoscopic evaluation might not be indicated. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| cdd198d4-7b34ff26-cdf455d8-f2c979c2-93535229 | 57940242 | 11204646 | Findings: The PICC ends in the upper SVC. The cardiomediastinal silhouette is normal, although evaluation is somewhat limited by patient's rotation. There is a moderate right pleural effusion, similar in size from the previous study on ___. No left pleural effusion is present. There is no consolidation or pneumothorax. Impression: Tip ends in the upper SVC. Results were communicated with the IV team at 10:45 a.m. on ___ via telephone by Dr. ___. | Findings: The NG tube ends in the upper SVC. The cardiomediastinal silhouette is normal, although evaluation is somewhat limited by patient's rotation. There is a moderate right pleural effusion, similar in size from the previous study on ___. No left pleural effusion is present. There is no consolidation or pneumothorax. Impression: Tip ends in the upper SVC. No left pleural effusion is present. Results were communicated with the IV team at 10:45 a.m. on ___ via telephone by Dr. ___. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| 016991da-a5224d79-0a00be4e-485841d2-f9e917e8 | 59171234 | 11204646 | Findings: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are constant. No evidence of pneumothorax. No other acute interval changes. | Findings: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are constant. No evidence of nodular opacities. No evidence of pneumothorax. No other acute interval changes. Nasogastric tube in place. | ['False negation', 'Add repetitions', 'Add medical device'] |
| 9f6c9e7b-4ccd8468-517c7976-e5deee18-02e95e8a | 59345943 | 11204646 | Findings: As compared to the previous radiograph, there is unchanged evidence of moderate cardiomegaly and a right pleural effusion. The signs indicative of fluid overload have increased in extent, best visible in the left upper lung. There is minimal blunting of the left costophrenic sinus, potentially indicative of the presence of a small pleural effusion. No evidence of pneumonia. | Findings: As compared to the previous radiograph, there is unchanged evidence of moderate cardiomegaly and no pleural effusion. The signs indicative of fluid overload have increased in extent, best visible in the right upper lung. There is minimal blunting of the left costophrenic sinsu, potentially indicative of the presence of a small pleural effusion. No evidence of pneumonia. | ['Change location', 'Add typo', 'False negation'] |
| 79c87d15-f10d7ef5-8935e2df-e2ed9032-32668f44 | 59627448 | 11204646 | Findings: As compared to the previous radiograph, the nasogastric tube is now visible. It is coiled in the stomach but the tip is located in the middle parts of the stomach. No evidence of complications, notably no pneumothorax. Otherwise unchanged chest radiograph. Unchanged cardiac silhouette. | Findings: As compared to the previous radiograph, the central venous line is now visible. It is coiled in the stomach but the tip is located in the middle parts of the stomach. No evidence of complications, notably no pneumothorax. Otherwise unchanged chest radiograph. Unchanged cardiac silhouette. There is presence of a pacemaker. | ['Change name of device', 'Add repetitions', 'Add medical device'] |
| 52117609-b59d4ebd-52c7b52f-db36024d-ceb8cb10, 551bcedc-af6b269e-41826aa7-ff9d0f78-4825ae4f | 53762508 | 11212873 | Impression: 1. Ill-defined patchy opacities in lung bases which may represent areas of infection or atelectasis. Small bilateral pleural effusions are present. 2. Subpleural opacity in the left lower lobe appears more prominent on the current exam, and corresponds to an area of pleural fat as noted on the prior chest CT. | Impression: 1. Ill-defined patchy opacities in lung bases which may represent areas of infection or atelectasis. No pleural effusions are present. 2. Subpleural opacity in the left lower lobe appears more prominent on the current exam, and corresponds too an area of pleural fat as noted on the prior chest CT. | ['Change severity', 'Change to homophone', 'False negation'] |
| 138e15e1-82368001-70725244-1ac06c0d-a272de11, 3470d736-53ab4170-ab83b760-57a5b839-c7302405 | 59983953 | 11212873 | Findings: An endotracheal tube approximately 7 cm from the carina and at the level of the clavicular head is in proper position. A feeding tube is seen within the stomach with the tip out of the field of view. A left chest tube is present. Mediastinal drains are in place. Sternal wires with a stabilizing device are present. A Swan-Ganz catheter is seen within the right atrium, but the distal tip cannot be traced further due to the overlying structures. The cardiomediastinal silhouette has the normal postoperative appearance. There is mild bibasilar atelectasis and right upper lobe atelectasis. There are no pleural effusions or pulmonary edema. The previously seen pulmonary edema has resolved. There is no pneumothorax. Impression: 1. Bibasilar and right upper lobe atelectasis. 2. Endotracheal tube, chest tube, mediastinal drains and Swan-Ganz catheter appear to be in the proper positions. | Findings: An endotracheal tube approximately 1 cm from the carina and at the level of the clavicular head is in proper position. A feeding tube is seen within the stomac with the tip out of the field of view. No left chest tube is present. Mediastinal drans are in place. Sternal wires with a stabilizing device are present. A Swan-Ganz catheter is seen within the right atrium, but the distal tip cannot be traced further due to the overlying structures. The cardiomediastinal silhouette has the normal postoperative appearance. There is mild bibasilar atelectasis and upper lobe atelectasis. There are no pleural effusions or pulmonary edema. The previously seen pulmonary edema has resolved. There is no pneumothorax. Impression: 1. Bibasilar and upper lobe atelectasis. 2. Endotracheal tube, chest tube, mediastinal drains and Swan-Ganz catheter appear to be in the proper positions. | ['Change measurement', 'Add typo', 'False negation'] |
| 2ae448b2-53515c0d-312135f4-a7a50238-20ffa8b0, daf87032-2b0e38da-25b00583-9645e9cf-b2beb530 | 50567642 | 11213613 | Impression: Improving pneumonia in the left lower lobe. Worsening opacity in the right lower lobe which could be due to increasing atelectasis, but developing pneumonia cannot be excluded and followup is recommended. | Impression: Improving pneumonia in the right lower lobe. Worsening opacity in the left lower lobe which could be due to increasing atelectasis, but developing pneumonia cannot be excluded and followup is recommended. There is a centrally placed NG tube. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 70cdba5b-2e0ec97d-779d4d58-23a484e4-02ec1b1c | 52190468 | 11213613 | Impression: In comparison with the study of ___, there are lower lung volumes. Engorgement and indistinctness of pulmonary vessels is consistent with worsening pulmonary vascular congestion. No definite acute focal pneumonia. | Impression: In comparison with the study of ___, there are upper lung volumes. Engorgement and indistinctness of pulmonary vessels is consistent with worsening pulmonary vascular congestion. No definite acute focal pneumonia. There is no central venous line. | ['Change location', 'Change to homophone', 'Add medical device'] |
| 60b7b7e2-29b9d91d-f3fd7cd8-8eca0ccf-2ac86d24, d95a8c9f-246f76d3-79c2407e-36d90a8c-83724850 | 52818853 | 11213613 | Findings: Heart size is normal when allowances are made for prominent bilateral pericardial fat pads, shown to better detail on CT abdomen of ___. Mediastinal and hilar contours are within normal limits and without change. Lungs are remarkable for upper lobe predominant emphysema, more severe in the right upper lobe than the left. No new focal lung abnormalities were detected, and there are no pleural effusions. Mild compression deformity in the mid thoracic spine is unchanged. Impression: Stable radiographic appearance of the chest with upper lobe predominant emphysema. No evidence of pneumonia. If symptoms persist, consider a chest CT for more complete evaluation if warranted clinically. | Findings: Heart size is normal when allowances are made for prominent bilateral pericardial fat pads, shown to better detail on CT abdomen of ___. Mediastinal and hilar contours are within normal limits and without change. Lungs are remarkable for upper lobe predominant emphysema, more severe in the left upper lobe than the left. No new focal lung abnormalities were detected, and there are no pleural effusions. Mild compression deformity in the mid thoracic spine is unchanged. No emphysema. No evidence of pneumonia. If symptoms persist, consider a chest CT for more complete evaluation if warranted clinically. No evidence of pneumonia. | ['Change location', 'Add repetitions', 'False negation'] |
| 229975a2-d2e6a791-a66a597a-9b370606-8323c2cd, ea67d96b-5e9c8ef1-ce01d8ec-5c0836f9-40596c5e | 55481818 | 11213613 | Findings: Linear opacities of the lung bases bilaterally likely reflect atelectasis. Hyperlucency of the upper zones is reflective of emphysema. No focal consolidation, pleural effusion, or pneumothorax. Heart size and mediastinal contours are normal. Osseous structures are demineralized diffusely with a compression deformity in the mid thoracic spine which is unchanged from ___. Impression: Emphysema and bibasilar atelectasis. No evidence of pneumonia. | Findings: Linear opacities of the lung bases bilaterally likely reflect atelectasis. Hyperlucency of the lower zones is reflective of emphysema. No focal consolidation, pleural effusion, or pneumothorax. Heart size and mediastinal counters are normal. Osseous structures are demineralized diffusely with a compression deformity in the mid thoracic spine which is unchanged from ___. An NG tube is seen in the esophagus, with its tip in the stomach. Impression: Emphysema and bibasilar atelectasis. No evidence of pneumonia. | ['Change location', 'Change to homophone', 'Add medical device'] |
| 37355a7b-cd57395e-8accb623-52bbdd41-53976f76, 7a1a7ec8-c865adb3-011681d5-d61e27b1-6d31ab75 | 50845269 | 11293517 | Findings: AP upright and lateral views of the chest were provided. Left chest wall pacer pack is again seen with leads extending into the right heart. Abandoned pacing leads are also noted in the right chest wall extending into the right heart. The heart remains moderately enlarged. Lung volumes are low, with equivocal ground-glass opacity on the frontal view, which appears less conspicuous on the lateral view most likely attributable to underpenetrated technique. No gross evidence for pneumonia or pulmonary edema. No large effusions are seen. There is no pneumothorax. Bony structures are intact. Impression: Limited study demonstrating moderate cardiomegaly and no overt edema or pneumonia. | Findings: AP upright and lateral views of the chest were provided. Left chest wall pacer pack is again seen with leads extending into the left heart. Abandoned pacing leads are also noted in the right chest wall extending into the right heart. The heart remains moderately enlarged. Lung volumes are low, with equivocal ground-glass opacity on the frontal view, which appears more conspicuous on the lateral view most likely attributable to underpenetrated technique. No gross evidence for pneumonia or pulmonary edema. No large effusions are seen. There is no pneumothorax. Bony structures are intact, except for a possible fracture of the right clavicle. Impression: Limited study demonstrating moderate cardiomegaly and mild pulmonary edema and pneumonia. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| 6f5a78a6-606c4fec-8ff6aaa9-b8ebe20c-88539ae6, 9365d3c7-5515995a-9a60e2d0-7c14ad59-92f8c798 | 52833948 | 11293517 | Findings: Frontal and lateral views of the chest were obtained. Lung volumes are slightly less as compared to the prior study. Again, there is enlargement of the cardiomediastinal silhouette which is slightly more prominent as compared to the prior study, which may be due to AP techique and lower lung volumes. Left-sided pacer device is stable. Right-sided abandoned leads are also unchanged. There is mild pulmonary vascular congestion. No definite focal consolidation is seen. There is no pleural effusion or evidence of pneumothorax. | Findings: Frontal and lateral views of the chess were obtained. Lung volumes are slightly less as compared to the prior study. Again, there is no enlargement of the cardiomediastinal silhouette. Left-sided dual-chamber pacemaker is stable. Right-sided central line is also unchanged. There is mild pulmonary vascular congestion. No definite focal consolidation is seen. There is no pleural effusion or evidence of pneumothorax. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 9abfcf21-da0840e6-626ec84f-027ee952-3bbbeffa, ac50a7e7-7e116074-b42ad5c9-c2a852c3-3c61019d | 53430284 | 11293517 | Findings: In comparison with study of ___, there is again enlargement of the cardiac silhouette with a pacer device in place. No definite vascular congestion, raising the possibility of underlying cardiomyopathy or pericardial effusion. No acute focal pneumonia. The right PICC line has been removed. | Findings: In comparison with study of ___, there is again enlargement of the cardiac silhouette with a pacer device in place. No definite vascular congestion, raising the possibility of underlying cardiomyopathy or pericardial effusion. No acute focal pneumonia. The right PICC line terminates in the mid SVC. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| 45aff2db-f97c8da4-6c6f992e-d40a0952-c0675aea, acea85a3-8db7b0ba-78f1bef1-81f7d8de-342f03f5 | 55101140 | 11293517 | Findings: Frontal and lateral views of the chest were obtained. Mild cardiomegaly is similar to prior. There is mild pulmonary congestion without overt pulmonary edema. No focal pulmonary consolidation, pleural effusion, or pneumothorax is seen. The osseous structures are unremarkable. The leads of an atriobiventricular ICD are in similar position to prior. Impression: Mild pulmonary congestion. | Findings: Frontal and lateral views of the chest were obtained. Mild cardiomegaly is similar to prior. There is mild pulmonary congestion without overt pulmonary edema. No focal pulmonary consolidation, pleural effusion, or pneumothorax is seen. The osseous structures are unremarkable. The leads of an atriobiventricular ICD are seen with the right atrium. No focal pulmonary consolidation, pleural effusion, or pneumothorax is seen. The osseous structures are unremarkable. Impression: No pulmonary congestion. | ['Change position of device', 'Add repetitions', 'False negation'] |
| 049f350d-00784726-84389895-f7bb753f-7695f2b6, 4c51a119-6f346625-6da3ca60-c048486b-db7e21e6 | 55525523 | 11293517 | Findings: AP upright portable chest radiograph is obtained. A left chest wall pacer device is again seen with lead tips extending into the right atrium and ventricle. Abandoned pacing leads are also seen in the right chest wall, extending into the right heart, not significantly changed. The heart is mildly enlarged. The lungs appear clear without definite signs of pneumonia or CHF. No large effusion or pneumothorax is seen. The overall cardiomediastinal silhouette is stable. Bony structures are intact. Impression: No acute findings in the chest. Stable mild cardiomegaly. Multiple pacer wires are unchanged in position. | Findings: AP upright portable chest radiograph is obtained. A left chest wall pacer device is again seen with lead tips extending into the superior vena cava. Abandoned pacing leads are also seen in the right chest wall, extending into the right heart, not significantly changed. The heart is severely enlarged. The lungs appear clear without definite signs of pneumonia or CHF. No large effusion or pneumothorax is seen. The overall cardiomediastinal silhouette is stable. Bony structures are intact. Impression: No acute findings in the chest. Severe cardiomegaly. Multiple pacer wires are unchanged in position. The ET tube is seen at the carina. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| 157c4099-34b42e61-710b038b-f6b80531-75d80abd, 40994464-b17516cf-be885c02-984e9fa1-79da2ac8 | 55831566 | 11293517 | Findings: Frontal and lateral chest radiographs demonstrate mediastinal and hilar contours are unremarkable. Stable mild cardiomegaly identified. Mild interstitial edema noted No pleural effusion or pneumothorax. No osseous abnormality identified. Stable positioning of atrioventricular ICD leads. Abandoned leads again noted in the right chest wall. Surgical clips project over the upper mediastinum. Impression: Mild cardiomegaly with mild interstitial pulmonary edema. | Findings: Frontal and lateral chest radiographs demonstrate mediastinal and hilar contours are unremarkable. Stable mild cardiomegaly identified. There are bilateral pleural effusions. No pleural effusion or pneumothorax. No osseous abnormality identified. Stable positioning of atrioventricular ICD leads in the lower SVC. Abandoned leads again noted in the right chest wall. Surgical clips project over the upper mediastinum. Stable mild cardiomegaly identified. Impression: Mild cardiomegaly with mild interstitial pulmonary edema. | ['Change position of device', 'Add repetitions', 'False prediction'] |
| 8b21e141-af653815-b3918024-c96d4b9e-6805e677, 908720ef-acf4956f-fe8d7aea-cacaf681-fe871544 | 56805129 | 11293517 | Findings: Frontal and lateral views of the chest demonstrate new pulmonary and mediastinal vascular congestion, perihilar haziness and chronic moderate cardiomegaly. New right infrahilar consolidation could be regional edema or concurrent pneumonia. The leads of an atriobiventricular ICD are unchanged in position, as are two additional right sided right ventricular leads which cross the chest wall from right to the left pectoral pacemaker. There is no pleural effusion, or pneumothorax. Impression: 1. Acute exacerbation of recurrent CHF. Possible right lower lobe pneumonia in the . | Findings: Frontal and lateral views of the chest disagree with new pulmonary and mediastinal vascular congestion, perihilar haziness and chronic moderate cardiomegaly. No right infrahilar consolidation could be regional edema or concurrent pneumonia. The leads of an endovascularly placed pacemaker are unchanged in position, as are two additional right sided right ventricular leads which cross the chest wall from right to the left pectoral pacemaker. There is no pleural effusion, or pneumothorax. Impression: 1. No signs of CHF exacerbation. Possible right lower lobe pneumonia in the. | ['Change name of device', 'Add contradiction', 'False negation'] |
| 3120d4cb-7c176726-716f3cd1-a656c370-8c4e0595, 9dbf45cb-e6b01b87-76e4d3db-7a480daf-192bce3b | 57001251 | 11293517 | Impression: New bibasilar opacities could represent atelectasis, sequelae of aspiration or pneumonia. | Impression: New bibasilar opacities cud represent atelectasis, sequelae of aspiration or pneumonia. | ['Add typo', 'Add contradiction', 'False prediction'] |
| 040c9a19-266c4559-fc377286-0a1680b5-724894f7, 20059946-988bfea1-f3ed6e1e-4ac2fbcf-517474b0 | 57774874 | 11293517 | Findings: Chest PA and lateral radiographs redemonstrate mild interstitial edema and mild cardiomegaly. No signs of aspiration and no change from prior CXR. | Findings: Chest PA and lateral radiographs redemonstrate severe interstitial edema and mild cardiomegaly. No signs of aspiration and no change from prior CXR. The left lung base shows a small consolidation. | ['Change severity', 'Add repetitions', 'False prediction'] |
| 7d987f2a-f684bbcb-c1e27bf0-0cb90406-cf56be90 | 50979785 | 11378150 | Findings: In comparison with the study of ___, post-operative changes are again seen in the left hemithorax with shift of the mediastinum to this side. Chest tube remains in place and there is no evidence of pneumothorax. The right lung is essentially clear except for some residual atelectatic change at the base. The gas along the upper chest border on the left and subcutaneous tissues is decreasing. There appears to be some increase in the extensive opacification in the left hemithorax. This could reflect additional pleural fluid, though in the appropriate clinical setting, the possibility of supervening pneumonia would have to be considered. | Findings: In comparison with the study of ___, post-operative changes are again seen in the left hemithorax with shift of the mediastinum to this side. Chest tube is positioned lower and there is no evidence of pneumothorax. The right lung is essentially clear except for some residual atelectatic change at the base. The gas along the upper chest border on the left and subcutaneous tissues is decreasing. There appears to be some increase in the extensive opacification in the left hemithorax. This could reflect additional pleural fluid, though in the appropriate clinical setting, the possibility of supervening pneumonia would have to be considered. A right-sided NG tube is noted. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 70e31905-dd605e80-305f056b-4f88ec80-cbb4b3fb, a03f6842-f6f68790-908cbde0-cdc1fde3-4f4ff90b | 52705433 | 11378150 | Findings: AP and lateral views of the chest are compared to previous exam from ___. Postoperative changes of left upper lobectomy are again seen with resection cavity completely opacified, without visualized pneumothorax. Slightly increased linear right basilar opacity is seen. Elsewhere, the lungs are hyperinflated but clear of confluent consolidation. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. Impression: Right basilar opacity may be due to atelectasis; however, infection is not completely excluded. Stable postoperative changes of left upper lobectomy. | Findings: AP and lateral views of the chest are compared to previous exam from ___. Postoperative changes of right upper lobectomy are again seen with resection cavity completely opacified, without visualized pneumothorax. Slightly increased linear right basilar opacity is seen. Elsewhere, the lungs are hyperinflated but clear of confluent consolidation. There is a central venous line present. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. Impression: Right basilar opacity may be due to atelectasis; however, infection is not completely excluded. Slightly increased linear right basilar opacity is seen. Stable postoperative changes of left upper lobectomy. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 28905df6-b5221808-9da88146-e62944a2-7fb81888, d725723c-750e19d9-78609d6d-c64127b3-03c1c5b6 | 54147285 | 11378150 | Impression: Satisfactory appearance after surgery. | Impression: Satisfactory appearance after surgery. There is evidence of postoperative complications. | ['Add contradiction', 'Add repetitions', 'False negation'] |
| 3b9b84d5-b76eb1db-a43caa85-b33c92a4-4ed50db2, ad35ad1a-5885c89f-5e87060d-67ba116d-22a409ca | 55092691 | 11378150 | Findings: PA and lateral chest radiographs were obtained. Left upper lobe volume loss is similar to prior study. There is no new consolidation, effusion, or pneumothorax. Leftward mediastinal shift is unchanged. Posterior fracture of the left sixth rib is unchanged. Fracture of the two uppermost mediastinal wires is stable. Impression: Stable left lung volume loss after left upper lobe lobectomy. | Findings: PA and lateral chest radiographs were obtained. Right upper lobe volume loss is similar to prior study. There is new consolidation, effusion, and pneumothorax. Leftward mediastinal shift is unchanged. Posterior fracture of the right sixth rib is unchanged. Fracture of the two uppermost mediastinal wires is stable. Impression: Stable left lung volume loss after left upper lobe lobectomy. A right central venous catheter is correctly positioned. | ['Change location', 'Add contradiction', 'Add medical device'] |
| fd480467-a520cdee-c10d86b1-219b21f7-64bb593d | 55743226 | 11378150 | Findings: Single portable chest radiograph demonstrates a large rounded opacity in the left lower lung, correlating with known left lung mass, better visualized on the ___ PET-CT. No focal opacification concerning for pneumonia. Bibasilar atelectasis is evident. Coarse linear interstitial markings in left upper lobe may reflect emphysematous change. There is no pneumothorax or pleural effusion. Prominent pericardial fat pads are evident; otherwise, cardiomediastinal contours are normal. Impression: No pneumothorax. Large left lower lobe mass, better evaluated on prior CT. | Findings: Single portable chest radiograph demonstrates a large rounded opacity in the left lower lung, correlating with known left lung mass, better visualized on the ___ PET-CT. No focal opacification eoncernign for pneumonia. No atelectasis is evident. Coarse linear interstitial markings in left upper lobe may reflect moderate emphysematous change. There is no pneumothorax or pleural effusion. No pericardial fat pads are evident; otherwise, cardiomediastinal contours are normal. Impression: No pneumothorax. Small left lower lobe mass, better evaluated on prior CT. | ['Change severity', 'Add typo', 'False negation'] |
| 2dcfc978-4f2b7c37-42839158-5805b52a-43671df7 | 59467402 | 11378150 | Findings: In comparison with the study of ___, there has been a lobectomy performed on the left. Chest tube is in place and there is no definite pneumothorax. Post-surgical opacification is seen at the left base consistent with atelectasis, effusion, and possible consolidation. The trachea has been pulled over to this side and there is mild mediastinal shift. Atelectatic changes are seen at the right base. Of incidental note is small amount of gas along the upper chest border on the left. | Findings: In comparison with the study of ___, there has been a lobectomy performed on the left. Pacemaker is in place and there is no definite pneumothorax. Post-surgical opacification is seen at the left base consistent with atelectasis, effusion, and possible consolidation. The trachea has been pulled over to this side and there is mild mediastinal shift. Atelectatic changes are seen at the write base. Of incidental note is small amount of gas along the upper chest border on the left. Central venous line is observed terminating in the superior vena cava. | ['Change name of device', 'Change to homophone', 'Add medical device'] |
| 741811fe-d3a0f32c-0f5c16f2-5ab6eace-f84f5233 | 50494220 | 11413236 | Impression: AP chest compared to ___ and ___: Aside from granulomatous lymph node calcifications in the aortopulmonic window node, cardiomediastinal silhouette is normal. Linear scarring in the left mid lung is longstanding. Lungs are otherwise clear. Infusion port catheter tip projects over the region of the superior cavoatrial junction. No pleural abnormality. | Impression: AP chest compared to ___ and ___: Aside from granulomatous lymph node calcifications in the aortopulmonic window node, cardiomediastinal silhouette is normal. No granulomatous lymph node calcifications. Linear scarring in the left mid lung is longstanding. Lungs are otherwise clear. Infusion port catheter tip projects over the region of the left atrium. No pleural abnormality. | ['Change name of device', 'Add repetitions', 'False negation'] |
| a94ddbc2-40a2c88a-c00a1b50-4a09d704-8ebb8115 | 50855550 | 11413236 | Impression: AP chest compared to ___ preoperative study: Subcutaneous emphysema is severe in the thoracoabdominal wall and neck. I do not see pneumomediastinum for certain, and no pneumothorax, though I suspect this is not an erect chest radiograph which would be required to exclude that. Lung volumes are quite low, exaggerating what is probably mild edema seen best on the right, and mild cardiomegaly. Large mediastinal lymph node calcification in the AP window is noted. Dr. ___ was paged to recommend repeat examination primarily to exclude pneumothorax. | Impression: AP chest compared to ___ preoperative study: Subcutaneous emphysema is mild in the thoracoabdominal wall and neck. I do not see pneumomediastinum for certain, and no pneumothorax, though I suspect this is not an erect chest radiograph which would be required to exclude that. Subcutaneous emphysema is mild in the thoracoabdominal wall and neck. Lung volumes are quite low, exaggerating what is probably moderate edema seen best on the right, and mild cardiomegaly. No mediastinal lymph node calcification is noted. Dr. ___ was paged to recommend repeat examination primarily to exclude pneumothorax. | ['Change severity', 'Add repetitions', 'False negation'] |
| 2e0c4b42-d1ef618d-2b25304c-1b6ef8a5-29e7671d, 4477b363-d135c994-0b74a62f-f481eccb-898a7db6 | 51161513 | 11413236 | Findings: The right Port-A-Cath reservoir projects over the right chest and is currently accessed; the catheter tip ends in the lower SVC. There has been interval placement of sternotomy wires, which are intact. The heart size is within normal limits and the mediastinal hilar contours do not appear widened. Calcified AP window node again seen. The lungs demonstrate left bailar opacity which is more linear in configuration on the lateral view. There is no pleural effusion or pneumothorax. Impression: Left costophrenic angle opacity, somewhat linear on the lateral view, more suggestive of atelectasis or scarring, less likely small focus of consolidation. No pleural effusion. | Findings: The right Port-A-Cath reservoir projects over the right chest and is currently accessed; the catheter tip ends in the right atrium. There has been interval placement of sternotomy wires, witch are intact. The heart size is within normal limits and the mediastinal hilar contours do not appear widened. No calcified AP window node is seen. The lungs demonstrate no opacity. There is no pleural effusion or pneumothorax. Impression: No left costophrenic angle opacity. No pleural effusion. | ['Change position of device', 'Change to homophone', 'False negation'] |
| d40ff923-1ae1c675-0bf6d047-42ce5585-8d8da7bb | 51499550 | 11413236 | Findings: AP portable upright view of the chest. Midline sternotomy wires and mediastinal clips are again noted. There is a right chest wall Port-A-Cath with its tip in the mid SVC. A calcific density in the region of the AP window corresponds with a calcified lymph node on prior CT. Lung volumes are low limiting evaluation. There is bibasilar atelectasis with bronchovascular crowding. No convincing signs of pneumonia though evaluation is limited. No large effusion or pneumothorax. Heart size is difficult to assess. Mediastinal contour is stable. Bony structures are intact. Impression: Limited exam with given low lung volumes with bibasilar atelectasis, difficult to exclude a superimposed pneumonia. | Findings: AP portable upright view of the chest. Midline sternotomy wires and mediastinal clips are again noted. There is a right chest wall endotracheal tube with its tip in the mid SVC. A calcific density in the region of the AP window corresponds with a calcified lymph node on prior CT. Lung volumes are low limiting evaluation. There is bibasilar atelectasis with bronchovascular crowding. No convincing signs of pneumonia though evaluation is limited. No large effusion or pneumothorax. No large effusion or pneumothorax. Heart size is difficult to assess. Mediastinal contour is stable. Bony structures are intact. There is mild cardiomegaly. Impression: Limited exam with given low lung volumes with bibasilar atelectasis, difficult to exclude a superimposed pneumonia. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| 2d291461-7354f6b1-b797f9c5-5c58ef2f-a516fa93, 86f89f10-d6932134-162d3d5b-689149a3-81dd2b70 | 51503417 | 11413236 | Findings: There are low lung volumes. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. Left central line terminates in the right atrium. Median sternotomy wires and mediastinal clips are noted. A calcified lymph node is noted in the AP window. Impression: No acute cardiopulmonary process. | Findings: There are low lung volumes. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. Left central line terminates in the mid right atrium. Median sternotomy wires and mediastinal clips are noted. No calcified lymph node is seen. Impression: No acute cardiopulmonary process except for mild pulmonary edema. | ['Change location', 'Add contradiction', 'False negation'] |
| 4ffe5eff-a5a604c2-4da5dcda-0801d405-88939c8f | 51568216 | 11413236 | Findings: Lung volumes are low, limiting evaluation of the lung bases, with perihilar atelectasis. Within this limitation, no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The aorta is tortuous. Heart size is difficult to evaluate in the setting of markedly low lung volumes. A right-sided Port-A-Cath tip projects at the level of the cavoatrial junction, as seen previously. Density in the aortopulmonary window appears similar compared to prior and likely corresponds to calcified nodes, as seen on prior CT. Sternal wires appear intact. Impression: Low lung volumes, limiting evaluation of the lung bases and heart size, without radiographic evidence for acute cardiopulmonary process on this single frontal view. | Findings: Lung volumes are low, limiting evaluation of the lung bases, with perihilar atelectasis. Within this limitation, no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The aorta is tortuous. Heart size is difficult to evaluate in the setting of markedly low lung volumes. A right-sided Port-A-Cath tip projects in the mid SVC, as seen previously. Density in the aortopulmonary window appears similar compared to prior and likely corresponds to calcified nodes, as seen on prior CT. Sternal wires appear intact. Impression: Low lung volumes, limiting evaluation of the lung bases and heart size. Low lung volumes, limiting evaluation of the lung bases and heart size, without radiographic evidence for acute cardiopulmonary process on this single frontal view. | ['Change position of device', 'Add repetitions', 'False prediction'] |
| 68fca727-3938158e-eb97e5dc-141e63e2-53d66c78, c9968397-d379cb18-8d6f80d9-6ede0af5-f8c4d52e | 51644170 | 11413236 | Findings: Patient is status post median sternotomy. Right-sided Port-A-Cath tip terminates in the upper SVC, unchanged. Cardiac silhouette remains moderately enlarged but unchanged. Multiple calcified mediastinal lymph nodes are again demonstrated suggestive prior granulomatous disease. The mediastinal and hilar contours are otherwise unremarkable. Lung volumes are persistently low with streaky atelectasis seen in the right lung base. No focal consolidation, pleural effusion or pneumothorax is seen. The pulmonary vasculature is not engorged. Impression: Persistently low lung volumes with streaky right basilar atelectasis. | Findings: Patient is status post median sternotomy. Right-sided Port-A-Cath tip terminates in the lower SVC, unchanged. Cardiac silhouette remians moderately enlarged but unchanged. No calcified mediastinal lymph nodes are demonstrated. The mediastinal and hilar contours are otherwise unremarkable. Lung volumes are persistently low with streaky atelectasis seeen in the right lung base. No focal consolidation, pleural effusion or pneumothorax is seen. The pulmonary vasculature is not engorged. Impression: Persistently low lung volumes with no atelectasis. | ['Change position of device', 'Add typo', 'False negation'] |
| 2f1eba54-06686151-156f45ff-76e953f6-03665181, 96f6b655-cb517472-567ebf62-3c6395e0-01936fb3 | 51943964 | 11413236 | Findings: Right chest wall Port-A-Cath terminates in the upper SVC. Postoperative mediastinum, including calcified left suprahilar lymph node, and cardiomegaly are unchanged from ___. Bibasilar atelectasis is mild. Impression: No evidence of pneumonia or pulmonary edema. | Findings: Right chest wall Port-A-Cath termintates in the upper SVC. Postoperative mediastinum, including calcified left suprahilar lymph node, and cardiomegaly are unchanged from ___. Bibasilar atelectasis is moderate. Impression: No evidence of pneumonia or pulmonary edema. | ['Change severity', 'Add typo', 'False negation'] |
| a17a8e28-46038399-4f9764d7-2338ca4c-6234bf11 | 52164077 | 11413236 | Findings: Single AP view of the chest. Right chest wall port is again seen, catheter tip not clearly identified due to motion. The lungs are grossly clear. Mild left basilar atelectasis versus scarring again noted. Cardiomediastinal silhouette is within normal limits. Calcified AP window nodes are seen. Osseous and soft tissue structures are unremarkable. Impression: No acute cardiopulmonary process. | Findings: Single AP view of the chest. Right chest wall port is again seen, catheter tip clearly identified. The lungs show extensive infiltrates. Mild left basilar atelectasis versus scarring again noted. Cardiomediastinal silhouette is within abnormal limits. Calcified AP window nodes are seen. Osseous and soft tissue structures show fractures. Impression: No acute cardiopulmonary process. Mild bilateral pleural effusions. | ['Change severity', 'Add contradiction', 'False prediction'] |
| 35a29873-f440b817-77e9b07e-ebd31997-8c62d96e, 46bdab14-1fa0233c-c0b0841d-4c0869de-6564ff0d | 52541396 | 11413236 | Findings: The patient is status post median sternotomy again with a top normal-sized cardiac silhouette and mildly tortuous thoracic aorta. Hilar contours are unremarkable. Lung volumes are low with right base atelectasis as well as increased focal retrocardiac opacity with lateral posterior lower lobe correlate. Right-sided Port-A-Cath is again demonstrated terminating at the cavoatrial junction. There is no pleural effusion or pneumothorax. There is no overt pulmonary edema. Calcified mediastinal lymph nodes are again noted. Impression: Low lung volumes with a focal retrocardiac opacity with lower lobe correlate on lateral view. This may represent either atelectasis or infection, and correlation with clinical presentation is recommended. | Findings: The patient is status post median sternotomy again with a top normal-sized cardiac silhouette and mildly tortuous thoracic aorta. Hilar contours are unremarkable. Lung volumes are low with right bass atelectasis as well as increased focal retrocardiac opacity with lateral posterior lower lobe correlate. Right-sided PICC line is again demonstrated terminating at the cavoatrial junction. There is no pleural effusion or pneumothorax. There is no overt pulmonary edema. Calcified mediastinal lymph nodes are again noted. An ET tube is in place. Impression: Low lung volumes with a focal retrocardiac opacity with lower lobe correlate on lateral view. This may represent either atelectasis or infection, and correlation with clinical presentation is recommended. | ['Change name of device', 'Change to homophone', 'Add medical device'] |
| 85487fb8-4d1bb78d-357fad99-bd6075d5-8b2da39c, edd0f3ed-1c73850b-834eb0a7-0bf47886-bce26021 | 53155287 | 11413236 | Findings: Lung volumes are low, leading to crowding of the bronchovascular structures. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The heart remains moderately enlarged, although this is accentuated by AP technique and low lung volumes. Calcified AP window node is again noted. A right-sided Port-A-Cath terminates within the upper-mid SVC, unchanged in position from the prior exam. Impression: Low lung volumes without evidence for acute cardiopulmonary process. | Findings: Lung volumes are low, leading to crowding of the bronchovascular structures. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The heart remains moderately enlarged, although this is accentuated by AP technique and low lung volumes. Calcified AP window node is again noted. A right-sided Port-A-Cath terminates within the mid SVC, unchanged in position from the prior exam. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. Impression: Low lung volumes without evidence for acute cardiopulmonary process. A right central venous line is observed in the subclavian vein. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 01162a03-2f26a872-9c7a120b-f5ce80a2-46b2577b, ed184d83-ae8d1e4b-471e594f-15e2ca32-860a8dbb | 53410264 | 11413236 | Findings: Right-sided Port-A-Cath terminates in the mid SVC as before. Heart is top-normal in size. Mediastinal and hilar contours are within normal limits. Lung volumes are low over the lungs are clear without focal consolidation, effusion or pneumothorax. Impression: No acute cardiopulmonary abnormality. | Findings: Right-sided Port-A-Cath terminates in the lower SVC as before. Heart is top-normal in size. Mediastinal and hilar contours are within normal limits. Lung volumes are low over the lungs are clear without focal consolidation, effusion or pneumothorax. Impression: No acute cardiopulmonary abnormality. There is mild pulmonary edema. | ['Change location', 'Add contradiction', 'False negation'] |
| 5a57f9ad-cca470ce-4338e8a1-bd61ba63-c40ce753 | 53836642 | 11413236 | Findings: The patient is status post sternotomy. A Port-A-Cath terminates in the right atrium. The heart is mildly enlarged. Calcified mediastinal lymph nodes are unchanged. The lung volumes are low. Streaky basilar opacities suggest minor atelectasis. There is no pleural effusion or pneumothorax. Cholecystectomy clips project over the right upper quadrant. Impression: Low lung volumes and streaky basilar opacities, most suggestive of minor atelectasis. No definite evidence of acute cardiopulmonary disease. | Findings: The patient is status post sternotomy. A Port-A-Cath termiantes in the right atrium. The heart is mildly enlarged. Calcified mediastinal lymph nodes are unchanged. The lung volumes are low. Streaky basilar opacities suggest minor atelectasis. There is no pleural effusion or pneumothorax. Cholecystectomy clips project over the right upper quadrant. A central venous line is present in the left subclavian vein. Impression: Low lung volumes and streaky basilar opacities, most suggestive of minor atelectasis. No definite evidence of acute cardiopulmonary disease. | ['Change name of device', 'Add typo', 'Add medical device'] |
| 30441716-407a53b5-7bec00c6-abac7a61-d6054dfd, dde647ea-ea029cfd-683e0c4d-fbd997f9-b2e32924 | 53966135 | 11413236 | Findings: In comparison with study of ___, there has been the development of areas of opacification at the left base most likely reflecting atelectasis and mild effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered. Port-A-Cath remains in place. | Findings: In comparison with study of ___, there has been the development of areas of opacification at the right base most likely reflecting atelectasis and mild effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered. Port-A-Cath remains in place. Port-A-Cath remains in place. No opacification noted. | ['Change location', 'Add repetitions', 'False negation'] |
| bf7c2bb6-a8ce931b-a0037382-88c9ab10-ef166969 | 53994053 | 11413236 | Findings: Right pectoral infusion port terminates in upper SVC. Sternotomy wires are intact. Lung volume is low. Mild bibasilar opacities likely reflect atelectasis. Calcification at the AP window likely reflect calcified lymph nodes in a unchanged from before. There is no large pleural effusion or pneumothorax. Mild cardiomegaly is similar to before. Impression: No convincing radiographic evidence for pneumonia is identified. Mild bibasilar opacities are likely atelectasis. | Findings: Left pectoral infusion port terminates in upper SVC. Sternotomy wires are intact. Lung volume is low. Mild bibasilar opacities likely reflect atelectasis. Calcification at the AP window likely reflects calcified lymph nodes unchanged from before. There is no large pleural effusion or pneumothorax. Mild cardiomegaly is similar to before. Left pectoral infusion port terminates in upper SVC. Impression: No convincing radiographic evidence for pneumonia is noted. Mild right bibasilar opacities reflect atelectasis. | ['Change location', 'Add repetitions', 'False prediction'] |
| 93173301-ef0856de-7bf3d950-005faeed-a2f8a466 | 54517998 | 11413236 | Impression: There are lower lung volumes. Bibasilar atelectasis have increased. Right port a cath tip is in the is confluence of the brachiocephalic vein. There is no pneumothorax. Cardiomegaly is stable | Impression: There are lower lung volumes. No atelectasis. Right port a cath tip is in the distal superior vena cava. There is no pneuemothorax. Cardiomegaly is stable. | ['Change position of device', 'Add typo', 'False negation'] |
| 5a43bc2b-3fc26154-5114dc49-e3d4f15e-459347eb, a8ad38e3-9a288818-536ed867-e22718fb-0d0833f5 | 55108847 | 11413236 | Findings: The patient is status post sternotomy. A Port-A-Cath terminates at the cavoatrial junction. The heart is at the upper limits of normal size. A calcified lymph node is seen along the aortopulmonary window. The cardiac, mediastinal and hilar contours do not appear significantly changed. The lung volumes are low. There is persistent patchy opacification in the left lower lobe, which appears somewhat more dense and compressed, perhaps coinciding with differences in lung volumes rather than a true interval change however. In fact, left basilar opacities are more similar to ___, where lungs volumes were somewhat lower than on the more recent prior examination. There is no pleural effusion or pneumothorax. Bony structures are unremarkable. Impression: Persistent left basilar opacification, suspected to represent primarily atelectasis. However, the possibility of superimposed pneumonia could be considered in the appropriate clinical setting versus increased atelectasis associated with low lung volumes. | Findings: The patient is status post sternotomy. A Port-A-Cath terminates in the mid SVC. The heart is at the upper limits of normal sýze. No calcified lymph node is seen. The cardiac, mediastinal and hilar contours do not appear significantly changed. The lung volumes are law. There is persistent patchy opacification in the left lower lobe, which appears somewhat more dense and compressed, perhaps coinciding with differences in lung volumes rather than a true interval change however. In fact, no left basilar opacities are noted, where lungs volumes were somewhat lower than on the more recent prior examination. There is no pleural effusion or pneumothorax. Bony structures are unremarkable. Impression: Persistent left basilar opacification, suspected to represent primarily atelectasis. However, the possibility of superimposed pneumonia could be considered in the appropriate clinical setting versus increased atelectasis associated with low lung volumes. | ['Change position of device', 'Add typo', 'False negation'] |
| 3b067bdb-1e77ce5c-db8d4831-dc9c23e2-e0e1724c, aef6ded2-a74cef0f-acdbb6d6-a96e3909-9fc8c2e9 | 55277653 | 11413236 | Findings: Lung volumes are low. No new focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Peripheral opacity in the left lung base appears improved from the prior study, and may represent residual atelectasis with scarring. Heart and mediastinal contours are stable with unchanged calcified aorticopulmonary window lymph node compatible with prior granulomatous disease. Right-sided Port-A-Cath is similarly positioned. Sternal wires appear intact on these views. The patient is status post CABG. Impression: No radiographic evidence for acute cardiopulmonary process. | Findings: Lung volumes are low. No knew focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Peripheral opacity in the left lung base appears improved from the prior study, and may represent residual atelectasis with scarring. Heart and mediastinal contours are stable with unchanged calcified aorticopulmonary window lymph node compatible with prior granulomatous disease. Right-sided PICC line is similarly positioned. Sternal wires appear intact on these views. The patient is status post CABG. A central venous line is noted with the tip in the distal SVC. Impression: No radiographic evidence for acute cardiopulmonary process. | ['Change name of device', 'Change to homophone', 'Add medical device'] |
| 5777b9e5-d14e2655-cb9eecfa-52bda043-992f6f80, 6eb1afd3-d7b2eea4-6367e332-aa78e2dd-387ee425 | 55420069 | 11413236 | Findings: Lung volumes are low. No focal consolidation is identified. The cardiomediastinal silhouette and hilar contours are stable. There is a calcified prevascular lymph node. There is no pleural effusion or pneumothorax. A left chest Port-A-Cath terminates at the level of the upper SVC, as before. Patient is status post median sternotomy. Impression: No evidence of acute cardiopulmonary process. | Findings: Lung volumes are law. No focal consolidation is identified. The cardiomediastinal silhouette and hilar contours are stable. There is a calcified subcarinal lymph node. There is no pleural effusion or pneumothorax. A left chest Port-A-Cath terminates at the level of the upper SVC, as before. Patient is status post median sternotomy. There is a central venos line in place. Impression: No evidence of acute cardiopulmonary process. | ['Change location', 'Add typo', 'Add medical device'] |
| db1c4e24-acd97bc7-d5e97d65-04ffb3e5-9c036419 | 55972946 | 11413236 | Findings: The patient is status post median sternotomy. Right-sided Port-A-Cath tip terminates in the right atrium. Lung volumes are low. This accentuates the cardiac silhouette size which is likely mildly enlarged. Calcified mediastinal nodes are re- demonstrated reflective of prior granulomatous disease. Mediastinal and hilar contours are otherwise unremarkable. There is no pulmonary vascular congestion. Patchy bibasilar airspace opacities most likely reflect atelectasis. There is no pleural effusion or pneumothorax. No acute osseous abnormalities detected. Impression: Low lung volumes with probable bibasilar atelectasis. | Findings: The patient is status post median sternotomy. Right-sided Port-A-Cath tip terminates in the mid SVC. Lung volumes are low. This accentuates the cardiac silhouette size which is likely mildly engorged. Mediastinal nodes are re-demonstrated reflective of prior granulomatous disease. Mediastinal and hilar contours are otherwise unremarkable. There is no pulmonary vascular congestion. No airspace opacities. There is no pleural effusion or pneumothorax. No acute osseous abnormalities detected. Impression: Low lung volumes with no atelectasis. | ['Change position of device', 'Change to homophone', 'False negation'] |
| 154a0276-f9cc72dc-9907f2e1-f1f11272-93cc90ff, 9e603808-3ea8ecd9-e7c87494-34d9258b-ea2bdd21 | 56921446 | 11413236 | Findings: PA and lateral chest radiographs were provided. Lung volumes are significantly low. There is no focal consolidation, pleural effusion or pneumothorax. There is bibasilar atelectasis. The cardiomediastinal silhouette is unchanged. Median sternotomy wires are intact. A right chest wall Port-A-Cath terminates at the cavoatrial junction. There is no free air under the hemidiaphragms. Osseous structures are intact. Impression: Low lung volumes but no acute process and no evidence of free peritoneal air. | Findings: PA and lateral chest radiographs were provided. Lung volumes are significantly low. There is no focal consolidation, pleural effusion or pneumothorax. There is bibasilar atelectasis. The cardiomediastinal silhouette is unchanged. Median sternotomy wires are intact. A right chest wall Port-A-Cath terminates in the mid SVC. There is an endotracheal tube in the trachea. There is no free air under the hemidiaphragms. There is no free air under the hemidiaphragms. Osseous structures are intact. Impression: Low lung volumes but no acute process and no evidence of free peritoneal air. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 11bf7fcd-96d58d34-49415fcc-c20c2b7d-1f340544 | 57332361 | 11413236 | Findings: The patient is status post median sternotomy. Right-sided Port-A-Cath is again seen without significant change in position, terminating at the cavoatrial junction. Again, there are low lung volumes and minimal bibasilar atelectasis. Ovoid calcification projecting over the left mediastinum is again seen. Subcentimeter left lower lung rounded calcification is stable and may represent a calcified granuloma. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There is no overt pulmonary edema. Impression: No significant interval change. | Findings: The patient is status post median sternotomy. Right-sided Port-A-Cath is again seen without significant change in position, terminating at the superior vena cava. Again, there are low lung volumes and minimal bibasilar atelectasis. Ovoid calcification projecting over the left mediastinum is again scene. Subcentimeter left lower lung rounded calcification is stable and may represent a calcified granuloma. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. An ET tube is seen with its tip in the trachea. The cardiac and mediastinal silhouettes are stable. There is no overt pulmonary edema. Impression: No significant interval change. | ['Change position of device', 'Change to homophone', 'Add medical device'] |
| 7634db9d-273d50e3-b619164d-90d11c3f-2a46ab37, cc3d0bf3-f2bb85cd-cd67adeb-9458eb46-ac522113 | 57361873 | 11413236 | Findings: PA and lateral chest radiograph demonstrate a right chest port, its tip which projects within the upper superior vena cava, unchanged in position relative to prior study. Median sternotomy wires appear intact. Cardiomediastinal silhouette appears stable relative to prior examination. Heart size is mildly enlarged. There is no evidence of pulmonary edema. Nodular opacities within the in right infrahilar region likely reflect vascular shadows. Lung volumes are low. Bibasilar atelectasis is moderate. There is no focal opacity convincing for infectious process. Calcification on the AP window could be due to calcified nodes. No large pleural effusion or pneumothorax is identified. Impression: Overall stable appearance of the chest with low lung volumes and basilar atelectasis. | Findings: PA and lateral chest radiograph demonstrate a left chest port, its tip which projects within the upper superior vena cava, unchanged in position relative to prior study. Median sternotomy wires appear intact. Cardiomediastinal silhouette appears stable relative to prior examination. Heart size is mildly enlarged. There is no evidence of pulmonary edoema. Nodular opacities within the in right infrahilar region likely reflect vascular shadows. Lung volumes are low. Bibasilar atelectasis is moderate. There is no focal opacity convincing for infectious process, but there is a small left pleural effusion. Calcification on the AP window could be due to calcified nodes. No large pleural effusion or pneumothorax is identified. Impression: Overall stable appearance of the chest with low lung volumes and basilar atelectasis, with no new significant pleural effusion. | ['Change location', 'Add typo', 'False prediction'] |
| 6edd5960-4028d9f1-6f2353cb-61d0c6bf-5048c68e | 58006032 | 11413236 | Findings: A left Port-A-Cath terminates within the mid SVC. Lower lung volumes are noted, leading to crowding of the bronchovascular structures. Mild atelectasis is seen at the left lung base. A calcified lymph node is again noted within the aorticopulmonary window. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The patient is status post median sternotomy, and cardiomediastinal silhouette is within normal limits. Impression: No evidence of acute cardiopulmonary process. | Findings: A left intra-aortic balloon pump terminates within the mid SVC. Lower lung volumes are noted, leading to crowding of the bronchovascular structures. Mild atelectasis is seen at the left lung base. A calcified lymph node is again noted within the aorticopulmonary window. There is a small pleural effusion on the right side. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The patient is status post median sternotomy, and cardiomediastinal silhouette is within normal limits. Impression: No evidence of acute cardiopulmonary process. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| 4c940923-a59ab393-7984e607-b473ed13-af98d60c | 58800563 | 11413236 | Findings: Single portable view of the chest. Right chest wall port is again seen. Streaky left basilar and right upper lung opacities are seen suggestive of atelectasis or scarring. Calcified mediastinal nodes are again seen. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. Impression: No acute cardiopulmonary process. | Findings: Single portable view of the chest. Left chest wall port is again seen. Streaky left basilar and right upper lung opacities are seen suggestive of atelectasis or scarring. Calcified mediastinal nodes are again seen. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. Streaky left basilar and right upper lung opacities are suggestive of atelectasis or scarring. Impression: No acute cardiopulmonary process. There is mild cardiomegaly noted. | ['Change location', 'Add repetitions', 'False prediction'] |
| 19cd7ef0-e01da8c2-54eba4e0-a3a25327-1ab839b7 | 58971300 | 11413236 | Findings: A Port-A-Cath terminating in the upper part of the superior vena cava appears unchanged since the more recent of the prior two studies. The patient is status post sternotomy. A calcified prevascular lymph node appears unchanged. The cardiac, mediastinal and hilar contours appear stable. The lung volumes are low. Streaky basilar opacity consistent with minor scarring is similar in the lingula. There is no substantial parenchymal opacity. Impression: No evidence of acute disease. | Findings: A Port-A-Cath terminating in the upper part of the superior vena cava appears unchanged since the more recent of the prior two studies. The patient is status post sternotomy. No prevascular lymph node is seen. The cardiac, mediastinal and hilar contours appear stable. The lung volumes are low. Streaky basilar opacity consistent with minor scarring is similar in the lingula. The lung volumes are low. There is no substantial parenchymal opacity. Impression: No evidence of acute disease. | ['Change name of device', 'Add repetitions', 'False negation'] |
| 722a3b68-5254c3ea-469c8294-7e6fb73d-46f35121 | 59218667 | 11413236 | Findings: Single portable view of the chest. Low lung volumes are seen with secondary crowding of the bronchovascular markings. Left chest wall port is seen with catheter tip within the right atrium. There is no large confluent consolidation or large effusion. Calcified bilateral hilar nodes are identified. Cardiomediastinal silhouette is within normal limits for technique and low inspiratory volume. Impression: No definite acute cardiopulmonary process given limitation of low lung volumes and portable technique. | Findings: Single portable view of the chest. Low lung volumes are seen with secondary crowding of the bronchovascular markings. No left chest wall port is seen with catheter tip within the right atrium. There is no large confluent consolidation or large effusion. Calcified bilateral hilar nodes are identified. Cardiomediastinal silhouette is within normal limits for technique and low inspiratory volume. Low lung volumes are seen with secondary crowding of the bronchovascular markings. Impression: No definite acute cardiopulmonary process given limitation of low lung volumes and portable technique. | ['Change severity', 'Add repetitions', 'False negation'] |
| 1a0662d4-8bee75af-c5c452a9-4b43c737-b74d27c1 | 59735304 | 11413236 | Findings: AP portable upright view of the chest. Right chest wall Port-A-Cath again noted with catheter tip extending to the upper SVC region. Midline sternotomy wires are again noted. There is a calcified ovoid structure projecting over the mediastinum likely a calcified lymph node. There is mild basilar atelectasis noted bilaterally. No focal consolidation concerning for pneumonia. No large effusion or pneumothorax is seen. Cardiomediastinal silhouette is stable. Bony structures are intact. Impression: Bibasilar atelectasis. No convincing evidence for pneumonia. | Findings: AP portable upright view of the chest. Right chest wall Port-A-Cath again noted with catheter tip extending to the right atrium. Midline sternotomy wires with catheter tip extending to the right atrium are again noted. There is a calcified ovoid structure projecting over the mediastinum likely a calcified lymph node. There is mild basilar atelectasis noted bilaterally. No focal consolidation concerning for pneumonia. No large effusion or pneumothorax is seen. Cardiomediastinal silhouette is stable. Bony structures are intact. Presence of an NG tube is seen. Impression: Bibasilar atelectasis. No convincing evidence for pneumonia. Bony structures are intact. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 8062997c-91b95843-31ddb21e-b92bf46a-73af4721 | 59753947 | 11413236 | Findings: Single frontal view of the chest demonstrates a right Port-A-Cath in unchanged position, terminating at the cavoatrial junction. Median sternotomy wires are present, along with surgical clips in the left upper quadrant. The heart is mildly enlarged, but stable compared with prior examinations, with redemonstration of calcified mediastinal lymph nodes. A rounded opacity in the lower left lung likely correlates to a calcified granuloma as seen on CT of the chest from ___. There is no evidence of pneumonia, pleural effusion, pneumothorax or overt pulmonary edema. The lung volumes are low, accentuating bibasilar atelectasis. No subdiaphragmatic free air is present. Impression: No subdiaphragmatic free air or other acute cardiopulmonary process. | Findings: Single frontal view of the chest demonstrates a left-sided Hickman catheter in unchanged position, terminating at the cavoatrial junction. Median sternotomy wires are present, along with surgical clips in the left upper quadrant. The heart is mildly enlarged, but stable compared with prior examinations, with redemonstration of calcified mediastinal lymph nodes. A rounded opacity in the lower left lung likely correlates to a calcified granuloma as seen on CT of the chest from ___. There is no evidence of pneumonia, pleural effusion, pneumothorax or overt pulmonary edema. The heart is mildly enlarged, but stable compared with prior examinations, with redemonstration of calcified mediastinal lymph nodes. The lung volumes are low, accentuating bibasilar atelectasis. There is minimal right pleural effusion. No subdiaphragmatic free air is present. Impression: No subdiaphragmatic free air or other acute cardiopulmonary process. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| 09b5b0a8-2cb137c2-240ac597-66295226-2b2af51c | 59798652 | 11413236 | Findings: Portable frontal view of the chest demonstrates low lung volumes. There is no pneumothorax. The left costophrenic angle is obscured, suggestive of a small pleural effusion. Retrocardiac opacity is noted, more conspicuous from prior exam. There is no right pleural effusion. There is apparent thickening of the minor fissure. Calcified lymph nodes within the AP window are again noted. The hilar and mediastinal silhouettes are unchanged. The heart size is top normal. There is no pulmonary edema. Port-A-Cath tip projects over cavoatrial junction. Partially imaged upper abdomen is unremarkable. Impression: Retrocardiac opacity is more conspicuous from ___ exam, which likely represents atelectasis or infection in the appropriate clinical setting. Possible small left pleural effusion. | Findings: Portable frontal view of the chest demonstrates low lung volumes. Their is no pneumothorax. The left costophrenic angle is obscured, suggestive of a moderate pleural effusion. Retrocardiac opacity is noted, more conspicuous from prior exam. There is no right pleural effusion. There is apparent thickening of the minor fissure. Calcified lymph nodes within the AP window are again noted. The hilar and mediastinal silhouettes are unchanged. The heart size is top normal. There is no pulmonary edema. Pacemaker is present. Port-A-Cath tip projects over cavoatrial junction. Partially imaged upper abdomen is unremarkable. Impression: Retrocardiac opacity is more conspicuous from ___ exam, which likely represents atelectasis or infection in the appropriate clinical setting. Possible large left pleural effusion. | ['Change severity', 'Change to homophone', 'Add medical device'] |
| 645dd223-bb4a40c3-d6a19aeb-fcd36a22-ca6478a3 | 50017760 | 11474065 | Impression: AP chest compared to ___: A region of consolidation in the right lower lung has been abnormal since at least mid ___, and has improved but not cleared. Moderate cardiomegaly is chronic. Pulmonary vascular congestion, also longstanding. There is no pulmonary edema. Pleural effusion is minimal if any. No pneumothorax. | Impression: AP chest compared to ___: A region of consolidation in the right lower lung has been abnormal since at least mid ___, and has improved but not cleared. Severe cardiomegaly is chronic. Pulmonary vascular congestion, also longstanding. There is no pulmonary edema. Pleural effusion is minimal if any. No pneumothorax. There is no pulmonary edema. An ET tube is in place. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| 835047f2-adf49b86-e80c6954-330c111c-da7aeea9 | 50955371 | 11474065 | Findings: Persistence of right middle lobe opacities obscuring the right heart border since ___ is concerning for pneumonia. The rest of the lungs appear unchanged since ___. Moderate bibasilar atelectasis is slightly improved. The heart size is exaggerated by compressive atelectasis. No pneumothorax. Note is made of partial resection of the ___ posterior rib. Impression: Persistence of right middle lobe opacities since ___ is concerning for pneumonia. | Findings: Mild right middle lobe opacities obscuring the right heart border since ___ is concerning for pneumonia. The rest of the lungs appear unchanged since ___. Severe bibasilar atelectasis is slightly improved. The heart size is exaggerated by compressive atelectasis. No pneumothorax. Right IJ central venous catheter is in place. Note is made of partial resection of the ___ posterior rib. Impression: Persistence of right middle lobe opacities since ___ is concerning for pneumonia. No significant opacity in the right middle lobe since ___. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| b0a2d047-4a01cf2e-c1d43e01-61ef7442-722d8f4e | 51394568 | 11474065 | Findings: The patient is status post right thoracotomy. Moderate layering right pleural effusion is present as well as right basilar atelectasis. Left lung is grossly clear, but there is an apparent small left pleural effusion. Subcutaneous emphysema is present in the right chest wall consistent with recent surgery. | Findings: The patient is status post left thoracotomy. Moderate layering right pleural effusion is present as well as rigth basilar atelectasis. Left lung is grossly clear, but there is an apparent small left pleural effusion. Subcutaneous emphysema is present in the right chest wall consistent with recent surgery. An NG tube is in the appropriate position. | ['Change location', 'Add typo', 'Add medical device'] |
| d77fc718-e1eacd2f-2fa45ea8-a06418df-85ae6300 | 52511628 | 11474065 | Impression: In comparison to the recent radiograph of 1 day earlier, subcutaneous emphysema has slightly decreased in extent, and pneumomediastinum also appears improved. Heterogeneous opacities in the right lung have slightly worsened in the right upper lobe and slightly improved at the right lung base. Left basilar opacities have nearly resolved, and a small left pleural effusion has decreased in size. | Impression: In comparison to the recent radiograph of 1 day earlier, subcutaneous emphysema has slightly decreased in extent, and pneumomediastinum also appears improved. Heterogeneous opacities in the right lung have slightly worsened in the right upper lobe and moderately improved at the right lung base. Left basilar opacities have nearly resolved, and a small left pleural effusion has decreased in size. Pneumoperitoneum is observed. | ['Change severity', 'Add repetitions', 'False prediction'] |
| dd86cc8c-ae1e2c39-3bc3e62b-b15de0ae-652648de | 52522246 | 11474065 | Findings: As compared to recent radiograph from a few hr earlier, the patient has reportedly undergone a tracheobronchial stent placement. Extensive pneumomediastinum is new, and accompanied by subcutaneous emphysema in the supraclavicular, cervical and chest wall regions. Small bilateral pneumothoraces are also demonstrated. Cardiac silhouette demonstrates left ventricular configuration is accompanied by pulmonary vascular congestion. Asymmetrically distributed heterogeneous opacities in the right mid and lower lobe could reflect asymmetrical edema, aspiration, or hemorrhage in the post procedural setting. Impression: Pneumomediastinum and bilateral small pneumothoraces following tracheobronchial stent placement. The findings are concerning for tracheobronchial rupture. | Findings: As compared to recent radiograph from a few hr earlier, the patient has reportedly undergone a tracheobronchial stent placement. Extensive pneumomediastinum is new, and accompanied by subcutaneous emphysema in the supraclavicular, cervical and lower abdominal regions. Small unilateral pneumothorax is also demonstrated. Cardiac silhouette demonstrates left ventricular configuration is accompanied by pulmonary vascular congestion and normal lung parenchyma. Asymmetrically distributed heterogeneous opacities in the right mid and lower lobe could reflect asymmetrical edema, aspiration, or hemorrhage in the post procedural setting. An endotracheal tube is in place. Impression: Pneumomediastinum and bilateral small pneumothoraces following tracheobronchial stent placement. The findings are not concerning for tracheobronchial rupture. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| e81bcf8f-2499df37-89d72ab3-6180b4ca-88ade891 | 52736624 | 11474065 | Findings: The patient is status post right thoracotomy. Apparent decrease in postoperative right pleural effusion and slight improvement in right basilar atelectasis. Otherwise, no relevant changes since recent study. | Findings: The patient is status post left thoracotomy. Apparent decrease in postoperative right pleural effusion and slight improvement in right basilar atelectasis. No pleural effusion seen. No pleural effusion seen. Otherwise, no relevant changes since recent study. | ['Change location', 'Add repetitions', 'False negation'] |
| d6b1f3db-eed8e0db-3a5d58a2-bfb0290f-f04dd972 | 53308168 | 11474065 | Impression: Interval worsening of subcutaneous emphysema accompanied by persistent pneumomediastinum and small bilateral pneumothoraces. Heterogeneous opacities in the right lung have worsened in the interval, and note is also made of a new small right pleural effusion and persistent small left pleural effusion. | Impression: Interval worsening of subcutaneous emphysema accompanied by persistent pneumomediastinum and large bilateral pneumothoraces. Heterogeneous opacities in the right lung have worsened in the interval, and note is also made of a new small right pleural effusion and persistent small left pleural effusion. There is minimal right base atelectasis. | ['Change severity', 'Change to homophone', 'False prediction'] |
| c1735f23-afbc50c0-23b33129-f274cfa7-737f29c2 | 53521887 | 11474065 | Findings: PA and lateral views of the chest ___ at 13:47 are submitted. Impression: Overall cardiac and mediastinal contours are stable. Calcified hilar lymph nodes are consistent with known sarcoidosis. Deformity of the right upper chest wall with some right lateral pleural thickening and scarring and volume loss in the right medial lung base are stable. The left hemidiaphragm is now better visualized and no developing airspace consolidation is appreciated. No pulmonary edema. No pneumothorax. Lower thoracic vertebroplasties best visualized on the lateral projection. | Findings: PA and lateral views of the chest ___ at 13:47 are submitted. There are areas of significant interstitial thickening. Impression: Overall cardiac and mediastinal contours are stable. Calcified hilar lymph nodes are consistent with known sarcoidosis. Deformity of the left upper chest wall with some right lateral pleural thickening and scarring and volume loss in the right medial lung base are stable. No notable deformities seen. The left hemidiaphragm is now better visualized and no developing airspace consolidation is appreciated. Diffuse airspace opacities throughout the lungs are noted. No pulmonary edema. Prominent signs of pulmonary edema. No pneumothorax. Cardiomegaly with a small pericardial effusion was noted. Lower thoracic vertebroplasties best visualized on the lateral projection. | ['Change location', 'Add contradiction', 'False prediction'] |
| c9f4d430-e4b86819-292b0c15-3b043b8f-eda461f1 | 53907259 | 11474065 | Findings: The previously seen chest tube has been removed without evidence of pneumothorax. The right loculated pleural effusion remains. The right hemithorax appears less opacified due to improved position of the patient, but mild residual diffuse opacification remains. The cardiac silhouette remains enlarged. Impression: No pneumothorax after chest tube removal. | Findings: The previously seen chest tube has been removed without evidnce of pneumothorax. No pleural effusion remains. The right hemithorax appears less opacified due to improved position of the patient, but mild residual diffuse opacification remains. The cardiac silhouette remains normal. Impression: No pneumothorax after chest tube remotal. | ['Change position of device', 'Add typo', 'False negation'] |
| bcd7e653-bdbda5eb-c1e8c446-d66776b2-7e86ed00 | 54030442 | 11474065 | Impression: AP chest compared to ___ at 5:06 p.m.: Right subclavian line has been withdrawn from the low to the mid SVC. Right basal atelectasis has improved. Lungs are clear, though pulmonary vasculature is now mildly engorged. Moderate cardiomegaly is chronic. Indentation of the cervical trachea is mild and unchanged. No pneumothorax. | Impression: AP chest compared to ___ at 5:06 p.m.: Right subclavian line has been withdrawn from the low to the upper SVC. Right basal atelectasis has improved. Lungs are clear, though pulmonary vasculature is now mildly ingorged. Moderate cardiomegaly is chronic. Indentation of the cervical trachea is mild and unchanged. No pneumothorax. A nasogastric tube is observed with its tip in the stomach. | ['Change position of device', 'Change to homophone', 'Add medical device'] |
| f292b1a8-2e6fdb2c-a2e020b7-ae3b0cc9-9e3866d1 | 54696391 | 11474065 | Findings: The patient is status post right thoracotomy with a worsening loculated right pleural effusion along the lateral and anterior pleura. There is diffusely increased hazy opacification of the right hemithorax, mainly due to the oblique positioning of the patient. Lung volumes are low with secondary widening of the cardiomediastinal silhouette. There is only mild vascular congestion. There is no pneumothorax. Unchanged chest tube. Impression: 1. Since yesterday morning, only minimal worsening of the right pleural effusion and atelectasis. 2. Diffusely increased hazy opacification of the right hemithorax, is mainly due to the oblique positioning of the patient | Findings: The patient is status post right thoracotomy with a small right pleural effusion along the lateral and anterior pleura. There is diffusely increased hazy opafication of the right hemithorax, mainly due to the oblique positioning of the patient. Lung volumes are low with secondary widening of the cardiomediastinal silhouette. There is no vascular congestion. There is no pneumothorax. Unchanged chest tube. Impression: 1. Since yesterday morning, no worsening of the right pleural effusion and atelectasis. 2. Diffusely increased hazy opacification of the right hemithorax, is mainly due to the oblique positioning of the patient. | ['Change severity', 'Add typo', 'False negation'] |
| e0e15315-038cc10d-12da55fb-533193ff-f67ce0bd | 55048341 | 11474065 | Impression: New right lung opacities, a represented as multiple pulmonary nodules, highly concerning for aspiration/pneumonia. Bleeding would be less likely. Rest of the findings are unchanged. | Impression: No pulmonary nodules, highly concerning for aspiration/pneumonia. Bleeding wold be less likely. Rest of the findings are unchanged. | ['Change location', 'Add typo', 'False negation'] |
| aa483dd9-3aa43e2a-f7cfb7e5-7205952e-ddfc95fd | 55570024 | 11474065 | Impression: Heart size and mediastinum are stable. Right basal consolidation is even more conspicuous than on the prior study. Left basal consolidation has progressed. Findings are concerning for development of bibasal infection. No pulmonary edema is currently seen. Postsurgical changes in the right hemi thorax are overall stable including subcutaneous air in the right upper chest wall and associated hematoma. | Impression: Heart size and mediastinum are stable. Right basal consolidation is even more conspicuous than on the prior study. Left middle consolidation has progressed. Findings are concerning for development of bibasal infection. No pulmonary edema is currently seen. No consolidation is seen. Postsurgical changes in the right hemi thorax are overall stable including subcutaneous air in the left upper chest wall and associated hematoma. | ['Change location', 'Add contradiction', 'False negation'] |
| 460d2f1e-3b268dd5-4eb6b5cc-a7af4619-93bac28c, a57921f1-082e4298-c45f0a33-97a652fc-627f468e | 56372001 | 11474065 | Impression: AP chest compared to ___: Greater opacification at the right lung base since ___ is probably a combination of slight worsening of pulmonary edema that has substantially improved since earlier on ___ has worsened slightly since ___ a.m. Moderate right pleural thickening or loculated fluid is stable since ___ and earlier post-operative study. In the mid portion of the left lung is a flame-shaped region of opacity that could be an early pneumonia. Small left pleural effusion and moderate cardiomegaly are stable. No pneumothorax. Findings supported by subsequent chest radiograph 5:35 a.m. on ___ available at the time of this review. | Impression: AP chest compared to ___: Grater opacification at the right lung base since ___ is probably a combination of slight worsening of pulmonary edema that has severely improved since earlier on ___ has worsened slightly since ___ a.m. Severe right pleural thickening or loculated fluid is stable since ___ and earlier post-operative study. In the mid portion of the left lung is a flame-shaped region of opacity that could be an early pneumonia. Small left pleural effusion and severe cardiomegaly are stable. There is a central venous line in place. Findings supported by subsequent chest radiograph 5:35 a.m. on ___ available at the time of this review. | ['Change severity', 'Add typo', 'Add medical device'] |
| 408936b5-77f25bee-8f73cc21-251fc7bc-013094dc | 56451222 | 11474065 | Findings: There is persistent right base atelectasis/ scarring. No new focal consolidation is seen. There is no large pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Impression: No significant interval change. | Findings: There is persistent left base atelectasis/scarring. No new focal consolidation is seen. There is no large pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. A central venous line is present. No significant interval change. Impression: No significant interval change. | ['Change location', 'Add repetitions', 'Add medical device'] |
| da99191c-5176d7bc-b809d55a-4429a7cd-ae8b21e9 | 56570382 | 11474065 | Findings: Portable semi-erect chest radiograph ___ at 21:02 is submitted. Impression: Overall cardiac and mediastinal contours are likely stable given patient rotation. Calcified hilar nodes are consistent with known sarcoidosis. There continues to be deformity of the right upper chest wall with some right lateral pleural thickening and scarring with volume loss at the right medial lung base. However, there has been interval obscuration of the lateral aspect of the left hemidiaphragm which when correlated with the recent CT may reflect an early pneumonia or aspiration. Clinical correlation is recommended. No pneumothorax. No pulmonary edema. No obvious pleural effusions. | Findings: Portable semi-erect chest radiograph ___ at 21:02 is submitted. Impression: Overall cardiac and mediastinal contours are likely stable given patient rotation. Calcified hilar nodes are consistent with known sarcoidosis. There continues to be deformity of the right upper chest wall with some right lateral pleural thickening and scarring with volume loss at the left medial lung base. However, now there has been interval obscuration of the lateral aspect of the left hemidiaphragm which when correlated with the recent CT may reflect an early pneumonia with aspiration. Clinical correlation is recomended. No pneumothorax. There is mild pulmonary edema. No pleural effusions. | ['Change location', 'Add typo', 'False prediction'] |
| 3b31865b-b41244e4-c46dbdca-c33ad6e4-3cca5768 | 56896759 | 11474065 | Findings: Compared the prior study, there is increase in opacity at the right mid to lower lung difficult to exclude small left pleural effusion. Pneumonia pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Chronic deformity of the posterior right fourth rib. Impression: Increase in opacity at the right mid to lower lung is nonspecific, could be due to infection and/ or aspiration. | Findings: Compared to the prior study, there is an increase in opacity at the left mid to lower lung difficult to exclude small left pleural effusion. Pneumonia pneumothorax is not seen. The cardiac and mediastinal silhouettes are stable. Chronic deformity of the posterior left fourth rib. Impression: Increase in opacity at the right mid to lower lung is nonspecific, could be due to infection and/ or aspiration. No increase in opacity at the right mid to lower lung. | ['Change location', 'Add contradiction', 'False negation'] |
| 0a8acf4e-79fa1809-f8cb320e-ec64a315-52784159, ecfe9bc7-52442f98-d8c652c2-2bb1c376-760a9f86 | 57174042 | 11474065 | Findings: PA and lateral chest views obtained with patient in upright position. Comparison is made with the next preceding AP single view chest examination of ___. The heart size is at the upper limit of normal variation. The heart configuration suggests a relative prominence of the left ventricular contour, a finding which in conjunction with the moderately widened and elongated thoracic aorta suggests the possibility of systemic hypertension. There is no acute pulmonary congestion. In the right hemithorax pleural thickenings are identified and seen to clear along the lateral chest wall. This coincides with the previously described local resection of the posterior aspect of the fourth rib related to previously performed tracheal reconstruction. These post-operative changes have not undergone any significant interval change. No pneumothorax is present. On the lateral view the posterior pleural sinuses are free from any free fluid, pleural effusion. Impression: Stable post-operative chest findings. No new acute infiltrates and no pneumothorax. | Findings: PA and lateral chest views obtained with patient in upright position. Comparison is made with the next preceding AP single view chest examination of ___. The heart size is at the upper limit of normal variation. The heart configuration suggests a relative prominence of the right ventricular contour, a finding which in conjunction with the moderately widened and elongated thoracic aorta suggests the possibility of systemic hypertension. There is no acute pulmonary congestion. In the right hemithorax pleural thickenings are identified and seen to clear along the lateral chest wall. This coincides with the previously described local resection of the posterior aspect of the fourth rib related to previously performed tracheal reconstruction. These post-operative changes have not undergone any significant interval change. No pneumothorax is present. On the lateral view the posterior pleural sinuses are free from any free fluid, pleural effusion. There is no pleural effusion or pneumothorax. Impression: Stable post-operative chest findings. No new acute infiltrates and no pneumothorax. There is an ill-defined opacity in the left lower lobe suggestive of atelectasis. | ['Change location', 'Add repetitions', 'False prediction'] |
| 965cab94-dee35b99-bf9616fc-1707a75d-e2368901 | 57723670 | 11474065 | Impression: PA and lateral chest, ___: Previous right pleural thickening is improving, following tracheobronchoplasty via right thoracotomy. Posterior rib osteotomy, unchanged in relative position. Normal postoperative cardiomediastinal silhouette, including borderline cardiomegaly predating surgery. Lungs grossly clear. Lateral view shows prior cementoplasty, vertebral bodies thoracolumbar spine. | Impression: PA and lateral chest, ___: Previous right pleural thickening is improving, following tracheobronchoplasty via right thoracotomy. Posterior rib osteotomy, unchanged in relative position. Normal postoperative cardiomediastinal silhouette, including borderline cardiomegaly predating surgery. Lungs grossly clear. A pacemaker is present. Lateral view shows prior cementoplasty, vertebral bodies thoracolumbar spine. Posterior rib osteotomy, unchanged in relative position. | ['Change location', 'Add repetitions', 'Add medical device'] |
| d09562d7-3ddb8397-a8101476-43ad0118-5fae5eb9 | 57848354 | 11474065 | Findings: In comparison with the study of ___, there is again evidence of mild pulmonary edema, more prominent on the right. More focal area of opacification at the base medially with poor definition of the right heart border raises the possibility of a middle lobe pneumonia. Right pleural thickening or loculated effusion is again seen. | Findings: In comparison with the stduy of ___, there is again evidence of moderate pulmonary edema, more prominent on the right. More focal area of opacification at the base medially with poor definition of the right heart border raises the possibility of a middle lobe pneumonia. Right pleural thickening or loculated effusion is again seen. There is a small left-sided pneumothorax. | ['Change severity', 'Add typo', 'False prediction'] |
| c1d5b4f7-c4ed16c1-202cd868-0f06cd8a-25de3389 | 58409843 | 11474065 | Impression: AP chest compared to ___ at 6:40 p.m.: There is no left subclavian line. An indwelling right subclavian line ends in the mid SVC. There is no pneumothorax or appreciable pleural effusion. Pulmonary vascular engorgement has improved, mild right lower lobe atelectasis has recurred. Heart size is moderately enlarged, but improved since earlier study. | Impression: AP chest compared to ___ at 6:40 p.m.: Ther is no left subclavian line. An indwelling right subclavian line ends in the lower SVC. There is no pneumothorx or appreciable pleural effusion. Pulmonary vascular engorgement has improved, mild right lower lobe atelectasis has recurred. Heart size is moderately enlarged, but improved since earlier study. There is also a presence of an ET tube. | ['Change position of device', 'Add typo', 'Add medical device'] |
| 859b40aa-1f46d6a7-7f299ecf-38260eb3-897580c1, 9f87b395-77bd9405-1004f2e1-701d44c2-7b6332ff | 58721487 | 11474065 | Findings: PA and lateral views of the chest provided. Lungs appear grossly clear. Subtle areas of scarring in the right mid lung not significantly changed from recent CT. No focal consolidation concerning for pneumonia. No effusion or pneumothorax. Cardiomediastinal silhouette is stable. Vertebroplasty changes at the lower thoracic spine noted. Chronic right fourth rib resection noted. Impression: No acute findings. | Findings: PA and lateral views of the chest provided. Lungs appear grossly clear. Subtle areas of scarring in the right lower lung not significantly changed from recent CT. No focal consolidation concerning for pneumonia. No effusion or pneumothorax. Cardiomediastinal silhouette is stable. Vertebroplasty changes at the lower thoracic spine noted. Vertebroplasty changes at the lower thoracic spine noted. Mild atelectasis at the left lung base. Impression: No acute findings. | ['Change location', 'Add repetitions', 'False prediction'] |
| 418536fe-ce5ff76a-25c69892-fa4beedf-88916c53 | 58952033 | 11474065 | Impression: In comparison with the study of ___, the patient is somewhat oblique, limiting the evaluation. However, there is no evidence of pneumothorax. Overall, probably little change. | Impression: In comparison with the study of ___, the patient is somewhat oblique, limiting the evaluation. However, there is no evidence of pneumothorax. Overall, probably little chagne. A pacemaker is present. | ['False negation', 'Add typo', 'Add medical device'] |
| 7bcd081b-869f44f4-57a93477-646a8796-ee97546c, e8f0762b-f26c36ff-f3ca5ab5-d71c03f7-c26f6b9e | 59083645 | 11474065 | Findings: PA and lateral views of the chest provided. An area of scarring in the right lower lung appears unchanged. Remainder both lungs appear relatively clear. Cardiomediastinal silhouette is stably prominent. No pneumothorax. Chronic right upper rib cage deformity and chronic changes related to vertebroplasty in the lower T-spine. Impression: No convincing evidence for pneumonia or edema. | Findings: PA and lateral views of the chest provided. An area of scarring in the left lower lung appears unchanged. Remainder both lungs appear relatively clear. Cardiomediastinal silhouette is stably prominent. No pneumothorax. Moderate left lower rib cage deformity and chronic changes related to vertebroplasty in the lower T-spine. Diffuse interstitial markings are noted throughout both lungs. Impression: No convincing evidence for pneumonia or edema. | ['Change location', 'Change to homophone', 'False prediction'] |
| ea2bfc51-e27284b8-51af06f3-06ed8266-9f18eb54 | 59155076 | 11474065 | Findings: One portable AP view of the chest. Again seen is mild pulmonary edema, mostly on the right, with slight improvement compared to ___. Right pleural thickening or loculated effusion is again seen and unchanged. There has been surgical removal of the right fourth rib posteriorly. Impression: 1. Persistent but improved mild pulmonary edema compared to prior study on ___. 2. Right pleural thickening or loculated effusion is stable. These findings were discussed with ___ at 2:30pm on ___ by telephone. | Findings: One portable AP view of the chest. Again seen is severe pulmonary edema, mostly on the right, with slight improvement compared to ___. Right pleural thickening or loculated effusion is not seen. There has been surgical removal of the right fourth rib posteriorly. Impression: 1. Persistent but improved mild pulmonary edema compared to prior study on ___. 2. Right pleural thickening or loculated effusion is stable. There are no persistent findings. These findings were discussed with ___ at 2:30pm on ___ by telephone. | ['Change severity', 'Add contradiction', 'False negation'] |
| 370db7dd-bdd6ffce-5e0e6b83-bc6f534f-61ce5045 | 59648796 | 11474065 | Impression: As compared to prior radiograph of 1 day earlier, subcutaneous emphysema and pneumomediastinum are again demonstrated. Bilateral pneumothoraces are not clearly identified on today's exam. Heterogeneous opacities in the right lung are similar, and exam is otherwise remarkable for worsening left basilar atelectasis with adjacent small left pleural effusion. | Impression: As compared to prior radiograph of 1 day earlier, subcutaneous emphysema and pneumomediastinum are again demonstrated. No pneumothoraces are identified on today's exam. Heterogeneous opacities in the right lung are similar, and exam is otherwise remarkable for worsening left basilar atelectasis with adjacent large left pleural effusion. | ['Change severity', 'Change to homophone', 'False negation'] |
| c9355375-ab810bbd-434a7359-567930d2-984ba8aa | 59691021 | 11474065 | Findings: In comparison with the study of ___, there is now a tracheal stent with its lower border at the mid clavicular level. There is better inspiration with continued enlargement of the cardiac silhouette. Right basilar opacification persists, consistent with a combination of known nodular process, consolidation, and post-procedure atelectasis. There is mild fullness of the pulmonary vessels, consistent with mild elevation of pulmonary venous pressure. | Findings: In comparison with the study of ___, there is now a tracheal stent with its lower border at the carina. There is better inspiratiion with continued enlargement of the cardiac silhouette. Right basilar opacification persists, consistent with a combination of known nodular process, consolidation, and post-procedure atelectasis. There is mild fullness of the pulmonary vessels, consistent with mild elevation of pulmonary venous pressure. No opacification persists. | ['Change position of device', 'Add typo', 'False negation'] |
| 0ba61f42-36b75725-d59c3425-259c54a6-7dd192bf, 501f88ca-6cf4e937-ea4584a1-eea40cc3-3333047d | 51244125 | 11512104 | Findings: Frontal and lateral radiographs of the chest were acquired. There is a diffuse interstitial abnormality, with a perihilar predominance, suggestive of mild interstitial pulmonary edema. Moderate enlargement of the cardiac silhouette is not significantly changed. A small left pleural effusion is not significantly changed. There is no definite right pleural effusion. The mediastinal contours are unchanged. There is a small hiatal hernia, not significantly changed. There is no pneumothorax. Surgical clips project over the upper abdomen on the lateral radiograph. Multilevel degenerative changes of the thoracolumbar spine are noted. Anterior wedging of a lower thoracic vertebral body is not significantly changed. Impression: 1. Mild interstitial pulmonary edema. No focal consolidation. 2. Moderate cardiomegaly, not significantly changed. 3. Unchanged small left pleural effusion. | Findings: Frontal and lateral radiographs of the chess were acquired. There is no interstitial abnormality. Moderate enlargement of the cardiac silhouette is not significantly changed. No left pleural effusion is noted. There is no definite right pleural effusion. The mediastinal contours are unchanged. There is a small hiatal hernia, not significantly changed. There is no pneumothorax. Surgical wires project over the upper abdomen on the lateral radiograph. Multilevel degenerative changes of the thoracolumbar spine are noted. Anterior wedging of a lower thoracic vertebral body is not significantly changed. Impression: 1. No interstitial pulmonary edema. No focal consolidation. 2. Moderate cardiomegaly, not significantly changed. 3. No small left pleural effusion. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 5d4e5d0a-add681d2-faf8a518-e0062eff-6554d2d2 | 52398109 | 11512104 | Findings: Lung volumes are low. The heart remains mildly enlarged. Aortic knob is calcified. Mediastinal and hilar contours are unchanged, with a small hiatal hernia again noted. Pulmonary vascularity is within normal limits. No focal consolidation, pleural effusion or pneumothorax is present. Multiple clips are seen in the right upper quadrant compatible with prior cholecystectomy. Degenerative changes of the left glenohumeral joint are incompletely assessed. Impression: No acute cardiopulmonary process. | Findings: Lung volumes are low. The heart remains mildly enlarged. Aortic knob is calcified. A nasogastric tube is seen with its tip in the stomach. Pulmonary vascularity is within normal limits. No focal consolidation, pleural effusion or pneumothorax is present. Multiple surgical sponges are seen in the right upper quadrant compatible with prior cholecystectomy. Degenerative changes of the left glenohumeral joint are incompletely assessed. Impression: No acute cardiopulmonary process, but a small left pleural effusion is noted. | ['Change name of device', 'Add contradiction', 'Add medical device'] |
| 294ebc2b-bda5301f-54062c24-9d36e9fe-0770d722, b8b6f229-6e131a36-ab9233fe-6db5132b-596d3e5e | 53379869 | 11512104 | Findings: Moderate enlargement of the cardiac silhouette is again noted, unchanged. The aorta is mildly tortuous and demonstrates mild atherosclerotic calcification. Hilar contours are within normal limits. Previous pattern of mild interstitial pulmonary edema has nearly completely resolved, with no focal consolidation, pleural effusion or pneumothorax identified. There are multilevel degenerative changes in the thoracic spine, with slight loss of height of a low thoracic/upper lumbar vertebral body, unchanged. Multiple clips in the upper abdomen are unchanged. Impression: Interval resolution in previous pattern of interstitial pulmonary edema. No radiographic evidence for pneumonia. | Findings: Moderate enlargement of the cardiac silhouette is again noted, unchanged. The aorta is mildly tortuous and demonstrates mild atherosclerotic calcification. Hilar coutours are within normal limits. Previous pattern of mild interstitial pulmonary edema has nearly completely resolved, with no focal consolidation, pleural effusion or pneumothorax identified. There are multilevel degenerative changes in the thoracic spine, with slight loss of height of a low thoracic/upper lumbar vertebral body, unchanged. No clips seen. Impression: No interstitial pulmonary edema. No radiographic evidence for pneumonia. | ['Change location', 'Add typo', 'False negation'] |
| 84d8e0b6-5b77cf98-4137deac-e588d6e8-ed535ab1, def6f212-4f61456d-60919d0b-c6cddaaf-db3f108a | 56889771 | 11512104 | Findings: Frontal and lateral views of the chest demonstrate low lung volumes. Moderate pulmonary edema is present. Costophrenic angles are obscured, suggestive of small pleural effusions. Moderate cardiomegaly is noted. Hilar and mediastinal silhouettes are unremarkable. Aortic arch calcifications are seen with tortuosity of the descending aorta. There is no pneumothorax. Impression: Moderate pulmonary edema and cardiomegaly, with associated small bilateral pleural effusions. | Findings: Frontal and lateral views of the chest demonstrate low lung volumes. Moderate pulmonary edema is present in the upper lung fields. Costophrenic angles are obscured, suggestive of small pleural effusions. A nasogastric tube is positioned with its tip below the diaphragm. Hilar and mediastinal silhouettes are unremarkable. Aortic arch calcifications are seen with tortuosity of the descending aorta. There is no pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Impression: Moderate pulmonary edema and cardiomegaly, with associated small bilateral pleural effusions. | ['Change location', 'Add repetitions', 'Add medical device'] |
| ff4180bc-fa800289-1e6a39c6-4c38b356-ad513e6a | 51114398 | 11540283 | Findings: Patient rotation slightly limits assessment. Endotracheal tube tip terminates approximately 3 cm from the carina. Enteric tube is seen coursing through the stomach with side port in the stomach, and tip off the inferior borders of the film. The patient is status post median sternotomy and CABG. Left-sided AICD lead terminates in the right ventricle. There is moderate enlargement of cardiac silhouette. Mild pulmonary vascular congestion is present. No focal consolidation, pleural effusion or pneumothorax is present. Impression: 1. Endotracheal tube and enteric tubes in standard positions. 2. Mild pulmonary vascular congestion. | Findings: Patient rotation slightly limits assessment. Endotracheal tube tip terminates approximately 3 mm from the carina. Enteric tube is seen coursing through the stomach with side port in the stomach, and tip off the inferior borders of the film. The patient is status post median sternotomy and CABG. Left-sided AICD lead terminates in the right ventricle. There is no enlargement of cardiac silhouette. Mild pulmonary vascular congestion is present. No focal consolidation, pleural effusion or pneumothorax is present. Impression: 1. Endotracheal tube and enteric tubes in standard positions. 2. Mild pulmonary vascular congestion. Endotracheal tube and enteric tubes in standard positions. | ['Change measurement', 'Add repetitions', 'False negation'] |
| e68bb7df-05039df8-44346b6b-c34ca52e-a92432c7 | 51230608 | 11540283 | Impression: A new AICD device with lead positioned through the left transvenous approach end into the right ventricle and is appropriate. No focal lung opacities concerning for pneumonia. Heart is top normal size. Mediastinal and hilar contours are normal. No evidence of pneumothorax. | Impression: A new PICC device with lead positioned through the left transvenous approach end into the right ventricle and is appropriate. No focal lung opacitites concerning for pneumonia. Heart is top normal size. Mediastinal and hilar contours demonstrate mild lymphadenopathy. No evidence of pneumothorax. | ['Change name of device', 'Add typo', 'False prediction'] |
| 456d62e4-2e673ffe-83ccc42f-f942c7fb-d5dbc58b, 4a6b6a7c-83ed2cdc-41c74d6e-ed8815a2-84ed02ff | 58773579 | 11540283 | Findings: The lungs are clear without focal consolidation, effusion, or edema. Left chest wall single lead pacing device is noted. Mild cardiomegaly is noted. Median sternotomy wires and mediastinal clips are seen. Prior endotracheal and enteric tubes are no longer visualized. Impression: Mild cardiomegaly without superimposed acute cardiopulmonary process. | Findings: The lungs are clear without focal consolidation, effusion, or hyperinflation. Left chest wall single lead vascular access device is noted. Mild cardiomegaly is noted. Median sternotomy wires and mediastinal cuffs are seen. Prior endotracheal and enteric tubes are no longer visualized. There is a small left pleural effusion. Impression: Mild cardiomegaly without superimposed acute pneumothorax. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| 04e57623-af378474-c0649f6f-0260ef77-8d56543d | 58056251 | 11565803 | Findings: AP single view of the chest has been obtained with patient in sitting semi-upright position. In comparison with the next preceding chest examination of ___, the ETT has been removed. Previously existing chest tube on the left side and advanced from below has been removed. No pneumothorax has developed in the apical area. Mild obscuration of left-sided diaphragm suggestive of some postoperative small amount of pleural effusion, but no other new abnormalities are identified. A right-sided internal jugular approach central venous line remains in place. Its termination point projects into the upper portion of the right atrium. This position is unchanged compared with the previous study. Impression: No evidence of pneumothorax following chest tube removal. | Findings: AP single view of the chest has been obtained with patient in setting semi-upright position. In comparison with the next preceding chest examination of ___, the nasogastric tube has been removed. Previously existing chest tube on the left side and advanced from below has been removed. No pneumithorax has developed in the apical area. Mild obscuration of left-sided diaphragm suggestive of some postoperative small amount of pleural effusion, but no other new abnormalities are identified. A right-sided nasogastric tube remains in place. Its termination point projects into the upper portion of the right atrium. This position is unchanged compared with the previous study. Mild to moderate cardiomegaly is also seen. Impression: No evidence of pneumothorax follwoing chest tube removal. | ['Change name of device', 'Add typo', 'False prediction'] |
| 0f1b4789-8c43bc5c-ec9ef921-5cd7c4a7-5acfae4d, e4f10f9a-3e1c894f-d953e192-b85712f5-9e72c3d6 | 59027235 | 11565803 | Findings: Right internal jugular line ends at lower SVC/cavoatrial junction. Patient is status post median sternotomy for CABG with borderline-sized heart and sternal sutures are intact. Since ___, left lower lung atelectasis, mild-to-moderate pleural effusion and mild right pleural effusion have improved. Mediastinal and hilar contours are in normal limits. Impression: Since ___, bilateral lower lung atelectasis, mild-to-moderate left and mild right pleural effusions have improved. | Findings: Left internal jugular line ends at lower SVC/cavoatrial junction. Patient is status post median sternotomy for CABG with borderline-sized heart and sternal sutures are intact. Since ___, no atelectasis is observed. Mediastinal and hilar coutours are in normal limits. Impression: Since ___, bilaterl lower lung atelectasis, mild-to-moderate left and mild right pleural effusions have impoved. | ['Change location', 'Add typo', 'False negation'] |
| 44d21fe9-7d185d5f-00927b0f-11bf3dce-45b85640 | 54093116 | 11569042 | Impression: Chest pain. COMPARISON: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The heart is again mild-to-moderately enlarged. The mediastinal and hilar contours appear unremarkable. There is patchy opacity in the right infrahilar region suggestive of minor atelectasis/scarring, but widespread opacities and pleural effusions have resolved. No pneumothorax is demonstrated. No evidence for acute disease. | Impression: Chest pain. COMPARISON: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The heart is again severely enlarged. The mediastinal and hilar contours appear unremarkable. There is patchy opacity in the right infrahilar region suggestive of minor atelectasis/scarring, but widespread opacities and pleural effusions have resolved. No pneumothorax is demonstrated. No evidence for acute disease. The mediastinal and hilar contours appear unremarkable. | ['Change severity', 'Add repetitions', 'False prediction'] |
| 1c51ebd2-e0c342a3-b529814b-bd3c289d-45148c5f, e03dd9c2-d0a3ddb0-0e9d72c3-1b4c5f92-9593c85f | 55883502 | 11569042 | Findings: AP upright and lateral views of the chest were provided. In this patient with known achalasia and dilated esophagus, there is no change in the appearance of the dilated distal esophagus which contains ingested debris. There is no sign of aspiration. Heart size cannot be readily assessed. No large pleural effusion. No pneumothorax. Bony structures intact. Impression: Dilated distal esophagus as seen previously containing ingested food contents. No signs of aspiration. Please refer to prior CT torso for full descriptive details of esophageal abnormalities. | Findings: PA upright and lateral views of the chest were provided. In this patient with known achalasia and dilated esophagus, there is no change in the appearance of the dilated distal esophagus which contains ingested debris. There is no sign of aspiration. Heart size cannot be readily assessed. There is a small pleural effusion. No pneumothorax. Bony structures intact. No large pleural effusion. Impression: Dilated distal esophagus as seen previously with a small nodule in the lower esophagus. No signs of aspiration. Please refer to prior CT torso for full descriptive details of esophageal abnormalities. | ['Change location', 'Add repetitions', 'False prediction'] |
| 4aeb5cd4-c071f14c-e4dcd046-420ce1ca-f6fedd70 | 56581797 | 11569042 | Findings: As compared to the previous radiograph, the nasogastric tube is likely coursing through the dilated esophagus and terminates near the gastroesophageal junction. The course is better appreciated on the lateral than on the frontal radiograph and best correlated with a CT torso examination from ___, to reflect abnormal anatomy. | Findings: As compared to the previous radiograph, the chest tube is likely coursing through the dilated esophagus and terminates near the gastroesophageal junction. The course is better appreciated on the lateral than on the frontal radiograph and best correlated with a CT torso examination from ___, to reflect abnormal anatomy. The course is better appreciated on the lateral than on the frontal radiograph and best correlated with a CT torso examination from ___, to reflect abnormal anatomy. A right-sided dual-chamber pacemaker device is also noted within the chest. | ['Change name of device', 'Add repetitions', 'Add medical device'] |
| 4c1ef8d6-96ad17ad-becaa578-175f9fc2-24c4304e, aac431c4-71ce2760-10747748-4fd37654-0f440dd6 | 57778607 | 11569042 | Findings: Nasogastric catheter is seen coursing through the dilated esophagus, consistent with achalasia, and appears to terminate in the esophagus at the level of the posterior costophrenic sulcus. Otherwise, the exam is unchanged with unremarkable mediastinal, hilar and cardiac contours. Lungs are clear. No pleural effusion or pneumothorax is evident. Impression: Enteric catheter coursing through dilated esophagus, ending in the distal esophagus at the level of the right posterior costophrenic angle. | Findings: Nasogastric catheter is seen coursing through the dilated esophagus, consistent with achalasia, and appears to terminate in the esophagus at the level of the mid esophagus. Otherwise, the exam is unchanged with unremarkable mediastinal, hilar and cardiac contours. Lungs are clearr. No pleural effusion or pneumothorax is evident. Impression: No enteric catheter seen. | ['Change position of device', 'Add typo', 'False negation'] |
| 737fe166-1d61ed17-45d7d04d-b55e438d-4f23f221 | 58093109 | 11569042 | Impression: 1. Bibasilar opacities, worse on the left, with possible new left effusion. 2. Limited assessment of superior mediastinum due to lordotic positioning. 3. Probable right humeral diaphysis enchondroma. When the patient is stable, recommend clinical correlation to exclude any right humeral atypical pain and baseline right humerus radiographs to include the entire lesion. | Impression: 1. Right basilar opacities, worse on the left, with possible new left effusion. 2. Limited assessment of superior mediastinum due to lordotic positioning. 3. Probable right humeral diaphysis enchondroma. When the patient is stable, recommend clinical correlation to exclude any right humeral atypical pain and baseline right humerus radiographs to include the entire lesion. Opacities bilaterally have resolved since prior study. A central venous line is noted, with the tip in an optimal position. | ['Change location', 'Add contradiction', 'Add medical device'] |
| d9ebed54-0d6d34ff-31652ffe-bcd2f65d-009a29ee | 58517699 | 11569042 | Impression: AP chest reviewed in the absence of prior chest radiographs: Moderately severe pulmonary edema is evenly distributed in the left lung. On the right, there is greater perihilar opacification extending into the lower lobe which could be asymmetric edema or concurrent pneumonia. A roughly spherical ___-mm wide opacity filling the apex of the right hemithorax should be considered a lung mass until proved otherwise. There is no appreciable pleural effusion. Heart size is normal. Pulmonary vasculature is engorged. Bulge in the left lower mediastinal contour is probably due to hiatus hernia, but could be a paraspinal lesion. Findings discussed by telephone at the time of dictation with Dr. ___. | Impression: AP chest reviewed in the absence of prior chest radiographs: Mild pulmonary edema is evenly distributed in the left lung. On the right, there is no perihilar opacification extending into the lower lobe which could be asymmetric edema or concurrent pneumonia. A roughly spherical ___-cm wide opacity filling the apex of the right hemithorax should be considered a lung mass until proved otherwise. There is a small pleural effusion. Heart size is normal. Pulmonary vasculature is normal. Bulge in the left lower mediastinal contour is probably due to hiatus hernia, but could be a paraspinal lesion. Findings discussed by telephone at the time of dictation with Dr. ___. | ['Change measurement', 'Add contradiction', 'False prediction'] |
| 2f108c10-c8669b9a-f7f02e0f-272d2904-dd0b345e, 5d7c1542-0e986689-16b380fc-7640a95a-8ef99ac8 | 50008596 | 11569093 | Findings: As compared to the previous radiograph, there is no relevant change. Extensive right pleural effusion, potentially combined with some degree of pleural thickening, relatively extensive atelectatic changes in the right lung bases. The extent of the ventilated lung parenchyma on the right is small and located around the right perihilar areas. Unremarkable left heart border, moderate tortuosity of the thoracic aorta. Normal appearance of the left lung without evidence of parenchymal changes or left pleural effusion. | Findings: As compared to the previous radiograph, there is no relevant change. No pleural effusion is observed, potentially combined with some degree of pleural thickening, relatively extensive atelectatic changes in the right lung bases. The extent of the ventilated lung parenchyma on the right is mall and located around the right perihilar areas. Unremarkable left heart border, mild tortuosity of the thoracic aorta. Normal appearance of the left lung without evidence of parenchymal changes or left pleural effusion. | ['Change severity', 'Change to homophone', 'False negation'] |
| 7482f461-69260c1c-6d80e1ef-de9d3167-e122de4e | 51887095 | 11569093 | Findings: There is persistent opacification of the right lower lung field, likely due to known pleural effusion and atelectasis. Small left pleural effusion is again noted. Overall, there has been no significant interval change. Endotracheal tube, left internal jugular catheter, and esophageal catheter are again seen in similar positions with esophageal catheter tip out of view. No pneumothorax is detected. Impression: Stable chest radiograph. | Findings: There is residual opacification of the right upper lung field, likely due to known pleural effusion and atelectasis. Small left pleural effusion is again noted. Significant interval change is noted in the lung opacification. Endotracheal tube, left internal jugular catheter, and esophageal catheter are again seen in similar positions with esophageal catheter terminating above the diaphragm. No pneumothorax is detected. Impression: Stable chest radiograph with new pneumothorax. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| 8f7116c2-c8a7adfb-d814bed2-2a427fde-6478fe3a, ab1e1361-80eb18db-60ce9d49-0c7e8e71-477b3559 | 51983905 | 11569093 | Findings: Chest PA and lateral radiograph demonstrates a markedly elevated right hemidiaphragm with adjacent compressive atelectasis or consolidation. Minimal blunting of the posterior costophrenic angle may indicate a small right pleural effusion. Left lung is clear. Cardiomediastinal borders are unremarkable. Impression: Right hemidiaphragm elevation with opacification posteriorly suggesting extensive adjacent lung atelectasis, though cannot exclude developing infectious process. Possible right pleural effusion as well. If findings do not resolve on subsequent radiography, evaluation with chest CT could be considered, preferably with intravenous contrast if possible. | Findings: Chest PA and lateral radiograph demonstrates a substantially elevated right hemidiaphragm with adjacent compressive atelectasis or consolidation. Minimal bluntng of the posterior costophrenic angle may indicate a moderate right pleural effusion. Left lung demonstrates a mild infiltrate. Cardiomediastinal borders are unremarkable. Impression: Right hemidiaphragm elevation with opacification posteriorly suggesting mild adjacent lung atelectasis, though cannot exclude developing infectious process. Possible right-sided pneumothorax as well. If findings do not resolve on subsequent radiography, evaluation with chest CT could be considered, preferably with intravenous contrast if possible. | ['Change severity', 'Add typo', 'False prediction'] |
| 5f961326-0ccce927-f726948a-19e43255-88306b58 | 52011372 | 11569093 | Findings: As compared to the previous radiograph, a pigtail was introduced into the right pleural cavity. The major part of the pre-existing right pleural effusion appears to be drained. However, a new air inclusion in the right basal pleural space. This pleural air does not manifest as an apical pneumothorax. In fact, in the apical and lateral parts of the right hemithorax, there is still abundant fluid visualized. The volume of the right hemithorax, overall, has not increased. However, a short-term followup is required to assess for potential developing tension. Normally appearing lung parenchyma on the left. Unchanged left heart border and tortuosity of the thoracic aorta. | Findings: As compared to the previous radiograph, a pigtail was introduced into the left pleural cavity. The major part of the pre-existing right pleural effusion appears to be drained. However, a new air inclusion in the right basal pleural space. This pleural air does not manifest as an apical pneumothorax. In fact, in the apical and lateral parts of the right hemithorax, there is still abundant fluid visualized. Normally appearing lung parenchyma on the left. No developing tension. Normally appearing lung parenchyma on the right. Unchanged left heart border and tortuosity of the thoracic aorta. | ['Change location', 'Add repetitions', 'False negation'] |
| ac8eedd7-c5de2735-141b666d-540b2d92-243ec57d | 52805540 | 11569093 | Findings: In comparison with the study of earlier in this date, there is increasing indistinctness of engorged pulmonary vessels, consistent with worsening vascular congestion. Continued elevation of the right hemidiaphragmatic contour. It is unclear whether this represents a subpulmonic effusion or an intrinsic diaphragmatic abnormality or enlarged liver. Left lung is essentially unchanged except for worsening pulmonary vascular congestion. | Findings: In comparison with the study of earlier in this date, there is increasing indistinctness of engorged pulmonary vessels, consistent with worsening vascular congestion. Continued elevation of the left hemidiaphragmatic contour. It is unclear whether this represents a subpulmonic effusion or an intrinsic diaphragmatic abnormality or enlarged liver. No vascular congestion. | ['Change location', 'Add typo', 'False negation'] |
| aa48f5aa-bc33341a-d09fad73-1b881cf5-ec400de4 | 53825501 | 11569093 | Findings: Right-sided chest tube has been removed. There is a hydropneumothorax in the inferior right chest. The amount of fluid has increased compared to the study from two days prior. The thick irregular pleural disease around the right lung is again visualized. The left lung is clear. Cardiac and mediastinal silhouettes are unchanged. | Findings: Right-sided chest tube is in place, terminating in the mid-axillary line. There is a hydropneumothorax in the inferior right chest. There is no significant change in the amount of fluid compared to the study from two days prior. The thick irregular pleural disease around the right lung is again visualized. The left lung has a new small nodule. Cardiac and mediastinal silhouettes are unchanged. A central venous line terminates in the lower SVC. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| a238199b-93d2aa00-f4451329-26e4438c-e170ad89 | 54670469 | 11569093 | Findings: As compared to the previous radiograph, the patient has been extubated. The nasogastric tube has been removed. There are moderate bilateral pleural effusions with relatively substantial areas of atelectasis. Size of the cardiac silhouette cannot be determined. No evidence of new parenchymal opacities suggesting pneumonia. A left internal jugular vein catheter remains in situ. | Findings: As compared to the previous radiograph, the patient has been extubated. The nasogatsric tube has been removed. There are mild bilateral pleural effusions. Size of the cardiac silhouette cannot be determined. No evidence of new parenchymal opacities suggesting pneumonia. A left internal jugular vein catheter is not observed. | ['Change severity', 'Add typo', 'False negation'] |
| d87efb8c-2b6c913c-52f20a43-a8cbf2ba-2b20410d | 54721804 | 11569093 | Impression: Considerable interval increase in the degree of opacification of the right lung. This may represent a combination of pleural fluid and collapse and/or consolidation. Given the rapid change, is there reason to suspect mucous plugging? Findings discussed with the covering house officer, Dr. ___, at ~ ___:___ p.m. on the day of the exam (___, phone). | Impression: Considerable interval increase in the degree of opacification of the left lung. This may represent a combination of pleural fluid and collapse and/or consolidation. Given the rapid change, is there reason to suspect mucous plugging? Findings discussed with the covering house officer, Dr. ___, at ~ ___:___ p.m. on the day of the exam (___, phone). Additional note: There is no definite change in the opacification of the right lung. There is a central venous line in place. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 4a15096e-ded396cd-2f74c587-afc7d7b0-c226c5cb, 5ab71143-d2a565ba-27ff9ac9-78770ac7-c74020d9 | 54749599 | 11569093 | Impression: AP chest compared to ___ through ___. There is still a large right pleural fluid collection, now with a smaller component of air, at the base of the right lung which is severely restricted by severe pleural thickening which has worsened along the costal and particularly along the right mediastinal pleural surface. It would be helpful in our evaluation to know whether the nature of the right pleural effusion was infectious, malignant, are otherwise inflammatory. Left lung is well inflated and clear. Heart is not enlarged. Vascular clips denote prior surgery at the level of the gastroesophageal junction. | Impression: AP chest compared to ___ through ___. There is still a large left pleural fluid collection, now with a smaller component of air, at the base of the left lung which is severely restricted by severe pleural thickening which has worsened along the costal and particularly along the left mediastinal pleural surface. It would be helpful in our evaluation to know whether the nature of the right pleural effusion was infectious, malignant, are otherwise inflammatory. Left lung is well inflated and clear. Left lung is well inflated and clear. Vascular clips denote prior surgery at the level of the gastroesophageal junction. There are central venous lines in place. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 68a9dec9-436c84d0-572f0df9-18929544-6b237d3b | 56084617 | 11569093 | Findings: A frontal upright view of the chest was obtained portably. Interval removal of the right pigtail catheter with replacement with a right chest tube within the loculated right basilar pneumothorax, which is unchanged. Volume loss in the right lung with surrounding pleural fluid is unchanged. The left lung is well expanded and clear without pneumothorax or effusion. Surgical clips project over the epigastrium. Aortic contour and left heart border are unchanged. Impression: Unchanged right basilar pneumothorax. | Findings: A frontal upright view of the chest was obtained portably. Interval removal of the right PICC line with replacement with a right chest tube within the loculated right basilar pneumothorax, which is unchanged. Volume loss in the right lung with surrounding pleural fluid is unchanged. The left lung is well expanded and clear without pneumothorax or effusion. Surgical clips project over the epigastrium. Ill-defined opacity is seen in the left lower lobe. Aortic contour and left heart border are unchanged. Impression: Unchanged right basilar pneumothorax. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| 395a7197-bac16c22-5e75d329-e014f2a8-5d6432e9 | 56389746 | 11569093 | Findings: Compared to the previous radiograph, the left IJ catheter has been removed. There are persistent bilateral pleural effusions along with unchanged opacification of right lung base. This suggests right middle and lower lobe collapse. Comparison is limited by patient rotation on current imaging. Opacification at the left lung base is unchanged, and pneumonia cannot be excluded. | Findings: Compared to the previos radiograph, the left IJ catheter hasbeen removed. Ther are persistent bilateral pleural effusions along with unchanged opacification of right lung base. This suggests right middle and lower lobe collapse. A new left-sided central venous line is present terminating in the right atrium. Comparison is limited by patient rotation on current imaging. Opacification at the left lung base is unchanged, and pneumonia cannot be excluded. | ['Change position of device', 'Add typo', 'Add medical device'] |
| 0d2a50a2-3711662a-d7838521-4dc58d09-3732a3ad | 57204814 | 11569093 | Findings: As compared to the previous radiograph, there is no relevant change. The course of the left internal jugular vein catheter is constant. Constant extensive left parenchymal opacity and extensive right apicolateral consolidation. Moderate elevation of the right hemidiaphragm with small pleural effusion. Unchanged aspect of the left heart border. No pneumothorax, no new opacities. | Findings: As compared to the previous radiograph, there is increased parenchymal opacity noted. The course of the left internal jugular vein catheter terminates near the subclavian vein. Extensive left parenchymal opacity with new right basilar consolidation. Moderate elevation of the right hemidiaphragm without any pleural effusion. Slightly irregular left heart border. No pneumothorax, new opacities are observed. A nasogastric tube is noted in the mid-esophagus. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| 967d441a-a13a3abb-92836835-665f96e3-d5916b82 | 58407493 | 11569093 | Findings: In comparison with the previous study, there is now an endotracheal tube in place with its tip only about 1.5 cm above the carina. This information wasd conveyed to Dr. ___. Intestinal tube extends well into the stomach. Left IJ catheter tip is unchanged. The extensive right apical lateral consolidation has substantially cleared. The opacification involving much of the left lung has decreased. It is unclear whether this represents clearing pneumonia or possible decrease in asymmetric pulmonary edema. Opacification at the left base silhouetting the hemidiaphragm is consistent with pleural effusion. Right hemidiaphragmatic contour is elevated, possibly relating to pleural effusion, with streaks of atelectasis at the base. | Findings: In comparison with the previous study, there is now an endotracheal tube in place with its tip only about 3 cm above the carina. This information wasd conveyed to Dr. ___. Intestinal tube extends well into the stomach. No Left IJ catheter is seen. The extensive right apical lateral consolidation has substantially worsened. The opacification involving much of the left lung has disappeared. It is unclear whether this represents clearing pneumonia or possible decrease in asymmetric pulmonary edema. Opacification at the left base silhouetting the hemidiaphragm is consistent with pleural effusion. There is a normal Right hemidiaphragmatic contour. | ['Change measurement', 'Add contradiction', 'False negation'] |
| 382dbe73-cac300e6-08430cac-cec951a4-86e9e1e1 | 59234239 | 11569093 | Impression: 1. ET tube terminating 5.1 cm above the carina. Orogastric tube terminating within the stomach. 2. Interval worsening of mild-to-moderate pulmonary edema. 3. Unchanged marked right hemidiaphragm elevation. | Impression: 1. ET tube terminating 5.4 cm above the carina. Orogastric tube terminating within the stomatch. 2. Interval worsening of mild-to-moderate pulmonary edema. Right-sided pleural effusion noted. 3. Unchanged marked right hemidiaphragm elevetion. | ['Change measurement', 'Add typo', 'False prediction'] |
| fef81fa7-75d8ca91-07651606-538e5b40-bb00dbff | 59413372 | 11569093 | Findings: Single frontal image of the chest was obtained. Again seen is a partially collapsed right lung with increased density at the inferior border of the lung, consistent with pleural effusion versus pleural thickening. Below the inferior border of the right lung is again seen a hydropneumothorax with an air-fluid level. There again appear to be some small opacities within the partially collapsed right lung. The left lung is seen again to be clear. Cardiomediastinal silhouette is unchanged. Impression: Unchanged chest radiograph from previous imaging. | Findings: Single frontal image of the chest was obtained. Again seen is a partially collapsed right lung with increased density at the inferior border of the lung, consistent with pleural effusion versus pleural thickening. Below the inferior border of the right lung is again seen a hydropneumothorax with an air-fluid level. There again appear to be some small opacities within the partially collapsed right lung. The left lung is noted to have nodular opacities. Cardiomediastinal silhouette is unchanged. Impression: Unchanged chest radiograph from previous imaging. A central venous line is in place with the tip located in the SVC. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| 3d9581e4-1ca59a74-f2f5dfee-2599dad8-491fc6a0 | 59433529 | 11569093 | Findings: The left lung is relatively well aerated and clear. The right hemithorax is markedly opacified with volume loss, circumferential pleural thickening and pleural fluid with near complete opacification of the right lung with right basal pleural catheter noted. Hydropneumothorax previously seen is not as well evaluated on this not fully upright film. Cardiac contours are somewhat obscured but unremarkable. | Findings: The left lung is relatively well aerated and clear. The right hemithorax exhibits normal aeration and no features of volume loss, pleural thickening, or pleural fluid. The right basal pleural catheter is noted 3cm from the carina. Hydropneumothorax previously seen is not as well evaluated on this not fully upright film. Cardiac contours are remarkably well defined. | ['Change position of device', 'Add contradiction', 'False negation'] |
| 3e6f368b-a8391960-74c08b06-25d8dafc-0c6e61fe, f144b596-88afdc30-0f893661-7b6e1b7c-29b129bf | 59718086 | 11569093 | Findings: As compared to the previous radiograph, there is no relevant change. Large fluid or pneumothorax on the right with air-fluid level in the posterior aspect of the lung. Massive generalized right-sided pleural thickening with slight decrease of the right hemithorax. Fibrotic changes of the lung parenchyma. On the left, there is no abnormality of the pleura or lung parenchyma. The left aspect of the heart border is unremarkable. | Findings: As compared to the previous radiograph, there is no relevant change. Large fluid or pneumothorax on the right with air-fluid level in the posterior aspect of the lung. Severe generalized right-sided pleural thickening with slight decrease of the right hemithorax. Fibrotic changes of the lung parenchyma. On the left, there is no abnormality of the pleura or lung parenchyma. The left aspect of the heart border is unremarkable. Severe generalized right-sided pleural thickening with slight decrease of the right hemithorax. A central venous line is in place. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| 51b6ffe9-580e1dd3-9aa94073-a614dd4f-e41809b0 | 59995358 | 11569093 | Findings: The patient has been extubated. Parenchymal opacities in the left lung are similar to mildly worsened. A left internal jugular vein catheter terminates in the mid SVC. The NG tube is no longer present. Again seen is the large right subpulmonic effusion. The small left pleural effusion is unchanged. There is no pneumothorax. | Findings: The patient has been intubated. Parenchymal opacities in the left lung are similar to mildly improved. A left internal jugular vein catheter terminates in the lower SVC. The NG tube is now present. Again seen is the large right subpulmonic effusion. The small left pleural effusion has increased. There is a small pneumothorax. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| eaa862a2-6c57e3ea-bad4024a-564f7f14-d963c808 | 50790949 | 11607628 | Impression: 1. Endotracheal tube appropriately retracted to 5 cm above the carina. 2. Resolution of pulmonary edema. 3. Stable moderate left greater than right bilateral pleural effusions. 4. Stable mild cardiomegaly. | Impression: 1. Endotracheal tube appropriately retracted to 2 cm above the carina. 2. Resolution of pulmonary edema. 3. Stable moderate left greater than right bilateral pleural effusions. 4. Stable mild cardiomegaly. 2. Resolution of pulmonary edema. | ['Change position of device', 'Add repetitions', 'False prediction'] |
| c154b276-3e9ecb31-b2fe9540-94554c09-d541d5fa | 52246418 | 11607628 | Impression: PA and lateral chest compared to AP chest on ___ and prior PA and lateral ___: Pulmonary vascular congestion is mild, but persistent. Relative enlargement of the cardiac silhouette compared to ___ suggests some increase in moderate cardiomegaly and/or pericardial effusion. If there is pericardial effusion it is probably not hemodynamically significant but that determination would require echocardiography. Small right pleural effusion which increased between ___ and ___ is stable. A left pleural abnormality could be due to a combination of pleural thickening and small effusion, is unchanged since ___. Transvenous right ventricular pacer lead is unchanged in position, tip projecting over the floor of the right ventricle close to the anticipated location of the apex. No pneumothorax. | Impression: PA and lateral chest compared to AP chest on ___ and prior PA and lateral ___: Pulmonary vaskular congestion is mild, but persistent. Relative enlargement of the cardiac silhouette compared to ___ suggests some increase in moderate cardiomegaly and/or pericardial effusion. If there is pericardial effusion it is probably not hemodynamically significant but that determination would require echocardioghraphy. Small right pleural effusion which increased between ___ and ___ is stable. No pleural abnormality is seen. Transvenous right ventricular pacer lead is unchanged in position, tip projecting over the floor of the right ventricle close to the anticipated location of the apex. No pneumothorax. | ['Change severity', 'Add typo', 'False negation'] |
| 9c44b35d-68d09c0c-3cfbce66-0341de07-1c0346ee, ae7fb131-28d05c98-90cbbc4c-f05c219a-1d0fed84 | 52356321 | 11607628 | Findings: Frontal and lateral views of the chest demonstrate left pectoral single lead AICD with stable position of lead terminating in the right ventricle. The heart appears globular and enlarged, more pronounced as compared to ___, morphology suggestive of pericardial effusion. There is plate-like atelectasis in the left base with associated pleural effusion, which is decreased since preceding exam. There is no pneumothorax or frank edema. Mild blunting of the right costophrenic angle is unchanged. Impression: 1. Short interval development of massive cardiomegaly with globular configuration, concerning for pericardial effusion. 2. Trace left effusion with plate-like atelectasis. Possible trace right effusion, unchanged. Findings reported to Dr. ___ by phone at 4 a.m. on ___. | Findings: Frontal and lateral views of the chest demonstrate left pectoral single lead pacemaker with stable position of lead terminating in the right ventricle. The heart appears globular and enlarged, more pronounced as compared to previous exams, morphology suggestive of pericardial effusion. There is plate-like atelectasis in the left base with associated pleural effusion, which is decreased since preceding exam. There is no pneumothorax or frank edema. Mild blunting of the right costophrenic angle is unchanged. Frontal view shows well-positioned central venous line terminating at the SVC. Impression: 1. Short interval development of massive cardiomegaly with globular configuration, concerning for pericardial effusion. 2. Trace left effusion with plate-like atelectasis. Possible trace right effusion, unchanged. Impression: No evidence of cardiomegaly or pericardial effusion. Findings reported to Dr. ___ by phone at 4 a.m. on ___. | ['Change name of device', 'Add contradiction', 'Add medical device'] |
| 54f4c142-ff4415c6-17466d42-d7531983-33acac69 | 56862577 | 11607628 | Findings: Comparison is made to prior study of ___. The endotracheal tube, feeding tube, and right IJ central venous catheter are stable in position. There is again seen cardiomegaly and left retrocardiac opacity, which is unchanged. There are no pneumothoraces or signs for overt pulmonary edema. A small right-sided pleural effusion is also present. | Findings: Comparison is maid to prior study of ___. The endotracheal tube, feeding tube, and right IJ central venous stent are stable in position. There is again seen cardiomegaly and left retrocardiac opacity, which is unchanged. There are no pneumothorax or signs for overt pulmonary edema. A small right-sided pleural effusion is also present. There is presence of a pacemaker device noted on the left side. | ['Change name of device', 'Change to homophone', 'Add medical device'] |
| b83e699f-f3106ae1-2e81b3c2-289d9017-3ddb459c | 57673768 | 11607628 | Findings: Comparison is made to the prior study from ___. The feeding tube, left IJ catheter and endotracheal tube are unchanged in position. There is persistent cardiomegaly. There is unchanged left retrocardiac opacity. There are no signs for overt pulmonary edema. There is a small right-sided pleural effusion as well. Overall, these findings are stable. | Findings: Comparison is made to the prior study from ___. The feeding tube, right IJ catheter and endotracheal tube are unchanged in position. There is no cardiomegaly. There is unchanged left retrocardiac opacity. There is no significant pulmonary edema. No pleural effusion is seen. Only some findings have changed. | ['Change location', 'Add contradiction', 'False negation'] |
| c375e421-68a1e118-133cd727-71b1be6f-8d62fa58 | 53339862 | 11673948 | Findings: AP portable upright view of the chest. Overlying ekg leads are present. Minimal platelike left basal atelectasis is noted. Otherwise lungs are clear without focal consolidation, effusion or pneumothorax. No signs of congestion or edema. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Impression: No acute intrathoracic process | Findings: AP portable upright view of the chest. Ekc overlying leads are present. Significant platelike left basal atelectasis is noted. Otherwise lungs are clear without focal consolidation, effusion or pneumothorax, although there is a small right-sided pleural effusion. No signs of congestion or mild edema. The cardiomediastinal silhouette is slightly enlarged. Imaged osseous structures shown multiple old fractures. Impression: No acute intrathoracic process | ['Change severity', 'Add typo', 'False prediction'] |
| 219d35dc-47d442ce-54f9249d-d852136c-093bcbac, 9fbe751e-040f98f7-66f9047b-8c7b8554-28250c9c | 57018476 | 11673948 | Impression: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. | Impression: In comparison with the study of ____, there is no change or evidence of acute cardiopulmonary disease. There is mild pulmonary edema present. No pneumonia, vascular congestion, or pleural effusion. A single central venous line is observed. | ['Add contradiction', 'Change to homophone', 'Add medical device'] |
| 27a4f085-5eaad330-a1153870-3ec2cd19-20a604cd, ea6b4ed1-85a1a289-da2233a9-5ff02b4c-e6290e00 | 53021526 | 11879886 | Findings: A left hilar mass is noted, which appears new compared with prior exam of ___. There is also increased vascular markings in the remaining lung fields as well as a new left-sided pleural effusion. There is mild-to-moderate cardiomegaly which appears to be slightly worsened compared with prior exam. There is no pneumothorax. Sternotomy wires are intact. Multiple surgical clips are noted in the left hemithorax. Impression: 1. New left hilar mass. A CT is recommended for further assessment. 2. Cardiomegaly associated to increased vascular markings and pleural effusion suggests pulmonary vascular congestion. | Findings: A left hilar mass is noted, which appears new compared with prior exam of ___. There is also increased vascular markings in the remaining lung fields as well as a new left-sided pleural effusion. There is mild-to-moderate cardiomegaly which appears to be slightly worsened compared with prior exam. There is a small left pneumothorax. Sternotomy wires are in an appropriate position. Multiple surgical clips are noted in the right hemithorax. Left central venous catheter terminates in the right atrium. Impression: 1. New left hilar mass. A CT is recommended for further assessment. 2. Cardiomegaly associated to increased vascular markings and pleural effusion suggests pulmonary vascular congestion. 3. No pneumothorax is identified. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| 94795c9f-9f6f801d-ed57d02c-5e9e02be-b35bf9a1, 9af84adc-9ec1d9e4-04c381af-f81edb77-c40f3fb4 | 54357764 | 11879886 | Impression: New diffuse interstitial opacities likely related to pulmonary edema, though atypical infection should also be considered. | Impression: No interstitial opacities seen likely related to pulmonary edema, though atypical infection should also be considered. There are no pneumothorax or effusion. | ['False negation', 'Add repetitions', 'Add medical device'] |
| 12fcd1f0-96b6eb00-a6a5ee27-7e8d19ee-63f16bc2, d8d4b15b-0a338acd-c5176214-7794d508-468e6e07 | 54972841 | 11879886 | Findings: PA and lateral views of the chest were obtained. Midline sternotomy wires and mediastinal clips are again noted. The lungs appear clear bilaterally without definite signs of pneumonia or CHF. The patient is known to have multiple pulmonary metastases which are not well seen. A lesion in the left lower lobe projects over the posterior margin of the heart on the lateral view. A nodular opacity is again noted in the left upper lobe. No pleural effusion or pneumothorax. Heart size is stable. Mediastinal contour is also stable. Bony structures appear intact. Impression: Known lung metastases are again noted though better assessed on prior CT. No definite signs of superimposed acute process. | Findings: PA and lateral views of the chest were obtained. Midline sternotomy wires and mediastinal screws are again noted. The lungs appear hyperinflated bilaterally without definite signs of pneumonia or CHF. The patient is known to have multiple pulmonary metastases which are not well seen. A lesion in the left lower lobe projects over the posterior margin of the heart on the lateral view. A nodular opacity is again noted in the left upper lobe. No pleural effusion or pneumothorax. Heart size is stable. No pleural effusion or pneumothorax. Mediastinal contour is also stable. Bony structures appear intact. The right lower lobe shows signs of consolidation. Impression: Known lung metastases are again noted though better assessed on prior CT. No definite signs of superimposed acute process. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| da8cd0dd-573be530-0024ff8e-15e20b59-21e4a61d | 56268607 | 11879886 | Impression: CHF with upper zone redistribution and diffuse vascular blurring. Minimal left lower lobe opacity also noted. Of note, the chest CT from ___ described innumerable pulmonary nodules. It would be difficult to distinguish interstitial metastatic disease from the findings on the current study, but the upper zone redistribution and overall blurring does appear more pronounced than on ___ and that rapid change supports the diagnosis of CHF. | Impression: CHF with upper zone redistribution and diffuse vascular blurring. No opacity noted. Of note, the chest CT from ___ described innumerable pulmonary nodules. It would be difficult to distinguish interstitial metastatic disease from the findings on the current study, but the upper zone redistribution and overall blurring does appear more pronounced than on ___ and that rapid change supports the diagnosis of CHF. Of note, the chest CT from ___ described innumerable pulmonary nodules. | ['Change location', 'Add repetitions', 'False negation'] |
| 2aadeb6e-8b5af4b3-f3ddd4f9-8d552d40-d8a5e821, a6f60ee9-d5a2f15e-67cea2a3-caf01923-79f4b71f | 56855230 | 11879886 | Findings: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are stable. Known lung nodules are better assessed by CT. Median sternotomy wires and mediastinal clips are again noted. Impression: No radiographic evidence for acute cardiopulmonary process. | Findings: No focal consolidation, pleural effusion, pneumothorax, or pneumonitis is detected. Heart and mediastinal contours are stable. Known lung nodules are better assessed by CXT. Median sternotomy wires and left supraclavicular clips are again noted. Impression: No radiographic evidence for acute cardiopulmonary process with possible pleural thickening. | ['Change position of device', 'Add typo', 'False prediction'] |
| 6aff92fc-a55af9c9-b11a0394-d2d62191-122cdf01 | 50720959 | 11880923 | Findings: In comparison with the study of ___, there is slightly better inspiration. The left hemidiaphragm is not sharply seen and there is hazy opacification at the left base. This suggests a possible atelectasis and effusion. Monitoring and support devices are unchanged. | Findings: In comparison with the study of ___, there is slightly better inspirations. The right hemidiaphragm is not sharply seen and there is hazy opacification at the left base. This suggests a possible atelectasis and effusion. Monitoring and support devices are unchanged. There is a presence of a central venous line. | ['Change location', 'Add typo', 'Add medical device'] |
| 6ccb4ace-96b61a6d-da4ac48b-808f3b8e-7d4547a8 | 50940921 | 11880923 | Findings: As compared to the previous radiograph, the monitoring and support devices are unchanged. The lung volumes have increased, likely reflecting increased ventilatory pressure. The pre-existing combination of a right parenchymal opacity and diffusion has decreased in extent and severity. The retrocardiac lung parenchyma has also slightly increased in transparency. No evidence of new parenchymal opacities. A left pleural effusion is not present. In the left perihilar areas, there is minimal peribronchial cuffing and an increase in diameter of the vascular structures, so that mild pulmonary edema cannot be excluded. | Findings: As compared to the previous radiograph, the miner monitoring and support devices are unchanged. The left lung volumes have increased, likely reflecting increased ventilatory pressure. The pre-existing combination of a left parenchymal opacity and diffusion has decreased in extent and severity. The retrocardiac lung parenchyma has also slightly increased in transparency. No evidence of new parenchymal opacities. A left pleural effusion is not present. In the left perihilar areas, there is minimal peribronchial cuffing and an increase in diameter of the vascular structures, so that mild pulmonary edema cannot be excluded. A centrally placed pacemaker is noted. | ['Change location', 'Change to homophone', 'Add medical device'] |
| 4db2b802-44d922f7-c712342d-b8af15be-7ac7a0ed | 50969842 | 11880923 | Findings: Endotracheal tube, nasogastric tube, right hemodialysis catheter and right-sided surgical drain are in unchanged position with interval removal of left-sided Swan with sheath still within the left internal jugular vein. Asymmetric right greater than left pulmonary edema and moderate pleural effusion are unchanged with progressive right sided volume loss and rightward shift of the mediastinum over the past ___ films. The heart size is top normal in size with normal cardiomediastinal contours. Impression: Progressive right sided volume loss since intubation could be due to mucous plugging iwith unchanged right effusion and vascular congestion. Findings discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone. | Findings: Endotracheal tube, nasogastric tube, right hemodialysis catheter and right-sided surgical drain are in unchanged position with interval removal of left-sided Swan with sheath now positioned in the left subclavian vein. Asymmetric left greater than right pulmonary edema and moderate pleural effusion are unchanged with progressive right sided volume loss and rightward shift of the mediastinum over the past ___ films. The heart size is moderately enlarged with normal cardiomediastinal contours. Impression: Progressive right sided volume loss since intubation could be due to mucous plugging iwith unchanged right effusion and vascular congestion are resolved. Findings discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| 023dcd40-03e11030-4c6944a1-00790e19-a79c5844, 9a09516b-ceca3649-56487727-bbd3b10c-a0cbd7b8 | 51034232 | 11880923 | Findings: In comparison with study of ___, there has been placement of an endotracheal tube with the tip approximately 3.5 cm above the carina. The left Swan-Ganz catheter tip is in the proximal pulmonary artery. Hemodialysis catheter tip remains in the right atrium. Left IJ catheter is in the region of the juncture with the left subclavian vein. Abdominal drains are seen bilaterally. Nasogastric tube extends only to the lower thoracic esophagus. It could be advanced ___-25 cm, which was conveyed to Dr. ___ by the resident on-call. Mild indistinctness of pulmonary vessels suggests some elevated pulmonary venous pressure. | Findings: In comparison with study of ___, there has been placement of an endotracheal tube with the tip approximately 2.5 cm above the carina. The left Swan-Ganz catheter tip is in the distal pulmonary artery. Hemodialysis catheter tip remains in the right atrium. Left IJ catheter is in the region of the juncture with the left subclavian vein. Abdominal drains are seen bilaterally. Nasogastric tube extends only to the lower thoracic esophagus. It could be advanced ___-25 cm, which was conveyed to Dr. ___ by the resident on-call. Mild indistinctness of pulmonary vessels suggests no elevated pulmonary venous pressure. A left-sided Port-A-Cath is also seen. | ['Change position of device', 'Add contradiction', 'Add medical device'] |
| 237483cb-a677cdd0-002483d2-76d60cbd-57b82bb8 | 51876627 | 11880923 | Findings: The tip of the endotracheal tube is 3 cm above the carina. This could be pulled back 1 cm for more optimal placement. The right-sided central line has the distal lead tip in the cavoatrial junction, stable. The right IJ central line has the distal lead tip in the mid SVC. It is pulled back slightly; it is now oblique to the SVC wall. There are again seen bilateral pleural effusions and left retrocardiac opacity. There is likely an unchanged element of mild fluid overload, stable. The nasogastric tube side port is again at the GE junction. | Findings: The tip of the endotracheal tube is 3 cm above the arena. This could be pulled back 1 cm for more optimal placement. The right-sided central line has the distal lead tip in the pulmonary artery, stable. The right IJ central line has the distal lead tip in the mid SVC. It is pulled back slightly; it is now oblique to the SVC wall. There are no pleural effusions. There is likely an unchanged element of mild fluid overload, stable. The nasogastric tube side port is again at the GE conjunction. | ['Change name of device', 'Change to homophone', 'False negation'] |
| c1bef603-3b1cf540-5d36a766-606c560d-9a61f31c | 52510525 | 11880923 | Findings: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are constant. Moderate cardiomegaly with minimal fluid overload. Retrocardiac atelectasis, combined to a small left pleural effusion. Volume loss in the middle lobe. No newly appeared focal parenchymal opacities. No evidence of pneumonia. | Findings: As compared to the previous radiograph, there is no relative change. The monitoring and support devices are constants. Mild cardiomegaly with minimal fluid overload. Retrocardiac atelectasis, combined to a large left pleural effusion. Volume gain in the middle lobe. Bibasilar interstitial changes. No evidence of pneumonia. | ['Change severity', 'Change to homophone', 'False prediction'] |
| 226379d0-ea16df78-cc85e54b-2f773a4c-8afb5ba2, 485bedf4-0bf798fc-68347feb-ab5ec81b-a7113818 | 53367019 | 11880923 | Findings: There has been interval placement of a right IJ approach tunneled HD catheter, the tip of which projects over the expected location of the right atrium. Lung volumes remain somewhat low, and there is interval increase in bibasilar airspace opacity, right greater than left, concerning for right lower lobe pneumonia. Small-moderate right greater than left pleural effusions are increased. There is no pneumothorax. The cardiac silhouette is top normal for size, and unchanged from prior. Mediastinal contours remain normal. Impression: 1. Interval hemodialysis catheter placement, the tip of which projects over the expected location of the right atrium. 2. New development of bilateral lower lobe atelectasis and/or pneumonia, with moderate right and small left pleural effusions. | Findings: There has been interval placement of a right jugular approach tunneled HD catheter, the tip of which projects over the expected location of the right atrium. Lung volumes remain somewhat lo, and there is interval increase in bibasilar airspace opacity, right greater than left, concerning for right lower lobe pneumonia. Patchy opacities observed in the upper lobes bilaterally. Small-moderate right greater than left pleural effusions are increased. There is no pneumothorax. The cardiac silhouette is normal with mild cardiomegaly for size, and unchanged from prior. Mediastinal contours remain normal.Impression: 1. Interval hemodialysis catheter placement, the tip of which projects over the expected location of the right atrium. 2. New development of thickened interlobular septa indicating interstitial edema with moderate right and small left pleural effusions. | ['Change name of device', 'Add typo', 'False prediction'] |
| 839c423e-0ad4e63c-cb7783d9-5a24793c-930b2b72 | 53737059 | 11880923 | Findings: Comparison is made to previous study from ___. There is an endotracheal tube whose distal tip is 5 cm above the carina, appropriately sited. There is a left IJ line with distal lead tip in the mid SVC slightly oblique to the SVC wall. There is a right-sided subclavian catheter with the distal lead tip in the distal SVC. The heart size is within normal limits. There are bilateral pleural effusions and a left retrocardiac opacity. There is no overt pulmonary edema or pneumothoraces. | Findings: Comparison is made too previous study from ___. There is an endotracheal tube whose distal tip is 6 cm above the carina, appropriately sited. There is a left IJ line with distal lead tip in the mid SVC slightly oblique to the SVC wall. There is a right-sided subclavian catheter with the distal lead tip in the distal SVC. There is a large anterior mediastinal mass. The heart size is within normal limits. There are bilateral pleural effusions and a left retrocardiac opacity. There is no overt pulmonary edema or pneumothoraces. | ['Change measurement', 'Change to homophone', 'False prediction'] |
| ced4ad92-0b5bdd09-b67b83a8-8f155ad4-de399934 | 54089797 | 11880923 | Findings: As compared to the previous radiograph, the monitoring and support devices are constant. Constant size of the cardiac silhouette. Constant right basal opacity, consisting of a combination of atelectasis and parenchymal consolidation. No new opacities. No pneumothorax. No larger left pleural effusion (the lateral parts of the left sinus are not included on the image). | Findings: As compared to the previous radiograph, the monitoring and support devices are constant. Constant size of the cardiac silhouette. Constant left basal opacity, consisting of a combination of atelectasis and parenchymal consolidation. Several larger left pleural effusion (the lateral parts of the left sinus are not included on the image). There is a subtle right pleural effusion. No pneumothorax. | ['Change location', 'Change to homophone', 'False prediction'] |
| 627948e7-0ba4b65a-61e23ed8-9cdf34c6-1578bb43 | 55084084 | 11880923 | Impression: AP chest compared to pre- and postoperative radiographs, ___ and ___: Small-to-moderate right pleural effusion has increased postoperatively since ___, but pulmonary vascular congestion has improved. Heart size is normal. Lungs are grossly clear. ET tube is in standard placement, nasogastric tube passes below the diaphragm and out of view. Dual-channel dialysis catheter ends in the region of the superior cavoatrial junction. A catheter entering the right heart from a left jugular introducer has been withdrawn from the main pulmonary artery to the cavity of the right ventricle. A second introducer in the left jugular is unchanged in position. No pneumothorax or appreciable left pleural effusion. | Impression: AP chest compared to pre- and postoperative radiographs, ___ and ___: Small-to-moderate right pleural effusion has increased postoperatively since ___, but pulmonary vascular congestion has improvad. Heart size is normal. Lungs are grossly clear. ET tube is in standard placement, nasogastric tube passes below the diaphragm and out of vew. Hemodialysis catheter ends in the region of the superior cavoatrial junction. A catheter entering the right heart from a left jugular introducer has been withdrawn from the main pulmonary artery to the cavity of the right ventricle. A second introducer in the left jugular is unchanged in position. No pneumothorax or appreciable left pleural effusion. A pacemaker is noted with leads terminating in the right atrium and right ventricle. | ['Change name of device', 'Add typo', 'Add medical device'] |
| 3bc5aaef-73a4b1b2-8a55d3ee-28d357d6-6c94acb0 | 55238105 | 11880923 | Findings: The patient has been extubated since the last exam. The right central line and left jugular line are in the same position. There is a feeding tube. The surgical catheter in the upper right abdomen has been also removed. Stability of the left mild pleural effusion with atelectasis, but worsening of the mild pleural effusion and atelectasis on the right. The mediastinal and cardiac contours are stable and normal. There is no pneumothorax. Impression: The patient has been extubated since the previous exam. Slight deterioration of a mild pleural effusion and atelectasis on the right side. | Findings: The patient has been ex-tubated since the last exam. The right PICC line and left jugular line are in the same position. There is a feeding tube. The surgical BLAKEMORE tube in the upper right abdomen has been also removed. Stability of the left mild pleural effusion with atelectasis, but worsening of the mild pleural effusion and atelectasis on the write. The mediastinal and cardiac contours are stable and normal. There is no pneumothorax. A left-sided dual-chamber pacemaker is noted. Impression: The patient has been tubed since the previous exam. Slight deterioration of a mild pleural effusion and atelectasis on the right side. | ['Change name of device', 'Change to homophone', 'Add medical device'] |
| 031f7904-9bf7d478-6ebc3f26-2ddf2209-700c9c83, 60742b25-1a7cae98-63ffe193-306dda7d-1977440c | 55514554 | 11880923 | Impression: PA and lateral chest compared to most recent prior chest radiographs, ___: Lungs are clear. Right lung base is elevated, probably due to a moderate amount of subpulmonic right pleural effusion. Lateral view shows a tiny left pleural effusion as well. There is no subpulmonic free air. | Impression: PA and lateral chest compared to most recent prior chest radiographs, ___: Lungss are clear. Right lung base is elevated, probably due to a small amount of subpulmonic right pleural effusion. Lateral view shows no pleural effusion as well. There is no subpulmonic free air. | ['Change severity', 'Add typo', 'False negation'] |
| 3698386f-a0655662-7d51247e-e53490e6-64f3d0c2, 421dff97-6d2b4aab-02ed28a8-54dd67f9-da2f957b | 56440140 | 11880923 | Findings: The endotracheal tube terminates no less than 3.4 cm above the carina. An orogastric tube terminates within the stomach with the side port near the gastroesophageal junction. A left internal jugular central venous line terminates in the mid SVC. A right subclavian triple-lumen catheter terminates in the lower SVC. There has been interval reduction in heart size as well as marked improvement in pulmonary edema. Small bilateral pleural effusions are slightly smaller. There is a persistent left retrocardiac opacity. There is no pneumothorax. Impression: 1. Endotracheal tube is appropriately positioned, 3.4 cm above the carina. 2. The orogastric tube should be advanced by 1-2 cm to ensure that the side port is beyond the gastroesophageal junction. 3. Improvement in decompensated congestive heart failure. 4. Persistent retrocardiac opacity representing consolidation or atelectasis. | Findings: The stethoscope terminates no less than 3.4 cm above the carina. An orogastric tube terminates within the stomach with the side port near the gastroesophageal junction. A left internal jugular pleural drain terminates in the mid SVC. A right subclavian triple-lumen catheter terminates in the lower SVC. There has been an interval reduction in hart size as well as marked improvement in pulmonary edema. Small bilateral pleural effusions are not present. There is a persistent left retrocardiac opacity. There is no pneumothorax. Impression: 1. Endotracheal tube is appropriately positioned, 3.4 cm above the carina. 2. The orogastric tube should be advanced by 1-2 cm too ensure that the side port is beyond the gastroesophageal junction. 3. No congestive heart failure. 4. Persistent retrocardiac opacity representing consolidation or atelectasis. | ['Change name of device', 'Change to homophone', 'False negation'] |
| 20826cb6-21536aea-251f6984-7d353fb1-029fb362, a7453c2f-c13c3176-9c623a8f-259c76c7-13466115 | 57045176 | 11880923 | Findings: The lungs are clear, the cardiomediastinal silhouette and hila are normal. There is a tiny right pleural effusion. There is right hemidiaphragm eventration. Nodular, rounded opacity at the left lung base likely represents nipple shadow. Impression: Tiny right pleural effusion. | Findings: The lungs show mild emphysema, the cardiomediastinal silhouette and hila are normal. There is a tiny right pleural effusion. There is right hemidiaphragm eventration. Nodular, rounded opacity at the left lung base likely represents a small mass. Impression: Right hemidiaphragm eventration. | ['Change severity', 'Add repetitions', 'False prediction'] |
| 7820a5b5-fd3de13c-aa0461e3-96296867-8e7e463e, 9bb86127-fb575908-ca75aaee-e4e15b0b-b804e9d3 | 57292244 | 11880923 | Findings: Small right pleural effusion is stable to slightly increased compared to prior and tracks into the fissures. Opacity in the right mid to lower lung field is new compared to ___. Retrocardiac linear opacities likely represent basilar atelectasis. Small right upper lobe perihilar opacity appears stable. Heart and mediastinal contours are stable. No pneumothorax is detected. Impression: New right lower lung opacity compared to ___, concerning for pneumonia, with stable to slightly increased small right pleural effusion. Findings discussed with Dr. ___ by ___ by telephone at 1:42 p.m. on ___ at the time of initial review of the study. | Findings: Small left pleural effusion is stable to slightly increased compared to prior and tracks into the fissures. Opacity in the right mid to lower lung field is new compared to ___. Retrocardiac linear opacities likely represent basilar atelectasis. Small right upper lobe perihilar opacity appears stable. Heart and mediastinal contours are stable. No pneumothorax is detected. Impression: No lower lung opacity compared to ___. Findings discussed with Dr. ___ by ___ by telephone at 1:42 p.m. on ___ at the time of initial review of the study. Findings discussed with Dr. ___ by ___ by telephone at 1:42 p.m. on ___ at the time of initial review of the study. | ['Change location', 'Add repetitions', 'False negation'] |
| 68f0511d-a790a0bc-cb8ef94a-c9af3e71-ab0c9352 | 58556085 | 11880923 | Findings: A new nasogastric tube has been placed. The current tube shows a normal course and a correct position in the proximal parts of the stomach. There is no evidence of complications, notably no pneumothorax. The other monitoring and support devices and the remaining appearance of the radiograph is constant. | Findings: A new nasogastric tube has been placed. The current tube shows a normal course and a correct position in the distal parts of the stomach. There is evidence of complications, notably a small pneumothorax. The other monitoring and support devices and the remaining appearance of the radiograph is constant. Streaky opacities in the lung bases likely reflect atelectasis. | ['Change location', 'Add contradiction', 'False prediction'] |
| 44c09f7b-0aed1234-2a1a02ab-3e91e954-54be38b1 | 58606191 | 11880923 | Findings: As compared to the previous radiograph, there is no relevant change. Pleural effusions bilaterally, right more than left, the distribution of which has changed, but not their overall extent. In the interval, the patient has been extubated. The other monitoring and support devices remain in place. Unchanged size of the cardiac silhouette. Unchanged mild fluid overload. | Findings: As compared to the previous radiograph, there is no revelant change. Pleural effusions bilaterally, right more than left, the distribution of which has changed, but not their overall extent. In the interval, the patient has been extubated. The other monitoring and support devices remain in place. A pacemaker is present. Unchanged size of the cardiac silhouette. Unchanged moderate fluid overload. | ['Change severity', 'Add typo', 'Add medical device'] |
| cd611c14-18a02010-13493fd2-e8f3a50a-fc345827 | 58862282 | 11880923 | Findings: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices, including the nasogastric tube, the left internal jugular vein catheter and the right double-lumen catheter, are unchanged. Borderline size of the cardiac silhouette. Extensive right lower lung opacities, combined to a right pleural effusion. Left retrocardiac atelectatic changes, accompanied by a small left pleural effusion. No newly appeared parenchymal opacities. No pneumothorax. | Findings: As compared to the previous radiograph, their is no relevant change. The monitoring and support devices, including the nasogastric tube exiting in the stomach, the left internal jugular vein catheter terminating in the SVC and the right double-lumen catheter are unchanged. Borderline size of the cardiac silhouette with evidence of mild pericardial effusion. Extensive right lower lung opacities, combined to a right pleural effusion. Left retrocardiac atelectatic changes, accompanied by a small left pleural effusion. Newly appeared parenchymal opacities in the left upper lobe. No pneumothorax. | ['Change position of device', 'Change to homophone', 'False prediction'] |
| e3ba16c1-e0005eef-0c0e37cd-1ad23c91-beac16e8 | 59196954 | 11880923 | Findings: Comparison is made to the prior study performed at 4:35 a.m. on ___. There is a right-sided catheter with the distal lead tip at the cavoatrial junction. There is a left IJ central venous line with the distal lead tip in the mid SVC. The endotracheal tube tip is 4.5 cm above the carina. The feeding tube whose distal tip is below the GE junction. These tubes are all unchanged in position. There is stable cardiomegaly. There is mild improved aeration at the lung bases. There remain bilateral pleural effusions. There are no signs for overt pulmonary edema or pneumothoraces. | Findings: Comparison is made to the prior study performed at 7:35 a.m. on ___. There is a right-sided catheter with the distal lead tip at the cavoatrial juction. There is a left IJ central venous line with the distal lead tip in the lower SVC. The endotracheal tube tip is 5.9 cm above the carina. Bilateral pulmonary nodules are seen in the lower lobes. The feeding tube whose distal tip is below the GE juncion. These tubes are all unchanged in position. There is stable cardiomegaly. There is mild improved aeration at the lung bases. Right-sided pleural effusion has increased. There are no signs for overt pulmonary edema or pneumothoraces. | ['Change measurement', 'Add typo', 'False prediction'] |
| 1d2eae56-aca1446e-78e09b18-02818224-5f58634a | 50901361 | 11893091 | Findings: As compared to the previous image, the patient has received an external pacemaker. The tip of the pacemaker is in expected correct position, as documented on the previous fluoroscopy. Unchanged position of the other monitoring and support devices. Moderate cardiomegaly with signs of mild pulmonary edema. No pleural effusions. No pneumothorax. Left apical pleural calcification. Mild atelectasis at the left lung bases. No evidence of pneumonia. | Findings: As compared to the previous image, the patient has received an external pacemaker. The tip of the pacemaker is in the right atrium, as documented on the previous fluoroscopy. Monitoring and support devices are placed differently. No cardiomegaly is seen. No pleural effusions. Right-sided pneumothorax is present. Left apical pleural calcification. No atelectasis is present. No evidence of pneumonia. | ['Change position of device', 'Add contradiction', 'False negation'] |
| 035c1d74-0c421b37-8b41923e-ac21bff9-23176ff2, 8854ac17-02cbb55b-6797803e-0247f114-8e114394 | 53024166 | 11893091 | Findings: The lungs are relatively hyperinflated. There is no focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax is detected. The pulmonary vasculature is not engorged and there is no overt pulmonary edema. The cardiac silhouette is top normal in size, as before. A left pectoral pacemaker is in place with dual leads terminating in the right atrium and right ventricle. The mediastinal and hilar contours are within normal limits. Impression: No focal consolidation concerning for pneumonia. | Findings: The lungs are relatively hyperinflated. There is no focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax is detected. The pulmonary vasculature is not engorged and there is no overt pulmonary edema. The cardiac silhouette is top normal in size, as before. A left pectoral pacemaker is in place with dual leads terminating in the right atrium and superior vena cava. The mediastinal and hilar contours are within normal limits. Impression: No focal consolidation. | ['Change position of device', 'Add repetitions', 'False negation'] |
| 79eee504-b1b60ab8-5e8dd843-b6ed87aa-670747b1 | 53774431 | 11893091 | Findings: Portable AP chest radiograph demonstrates severe cardiomegaly, both interstitial and alveolar edema as well as small bilateral pleural effusions. A more confluent opacity is seen in the right middle lobe. There is no pneumothorax. Atherosclerotic calcifications are noted in the aortic arch. Impression: Marked pulmonary edema. Follow up CXR after diuresis may be helpful to exclude underlying pneumonia in right middle lobe. | Findings: Portable AP chest radiograph demonstrates moderate cardiomegaly, both interstitial and alveolar edema as well as smal bilateral pleural effusions. A large confluent opacity is seen in the right middle lobe. There is no pnemothorax. Atherosclerotic calcifications are noted in the aortic arch. There is a small pericardial effusion. Impression: Mild pulmonary edema. Follow up CXR after diuresiss may be helpful to exclude underlying pneumonia in right middle lobe. | ['Change severity', 'Add typo', 'False prediction'] |
| 5b21b33c-9e45c0df-2d6b0f08-b7846556-f1e63e19, f0e71e50-eb720bc4-ed412179-8b07b163-cd37195b | 53794474 | 11893091 | Findings: As compared to the previous radiograph, the monitoring and support devices, including the temporal right pacemaker, have all been removed. The patient is in unchanged moderate pulmonary edema, with moderate cardiomegaly but without pleural effusions. No newly appeared parenchymal opacities. Unchanged mild atelectatic changes at the lung bases. No other relevant changes. | Findings: As compared to the previous radiograph, the monitoring and support devices, including the temporal right pacemaker, have all been removed. The patient is in unchanged mild pulmonary edema, with moderate cardiomegaly but without pleural effusions. No newly appeared parenchymal opacties. Unchanged moderate atelectatic changes at the lung bases. No other relevant changes. Left central venous line in place. | ['Change severity', 'Add typo', 'Add medical device'] |
| bc998aad-c88d87cc-d89c4aa6-63477af5-c75767d8 | 54669609 | 11893091 | Impression: 1. There continues to be bilateral interstitial process, but this has improved since the prior study, and is more similar to baseline of ___, therefore, likely reflecting chronic age-related or small airways changes. More focal patchy opacity at the left base likely reflects compressive atelectasis given the pleural effusion, although pneumonia can not be excluded. No pneumothorax is seen. Overall, cardiac and mediastinal contours are stable. | Impression: 1. There continues to be bilateral interstitial process, but this has improved since the prior study, and is more similar to baseline of ___, therefore, likely reflecting chronic age-related or small airways changes. More focal patchy opacity at the left base likely reflects compressive atelectasis given the pleural effusion, although pneumonia can not be excluded. No pneumothorax is seen. There continues to be bilateral interstitial process, but this has improved since the prior study, and is more similar to baseline of ___, therefore, likely reflecting chronic age-related or small airways changes. No pneumonia seen. Overall, cardiac and mediastinal contours are stable. | ['Change severity', 'Add repetitions', 'False negation'] |
| 68d1a72f-0552bded-deae306a-343f5d03-ccf9853f, c02fe512-8d310525-2b66511f-df530900-ddfc1fa6 | 55255832 | 11893091 | Findings: The lead positions of the dual-chamber pacemaker is unchanged compared to the prior exam. There is moderate cardiomegaly. The lungs demonstrate moderate pulmonary edema but no evidence of pleural effusions or pneumothorax. Mild atelectatic changes at the lung bases are unchanged. Incidental note is made of chronic stable calcified scarring in the left apex. There are no new parenchymal opacities. There is no evidence of pneumothorax. Impression: Unchanged lead positions from recently inserted dual-chamber pacemaker. | Findings: The lead positions of the single-chamber pacemaker is unchanged compared to the prior exam. There is moderate cardiomegaly. The lungs demonstrate moderate pulmonary edema but no evidence of pleural effusions or pneumothorax. Mild atelectatic changes at the lung bases are unchanged. There is no evidence of pneumothorax. Incidental note is made of chronic stable calcified scarring in the left apex. There are no new parenchymal opacities. A right-sided vascular stent is seen within the brachiocephalic vein. Impressions: Unchanged lead positions from recently inserted dual-chamber pacemaker. | ['Change name of device', 'Add repetitions', 'Add medical device'] |
| 2773b5c2-bd9e0357-064af3b4-ddc4997e-61ff380f | 55430447 | 11893091 | Findings: Single portable view of the chest demonstrates normal lung volumes. Costophrenic angles are minimally blunted, suggestive of trace pleural effusions. Bibasilar opacities obscure hemidiaphragms. Right lung base opacity is more conspicuous on today's exam. Moderate pulmonary edema. Hilar and mediastinal silhouettes are unremarkable. Heart is mildly enlarged. Impression: Moderate pulmonary edema with mild cardiomegaly and possible trace pleural effusions, progressed from ___ exam. | Findings: Single portable view of the chest demonstrates normal lung volumes. Costophrenic angles are minimally blunted, suggestive of trace pleural effusions. Bibasilar opacities obscure hemidiaphragms. No right lung base opacity is seen. Mild pulmonary edema. Hilar and mediastinal silhouettes are unremarkable. Heart is severely enlarged. Impression: Mild pulmonary edema with mild cardiomegaly and possible trace pleural effusions, progressed from ___ exam. Bibasilar opacities obscure hemidiaphragms. | ['Change severity', 'Add repetitions', 'False negation'] |
| 8a301a4d-4df7ca0e-b32741cd-f7fe73d9-4605a414 | 56555909 | 11893091 | Findings: Mild-to-moderate cardiomegaly is accompanied by upper zone vascular redistribution, vascular indistinctness and mild interstitial edema. A slightly more confluent opacity at the right lung base medially may reflect asymmetrical dependent edema, but followup radiographs may be helpful to exclude a developing infection in this region. Small bilateral pleural effusions have improved since previous study. Calcified right hilar lymph nodes are unchanged. | Findings: Mild-to-moderate cardiomegaly is accompanied by upper zone vascular redistribution, vascular indistinctness and mild interstitial edema. No interstitial edema. A slightly more confluent opacity at the right lung base medially may reflect asymmetrical dependent edema, but followup radiographs may be helpful to exclude a developing infection in this region. Moderate bilateral pleural effusions have improved since previous study. Calcified right hilar lymph nodes are unchanged. Calcified right hilar lymph nodes are unchanged. | ['Change severity', 'Add repetitions', 'False negation'] |
| 07ec545e-2a913153-c28cae67-2c38c3b4-c1d7e30a | 57330158 | 11893091 | Findings: Newly placed endotracheal tube terminates approximately 3.6 cm above the carina, and a nasogastric tube courses below the diaphragm. A 3-cm diameter rounded lucency is identified lateral to the endotracheal tube and nasogastric tube to the left of midline. Although potentially representing an over-distended endotracheal tube cuff, the position is more lateral than expected for this condition. Alternative possibilities include an air-filled diverticulum arising from the trachea or esophagus. Findings were communicated by telephone with Dr. ___ on ___ at 4:00 p.m. at the time of discovery. Exam is otherwise remarkable for persistent cardiomegaly and worsening congestive heart failure with increasing perihilar edema and persistent small right pleural effusion. | Findings: Newly placed endotracheal tube terminates approximately 2.6 cm above the carina, and a nasogastric tube courses below the diaphragm. A 3-cm diameter rounded lucency is identified lateral too the endotracheal tube and nasogastric tube to the left of midline. Although potentially representing an over-distended endotracheal tube cuff, the position is more lateral than expected for this condition. Alternative possibilities include an air-filled diverticulum arising from the trachea or esophagus. Findings were communicated by telephone with Dr. ___ on ___ at 4:00 p.m. at the time of discovery. Exam is otherwise remarkable for persistent cardiomegaly and worsening congestive heart failure with no perihilar edema or right pleural effusion. | ['Change position of device', 'Change to homophone', 'False negation'] |
| 59a291bb-a5b73755-8efc4039-1a4e13f2-887e46d2, b6a2b75a-2f7feeff-1e47f4d0-1d86b2ff-c5d8d6c1 | 52008677 | 11906222 | Findings: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are within normal limits. Aortic calcifications are again noted. A shunt catheter courses along the right neck, right medial chest, and right abdomen, incompletely imaged. Mid-thoracic vertebral body compression deformity is again noted. Old right rib fractures are noted. Hardware projecting over the lumbar spine at the inferior margin of the image is incompletely evaluated. Impression: Stable chest radiographs without evidence for acute process. | Findings: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are withon normal limits. No aortic calcifications are noted. A shunt catheter courses along the right neck and ends at the right atrium. Mid-thoracic vertebral body compression deformity is again noted. No right rib fractures are noted. Hardware projecting over the lumbar spine at thee inferior margin of the image is incompletely evaluated. Impression: Stable chest radiographs without evidence for acute process. | ['Change position of device', 'Add typo', 'False negation'] |
| 567bcd19-6ab220b4-8f8eb57b-5f94b009-a4007fc7 | 53854854 | 11906222 | Findings: No previous images. There is mild hyperexpansion of the lungs, suggesting some underlying chronic pulmonary disease. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. Of incidental note is an old healed rib fracture on the right. | Findings: No previous images. There is moderate hyperexpansion of the lungs, suggesting some underlying chronic pulmonary disease. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. Of incidental note is an old healed rib fracture on the right. There are no rib fractures noted. | ['Change severity', 'Add repetitions', 'False negation'] |
| a7b100cd-08c2be2d-a32c2dac-020c1d75-1bd5b887 | 55124994 | 11906222 | Findings: As compared to the previous examination, the patient has been intubated. The tip of the endotracheal tube projects 3.7 cm above the carina. The patient also has received a nasogastric tube, the course of the tube is unremarkable, the tip of the tube does not display on the image. The ventriculoperitoneal shunt and the left subclavian access line are unchanged. There is no evidence of complications, notably no pneumothorax. The lung volumes are increased, with subsequent decrease in severity and extent of a pre-existing right basal medial parenchymal opacity. No newly appeared parenchymal opacities, unchanged size of the cardiac silhouette. No pleural effusions. | Findings: As compared to the previous examination, the patient has been intubated. The tip of the endotracheal tube projects 5.8 cm above the carina. The patient also has received a nasogastric tube, the course of the tube is unremarkable, the tip of the tube does not display on the image. The ventriculoperitoneal shunt and the left subclavian access line are unchanged. There is no evidence of complications, notably no pneumothorax. The lung volumes are increased, with subsequent decrease in severity and extent of a pre-existing right basal medial parenchymal opacity. New parenchymal opacities present, unchanged size of the cardiac silhouette. No pleural effusions. | ['Change measurement', 'Add contradiction', 'False negation'] |
| 345c27ae-8dc96bd7-cd59fd7f-e18c90bc-71bf8122 | 56779415 | 11906222 | Findings: As compared to the previous radiograph, the monitoring and support devices are unchanged. There is improved ventilation of the lung bases, with almost complete resolution of a pre-existing small right basal atelectasis. No newly occurred focal parenchymal opacity suggesting pneumonia. Normal size of the cardiac silhouette. No pulmonary edema. No pneumothorax. | Findings: As compared to the previous radiograph, the monitoring and support devices are unchanged. There is deteriorating ventilation of the lung bases, with almost complete resolution of a pre-existing small right basal atelectasis. No newly occurred focal parenchymal opacity suggesting pneumonia. Normal size of the cardiac silhouette. No trace of pulmonary edema. There is mild pneumothorax. | ['Change severity', 'Add contradiction', 'False negation'] |
| 42e634b1-94de1686-ecd12cab-6619202e-8694c45c, 64927291-fe42a66c-af054049-3d17501b-5de4163c | 57232140 | 11906222 | Findings: On the initial image, the Dobbhoff tube tip is seen in the mid portion in the esophagus. On the second image, the Dobbhoff tube has been advanced and is appropriately sited within the fundus and body of the stomach. There are old healed rib fractures on the right side. There is some atelectasis and some increased density at the left lung base. No pneumothoraces are seen. Cardiac size is within normal limits. | Findings: On the initial image, the NGT tip is seen in the mid portion in the esophagus. On the second image, the Dobbhoff tube has been advanced and is appropriately sited within the fundus and body of the jejunum. There are old healed rib fractures on the right side. There is some atelectasis and some increased density at the left lung apex. No pneumothoraces are seen. Cardiac size is mildly enlarged. Small bilateral pleural effusions are present. | ['Change name of device', 'Add contradiction', 'Add medical device'] |
| 20ae33e5-c3a0b30d-d737101f-b47e9ae1-d804765a, efc879d0-ba7f1b53-560419c8-f53bda85-6bd62bb3 | 59697640 | 11906222 | Findings: Frontal and lateral radiographs of the chest were acquired. Multiple EKG leads project over the chest wall on both radiographs. A ventriculoperitoneal shunt courses along the right cervical and thoracic region, extending out of the field of view inferiorly. The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Multiple old right-sided rib fractures are redemonstrated. A severe compression deformity of a mid thoracic vertebral body is not significantly changed. Impression: No acute cardiac or pulmonary process. | Findings: Frontal and lateral radiographs of the chest wear acquired. Multiple EKG leads project over the chest wall on both radiographs. A ventriculoperitoneal shunt courses along the right cervical and thoracic region, extending out of the field of view inferiorly. The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. An ET tube is present, its tip positioned appropriately. No pneumothorax is scene. Multiple old right-sided rib fractures are redemonstrated. A mild compression deformity of a mid thoracic vertebral body is not significantly changed. Impression: No acute cardiac or pulmonary process. | ['Change severity', 'Change to homophone', 'Add medical device'] |
| c2af2ab3-6a11cbae-d9fa4d64-21ab221e-cf6f2146, e3f70313-96cbc5f8-075aba46-13c9468e-d24a2421 | 50241018 | 11924226 | Findings: Well expanded and clear lungs. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are within normal limits. Visualized upper abdomen is unremarkable. Impression: Normal chest radiograph. No pleural effusion or pneumonia. | Findings: Well expanded and clear right lung. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are within normal limits. Visualized upper abdomen is unremarkable. No pleural effusion or pneumothorax. Impression: Normal chest radiograph. No pleural effusion or pneumonia. A central venous line is present. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 7e445e5a-27e30425-98d438f2-9619da9c-e53b8453, a91c2734-4b90f056-3da51afd-4dc3ad1f-ab52a530 | 53372149 | 11924226 | Impression: Lungs are fully expanded and aside from a small linear band of atelectasis or scarring in the left lower lobe, essentially clear. Effacement of the aortopulmonic window is a long-standing feature, not clinically significant. Cardiomediastinal and hilar silhouettes are otherwise normal. There is no pleural abnormality. , | Impression: Lungs are fully expanded and aside from a small linear band of atelectasis or scarring in the right lower lobe, essentially clear. Effacement of the aortopulmonic window is a long-standing feature, not clinically significant. No effacement of the aortopulmonic window. Cardiomediastinal and hilar silhouettes are otherwise normal. There is no pleural abnormality. , | ['Change location', 'Add repetitions', 'False negation'] |
| 417162c9-a460e98a-56bf6ab3-b6c591a2-86230b6d, 6b93ec0b-b35a1d19-cbcefb65-297d04fe-ca31986d | 56051681 | 11924226 | Findings: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. There is no free air below the right hemidiaphragm. Mild degenerative change in the mid thoracic spine noted on the lateral projection. Impression: No signs of pneumonia. | Findings: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. There is no free air below the right hemidiaphragm. Moderate degenerative change in the mid thoracic spine noted on the lateral projection. An external pacemaker is noted in the left chest. Impression: Evidence of focal consolidation, likely pneumonia. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| efd6465a-dbaa29e8-244c7d40-06f432d7-c7150e7d, f0b4c2e6-5afdf412-e46020a3-5193d52e-f55fb9a9 | 56091680 | 11924226 | Findings: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary process. | Findings: Cardiac, mediastinal and hilar contors are normal. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. There is a right-sided pleural effusion. Impression: No acute cardiopulmonary process. Mild right pleural effusion is seen. | ['Add typo', 'Add contradiction', 'False prediction'] |
| cd42734e-8fe721ac-423f5e55-6f472c98-fa3838a2, db2f7a2d-b2d3967f-b0b29d90-6208dc63-77e4e094 | 56353295 | 11924226 | Findings: As compared to the previous radiograph, the lung volumes have minimally decreased. In the retrocardiac lung areas there is a very subtle parenchymal opacity that projects over the spine on the lateral radiograph. In the light of the clinical history, this opacity is suspicious for pneumonia. There is no other lung parenchymal abnormality. No pulmonary edema. No pleural effusions. Normal hilar and mediastinal contours. At the time of dictation, Dr. ___ was paged to notification at 9:31 a.m., ___. | Findings: As compared to the previous radiograph, the lung volumes have minimally decreased. In the retrocardiac lung areas there is a very subtle parenchymal opacity that projects over the pelvis on the lateral radiograph. In the light of the clinical history, this opacity is suspicious for pneumonia. There is no other lung parenchymal abnormality. No pulmonary edema. No pleural effusions. Normal hilar and mediastinal contours. At the time of dictation, Dr. ___ was paged to notification at 9:31 a.m., ___. A central venous line is in place. In the retrocardiac lung areas there is a very subtle parenchymal opacity that projects over the pelvis on the lateral radiograph. | ['Change location', 'Add repetitions', 'Add medical device'] |
| dc00203a-4168ce8c-d79d47d2-eef8780b-d3fe037a | 56990167 | 11924226 | Findings: Heart size is normal. Lung fields are clear. The superior mediastinum appears slightly widened, but this may be projectional. Patient is mildly rotated. Followup films in four to six weeks' time are recommended to keep this area under observation. Because of varying degrees of rotation, comparison to the previous examination of ___ is difficult. | Findings: Heart size is normal. Lung field are cleae. The superior mediastinum appears slightly widened, but this may be projectional. Patient is mildly rotated. Followup films in four to six weeks' time are recommended to keep this are under observation. A pacemaker is present. Because of varying degrees of rotation, comparison to the previous examination of ___ is difficult. | ['Change location', 'Add typo', 'Add medical device'] |
| fe5dd4a7-d88ab43b-fe20fb3b-aa6f0fe1-c9efd533 | 58367071 | 11924226 | Impression: No acute cardiopulmonary process. | Impression: Large bilateral pleural effusions noted. | ['False prediction', 'Add typo', 'Add medical device'] |
| 21d9c2b2-5e94a363-aa3b9d61-a6858503-795b84ab, 2ea8f7b3-8e1fd4ff-87a29ebc-702190c4-45123977 | 53222889 | 11928692 | Findings: Frontal and lateral radiographs of the chest is limited by underpenetration which is likely secondary to body habitus. The lungs appear clear, however it is not possible to exclude a consolidation in the lateral inferior costophrenic angles. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. Impression: The lungs appear clear, however it is not possible to exclude a consolidation in the lateral inferior costophrenic angles. | Findings: Frontal and lateral radiographs of the chest is limited by underpenetration which is likely secondary to body habituxe. The lungs appear clear, however it is not possible to exclude a consolidation in the mid inferior costophrenic angles. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. Impression: The lungs appear clear, however it is not possible to exclude a consolidation. | ['Change location', 'Add typo', 'False negation'] |
| 129d1cfc-6a372c68-c84b5eaf-53903d40-670d6d9c, 3606dd6e-1d4e216a-0251de47-cb1445d6-fcb76ed3 | 54164323 | 11928692 | Findings: There is a left pacemaker with appropriately positioned right atrial and right ventricular leads. The heart is moderately enlarged, increased in size compared to ___. There is pulmonary venous congestion with cephalization and predominantly perihilar heterogeneous opacities, consistent with mild interstitial pulmonary edema. No pleural effusions or pneumothorax. Possible slight loss of height of a upper mid thoracic vertebral body would be unchanged compared to ___. Impression: Mild interstitial pulmonary edema thought to be cardiogenic in etiology given increased moderate cardiomegaly. | Findings: There is a left pacemaker with appropriately positioned right atrial and right ventricular leads. The heart is mildly enlarged, increased in size compared to ___. There is pulmonary venous congestion with cephalization and predominantly perihilar heterogeneous opacities, consistent with mild interstitial pulmonary edema. No pleural effusions or pneumothorax. Possible slight loss of height of a upper mid thoracic vertebral body would be unchanged compared to ___. Impression: Mild interstitial pulmonary edema thought to be cardiogenic in etiology given increased moderate cardiomegaly. Moderate interstitial pulmonary edema thought to be cardiogenic in etiology given increased moderate cardiomegaly. | ['Change severity', 'Add contradiction', 'False negation'] |
| 2c5c8a39-6ae3dd9e-2b4d5279-6bb07505-1b57f5ab, df66e950-78bfa09d-ccc14e43-193ef713-3c2bd5a4 | 55947318 | 11928692 | Impression: Findings suggesting mild interstitial pulmonary edema along with mild cardiomegaly and linear atelectasis at the left lung base. No evidence of acute pneumonia or pneumothorax. | Findings: Moderate interstitial pulmonary edema. The heart is large. Linear atelectasis at the left lung base is noted. There is evidence of acute pneumonia. A small pneumothorax is seen. | ['Change severity', 'Add contradiction', 'False prediction'] |
| 07b49600-045da45b-0a9a9c85-40312bf9-29eb90ba | 50921864 | 11934114 | Impression: PA and lateral chest compared to ___ at 11:03 a.m.: New feeding tube, without a wire stylet, ends in the mid esophagus just below the level of the carina. Moderate-to-large right pleural effusion is probably increased in volume, but comparison is difficult because patient is supine on this study, erect on the earlier study today. Consolidation at both lung bases is probably due to worsening atelectasis but of course pneumonia and large scale aspiration are not excluded. Patient is rotated to her left which distorts the cardiac silhouette, probably mildly enlarged but unchanged. The left rib fractures are in various stages of healing. Thoracic aorta is tortuous and heavily calcified. No pneumothorax. Dr. ___ ___ I discussed these findings by telephone at the time of dictation. | Impression: PA and lateral chest compared to ___ at 11:03 a.m.: New feeding tube, without a wire stylet, ends in the mid esophagus just above the level of the carina. Moderate-to-large write pleural effusion is probably increased in volume, but comparison is difficult because patient is supine on this study, erect on the earlier study today. Consolidation at both lung bases is probably due to worsening atelectasis but of course pneumonia and large scale aspiration are not excluded. Patient is rotated to her left which distorts the cardiac silhouette, probably mildly enlarged but unchanged. A central venous line is also noted in the right atrium. The left rib fractures are in various stages of healing. Thoracic aorta is tortuous and heavily calcified. No pneumothorax. Dr. ___ ___ I discussed these findings by telephone at the time of dictation. | ['Change position of device', 'Change to homophone', 'Add medical device'] |
| 4fc6f280-2eae00ca-b8720682-3d0a8eee-b2dbb3c6 | 51139077 | 11934114 | Findings: As compared to the previous radiograph, the bilateral pleural effusions are unchanged in extent and distribution. Also unchanged is the moderate cardiomegaly as well as the signs indicative of mild fluid overload. No focal parenchymal opacities have newly occurred in the lung parenchyma. The old healed left rib fractures are unchanged. The nasogastric tube has been removed in the interval. The right PICC line is in unchanged position. | Findings: As compared to the previous radiograph, the bilateral pleural effusions are unchanged in extent and distribution. Also unchanged is the moderate cardiomegaly as well as the signs indicative of mild fluid overload. No focal parenchymal opacities have newly occurred in the lung parenchyma. The old healed left rib fractures are unchanged. The nasogastric tube is currently placed. The right PICC line terminates in the mid SVC. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| f9a68aca-c5a51654-80b6c990-e35e78ae-63dcc3b2 | 51328698 | 11934114 | Findings: Single semi-erect portable view of the chest was obtained. Opacity projecting over the right mid to lower lung is likely due to pleural effusion with overlying atelectasis, underlying consolidation cannot be excluded. If want to know full extent of pleural effusion, consider decubitus views. There is a nodular opacity projecting over the lateral right lower hemithorax, most likely representing nipple shadow, although attention at followup once pleural effusion resolved is suggested. There is a small left pleural effusion. The cardiac silhouette is top normal to mildly enlarged. The aortic knob is calcified. | Findings: Single semi-erect portable view of the chest was obtained. Opacity projecting over the right mid to lower lung is likely due to pleural effusion with overlying atelectasis, underlying consolidation cannot be excluded. If want to know full extent of pleural effusion, consider decubitus views. There is a nodular opacity projecting over the lateral left lower hemithorax, most likely representing nipple shadow, although attention at followup once pleural effusion resolved is suggested. There is a small left pleural effusion. The cardiac silhouette is top normal to mildly enlarged. The aortic knob is calcified. A central venous line is noted in a favorable position. | ['Change location', 'Add repetitions', 'Add medical device'] |
| df76c29b-3a305594-6510b7d9-7054ad7c-fb7278a0 | 52020944 | 11934114 | Findings: Comparison is made to prior study from ___. There has been placement of nasogastric tube whose tip and side port are below the gastroesophageal junction appropriately sited. There are again seen large bilateral pleural effusions, right greater than left and a left retrocardiac opacity. These findings are stable. | Findings: Comparison is made to prior study from ___. There has been placement of nasogastric tube whose tip and side port are within the mid esophagus. There are again seen large bilateral pleural effusions, right greater than left and a left retrocardiac opacity. These findings are stable. There is no evidence of pneumothorax seen. | ['Change position of device', 'Add repetitions', 'False prediction'] |
| 67653b61-d4cdc144-670c5d2f-1d19f3a2-480d85a1 | 52152296 | 11934114 | Findings: Right PICC line ends at low SVC. Moderate right pleural effusion with adjacent lung atelectasis has decreased since ___. Minimal left pleural effusion is unchanged. There are no new lung opacities of concern for pneumonia. Heart size, mediastinal and hilar contours are stable. Impression: Moderate right pleural effusion with adjacent lung atelectasis has improved since ___. | Findings: Right central line ends at low SVC. Moderate right pleural effusion with adjacent lung atelectasis has decreased sinse ___. No left pleural effusion. There are no new lung opacities of concern for pneumonia. Heart size, mediastinal and hilar contours are stable. Impression: Right pleural effusion with adjacent lung atelectasis has improved since ___. | ['Change name of device', 'Add typo', 'False negation'] |
| de3aab87-d8c3b45e-2312deb9-70e80ce0-17b557d2, fee52ef3-e8e58680-e83b3d50-fa52077b-106381ff | 52625540 | 11934114 | Findings: In comparison with study of ___, there has been placement of a nasogastric tube with tip in the distal stomach. Otherwise, there is little overall change with large right and moderate left pleural effusion with enlargement of the cardiac silhouette and evidence of pulmonary vascular congestion. | Findings: In comparison with study of ___, there has been placement of a nasogastric tube with tip in the proximal stomach. Otherwise, there is little overall change with no pleural effusion and evidence of pulmonary vascular congestion. | ['Change position of device', 'Change to homophone', 'False negation'] |
| dc63738e-e751f65e-82a68318-2d812b04-d30cf7f3 | 53100359 | 11934114 | Findings: Since ___, moderate-to-large right pleural effusion with right lung atelectasis and left lower lung volume loss reflected as increased retrocardiac density are unchanged. Left upper lung is clear. Mildly enlarged heart, mediastinal and hilar contours are unchanged. | Findings: Since ___, mild right pleural effusion with right lung atelectasis and left lower lung volume loss reflected as increased retrocardiac density are unchanged. Left upper lung is clear. Mildly enlarged heart, mediastinal and hilar contours are unchanged. There is the presence of a right-sided central venous catheter. Impression: Moderate-to-large right pleural effusion with right lung atelectasis and left lower lung volume loss reflecting increased retrocardiac density. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| e32d8967-9d4234f1-98ac9b11-3c5e73f4-cc690e1a | 55027268 | 11934114 | Findings: Single AP upright portable view of the chest was obtained. The patient is rotated to the left. Large area of opacification involving the right mid to lower lung suggests pleural effusion with overlying atelectasis, underlying consolidation cannot be excluded. There is also blunting of the left costophrenic angle which may be due to pleural effusion. The left retrocardiac opacity and obscuration of the left hemidiaphragm is seen, may be due to pleural effusion and atelectasis although underlying consolidation not excluded. The cardiac and mediastinal silhouettes are shifted leftward of midline presumably due to patient positioning/rotation. Suggest repeat with better positioning when patient able. | Findings: Single AP upright portable view of the chest was obtained. The patient is rotated to the left. Large area of opacification involving the right mid to lower lung suggests moderate pleural effusion with overlying atelectasis, underlying consolidation cannot be excluded. There is also blunting of the left costophrenic angle which may be due to pleural effusion. The left retrocardiac opacity and obscuration of the left hemidiaphragm is seen, may be due to pleural effusion and atelectasis although underlying consolidation not excluded. The cardiac and mediastinal silhouettes are shifted leftward of midline presumably due to patient positioning or rotation. Suggest repeat with better positioning when patient able. Central venous line is noted. | ['Change severity', 'Add repetitions', 'Add medical device'] |
| 14f914fe-fe271488-782a6d68-11bd9c45-8c2b816b, d8bc7ccc-a2bac7c8-1dd6d0a5-5ed27c66-4f556bac | 57363067 | 11934114 | Findings: There is interval worsening of now mild-to-moderate interstitial pulmonary edema and small-to-moderate bilateral layering pleural effusions. There is no evidence of pneumothorax. There is associated bibasilar atelectasis with no focal opacities concerning for pneumonia. The cardiomediastinal and hilar contours are stable demonstrating moderate cardiomegaly. Note is made of multiple left-sided rib fractures that in retrospect can be demonstrated on radiographs from ___. Impression: 1. Worsened now mild-to-moderate interstitial pulmonary edema and small-to-moderate bilateral layering pleural effusions. 2. Left-sided rib fractures in retrospect apparent since at least ___. | Findings: There is interval worsening of now severe interstitial pulmonary edema and small-to-moderate bilateral layering pleural effusions. The left lung has evidence of pneumothorax. There is associated bibasilar atelectasis with extensive focal opacities concerning for pneumonia. The cardiomediastinal and hilar contours are stable demonstrating moderate cardiomegaly. Note is made of multiple left-sided rib fractures that in retrospect can be demonstrated on radiographs from ___. A central venous catheter tip projects over the right atrium. Impression: 1. Worsened now mild-to-moderate interstitial pulmonary edema and small-to-moderate bilateral layering pleural effusions. 2. Left-sided rib fractures in retrospect apparent since at least ___. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| 60fa6a80-205ed57c-835e6296-1969c8b7-58eeaacf | 58600769 | 11934114 | Impression: AP chest compared to ___. Large right pleural effusion has progressed slowly since ___. Also, increased his moderate enlargement of the cardiac silhouette and a smaller left pleural effusion. Pulmonary vascular congestion is present, but I would not say there is pulmonary edema. Consolidation in the left lower lobe could be atelectasis or pneumonia. It developed between ___ and ___. Right PIC line ends in the mid SVC. No pneumothorax. | Impression: AP chest compared to ___. Large right pleural effusion has significantly progressed since ___. Also, increased his severe enlargement of the cardiac silhouette and a smaller left pleural effusion. Pulmonary vascular congestion is present, but there is mild pulmonary edema. Consolidation in the right lower lobe could be atelectasis or pneumonia. It developed between ___ and ___. Right PIC line ends in the mid SVC. No pneumothorax. Consolidation in the right lower lobe could be atelectasis or pneumonia. | ['Change severity', 'Add repetitions', 'False prediction'] |
| f1a86b6c-1907b6f9-4893b125-c7f89eee-604fbd73 | 58725099 | 11934114 | Findings: Orogastric tube is seen to course below the diaphragm into the stomach and is appropriate. Right PICC line ends at cavoatrial junction. Mild-to-moderate right pleural effusion with associated lung atelectasis is unchanged since prior radiograph from ___, acquired two to three hours apart. Mild to moderately enlarged heart size, mediastinal and hilar contours are unchanged. Pleural effusion if any is minimal on the left side. Left lower lung atelectasis is unchanged. | Findings: Orogastric tube is seen to course below the diaphragm into the stomach and is appropriate. Right triple-lumen catheter ends at cavoatrial junction. Mild-to-moderate right pleural effusion with associated lung atelectasis is unchanged since prior radiograph from ___, acquired two to three hours apart. Mild to moderately enlarged heart size, mediastinal and hilar contours are unchanged. Pleural effusion if any is minimal on the left side. Left lower lung atelectasis is unchanged. Significant pulmonary edema is noted. | ['Change name of device', 'Add repetitions', 'False prediction'] |
| 91c320f3-73212556-e2380f4b-f3331485-e35cf39e | 59763671 | 11934114 | Findings: Comparison is made to prior study from ___. There is no interval change. There is again seen a nasogastric tube which is appropriately sited. There are bilateral pleural effusions and left retrocardiac opacity. There are no pneumothoraces or signs for overt pulmonary edema. | Findings: Comparison is made to prior study from ___. There is no ingterval change. There is again seen a nasogastric tube terminating in the stomach. No pleural effusions are seen. There are no pneumothoraces or signs for overt pulmonary edema. | ['Change position of device', 'Add typo', 'False negation'] |
| a2f93b13-6b7f3079-3610454c-347f5e93-ad8f103b, c826aa5d-6ff5ee3a-11a18fb2-ab264bed-566e1edb | 51988570 | 12074041 | Findings: Frontal and lateral views of the chest were obtained. A single-lead left-sided AICD is again seen with lead extending to the expected position of the right ventricle. There has been interval removal of a right internal jugular central venous catheter. There is minimal interstitial edema. No large pleural effusion or pneumothorax. The cardiac silhouette remains mildly enlarged. The aorta is tortuous. No focal consolidation seen. Impression: Minimal interstitial edema and mild cardiomegaly. | Findings: Frontal and lateral views of the chest were obtained. A single-lead left-sided pacemaker is again seen with lead extending to the expected position of the right ventricle. There has been interval removal of a right internal jugular central venous catheter. There is minimal interstitial edema. No large pleural effusion or pneumothorax. The cardiac silhouette remains mildly enlarged. The aorta is tortuous. No focal consolidation seen. There is a centrally placed venous catheter. Impression: Minimal interstitial edema and mild cardiomegaly. The cardiac silhouette remains mildly enlarged. | ['Change name of device', 'Add repetitions', 'Add medical device'] |
| af39d55c-0622bc39-b9865798-29ff5a61-eb7cfb93 | 52874646 | 12074041 | Findings: The cardiac, mediastinal, and hilar contours appear unchanged. The lung volumes are low. There is a patchy left basilar opacity obscuring the cardiac border and apex of the left hemidiaphragm, worrisome for pneumonia. Elsewhere, the lungs appear clear. There are no pleural effusions or pneumothorax. Impression: New left basilar opacity worrisome for pneumonia. | Findings: The cardiac, mediastinal, and hilar contours appear unchanged. The lung volumes are low. There is a patchy left basilar opacity obscuring the cardiac border and apex of the left hemidiaphragm, worrisome for pneumonia. Elsewhere, the lungs appear clear. No opacity is seen. There are no pleural effusions or pneumothorax. Impression: No opacity is observed. | ['Change location', 'Change to homophone', 'False negation'] |
| b4a1b5bb-c12e1164-ded8460a-ccc5b283-abc72a43 | 52969052 | 12074041 | Findings: A pacer/defibrillator unit projects over the left chest with a lead terminating in the right ventricle. The heart size is mildly enlarged, although this may be exaggerated by AP technique. The mediastinal contours demonstrate calcified atherosclerotic disease of the aortic knob. The hilar contours demonstrate mild vascular engorgement. The lungs also demonstrate widespread hazy opacity, compatible with pulmonary edema. There is no large pleural effusion or pneumothorax. Degenerative changes are present in the bilateral glenohumeral joints. Impression: Pulmonary edema. | Findings: A left-sided chest tube projects over the left chest with a lead terminating in the right ventricle. The heart size is mildly enlarged, although this may be exaggerated by AP technique. The mediastinal contours are normal with no evidence of aortic knob calcification. The hilar contours demonstrate mild vascular engorgement. The lungs also demonstrate widespread hazy opacity, compatible with pulmonary edema. There is no large pleural effusion or pneumothorax. Degenerative changes are present in the bilateral glenohumeral joints. Impression: No pulmonary edema. | ['Change name of device', 'Add contradiction', 'False negation'] |
| 172a847d-d8c6570a-3cb0cff9-cb4ca0bd-3a8b93f1 | 53353190 | 12074041 | Findings: Portable AP chest radiograph is obtained with patient in the upright position. Cardiomediastinal contours are stable. On the left, there are unchanged areas of basal atelectasis and a moderate left pleural effusion that is unchanged. There is improvement in the pulmonary edema with persistence of mid right lung hazy opacification laterally, possibly suggesting consolidation in this region. Impression: As edema apperas to be improving, persistent right opacification is concerning for consolidation and pneumonia should be considered in the appropriate clinical context. | Findings: Portable AP chest radiograph is optained with patient in the upright position. Cardiomediastinal contours are stable. On the right, there are unchanged areas of basal atelectasis and a moderate pleural effusion that is unchanged. There is improvement in the pulmonary edema with no right lung consolidation. Impression: As edema appears to be improving, no right opacification or consolidation is seen. | ['Change location', 'Add typo', 'False negation'] |
| ebfa6753-3f0b7933-ca42ef98-0ce8ca94-b03f6676 | 53840157 | 12074041 | Findings: Again seen is mild cardiomegaly, pulmonary vascular redistribution and patchy alveolar infiltrates. The lateral film is limited by the arm projecting over the lateral lungs. There is increased opacity at both bases and it is unclear if this is due to atelectasis or focal infiltrate. The overall impression is that of pulmonary edema which is similar compared to the study from earlier the same day. | Findings: Again seen is mild cardiomegaly, pulmonary vascular redistribution and patchy alveolar infiltrates. The lateral film is limited by the arm projecting over the lateral lungs. There is increased opacity at both bases and it is unclear if this is due to atelectasis or focal infiltrate. The overall impression is that of moderate pulmonary edema which is similar compared to the study from earlier the same day. A right-sided central venous catheter is noted in the SVC. | ['Change severity', 'Add contradiction', 'Add medical device'] |
| a194aa87-2cb7c882-7602c814-7712dbb4-9ac8dea7, f430ec0f-40b790de-a5178baf-9dd6c108-9fc32de6 | 54973829 | 12074041 | Findings: The heart is at the upper limits of normal size. Linear calcification projects over the right lung apex. The lungs appear otherwise clear. There are no pleural effusions or pneumothorax. Vascular calcifications are widespread. No free air is demonstrated. There are moderate to severe degenerative changes involving each glenohumeral joints. Mild degenerative changes are present along the visualized lower thoracic spine. Impression: No evidence of acute disease. | Findings: The heart is at the upper limits of normal size. Linear calcification projects over the left lung apex. The lungs appear otherwise clear. There are no pleural effusions or pneumothorax. Vascular calcifications are widespread. ET tube is present projecting over the mediastinum. No free air is demonstrated. There are moderate to severe degenerative changes involving each glenohumeral joints. Linear calcification projects over the left lung apex. Mild degenerative changes are present along the visualized lower thoracic spine. Impression: No evidence of acute disease. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 765fd687-06776030-fe337975-2739eab4-decbb9c2 | 56502688 | 12074041 | Findings: New mild pulmonary arteries cephalization with increased interstitial markings are compatible with mild interstitial edema. Mild cardiac enlargement is stable. There are bibasilar opacities that could be explained in part by small bilateral pleural effusion and atelectasis; however, pneumonia or aspiration cannot be excluded. There is no pneumothorax. Impression: 1. New mild interstitial edema with stable mild cardiomegaly. 2. Bibasilar opacities could be in part explained by small pleural effusion and atelectasis. However, aspiration or pneumonia cannot be excluded. This has been verbally discussed with referring physician. | Findings: New moderate pulmonary arteries cephalization with increased interstitial markings are compatible with mild interstitial edema. Severe cardiac enlargement is stable. There are bibasilar opacities that could be explained in part by large bilateral pleural effusion and atelectasis; however, pneumonia or aspiration cannot be excluded. There is no pneumothorax. Impression: 1. New mild interstitial edema with severe cardiomegaly. 2. Bibasilar opacities could be in part explained by large pleural effusion and atelectasis. However, aspiration or pneumonia cannot be excluded. Stable cardiomediastinal contour. This has been verbally discussed with referring physician. | ['Change severity', 'Add contradiction', 'False prediction'] |
| 467d9162-e7cce16e-70dfaa79-1867728f-1db6394e | 57679936 | 12074041 | Findings: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. The transparency of the lung parenchyma on the right has increased more than on the left. On the left, there are unchanged areas of left basal atelectasis and a moderate left pleural effusion. Borderline size of the cardiac silhouette. No newly appeared parenchymal opacities. | Findings: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. The transparency of the lung parenchyma on the right has increased more than on the left. On the left, there are unchanged areas of left basal atelectasis and a large left pleural effusion. Bordeline size of the cardiac silhouette. No newly appeared parenchymal opacities. | ['Change severity', 'Add typo', 'False negation'] |
| 7568a044-7f2b130e-9af97f69-17cda54e-cb366755 | 50751429 | 12110863 | Findings: Since the prior exam, there is increasing opacification at the right base, which is most likely due to aspiration, given the acute change. Otherwise, remaining lung fields are stable, including right lower lobe bronchiectasis and scarring. There is continued diffuse interstitial prominence. There is no definite pulmonary edema. There is no pleural effusion or pneumothorax. The heart is severely enlarged. Post-CABG changes are stable. A pacemaker is in place. The wires are in appropriate position. Impression: Increasing opacity in the right lower lung zone is worrisome for aspiration. Stable interstitial prominence and right lower lobe scaring. | Findings: Since the prior exam, there is increasing opacification at the right base, which is most likely due to aspiration, given the acute chang. Otherwise, remaining lung fields are stable, including right lower lobe bronchiectasis and scarring. There is continued diffuse interstitial prominence. There is no definite pulmonary edema. There is no pleural effusion or cardiomegaly. The heart is severely enlarged. Post-CABG changes include a left-sided chest tube. A dual-chamber ICD is in place. The wires are in appropriate position. Impression: Increasing opacity in the right lower lung zone is worrisome for congestive heart failure given the interstitial prominence and right lower lobe scaring. | ['Change name of device', 'Add typo', 'False prediction'] |
| 67412cf5-519f1711-72f5a403-2e6ec7fa-84dfa6b6 | 52268728 | 12110863 | Findings: AP portable upright chest radiograph was provided. Midline sternotomy wires and left chest wall pacer device again noted with pacer lead extending into the region of the right atrium and right ventricle. Multiple mediastinal clips are noted. As seen on prior high res CT, areas of scarring evidenced by subtle linear reticular opacity at the right lung base present. The heart is mildly enlarged. There is no definite effusion, though the left CP angle is excluded. No pneumothorax. No signs of CHF or discrete signs of pneumonia. Bony structures are intact. Impression: Cardiomegaly with stable area of scarring at the right lung base. | Findings: AP portable upright chest radiograph was provided. Midline sternotomy wires and left chest wall pacer device again noted with pacer lead extending into the region of the left atrium and right ventricle. Multiple mediastinal clips are noted. As seen on prior high res CT, areas of scarring evidenced by subtle linear reticular opacity at the right lung base present. The heart is mildly enlarged. There is no definite effusion, though the left CP angle is excluded. No pneumothorax. No signs of CHF or discrete signs of pneumonia. Bony structures are intact. Impression: Cardiomegaly with no evidence of scarring at the right lung base. No cardiomegaly or scarring at the right lung base. | ['Change position of device', 'Add contradiction', 'False negation'] |
| 22a06cfc-11fababd-02d9a890-42cbc80e-34757e33 | 53008088 | 12110863 | Findings: The patient is status post median sternotomy and CABG. Left-sided dual-chamber pacemaker device is present with leads terminating in the right atrium and right ventricle. Moderate cardiomegaly is unchanged. Mild pulmonary vascular engorgement is likely present, similar compared to the prior study. Probable small bilateral pleural effusions are present. Pleural thickening within the lung apices is is unchanged. No pneumothorax is identified. Streaky bibasilar opacities likely reflect a combination of atelectasis with chronic fibrotic changes, more so in the right lung base. No pneumothorax is detected. No acute osseous abnormalities seen. Elevation of the right hemidiaphragm is unchanged. Remote fracture of the proximal right humerus is again noted. Impression: Mild pulmonary vascular congestion, similar compared to the previous exam, with probable small bilateral pleural effusions. Bibasilar streaky airspace opacities could reflect a combination of atelectasis with chronic changes. | Findings: The patient is status post median sternotomy and CABG. Left-sided AICD device is present with leads terminating in the right atrium and right ventricle. Moderate cardiomegaly is unchanged. Severe pulmonary vascular engorgement is likely present, similar compared to the prior study. Probable small bilateral pleural effusions are present. Pleural thickening within the lung apices is is unchanged. No pneumothorax is identified. Streaky bibasilar opacities likely reflect a combination of atelectasis with chronic fibrotic changes, more so in the right lung base. Right-sided pleural effusion is detected. No acute osseous abnormalities seen. Elevation of the right hemidiaphragm is unchanged. Remote fracture of the proximal right humerus is again noted. Impression: Mild pulmonary vascular congestion, similar compared to the previous exam, with probable small bilateral pleural effusions. Bibasilar streaky airspace opacities could reflect a combination of atelectasis with acute changes. | ['Change name of device', 'Add contradiction', 'False prediction'] |
| e538135c-ebad1b7e-5f239803-3d6bcf94-7c5fddc4 | 55498995 | 12110863 | Findings: The patient is status post median sternotomy and CABG. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette persistently enlarged. Two lead left-sided pacemaker is again seen, unchanged in position. There are slightly low lung volumes and there is persistent mild elevation of the right hemidiaphragm. Slight blunting of the right costophrenic angle is stable. Stable right base scarring is again seen. There is no evidence of pneumothorax. No overt pulmonary edema is seen. There may be mild pulmonary vascular congestion. Impression: Stable cardiomegaly with possible mild pulmonary vascular congestion, without overt pulmonary edema. | Findings: The patient is status post median sternotomy and CABG. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette persistently enlarged. Two lead left-sided AICD is again seen, unchanged in position. There are slightly low lung volumes and there is persistent mild elevation of the right hemidiaphragm. Slight blunting of the right costophrinic angle is stable. Stable right base scarring is again seen. There is a small pleural effusion on the left side. No overt pulmonary edema is seen. There may be mild pulmonary vascular congestion. Impression: Stable cardiomegaly with possible mild pulmonary vascular congestion, without overt pulmonary edema. There is a subtle nodule in the right upper lobe. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| 6f619231-f8a0ab48-6858a7eb-b0ee9c1c-de3385c9, c12759af-b70b6882-d6cca08e-8811c264-7caf797c | 55875120 | 12110863 | Findings: Since the prior exam, there appears to be increased interstitial prominence, although no overt pulmonary edema. Stable bronchiectasis and scarring is again noted at the right base. There is no dense consolidation. There is no pleural effusion or pneumothorax. Severe cardiomegaly is present. A pacemaker is in place with wires in unchanged position. The patient is status post a CABG. The sternal wires are intact. There are severe degenerative changes of the bilateral shoulders. Impression: 1. Mild interval increase in interstitial prominence without definite pulmonary edema. 2. Stable right lower lobe scarring and bronchiectasis. | Findings: Since the prior exam, there appears too be increased interstitial prominence, although no overt pulmonary edema. Stable bronchiectasis and scarring is again noted at the right base. There is no dense consolidation. There is no pleural effusion or pneumothorax. Severe cardiomegaly is present. An ICD is in place with wires in unchanged position. The patient is status post a CABG. The sternal wires are intact. There are severe degenerative changes of the bilateral shoulders. Presence of a central venous line with tip in the SVC. | ['Change name of device', 'Change to homophone', 'Add medical device'] |
| 1e63fbae-cd836c8c-60c8d534-08ef62b9-a33e82f2, fba838cc-fa4eb8b6-b3e8de64-e89c00ab-1bb9216a | 59358922 | 12110863 | Impression: 1. Right lower lobe fibrosis. 2. Moderate cardiomegaly. 3. Interval right humeral neck fracture. | Impression: 1. Left lower lobe fibrosis. 2. Moderate cardiomegaly. 3. No humeral neck fracture. | ['Change location', 'Add contradiction', 'False negation'] |
| 0b53daa0-d9ca6166-9622edee-57037ea3-8a1bf264, e53b12a2-325afb40-3283ac75-9f92dfc7-5e579ec0 | 52979134 | 12124741 | Findings: Lungs are low in volume but clear. There is no pleural effusion or pneumothorax. A left subclavian Port-A-Cath is seen terminating in the superior cavoatrial junction. Heart is top normal in size and normal cardiomediastinal silhouette. Slight leftward deviation of the trachea is stable and perhaps due to thyroid enlargement. Impression: No acute intrathoracic process. | Findings: Lungs are low in volume but clear. There is no pleural effusion or pneumothorax. A left subclavian Port-A-Cath is seen terminating in the mid SVC. Heart is top normal in size and normal cardiomediastinal silhouette. Slight leftward deviation of the trachea is stable and perhaps due to thyroid enlargement. Impression: No acute intrathoracic process, although mild pulmonary edema is noted. | ['Change position of device', 'Add contradiction', 'False negation'] |
| 783fc94d-12b747b1-600f2e10-c1c51d2a-97240f95, ebd066f6-f32177f2-c211270d-aeb7bae8-f4b6d9a2 | 53352013 | 12124741 | Findings: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are again noted. The previously noted Port-A-Cath has been removed. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm is seen. Impression: No acute findings in the chest. | Findings: PA and lateral views of the chest provyded. An abnormal buildup of fluid in the right hemithorax is present. Mundline sternotomy wires and mediastinal clips are again noted. The previously noted Port-A-Cath that enters the superior vena cava is correctly placed. The lungs are clear bilaterally with bibasilar atelectasis. Cardiomediastinal silhouette is staable. Bony structures show fractures in multiple ribs. No free air below the left hemidiaphragm is seen. Impression: No significant interstitial or alveolar densities. | ['Change position of device', 'Add typo', 'False prediction'] |
| 1360763e-71ee973d-a29d16c9-9763397e-37844701 | 53809636 | 12124741 | Impression: 1) Interval removal of left chest tube. No new pneumothorax or increase in left-sided effusion. 2) Equivocal slight increase in opacity at right base. Otherwise, I doubt significant interval change. | Impression: 1) Interval removal of left chest tube. Small new pneumothorax noted on the left side. 2) Equivocal slight increase in opacity at right base. Otherwise, significant interval change observed. | ['Change severity', 'Add contradiction', 'False prediction'] |
| b057552d-dcaef0e0-258a2453-37c600b2-d8d2b31f | 55477134 | 12124741 | Impression: Continued mild CHF and bibasilar opacities with small effusions. However, overall improved compared with one day earlier. | Impression: Continued moderate CHF and bibasilar opacities with small effusions. However, overall improved comapred with one day earlier. The heart appears significantly enlarged. | ['Change severity', 'Add typo', 'False prediction'] |
| 7ceecc91-32932b6b-bf0ae761-92a74cf7-fe124fbc | 57169558 | 12124741 | Impression: AP chest compared to ___: The patient has been extubated and lung volumes are lower. There has been a disproportional increase in caliber of the mediastinum, which could be due to bleeding or vascular engorgement due to cardiac tamponade. Lung periphery shows no vascular engorgement, so left heart function is not incriminated. There is no pneumothorax or appreciable pleural effusion, left basal pleural tube is still in place. Bibasilar atelectasis is only moderate and unchanged. Right subclavian line ends in the right atrium. ___ was paged as soon as this examination appeared for review and I discussed the findings with ___ at the time of dictation. | Impression: AP chest compared to ___: The patient has been extubated and lung volumes are lower. There has been a disproportional increase in caliber of the mediastinum, which could be due to bleeding or vascular engorgement due to cardiac tamponade. Lung periphery shows no vascular engorgement, so right heart function is not incriminated. There is no pneumothorax or appreciable pleural effusion, left basal pleural tube is still in place. Lung periphery shows no vascular engorgement, so right heart function is not incriminated. Right subclavian line ends in the right atrium. An endotracheal tube is present. ___ was paged as soon as this examination appeared for review and I discussed the findings with ___ at the time of dictation. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 72a15dc0-cfcca17f-201baf20-76f2e298-e4123143 | 57320234 | 12124741 | Findings: A right port catheter tip ends in the mid SVC. Sternal wires are intact and midline. There are small bilateral pleural effusions, slightly larger on the left than on the right. The cardiac silhouette is moderately enlarged. There is mild engorgement of the pulmonary vasculature. There has been improvement in the previously noted pulmonary edema with minimal residual edema. There is plate-like atelectasis seen in the left base. There is no consolidation or pneumothorax. Impression: 1. Small bilateral pleural effusions. 2. Improvement in pulmonary edema. | Findings: A right port catheter tip ends in the lower SVC. Sternal wires are fractured and slightly displaced. There are small bilateral pleural effusions, with no effusion noted on the right side. The cardiac silhouette is normal in size. There is mild engorgement of the pulmonary vasculature. There has been worsening in the previously noted pulmonary edema with significant residual edema. There is plate-like atelectasis seen in the right base. There is no consolidation or pneumothorax. Impression: 1. Moderate bilateral pleural effusions. 2. Improvement in pulmonary edema. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| 234b22c4-55fb91a9-44f7a42f-b764d462-018d3bb9 | 50323020 | 12136799 | Findings: Single portable AP view of the chest is compared to previous exam from ___. The lungs are clear of focal consolidation. There is, however, persistent blunting of the right costophrenic angle, potentially due to pleural thickening especially in the setting of multiple prior healed right rib fractures. Cardiomediastinal silhouette is stable. No visualized free air below the diaphragm. Impression: No acute cardiopulmonary process. No visualized free air. | Findings: Single portable AP view of the chest is compared to previous exam from ___. The lungs are clear of focal consolidation. There is, however, persistent blunting of the left costophrenic angle, potentially due to pleural thickening especially in the setting of multiple prior healed right rib fractures. Cardiomediastinal silhouette is stable. No visualized free air below the diaphragm. Impression: There is no pleural thickening. No visualized free air. No visualized free air. | ['Change location', 'Add repetitions', 'False negation'] |
| 03da26e7-8b50eef0-1b7ebc08-6a620d75-b320cbc4, 22828c64-011878e3-cbd88035-2965e173-693deab2 | 51835810 | 12136799 | Findings: PA and lateral views of the chest were obtained. Multiple right rib deformities are noted along the right lateral rib cage. Areas of pleuroparenchymal scarring are noted in the underlying lung. Otherwise, the lungs appear clear bilaterally without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures appear stable without definite signs of an acute fracture. No free air below the right hemidiaphragm is seen. Impression: Stable deformity along the right lateral rib cage. No acute findings. | Findings: PA and lateral views of the chest were obtained. Multiple right rib deformities are noted along the right lateral rib cage. No areas of pleuroparenchymal scarring are noted. Otherwise, the lungs appear clear bilaterally without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures appear stable without definite signs of an acute fracture. No free air below the left hemidiaphragm is seen. Bony structures appear stable without definite signs of an acute fracture. Impression: No deformity is seen. No acute findings. | ['Change location', 'Add repetitions', 'False negation'] |
| 44a2ba52-bf35cfa7-d309c49c-306c1f3e-ba524d4a | 54457720 | 12136799 | Impression: AP chest compared to ___: Right pleural scarring is chronic. Lungs are clear. Cardiomediastinal silhouette is normal. | Impression: AP chest compared to ___: Left pleural scarring is chronic. Lungs are clear. Cardiomediastinal silhouette is normal. Left pleural scarring is chronic. | ['Change location', 'Add repetitions', 'False negation'] |
| 070b58a0-da9b8080-6eeeaf5a-46226e7b-2f9453fa, c875e4c8-ab736220-04569ba0-857889ce-042ea536 | 54100996 | 12145137 | Findings: AP portable view of the chest is obtained. Previously seen left juxtahilar opacity lateral to the fiducial seeds has decreased in size and persists since the prior study. No new focal consolidation is seen.There is prominence of the right hilum which is slightly increased since the prior study, which may relate to patient positioning, although underlying increased lymphadenopathy cannot be excluded. A left subclavian central venous catheter is again seen, unchanged in position. Cardiac and mediastinal silhouettes are stable. Chronic right chest wall deformity again seen. Impression: 1. Left suprahilar opacity and fiducial seeds are again seen, although appears slightly less prominent/small in size, although as mentioned on the prior study, could be further evaluated by chest CT or PET-CT. 2. Right hilum appears slightly more prominent as compared to the prior study, which may be due to patient positioning, although increased right hilar lymphadenopathy is not excluded. | Findings: AP portable view of the chset is obtained. Previously seen left juxtahilar opacity lateral to the fiducial seeds has decreased in size and persists since the prior study. No new focal consolidation is seen.There is prominence of the rigt hilum which is moderately increased since the prior study, which may relate to patient positioning, although underlying increased lymphadenopathy cannot be excluded. A left subclavian central venous catheter is again seen, unchanged in position. Cardiac and mediastinal silhouettes are stable. Chronic right chest wall deformity again seen. A nasogastric tube is noted in place. Impression: 1. Left suprahilar opacity and fiducial seeds are again seen, although appears slightly less prominent/small in size, although as mentioned on the prior study, could be further evaluated by chest CT or PET-CT. 2. Right hilum appears moderately more prominent as compared to the prior study, which may be due to patient positioning, although increased right hilar lymphadenopathy is not excluded. | ['Change severity', 'Add typo', 'Add medical device'] |
| 61b4d5e0-66a2bcaf-6c4d6c19-6b735e59-b1390cb2 | 54833205 | 12145137 | Findings: Again identified is a left juxta-hilar mass adjacent to a fiducial seed and a right hilar mass. Multiple other nodules are also identified but better delineated on recent CT. Otherwise, the lungs are without a focal consolidation or pneumothorax. A small right pleural effusion is noted. An overlying left subclavian central line is visualized in place. There is stable elevation of the left hemidiaphragm. No free air is noted in the abdomen. Impression: Findings consistent with known intrathoracic malignancy. No evidence of infection or other acute process. | Findings: Again identified is a left juxta-hilar mass adjacent to a fiducial seed and a right hilar mass. Multiple other nodules are also identified but better delineated on recent CT. Otherwise, the lungs show a large focal consolidation but no pneumothorax. A moderate right pleural effusion is noted. An overlying left subclavian central lion is visualized in place. There is stable elevation of the left hemidiaphragm. No free air is noted in the abdomen. Several calcified granulomas in the lung fields. Impression: Findings consistent with known intrathoracic malignancy. No evidence of infection or other acute to process. | ['Change severity', 'Change to homophone', 'False prediction'] |
| 23f0b24d-61c1f12c-eb2434aa-f6d2c69e-86a2cd20 | 50127750 | 12185775 | Impression: AP chest compared to ___: Small-to-moderate left pleural effusion has increased slightly over the past several days. Moderate enlargement of the cardiac silhouette accompanied by mediastinal vascular engorgement is also slightly more pronounced. Pulmonary vasculature is engorged but there is no edema. Consolidation has been present without appreciable change in the left lower lobe since at least ___. Mediastinum widened at the thoracic inlet by a combination of tortuous vessels and mediastinal fat deposition. Right jugular introducer ends just above the junction with left brachiocephalic vein. | Impression: AP chest compared to ___: Small-to-moderate right pleural effusion has increased slightly over the past several days. Moderate enlargement of the cardiac silhouette accompanied by mediastinal vascular engorgement is also slightly more pronounced. Pulmonary vasculature is engorged but there is no edema. Consolidation has been present without appreciable change in the left lower lobe since at least ___. Mediastinum widened at the thoracic inlet by a combination of tortuous vessels and mediastinal fat deposition. Right jugular introducer ends just above the junction with left brachiocephalic vein. A central venous line is in place. | ['Change location', 'Add repetitions', 'Add medical device'] |
| 11b1705d-30db94a7-a7782a30-f6fbb83d-d63373de | 50491354 | 12185775 | Impression: 1. Right internal jugular Swan-Ganz catheter with its tip in the right pulmonary artery, unchanged. Endotracheal tube has its tip at the thoracic inlet in satisfactory position. Nasogastric tube is seen coursing below the diaphragm. There is blunting of left costophrenic angle with some retrocardiac opacity likely reflecting a small effusion with patchy compressive atelectasis. Pneumonia cannot be entirely excluded. Improving with residual minimal interstitial edema. Left upper and mid calcified nodules likely reflect granulomata. No pneumothorax. Overall, cardiac and mediastinal contours are stable. | Impression: 1. Right internal jugular Swan-Ganz catheter with its tip in the right atrium, unchanged. Endotracheal tube has its tip at the thoracic inlet in satisfactory position. Nasogastric tube is seen coursing below the diaphragm. There is blunting of right costophrenic angle with some retrocardiac opacity likely reflecting a small effusion with patchy compressive atelectasis. Pneumonia cannot be entirely excluded. There is no evidence of pneumonia. Improving with residual minimal interstitial edema. Left upper and mid calcified nodules likely reflect granulomata. No pneumothorax. There is a right-sided pacemaker. Overall, cardiac and mediastinal contours are stable. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 42ca390f-5819f578-c74fd59e-a7561a1a-0040b454 | 50729749 | 12185775 | Impression: ET tube tip is 4.8 cm above the Carina. NG tube tip is in the stomach. Left central venous line tip is at the level of mid SVC. Heart size and mediastinum are enlarged. Pulmonary edema has substantially improved since the prior study. | Impression: ET tube tip is 5.9 cm above the Carina. NG tube tip is in the sotmach. Right central venous line tip is at the level of mid SVC. Heart size and mediastinum are enlarged. Pulmonary edema has substantially improved since the prior study with new bilateral pleural effusions. | ['Change measurement', 'Add typo', 'False prediction'] |
| c9bd6dd6-c8328950-4f61c412-81766efb-2d9c193f, dcd6fbb9-e2ec404a-8b19713d-5379757a-105c3803 | 50953777 | 12185775 | Findings: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding portable chest examination of ___. Heart size is unchanged. Previously described moderate pulmonary congestive pattern with some upper zone re-distribution has normalized. Presently no evidence of pulmonary interstitial alveolar edema and the lateral as well as posterior pleural sinuses are free from any fluid accumulation. No pneumothorax in the apical area. No acute infiltrates. Lateral and posterior pleural sinuses are free. A previously described old calcified granuloma in the left upper lobe area is unchanged. Impression: No evidence of new acute pulmonary infiltrates. | Findings: PA and lateral chest views were obtained with the patient in the supine position. Analysis is performed in direct comparison with the next preceding portable chest examination of ___. Heart size is increased. Previously described moderate pulmonary congestive pattern with some lower zone re-distribution has normalized. Presently no evidence of pulmonary interstitial alveolar edema and the lateral as well as posterior pleural sinuses are free from any fluid accumulation. There is a nasogastric (NG) tube in place. No pneumothorax in the apical area. There are acute infiltrates. Lateral and posterior pleural sinuses show fluid accumulation. A previously described old calcified granuloma in the right upper lobe area is unchanged. Impression: No evidence of new acute pulmonary infiltrates. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 42a56014-a47bf1c7-ea0611ef-536278b4-881a4f91 | 51309585 | 12185775 | Impression: AP chest compared to ___ through ___: Moderately severe pulmonary edema has worsened again. The relatively greater opacification at the right lung base seen previously was due to a combination of edema, atelectasis and right pleural effusion, so it is not necessary to invoke possible pneumonia to explain the current radiographic findings. Moderate-to-severe cardiomegaly is chronic. Pulmonary vascular engorgement and distention of mediastinal veins have worsened. No pneumothorax. Large calcified granulomas longstanding in the upper lungs. | Impression: AP chest compared to ___ through ___: Moderately severe pulmonary edema has worsened again. The relatively greater opacification at the left lung base seen previously was due to a combination of edema, atelectasis and right pleural effusion, so it is not necessary to invoke possible pneumonia to explain the current radiographic findings. Moderate-to-severe cardiomegaly is chronic. Pulmonary vascular engorgement and distention of mediastinal veins have improved. No pneumothorax. Large calcified granulomas longstanding in the upper lungs. There is an ET tube in place. | ['Change location', 'Add contradiction', 'Add medical device'] |
| 996aed23-e2ca70b1-ece8d46f-47a6d9f9-dbb95bfe, f81d607d-d297abbb-83eb3c46-290321ba-aaa66ba9 | 51682896 | 12185775 | Findings: Cardiac silhouette remains enlarged, accompanied by pulmonary vascular congestion. Interstitial edema has improved in the interval. Bibasilar atelectasis is again demonstrated, with improvement on the left. Bilateral small pleural effusions are also evident as well as multiple calcified granulomas in the left lung. | Findings: Cardiac silhouette remains enlarged, accompanied by pulmonary vascular congestion. Interstitial edema has improved in the interval. Bibasilar atelectasis is again demonstrated, with worsening on the left. Bilateral small pleural effusion is also evident as well as multiple calcified granulomas in the left lung, with a small right lung mass. | ['Change location', 'Change to homophone', 'False prediction'] |
| f9b1c946-2770d2d6-e7a89dc5-0e3d42e2-77117240 | 51826366 | 12185775 | Findings: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette. Pulmonary vascularity is mildly engorged but less prominent than on the previous study. Opacification at the bases with obscuration of the hemidiaphragms is consistent with bilateral layering effusions, more prominent on the left, with underlying compressive atelectasis. Central catheter tip again extends to the upper to mid portion of the SVC. | Findings: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette. Pulmonary vascularity is mildly engorged but less prminent than on the previous study. Opacification at the bases with obscuration of the hemidiaphragms is consistent with bilateral layering effusions, more prominent on the left, with underlying compressive atelectasis. Central catheter tip again extends to the upper to mid portion of the right atrium. Pulmonary edema is also noted within both lungs. | ['Change name of device', 'Add typo', 'False prediction'] |
| 4fe86d2a-a88e414b-d58dd0c1-51340b76-e7353509 | 52400146 | 12185775 | Impression: AP chest compared to ___ through ___: Previous pulmonary edema has not recurred. Mild-to-moderate cardiomegaly is stable, and there is no change in the configuration of the thoracic aorta to suggest dissection, although that diagnosis is not excluded by the stable appearance on conventional chest radiographs. No pneumothorax or pleural effusion is present. | Impression: AP chest compared to ___ through ___: Previous pulmonary edema has recurred. Severe cardiomegaly is stable, and there is no change in the configuration of the thoracic aorta to suggest dissection, although that diagnosis is not excluded by the stable appearance on conventional chest radiographs. No pneumothorax or pleural effusion is present. Mild pneumothorax present. | ['Change severity', 'Add contradiction', 'False negation'] |
| 9911ed32-2bf726d7-dfcdceb1-dc248f4e-b62bb269 | 53053450 | 12185775 | Findings: As compared to the previous radiograph, the pre-existing opacities at the right lung base have improved. The left lung base is unchanged. Overall, the signs indicative of pulmonary edema have slightly decreased in severity but they are still clearly present. Unchanged moderate cardiomegaly and left calcified lung granulomas. | Findings: As compared to the previous radiograph, the pre-existing opacities at the right lung base have iimproved. The left lung base is unchanged. Overall, the signs indicative of pulmonary edema have slightly decreased in severity but they are still clearly present. Unchanged mild cardiomegaly and left calcified lung granulomas. A central venous line is in place. | ['Change severity', 'Add typo', 'Add medical device'] |
| 31b151ec-75ddc4a9-e85ecaab-f72df771-c55ef3b5, 8c58ba80-5157991a-30a3a6c0-db670ba0-d1aee122 | 53295276 | 12185775 | Findings: Cardiomediastinal contours are unchanged. Multiple calcified nodules throughout the lungs are unchanged. Otherwise The lungs are clear. The lungs are mildly hyperexpanded. There is no pneumothorax or pleural effusion. There are mild degenerative changes in the thoracic spine. Impression: No acute cardiopulmonary abnormalities | Findings: Cardiomediastinal contours are unchenged. Multiple calcified nodules throughout the lungs are unchanged. Otherwise The lungs are clear. The lungs are severely hyperexpanded. There is no pneumothorax or pleural effusion. There are moderate degenerative changes in the thoracic spine. An NG tube is present in the stomach. Impression: No acute cardiopulmonary abnormalities | ['Change severity', 'Add typo', 'Add medical device'] |
| f0d18848-8b3b0e31-92ab7c89-0a569510-bac46a4e | 53349756 | 12185775 | Findings: The PICC line on the right has migrated slightly more proximally with the distal lead tip now in the proximal SVC. Heart size is within normal limits. There is a left retrocardiac opacity and a small left-sided pleural effusion. There is no signs for acute pulmonary edema or pneumothoraces. Calcified granulomas are seen within the left upper lobe. Impression: As above. | Findings: The central venous catheter on the right has migrated slightly more proximally with the distal lead tip now in the proximal SVC. Heart size is within normal limits. There is a left retrocardiac opacity and a small left-sided pleural effusion. There is no signs for acute pulmonary edema or pneumothoraces. Calcified granulomas are scene within the left upper lobe. Impression: There is significant cardiomegaly noted. | ['Change name of device', 'Change to homophone', 'False prediction'] |
| d20291fc-8d626aa2-b3b2ef02-6f8b81ac-12f2432d | 53462705 | 12185775 | Findings: There has been interval removal of a right-sided PICC line. The cardiac silhouette remains enlarged. There has been resolution of bilateral pleural effusions. Again visualized are two calcified left upper lobe granulomas. Impression: 1. Resolution of bilateral pleural effusions. 2. Heart size remains enlarged. This could be indicative of cardiomyopathy or a pericardial effusion. | Findings: There has been interval removal of a left-sided PICC line. The cardiac silhouette remains enlarged. There has been resolution of bilateral pleural effusions. Again visualized are two calcified left upper lobe granulomas. There is a right IJ catheter in place. The cardiac silhouette remains enlarged. Impression: 1. Resolution of bilateral pleural effusions. 2. Heart size remains enlarged. This could be indicative of cardiomyopathy or a pericardial effusion. | ['Change position of device', 'Add repetitions', 'Add medical device'] |
| 3398c38d-190a9992-bebb2e85-7ca0c527-214906cb | 53768980 | 12185775 | Impression: Left subclavian catheter tip is in the upper SVC. Mild to moderate pulmonary edema has increased. No other interval change from prior study. | Impression: Left subclavian ET tube tip is in the upper SVC. No other interval change from prior study. No other interval change from prior study. A right-sided PICC line is noted. | ['Change name of device', 'Add repetitions', 'Add medical device'] |
| cab19714-ab5c9c6b-9130cd3c-ca463b15-840b0cc4 | 53850178 | 12185775 | Impression: AP chest compared to ___: Mild pulmonary edema and mediastinal and pulmonary vascular engorgement have improved since ___. Small right pleural effusion has decreased. Lobar collapse has not recurred. Mild-to-moderate cardiomegaly is unchanged. No pneumothorax. | Impression: AP chest compared to ___: No pulmonary edema. Small left pleural effusion has decreased. Lobarr collapse has not recurred. Mild-to-moderate cardiomegaly is unchanged. No pneumothorax. | ['Change location', 'Add typo', 'False negation'] |
| 96e29c8f-cbe25758-3c1d7c4e-4f3ed96e-857a1bc7 | 53923012 | 12185775 | Findings: Again visualized is a stable right lower lobe opacity consistent with small to moderate right pleural effusion. Improved asymmetric edema is noted on the left. There is no evidence of new consolidation or pneumothorax. Cardiomediastinal silhouette remains stable. Osseous structures remain normal. Impression: 1. Stable small to moderal right pleural effusion. 2. Improved asymmetric edema is noted on the left. | Findings: Again visualized is a stable right lower lobe opacity consistent with small to moderate left pleural effusion. Improved asymmetric edema is noted on the leff. There is new evidence of consolidation in the right upper lobe. Cardiomediastinal silhouette remains enlarged. Osseous structures remain abnormal. Impression: 1. Stable small to moderate right pleural effusion. 2. New pulmonary nodule detected in the right lung. | ['Change location', 'Add typo', 'False prediction'] |
| b738cf47-6ae04cdf-25d11841-ddcb8d78-fe7feceb | 53930112 | 12185775 | Findings: A right internal jugular central line ends in the upper SVC. The Swan-Ganz catheter has been removed. A new consolidation at the right base is concerning for possible pneumonia, aspiration, or less likely infarction. Small bilateral pleural effusions are stable. Calcified granulomas in the left mid lung zone are unchanged. Impression: 1. New right basilar consolidation is most concerning for pneumonia or aspiration. Less likely, it may be infarction. 2. Stable small bilateral pleural effusions. 3. Mild enlargement of the cardiac silhouette is unchanged. Results were discussed with ___ at 11:20 on ___ via telephone by Dr. ___. | Findings: A right internal jugular central line ends in the lower SVC. The Swan-Ganz catheter has been removed. No consolidation is seen. Small bilateral pleural effusions are stable. Calcified granulomas in the left mid lung zone are unchanged. Impression: 1. New right basilar consolidation is most concerning for pneumonia or aspiration. Less likely, it may be infarction. 2. Stable small bilateral pleural effusions. 3. Mild enlargement of the cardiac silhouette is unchanged. The results were not discussed with ___ at 11:20 on ___ via telephone by Dr. ___. | ['Change position of device', 'Add contradiction', 'False negation'] |
| 91ba091c-cee12c63-ff22dde9-147ea7bb-418900c4, dc3b047f-54a16324-3e28091b-9d53d461-debc37f2 | 54133721 | 12185775 | Findings: AP and lateral views of the chest. Low lung volumes. Two calcified granulomas in the left lung are unchanged. No focal consolidation or pneumothorax. There are small bilateral pleural effusions. Cardiomediastinal and hilar contours are stable. Degenerative changes are again seen in the spine. Impression: Small bilateral pleural effusions. | Findings: AP and lateral views of the chest. No abnormalities noted in lung volumes. Two calcified granulomas in the right lung are unchanged. No focal consolidation or pneumothorax. No pleural effusions. Cardiomediastinal and hilar contours are stable. Degenerative changes are again seen in the spine. Impression: Small bilateral pleural effusions and clear lungs. | ['Change location', 'Add contradiction', 'False negation'] |
| f2a7f664-bfff0efe-5bb44ad4-469f58a4-0e6b7892 | 54211038 | 12185775 | Findings: New endotracheal tube is seen appropriately positioned terminating no less than 2.5 cm above the carina. There are low lung volumes bilaterally with moderate pulmonary edema . Small quantity of bilateral pleural effusion is seen. Cardiomediastinal silhouette is somewhat obscured but is stable and within normal limits. Impression: Appropriately placed ET tube. Moderate pulmonary edema. These findings were reported to Dr. ___ at 4:55 p.m. via phone by ___. | Findings: New endotracheal tube is seen appropriately positioned terminating no less than 2.5 cm above the carina. There are low lung volumes bilaterally with mild pulmonary edema. Large quantity of bilateral pleural effusion is seen. Cardiomediastinal silhouette is somewhat obscured but is stable and within normal limits. Impression: Appropriately placed ET tube. Mild pulmonary edema. No pleural effusion is seen. These findings were reported to Dr. ___ at 4:55 p.m. via phone by ___. | ['Change severity', 'Add contradiction', 'False negation'] |
| d3905d7d-0e7ed6e5-b6ec0f08-c5b5dcd8-ad786679, ea54418c-e36750cc-060592a5-0239e442-40b57ba0 | 55391561 | 12185775 | Findings: As compared to the previous radiograph, the lung volumes have increased. The right internal jugular vein introduction sheath has been removed. The pre-existing right pleural effusion has completely resolved. On the left, however, the pre-existing pleural effusion persists and has minimally increased in extent. There are subsequent areas of retrocardiac and basal atelectasis. Borderline size of the cardiac silhouette. Two calcified lung nodules in the left apex. | Findings: As compared to the previous radiograph, the lung balloons have increased. The right internal jugular vein introduction sheath has been removed. The pre-existing right pleural effusion has completely resolved. On the left, however, the pre-existing pleural effusion persists and has minimally increased in extent. There are subsequent areas of retrocardiac and basal atelectasis. Borderline size of the cardiac silhouette. Two calcified lung nodules in the right apex. An NG tube is present with its tip in the stomach. | ['Change location', 'Change to homophone', 'Add medical device'] |
| e6b4a152-bc73f001-84e7b150-4191779a-754f8459 | 55494760 | 12185775 | Impression: 1. Extensive bilateral patchy pulmonary opacities. In the setting of central vascular congestion, this is most likely severe pulmonary edema, but pneumonia cannot be excluded, particularly at the left base. 2. ET tube terminating 4.7 cm above the carina. Orogastric tube within the stomach. | Impression: 1. Extensive bilateral patchy pulmonary opacities. In the setting of central vascular congestion, this is most likely severe pulmonary edema, but pneumonia cannot be excluded, particularly at the left bass. 2. ET tube terminating 5.6 cm above the carina. Orogastric tube within the stomach. Additionally, the patient has a pacemaker. | ['Change measurement', 'Change to homophone', 'Add medical device'] |
| b570093b-0dc0e880-c0006423-ad6a31ed-d87e89fa | 55958316 | 12185775 | Impression: AP chest compared to ___, 5:26 a.m. Severe cardiomegaly and mediastinal and hilar vascular engorgement persists but there has been very significant improvement in previous pulmonary edema, now only minimal, persisting at the base of the right lung. Small right pleural effusion is likely. No pneumothorax. | Impression: AP chest compared to ___, 5:26 a.m. Severe cardiomegaly and mediastinal and hilar vascular engorgement persists but there has been very significant improvement in previous pulmonary edema, now only moderate, persisting at the base of the right lung. Large right pleural effusion is likely. No pneumothorax. | ['Change severity', 'Change to homophone', 'False negation'] |
| d616d0a0-41025591-43cd391a-ee10bd11-29c865b3 | 56043671 | 12185775 | Findings: A right PICC has been placed with the tip terminating in the proximal right atrium, which should be retracted 2 cm to place in the low SVC. The inspiratory lung volumes are decreased. There is mild right basilar atelectasis. Calcified pulmonary granulomas are unchanged. There is no focal consolidation concerning for pneumonia, significant pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are stable. No acute osseous abnormality is detected. Impression: Right PICC terminating in the proximal right atrium should be retracted 2 cm to place in the low SVC. | Findings: A right PICC has been placed with the tip now in the mid-SVC, which should be retracted 2 cm to place in the low SVC. The inspiratory lung volumes are decreased. There is mild right basilar atelectasis. Calcified pulmonary granulomas are unchanged. There is no focal consolidation concerning for pneumonia, but mild consolidation is noted in the left upper lobe. There is significant pleural effusion and pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are stable. No acute osseous abnormality is detected. Impression: Right PICC terminating in the proximal right atrium should be retracted 2 cm to place in the low SVC, but the low SVC placement is adequate. | ['Change position of device', 'Add contradiction', 'False prediction'] |
| b529320a-394d7b79-a3e8c3da-c28c6b94-7ec08b51 | 56143620 | 12185775 | Findings: In comparison with the study of ___, there is little overall change. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis. Central catheter remains in place. | Findings: In comparison with the study of ___, there is little overall change. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis. Central catheter terminates in the mid SVC. Findings: In comparison with the study of ___, there is little overall change. No pleural effusions seen. | ['Change position of device', 'Add repetitions', 'False negation'] |
| 957c26f1-18da168e-71c98f71-7f791b2a-4cb759cb | 56494283 | 12185775 | Impression: Severe cardiomegaly and widened mediastinum are unchanged. Pulmonary edema has markedly improved. Retrocardiac opacities have improved consistent with improving atelectasis and small left effusion. There is no pneumothorax. Lines and tubes are in standard position. calcified granulomas in the left upper lobe are again noted. | Impression: Severe cardiomegaly and widened mediastinum are unchanged. Pulmonary edema has markedly improved. Retrocardiac opacities have improved consistent with improving atelectasis and small left effusion. There is right-sided pneumothorax. Lines and tubes are in standard position. calcified granulomas in the right upper lobe are again noted. | ['Change location', 'Add contradiction', 'False prediction'] |
| 45e31ec5-029d54e9-1acec167-663a1397-bccb2493 | 56614076 | 12185775 | Findings: As compared to the previous radiograph, there is a minimal decrease in extent of a pre-existing small right pleural effusion. Interstitial markings, on the other hand, are slightly increased, potentially reflecting increased interstitial fluid contents. Unchanged ___ of the cardiac silhouette. Unchanged basal areas of atelectasis, unchanged right venous introduction sheath. Also unchanged are left lung calcified granulomas. Overall, the findings indicate a mild increase in pulmonary edema. | Findings: As compared to the previous radiograph, there is a minimal decrease in extent of a pre-existing small left pleural effusion. Interstitial markings, on the other hand, are slightly increased, potentially reflecting increased interstitial fluid contratns. Unchanged size of the cardiac silhouette. Unchanged basal areas of atelectasis, unchanged right venous introduction sheath. Also unchanged are left lung calcified granulomas. Overall, the findings indicate a mild increase in pulmonary edema. An ET tube is seen in the trachea. | ['Change location', 'Add typo', 'Add medical device'] |
| 98bf2cef-0c6a64e5-89934255-e10b6ef7-c38474b7 | 57024984 | 12185775 | Findings: Right upper and lower lobe opacities are new since the prior day, with indistinctness of the pulmonary vessels, suggesting pulmonary edema. However, concurrent pneumonia cannot be excluded, in the correct clinical setting. The right PICC line terminates in the lower SVC, and the ET tube terminates 4.5 cm above the carina. Unchanged calcified pulmonary granulomas in the left lung. No pneumothorax. Stable cardiomediastinal borders. Impression: New right upper and lower lobe opacities with indistinctness of the pulmonary vessels suggests pulmonary edema. However, in the correct clinical setting, concurrent pneumonia cannot be excluded. | Findings: Right upper and lower lobe opacities are new since the prior day, with indistinctness of the pulmonary vessels, suggesting pulmonary edema. However, concurrent pneumonia cannot be ecluded, in the correct clinical setting. The right PICC line terminates in the lower SVC, and the ET tube terminates 5.4 cm above the carina. Unchanged calcified pulmonary granulomas in the left lung. No pneumothorax. Stable cardiomediastinal borders. A pacemaker is present. Impression: New right upper and lower lobe opacities with indistinctness of the pulmonary vessels suggests pulmonary edema. However, in the correct clinical setting, concurrent neumonia cannot be excluded. | ['Change measurement', 'Add typo', 'Add medical device'] |
| 135f90e3-562abed8-10d18797-fc0fc641-ea889ffb | 57164346 | 12185775 | Impression: AP chest compared to ___, 6:56 p.m.: Previous mild pulmonary edema has cleared from the right lung, improving on the left. Small left pleural effusion has increased. No appreciable right pleural effusion. Moderate cardiomegaly has improved. Tip of the endotracheal tube is no less than 4.5 cm above the carina, in standard placement. Swan-Ganz catheter ends in the right descending pulmonary artery and care should be taken that it not advance any further when it is not in the wedge position. Nasogastric tube passes into the distal stomach and out of view. No pneumothorax. | Impression: AP chest compared to ___, 6:56 p.m.: Previous mild pulmonary edema has cleared from the right lung, improving on the left. No pleural effusion is observed. No appreciable right pleural effusion. Moderate cardiomegaly has improved. Tip of the endotracheal tube is no less than 3.5 cm above the carina, in standard placement. Swan-Ganz catheter ends in the right descending pulmonary artery and care should be taken that it knot advance any further when it is not in the wedge position. Nasogastric tube passes into the distal stomach and out of view. No pneumothorax. | ['Change measurement', 'Change to homophone', 'False negation'] |
| 552b9cdb-02b1e116-417a8a56-d2f54f1e-865a2a0c | 57463116 | 12185775 | Impression: AP chest compared to ___ and ___, 9:25 a.m.: Tip of the endotracheal tube is at the upper margin of the clavicles, 6 cm from the carina. It could be advanced 2 cm for more secured seating. Severe cardiomegaly is worse. Mild interstitial edema persists. Severe opacification of the left lower lung could be atelectasis and pleural effusion but raises concern for pneumonia. Pleural effusion, at least moderate on the right, is unchanged. No pneumothorax. Swan-Ganz catheter ends in the right pulmonary artery and a nasogastric tube passes below the diaphragm and out of view. No pneumothorax. | Impression: AP chest compared to ___ and ___, 9:25 a.m.: Tip of the endotracheal tube is at the upper margin of the clavicles, 5 cm from the carina. It could be advanced 2 cm for more secured seating. Severe cardiomegaly is worse. Mild interstitial edema persists. Severe opacification of the left lower lung could be atelectasis and pleural effusion but raises concern for pneumonia. Pleural effusion, at least moderate on the right, is unchanged. No pneumothorax. Swan-Ganz catheter ends in the right pulmonary artery and a nasogastric tube passes below the diaphragm and out of view. No pneumothorax.No pneumothorax. | ['Change measurement', 'Add repetitions', 'False prediction'] |
| a7d5115b-c9749937-8502636c-ce1d2580-57e370dc, e3ee1499-119d0bc0-6cddf725-9d2d60d8-d34f9fc7 | 57910301 | 12185775 | Findings: The ET and NG tubes have been removed. A right PICC line terminates in the low SVC. Calcified left lung nodules are unchanged. The lungs are otherwise clear except for left basilar atelectasis. A small left pleural effusion has developed. Moderate cardiomegaly is unchanged. Impression: No evidence of pulmonary edema. Increased small left pleural effusion. Stable moderate cardiomegaly. | Findings: The ET and NG tubes have been removed. A right PICC line terminates in the right atrium. No left lung nodules are seen. The lungs are otherwise clear except for left basilar atelectasis. A small left pleural effusion has developed. Moderate cardiomegaly is unchanged. Impression: No evidence of pulmonary edema. No pleural effusion. Stable moderate cardiomegaly. | ['Change position of device', 'Add contradiction', 'False negation'] |