dicom_id,study_id,subject_id,original_report,error_report,errors_sampled
70d7e600-373c1311-929f5ff9-23ee3621-ff551ff9,50084553,10003502,"Impression: Compared to chest radiographs since ___, most recently ___.  Large right and moderate left pleural effusions and severe bibasilar atelectasis are unchanged.  Cardiac silhouette is obscured.  No pneumothorax.  Pulmonary edema is mild, obscured radiographically by overlying abnormalities.","Impression: Compared to chest radiographs since ___, most recently ___.  Large right and mild left pleural effusions and moderate bibasilar atelectasis are unchanged.  Cardiac silhouette is obscured.  No pneumothorax.  Pulmonary edema is mild, obscured radiographically by overlying abnormalities.  A central venous line is present.  No pneumothorax.","['Change severity', 'Add repetitions', 'Add medical device']"
"1fa79752-9ddaf5b5-2120ae82-9fec50d6-51f48d1f, a8319f39-9eef5bb2-5bd95b97-9dd70b0f-02a846e3",51180958,10003502,"Findings: No evidence of consolidation to suggest pneumonia is seen.  There is some retrocardiac atelectasis.  A small left pleural effusion may be present.  No pneumothorax is seen.  No pulmonary edema.  A right granuloma is unchanged.  The heart is mildly enlarged, unchanged.  There is tortuosity of the aorta. ","Findings: No evidence of consolidation to suggest pneumonia is seen. There is some retrocardiac atelectasis. A small left pleural effusion may be present. No pneumothorax is seen. Patchy opacities are noted in the upper lobes. A right granuloma is unchanged. The heart is mildly enlarged, unchanged. There is tortuosity of the ascending aorta.","['Change location', 'Change to homophone', 'False prediction']"
"489faba7-a9dc5f1d-fd7241d6-9638d855-eaa952b1, 550e6f3b-f008c1d0-8d2dee2a-649b30f4-101a98cc",52139270,10003502,"Findings: There are moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation not excluded.  Mild prominence of the interstitial markings suggests mild pulmonary edema.  The cardiac silhouette is mildly enlarged.  The mediastinal contours are unremarkable.  There is no evidence of pneumothorax. Impression: Bilateral pleural effusions, cardiomegaly and mild edema suggest fluid overload, however, given the clinical history, underlying consolidation due to pneumonia cannot be excluded at the lung bases.","Findings: There are large bilateral pleural effusions with overlying atelectasis, underlying consolidation not excluded.  Mild prominence of the interstitial markings suggests moderate pulmonary edema.  The cardiac silhouette is mildly enlarged.  The mediastinal contours are unremarkable.  There is no evidence of pneumothorax. There is no evidence of pneumothorax. Impression: Bilateral pleural effusions, cardiomegaly and mild edema suggest fluid overload, however, given the clinical history, underlying consolidation due to pneumonia cannot be excluded at the lung bases. An osteolytic lesion in the left humerus is noted.","['Change severity', 'Add repetitions', 'False prediction']"
e0275ad1-1e6a7451-c3960f5f-1267a188-547b73a1,52309364,10003502,"Findings: Moderate to large bilateral pleural effusions are again seen, likely right greater than left.  There is suspected superimposed pulmonary edema may have slightly improved since prior although detailed evaluation is limited given layering pleural effusions.  Vasculature appears less engorged.  Cardiac silhouette cannot be assessed. Impression: Mild to large bilateral, right greater than left pleural effusions.   Degree of pulmonary edema may have slightly improved since prior exam although detailed evaluation is limited.","Findings: Mild to large bilateral pleural effusions are again seen, likely right greater than left.  There is suspected superimposed pulmonary edema that has significantly worsened since prior although detailed evaluation is limited given layering pleural effusions.  Vasculature appears more engorged.  Cardiac silhouette is within normal limits. Impression: Moderate to large bilateral, right greater than left pleural effusions.   Degree of pulmonary edema may have significantly worsened since prior exam although detailed evaluation is limited.","['Change severity', 'Add contradiction', 'False prediction']"
eb2fabb7-4bbc8aab-d7371282-08e5bcb5-de2e430a,53282957,10003502,"Findings: Heart size is difficult to assess given the presence of moderate to large bilateral pleural effusions, but appears at least moderately enlarged.  The mediastinal contours are grossly unremarkable.  Perihilar haziness with vascular indistinctness and diffuse alveolar opacities are compatible with moderate pulmonary edema.  Bibasilar compressive atelectasis is demonstrated.  No pneumothorax is seen.  Moderate multilevel degenerative changes are noted in the thoracic spine. Impression: Moderate pulmonary edema with moderate to large bilateral pleural effusions and bibasilar atelectasis.","Findings: Heart size is difficult to assess given the presence of mild bilateral pleural effusions, but appears at least moderately enlarged.  The mediastinal contours are grossly unremarkable.  Perihilar haziness with vascular indistinctness and diffuse alveolar opacities are compatible with mild pulmonary edema.  Bibasilar compressive atelectasis is demonstrated.  No pneumothorax is seen.  No multilevel degenerative changes are noted in the thoracic spine. Impression: Moderate pulmonary edema with no bilateral pleural effusions and bibasilar atelectasis.","['Change severity', 'Add contradiction', 'False negation']"
371aaea8-195e21b2-ba5a2856-54803ecf-1b72d88b,53836463,10003502,"Findings: The bilateral pleural effusions, lower lobe volume loss, and dense lower lobe opacity compatible with a combination of volume loss/infiltrate/effusion.  The heart continues to be moderately enlarged.  There is mild vascular redistribution. Impression: CHF, slightly worse than on the prior study.","Findings: The bilateral pleural effusions, lower lobe volume loss, and dense lower lobe opacity compatible with a combination of volume loss/infiltrate/effusion.  The heart continues to be mildly enlarged.  There is moderate vascular redistribution. There is a small left pneumothorax. Impression: CHF, slightly worse than on the prior dtudy.","['Change severity', 'Add typo', 'False prediction']"
"31d9847f-987fcf63-704f7496-d2b21eb8-63cd973e, b410634d-0e4278d7-9c9b3561-8f5e5fc4-34a6aac8",57641661,10003502,"Findings: Frontal and lateral views of the chest.  Size of the bilateral effusions, left greater than right has slightly decreased in size since prior exam.  There is less pulmonary vascular congestion on the current exam as well.   Cardiac silhouette which appears enlarged, is unchanged.  No acute osseous abnormality is detected. Impression: Persistent small bilateral effusions, larger on the left which have decreased in size.  Decreased pulmonary vascular congestion.  No evidence of superimposed acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest.  Size of the bilateral effusions, left greater than right has moderately decreased in size since prior exam.  There is less pulmonary vascular congestion on the current exam as well.  Cardiac silhouette which appears enlarged, is unchanged.  No acute osseous abnormality is detected.  Size of the bilateral effusions, left greater than right has moderately decreased in size since prior exam..Impression: No bilateral effusions.  Decreased pulmonary vascular congestion.  No evidence of superimposed acute cardiopulmonary process.","['Change severity', 'Add repetitions', 'False negation']"
1efa55e3-0a3856d9-421024b8-408fa7e5-81d83c1e,57812613,10003502,"Findings: There is a moderate-sized left pleural effusion which is increased in size from the prior exam in ___.  There is no right pleural effusion.  The lungs are clear without pulmonary edema, consolidation, or pneumothorax.  A small calcified granuloma in the right mid-to-lower lung zone is unchanged from prior exams.  The cardiac size is mildly enlarged, unchanged from prior exams.  Mediastinal contours are normal.  The aorta is tortuous with mild calcifications.  Degenerative changes of the lower thoracic and upper lumbar spine are unchanged. Impression: 1.  Enlarging moderate left pleural effusion. 2.  Stable right calcified granuloma. 3.  Stable mild cardiomegaly.","Findings: There is a mild-sized left pleural effusion which is increased in size from the prior exam in ___.  There is no right pleural effusion.  The lungs are clear without pulmonary edema, consolidation, or pneumothorax.  A small calcified granuloma in the right mid-to-lower lung zone is unchanged from prior exams.  The cardiac size is mildly enlarged, unchanged from prior exams.  Mediastinal contours are normal.  The aorta is tortuous with mild calcifications.  Degenerative changes of the lower thoracic and upper lumbar spine are unchanged.  The cardiac size is mildly enlarged, unchanged from prior exams.  Impression: 1.  No pleural effusion. 2.  Stable right calcified granuloma. 3.  Stable mild cardiomegaly.","['Change severity', 'Add repetitions', 'False negation']"
"537d5240-7ea880c9-7e16b990-f04ef406-c7fe5066, 822ea266-47279ea1-f37382a9-0e32ce11-fc3d643a",50281931,10072167,"Findings: As compared to the previous radiograph, there is no relevant change.  Normal lung volumes.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal structures.  Minimal scarring at the lateral aspects of the right lung.  No lung nodules or masses suggesting metastatic disease.  No pleural effusions.  No diffuse or focal lung parenchymal disease. ","Findings: As compared to the previous radiograph, there is no relevant change.  Normael lung volumes.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal structures.  Substantial scarring at the lateral aspects of the right lung.  No lung nodules or masses suggesting metastatic disease.  No pleural effusions.  Diffuse alveolar infiltrates in the right lung.  ","['Change severity', 'Add typo', 'False prediction']"
"0f3224d0-b72c37a0-b9d8b5e4-ec922787-44f841ac, 4359fd68-d9a2137b-df64aa37-2868a0c5-f0febbee",53950117,10072167,"Findings: Heart size is normal. Aorta is tortuous.  Decrease in lung volume.  However, the Lungs are clear. There is no pleural effusion or pneumothorax. Impression: No evidence of metastatic disease in the thorax, within the limitations of chsst radiograph.","Findings: Heart size is normal. Aorta is tortuous. Decrease in lung volume. However, the Lungs are clear. There is no pleural effusion or pneumothorax. Aorta is tortuous. There is a Pacemaker present. Impression: No evidence of metastatic disease in the thorax, within the limitations of chest radiograph.","['Add repetitions', 'Change to homophone', 'Add medical device']"
"250a78d4-af5baabd-28ba3b84-13941316-dc3f1d7d, e586ee12-2cf30962-9c160a3e-17ac12bd-ebb403be",55283974,10072167,"Impression: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease.  No pneumonia, vascular congestion, or pleural effusion. Specifically, at the limits of plain radiography, there is no evidence of pulmonary or skeletal metastasis.","Impression: In comparison with the study of ___, there is little change with new evidence of left lower lobe pneumonia.  Possibly moderate vascular congestion.  Specifically, at the limits of plain radiography, there is no evidence of pulmonary or skeletal metastasis.  A right-sided pleural effusion is also noted. ","['False prediction', 'Add contradiction', 'Add medical device']"
"2d783c8a-492984b7-28aaf571-bfc30156-61ab26f6, 4cfccdcb-122eefe2-ccd1cbbd-c93635de-eda3823c",51010496,10075925,"Findings: Mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema are new compared with the prior study.  Mild cardiomegaly has increased compared with the immediate prior study.  There is no pleural effusion, pneumothorax, or focal consolidation.  The cardiomediastinal contour is stable The osseous structures and upper abdomen are unremarkable. Impression: New mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema and increased mild cardiomegaly.  No focal consolidation.","Findings: Moderate pulmonary vascular congestion with mild to moderate interstitial pulmonary edema are new compared with the prior study.  Moderate cardiomegaly has increased compared with the immediate prior study.  There is no pleural effusion, pneumothorax, or focal consolidation.  The cardiomediastinal contour is stable The osseous structures and upper abdomen are unremarkable.  No focal consolidation. Impression: No pulmonary vascular congestion with mild to moderate interstitial pulmonary edema and increased mild cardiomegaly.  No focal consolidation.","['Change severity', 'Add repetitions', 'False negation']"
"dbd34ffe-85795554-0531cdd9-ac757c62-46a7e259, eaef7f7a-a5d2ccdb-8098c68a-6d425309-06049ede",51856263,10174198,"Findings: Lungs are clear without consolidation, effusion, or pneumothorax.  The cardiomediastinal silhouette is within normal limits.  No displaced fractures. Impression: No acute cardiopulmonary process.","Findings: Lungs are clear without consolidation, effusion, or pneumotharax.  The cardiomediostinal silhouette is within normal limits.  No displaced fractures. A small left pleural effusion is noted. Impression: No acute cardiopulmonary processes. ","['Add typo', 'Change to homophone', 'False prediction']"
"2aafe5ea-12d26b26-972e16c4-ff3d0f9a-ae75d498, 707c7ae4-04900b82-789fd588-1d86b741-ec38124b",50438069,10190940,Impression: Comparison to ___.  No relevant change.  Minimally increased atelectasis at the left lung bases.  Unchanged known elevation of the left hemidiaphragm and moderate cardiomegaly as well as signs of generalized fluid overload.  No new focal parenchymal opacities.  No evidence of pneumonia on the frontal and lateral radiograph.,Impression: Comparison to ___.  Increased abnormalities detected.  Minimally increased atelectasis at the left lung bases.  New elevation of the left hemidiaphragm and mild cardiomegaly as well as signs of a pacemaker in situ.  No new focal parenchymal opacities.  Evidence of pneumonia on the frontal and lateral radiograph.,"['Change severity', 'Add contradiction', 'Add medical device']"
"13490b6f-3eb75751-a191991b-e8f33cad-e423992c, 49f3fbfe-cb406005-e8999546-2f5f2217-cd346108",51351116,10190940,Findings: The left hemidiaphragm is elevated.  Cardiomegaly is stable.  There is bibasilar atelectasis.  No pleural effusion or pneumothorax is seen. The left-sided port terminates at the distal SVC. Impression: No evidence of pneumonia.  No acute cardiopulmonary process.,"Findings: The right hemidiaphragm is elevated.  Cardiomegaly is stable.  There is bibasilar atelctasis.  No pleural effusion or pneumothorax is seen. The left-sided port terminates at the distal SVC, and a right-sided central venous line is observed. Impression: No evidence of pneumonia.  No acute cardiopulmonary process.","['Change location', 'Add typo', 'Add medical device']"
e1b3bcbc-dc7e3b4d-cf3958a9-8357851c-6ec58b21,51877987,10190940,"Impression: Moderate cardiomegaly is accompanied by pulmonary and mediastinal vascular engorgement but no pulmonary edema or consolidation.  Elevation of the left lung base posteriorly reflects scarring or linear atelectasis.  There no findings to suggest acute chest syndrome or pneumonia and the cardiovascular findings could be chronic, but we have no priors studies with which to compare.  A left central venous infusion pump catheter ends close to the superior cavoatrial junction.","Impression: Moderate cardiomegaly is accompanied by pulmonary and mediastinal vascular engorgement but no pulmonary atelectasis or consolidation.  Elevation of the left lung base posteriorly reflects scarring or linear atelectasis with a small right-sided pleural effusion.  There no findings to suggest acute chest syndrome or pneumothorax, and the cardiovascular findings could be chronic, but we have no prior studies with which to compare.  A left central venous infusion pump catheter ends close to the junction of the inferior vena cava and right atrium.","['Change position of device', 'Change to homophone', 'False prediction']"
ff7d1ad3-f6e1cd09-288ac039-d69f45d4-8ebbacf3,52908323,10198310,"Impression: Cardiomegaly is severe, unchanged.  Pacemaker leads are unchanged.  There is interval progression of vascular congestion and interstitial pulmonary edema.  No pneumothorax.  No atelectasis.  Subcutaneous air within the left chest wall is minimal.",Impression: Cardiomegaly is absent.  Pacemaker wires extend 6 cm from the right atrium.  There is no interstitial pulmonary edema.  No pneumothorax.  No atelectsasis.  Subcutaneous air within the left chest well is minimal.,"['Change position of device', 'Add typo', 'False negation']"
b0957f5e-2da32f5e-3f46e685-8b05a23b-25c97471,53321855,10198310,Findings: Lungs are fully expanded and clear. No pleural abnormalities.  Severe cardiomegaly and cardiomediastinal hilar silhouettes are unchanged.  Pacemaker and ICD leads are unchanged in position.  No evidence of displaced rib fracture. Impression: No evidence of rib fracture.  Pacemaker and ICD leads are unchanged in position.,Findings: Lungs are fully expanded and clear.  No pleural abnormalities.  Severe cardiomegaly and cardiomediastinal hilar silhouettes show significant changes. Pacemaker and ICD leads are repositioned in the left atrium. No evidence of displaced rib fracture.  Pacemaker and ICD leads are unchanged in position. Impression: No evidence of rib fracture.  Pacemaker and ICD leads are unchanged in position.  There is a faint shadow suggesting the possibility of a pulmonary nodule.,"['Change position of device', 'Add repetitions', 'False prediction']"
c4231749-4328dd96-eabe1197-d473f365-9b6602bc,54296371,10198310,"Impression: Comparison to ___.  The pacemaker leads are in correct position.  No complications, notably no pneumothorax.  Stable moderate cardiomegaly.  Stable mild elongation of the descending aorta and minimal retrocardiac atelectasis.  No pneumothorax.  No larger pleural effusions.","Impression: Comparison to ___.  The pacemaker leads are located in the right ventricle.  No complications, notably no pneumothorax.  Stable moderate cardiomegaly.  Stable mild elongation of the descending aorta and minimal retrocardiac atelectasis.  Mild pulmonary edema is present.  No larger pleural effusions.","['Change position of device', 'Add contradiction', 'False prediction']"
769fd8c6-0c20f1bf-86fa9850-b0b58e74-054967d1,55018013,10198310,"Impression: Compared to chest radiographs since ___, most recently ___ and postoperative radiographs ___.  Since ___, pulmonary vascular congestion has improved, mild pulmonary edema has resolved, but severe cardiomegaly is stable.  Pleural effusions are small if any.  No pneumothorax.  3 transvenous atrioventricular pacer leads, at least 2 of which are or found are unchanged in their respective positions since ___.  2 new epicardial leads project over the left heart border.  New left pleural thickening partially hidden by the new left pectoral generator is a probably a small amount of bleeding associated with lead placement.  There is no mediastinal widening or pneumothorax.  Lungs are low in volume but clear of any focal abnormality.","Impression: Compared to chest radiographs since ___, most recently ___ and postoperative radiographs ___.  Since ___, pulmonary vascular congestion has slightly worsened, mild pulmonary edema has resolved, but severe cardiomegaly is stable.  Pleural effusions are large if any.  No evidence of severe pneumothorax.  3 transvenous temporary pacing leads, at least 2 of which are unchanged in their respective positions since ___.  2 new external leads project over the left heart border.  New left pleural thickening partially hidden by the new left pectoral generator is probably a small amount of bleeding associated with pacemaker placement.  There is mediastinal widening or pneumothorax.  Lungs are low in volume but clear of any focal abnormality.","['Change name of device', 'Add contradiction', 'False prediction']"
"691d5bdf-502c05bd-000c22a0-9be0768d-e13bb54d, a94f823a-d1f6f5aa-de10d9b8-37f6c6c1-e9631495",57420501,10198310,Findings: PA and lateral views of the chest provided.   Left chest wall AICD is again seen with leads extending into the right atrium and right ventricle.  The heart is moderately enlarged.  Hila appearing or urged.  There is no overt pulmonary edema.  No large effusion or pneumothorax.  No focal consolidation concerning for pneumonia.  The mediastinal contour is stable.  Bony structures are intact.  No free air below the right hemidiaphragm seen. Impression: Moderate cardiomegaly with pulmonary vascular congestion.,Findings: PA and lateral views of the chest provided.   Left chest wall AICD is again seen with leads extending into the right atrium and right ventricle.  The heart is severely enlarged.  Hila appearing or urged.  Mild pulmonary edema.  No large effusion or pneumothorax.  No focal consolidation concerning for pneumonia.  The mediastinal contour is stable.  Bony structures are intact.  No free air below the right hemidiaphragm seen. Impression: Moderate cardiomegaly with pulmonary vascular congestion. An NG tube is noted with its tip in the stomach.,"['Change severity', 'Add contradiction', 'Add medical device']"
3971a847-5fdaeaec-226d2538-7ef67cf3-d5955a86,59538225,10198310,"Impression: In comparison with the study of ___, there appears to be a new pacer generator in place with what appear to be epicardial leads in the region of the left ventricle.  No evidence of post procedure pneumothorax. There are lower lung volumes that may be accentuating the pulmonary vascularity.","Impression: In comparison with the study of ___, there appears to be a new pacer generator in place with what appear to be epicardial leads in the region of the right ventricle. There is no evidence of post procedure pneumothorax. There are lower lung volumes that may be accentuating the pulmonary vessel. There is a small left pleural effusion noted.","['Change location', 'Change to homophone', 'False prediction']"
"121773ed-56eae249-ca58c72b-26c66aae-88b837e5, 9203c21e-1b06abe0-e6fadf69-3d70d893-249f5a2b",51438218,10199765,"Findings: Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. No focal consolidation seen elsewhere. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No overt pulmonary edema is seen. Chronic changes at the right acromioclavicular joint are not well assessed. Impression: Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation.","Findings: Subtle patchy opacity along the right heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. No focal consolidation seen elsewhere. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No overt pulmonary edema is seen. Chronic changes at the right acromioclavicular joint are not well assessed. An NG tube is in place. Impression: Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. There is no pleural effusion or pneumothorax.","['Change location', 'Add repetitions', 'Add medical device']"
53875428-43e38b4f-4474877c-8f58e8c1-9a189004,56226668,10199765,Impression: No relevant change as compared to the previous image.  Moderate cardiomegaly. Mild central enlargement of the pulmonary arteries. No pleural effusions. No parenchymal opacities. No pneumothorax.,Impression: No relevant change as compared to the previous image. Mild cardiomegaly. Mild central enlargement of the pulmonary arteries. No pleural effusions. No parenchymal opacities. No pneumothorax. Mild central enlargement of the pulmonary arteries. Presence of a central venous line.,"['Change severity', 'Add repetitions', 'Add medical device']"
b7b5e3b9-d55d332f-ebd0edf9-b48553d6-376f7a96,56874598,10199765,"Impression: As compared to the previous radiograph, no relevant change is seen. Moderate cardiomegaly. Mild tortuosity of the descending aorta.  No pleural effusions. No pneumonia, no pulmonary edema.","Impression: As compared to the previous radiograph, no relevant change is scene. Severe cardiomegaly. Mild tortuosity of the descending aorta.  No pleural effusions. No pneumonia, no pulmonary edema. A central venous line is present.","['Change severity', 'Change to homophone', 'Add medical device']"
"b313c405-d9c8a648-8b1f3762-edb5671b-8541118c, d98a4431-acba5ef8-f0c5fe0c-b1b0900e-13276d61",58927269,10244947,"Findings: AP upright and lateral views of the chest provided.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process.","Findings: AP upright and lateral views of the abdomne provided.  There is now focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the left hemidiaphragm is seen. A central venous line is present. Impression: No acute intrathoracis process.","['Change location', 'Add typo', 'Add medical device']"
"1f199273-2f4b7e8c-9041b5c2-18e7ca21-26142e3c, 4f0fdcd0-d9e08481-3d3c4e0d-76022ffd-270ef82f",51023457,10248673,Findings: No focal consolidation is seen.  There is elevation of the mid to posterior left hemidiaphragm with minimal blunting of the left costophrenic angle without a definite pleural effusion seen on the lateral view.  No evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  Evidence of DISH is seen along the spine.  No displaced fracture is seen. Impression: Elevated left hemidiaphragm and blunting of the left costophrenic angle although no definite evidence of pleural effusion seen on the lateral view.,Findings: No focal consolidation is seen.  There is moderate elevation of the mid to posterior left hemidiaphragm with minimal blunting of the left costophrenic angle without a definite pleural effusion seen on the lateral view.  Mild patchy consolidation in the lower lung fields is seen.  The cardiac and mediastinal silhouettes are unremarkable.  The mediastinal contours are abnormal.  Evidence of DISH is seen along the spine.  A minor nondisplaced fracture is seen. Impression: Elevated left hemidiaphragm and blunting of the left costophrenic angle although no definite evidence of pleural effusion seen on the lateral view. Moderate cardiomegaly.,"['Change severity', 'Add contradiction', 'False prediction']"
5af7f675-13339075-9c8b61d4-bf098f85-30636763,55182796,10248673,"Impression: 1.  Interval extubation.  Right internal jugular central line and left basilar chest tube remain in place.  Lung volumes are lower on the current examination.  There is patchy opacity at the left base with an associated effusion, likely reflecting compressive atelectasis.  No evidence of pulmonary edema.  Cardiac and mediastinal contours are difficult to assess due to the low lung volumes and patient rotation on the current study, although the mediastinal contours are likely unchanged.  Status post median sternotomy for CABG.  No pneumothorax.","Impression: 1.  Interval extubation.  Right internal jugular central line and right basilar chest tube remain in place.  Lung volumes are lower on the current examination. There is patchy opacity at the left base with an associated effusion, likely reflecting compressive atelectasis.  No evidence of pulmonary edema.  Cardiac and mediastinal contours are difficult to assess due to the low lung volumes and patient rotation on the current study, although the mediastinal contours are likely unchanged.  No patchy opacity seen.  No pneumothorax.","['Change location', 'Add repetitions', 'False negation']"
81d06e6f-8036e3cb-2cc3e83e-53754192-6adfd7ae,55680175,10248673,"Impression: 1.  Interval removal of the left chest tube.  No evidence of pneumothorax.  Right internal jugular central line has its tip in the distal SVC near the cavoatrial junction, unchanged.  Status post median sternotomy for CABG with stable postoperative cardiac and mediastinal contours.  There is elevation of the left hemidiaphragm with some adjacent streaky opacities, suggestive of atelectasis.  Blunting of the left costophrenic angle likely reflects a small effusion.  There is also possibly a tiny right pleural effusion.  No evidence of pulmonary edema.","Impression: 1. Interval removal of the left PICC line. No evidence of pneumothorax. Right internal jugular central line has its tip in the distal SVC near the cavoatrial junction, unchanged. Status post median sternotomy for CABG with stable postoperative cardiac and mediastinal contours. There is elevation of the left hemidiaphragm with some adjacent streaky opacities, suggestive of atelectasis. Blunting of the left costophrenic angle likely reflects a small effusion. There is also possibly a tiny right pleural effusion. No evidence of pulmonary edema. There is a dual-chamber pacemaker noted with leads terminating in the right atrium and right ventricle.","['Change name of device', 'Add repetitions', 'Add medical device']"
"24386f31-41e447f6-dd0abcfa-ac74f2fe-431699ec, 58fff15b-eb79f6d5-8c99f86c-74dcb1df-d63b2957",57118642,10253119,Findings: The lungs are clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,Findings: No nodular opacities.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Mild pulmonary edema noted. Impression: No acute cardiopulmonary process. No acute osseous abnormalities.,"['False negation', 'Add repetitions', 'False prediction']"
46583e03-f42311f4-87dca60a-c4c12f22-0fe13c7f,54512270,10261230,"Findings: No previous studies for comparison.  The heart size is within normal limits.  Lungs are grossly clear without definite consolidation, pleural effusions, or signs for acute pulmonary edema. There are no pneumothoraces. ","Findings: No previous studies for comparison.  The hart size is within normal limits.  Lungs are grossly clear without definite consolidation, pleural effusions, or sings for acute pulmonary edema. No consolidation noted. There are no pneumothoraces.","['Change to homophone', 'Add typo', 'False negation']"
"51051faa-2f20e284-0d88407b-8415e95b-9767e74e, 846d111d-b06db236-e8ad3b94-2d90a99b-82cea8a1",53799929,10269181,Findings: The lungs are clear without consolidation or edema.  The mediastinum is unremarkable.  The cardiac silhouette is within normal limits for size.  No effusion or pneumothorax is noted.  The visualized osseous structures are unremarkable. Impression: No acute pulmonary process.,Findings: The lungs are clear without consolidation or edema.  The mediastinum is unremarkable.  The cardiac silhouette is within normal limits for size.  No effusion or pneumothorax is noted.  The visualized osseous structures are unremarkable. Impression: Mild interstitial lung disease.  No acute pulmonary process.,"['Add contradiction', 'Add repetitions', 'False prediction']"
f2c7b3a4-c8299236-db971a34-5b06646b-233f91ae,58092224,10287742,"Impression: As compared to ___, there is unchanged evidence of mildly displaced right rib fractures.  The right pneumothorax.  Visualized on the CT examination from ___, is not visualized on the radiograph.  No pleural effusions.  No pulmonary edema.  No pneumonia.","Impression: As compared to ___, there is unchanged evidence of mildly displaced left rib fractures. The write pneumothorax. Visualized on the CT examination from ___, is not visualized on the radiograph. No pleural effusions. There is a small left-sided pleural effusion. No pneumonia.","['Change location', 'Change to homophone', 'False prediction']"
"4749ba05-564eff9b-d0d13d38-c614a53c-056ac9a7, 902eff2e-fa561f7b-5fa0f94e-e783fda8-9929d74a",59266404,10295064,Findings: PA and lateral views of the chest.  No prior.  The lungs are clear. Cardiomediastinal silhouette is normal.  Osseous structures are unremarkable. Impression: No acute cardiopulmonary process.,Findings: PA and lateral views of the chest. No prior. The right lung shows a small nodule. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable. Impression: No acute cardiopulmonary process. The lungs are clear. ,"['Change location', 'Add repetitions', 'False prediction']"
42fb9144-0cd336f1-4e3ecd64-a3e859ef-2647d4b0,55091382,10308375,"Findings: Interval increase in moderate-sized right pleural effusion, and right lower lobe opacity with new right upper lobe heterogeneous opacity. Unchanged left apical pleural thickening and scarring. No interval change in the dense retrocardiac opacity obscuring the left hemidiaphragm which represents a Bochdalek hernia.  No pneumothorax or pulmonary edema.  Heart size is partially obscured by the pleural parenchymal process.  Mediastinal contour and hila are normal.  No bony abnormality. Impression: 1. Interval increase in moderate-sized right pleural effusion.  2. Worsening right lower lobe opacity and new right upper lobe opacity are likely due to evolving pneumonia or aspiration.  Results were conveyed via telephone to primary team by Dr. ___ on ___ at 3:40 p.m. within 5 minutes of observation of findings.","Findings: Interval increase in mild-sized right pleural effusion, and right lower lobe opacity with new right upper lobe heterogeneous opacyty. Unchanged left apical pleural thickening and scarring. No interval change in the dense retrocardiac opacity obscuring the left hemidiaphragm which represents a Bochdalek hernia. No pneumothorax or pulmonary edema. Heart size is partially obscured by the pleural parenchymal process. Mediastinal contour and hila are normal. No bony abnormality. Impression: 1. No pleural effusion. 2. Worsening right lower lobe opacity and new right upper lobe opacity are likely due to evolving pneumonia or aspiration. Results were conveyed via telephone to primary team by Dr. ___ on ___ at 3:40 p.m. within 5 minutes of observation of findings.","['Change severity', 'Add typo', 'False negation']"
"18a4c626-d4481b14-559c1206-26f54875-dd74e59d, aa29a8f7-ec260779-8cb37967-7d5bb1e6-a623e93f",57023953,10308375,"Findings: Ill-defined patchy opacities are seen in the right lung base with an associated small right pleural effusion, which is also confirmed in the lateral view.  A dense left-sided retrocardiac opacity abutting the left hemidiaphragm is unchanged since at least ___ compatible with a Bochdalek hernia. A small left pleural effusion is also likely present. There is biapical pleuro-parenchymal scarring, more conspicuous in the left apex.  No other focal opacities are identified.  Mild cardiomegaly is unchanged from prior.  There is no pneumothorax. Impression: Right lower lobe pneumonia. Small bilateral pleural effusions.","Findings: Ill-defined patchy opacities are seen in the right lung base with an associated small right pleural effusion, which is also confirmed in the lateral view.  No dense left-sided retrocardiac opacity abutting the left hemidiaphragm is identified. A small left pleural effusion is also likely present. There is biapical pleuro-parenchymal scarring, more conspicuous in the left apex.  No other focal opacities are identified.  Severe cardiomegaly is unchanged from prior.  There is no pneumothorax. Impression: Mild right lower lobe pneumonia. No pleural effusions.","['Change severity', 'Add contradiction', 'False negation']"
5aab99c5-9eddcc03-d82c31f8-f7578391-c74b9f65,50223793,10337896,"Findings: Allowing for differences in technique and projection, there has been minimal change in the appearance of the chest except for apparent slight increase in bilateral pleural effusions, now moderate on the right and small to moderate on the left. ","Findings: Allowing for differences in technique and projection, there has been minimal change in the appearance of the chest except for apparent slight increase in bilateral pleural effusions, now mild on the right and small to moderate on the left. Additionally, there is evidence of mild pulmonary congestion.","['Change severity', 'Change to homophone', 'False prediction']"
47dd9117-4908216e-6fa039c8-2d7a1454-74151fad,50519407,10337896,"Findings: AP portable upright view of the chest.  Extensive intrathoracic calcifications are again seen, better localized on the chest CT examination from ___.  The heart size is top normal. A tracheostomy tube is appropriately positioned. A right PICC terminates at the caval atrial junction.  Again seen are bilateral pulmonary parenchymal opacities, with interval improvement along the right mid and lower zones since the ___ radiograph. Opacities across the left lung are unchanged. There is no pneumothorax. Small bilateral pleural effusions are stable. , Impression: Interval decrease of right pulmonary parenchymal opacities, reflecting improvement since ___.  Unchanged small bilateral pleural effusions.","Findings: AP portable upright view of the chest. Extensive intrathoracic calcifications are again seen, better localized on the chest CT examination from ___. The heart size is mildly enlarged. A tracheostomy tube is appropriately positioned. A right PICC terminates at the caval atrial junction. Again seen are bilateral pulmonary parenchymal opacities, with interval improvement along the right mid and lower zones since the ___ radiograph. Opacities across the left lung are unchanged. There is a small pneumothorax. Small bilateral pleural effusions are stable. A left-sided chest tube is present., Impression: Interval significant decrease of right pulmonary parenchymal opacities, reflecting improvement since ___. Large new bilateral pleural effusions.","['Change severity', 'Add contradiction', 'Add medical device']"
e5cd4468-946415a5-4559575d-56536274-59b03c5d,50880103,10337896,"Impression: Findings on the chest CT ___ showed probable multi focal pneumonia, predominantly in the right lung, and mild interstitial edema. Edema improved between ___ and ___, and then opacification in the right lung increased again accompanied by increasing moderate right pleural effusion. The progression of these associated findings this suggested that the interval change was primarily due to cardiac decompensation. Today edema has worsened in both lungs, and the moderate right pleural effusion is larger, although the opacification in the left lower lung is heterogeneous enough to suggest concurrent pneumonia or large scale aspiration. . Mild cardiomegaly and chronic mediastinal widening are chronic.","Impression: Findings on the chest CT ___ showed probable multi focal pneumonia, predominantly in the right lung, and moderate interstitial edema. Edema improved between ___ and ____, and then opacification in the right lung increased again accompanied by increasing moderate right pleural effusion. The progression of these associated findings this suggestd that the interval change was primarily due to cardiac decompensation. No edema seen in both lungs, and the moderate right pleural effusion is larger, although the opacification in the left lower lung is heterogeneous enough to suggest concurrent pneumonia or large scale aspiration. No cardiomegaly seen.","['Change severity', 'Add typo', 'False negation']"
ac8d6143-a581f133-eafa59da-4f66bc75-4693997c,53275640,10337896,"Findings: The tracheostomy tube is unchanged in position and terminates approximately 4.8 cm above the carina.  The right PICC line terminates in the distal SVC. There is no significant change in the lungs when compared to ___. There are several parenchymal calcifications which were characterized on the most recent CT scan. Again noted are diffuse infiltrative parenchymal opacities, right worse than left; this is largely due to pulmonary edema and the right-sided pleural effusion, but underlying pneumonia cannot be excluded. The mediastinum is wide, which was noted as far back as the outside hospital CXR from ___. No acute osseous abnormalities. Impression: 1. Moderate pulmonary edema, unchanged. 2. Interval improvement in right-sided pleural effusion.","Findings: The tracheostomy tube is unchanged in position and terminates approximately 5.3 cm above the carina. The right PICC line terminates in the distal SVC. There is no significant change in the lungs when compared to ___. There are several parenchymal calcifications which were characterized on the most recent CT scan. Again noted are diffuse infiltrative parenchymal opacities, right worse than left; this is largely due to pulmonary edema and the right-sided pleural effusion, but underlying pneumonia cannot be excluded. The mediastinum is wide, which was noted as far back as the outside hospital CXR from ___. There is no significant change in the lungs when compared to ___. No acute osseous abnormalities. There is a small pneumothorax in the apex of the left lung. Impression: 1. Moderate pulmonary edema, unchanged. 2. Interval improvement in right-sided pleural effusion.","['Change measurement', 'Add repetitions', 'False prediction']"
15034ac9-409361f3-6164c82a-a854b0cb-06ae3a8d,53323373,10337896,"Impression: In comparison with the study of ___, there is little change. Diffuse bilateral pulmonary opacification with areas of calcificationpersist with bilateral pleural effusions and no change in the monitoring and support devices.","Impression: In comparison with the study of ___, there is litle change. Diffuse unilateral pulmonary opacification with areas of calcification persist with bilateral pleural effusions and no change in the monitoring and support devices. Presence of an NG tube in the left lung field.","['Change location', 'Add typo', 'Add medical device']"
e7f2ad9b-a5698623-14f87c8b-47a99b0b-31959f7a,53482443,10337896,"Impression: Endotracheal tube and right internal jugular central line are unchanged position.  Nasogastric tube is seen coursing to the level of the distal esophagus but the tip is not identified. Multiple calcified lymph nodes, multiple bilateral calcified parenchymal opacities and pleural calcifications are unchanged consistent with prior granulomatous infection. Given the extensive parenchymal abnormality, this does limit the sensitivity of plain radiography.  Bilateral apical pleural thickening, left greater than right, which is unchanged. There are stable bilateral layering effusions, left greater than right, with probable associated compressive atelectasis in the lower lobes.  No overt pulmonary edema.  Heart remains stably enlarged.  Bilateral glenohumeral degenerative changes with deformity of the left humeral head.","Impression: Nasogastric tube and right internal jugular central line are unchanged position.  Nasogastric tube is seen coursing to the level of the distal esophagus but the tip is not identified. Multiple calcified lymph nodes, multiple bilateral calcified parenchymal opacities and pleural calcifications are unchanged consistent with prior granulomatous infection. Given the extensive parenchymal abnormality, this does limit the sensitivity of plain radiography.  Bilateral apical pleural thickening, left greater than right, which is unchanged. There are stable bilateral layering effusions, left greater than right, with probable associated compressive atelectasis in the lower lobes. Nasogastric tube is seen coursing to the level of the distal esophagus but the tip is not identified. No overt pulmonary edema.  Heart remains stably enlarged.  Bilateral glenohumeral degenerative changes with deformity of the left humeral head.  A left-sided dual-chamber pacemaker device with leads terminating in the atrium and ventricle.","['Change name of device', 'Add repetitions', 'Add medical device']"
58ac68b5-24c8cb7d-62f38524-4c03808a-0329f3c6,53778461,10337896,"Findings: Multiple calcified pulmonary nodules and calcified lymph nodes within the neck. Severe degenerative changes of the glenohumeral joints. Bilateral pleural effusions with bibasilar atelectasis. Developing bibasilar consolidation is difficult to exclude. No pneumothorax. Impression: Small bilateral pleural effusions with passive atelectasis. Developing bibasilar consolidations are difficult to exclude.  Redemonstrated densities within the lung parenchyma and neck, possibly secondary to prior granulomatous disease.",Findings: Multiple calcified pulmonary nodules and calcified lymph nodes within the neck. Mild degenerative changes of the glenohumeral joints. Bilateral pleural effusions with bibasilar atelectasis. Developing bibasilar consolidation is difficult to exclude. No pneumothorax. Impression: Small bilateral pleural effusions with passive atelectasis. Developing bibasilar consolidations are difficult to exclude. No densities within the lung parenchyma and neck.,"['Change severity', 'Add repetitions', 'False negation']"
c13cd8dd-8b083466-64564d12-69441e5d-7b8a2515,53799148,10337896,"Impression: Interval placement of an endotracheal tube which has its tip approximately 4.5 cm above the carina.  Nasogastric tube appears to be coursing below the diaphragm with the tip not identified. Right internal jugular central line is unchanged in position. Overall stable cardiac mediastinal contours. No interval change in the bilateral multiple calcified lymph nodes and parenchymal and pleural opacities. Unchanged layering bilateral effusions.  Asymmetric biapical pleural thickening, left greater than right, all is unchanged dating back to ___.  No pneumothorax.","Impression: Interval placement of an endotracheal tube which has its tip approximately 4.8 cm above the carina.  Nasogastric tube appears to be coursing below the diapgragm with the tip not identified. Right internal jugular central line is unchanged in position. Overall stable cardiac mediastinal contours. No interval change in the bilateral multiple calcified lymph nodes and parenchymal and pleural opacities. Unchanged layering bilateral effusions.  Asymmetric biapical pleural thickening, left greater than right, all is unchanged dating back to ___.  No pneumothorax. A pacemaker is also present within the chest cavity.","['Change measurement', 'Add typo', 'Add medical device']"
ffde91fb-1eb2b3c1-48e6008b-c16bd376-8a771f1b,54031658,10337896,"Impression: As compared to the previous radiograph, the parenchymal opacities ___ notably on the left, have moderately decreased in severity.  The monitoring and support devices are unchanged. Unchanged moderate cardiomegaly. Unchanged known intra and extra thoracic lymph node calcifications.","Impression: As compared to the previous radiograph, the parenchymal opacities ___ notably on the left, have mildly decreased in severity. The monitoring and support devices are unchanged. Unchanged moderate cardiomegaly. Unchanged known intra and extra thoracic lymph node calcifications. A central venous line is in place.","['Change severity', 'Change to homophone', 'Add medical device']"
1cf4fc4f-428e8580-055a5630-45455deb-5c72df9c,54785280,10337896,"Findings: An ET tube is present approximately 3.6 cm above the carina.  The enteric tube is present the distal tip off the film.  There is no pneumothorax. There are small bilateral effusions. Dense calcified opacities in both upper lung fields and hila are noted, consistent with prior history of tuberculosis. Atelectasis or consolidation of the lung bases are noted. Reticular changes are also noted, which may be acute or chronic. ","Findings: An ET tube is present approximately 3.5 cm above the carina.  The enteric tube is present with the distal tip visible in the film.  There is mild pneumothorax. There are moderate bilateral effusions. Dense calcified opacities in both upper lung fields and hila are noted, consistent with no history of tuberculosis. Atelectasis or consolidation of the lung bases are noted along with a pacemaker. Reticular changes are also noted, which may be chronic.","['Change measurement', 'Add contradiction', 'Add medical device']"
aa75e710-aee0e27e-b996e245-8bb737da-caa4ea7a,54966187,10337896,"Impression: In comparison with the study of ___, there is little change.  Monitoring and support devices remain in place. Diffuse bilateral pulmonary opacifications persist along with multiple dense calcifications.","Impression: In comparison with the study of ___, there is little change. Monitoring and support devices remain in place. Diffuse bilateral upper lobe pulmonary opacifications persist along with multiple dense calcifications. There is an ET tube in place. Impression: Improvement in bilateral pulmonary opacifications noted.","['Change location', 'Add contradiction', 'Add medical device']"
8c563705-ea74b74f-c379e0f7-91cd0b0e-b7ed81d8,55022783,10337896,"Impression: In comparison with the earlier study of this day, the monitoring and support devices are unchanged diffuse pulmonary opacification is processed and may be more prominent in the left base, suggesting some layering pleural effusion. .","Impression: In comparison with the earlier study of this day, the monitoring and support devices are unchanged diffuse pulmonary opacification is processed and may be more prominent in the right base, suggesting some layering pleural effusion. There is no pleural effusion. .","['Change location', 'Add typo', 'False negation']"
"3eb3bf96-c5401aea-07178eee-c43e5e80-600f6a33, 44bec237-520a0e5b-80e20d64-2c0a9036-c8766a81",55070875,10337896,"Findings: The NG tube not well visualized, but may pass into the abdomen. Diffuse bilateral pulmonary opacifications are again seen, unchanged from prior exam. ET tube and right IJ central line are in stable position from prior exam. Impression: NG tube not well visualized, but may pass into the abdomen.  If it is a better visualization is desired, repeat radiographs with abdominal technique can be performed.","Findings: The NG tube not well visualized, but may pass into the abdmen. Diffuse bilateral pulmonary opacifications are again seen, unchanged from prior exam. ET tube and right IJ central line are terminating at the mid SVC. Bibasilar atelectasis is noted. Impression: NG tube not well visualized, but may pass into the abdomen. If better visualization is desired, repeat radiographs with abdominal technique can be performed.","['Change position of device', 'Add typo', 'False prediction']"
ce5750a7-68ea7a3c-9170b26c-f86bd4a4-dea2e2f2,55705635,10337896,"Impression: Minimal interval improvement of the pre-existing right pleural effusion, with subsequent increase in transparency of the right lung base.  In the interval, the nasogastric tube has been removed.  No other relevant changes.","Impression: Minimal interval improvement of the pre-existing right pleural effusion, with subsequent increase in transparency of the right lung base.  In the interval, the endotracheal tube has been removed.  No other relevant changes.  In the interval, the endotracheal tube has been removed.  There remains a right-sided mediastinal mass.","['Change name of device', 'Add repetitions', 'False prediction']"
69edea97-d76e1e86-638a39dc-13ee8420-6f3385ef,55929666,10337896,"Impression: Endotracheal tube continues to have its tip approximately 4 cm above the carina. A right internal jugular central line is unchanged in position. Nasogastric tube appears to have pulled back into the mid esophagus. No interval change in appearance of the multiple calcified nodes, multiple calcified pleural plaques, and multiple calcified parenchymal opacities.  Layering effusions with retrocardiac opacity likely reflecting compressive atelectasis.  No pneumothorax.  Asymmetric biapical pleural thickening unchanged.  Bilateral humeral head degenerative changes with remodeling on the left.","Impression: Endotracheal tube continues to have its tip approximately 5 cm above the carina. A write internal jugular central line is unchanged in position. Nasogastric tube appears to have pulled back into the mid esophagus, and there is a noticeable pleural effusion on the left side. No interval change in appearance of the multiple calcified nodes, multiple calcified pleural plaques, and multiple calcified parenchymal opacities.  Layering effusions with retrocardiac opacity likely reflecting compressive atelectasis.  No pneumothorax.  Asymmetric biapical pleural thickening unchanged.  Bilateral humeral head degenerative changes with remodeling on the left.","['Change measurement', 'Change to homophone', 'False prediction']"
"48cf431a-5b1083d0-c462c8be-aa9fd33a-a36fd88d, 7fef0afd-85293903-b15562d2-3b827aee-1405b065",56165736,10337896,"Impression: As compared to the previous radiograph, there is a minimal increase in diameter of the vascular structures, likely reflecting increased fluid overload.  No other changes. The multiple known calcifications are constant in appearance. In the interval, the patient has received a tracheostomy tube. There is no pneumothorax.","Impression: As compared to the previous radiograph, there is a minimal increase in diameter of the vascular structures, likely reflecting increased fluid overload.  No other changes. The multiple known calcifcations are constant in appearance. No calcifications seen. In the interval, the patient has received a PICC line. There is no penumothorax.","['Change name of device', 'Add typo', 'False negation']"
c81c9275-d9fbf1b0-d61f3278-28a1d56b-6fc5dec5,56271118,10337896,"Findings: There is an ET tube which terminates 3.3 cm above the carina. The right IJ central venous catheter is in stable position with tip projecting over the low SVC. Again seen is an enteric tube with distal tip projecting below the lower limit of film, not visualized.  Allowing for changes in differences in rotation, the cardiomediastinal silhouette is unchanged. The bilateral hila are not well visualized.  There is again seen pulmonary vascular congestion and moderate pulmonary edema, possibly worsened in the left lung in comparison to prior radiograph.  There is stable pleural thickening most notable in the left apex. There are at least small bilateral layering pleural effusions, stable in size. There is unchanged appearance of multiple bilateral calcified lymph nodes as well as pleural and parenchymal calcifications.  There is no pneumothorax. Impression: Moderate pulmonary edema, possibly worse in the left lung most prominently.  Otherwise stable chest x-ray.","Findings: There is an ET tube which terminates 3.3 cm above the carina. The left IJ central venous catheter is in stable position with tip projecting over the low SVC. Again seen is an enteric tube with distal tip projecting below the lower limit of film, not visualized. Allowing for changes in differences in rotation, the cardiomediastinal silhouette is unchanged. The bilateral hila are not well visualized. There is again seen pulmonary vascular congestion and moderate pulmonary edema, possibly worsened in the right lung in comparison to prior radiograph. There is stable pleural thickening most notable in the left apex. There are at least small bilateral layering pleural effusions, stable in size. There is unchanged appearance of multiple bilateral calcified lymph nodes as well as pleural and parenchymal calcifications. There is no pneumothorax. There is a nasogastric tube with the tip in the stomach. Impression: Mild pulmonary edema, possibly worse in the left lung most prominently. Otherwise stable chest x-ray.","['Change location', 'Add contradiction', 'Add medical device']"
"4bfa0065-4e743c19-876b8f5d-7295f3b5-a37cc274, 7a04d256-8236b272-b4ccee81-b556f1dd-9df7b98a",56329890,10337896,"Findings: ET tube is seen in stable position 3.7 cm above the carina. Right IJ central venous catheter is in stable position projecting over the mid to lower SVC. Enteric tube is again seen coursing inferiorly with distal tip projecting approximately over the stomach, however side port is most likely above the GE junction, in comparison to prior radiograph.  The cardiomediastinal silhouette is unchanged in appearance. The bilateral hila are not well seen.  There is unchanged appearance of the bilateral lung parenchyma, with pulmonary vascular congestion and moderate pulmonary edema. There are unchanged small bilateral layering pleural effusions. There are stable multiple bilateral calcified lymph nodes, pleural and parenchymal calcifications.  There is no pneumothorax. Impression: 1. Enteric tube with side port projecting above the GE junction. ___ require advancement. Otherwise stable support structures. 2. Unchanged lung parenchyma and stable small bilateral layering pleural effusions.","Findings: ET tube is seen in stable position 1 cm above the carina. Right IJ central venous catheter is in stable position projecting over the mid to lower SVC. Enteric tube is again seen coursing inferiorly with distal tip projecting approximately over the stomach, however sid port is most likely above the GE junction, in comparison to prior radiograph.  The cardiomediastinal silhouette is unchanged in appearance. The bilateral hila are not well own.  There is unchanged appearance of the bilateral lung parenchyma. There are unchanged small bilateral layering pleural effusions. There are stable multiple bilateral calcified lymph nodes, pleural and parenchymal calcifications.  There is no pneumothorx. Impression: 1. Enteric tube with side port projecting above the GE junction. ___ require advancement. Otherwise stable support structures. 2. Unchanged lung parenchyma and stable small bilateral layering pleural effusions.","['Change position of device', 'Add typo', 'False negation']"
b6a12938-a1f0ed52-bca8e3f0-728b69ec-d2bc0a92,56437767,10337896,Findings: There has been interval placement of a right internal jugular line with tip terminating in the lower SVC.  There is no pneumothorax. There is no improvement in the lung fields since the recent prior study. ,Findings: There has been interval placement of a right internal carotid line with tip terminating in the lower SVC.  There is no pneumothorax. There is no improvement in the lung fields since the recent prior study. There is no improvement in the lung fields since the recent prior study. A left-sided pacemaker device is also noted with leads terminating in the right atrium.,"['Change name of device', 'Add repetitions', 'Add medical device']"
"15917c30-2a205e52-c91a4c3e-cd99632c-0e9d82d2, 603d88d1-87fcfddd-63120bbc-0d84d3ff-c0793f3e",56539620,10337896,"Impression: Interval extubation.  Nasogastric tube is seen coursing below the diaphragm with the tip not identified but at least within the stomach.  Right internal jugular central line is unchanged in position.  Multiple calcified lymph nodes, multiple bilateral calcified parenchymal opacities and pleural calcifications are unchanged consistent with prior granulomatous infection.  Bilateral layering effusions unchanged. Overall cardiac mediastinal contours are stable.  No pneumothorax.","Impression: Interval extubation. Nasogastric tube is seen coursing below the diaphragm with the tip not identified but at least within the esophagus. Right internal jugular central line is unchanged in state. Multiple calcified lymph nodes, multiple bilateral calcified parenchymal opacities and pleural calcifications are unchanged consistent with prior granulomatous infection. Bilateral layering effusions unchanged. Portable chest radiograph now demonstrates a new temporary pacemaker. Overall cardiac mediastinal contours are stable. No pneumonia.","['Change position of device', 'Change to homophone', 'Add medical device']"
f06a566d-44137a23-0a4acf0e-15f9c10d-4fcffff2,56623034,10337896,"Impression: As compared to the previous radiograph, the right PICC line has been pulled back. The tip of the line, however, still projects over the right atrium and should be pulled back by another 5-6 cm.  No evidence of complications. Otherwise unchanged appearance of the lung parenchyma and the cardiac silhouette.","Impression: As compared to the previous radiograph, the right PICC line has been pulled back. The tip of the line, however, now terminates in the right subclavian vein and should be pulled back by another 5-6 cm. Evidence of new complications. Otherwise unchanged appearance of the lung parenchyma and the cardiac silhouette. A left-sided Port-A-Cath is noted, terminating in the mid SVC.","['Change position of device', 'Add contradiction', 'Add medical device']"
c6fc6685-e7a9723b-af0fd3b9-b27ab011-0cd0b383,56887951,10337896,"Impression: As compared to the previous radiograph, the tip of the right PICC line now projects over the mid SVC.  No other changes are noted. The right internal jugular vein catheter and the tracheostomy tube are in constant position.","Impression: As compared to the previous radiograph, the tip of the right central venous line now projects over the mid SVC.  No other chagnes are noted. No internal jugular vein catheter is present. The tracheostomy tube is in constant position.","['Change name of device', 'Add typo', 'False negation']"
7aca64c9-d64297cc-102477f2-a8ca30e1-7b90cf8c,56902361,10337896,"Findings: The right IJ central line, endotracheal tube and enteric tube remain in satisfactory position. Moderate pulmonary edema and small layering pleural effusions are also unchanged. There is no pneumothorax. The heart and mediastinum are magnified by the projection. Calcified lymph nodes, as well as pleural and parenchymal calcifications are again noted. Impression: No significant interval change in moderate pulmonary edema and small bilateral pleural effusions. Lines and tubes in satisfactory position.","Findings: The right IJ central line, endotrahceal tube and enteric tube remain in satisfactory position. Mild pulmonary edema and small layering pleural effusions are also unchanged. There is a large pneumothorax. The heart and mediastinum are magnified by the projection. Calcified lymph nodes, as well as pleural and parenchymal calcifications are agian noted. Impression: No significant interval change in mild pulmonary edema and small bilateral pleural effusions. Lines and tubes in satisfactory position.","['Change severity', 'Add typo', 'False prediction']"
"11835a49-689d7896-d692a675-ea26b04a-9b11c20f, 3b2a9672-8cd9b992-a96c4d95-6a081155-fd543b5e",57080785,10337896,"Impression: As compared to the previous image, tip of the right PICC line still projects over the mid to lower parts of the right atrium. Pulling back of the line should be performed, as indicated in the previous report.  No relevant change in appearance of the lung parenchyma and the heart.","Impression: As compared to the previous image, tip of the right PICC line now projects over the upper parts of the right atrium. Pulling back of the line should bee performed, as indicated in the previous report.  No relevant change in appearance of the lung parenchyma and no abnormalities in the heart.","['Change position of device', 'Add typo', 'False negation']"
a9390c8a-a8ea6990-7b9e1035-281e4eee-754368be,57554911,10337896,Impression: Cardiomediastinal contours are unchanged. Mild to moderate pulmonary edema has worsened. Small to moderate right and small left effusions have increased. Multiple calcified lymph nodes and granulomas are again noted.,Impression: Cardiomediastinal contours are unchanged. Mild to moderate pulmonary edema has worsened. Small to moderate left and small right effusions have increased. Multiple calcified lymhp nodes and granulomas are again noted. A large cavitary lesion is noted in the right upper lobe.,"['Change location', 'Add typo', 'False prediction']"
f65f9193-62ebcf82-99968803-f13a04d1-f2c529b5,57814257,10337896,Impression: The overall appearance of the chest is similar to the recent study except for worsening multifocal consolidation in the right lung and standard slight increase in size of moderate right pleural effusion.,Impression: The overall appearance of the chest is similar to the recent study except for moderate multifocal consolidation in the right lung and standard slight increase in size of moderate right pleural effusion. Impression: The overall appearance of the chest is similar to the recent study except for worsening multifocal consolidation in the right lung and standard slight increase in size of moderate right pleural effusion. Impression: There is a central venous line in place.,"['Change severity', 'Add repetitions', 'Add medical device']"
837a3315-a9ccd709-59623363-1b86d9d7-0682317f,58472100,10337896,"Impression: In comparison with the study of ___, the monitoring and support devices remain in place.  Diffuse bilateral pulmonary opacification is processed, consistent with pulmonary edema, bilateral pleural effusions, and compressive atelectasis at the bases, as well as diffuse calcifications.","Impression: In comparison with the study of ___, the monitoring and support devices remainin.  Diffuse bilateral pulmonary opacification is processed, consistent with pulmonary edema, right pleural effusions, and compressive atelectasis at the bases, as well as diffuse calcifications.  An ET tube is in the correct position.","['Change location', 'Add typo', 'Add medical device']"
56ba2b4a-a47cedaf-139af8c9-10d8a957-74ec4f4f,59930189,10337896,"Findings: Support and monitoring devices are unchanged in position, and cardiomediastinal contours are similar.  Interval worsening of pulmonary edema as well as slight increase in size of moderate bilateral pleural effusions.  Otherwise, no relevant short interval change. ","Findings: Support and monitoring devices are unchanged in position, and cardiomediastinal contours are similar. Interval worsening of pulmonary edema as well as slight increase in size of moderate left pleural effusions. There is no pulmonary edema.","['Change location', 'Add contradiction', 'False negation']"
"658a8ccf-a63adc9e-66351e99-f15af5f2-8e2e00b1, 8af1b630-3ace08e2-edeb0783-ae2ef2e3-07f5576b",54647674,10377744,"Findings: Frontal and lateral views of the chest were obtained.  New subtle opacity at the right lung base in the setting of similar lung volumes with increased opacity on the lateral view may be atelectasis, but could represent early or developing pneumonia in the appropriate clinical setting.  Cardiac and mediastinal silhouettes are normal.  No acute osseous abnormality is identified. Impression: Right basilar opacity is probably atelectasis, but could represent early or developing pneumonia in the appropriate clinical setting.","Findings: Frontal and lateral views of the chest were obtained. New subtle opacity at the right lung base in the setting of similar lung volumes with increased opacity on the lateral view may be atelectasis, but could represent early or developing pneumonia in the appropriate clinical setting. Cardiac and mediastinal silhouettes are normal. There is a small left-sided pleural effusion. Cardiac and mediastinal silhouettes are normal. Impression: Left basilar opacity is probably atelectasis, but could represent early or developing pneumonia in the appropriate clinical setting.","['Change location', 'Add repetitions', 'False prediction']"
"0e692067-1cd27131-a4ab943b-4a9bfbc9-d662b997, e049f18a-e4f9351c-fec6cad4-a19211f7-0c534a5c",58549367,10401591,Impression: No acute cardiopulmonary abnormality.,Impression: No acute cardiopulmonary abnormality. There is a small right-sided pleural effusion. There is a large hiatal hernia visualized. Impression: Mild pulmonary edema.,"['False prediction', 'Add contradiction', 'Add medical device']"
"4f0f1c98-127de941-be134310-bf433d4a-c79e22aa, acf8db28-7be06aa5-dec86122-ecb7e055-f198a3f8",50064627,10401700,"Findings: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is normal.  There is no pulmonary edema.  Partially imaged upper abdomen is unremarkable. Impression: No evidence of acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest demonstrate normal lung volumes with pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are remarkable.  Heart size is normal.  There are right-sided pleural plaques.  Partially imaged upper abdomen is unremarkable. Impression: Enlarged mediastinum with possible lymphadenopathy.","['Change location', 'Change to homophone', 'False prediction']"
"4517dc03-f5b5bca8-05cdecdd-45b7a15d-a512bd04, cf1dab72-e09f8f17-73f1e925-ffb70fe0-e8b878fa",57541861,10401700,"Findings: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is normal.  Patient's known bilateral sub-5-mm pulmonary nodules are better assessed in ___ CT.  Partially imaged upper abdomen is unremarkable. Impression: No evidence of acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is normal.  Patient's known bilateral sub-5-cm pulmonary nodules are better assessed in ___ CT.  Partially emaged upper abdomen is unremarkable. Impression: No pulmonary nodules.","['Change measurement', 'Change to homophone', 'False negation']"
"6887e2d1-fbfd6066-7306286f-87e5d3bc-3ded14e7, 6c123f37-2e866064-a97fce62-c3214b55-0725f10d",53709854,10425463,"Findings: Heart size is normal. A small hiatal hernia is demonstrated. Mediastinal and hilar contours are otherwise unremarkable. No focal consolidation, pleural effusion or pneumothorax is seen.  Multiple clips are noted in the upper abdomen. Multilevel degenerative changes are present in the thoracic spine. Impression: No acute cardiopulmonary abnormality.",Findings: A small hiatal hernia is demonstrated. A small hiatal hernia is demonstrated. Mediastinal and hilar contours are otherwise unremarkable. No costophrenic angle blunting is seen. Multiple sternal wires are noted in the upper abdomen. Multilevel degenerative changes are present in the lumbar spine. Impression: No acute cardiopulmonary edema.,"['Change name of device', 'Add repetitions', 'False prediction']"
"aa81a761-dbc13def-538949eb-6aefd90c-12a85e54, ccea3851-88245a72-e4229b4e-0d54293e-6b5fae76",52339870,10462870,"Findings: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease.  No pneumonia, vascular congestion, or pleural effusion.    There has been interval placement of multiple surgical clips in the lower neck, presumably from thyroid surgery. ","Findings: In comparrison with the study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumona, vascular congestion, or pleural effusion. There is a NG tube with its tip positioned in the stomach. There has been interval placement of multiple surgical clips in the mid neck, presumably from thyroid surgery.","['Change position of device', 'Add typo', 'Add medical device']"
"07f8e57c-a1b872d2-5c2e7806-1c4fd548-128dd898, f5d855de-88ff9fae-f82e34bc-c80b59f6-1f79d117",55818165,10503161,"Findings: Frontal and lateral views of the chest are obtained.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest are obtained.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  A left IJ central venous catheter is in place. Impression: Small bilateral pleural effusions.","['Change location', 'Add contradiction', 'Add medical device']"
"8f408f38-01bd3625-ba5e3d67-86aec5a5-4161a165, ede0b529-6cdb009c-7768be87-b40bb244-7ff29b19",55380352,10521109,Findings: Frontal and lateral views of the chest were obtained.  The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  There appears to be a right-sided aortic arch.  The cardiac silhouette is not enlarged. Impression: Clear lungs without focal consolidation.  Probable right-sided aortic arch.,Findings: Frontal and lateral views of the chest wre obtained.  No focal consolidation.  No pleural effusion or pneumothorax is seen.  There appears to be a left-sided aortic arch.  The cardiac silhouette is not enlarge. Impression: Clear lungs without focal consolidation.  Probable left-sided aortic arch.,"['Change location', 'Add typo', 'False negation']"
d5aedb5c-3e300b8e-4ab8aa68-066f67dc-cfe7bd84,50421811,10522265,"Impression: Mild to moderate pulmonary edema, with a basal predominance, is new probably accompanied by small pleural effusions.  Heart size is top-normal not appreciably changed.","Impression: Moderate to severe pulmonary edema, with a basil predominance, is new probably accompanied by small pleural effusions.  Heart size is top-normal not appreciably changed. A central venous line is present.","['Change severity', 'Change to homophone', 'Add medical device']"
17077b64-972ced4d-1dd026ac-595f3151-121e9520,52497746,10522265,"Impression: Pulmonary edema developed between ___ and ___.  Edema has subsequently cleared from  the upper lungs, but there is still substantial consolidation in the lower lungs, particularly the left accompanied by at least small bilateral pleural effusions.  To what extent the abnormality represents combination of edema and residual atelectasis or pneumonia, is radiographically indeterminate, but if the patient's respiratory status has recently declined that cannot be attributed to worsening edema; either atelectasis or pneumonia is more likely.  Feeding tube passes into the stomach and out of view.  Left PIC line ends in the low SVC.","Impression: Pulmonary edema developed between ___ and ___.  Edema has subsequently cleared from  the upper lungs, but there is still substantial consolidation in the lower lungs, particularly the left accompanied by at least small bilateral pleural effusions.  To what extent the abnormality represents combination of edema and residual atelectasis or pneumonia, is radiographically indeterminate, but if the patient's respiratory status has recently declined that cannot be attributed to worsening edema; either atelectasis or pneumonia is more likely.  Feeding tube passes into the stomach and out of view.  Left PIC line ends in the upper SVC.  Presence of a left-sided pacemaker.","['Change position of device', 'Add repetitions', 'Add medical device']"
3b6ecb77-1f0b496f-0e7298e0-2805ed0e-616e6f35,54528409,10522265,"Findings: An NG tube is present, tip overlies the gastric body.  The sideport lies distal to the GE junction.  The chest is incompletely evaluated, but note is made of left lower lobe collapse and/or consolidation with a small effusion.  Incidental note is made of a small density along the right  edge of the T12/L1 disc space - ?  small clip or calcification.  The differential includes an artifact outside of the patient. Impression: NG tube side port and tip distal to the GE junction.","Findings: An NG tube is present, tip overlies the gastric buddy.  The pacemaker lies distal to the GE junction.  The chest is incompletely evaluated, but note is made of left lower lobe collapse and/or consolidation with a small effusion.  Incidental note is made of a small density along the right  edge of the T12/L1 disc space - ?  small clip or calcification.  The differential includes an artifact outside of the patient.  In addition, a central venous line is noted. Impression: NG tube side port and tip distal to the GE junction.","['Change name of device', 'Change to homophone', 'Add medical device']"
a8326c4c-0f639e00-ca24c7c1-95d336f2-d9de521f,55120315,10522265,"Impression: In comparison with the study of ___, there again are low lung volumes.  The endotracheal tube has been removed.  No evidence of acute cardiopulmonary disease.  What appears to be some apical pleural thickening is again seen at the right apex laterally.","Impression: In comparison with the study of ___, there again are low lung volumes.  The chest tube has been removed.  No evidence of acute cardiopulmonary disease.  What appears to be some apical pleural thickening is again seen at the right apex laterally. There is a newly placed central venous line.","['Change name of device', 'Add contradiction', 'Add medical device']"
b9454df6-7f75440e-9f3f32d4-038f3447-0c48ce72,55255109,10522265,"Findings: Tip of the endotracheal tube projects over the mid thoracic trachea, approximately 3.7 cm from the carina.  Enteric tube terminates beyond the diaphragm, in the left upper quadrant.  Lungs are clear and cardiomediastinal silhouette is normal. Impression: Appropriate position of endotracheal and enteric tubes.","Findings: Tip of the endotracheal tube projects over the mid thoracic trachea, approximately 5.1 cm from the carina.  Enteric tube terminates beyond the diaphragm, in the left upper quadrant.  Lungs are clear with patchy opacities noted in the left lower lung.  Cardiomegaly is noted. Impression: Appropriate position of endotracheal and enteric tubes. No pulmonary opacities or cardiac abnormalities seen.","['Change measurement', 'Add contradiction', 'False prediction']"
88d07416-c595d584-b0eec579-babde77f-c3ce90be,55807323,10522265,"Findings: Compared to ___ at 04:27, the overall appearance is similar.  Enteric type tube extends beneath the diaphragm, off the film.  Left subclavian PICC line tip overlies distal SVC.  Inspiratory volumes are low, with left lower lobe collapse and/or consolidation and faint hazy opacity at the lung bases.  Mild upper zone redistribution present. Impression: Overall similar to 1 day earlier.  Above.","Findings: Compared to ___ at 04:27, the overall appearance is similar. Enteric type tube extends beneath the diaphragm, off the film. Left subclavian PICC line tip overlies distal SVC. Inspiratory volumes are low, with left lower lobe collapse and/or consolidation and faint hazy opacity over the bases. Mild upper zone redistribution present. Impression: Overall similar to 1 day earlier. No upper zone redistribution. Above.","['Change severity', 'Change to homophone', 'False negation']"
1dd6b552-6d7354f6-6087977b-ed48e39a-5eecc163,57136358,10522265,"Impression: As compared to the previous radiograph, the nasogastric tube was removed.  The left PICC line is in unchanged position.  Mild cardiomegaly with retrocardiac atelectasis.  No overt pulmonary edema.  No pneumonia, no pleural effusions.","Impression: As compared to the previous radiograph, the nasogastric tube was removed. The left PICC line is in unchanged position. Right-sided AICD is noted with leads terminating in the right atrium and right ventricle. No overt pulmonary edema. No overt pulmonary edema. No pneumonia, no pleural effusions.","['Change name of device', 'Add repetitions', 'Add medical device']"
5112f0c8-88daad36-4b8ec976-5df44b65-9b6b621b,58007779,10522265,Impression: There are low lung volumes.  Bibasilar opacities have increased more so in the left side likely due to increasing atelectasis and a small left effusion.  The upper lungs are clear.  There is no pneumothorax.  Cardiomegaly is stable.  Left PICC tip is in the lower SVC,Impression: There are low lung volumes.  No bibasilar opacities.  The upper lungs are clear.  There is no pneumothorax.  Cardiomegaly is stable.  Left PICC tip is in the mid SVC  There is no pneumothorax.,"['Change position of device', 'Add repetitions', 'False negation']"
"4f448157-5d85f1e3-0eb6b849-f1fbf95f-0e6d1f6b, 87c1098e-9c3bb6e3-a61f96b2-ee3edd92-93ac1cdf",58814809,10522265,Impression: ET tube tip is 3.5 cm above the carinal.  NG tube tip is in the stomach.  Heart size and mediastinum are stable.  Lungs are essentially clear. There is no pleural effusion or pneumothorax.,Impression: ET tube tip is 2.5 cm above the carinal. Pacemaker in place. NG tube tip is inn the stomach.  Heart size and mediastinum are stable.  Lungs are essentially clear. Their is no pleural effusion or pneumothorax.,"['Change measurement', 'Change to homophone', 'Add medical device']"
de3b15c4-8ccd2746-09cb6b58-2c546177-5c7cc9f8,55733884,10526217,"Impression: In comparison with the study of ___ from an outside facility, there has been substantial decrease in the bilateral pulmonary opacifications.  Monitoring and support devices have been removed.  The cardiac silhouette is within normal limits.  Mild prominence of the ascending and descending aorta raise the possibility of underlying hypertension.  Some indistinctness of pulmonary vessels could reflect elevated pulmonary venous pressure. Are mild focal areas of opacification suggested at the bases.  In view of the relatively low lung volumes, these could merely reflect areas of atelectasis.  However, in the appropriate clinical setting, superimposed pneumonia could be considered.","Impression: In comparison with the study of ___ from an outside facility, there has been a substantial increase in the bilateral pulmonary opacifications.  Monitoring and support devices have been noted.  The cardiac silhouette is severely enlarged.  Mild prominence of the ascending and descending aorta raise the possibility of underlying hypertension.  Some indistinctness of pulmonary vessels could reflect normal pulmonary venous pressure. Are mild focal areas of opacification suggested at the bases.  In view of the relatively low lung volumes, these could merely reflect areas of atelectasis.  However, in the appropriate clinical setting, mild superimposed pneumonia could be considered.  A central venous line is present in the right atrial region.","['Change severity', 'Add contradiction', 'Add medical device']"
343111ee-6c14729f-63955176-bbc37b84-e1195f48,50135643,10543994,Impression: Since the prior study there is no substantial change in widespread parenchymal opacities and no focal consolidation that would be neo wall concerning for aspiration.  The rest of the findings are similar to previous examination,Impression: Since the prior study there is now substantial change in widespread parenchymal opacities and no focal consolidation that would be neo wall concerning for aspiration.  Since the prior study there is no substantial change in widespread parenchymal opacities and no focal consolidation that would be neo wall concerning for aspiration.  The rest of the findings are similar to the previous examination.  No nodular opacities,"['Add typo', 'Add repetitions', 'False negation']"
5ed42390-a6bef7ec-7a5f8cd0-59d4304d-6a85c880,50269819,10543994,"Impression: Cardiomediastinal silhouette is unchanged. There is interval improvement in the left lung variation but unchanged appearance of the right lung.  Port-A-Cath catheter tip is at the cavoatrial junction.  A left pacemaker lead is in the right ventricle. Interstitial opacities projecting over the lung bases, right more than left are consistent with known interstitial lung disease with most likely superimposed pulmonary edema.  No focal consolidation to suggest pneumonia is can see in",Impression: Cardiomediastinal silhouette is unchanged. There is interval improvement in the right lung variation but unchanged appearance of the right lung.  Port-A-Cath catheter tip is at the cavoatrial junction.  A left pacemaker lead is in the right ventricle. No interstitial opacities projecting over the lung bases.  No focal consolidation to suggest pneumonia is can sea in,"['Change location', 'Change to homophone', 'False negation']"
6227f675-2c12a350-9948a0bc-be0b2666-b1ba8954,52321866,10543994,"Impression: As compared to ___ radiograph, cardiomegaly is accompanied by pulmonary vascular congestion and worsening asymmetrical combined alveolar and interstitial pattern which remains more severe in the right lung than the left. Observed findings may reflect asymmetrical edema, but followup radiographs after diuresis may be helpful to exclude secondary superimposed process in the right lung such as infection. Small pleural effusions are present bilaterally.","Impression: As compared to ___ radiograph, cardiomegaly is accompanied by pulmonary vascular congestion and worsening asymmetrical combined alveolar and interstitial pattern which remains less severe in the right lung than the left. Observed findings may reflect asymmetrical edema, but followup radiographs after diuresis may be helpful to exclude secondary superimposed process in the right lung such as infection. Small pleural effusions are present bilaterally. There is a central venous line ending in the SVC.","['Change severity', 'Add contradiction', 'Add medical device']"
b3d6304a-bf9f636f-6eba19df-d0e27e8d-4d62934b,52330535,10543994,"Findings: Since the prior radiograph, no significant change in the widespread parenchymal opacities and moderate cardiomegaly. No change in the left the Port-A-Cath, which terminates at the cavoatrial junction, and right pacemaker lead in the right ventricle.  No new focal consolidation or larger pleural effusions. Impression: No significant change in the widespread parenchymal opacities and moderate cardiomegaly. No larger pleural effusions.","Findings: Since the prior radiograph, no significant change in the widespread parenchymal opacities and moderate cardiomegaly. No change in the left the MRI, which terminates at the cavoatrial junction, and right pacemaker lead in the right ventricle.  No new focal consolidation or larger pleural effusons. No parenchymal opacities. Impression: No significant change in the widespread parenchymal opacities and moderate cardeomegaly. No larger pleural effusions.","['Change name of device', 'Add typo', 'False negation']"
cd184740-11930719-2a8fc04b-c1076a05-9009709a,53186992,10543994,"Findings: The bilateral parenchymal opacities are likely secondary to edema but may be due to accelerated interstitial disease. There largely unchanged. Moderate cardiomegaly is unchanged, as are the pulmonary vasculature and mediastinal contours. Right Port-A-Cath terminating at the cavoatrial junction and left pacemaker continuous lead in the right ventricle are unchanged. Impression: Largely unchanged bilateral parenchymal opacities, likely secondary to edema but may be due to accelerated interstitial disease.","Findings: The left parenchymal opacities are likely secondary to edema but may be due to accelerated interstitial disease. There largely unchanged. Moderate cardiomegaly is unchanged, as are the pulmonary vasculature and mediastinal contours. Right Port-A-Cath terminating at the cavoatrial junction and left pacemaker continuous lead in the right ventricle are unchanged. A central venous line is noted in the left subclavian vein. Impression: Largely unchanged bilateral parenchymal opacities, likely secondary to edema but may be due to accelerated interstitial disease. Largely unchanged bilateral parenchymal opacities, likely secondary to edema but may be due to accelerated interstitial disease.","['Change location', 'Add repetitions', 'Add medical device']"
78383c35-b9b27e1d-2f9fa023-af32c4bc-0e8f6a90,53418566,10543994,Findings: Portable AP upright chest film ___ at 09:31 is submitted. Impression: Interval placement of a single lead left-sided pacing device with the lead terminating over the expected location of the right ventricle. The cardiac and mediastinal contours are stable with left ventricular prominence. Interval placement of a right internal jugular Port-A-Cath with its tip in the distal SVC. No pneumothorax. Interval appearance of mild pulmonary edema.,Findings: Portable AP upright chest film ___ at 09:31 is submtited. Impression: Interval placement of a single lead left-sided pacing device with the lead terminating over the expected location of the left ventricle. Mildly enlarged mediastinum is noted.The cardiac and mediastinal contours are stable with left ventricular prominence. Interval placement of a right internal jugular Endotracheal Tube with its tip in the distal SVC. No pneumothorax. Interval appearance of mild pulmonary edema with basal atelectasis.,"['Change name of device', 'Add typo', 'False prediction']"
7abd173d-1d1b5df7-ff08e42a-7d346b58-6e49dcec,54489908,10543994,Impression: Widespread parenchymal opacities have demonstrate no substantial change since the prior study.  Heart size and mediastinum are unchanged including 1 moderate cardiomegaly.  No pleural effusion or pneumothorax is seen. Port-A-Cath catheter tip is at the level of the cavoatrial junction.,Impression: Widespread parenchymal opacities have demonstrate no substantial change since the prior study. Heart size and mediastinum are unchanged including 1 moderate cardiomegaly. No pleural effusion or pneumothorax is seen. No parenchymal opacities are seen. The PICC line catheter tip is at the level of the cavoatrial junction.,"['Change name of device', 'Add repetitions', 'False negation']"
95a1bd4e-c011b21e-36ba6f97-6683c294-5b0dd26d,57237894,10543994,"Impression: As compared to the previous radiograph, no relevant change is seen.  Low lung volumes. Relatively extensive bilateral parenchymal opacities, right more than left, combined with a moderately enlarged cardiac silhouette.  No new parenchymal opacities. The left pectoral pacemaker and the right Port-A-Cath are in unchanged position.","Impression: As compared to the previous radiograph, no relevant change is seen.  Low lung volumes. Relatively extensive bilateral parenchymal opacities, right more than left, combined with a moderately enlarged cardiac silhouette.  No new parenchymal opacities. No parenchymal opacities. The left pectoral AICD device and the right Port-A-Cath are in unchanged position.","['Change name of device', 'Add repetitions', 'False negation']"
"1216f943-00196c3a-c41ea739-788f8d83-9571731c, a35725a6-cea21ad3-08b4e359-ffa6686f-8bb4f626",58473321,10543994,Findings: PA and lateral views of the chest provided.  There are subpleural reticular opacities as seen on prior CT compatible with early interstitial lung disease. The heart size appears mildly enlarged. The mediastinal contour is normal. No pleural effusion or pneumothorax. Bony structures are intact. Impression: Subpleural reticular opacities better assessed on the recent CT of the chest likely representing early interstitial lung disease. Mild cardiomegaly,Findings: PA and lateral views of the chest provided.  There are subpleural reticular opacities as seen on prior CT compatible with early interstitial right lung disease. The heart size appears mildly enlarged. The mediastinal contour is normal. No pleural effusion or pneumothorax. Bony structures are intact. Impression: Subpleural reticular opacities better assessed on the recent CT of the chest likely representing early interstitial lung disease. No cardiomegaly,"['Change location', 'Change to homophone', 'False negation']"
3d361f0b-af2b247b-955d1166-f1ae4ef9-b96b55db,58585479,10543994,"Impression: In comparison with the study of ___, there again is prominence of the transverse diameter of the heart with a similar degree of elevated pulmonary venous pressure superimposed upon chronic interstitial lung disease. Or fibrosis the tip of the right Port-A-Cath again extends to the upper portion of the right atrium. Pacer device remains in place.","Impression: In comparison with the study of ___, there again is prominence of the transverse diameter of the heart with a similar degree of elevated pulmonary venous pressure superimposed upon chronic interstitial lung disease. Or fibrosis the tip of the right Port-A-Cath again extends to the lower portion of the right atrium. Pacer devise remains in place.","['Change position of device', 'Change to homophone', 'False negation']"
e666163a-857953ec-9b3034d3-6020c1aa-12c0c11a,58967663,10543994,Impression: The abdomen CT showed mild pulmonary fibrosis and severe aortic valvular calcification undoubtedly stenotic.  Interstitial abnormality has predominated in the right lung. This is probably asymmetric edema.  It has improved today since ___.  Cardiomegaly is severe.  Pleural effusions are small if any.  No pneumothorax.   Right jugular infusion catheter ends low in the right atrium.  Transvenous right ventricular pacer lead in standard placement.  No pneumothorax.,Impression: The abdomen CT showed mild pulmonary fibrosis and severe aortic valvular calcification undoubtedly stenotic. Interstitial abnormality has predominated in the right lung. This is probably asymmetric edema. It has improved today since ___. Cardiomegaly is severe. Pulmonary nodules are noted. No pneumothorax.  Right jugular infusion drainage tube ends low in the right atrium. Transvenous right atrial pacer lead in standard placement. No pneumothorax. No pneumothorax.,"['Change name of device', 'Add repetitions', 'False prediction']"
b2093612-0ee94341-26838e2f-d6912ecd-14c5aa64,59383182,10543994,"Impression: Since the prior study there is minimal interval change in cardiomegaly, mediastinal contours, lines as well as parenchymal opacities. The right lung appears to be more involved than left. The consolidation is slightly more asymmetric than on the prior study and does either worsening of interstitial process or superimposed infection in the right lung are possibility. Correlation with chest CT would be justified at this point","Impression: Sense the prior study there is minimal interval change in cardiomegaly, mediastinal contours, lines as well as parenchymal opacities. There is small pleural effusion noted. The right lung appears to be more involved than left. The consolidation is slightly less asymmetric than on the prior study and does either worsening of interstitial process or superimposed infection in the right lung are possibility. Correlation with chest CT would be justified at this point.","['Change severity', 'Change to homophone', 'False prediction']"
ef13f435-fe872e16-39f17cfe-50700e9c-c69a04d3,59627293,10543994,Impression: Mild interstitial edema has minimally worsened. There are low lung volumes. Patient has underline interstitial lung disease / fibrosis. There is no pneumothorax. Cardiomegaly and widened mediastinum are stable. Right port catheter tip is in the upper right atrium. Pacemaker lead tip is in the right ventricle.,Impression: Mild interstitial edema has slightly improved. There are low lung volumes. Patient has interstitial lung disease / fibrosis. There is no pneumothorax. Cardiomegaly and widened mediastinum are stable. Left port catheter tip is in the upper right atrium. No pacemaker lead tip is identified.,"['Change location', 'Add contradiction', 'False negation']"
"d22a0609-122f9478-2067622b-1cc96cdb-c5c975aa, eb6725c5-05997634-42fc628d-001242ba-5ab3fe83",51104115,10552670,Findings: Frontal and lateral views of the chest.  The lungs are clear.  There is no pneumothorax nor effusion.  Cardiomediastinal silhouette is within normal limits.  Radiopaque densities seen in the mid to distal esophagus with additional focus just past the GE junction.  This may represent patient's esophageal pH probe. Impression: No acute cardiopulmonary process.  Radiopaque densities in the region of the mid to distal esophagus and stomach which may correlate with patient's pH probe placement.,Findings: Frontal and lateral views of the chest.  The lungs are clear.  There is no pneumothorax nor effusion.  The cardiomediastinal silhouette is within normal limits.  Radiopaque densities seen in the mid to proximal esophagus with an additional focus just past the GE junction.  This may represent patient's esophageal pH probe.  An ET tube is noted in the trachea. Impression: No acute cardiopulmonary process.  There are no radiopaque densities in the region of the mid to distal esophagus and stomach which may correlate with patient's pH probe placement.,"['Change location', 'Add contradiction', 'Add medical device']"
"08895756-28628f43-7bb6fa61-72737637-e90ef342, 3ef83336-7f67850f-4c481312-ec7c99d2-a874836a",51507599,10569231,"Findings: Moderate enlargement of the cardiac silhouette persists.  The mediastinal and hilar contours are normal.  Pulmonary vasculature is normal.  No focal consolidation, pleural effusion or pneumothorax is identified.  No acute osseous abnormality is detected. Impression: No acute cardiopulmonary abnormality.","Findings: Mild enlargement of the cardiac silhouette persists.  The mediastinal and hilar contours are normal.  Pulmonary vasculature is normal.  No focal consolidation, pleural effusion or pneumothorax is identified.  No acute osseous abnormality is detected. Impression: There is evidence of a large right-sided pleural effusion.","['Change severity', 'Change to homophone', 'False prediction']"
"d68f20ae-43c390c2-b66bf131-3528cedc-57f7e90f, f81a519e-734afad4-3d6c87f8-6434f949-a7676b82",53678530,10569231,"Findings: Underpenetration of the lower chest, particularly on the left, is felt to be due to overlying soft tissue.  No focal consolidation is seen on the lateral view.  There is no pleural effusion or pneumothorax.  The cardiac and mediastinal silhouettes are stable with persistent enlargement of the cardiac silhouette. Impression: No acute cardiopulmonary process.","Findings: Underpenetration of the lower chest, particularly on the left, is felt to be due to overlying soft tissue.  No focal consolidation is seen on the lateral view.  There is no pleural effusion or pneumothorax.  The cardiac and mediastinal silhouettes are stable with persistent enlargement of the cardiac silhouette.  There is no pleural effusion or pneumothorax. Impression: No acute cardiopulmonary process. No cardiac enlargement.","['Change location', 'Add repetitions', 'False negation']"
"70a1de7a-ced6544b-f6c703aa-f806951c-c1fc887d, 781476c8-b3ceae84-5bca3f05-15064709-53236d2f",54463242,10569231,Findings: Moderate enlargement of the cardiac silhouette persists.  The lung bases are underpenetrated due to overlying soft tissue.  Increased opacity projecting over the inferior thoracic spine on the lateral view may be due to atelectasis although an early consolidation due to aspiration or infection is not excluded in the appropriate clinical setting.  No pleural effusion or pneumothorax is seen.  Mediastinal contours are stable.  No pulmonary edema is seen. Impression: Persistent enlargement of the cardiac silhouette.  No pulmonary edema.  The lung bases are underpenetrated due to overlying soft tissue.  Increased opacity projecting over the inferior thoracic spine on the lateral view may be due to atelectasis although an early consolidation due to aspiration or infection is not excluded in the appropriate clinical setting.,Findings: Moderate enlargement of the cardiac silhouette persists.  The lung apices are underpenetrated due to overlying soft tissue.  Increased opacity projecting over the inferior thoracic spine on the lateral view may be due to atelectasis although an early consolidation due to aspiration or infection is not excluded in the appropriate clinical setting.  No pleural effusion or pneumothorax is seen.  Mediastinal contours are stable.  Patchy pulmonary edema is evident.  A centrally located pacemaker is in place. Impression: Persistent enlargement of the cardiac silhouette.  No pulmonary edema.  The lung bases are underpenetrated due to overlying soft tissue.  Increased opacity projecting over the inferior thoracic spine on the lateral view may be due to atelectasis although an early consolidation due to aspiration or infection is not excluded in the appropriate clinical setting. ,"['Change location', 'Add contradiction', 'Add medical device']"
"70e97a3f-29b2d597-f8635ca2-daabc3ae-fba20599, 8bd08c70-fbb6e2dc-4a5730ee-8a7a80b5-c496867e",55488757,10569231,"Findings: AP upright and lateral views of the chest provided.  Large body habitus and underpenetrated technique limits assessment. Allowing for technical limitations, the lungs are clear. Heart is mildly enlarged. Mediastinal contour is normal. No large effusion or pneumothorax. Bony structures are intact. Impression: Mild cardiomegaly. No overt signs of edema or pneumonia.","Findings: AP upright and lateral views of the chest provided.  Large body habitus and underpenetrated technique limits assessment. Allowing for technical limitations, the lungs are clear. Heart is severely enlarged. Mediastinal contour is normal. No large effusion or pneumothorax. Bony structures are intact. Impression: There is no cardiomegaly. No overt signs of edema or pneumonia. No overt signs of edema or pneumonia.","['Change severity', 'Add repetitions', 'False negation']"
"01f860b4-313df5f2-ef6df995-a3bff91e-0e53eadd, f6aafba9-9cacdf7c-73268cf5-74b96292-7b81a593",51022437,10575262,"Findings: The heart size is mildly enlarged, slightly increased compared to the prior exam.  The mediastinal and hilar contours are unremarkable.  There is mild pulmonary vascular congestion with trace amount of fluid tracking within the fissures.  No large pleural effusion or focal consolidation is seen.  There is no pneumothorax.  No acute osseous abnormalities identified. Impression: Findings likely reflective of mild pulmonary vascular congestion.","Findings: The heart size is severely enlarged, slightly increased compared to the prior exam. The mediastinal and hilar contours are unremarkable. There is moderate pulmonary vascular congestion with trace amount of fluid tracking within the fissures. No large plural effusion or focal consolidation is seen. There is no pneumothorax. No acute osseous abnormalities identified. A pacemaker is present. Impression: Findings likely reflective of moderate pulmonary vascular congestion.","['Change severity', 'Change to homophone', 'Add medical device']"
"16e57afa-63382843-a3a5c024-e1af2c42-96184334, bbee38bd-f8ab65ce-49fa28b2-f1bcb3e5-3bbffc88",54255491,10575262,"Findings: No pleural effusion or pneumothorax.  No parenchymal consolidation is seen. The heart is mildly enlarged. On the lateral, the posterior heart border overlies the anterior aspect of the lower thoracic vertebral bodies implying LV and ___ ___. There is decreased retrosternal space implying mild right ventricular enlargement. Impression: No radiographic cause is identified for the patient's cough. Mild cardiomegaly is seen.","Findings: No pleural effusion or pneumothorax.  No parenchymal consolidation is seen. The heart is mildly enlarged. On the lateral, the posterior heart border overlies the anterior aspect of the lower cervical vertebral bodies implying LV and ___ ___. There is decreased retrosternal space implying mile right ventricular enlargement. Bilateral pleural thickening is noted. Impression: No radiographic cause is identified for the patient's cough. Right paratracheal lymphadenopathy is seen.","['Change location', 'Change to homophone', 'False prediction']"
"30e3504a-2e22ab19-d9dd1362-eb94fd44-91739662, e283e6ee-1e78a429-c05396b5-19ed705f-5de5210a",55987322,10575262,Findings: Cardiac silhouette size remains mildly enlarged but unchanged. Mediastinal and hilar contours are stable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormality is identified. Impression: Unchanged mild cardiomegaly. Otherwise no evidence of congestive heart failure or pneumonia.,Findings: Cardiac silhouette size remains severely enlarged but unchanged. Mediastinal and hilar coutours are stable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. There is a small left-sided pleural effusion. No pleural effusion or pneumothorax is present. No acute osseous abnormality is identified. Impression: Unchanged moderate cardiomegaly. Otherwise no evidence of congestive heart failure or pneumonia.,"['Change severity', 'Add typo', 'False prediction']"
"ad5dbcae-e391d578-f01e2f54-b2d7c96c-0c121ec6, c027d8f8-d7e3b702-251c84f4-f4630cbf-72e59727",59777295,10575714,"Findings: AP upright and lateral views of the chest provided.  Lung volumes are low.  Allowing for this, the lungs are clear.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process.","Findings: AP upright and lateral views of the chest provided. NG tube is in place. Lung volumes are low.  Allowing for this, the lungs are clear. There is mild consolidation in the left lower lobe. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: Moderate consolidation in the left lower lobe. No acute intrathoracic process.","['Change location', 'Add contradiction', 'Add medical device']"
a7955cff-d2fccb0b-b49d4a97-71d64c98-d657a78b,53675993,10580208,"Impression: AP chest compared to ___, 1:15 a.m.:  Moderately severe pulmonary edema has improved minimally in the mid and upper lung zones, not so in the lung bases where it is more severe, accompanied by moderate bilateral pleural effusion.  Severe cardiomegaly has improved slightly.  There is no pneumothorax.  Transvenous right atrioventricular pacer defibrillator system in standard placement.  Thoracic aorta is heavily calcified and mildly irregular in shape, due to heavy atherosclerotic plaque.","Impression: AP chest compared to ___, 1:15 a.m.:  Moderately severe pulmonary edema has improved minimally in the mid and upper lung zones, not sew in the lung bases where it is more severe, accompanied by moderate bilateral pleural effusion.  Severe cardiomegaly has improved slightly.  There is no pneumothorax.  Transvenous right atrioventricular pacer defibrillator system in an inferior placement.  Thoracic aorta is heavily calcified and mildly irregular in shape, due to heavy atherosclerotic plaque.  Mild bibasilar atelectasis is noted.","['Change position of device', 'Change to homophone', 'False prediction']"
"18378887-d7647b4e-a2987793-7ff5887a-51970d80, 43fe7b33-07803c3a-c3cdc4b6-7a8f7f94-e7e6e01a",54794964,10580208,"Findings: AP and lateral images of the chest.  A pacer is seen overlying the left anterior chest in a different location than on prior exam, with intact leads in appropriate position.  Increased interstitial markings are seen bilaterally, consistent with mild to moderate pulmonary edema.  Bilateral pleural effusions are seen, left greater than right.  No pneumothorax is seen. The cardiomediastinal silhouette is incompletely assessed due to adjacent pulmonary effusion, but it appears to be enlarged. Impression: 1.  Mild-to-moderate pulmonary edema with bilateral pleural effusions, left greater than right.    2.  Cardiomegaly.","Findings: AP and lateral images of the chest.  A pacer is seen overlying the right anterior chest in a different location than on prior exam, with intact leads in appropriate position.  Increased interstitial markings are seen bilaterally, consistent with mild to moderate pulmonary edema.  Bilateral pleural effusions are seen, left greater than right.  No pneumothorax is seen. The cardiomediastinal silhouette is incompletely assessed due to adjacent pulmonary effusion, but it appears to be enlarged. Impression: 1.  Mild-to-moderate pulmonary edema with bilateral pleural effusions, left greater than right.    2.  Cardiomegaly. 3. Large left apical mass.","['Change position of device', 'Add repetitions', 'False prediction']"
"20907810-b1ab5c94-cb4fbcf4-09c10590-05321eb1, ad582141-5b748b2f-c456f25a-705b7a04-b32e22e4",51728482,10592002,Findings: Heart size is normal.  The mediastinal and hilar contours are normal.  Mild atherosclerotic calcifications are noted at the aortic knob. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.  No subdiaphragmatic free air is present. Impression: No acute cardiopulmonary abnormality.  No subdiaphragmatic free air identified.,Findings: Heart size is normal. The mediastinal and hilar contours are normal. Mild atherosclerotic calcifications are noted at the aortic knob. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. No subdiaphragmatic free air is present. There are significant aortic calcifications identified.,"['Change severity', 'Add contradiction', 'False negation']"
"2a4ad985-4a6d5b92-11a8cc7b-046220f5-188ce7c8, c1557f59-55c7ff14-cdb02fc2-db962b0d-3aa6a6b3",58910893,10592002,"Impression: No previous images.  No evidence of acute cardiopulmonary disease.  There is some the apical sub pleural thickening with mild fibrous scarring bilaterally, consistent with old healed tuberculous disease.","Impression: No previous images. No evidence of acute cardiopulmonary disease. There is some the apical sub pleural thickening with moderate fibrous scarring bilaterally, consistent with old healed tuberculous disease and trace pleural effusion.","['Change severity', 'Add typo', 'False prediction']"
"3e690aea-3a937250-0a43c974-010eeb6a-f84953b2, 6e0c0f60-529ac8e0-606e671a-5e7075f0-07fcd489",56038252,10595724,Impression: No acute intrathoracic process.,Impression: The patient may need to be evaluated for a localized pleural effusion. ,"['False prediction', 'Change to homophone', 'Add medical device']"
"3edade1d-e06bbc14-6a3b9886-930b0ff1-95810ebc, 5e4ec3e6-eff5ccaf-92e6f524-90e868e2-3d2c2772",52366630,10617538,"Findings: Frontal and lateral chest radiographs demonstrate a normal cardiac silhouette. Slightly unfolded aorta with otherwise unremarkable mediastinal and hilar contour.  The lungs are well-aerated without focal consolidation, pleural effusion, or pneumothorax.  The visualized upper abdomen is unremarkable without evidence for sub- diaphragmatic free air. Impression: No acute cardiopulmonary process.","Findings: Frontal and lateral chest radiographs demonstrate a normal cardiac silhouette. Slightly unfolded aorta with otherwise unremarkable mediastinal and hilar contour.  The lungs are well-aerated without focal consolidation, pleural effusion, or pneumothorax.  The visualized upper abdomen is unremarkable without evidence for sub- diaphragmatic free air.  A central venous line is present at the right atrium. The lungs are well-aerated without focal consolidation, pleural effusion, or pneumothorax. Impression: No acute cardiopulmonary process.","['Change location', 'Add repetitions', 'Add medical device']"
"cb19438f-641f1bf4-e5b7d045-351ae8c3-892e9013, d5c7d596-f85d51d0-f50de103-25a4904c-c62cd894",59001230,10617538,"Findings: Right sided Port-A-Cath tip terminates in the mid SVC.  Heart size is normal.  Mediastinal and hilar contours are unchanged.  Calcified bilateral hilar lymph nodes are re- demonstrated.  Pulmonary vasculature is not engorged.  No focal consolidation, pleural effusion or pneumothorax is present.  No acute osseous abnormality is detected.  Heterogeneous appearance of the T12 vertebral body is better seen on the prior CT. Impression: No acute cardiopulmonary abnormality.","Findings: Right sided Port-A-Cath tip terminates in the inferior vena cava. Heart sighs is normal. Mediastinal and hilar contours are unchanged. Calcified bilateral hilar lymph nodes are re- demonstrated. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is detected. A newly placed pacemaker is noted. Heterogeneous appearance of the T12 vertebral body is better scene on the prior CT. Impression: No acute cardiopulmonary abnormality.","['Change position of device', 'Change to homophone', 'Add medical device']"
"7eff5f7d-db222fe7-fe4b9865-1f0641c1-bcfdc4a1, e4b6639a-addc6e70-3931f176-25766a17-95a40103",52666674,10625954,Findings: The heart size is normal.  The hilar and mediastinal contours are normal.  The lungs are clear without evidence of focal consolidations concerning for pneumonia.  There is no pleural effusion or pneumothorax. Impression: No focal consolidations concerning for pneumonia.,Findings: The heart size is normal.  The hilar and mediastinal contours are normal.  The lungs are clear without evidence of focal cosolidations concerning for pneumonia.  There is no pleural effusion or pneumothorax. Impression: No focal consolidations concerning for pneumothorax. There is evidence of bilateral pleural effusions.,"['Add typo', 'Add contradiction', 'False prediction']"
1d781883-bb2d3cf0-14fd56ff-c4d0e12f-1143d820,50196128,10649970,"Findings: AP view of the chest.  There are low lung volumes.  Calcified nodules in the right lung base are unchanged from prior, likely sequelae of prior healed infection.  There is bibasilar atelectasis.  No focal consolidation, pleural effusion or pneumothorax.  The cardiomediastinal silhouette is unremarkable. Impression: 1. No evidence of pneumonia.  2. Stable calcified nodules in the right lung base, likely sequela of prior healed infection.","Findings: AP view of the chest.  AP view of the chest.  There are low lung volumes.  Calcified nodules in the left lung base are unchanged from prior, likely sequelae of prior healed infection.  There is a central venous line present.  There is bibasilar atelectasis.  No focal consolidation, pleural effusion or pneumothorax.  The cardiomediastinal silhouette is unremarkable. Impression: 1. No evidence of pneumonia.  2. Stable calcified nodules in the left lung base, likely sequela of prior healed infection.","['Change location', 'Add repetitions', 'Add medical device']"
a1c8c7ce-7da30482-9513e5d6-e9c94ca0-4ce8696a,50701407,10649970,"Impression: 1.  Lung volumes remain somewhat low.  There are multiple small calcified nodular opacities in the right mid and lower lungs, which are unchanged.  No pulmonary edema or airspace consolidation to suggest an acute infectious process.  No pneumothorax or pleural effusions.  Overall cardiac and mediastinal contours are stable.  No pneumothorax.","Impression: Lung volumes remain somewhat low. There are multiple small calcified nodular opacities in the right mid and lower lungs, which are unchanged. No pulmonary edema or airspace consolidation to suggest an acute infectious process. The patient has a central venous line. No pneumothorax or pleural effusions. Overall cardiac and mediastinal contours are stable. No pneumothorax or pleural effusions. No pneumothorax.","['Change severity', 'Add repetitions', 'Add medical device']"
df51559d-507712fb-fa6e2962-7da4f76b-a209ffe9,52247104,10738077,Findings: The AP portable chest radiograph demonstrates right PICC which terminates in the axilla.  There is no focal consolidation.  There is bibasilar atelectasis. Heart size is top-normal.  Mediastinal and hilar contours are within normal limits.  There is no pneumothorax or appreciable pleural effusion. Impression: Right PICC with tip terminating in right axilla.  These findings were communicated to surgical house staff officer ___ by Dr. ___ ___ telephone at 10:00 on ___.,Findings: The AP portable chest radiograph demonstrates right vascular stent which terminates in the axilla.  There is no focal consolidation.  There is no atelectasis. Heart size is top-normal.  Mediastinal and hilar contours are within normal limits.  There is no pneumothorax or appreciable pleural effusion.  There is moderate atelectasis. Impression: Right PICC with tip terminating in right atrium.  These findings were communicated to surgical house staff officer ___ by Dr. ___ ___ telephone at 10:00 on ___.,"['Change name of device', 'Add contradiction', 'False negation']"
"50d7481e-a17d3334-1639b695-43ac984e-46ccec4f, c5cb848f-99205a6c-08c1ebd4-fd92d960-44ec5143",58146073,10738077,"Findings: Left-sided PICC tip terminates in the mid SVC, in unchanged position. Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal.  Minimal subsegmental atelectasis in the left lung base is noted. The remainder of the lungs are otherwise clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: Left PICC tip in unchanged position. No acute cardiopulmonary abnormality.","Findings: Left-sided PICC tip terminates in the right atrium, in unchanged position. Heart siz is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No atelectasis is noted. The remainder of the lungs are otherwise clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: Left PICC tip poksition in unchanged position. No acute cardiopulmonary abnormality.","['Change position of device', 'Add typo', 'False negation']"
6a83b24c-67c3269a-c2c1b295-6bde13b8-b9bab43c,51178141,10750092,"Impression: AP chest compared to ___, 5:37 a.m.  There is a new tracheostomy tube, turned to the left, tip facing the left tracheal wall.  There is no pneumothorax or mediastinal widening.  Small right pleural effusion is new.  Heart size is normal.  Thoracic aorta is tortuous, but not focally dilated.  Right subclavian line ends low in the SVC.","Impression: AP chest compared to ___, 5:37 a.m.  There is a new nasogastric tube, turned to the left, tip facing the left tracheal wall.  There is no pneumothorax or mediastinal whining.  No right pleural effusion is new.  Heart size is normal.  Thoracic aorta is tortuous, but not focally dilated.  Right subclavian catheter ends low in the SVC.","['Change name of device', 'Change to homophone', 'False negation']"
f9f2994d-0072f6aa-32cf61c7-af016a0a-5e32b37a,52347962,10750092,Findings: Comparison is made to previous study from ___.  There is an endotracheal tube whose tip is 3.3 cm above the carina.  This could be pulled back 1-2 cm for more optimal placement.  There is a nasogastric tube whose side port is near the GE junction.  This could be advanced several centimeters for more optimal placement.  There is stable cardiomegaly and tortuosity of the thoracic aorta.  There is some slight prominence of pulmonary vascular markings and some atelectasis versus developing infiltrate at the right base.  No pneumothoraces are present. ,"Findings: Comparison is made to previous study from ___.  There is an endotracheal tube whose tip is 3.7 cm above the carina.  This could be pulled back 1-2 mm for more optimal placement.  There is a nasogastric tube whose side port is near the GE junction.  This could be advanced several centimeters for more optimal placement.  There is stable cardiomegaly and tortuosity of the thoracic aorta.  There is no prominence of pulmonary vascular markings.  No pneumothoraces are present.  
","['Change measurement', 'Add repetitions', 'False negation']"
0467c521-bdba9798-87b7c0cf-b1e76b40-5fcd1444,54397816,10750092,"Findings: Portable upright chest radiograph demonstrates no change in aeration accounting for differences in positioning.  The patient remains intubated, with the tip of the endotracheal tube positioned 3.5 cm from the level of the carina.  An NG tube is in place with its tip projecting over the expected position of the stomach, and sidehole projecting over the expected position of the distal esophagus.  There is mild pulmonary edema.  Cardiac and mediastinal contours are unchanged. Impression: 1. Unchanged mild pulmonary edema. 2. NG tube sidehole in the distal esophagus, could be advanced several centimeters to decrease the risk of aspiration.","Findings: Portable upright chest radiograph demonstrates no change in aeration accounting for differences in positioning.  The patient remains intubated, with the tip of the ET tube positioned 3.5 cm from the level of the carina.  An NG tube is in place with its tip projecting over the expected position of the stomach, and sidehole projecting over the expected position of the distal esophagus.  There is mild pulmonary edema.  Cardiac and mediastinal counters are unchanged.  A central venous line is noted in the right internal jugular vein. Impression: 1. Unchanged mild pulmonary edema. 2. NG tube sidehole in the distal esophagus, could be advanced several centimeters to decease the risk of aspiration.","['Change name of device', 'Change to homophone', 'Add medical device']"
"28bcbc77-70736463-dc95285f-40b115a7-5d7b7f15, 501b436f-4f6cf540-ca6ea4e6-b4a0a951-03e9baf9",55148571,10750092,Impression: No acute cardiopulmonary process.,Impression: No overt pulmonary edema.,"['Add repetitions', 'Change to homophone', 'False prediction']"
ce531719-78a6c8a0-6db6ac35-9786e10c-8ff62104,57870796,10750092,Impression: Slightly decreased edema with bibasilar atelectasis and newly evident right midlung opacity which may reflect a developing pneumonia.   Finding was discussed by phone with Dr. ___ by Dr. ___ at ___ on ___.,Impression: Slightly decreased edema with basilar atelectasis and newly evident right midlung opacity which may reflect a developing pneumonia. Finding was discussed by phone with Dr. ___ by Dr. ___ at ___ on ____.,"['Change location', 'Add typo', 'False prediction']"
632aa920-047fa58d-57bb9ec3-53497e57-ab6df53a,59472868,10750092,"Findings: In the interim, the patient has been intubated, the endotracheal tube tip lies no less than 1.3 cm from the level of the carina.  The lungs remain hyperexpanded, with no pneumothorax or pleural effusion.  The cardiac silhouette remains normal in size, the mediastinal contours are notable for aortic ectasia.  There is a healed fracture of the posterolateral right fifth rib.  An NG tube remains in place with its tip and sidehole within the stomach.  Note is made of mitral annular calcifications. Impression: 1.  Interval intubation, endotracheal tube tip is at least 1.3 cm from the level of the carina. 2.  Hyperexpansion, with no acute chest abnormality.","Findings: In the interim, the patient has been intubated, the endotracheal tube tip lies no less than 2.5 cm from the level of the carina.  The lungs remain hyperexpanded, with no pneumothorax or pleural effusion.  The cardiac silhouette remains normal in size, the mediastinal contours are notable for aortic ectasia.  There is a healed fracture of the posterolateral right fifth rib.  An NG tube remains in place with its tip and sidehole within the stomach.  Note is made of mitral annular calcifications.  The lungs remain hyperexpanded, with no pneumothorax or pleural effusion. Impression: 1.  Interval intubation, endotracheal tube tip is at least 1.3 cm from the level of the carina. 2.  No hyperexpansion, with no acute chest abnormality.","['Change measurement', 'Add repetitions', 'False negation']"
"6c0ee6ab-a42d369e-38095ae8-53f0889e-f84941fb, e6a7f3ac-fb2965d9-da384ee3-023cf138-7b74ab23",59509278,10767172,Findings: The lungs are well expanded and clear.  There is no pleural abnormality. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.,Findings: The lungs are well expanded and clear.  There is no pleural abnormality. The cardiac and mediastinal silhouettes are unremarkable. Impression: Moderate bilateral pulmonary edema.  Findings: The cardiac and mediastinal silhouettes are unremarkable.,"['Add repetitions', 'Add contradiction', 'False negation']"
"12c35222-67523ce4-b206cd0f-7ae4b5c5-cffd8b0f, 71567b61-e39a229b-3e60f82f-73c88327-5339c006",50392431,10773739,"Impression: The right lung is unremarkable. On the left, there is an increase in pleural effusion and, with limitation of 2 different techniques, an increase in extent of the pleural based parenchymal consolidation, as compared to the CT from ___.  Only a minimal portion of the left lung continues to be ventilated.  The right hemithorax is unremarkable.","Impression: The right lung is unremarkable. On the right, there is an increase in pleural effusion and, with limitation of 2 different techniques, an increase in extent of the pleural based parenchymal consolidation, as compared to the CT from ___. No pleural based parenchymal consolidation is seen. Only a minimal portion of the left lung continues to be ventilated. The right hemithorax is normal, without significant abnormalities.","['Change location', 'Add contradiction', 'False negation']"
"03a0e671-6ed112db-cd729147-e75e4c14-8b10b571, 27301340-4a2d61c1-9754659f-1f32a3ba-c517d70f",52243706,10773739,Impression: The left upper chest tube is been removed. The lower chest tube is still in place.  There is interval improved appearance of the lungs with decreased effusions bilaterally. There continues to be volume loss/ infiltrate in the left lower lung and a layering left effusion.,Impression: The left upper chest tube is been removed. The lower chest tube is now in the right side.  There is interval improved appearance of the linges with decreased effusions bilaterally. No volume loss or infiltrate is seen. ,"['Change position of device', 'Add typo', 'False negation']"
7ce067b7-43b86b45-28974414-6f1c4688-b7f94e66,53225875,10773739,"Findings: The tiny volume of residual air in the left pleural space laterally and anteriorly, in the small, stable volume of loculated left pleural fluid or pleural thickening, reflects recent removal of the left thoracostomy tube.  The left hemidiaphragm is more elevated now than it was several days ago, an indication of greater volume loss in the left lower lobe.  The right lung and pleural space and visible mediastinal contours and structures are normal. Impression: 1. Small amount of thoracostomy related air and residual pleural fluid loculation, unchanged. 2. Mild volume loss at the left lower lobe.","Findings: The tiny volume of residual air in the left pleural space laterally and anteriorly, in the small, stable volume of loculated left pleural fluid or pleural thickening, reflects recent removal of the left chest tube. The left hemidiaphragm is more elevated now than it was several days ago, an indication of greater volume loss in the left lower lobe. The right lung and pleural space and visible mediastinal contours and structures are normal. The left lung shows mild fibrosis. Impression: 1. Small amount of thoracostomy related air and residual pleural fluid loculation, unchanged. 2. Mild volume loss at the left lower lobe. The left hemidiaphragm is more elevated now than it was several days ago, an indication of greater volume loss in the left lower lobe.","['Change name of device', 'Add repetitions', 'False prediction']"
e6f661d0-3ef9f93a-c00603f2-8e7d049d-6a3a0581,54534488,10773739,Impression: 2 left-sided chest tubes are again seen. There continues to be a moderate left effusion. There is left sided pulmonary vascular redistribution and alveolar edema that is slightly increased compared to the study from the prior day.  The right lung is clear.,Impression: 2 left-sided chest tubes are again seen. There continues to be a moderate left effusion. There is right sided pulmonary vascular redistribution and alveolar edema that is slightly increased compared to the study from the prior day. The rught lung is clear. A central venous line is present in the right thorax.  ,"['Change location', 'Add typo', 'Add medical device']"
"1ded0fc6-dc59870e-c054eea2-5b6cceee-6151983d, fa7b20f1-0fd5ce93-b4aaf450-db44d8ec-8f3df713",56346242,10773739,Findings: The left-sided chest tube is been removed. There is a small left apical lateral pneumothorax. The volume loss/a atelectasis/effusion on the left is similar compared to prior Compared to the prior study there is no significant interval change Impression: Small left pneumothorax.,Findings: The left-sided Foley catheter is been removed. There is a small left apical lateral pneumothorax. Their is a small right pleural effusion. The volume loss/a atelectasis/effusion on the left is similar compared to prior Compared to the prior study there is no significant interval change Impression: Small left pneumothorax.,"['Change name of device', 'Change to homophone', 'False prediction']"
203fcaff-aaa7aa30-f1eeb9d0-d903b93f-b2bc1a10,57343946,10773739,"Impression: Interval increase in opacification of the left lung is probably a function of pleural restriction and had asymmetric edema, accompanying increase in the volume of pleural fluid at the base of the left hemi thorax. Apical and basal pleural tubes are unchanged in position.  Right lung is clear. Heart is mildly enlarged. Elevation of the left hemi diaphragm is probably a function of left lower lobe atelectasis and pleural fixation.  No pneumothorax.","Impression: Interval increase in opacification of the right lung is probably a function of pleural restriction and had asymmetric edema, accompanying increase in the volume of pleural fluid at the base of the left hemi thorax. Apical and basal pleural tubes are unchanged in position.  Right lung is clear. Heart is mildly enlarged. Elevation of the left hemi diaphragm is probably a function of left lower lobe atelectasis and pleural fixation.  No pneumothorax. Right lung is clear. Mild bilateral pleural effusion is noted. ","['Change location', 'Add repetitions', 'False prediction']"
4f3d57de-827269dc-785ac7cd-9b9c4f86-8366d5da,58663163,10773739,"Impression: Following insertion of left apical and basal pleural drains, there has been a substantial decrease in the volume of left pleural effusion, small to moderate, and largely basal.  Left lower lobe is poorly aerated, so I cannot exclude pneumonia there. The upper lung is clear. There is mild re-expansion edema in the left midlung.  Right lung is clear.  CT scanning would be helpful in assessing both the left pleural space an the lower lung, depending course upon the profile of the thoracentesis aspirate.  No pneumothorax.","Impression: Following insertion of left apical and baffal pleural drains, there has been a substantial decrease in the volume of right pleural effusion, small to moderate, and largely basal.  Right lower lobe is poorly aerated, so I cannot exclude pneumonia there. The upper lung is clear. There is mild re-expansion edema in the left lower lung.  Left lung is clear. Multiple nodular opacities are noted in the right lung base. CT scanning would be helpful in assessing both the left pleural space an the lower lung, depending course upon the profile of the thoracentesis aspirate.  Small pneumothorax is present.","['Change location', 'Add typo', 'False prediction']"
"0634e821-c53b5925-d799ae9a-7d89063e-d8f88591, 0c04004a-a36c9c30-f869bd3d-e4497073-49914c51",59278582,10773739,Findings: Cardiomediastinal contours are normal. The right lung is clear. There is no pneumothorax or right pleural effusion. There is mild elevation of the left hemidiaphragm unchanged from prior. Opacities in the left lower hemithorax have markedly improved with residual probably scarring. Blunting of the left costophrenic angles could represent a small effusion or pleural thickening.  The osseous structures are unremarkable Impression: No acute cardiopulmonary abnormalities.  Minimal residual linear opacities in the left lower lung likely scarring and small left effusion and or pleural thickening,Findings: Cardiomediastinal contours are nominal. The right lung is clear. There is no pneumothorax or right pleural effusion. There is mild elevation of the left hemidiaphragm unchanged from prior. Nodules in the left lower hemithorax have markedly improved with residual probably scarring. Blunting of the left costophrenic angles could represent a small effusion or pleural thickening. There are scattered calcifications within the osseous structures. Impression: No acute cardiopulmonary abnormalities. Minimal residual linear opacities in the left lower lung likely scarring and small left effusion and or pleural thickening. There is mild hyperinflation of the lungs.,"['Change severity', 'Change to homophone', 'False prediction']"
"864c32b8-9a203655-831c5b9a-f9adadcb-767da6bb, eae6b2ca-4d2a18ae-8fbf9cf4-15cf90bc-2ae81da1",51475084,10785610,Findings: The lungs are clear. The cardiomediastinal silhouette is normal.  No acute osseous abnormalities identified. Impression: No acute cardiopulmonary process.,Findings: The longs are clear. The cardiomediastinal silhouette is abnormal. No acute osseous abnormalities identified. The left lung shows a small area of opacity concerning for pneumonia. Impression: No acute cardiopulmonary process.,"['Add contradiction', 'Change to homophone', 'False prediction']"
49910657-1f377f22-5cc20631-adab4e1a-1debb4b0,50512608,10803114,Findings: Small right apical and basilar pneumothorax is not significantly changed compared to the most recent radiograph from ___.  The previously seen small caliber right pleural catheter on the prior chest radiograph is no longer identified.  There are two new larger bore pleural catheters projecting over the right lung base.  There has been interval improvement of the small right-sided pleural effusion.  The left lung is clear without evidence of focal consolidations. There is mild right basilar atelectasis.  The hilar and mediastinal contours are normal. Impression: 1. S/p placement of two new larger bore pleural catheters projecting over the right lung base. Small right pneumothorax not significantly changed compared to the most recent radiograph.  2. Mild right basilar atelectasis.,Findings: Small right apical and basilar pneumothorax is not significantly changed compared to the most recent radiograph from ___. The previously seen small caliber right pleural catheter on the prior chest radiograph is no longer identified. There are two new Foley catheters projecting over the right lung base. There has been interval improvement of the small right-sided pleural effusion. There is no basilar atelectasis. The left lung is clear without evidence of focal consolidations. There is mild right basilar atelectasis. The hilar and mediastinal contours are normal. Impression: 1. S/p placement of two new larger bore pleural catheters projecting over the right lung base. Small right pneumothorax worsened compared to the most recent radiograph. 2. Mild right basilar atelectasis.,"['Change name of device', 'Add contradiction', 'False negation']"
a239d4b6-5c88ad05-ed28dae6-22f93f18-4538a559,50901934,10803114,"Findings: Comparison to the most recent preceding radiograph, there is a slight reaccumulation of fluid in the right pleural space.  Two chest tubes are noted in that space.  A tiny apical pneumothorax is present.  Right atelectasis is also present.  The left lung is essentially clear.  Cardiac size is normal. ","Findings: Comparison to the most recent preceding radiograph, there is a slight reaccumulation of fluid in the left pleural space.  Two chest tubes are noted in that space.  No pneumothorax is present.  Right atelectasis is also present.  The left lung is essentially clear.  Cardiac size is normal.  Impression: Nodular areas identified within both lungs.","['Change location', 'Add contradiction', 'False negation']"
21b088f4-785d17f9-7d448101-6744c865-87dd790b,52569432,10803114,"Impression: Pigtail right base.  No pneumothorax, reduced effusion.","Impression: ET tube present in the trachea.  No pneumotherax, reduced effusion.","['Change location', 'Add typo', 'Add medical device']"
24dcc6bd-268da180-8371ae76-64cd7bcd-550a8701,53287973,10803114,"Impression: 1.  There is a stable small right apical pneumothorax.  Two right basilar chest tubes remain in place and there is contiguous patchy airspace disease in this vicinity which is essentially unchanged.  A small but stable right effusion is likely present.  The left lung remains clear.  Overall, cardiac and mediastinal contours are stable.  No evidence of pulmonary edema.","Impression: 1.  There is a stable large right apical pneumothorax.  Two right basilar chest tubes remain in place and there is contiguous patchy airspace disease in this vicinity which is essentially unchanged.  A small but stable right effusion is likely present.  The left lung remains clear.  Overall, cardiac and mediastinal contours are stable.  No evidence of pulmonary edema.  No left-sided pleural effusion is observed.","['Change severity', 'Add repetitions', 'False prediction']"
dd5da479-b1000fad-3146bb1a-6a6c7244-25e07794,53696310,10803114,"Findings: In comparison with study of ___, there is little interval change in the appearance of the small residual effusion and atelectatic changes at the right base with Pleurx catheter in place.  No evidence of pneumothorax. ","Findings: In comparison with study of ___, there is little interval change in the appearance of the small residual effusion and atelectatic changes at the right base with Hickman catheter in place. There is no evidence of pneumothorax. A central venous line is noted in the left subclavian vein.","['Change name of device', 'Change to homophone', 'Add medical device']"
"3bcd0d92-81373a0a-8fb28e74-2cac5886-c8fd319b, c3c8dab4-129cc1cd-e3818349-2e9417a3-50ceda9c",53790841,10803114,"Findings: PA and lateral chest views were obtained with patient in upright position.  Analysis is performed in direct comparison with the next preceding similar study of ___.  The heart size remains normal.  No configurational abnormality is seen.  Unremarkable appearance of thoracic aorta.  The pulmonary vasculature is not congested.  No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free.  No evidence of pneumothorax in the apical area on the frontal views.  As already seen on the preceding study, there is a mild degree of right-sided convex scoliosis in the thoracic spine with moderate degree of degenerative changes, but no other skeletal abnormalities are identified. Impression: Stable chest findings, no cardiomegaly, pulmonary congestion or interstitial abnormalities suspicious for amiodarone toxicity.","Findings: AP and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. The heart size remains enlarged. No configurational abnormality is seen. Unremarkable appearance of abdominal aorta. The pulmonary vasculature is congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No evidence of pneumothorax in the apical area on the frontal views. Mild pulmonary edema is present. As already seen on the preceding study, there is a mild degree of left-sided convex scoliosis in the thoracic spine with moderate degree of degenerative changes, but no other skeletal abnormalities are identified. Impression: Stable chest findings, no cardiomegaly, pulmonary congestion or interstitial abnormalities suspicious for amiodarone toxicity. ","['Change location', 'Add contradiction', 'False prediction']"
"583ddbd2-50f85c61-b2d63c29-0c4cc293-77060208, a9c0a1f8-cb2a4f30-656ef3e2-e80e3406-e70d3c53",54240463,10803114,Findings: A large subpulmonic effusion is present on the right with associated atelectasis.  The heart size is at the upper limits of normal and the visualized mediastinal and hilar contours are within normal limits.  The left lung is clear.  There is no pneumothorax.  Two locules of gas in the left upper abdomen represent the gastric bubble and splenic flexure of the colon. Impression: Large right pleural effusion with associated atelectasis.,Findings: A right-sided pleural effusion with associated atelectasis is present. The heart size is upper limits of noral and the visualized mediastinal and hilar contours are within normal limits.  Bibasilar opacities likely representing infiltrates are noted. The left lung is clear.  There is no pneumothorax.  Two locules of gas in the left upper abdomen represent the gastric bubble and splenic flexure of the olon. Impression: Large right pleural effusion with associated atelectasis.,"['Change position of device', 'Add typo', 'False prediction']"
"d5afdb09-0bfe8802-651a2d06-44efa800-80a795fe, ffc73da5-5e52ccfd-028a2711-ae2702af-ad87c455",56199877,10803114,"Findings: The cardiac, mediastinal and hilar contours appear unchanged.  There is no shift of mediastinal structures.  There is a large right-sided pleural effusion, which has increased since the earlier radiographs and perhaps slightly since the more recent CT.  There is no pneumothorax.  The left lung remains clear. Impression: Similar to increased right-sided pleural effusion, large in size. No evidence of pneumothorax.","Findings: The cardiac, mediastinal and hilarious contours appear unchanged.  There is no shift of mediastinal structures.  There is no pleural effusion.  There is no pneumothorax.  The left lung remains clear. Impression: Similar to increased right-sided pleural effusion, massive in size. No evidence of pneumothorax.","['Change severity', 'Change to homophone', 'False negation']"
"2bbed805-9edabe38-d0476a90-21720847-53aa7ab7, 4e706237-7bfcb1f1-73ed2f42-d39a58df-de79389a",56530218,10803114,"Impression: 1.  Two right basilar chest tubes remain in place.  There is a stable small right apical pneumothorax.  Contiguous patchy airspace disease at the right base is also seen and stable.  There is a small residual right pleural effusion vs. pleural thickening, unchanged.  Left lung is clear.  No evidence of pulmonary edema.  Heart remains enlarged.  Mediastinal contours are unchanged.","Impression: 1.  Two right basilar chest tubes remain in place.  There is a stable small right apical pneumothoramx.  Contiguous patchy airspace disease at the right base is absnt.  There is a small residual right pleural effusion vs. pleural thickening, slightly enlarged.  Left lung is clear.  No evidence of pulmonary edema.  Heart remains mildy enlarged.  Mediastinal contours are unchanged.","['Change severity', 'Add typo', 'False negation']"
44a77474-9433858c-b46ea842-b78cbd76-b08fc180,56814699,10803114,Impression: No change.,Findings: The heart is within normal limits in size. Lungs are free of acute infiltrates. There is no evidence of pneumothorax or pleural effusion. Multiple surgical clips are present in the right upper quadrant.,"['Add contradiction', 'Add typo', 'Add medical device']"
"6e7b243d-a11a3f29-49057751-677985e1-c29b0e67, c9cf7fd7-7209115e-f7497506-5548d12f-30259e65",56915281,10803114,Findings: Frontal and lateral views of the chest demonstrate similar configuration as a right basal approach pleural catheter in place.  There is a persistent small right pleural effusion with associated atelectasis and a small perifissural component.  Previously seen pneumothorax component in the right basal hydropneumothorax is no longer visible.  The right upper lung and left lung appear well aerated.  There is no pulmonary edema or left pleural effusion.  The heart is normal in size.  The mediastinal and hilar contours are within normal limits.  Multilevel upper thoracic anterior spondylosis is present. Impression: Stable small right pleural effusion with associated atelectasis and pleural chest catheter in place.,Findings: Frontal and lateral views of the chest demonstrate similar configuration as a right basal approach pleural vaccum in place.  There is a persistent small right pleural effusion with associated atelectasis and a small perifissural component.  Previously sen pneumothorax component in the right basal hydropneumothorax is no longer visible.  The right upper lung and left lung appear well aerated.  There is no pulmonary edema or left pleural effusion.  The heart is normal in size.  The mediastinal and hilar contours are within normal limits.  Multilevel upper thoracic anterior spondylosis is present.  A left-sided central venous line is seen terminating in the superior vena cava. Impression: Stable small right pleural effusion with associated atelectasis and pleural chest cathter in place.,"['Change name of device', 'Add typo', 'Add medical device']"
e29f99dd-1ecf184b-8a7a3240-781f606a-b37061da,58469461,10803114,"Findings: PA and lateral views of the chest demonstrate a right-sided pleural catheter in unchanged position.  The pleural effusion has decreased in size, now only a small amount remains, but there is now air within the pleura. The chest is otherwise unchanged, including right basal atelectasis, and clear left lung.  Cardiac size remains stable. Impression: Interval decrease in the amount of fluid but increase in the amount of air within the right pleura compatible with a small hydropneumothorax.","Findings: PA and lateral views of the chest demonstrate a right-sided vascular stent in unchanged position.  The pleural effusion has decreased in size, now only a small amount remains, but there is now air within the pleura. The pleural effusion has decreased in size, now only a small amount remains, but there is now air within the pleura. The chest is otherwise unchanged, including right basal atelectasis, and clear left lung.  No pleural air is seen. Impression: Interval decrease in the amount of fluid but increase in the amount of air within the right pleura compatible with a small hydropneumothorax.","['Change name of device', 'Add repetitions', 'False negation']"
"3b21641a-0dbd0858-0948dffc-42b3b047-a2153a8a, e5fe40d3-47686c41-bd3deb46-bff9a8dd-60e1fc04",56869570,10807361,"Findings: PA and lateral views of the chest provided.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. 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 abdomen provided. There is no focal consolidation, effusion, or pneumotorax. The cardiomediastinal silettou is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. An NG tube is in place. Impression: No acute intrathoracic process.","['Change location', 'Add typo', 'Add medical device']"
30b12960-af4bffa5-615613dd-d0a3cdcc-f885a90f,59649487,10817099,Findings: Interval extubation.  Cardiomediastinal contours are within normal limits and without change.  Improved aeration at the lung bases with residual subsegmental atelectasis at the left lung base. Impression: Improving aeration at lung bases with residual left lower lobe subsegmental atelectasis.,Findings: Interval extubation.  Cardiomediastinal contours are within normal limits and without change.  Improved aeration at the left lung base with residual subsegmental atelectasis at the left lung base. Impression: No subsegmental atelectasis.,"['Change location', 'Change to homophone', 'False negation']"
"635af03b-69756d41-3660ec05-e2c0ec37-d732f2cc, bb1e3b63-37b0c06b-9ee2551f-b2d7cf01-ed2f7d8b",50702835,10862054,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The heart is top-normal in size.  There is mild unfolding of the thoracic aorta.  The cardiac and mediastinal silhouettes are otherwise unremarkable. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without vocal consolidation.  No pleural effusion or pneumothorax is seen.  The heart is top-normal in size.  No unfolding of the thoracic aorta.  The cardiac and mediastinal silhouettes are otherwise unremarkable. Impression: No acute cardiopulmonary process.,"['Change severity', 'Change to homophone', 'False negation']"
"6320a177-342a4fd7-a6b6cd85-53265126-c5592815, 7ca81fd6-1bf2f074-46a147a6-c0a1560d-28d9dde0",52442425,10862054,Findings: Frontal and lateral views of the chest were obtained.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable.  Hilar contours are also stable. Impression: No acute cardiopulmonary process.,Findings: Frontal and lateral views of the leg were obtained.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable.  Hilar counters are also stable. A left-sided central venous line is present. Impression: No acute cardiopulmonary process.,"['Change location', 'Change to homophone', 'Add medical device']"
48c29455-ce143787-9c665645-6d085f76-c141b0f1,52877968,10862054,"Impression: PA and lateral chest compared to ___:  Normal heart, lungs, hila, mediastinum and pleural surfaces.","Impression: PA and lateral chest compared to ___:  Cardiac silhouette is top normal, lungs, hila, mediastinum and pleural surfaces.  Mild pleural effusion present. No pleural effusion noted.","['Change location', 'Add contradiction', 'False prediction']"
"e5ba8565-97cf1086-bd6674d6-78042027-ad400dce, fde68247-83632d38-2e159579-20fba1c5-c7473876",53265978,10893584,"Findings: The lungs are clear bilaterally. The heart may be at the upper limit of normal, however there are low lung volumes and magnification artifact present (AP film).  No pleural effusion or pneumothorax is seen. On the lateral, a thin-walled ring shadow unlikely be of significance is seen. Impression: No radiographic evidence for the patient's leukocytosis.","Findings: The lungs are clear bilaterally. The heart may be at the upper limit of normal, however there are low lung volumes and magnification artifact present (AP film). No pleural effusion or pneumothorax is seen. On the lateral, a thin-walled ring shadow unlikely be of significance is seen. No pleural effusion or pneumothorax is seen. Impression: No radiographic evidence of a left-sided pleural effusion. ","['Change location', 'Add repetitions', 'False prediction']"
"74155497-e80ec02f-154721b7-bc76f816-069c92eb, d1552af1-5b159d3e-4058cc59-8af87caf-375f46e7",53623762,10924949,Findings: Lung volumes are low and exaggerate pulmonary vascular markings.  There are bibasilar atelectatic changes but the lungs are otherwise without a focal consolidation.  The cardiac and mediastinal contours appears stable.  Left ventriculoperitoneal shunt is again visualized traversing through the chest into the upper abdomen.  No acute fractures are identified.  Severe degenerative changes are noted at the right glenohumeral joint with moderate degenerative changes throughout the thoracolumbar spine. Impression: No acute cardiopulmonary process.,Findings: Lung volumes are low and exaggerate pulmonary vascular markings. There are bibasilar aspiratory changes but the lungs are otherwise without a focal consolidation. The cardiac and mediastinal contours appears stable with left-sided pleural effusion. Left ventriculoperitoneal shunt is again visualized traversing through the chest into the upper abdomen. No significant fractures are identified. Severe degenerative changes are noted at the right glenohumeral joint with mild degenerative changes throughout the thoracolumbar spine. Impression: Mild acute cardiopulmonary process.,"['Change severity', 'Change to homophone', 'False prediction']"
"9174f95c-f3fdd1b5-b0a921a6-de43c3e8-939bcfa2, f4ec1ae5-a9b3e696-9647c6e3-2518312e-e435cf0a",58001725,10924949,"Findings: Frontal lateral views of the chest.  Tubing seen along the left anterior chest wall, presumably from a ventriculoperitoneal shunt.  Relatively low lung volumes are seen.  The lungs however are clear of consolidation or effusion.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormality detected. Impression: No acute cardiopulmonary process.","Findings: Frontal lateral views of the chest. Tubing seen along the right anterior chest wall, presumably from a ventriculoperitoneal shunt. No tubing seen. Relatively low lung volumes are seen. The lungs however are clear of consolidation or effusion. Mild right-sided consolidation noted. Cardiomediastinal silhouette is within normal limits. Slight cardiomegaly is observed. No acute osseous abnormality detected. Impression: No acute cardiopulmonary process.","['Change location', 'Add contradiction', 'False negation']"
"171a4674-65e7ed96-c63bae1f-faa3fd7d-07ac9309, 4d5310fd-468856e6-1b902127-c506ed84-8b93870d",53302173,10986871,"Findings: Cardiomediastinal and hilar contours are stable demonstrating mild cardiomegaly.  Mitral annular calcifications are noted.  Bibasilar opacities, left greater than right are demonstrated and may represent infection or atelectasis.  Lower lung volumes on the current exam results in crowding of the bronchovascular markings.  The aorta is tortuous and calcified.  There is no pneumothorax.  There is no pleural effusion.  There is marked degenerative change involving the glenohumeral joints bilaterally. Impression: Bibasilar opacities, left greater than right suggest infection or atelectasis. Mild cardiomegaly is stable.",Findings: Cardiomediastinal and hilar contours are stable demonstrating mild cardiomegaly.  Mitral annular calcifications are noted.  No opacities are demonstrated.  Lower lung volumes on the current exam results in crowding of the broncho-vascular markings.  The aorta is tortuous and calcified.  There is no pneumothorax.  There is no pleural effusion.  There is marked degenerative change involving the glanohumeral joints bilaterally. Impression: No bibasilar opacities suggest infection or atelectasis. Severe cardiomegaly is stable.,"['Change severity', 'Change to homophone', 'False negation']"
d0d2bd0c-8bc50aa2-a9ab3ca1-cf9c9404-543a10b7,54076811,11001469,Impression: No evidence of free air.,Impression: No evidence of free air. No evidence of free air. Impression: Free air noted in the abdominal cavity.,"['Add repetitions', 'Add contradiction', 'False negation']"
"0ab98ebc-3e42c243-135283ca-41290b6b-639453bd, 47cc7240-5f6606db-9489804d-ba5151f2-7b875507",53261242,11045233,"Findings: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.  Mild multilevel degenerative changes of visualized thoracic spine are noted. Impression: No acute cardiopulmonary process.","Findings: There is no focal consolidation, pleural effusion, pneumothorax, or mild pulmonary edema. The cardiomediastinal silhouette is within normal limits. Slight multilevel degenerative changes of visualized thoracic spine are noted. Impression: Mild cardiopulmonary process is present.","['Change severity', 'Add contradiction', 'False negation']"
5baac073-ce7e3f3a-9ba21c8f-9237a435-845c26f6,50986892,11068484,"Findings: Since ___, substantial pulmonary edema is increased, bilateral layering pleural effusions, right greater than left, are increased with persistent bibasilar and retrocardiac atelectasis.  Lung volumes remain low.  Cardiomegaly is difficult to evaluate but also appears worse.  No pneumothorax. Impression: Substantial pulmonary edema is increased, bilateral layering pleural effusions, right greater than left, are also increased with persistent bibasilar retrocardiac atelectasis since ___","Findings: Since ___, substantial pulmonary edema is increased, bilateral basal pleural effusions, right greater than left, are increased with persistent bibasilar and retrocardiac atelectasis. Lung volumes remain low. Cardiomegaly is difficult to evaluate but also appears worse. No pneumothorax. Substantial pulmonary edema is increased, bilateral layering pleural effusions, right greater than left, are increased with persistent bibasilar and retrocardiac atelectasis. Impression: Substantial pulmonary edema is increased, bilateral layering pleural effusions, right greater than left, are also increased with new left upper lobe consolidation since ___","['Change location', 'Add repetitions', 'False prediction']"
9613d784-ef4fadd2-8b33b9c3-3db90fd4-6730c5d6,52314386,11068484,Findings: Compared to the prior study there is no significant interval change. Impression: No change.,Findings: Compared to the prior study their is no significant interval change. There is an infiltrate in the right middle lobe. Impression: No change.,"['Change severity', 'Change to homophone', 'False prediction']"
"2c072c9e-42b8fab0-a0fd256c-780bc612-53941594, 35626d65-acd62381-7a66c7ef-04150642-7e5e9b32",53544633,11068484,"Impression: As compared to ___ radiograph, cardiomegaly is accompanied by improved pulmonary vascular congestion and decrease in size of left pleural effusion, now small.  A moderate right pleural effusion persists with adjacent basilar atelectasis and or consolidation.  Elevation of the right hemidiaphragm is a persistent finding since ___.","Impression: As compared to ___ radiograph, cardiomegaly is accompanied by improved pulmonary vascular congestion and decrease in size of right pleural effusion, now small. A moderate right pleural effusion persists with adjacent basilar atelectasis and or consolidation. A moderate right pleural effusion persists with adjacent basilar atelectasis and or consolidation. Elevation of the right hemidiaphragm is a persistent finding since ___. Subtle ground-glass opacities are noted in the left upper lobe.","['Change location', 'Add repetitions', 'False prediction']"
5a686ceb-f01792db-cdba870c-da79a22f-f34265ea,54047608,11068484,"Findings: Lung volumes remain low.  Silhouetting of the left hemidiaphragm and blunting of the left costophrenic angle is new compared to the prior exam and suggest presence of small pleural effusion.  Is probably also atelectasis. There is moderate pulmonary edema.  Heart size is probably a moderate to severely enlarged, even in the setting of low lung volumes and portable technique.  Elevation of the right hemidiaphragm is unchanged.  Severe pulmonary vascular engorgement is overall unchanged.  Right infrahilar opacity may reflect combination of atelectasis, edema.  Concurrent infection cannot be excluded.  No pneumothorax.  Extensive aortic knob calcifications are unchanged. Impression: Low lung volumes.  Findings most consistent with volume overload. However, concurrent infection cannot be excluded.  This patient could benefit from a chest CT non-emergently.","Findings: Lung volumes remain low. Silhouetting of the left hemidiaphragm and blunting of the left costophrenic angle is knew compared to the prior exam and suggest presence of small pleural effusion. There is probably also atelectasis. There is mild pulmonary edema. Heart size is probably a moderate to severely enlarged, even in the setting of low lung volumes and portable technique. Elevation of the right hemidiaphragm is unchanged. Severe pulmonary vascular engorgement is overall unchanged. Right infrahilar opacity may reflect combination of atelectasis, edema. A central venous line is present. Concurrent infection cannot be excluded. No pneumothorax. Extensive aortic knob calcifications are unchanged. Impression: Low lung volumes. Findings most consistent with volume overload. However, concurrent infection cannot be excluded. This patient could benefit from a chest CT non-emergently. ","['Change severity', 'Change to homophone', 'Add medical device']"
c4752408-15e8abd3-707ec66e-a1449931-5430926e,55945977,11068484,"Findings: Portable semi-erect chest radiograph ___ at 23:12 is submitted. Impression: Lung volumes remain low with crowding of the vasculature and bibasilar opacities likely representing atelectasis, although pneumonia or aspiration cannot be excluded.  Worsening mild perihilar edema.  Stable cardiac and mediastinal contours with calcification of the aortic knob.  No pneumothorax.",Findings: Portable semi-erect chest radiograph ___ at 23:12 is submited. Impression: Lung volumes remain low with crowding of the vasculature and no opacities observed. Worsening moderate perihilar edema. Stable cardiac and mediastinal contours with calcification of the aortic knub. No pneumothorax.,"['Change severity', 'Add typo', 'False negation']"
4cac02f5-71a07948-2e40edb0-d546dcad-b3683965,55984935,11068484,Findings: AP portable upright view of the chest.   Lung volumes are markedly low limiting evaluation.  There is chronic elevation of the right hemidiaphragm.  Left mid to lower lung opacity could reflect the presence of pneumonia or aspiration.  There is pulmonary vascular congestion with at least mild pulmonary edema.  Pleural effusions are likely present.  Heart size cannot be assessed.  No pneumothorax.  Bony structures appear grossly intact. Impression: Limited exam with left lower lung consolidation concerning for pneumonia or aspiration.  Mild pulmonary edema with bilateral pleural effusions.,Findings: AP portable upright view of the chest.  Lung volumes are moderately low limiting evaluation.  There is chronic elevation of the right hemidiaphragm.  Left mid to lower lung opacity could reflect the presence of pneumonia or aspiration.  There is pulmonary vascular congestion with at least mild pulmonary edema.  Pleural effusions are likely present.  Lung volumes are moderately low limiting evaluation.  No pleural effusions.  No pneumothorax.  Bony structures appear grossly intact. Impression: Limited exam with left lower lung consolidation concerning for pneumonia or aspiration.  No pulmonary edema with bilateral pleural effusions.,"['Change severity', 'Add repetitions', 'False negation']"
"5da374a7-95f81d01-9c2072c5-7a5799b7-2f7164e0, fadc81b1-9ea238c0-58b6e7a8-915e4bbc-34aee7b4",56360523,11068484,"Findings: AP upright and lateral views the chest were provided.  Lung volumes are low limiting assessment.  Elevation of the right hemidiaphragm is again noted.  There is bibasilar atelectasis.  Hilar congestion and mild pulmonary edema is noted.  No large effusions are seen.  Heart size cannot be assessed.  Mediastinal contour appears grossly unchanged with atherosclerotic calcifications of the aortic knob.  Bony structures are grossly intact. Impression: Mild edema, bibasilar atelectasis.","Findings: AP upright and lateral views the chest were provided.  Lung volumes are low limiting assessment.  Elevation of the right hemidiaphragm is again noted.  There is bibasilar atelectasis.  Hilar congestion and moderate pulmonary edema is noted.  No large effusions are seen.  Heart size cannot be assessed.  Mediastinal contour appears grossly unchanged with atherosclerotic calcifications of the aortic knob.  Bony structures are grossly intact.  There is bibasilar atelectasis. Impression: No edema, bibasilar atelectasis.","['Change severity', 'Add repetitions', 'False negation']"
06e2fd1d-35c95f84-e6021f4a-4611a14e-a4b9a693,57395441,11068484,Findings: Compared to the prior study there is no significant interval change. Impression: No change.,Findings: Compared to the prior study there is no significant interval change. Impression: Mild change.,"['Change severity', 'Add contradiction', 'False prediction']"
"804c7e55-eb848216-fc96a88b-0e374004-dacbc260, a85d21f5-217f24d8-6de4274b-ec73620f-ac05403c",59455276,11068484,Impression: Heart size is prominent but stable.  There are calcifications of the thoracic aorta.  There are very low lung volumes.  There is atelectasis at the lung bases.  There is a left retrocardiac opacity.  There is prominence of the pulmonary interstitial markings suggestive of mild pulmonary edema.  No pneumothoraces are seen.,Impression: Heart size is prominent but stable. There are calcifications of the thoracic aorta. There are very low lung volumes. There is atelectasis at the lung bases. There is a left retroclavicualr opacity. There is prominence of the pulmonary interstitial markings suggestive of mild pulmonary edema. No pneumothoraces are seen. There is a small pleural effusion on the right.,"['Change location', 'Add repetitions', 'False prediction']"
b0f9a42a-784e16e8-201986c2-ae91c454-6f5cbbd6,59971654,11068484,"Impression: Severe cardiomegaly and pulmonary vascular engorgement are unchanged since ___.  Mild pulmonary edema on present on ___ has resolved.  Atelectasis in the right middle lobe and atelectasis or consolidation in the infrahilar left lower lobe are unchanged.  Pleural effusions are small if any. No pneumothorax.  Chest CT scanning would be useful to determine the extent of pulmonary abnormality the size of right pleural effusion, and the presence if any pericardial effusion.  Chest CTA would of course be diagnostic regarding pulmonary emboli.",Impression: Severe cardiomegaly and pulmonary vascular engorgement are unchanged since ___.  Mild pulmonary edema on present on ___ has resolved.  Atelectasis in the right middle lobe and atelectasis or consolidation in the infrahilar left lower lobe are unchanged.  Large pleural effusions are small if any. No pneumothorax.  No pulmonary abnormality.  Chest CTA would of course be diagnostic regarding pulmonary emboli.  Mild pulmonary edema on present on ___ has resolved.,"['Change severity', 'Add repetitions', 'False negation']"
"1f6d1038-c6cffc09-b682f19e-854afec7-cef098a5, f52765f8-018073b3-3ce025f3-c3820e4f-a3c35f56",56811276,11082901,Findings: Lungs are clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,Findings: Lungs are cleer.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. An endotracheal tube is noted.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,"['Add typo', 'Add repetitions', 'Add medical device']"
"4eb4be03-2765d772-09f40d82-96431de2-b7ca17e9, b21d03fd-ba77c145-efcda1f7-654925ed-bba4d6e8",51797846,11091816,"Findings: Mild enlargement of the cardiac silhouette is present.  The aorta is tortuous. The mediastinal and hilar contours are otherwise unremarkable.  Pulmonary vasculature is not engorged.  Lungs are clear.  No focal consolidation, pleural effusion or pneumothorax is present.  There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.","Findings: Severe enlargement of the cardiac silhouette is present.  The aorta is tortuous.  Enhanced mediastinal and hilar contours are present.  Pulmonary vasculature is not engorged.  Lungs are clear.  No focal consolidation, pleural effusion or pneumothorax is present.  There are no acute osseous abnormalities. Impression: Mild cardio megaly detected. ","['Change severity', 'Add contradiction', 'False negation']"
"b4a9606f-2d62a1a5-c7d2c5e1-7ca25c12-e1d2f15f, bc2e5f8e-5fa53cf8-97cc7920-21879c69-eada094b",57451515,11128012,"Findings: The lungs are clear without focal consolidation, pleural effusion or pneumothorax.  There is no pulmonary edema.  The heart is normal in size, and the mediastinal contours are normal.  There continues to be elevation of the right hemidiaphragm, similar to prior radiographs. Impression: No acute cardiopulmonary process.","Findings: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary nodule. The heart is normal in sighs, and the mediastinal contours are normal. There continues to be elevation of the left hemidiaphragm, similar to prior radiographs. Impression: No acute cardiopulmonary process.","['Change location', 'Change to homophone', 'False prediction']"
30e1c508-1a2ca634-02f30afb-06fc43a9-d7eac519,51942946,11134683,Findings: No focal consolidation is seen. Biapical pleural thickening is noted.  No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. The aorta is calcified and tortuous. Old posterior lateral left ninth rib fracture was better seen on prior x-ray. Impression: No acute cardiopulmonary process.,Findings: No focal consolidation is seen. Biapical pleural thickening is noted. No pleural effusion or pneumothorax is seen. The cardiac silhouette is left-medial. The aorta is calcified and tortuous. Old posterior lateral left ninth rib fracture was better seen on prior x-ray. There is a right-sided pacemaker. The cardiac silhouette is left-medial. Impression: No acute cardiopulmonary process.,"['Change location', 'Add repetitions', 'Add medical device']"
9f4042d8-67b0cf43-edad00d1-e8a6f893-c8c3548c,50091414,11135350,"Impression: Since ___, the patient has been intubated, with tip of endotracheal tube terminating within 2 cm of the carina.  This can be withdrawn a few cm for standard positioning.  Additionally, the cuff of the tube is apparently over distended.  Cardiomegaly is accompanied by improved pulmonary vascular congestion and near resolution of interstitial edema.  Small pleural effusions have also decreased in size in the interval.","Impression: Since ___, the patient has been intubated, with tip of endotracheal tube terminating within 3 cm of the carina.  This can be withdran a few cm for standard positioning.  Additionally, the cuff of the tube is apparently over distended.  Cardiomegaly is accompanied by improved pulmonary vascular congestion and near resolution of interstitial edema.  Small pleural effusions have also decreased in size in the interval.  An NG tube is present and its position is appropriate.","['Change measurement', 'Add typo', 'Add medical device']"
e2cc529b-ba7a0982-effc5cf0-662077a9-c2ce376f,52432586,11135350,"Impression: Compared to prior radiograph of 1 day earlier, endotracheal tube remains relatively low, with tip terminating 2 cm above the carina.  Cardiomegaly is accompanied by pulmonary vascular congestion and slight worsening of pulmonary edema.  Bilateral pleural effusions are a persistent finding, and left retrocardiac atelectasis or consolidation has improved.","Impression: Compared to prior radiograph of 1 day earlier, endotracheal tube remains relatively low, with tip terminating 4 cm above the carina.  Cardiomegaly is accompanied by pulmonary vascular congestion and slight worsening of pulmonary edema.  Bilateral pleural effusions are a persistent finding, and left retrocardiac atelectasis or consolidation has improved. Cardiomegaly is accompanied by pulmonary vascular congestion and slight worsening of pulmonary edema.  A right-sided central venous line is noted in appropriate position.","['Change position of device', 'Add repetitions', 'Add medical device']"
a49ebd3a-d86b070c-87256a4b-f5bb2b7e-f8ebaa00,53036339,11135350,Findings: Assessment is somewhat limited due to marked patient rotation.  The endotracheal tube tip is 2 cm above the carina.  A right internal jugular catheter terminates in the distal SVC.  There is persistent left lower lobe atelectasis.  The heart remains enlarged.  Bilateral pleural effusions are similar in appearance when compared to the prior study.  Airspace opacity at the right lung base may reflect either atelectasis or infection. Impression: Bibasilar atelectasis versus consolidation.  Otherwise no significant interval change when compared to the prior study.,Findings: Assessment is somewhat limited due to marked patient rotation.  The endotracheal tube tip is 3 cm above the carina.  A right internal jugular catheter terminates in the distal SVC.  There is persistent left lower lobe atelectasis.  The heart remains enlarged.  Bilateral pleural effusions are similar in appearance when compared to the prior study.  Airspace opacity at the right lung base may reflect either atelectasis or infection.  Airspace opacity at the right lung base may reflect either atelectasis or infection. Impression: Bibasilar atelectasis versus consolidation.  Otherwise no significant interval change when compared to the prior study.,"['Change measurement', 'Add repetitions', 'False prediction']"
f3a27e2d-1d0d73bc-b7394f0c-7ed82c79-189ddee5,53277637,11135350,"Findings: Since the chest radiographs obtained 3 days prior, there has been a significant increase in left lung atelectasis with leftward mediastinal shift. Patient positioning does not account for all apparent mediastinal shift.  Unable to assess for concomitant left pleural effusions or consolidation.  The right lung is fully expanded and clear. Impression: Subtotal left lung collapse with significant leftward mediastinal shift concerning for an airway obstruction such as an endobronchial lesion, foreign body, or mucous plug.","Findings: Since the chest radiographs obtained 3 days prior, there has been a moderate increase in left lung atelectasis with leftward mediastinal shift. Patient positioning does not account for all apparent mediastinal shift. Unable to assess for concomitant left pleural effusions or consolidation. The right lung is fully expanded and clear.  Unable to assess for concomitant left pleural effusions or consolidation. Impression: Subtotal left lung collapse with significant leftward mediastinal shift concerning for an airway obstruction such as an endobronchial lesion, foreign body, or mucous plug. Presence of a central venous line noted.","['Change severity', 'Add repetitions', 'Add medical device']"
317f2687-c3bf422b-70bb63ef-c094a677-6c81f799,53452058,11135350,"Impression: The tip of the endotracheal tube again is low and is 1.4 cm above the carina.  This could be pulled back for more optimal placement.  Right IJ central line has the distal lead tip in the distal SVC, unchanged.  Heart size is enlarged but stable. There is a left retrocardiac opacity and bilateral effusions.  There has been mild improvement of the pulmonary interstitial edema.","Impression: The tip of the endotracheal tube again is low and is 1.8 cm above the carina.  This could be pulled back four more optimal placement.  Right IJ central line has the distal lead tip in the distal SVC, unchanged. An endotracheal tube is noted in the trachea. Heart size is enlarged but stable. Their is a left retrocardiac opacity and bilateral effusions.  There has been mild improvement of the pulmonary interstitial edema.","['Change measurement', 'Change to homophone', 'Add medical device']"
"120e5b75-c3500201-4fcbcd62-51265bb3-e3371c84, 598d6145-85bfdcdc-b0cd756d-4d72d599-79e3f10a",53762826,11135350,"Findings: AP upright and lateral views of the chest provided.  Tiny clips in the left axilla are again noted. The heart remains mildly enlarged. There is no focal consolidation, large effusion, or pneumothorax. A rounded density at the right pulmonary hilum likely represents a large vessel en face.  No convincing signs of pneumonia or edema.  Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Impression: Mild cardiomegaly. Otherwise unremarkable.","Findings: AP upright and lateral views of the chest provided. Tiny clips in the left axilla are again noted. The heart remains mildly enlarged. There is no focal consolidation, large effusion, or pneumothorax. A rounded density at the right pulmonary hilum likely represents a large PICC line. No convincing signs of pneumonia or edema. A chest tube is seen in the left thorax. No free air below the right hemidiaphragm is seen. Impression: Moderate cardiomegaly. Otherwise unremarkable.","['Change name of device', 'Add contradiction', 'Add medical device']"
cd3281a8-6fdf014d-d38263aa-913e7ac6-50920fae,53772313,11135350,"Impression: As compared to the previous image, no relevant change is seen.  The endotracheal tube and the right internal jugular vein catheter are constant position.  Moderate cardiomegaly.  Unchanged mild enlargement of the right hilus.  .  Overall low lung volumes with mild fluid overload but no overt pulmonary edema.  No evidence of pneumonia.","Impression: As compared to the previous image, no relevant change is seen.  The endotracheal tube and the right internal jugular vein catheter are in a slightly superior position.  No cardiomegaly.  Unchanged mild enlargement of the right hilus.  .  Overall low lung volumes with mild fluid overload but no overt pulmonary edema.  There are signs consistent with pneumonia.","['Change position of device', 'Add contradiction', 'False negation']"
2d945b0a-0962f1ea-b9f44bcd-83adc688-3a74a962,54266284,11135350,"Impression: As compared to ___, signs indicative of pulmonary edema have increased.  There is now moderate pulmonary edema.  Moderate cardiomegaly.  Low lung volumes.  Minimal blunting of the costophrenic sinuses, potentially indicative of pleural effusions.","Impression: As compared to ___, signs indicative of pulmonary edema have increased.  There is now mild pulmonary edema.  Moderate cardiomegaly.  Low lung volumes.  Minimal blunting of the costophrenic sinuses, potentially indicative of pleural effusions. A pacemaker is present.","['Change severity', 'Add contradiction', 'Add medical device']"
"05213484-b9cc6edd-f1208b60-51391906-10549d97, 3dd5a5cf-d8a6dc19-0e4fbd9e-3c8cb517-68034727",57156490,11135350,"Impression: As compared to the previous radiograph, the patient has been extubated.  The right internal jugular vein catheter remains in unchanged position.  Unchanged moderate cardiomegaly with new partial left lower lobe atelectasis.  No change in appearance of the right lung.","Impression: As compared too the previous radiograph, the patient has been extubated.  The right PICC line remains in unchanged position.  Unchanged moderate cardiomegaly with no atelectasis.  No change in appearance of the right lung.  ","['Change name of device', 'Change to homophone', 'False negation']"
0a7b4797-26061ea5-69f731ec-a45b9e8e-b4a66113,57437729,11135350,Findings: ET tube is seen with tip approximately 1.8 cm from the carina.  Enteric tube seen passing below the inferior field of view.  Lower lung volumes are noted on the current exam with bilateral parenchymal opacities which could be due to edema or infection.  Prominence of the right hilum is again noted.  Moderate cardiomegaly and appears to have progressed since prior could potentially be in part due to changes in positioning.  No acute osseous abnormalities.  Surgical clips project over the left chest wall/axilla. Impression: ET and enteric tubes as above.  Cardiomegaly with bilateral parenchymal opacities potentially infection or edema.,"Findings: ET tube is seen with tip approximately 5 mm from the carina.  Enteric tube scene passing below the inferior field of view.  Lower lung volumes are noted on the current exam with bilateral parenchymal opacities which could be due to edema or infection.  Prominence of the right hilum is again noted, with a new 2 cm nodule in the left upper lobe.  Moderate cardiomegaly and appears to have progressed since prior could potentially be in part due to changes in positioning.  No acute osseous abnormalities.  Surgical clips project over the left chest wall/axilla. Mild pleural effusion observed on the right. Impression: ET and enteric tubes as above.  Cardiomegaly with bilateral parenchymal opacities potentially infection or edema.","['Change measurement', 'Change to homophone', 'False prediction']"
e9151bd8-1aa6fa8b-d9bfa6c6-4035e4a5-e0e856bd,57976096,11135350,Impression: Tip of endotracheal tube continues to terminate within 1.5 cm above the carinal with the neck in a flexed position.  Cardiomediastinal contours are stable.  Small to moderate right pleural effusion has apparently increased in size in the interval.  No other relevant changes.,Impression: Tip of endotracheal tube continues to terminate within 1.5 mm above the carinal with the neck in a flexed position.  Cardiomediastinal contours are stable.  Small to moderate right pleural effusion has apparently increased in size in the interval.  No other relevant changes.  Pacemaker is noted in the left thoracic region.  Small to moderate right pleural effusion has apparently increased in size in the interval.,"['Change measurement', 'Add repetitions', 'Add medical device']"
7a9248b7-731f2e31-4c7a766b-902c1682-03ec67c8,57998601,11135350,"Impression: As compared to ___, the monitoring and support devices are constant.  Increasing right pleural effusion.  Unchanged moderate cardiomegaly with signs of mild to moderate pulmonary edema.  Increasing extent of a left retrocardiac atelectasis.","Impression: As compared to ___, the monitoring and support devices are constant.  Decreasing right pleural effusion.  Unchanged mild cardiomegaly with signs of mild to moderate pulmonary edema.  Increasing extent of a left retrocardiac atelectasis.  A right IJ central venous catheter is in place.","['Change severity', 'Add contradiction', 'Add medical device']"
532c6ecd-2488a763-5bd16f91-8214f9de-8fb8c49d,58052703,11135350,Impression: ___.,Please provide me with a chest X-ray radiology report so that I can proceed with the task as requested.,"['Add typo', 'Change to homophone', 'Add medical device']"
02ae05fc-ce6ab459-7561db4d-881fb85b-5a207608,58767809,11135350,"Findings: Since the chest radiograph obtained 1 day prior, there is substantial improvement in aeration throughout the left lung.  Subtotal collapse has resolved with minimal residual atelectasis of the apex and lung base.  Right lung is fully expanded and clear.  No obvious consolidations.  Moderate cardiomegaly is unchanged.  Pleural effusions small, if any. Impression: Substantially increased left lung aeration with minimal residual atelectasis of the left apex and left lung base.","Findings: Since the chest radiograph obtained 1 day prior, there is mild improvement in aeration throughout the left lung.  Subtotal collapse has resolved with no residual atelectasis of the apex and lung base.  Right lung is fully expanded and clear.  No obvious consolidations.  Left lung shows new increased opacities.  Cardiomegaly is unchanged.  No pleural effusions. Impression: Substantially increased left lung aeration with minimal residual atelectasis of the left apex and left lung base.  ","['Change severity', 'Add contradiction', 'False negation']"
"556d5af6-986670c8-db365f47-e8286407-b025908b, 88877d10-188b5a1e-d99e6d09-75236a50-63e30ee8",59122716,11135350,"Findings: AP and lateral views of the chest.  The right lung is clear.  There is obscuration of the left hemidiaphragm, which is clearly seen on prior and could be due to underlying left basilar atelectasis or pneumonia.  Increased opacity over the spine on the lateral view is likely in part due to degenerative, the tortuous descending thoracic aorta and hilar vasculature, although superimposed component of overlying consolidation is also possible in this region.  Atherosclerotic calcifications are noted at the aortic arch.  There is a sliver of lucency projecting over the upper abdomen to the left of midline.  This is of could be due to pneumomediastinum or potentially free intraperitoneal air.  Consider repeat examination with a chest x-ray with PA technique if possible.  Otherwise, CT scan may be necessary.    Findings were discussed with Dr. ___ at 5:35 p.m. on ___ by Dr. ___ ___ the phone 2 minutes after time of discovery. ","Findings: AP and lateral views of the chest.  The left lung is clear.  There is obscuration of the left hemidiaphragm, which is clearly seen on prior and could be due to underlying left basilar atelectasis or pneumonia.  Increased opacity over the spine on the lateral view is likely in part due to degenerative, the tortuou descnding thoracic aorta and hilar vasculature, although superimposed component of overlying consolidation is also possible in this region.  Atherosclerotic calcifications are noted at the aortic arch.  There is a sliver of lucency projecting over the upper abdomen to the left of midline.  This is of could be due to pneumomediastinum or potentially free intraperitoneal air.  Consider repeat examination with a chest x-ray with PA technique if possible.  Otherwise, CT scan may be necessary.  A bilateral pleural effusion is present.  Findings were discussed with Dr. ___ at 5:35 p.m. on ___ by Dr. ___ ___ the pone 2 minutes after time of discovery. ","['Change location', 'Add typo', 'False prediction']"
56291d00-a7244635-53aa8eb3-dce3a174-bc250ba0,59746851,11135350,"Impression: Consolidation in the left lower lobe is new since ___, without improvement since ___.  Previous moderate right pleural effusion is slightly smaller.  Severe cardiomegaly is not.  There is no pulmonary edema.  No pneumothorax.  ET tube is in standard placement.  Sharp definition of the upper margin of the cuff indicates secretions pooling above the.  Right jugular line ends in the low SVC.",Impression: There is no consolidation.  Previous moderate right pleural effusion is slightly smaller.  Mild cardiomegaly is not.  Mild pulmonary edema.  No pneumothorax.  ET tube is placed 2 cm above the carina.  Sharp definition of the upper margin of the cuff indicates secretions pooling above the.  Right jugular line ends in the mid right atrium.,"['Change position of device', 'Add contradiction', 'False negation']"
"4662c1cc-57eb400d-e894dd62-0486f8e4-6b84a7e1, a5c3470b-be30e581-14b6f2be-8eb54504-adeaa406",51953245,11144972,"Findings: Frontal and lateral views of the chest were obtained.  There is prominence of the hila raising concern for vascular engorgement, although underlying lymphadenopathy may be present and could be further evaluated for on chest CT.  No focal consolidation is seen.  There is minimal pulmonary vascular congestion.  The cardiac and mediastinal silhouettes are unremarkable.  There is no pleural effusion or pneumothorax. Impression: Prominence of the hila could be due to vascular engorgement, although underlying lymphadenopathy not excluded.  Findings could be further evaluated on non-urgent chest CT.","Findings: Frontal and lateral views of the chest were obtained.  There is prominence of the hila raising concern for vascular engorgement, although underlying lymphadenopathy may be present and could be further evaluated for on chest CT.  No focal consolidation is seen.  There is minimal pulmonary vascular congestion.  The cardiac and mediastinal silhouettes are unremarkable.  No pulmonary vascular congestion is observed.  There is no pleural effusion or pneumothorax. Impression: Prominence of the left hila could be due to vascular engorgement, although underlying lymphadenopathy not excluded.  Findings could be further evaluated on non-urgent chest CT.  There is no prominence of the hila.","['Change location', 'Add contradiction', 'False negation']"
1d6f62f9-adc5107d-e66dba67-28c879ec-bcf9e17a,56430288,11164575,"Findings: As compared to the previous radiograph, there is no relevant change.  Borderline size of the cardiac silhouette.  No acute process, in particular no pneumonia or pulmonary edema.  No pleural effusions.  No pneumothorax. ","Findings: As compared to the previous radiograph, there is no relevant change.  Cardiac pacemaker is in place.  No acute process, in particular no pneumonia or pulmonary edema.  No pleural effusions.  Moderate pulmonary edema is seen.  ","['Add medical device', 'Add contradiction', 'False negation']"
f9624358-214a129c-dc05b026-e49885ed-66224bdb,54099371,11177224,"Findings: Single frontal view of the chest.  Heart size and mediastinal contours are stable.  Left lower lobe atelectasis persists.  Pulmonary vascular markings have increased and the hila appear indistinct and hazy, findings consistent with interval worsening of pulmonary edema.  In addition, multiple widely distributed small rounded opacities were not seen on ___ and, given the short time interval, likely represent vascular structures. Impression: Slight interval worsening of pulmonary edema with persistent left lower lobe atelectasis.  Multiple bilateral small rounded opacities, new since ___, are most likely engorged vessels, but follow-up is recommended after resolution of pulmonary edema.","Findings: Single frontal view of the chest.  Heart size and mediastinal contours are stable.  Left lower lobe atelectasis persists.  Pulmonary vascular markings have decreased and the hila appear indistinct and hazy, findings consistent with interval worsening of pulmonary edema.  In addition, multiple widely distributed small rounded opacities were not seen on ___ and, given the short time interval, likely represent vascular structures.  Small left-sided pleural effusion is noted. Impression: Slight interval improvement of pulmonary edema with persistent left lower lobe atelectasis.  Multiple bilateral small rounded opacities, new since ___, are most likely engorged vessels, but follow-up is recommended after resolution of pulmonary edema.","['Change severity', 'Add contradiction', 'False prediction']"
25a4da29-677dfc01-3c7bc2e9-ca5766ff-8910f5a1,57718675,11177224,Findings: Portable semi-upright radiograph of the chest demonstrates increased interstitial markings in the bilateral lungs concerning for pulmonary edema.  Increased opacification in the retrocardiac region raises concern for atelectasis versus pneumonia.  There is a small left-sided pleural effusion.  Cardiomediastinal and hilar contours are unchanged.  No pneumothorax. Impression: 1.  Interval increase in interstitial markings raises concern for pulmonary edema.  2.  Retrocardiac opacity is consistent with atelectasis or less likely pneumonia.,Findings: Portable semi-upright radiograph of the chest demonstrates increased interstitial markings in the bilateral lungs concerning for pulmonary edema.  Increased opacification in the retrocardiac region raises concern for atelectasis versus pneumonia.  There is a small right-sided pleural effusion.  Cardiomediastinal and hilar contours are unchanged.  Small bilateral pleural effusions observed.  Impression: 1.  Interval decrease in interstitial markings raises concern for pulmonary edema.  2.  Retrocardiac opacity is consistent with atelectasis or less likely pneumonia.,"['Change location', 'Add contradiction', 'False prediction']"
a9f45db3-3320935c-32abfa1d-70c84639-f9d19d75,53038461,11181748,"Impression: As compared to the previous radiograph, the right pleural effusion has been almost completely drained.  There is no evidence of pneumothorax.  Otherwise unchanged radiograph.","Impression: As compared to the previous radiograph, the left pleural effusion has been almost completely drained.  There is no edvidence of pneumothorax.  Otherwise unchanged radiograph containing a central venous line.","['Change location', 'Add typo', 'Add medical device']"
c75317be-225faf00-b7bccd06-b199a930-a4ef45ff,53610077,11181748,Findings: Right-sided pleural effusion has minimally decreased.  Right-sided adjacent atelectasis and fluid along the fissure have also decreased.  The left lung is clear.  The cardiomediastinal silhouette is unchanged.  Numerous calcified lesions in the right chest wall are stable. Impression: Slight interval decrease in right-sided pleural effusion and atelectasis.,Findings: Left-sided pleural effusion has minimally decreased. Right-sided adjacent atelectasis and fluid along the fissure have also decreassed. The left lung is clear. The cardiomediastinal silhouette is unchanged. Numerous calcified lesions in the right chest wall are stable. There is a small nodular opacity in the left lung apex. Impression: Slight interval decrease in right-sided pleural effusion and atelectasis.,"['Change location', 'Add typo', 'False prediction']"
"7a54f39f-f199adbd-22bd79bc-f9ef8f44-0ee9682f, febddc5e-2a9cf23a-7c6c7b4b-227c0ad3-96a82b0d",53956979,11181748,Findings: Cardiomediastinal silhouette is stable.  Moderate right pleural effusion has decreased in size with better aeration of the right lung.  The left lung is clear.  There is no left pleural effusion.  No pneumothorax. Impression: Interval decreased moderate right pleural effusion.,"Findings: Cardiomediastinal silhouette is stabile.  Mild right pleural effusion has decreased in size with better aeration of the right lung.  The left lung is clear, with a small atelectasis in the upper lobe.  There is no left pleural effusion.  No empyema. Impression: Interval decreased mild right pleural effusion.","['Change severity', 'Add typo', 'False prediction']"
589ad56b-158c86eb-cb95283c-8452b1ed-44503295,54592417,11181748,Impression: New atelectasis right middle lobe probably due to increased small right pleural effusion.  Left lung clear.  Heart size normal.,Impression: New atelectasis right middle lobe probably due to increased mild right pleural effusion.  Left lung clear.  Heart size normal.  Left lung clear.,"['Change severity', 'Add repetitions', 'Add medical device']"
"648179a6-4fa29136-911690e6-f934aaa8-bcd92eef, 6fab1ad7-445ea2a4-e4074846-ffc0bcd0-3a5972ca",55851177,11181748,"Findings: A large right pleural effusion is new from the prior study.  Superimposed opacity likely represents compressive atelectasis, however infectious process could be considered the proper clinical setting.  There is no left pleural effusion.  There is mild pulmonary vascular congestion without overt pulmonary edema. Impression: 1. New large right pleural effusion. 2. Superimposed opacity may represent compressive atelectasis or infectious process in the proper clinical setting. 3. Mild pulmonary vascular congestion without overt pulmonary edema.","Findings: A moderate right pleural effusion is new from the prior study.  Superimposed opacity likely represents compressive atelectasis, however infectious process could be considered the proper clinical setting.  There is no left pleurl effusion.  There is moderate pulmonary vascular congestion without overt pulmonary edema.Nasogastric tube is noted in the stomach. Impression: 1. New large right pleural effusion. 2. Superimposed opacity may represent compressive atelectasis or infectious process in the proper clinical setting. 3. Moderate pulmonary vascular congestion without overt pulmonary edema.","['Change severity', 'Add typo', 'Add medical device']"
"20a8146b-74dd756c-382fd16f-2248a7d2-a74b9bbd, 3b81672c-7380f29c-16a0623b-5e6342fc-243805ea",58227020,11181748,"Findings: Small right pleural effusion is stable.  There is no evidence of pneumothorax, lobar consolidation, or pulmonary edema.  No left-sided pleural effusion.  The cardiomediastinal silhouette is unchanged from the prior examination. Impression: Stable small right pleural effusion.","Findings: Large right pleural effusion is stable.  There is no evidence of pneumothorax, lobar consolidation, or pulmonary edema.  No left-sided pleural effusion.  The cardiomediastinal silhouette is unchanged from the prior examination.  An osteolytic lesion is seen in the left clavicle. Impression: Stable small right pleural effusion.","['Change severity', 'Add repetitions', 'False prediction']"
f2ed03fa-b7c00d7d-985f0cb3-dc9fb555-01c54c25,54514716,11197890,"Impression: The lung volumes are normal. The patient is intubated. The tip of the endotracheal tube projects 4.5 cm above the carinal. The course of the nasogastric tube is unremarkable.  No pleural effusions.  No pneumonia, no pulmonary edema. Moderate tortuosity of the thoracic aorta.","Impression: The lung volumes are normal. The patient is intubated. The tip of the endotracheal tube projects 5.3 cm above the carinal. The course of the nasogastric tube is unremarkable.  No pleural effusions.  No pneumonia, no pulmonary edema. Moderate tortuosoty of the thoracic aorta. There is a small right-sided pleural effusion.","['Change measurement', 'Add typo', 'False prediction']"
"61f52c00-7a583d5a-eb7fe590-480bddd5-3a5776dc, cb6b6702-9109f7be-cb626f90-5de5b6ef-4f4c7ad9",57239326,11216230,"Findings: No focal consolidation, pleural effusion or pneumothorax is seen.  Prominent bilateral interstitial markings are stable from prior exam.  The cardiac silhouette is normal in size.  Multiple bilateral rib deformities reflect prior fractures. Impression: No acute cardiopulmonary process.","Findings: No focal consolidation, pleural effusion, or pneumothorax is seen. Prominent right interstitial markings are stable from a prior exam. The cardiac silhouette is mildly enlarged. Multiple bilateral rib deformities reflect prior fractures and new acute fractures on the left. Impression: No acute cardiopulmonary process.","['Change location', 'Add contradiction', 'False prediction']"
34aad429-6b57597f-a1caa34d-d84cef06-3bc0c4ab,58384629,11219382,Impression: Comparison to ___.  No relevant change.  No pneumonia.  Mild overinflation.  Normal size of the heart.  Minimal bilateral apical scarring.,Impression: Comparison to ___b.  No releverant change.  No pneumonia.  Moderate overinflation.  Normal size of the heart.  Minimal bilateral apical scarring. An ET tube is in place.,"['Change severity', 'Add typo', 'Add medical device']"
"0301c574-112ee0a8-1ccd9da9-2d579a55-b2f80210, 7aebcf40-c513d753-29abca25-111aef26-ba376639",51350911,11226572,"Findings: Chest PA and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours.  The lungs are clear.  No pleural effusion or pneumothorax is evident. Impression: No acute intrathoracic process or evidence of recurrent sarcoidosis.","Findings: Chest PA and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours.  Minimal bilateral pleural effusion is present.  The lungs aer clear.  No pleural effusion or pneumothorax is evident. Impression: No acute intrathoracic process or evidence of recurrent scarcoidosis.","['Change location', 'Add typo', 'False prediction']"
"da9de99a-88589600-954a7bf7-b947b366-25d4cf16, f2f96a77-ffa800e0-fe3c692c-487ed51b-87b84b10",51860612,11226572,"Findings: Focal opacity in the left lower lobe is not from nipple shadow and on retrospective review was imaged in the CT abdomen and pelvis on ___ and likely represents atelectasis or focal scarring. No new focal opacity, pneumothorax, pleural effusion or pulmonary edema.  Heart size, mediastinal contour and hila are normal.  No bony abnormality. Impression: Focal opacity in the left lower lobe likely represents atelectasis or focal scarring.","Findings: Focal opacity in the left lower lobe is not from nipple shadow and on retrospective review was imaged in the CT abdomen and pelvis on ___ and likely represents atelectasis or focal scarring. No new focal opacity, pneumothorax, pleural effusion or pulmonary edema. There is a small pleural effusion in the right lung base. Heart size, left mediastinal contour and hila are normal.  No new focal opacity, pneumothorax, pleural effusion or pulmonary edema. No bony abnormality. Impression: Focal opacity in the left lower lobe likely represents atelectasis or focal scarring.","['Change location', 'Add repetitions', 'False prediction']"
"48f65bd6-fd930f65-27b3123b-39cb33cc-049a89be, 7c3703a8-64b5649b-f5839d8c-3e2cf8e8-d0e6eee3",53521127,11226572,"Findings: The lungs are hyperinflated.  Multifocal bilateral opacities are concerning for multifocal pneumonia atypical infection or viral infection. No pleural effusion, edema, or pneumothorax. Heart size is normal. Hilar contours are unchanged.  No mediastinal widening. Impression: Multifocal pneumonia, atypical or viral.","Findings: The lungs are hyperinflated. Multifocal bilateral opacities are concerning for multifocal pneumonia atypical infection or viral infection. No pleural effusion, edema, or pneumothorax. Heart size is normal. Hilar contours are unchanged. No mediastinal widening. There is a large mass in the left lung. Heart size is normal.","['Change location', 'Add repetitions', 'False prediction']"
c7524a34-034ad3d1-e934a59f-85f18631-6f81adad,53764194,11226572,"Findings: Previously seen focal consolidation at the lingula is resolved and there is only minimal residual interstitial thickening. There is no consolidation, pleural effusion, or pneumothorax.  Cardiomediastinal and hilar silhouette are normal size and unchanged.  There is no radiographic findings that suggests sarcoidosis. The lungs are mildly hyperinflated. Impression: No evidence of pneumonia.","Findings: Previously seen focal consolidation at the lingula is resolved and there is only moderate residual interstitial thickening. There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouette demonstrate mild cardiomegaly. There is no radiographic findings suggesting sarcoidosis. The lungs are mildly hyperinflated with bibasilar atelectasis. Impression: No evidence of pneumonia. Early signs of lung infection.","['Change severity', 'Add contradiction', 'False prediction']"
"648ee6d5-cb5e79fb-b7aca47b-5b20049b-042b1f8a, efa7ce32-9434194a-c88b2633-833bc1e5-4b39a4fc",54348250,11226572,"Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  The chest appears somewhat hyperinflated.  There is no pleural effusion or pneumothorax.  There is no indication of lymphadenopathy or parenchymal interstitial disease that would be likely to reflect sarcoidosis.  In the lingula, there is persistent minor opacification, but considerably reduced so possibly due to scarring from a prior process. Impression: Persistent lingular opacity, but markedly reduced, so possibly due to scarring; although perhaps unlikely recurrent pneumonia at the site is not entirely excluded, however.  No radiographic findings particularly suggestive of active sarcoid.","Findings: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The chest appears somewhat hyperinflated with bilateral pleural effusions. There is no pleural effusion or pneumothorax. No opacification noted. There is no indication of lymphadenopathy or parenchymal interstitial disease that would be likely to reflect sarcoidosis. In the lingula, there is persistent minor opacification, but considerably reduced so possibly due to scarring from a prior process. Impression: Persistent lingular opacity, but markedly reduced, so possibly due to scarring; although perhaps unlikely recurrent pneumonia at the site is not entirely excluded, however. Mild interstitial lung disease findings suggestive of active sarcoid.","['False prediction', 'Add contradiction', 'False negation']"
80ebdd2c-d387828d-89e90960-df690604-91bd8696,56558940,11226572,"Findings: The cardiac, mediastinal and hilar contours appear stable.  There is no pleural effusion or pneumothorax.  The lungs appear clear aside from minor unchanged scarring in the lingula. Impression: No evidence of acute cardiopulmonary disease.","Findings: The cardiac, mediastinal and hilar contours appear sable.  There is no pleural effusion or pneumothorax.  An ET tube is seen with its tip just above the carina.  The lungs appear clear aside from minor unchanged scarring in the lingula. Impression: Moderate bilateral pleural effusions and pneumothorax.","['Add typo', 'Add contradiction', 'Add medical device']"
"a2c7838e-c081e69b-ecdee541-780db068-00b5fd81, c468a266-8cdc345b-7830d55d-85f6be9c-42a47dc9",59178330,11226572,"Findings: There is o pacitiy at the left lung base, but is unchanged since ___ when patient was asymptomatic. This suggests chronic scarring.  Otherwise, there are no focal consolidations, pleural effusions or pneumothorax. No evidence of hilar lymphadenopathy. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Impression: Left lung base opacity, likely due to chronic atelectasis. No hilar lymphadenopathy.","Findings: There is opacity at the right lung base, but is unchanged since ___ when patient was asymptomatic. This suggests chronic scarring. However, new focal consolidation is present. Otherwise, there are no focal consolidations, pleural effusions or pneumothorax. No evidence of hilar lymphadenopathy. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Impression: No evidence of left lung base opacity. No hilar lymphadenopathy.","['Change location', 'Add contradiction', 'False negation']"
"1231dc8f-4cf6ae66-2754d2f7-db1abf04-fe0eb62b, ecd38a1a-a066f8ff-860275d8-be7ba46b-09449675",59951875,11226572,"Findings: Frontal and lateral views of the chest were obtained.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  Mild left base and lingular linear atelectasis/scarring is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable. Impression: No acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest were obtained.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  Moderate left base and lingular linear atelectasis/scarring is scene.  The cardiac and mediastinal silhouettes are stable and unremarkable. Impression: No acute cardiopulmonary process.","['Change severity', 'Change to homophone', 'False negation']"
"0f4d6e3a-d8e36345-55070513-6f057329-b4f1283b, 55ba8d4b-a90e56a6-4209b8bf-e6950992-a13cab93",59535336,11260884,"Findings: The lungs are clear of focal consolidation, pleural effusion or pneumothorax.  The heart size is normal.  The mediastinal contours are normal. Degenerative changes are noted in the thoracolumbar spine. Impression: No acute cardiopulmonary process.","Findings: The langs are clear of focal consolidation, pleural effusion or pneumothorax.  The heart size is normal.  The mediastinal contours are normal. No degenerative changes are noted. Impression: No acute cardiopulmonary process. Impression: Severe degenerative changes in the thoracolumbar spine.","['Add contradiction', 'Add typo', 'False negation']"
"7b305795-f3816546-a9a8227a-013d0d53-47dec574, 7c4d214c-4ec4e4bd-71675aed-fad9c05a-e679ee9a",54116119,11285398,"Findings: PA and lateral views of the chest provided.   Lungs are clear.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process.","Findings: AP and lateral views of the chest provided. Lungs are not clear. Lateral opacities noted, possible consolidation, and mild effusion. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. There is free air below the right hemidiaphragm. Impression: No acute intrathoracic process. There is a right IJ central venous catheter in place.","['Change location', 'Add contradiction', 'Add medical device']"
dc423670-4243d370-0917d0d7-e7ccb499-f9e256e6,50043121,11287042,"Findings: Interval resolution of the right subpulmonic effusion. Mild elevation of the left hemidiaphragm, most likely secondary to bowel distention and interposition of bowel between the spleen and left hemidiaphragm. No focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. Stable appearance of the cardiomediastinal silhouette. No sub-diaphragmatic intra-abdominal free air. Impression: 1.  Interval resolution of the right subpulmonic pleural effusion.  2.  No acute cardiopulmonary process.","Findings: Interval resolution of the right subpulmonic effusion. Moderate elevation of the left hemidiaphragm, most likely secondary to bowel distention and interposition of bowel between the spleen and left hemidiaphragm. No focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. Stable appearance of the cardiomediastinal silhouette. No sub-diaphragmatic intra-abdominal free air. Impression: 1. Interval resolution of the right subpulmonic pleural effusion. 2. Mild focal consolidation in the left lower lobe.  3. No acute cardiopulmonary process.","['Change severity', 'Add contradiction', 'False negation']"
"2cd661d7-82b0c37e-0db4c82f-d0b33edb-842bf86c, 87ca06e4-657d51bb-8f660ff0-655f3f25-3c421dbe",50391562,11287042,"Impression: Small to moderate right subpulmonic pleural effusion has re accumulated, substantially smaller than its volume on ___.  Aside from mild right basal atelectasis lungs are clear.  There is no left pleural effusion. There is no evidence of central lymph node enlargement.  Incidental note is made of a heavily calcified mitral anulus and possible left atrial enlargement, but there is no overall cardiomegaly or any pulmonary vascular congestion or pulmonary edema.","Impression: Small to large right subpulmonic pleural effusion has re accumulated, substantially smaller than its volume on ___.  Aside from mild right basal atelectasis lungs are clear.  There is no left pleural effusion. There is no evidence of central lymph node enlargement.  Incidental note is maid of a heavily calcified mitral anulus and possible left atrial enlargement, but there is no overall cardiomegaly or any pulmonary vascular congestion or pulmonary edema.","['Change severity', 'Change to homophone', 'False negation']"
"1ad21961-ee94488b-7fc68fbd-3a8a8100-9b71edfc, 31afabb5-1bab1f87-ced724a1-8ae227f6-6bca4f42",50657073,11287042,"Findings: PA and lateral views of the chest provided.   A small right pleural effusion is noted not significantly changed from the prior PET-CT allowing for differences in modality. Otherwise, lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. Impression: Small right pleural effusion, not significantly changed from prior PET-CT.","Findings: PA and lateral views of the chest privided.  A small left pleural effusion is noted not significantly changed from the prior PET-CT allowing for differences in modulation. Otherwise, lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. A central venous line is present. Impression: Small left pleural effusion, not significantly changed from prior PET-CT.","['Change location', 'Add typo', 'Add medical device']"
"a0baf1bf-063bb5ba-1044c1ee-23f0b7ed-24b8169a, d3e2e4d5-85f72646-4f703a66-df6941af-3344c515",53208211,11287042,Impression: Moderate subpulmonic right pleural effusion smaller today than on ___. There is probably mild right basal atelectasis. Lungs are otherwise clear.  No left pleural effusion..  Mediastinum is midline and contours are normal.  Stomach is moderately distended with air.  No pneumothorax.,Impression: Moderate subpulmonic left pleural effusion smaller today than on ___. There is probably mild right basel atelectasis. Lungs are otherwise clear.  No left pleural effusion..  Mediastinum is midline and contours are normal.  Stomach is moderately distended with air.  No pneumothorax.***Added central venous line.***,"['Change location', 'Add typo', 'Add medical device']"
b8084cc6-129daa21-5e7278cf-1038961e-a964e354,54197597,11287042,Findings: The lungs are clear. A small right pleural effusion is stable. The heart and mediastinum are within normal limits despite the projection.  There is no pneumothorax. Impression: Clear lungs with no evidence of pneumothorax. Stable small right pleural effusion.,Findings: The lungs are clear. A large right pleural effusion is stable. The heart and mediastinum are within normal limits despite the projection.  There is no pneumothorax. There is no pneumothorax. An ET tube is present. Impression: Clear lungs with no evidence of pneumothorax. Clear lungs with no evidence of pneumothorax. Stable small right pleural effusion.,"['Change severity', 'Add repetitions', 'Add medical device']"
"579d3a5f-1e6911b4-307a3da3-6a8c84c8-27cfb985, 58a552fb-7fb1145c-d82ff0eb-3efacd83-c20fb38f",56219888,11287042,Impression: Heart size and mediastinum are stable. Lungs are clear. Elevated right hemidiaphragm is re- demonstrated as well as calcified mitral anulus. There is no definitive pleural effusion seen and there is no pneumothorax.  Prior mediastinal lesions to the as seen on the previous chest CT are not clearly seen on the current examination,"Impression: Heart size and mediastinum are sable. Lungs are clear. Elevated right hemidiaphragm is re-demonstrated as well as calcified mitral anulus. There is a small left pleural effusion seen, but there is no pneumothorax. Prior mediastinal lesions to t he as seen on the previous chest CT are not clearly seen on the current examination.","['Change location', 'Add typo', 'False prediction']"
"620d7dcf-06e6a794-87f53b98-bc55811e-8fc54800, a19d711b-6c29af26-11883860-c9e6a00a-dd8b349c",56969632,11287042,Findings: PA and lateral views of the chest provided.  There is new retrocardiac opacity consistent with left lower lobe pneumonia.  Mild elevation of the right hemidiaphragm is again noted with stable blunting of the right CP angle suggesting small right pleural effusion versus pleural thickening. No pneumothorax. No edema. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. Impression: Left lower lobe pneumonia.,Findings: PA and lateral views of the chest prvovided. There is new retrocardiac opacity consistent with left lower lobe pneumonia. Moderate elevation of the right hemidiaphragm is again noted with stable blunting of the right CP angle suggesting small right pleural effusion versus pleural thickening. No pneumothorax. No edema. A central venous line is present. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. Impression: Left lower lobe pneumonia.,"['Change severity', 'Add typo', 'Add medical device']"
ebff6ece-1b6243e8-1f3cd0af-af4824b5-3f629000,58000103,11287042,"Impression: Small right pleural effusion is overall stable. There is new bandlike opacity in the right mid lung, concerning for atelectasis or developing infectious process. Alternatively it might represent the fluid in the fissure (major).  Lungs are essentially clear otherwise. No pleural effusion demonstrated on the left.","Impression: Large right pleural effusion is overall stable. There is new bandlike opacity in the right mid lung, concerning for atelectasis or developing infectious process. Alternatively it might represent the fluid in the fissure (major).  Lungs are essentially clear otherwise. No pleural effusion demonstrated on the left. Impression: There is no right pleural effusion.","['Change severity', 'Add contradiction', 'False negation']"
cd8b3583-06cd4871-e09025fe-a2a60b90-348e7521,51634516,11307058,"Findings: Compared with the most recent radiograph, left lower lobe opacity compatible with infection is grossly unchanged.  There is minimal right basilar atelectasis.  Lobulated contour abutting the aortic arch and projecting over the AP window is compatible with thoracic aortic aneurysm and prior dissection.  Intact median sternotomy wires.  No pneumothorax.  Tiny, if any, right pleural effusion. Impression: Persistent left lower lobe consolidation, compatible with infection.  Small right pleural effusion.","Findings: Compared with the most recent radiograph, left lower lobe opacity compatible with infection is grossly unchanged.  There is moderate right basilar atelectasis.  Lobulated contour abutting the aortic arch and projecting over the AP window is compatible with thoracic aortic aneurysm and prior dissection.  Intact median sternotomy wires.  No pneumothorax.  Tiny, if any, right pleural effusion. There is moderate right basilar atelectasis. Impression: No left lower lobe consolidation.  Small right pleural effusion.","['Change severity', 'Add repetitions', 'False negation']"
"3f5dec1b-45644e70-ed34cbb0-1a80da55-77581541, a39f20a8-d6fcb2c5-62904bb6-546afe49-0d7926bc",51697632,11307058,"Findings: There is new left lower lobe opacity compatible with infection.  Elsewhere, lungs are clear.  Lobulated contour abutting the aortic arch and projecting over the AP window on the frontal view is compatible with thoracic aortic aneurysm with prior dissection.  No acute osseous abnormalities. Impression: Left lower lobe consolidation compatible with pneumonia.  Repeat after treatment suggested to document resolution. Stable appearance of the mediastinum with abnormal aortic contour as seen on multiple priors.","Findings: There is new right lower lobe opacity compatible with infection.  Elsewhere, lungs are cler.  Lobulated contour abutting the aortic arch and projecting over the AP window on the frontal view is compatible with thoracic aortic aneurysm with prior dissection.  No acute osseous abnormalities noted, but evidence of right side rib fractures. Impression: Left lower lobe consolidation compatible with pneumonia.  Repeat after treatment suggested to document resolution. Stable appearance of the mediastinum with abnormal aortic contour as seen on multiple priors.","['Change location', 'Add typo', 'False prediction']"
"ab25e52b-e8eebab5-500ce27e-c39b6376-71e6f3f1, b040bf26-e5aa5364-1a53b33b-6aea1bb0-89637102",53295563,11307058,"Impression: In comparison with the study of ___, there is again a hyperexpansion of the lungs consistent with chronic pulmonary disease.  Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.  There is substantial prominence of the descending aorta, better characterized on the CT of the chest from ___.","Impression: In comparison with the study of ___, there is again a hyperexpansion of the lungs consistent with chronic pulmonary disease.  Cardiac silhouette is within normal limits with mild interstitial edema and there is no vascular congestion, pleural effusion, or acute focal pneumonia. The cardiac silhouette shows no vascular congestion, pleural effusion, or acute focal pneumonia. There is substantial prominence of the descending aorta, better characterized on the CT of the chest from ___. An NG tube is seen with its tip located in the stomach.","['False prediction', 'Add repetitions', 'Add medical device']"
"1b56958d-2db30a47-c149a47c-5161435f-f70948bd, 5f053b2c-56f23cae-42d6a64d-cc58332c-8a49a6fe",54070533,11307058,Findings: Patient is status post median sternotomy.  The appearance of the cardiac and mediastinal silhouettes is stable ; patient has reported history of known thoracic aortic dissection and descending aortic dilatation.  There is a likely hiatal hernia.  No focal consolidation is seen.  No large pleural effusion or pneumothorax.  No overt pulmonary edema. Impression: No acute cardiopulmonary process.  Stable appearance of the mediastinum.,"Findings: Patient is status post median sternotomy.  The appearance of the cardiac and mediastinal silhouettes is stable, with the heart severely enlarged.  There is a likely hiatal hernia.  Mild focal consolidation is seen.  There is a small pleural effusion and pneumothorax.  Severe overt pulmonary edema.  There is an endotracheal tube terminating 5 cm above the carina. Impression: Mild cardiopulmonary congestion.  Stable appearance of the mediastinum.","['Change severity', 'Add contradiction', 'Add medical device']"
"a0c5a980-ee72873e-6b8ab2e4-ccf5e1b7-56693b1b, da624dca-d4652abd-453c6fc6-a97f99a7-93578866",56032638,11307058,"Impression: In comparison with the study of ___, there is little change.  The aneurysm and dilatation of the descending aorta is unchanged.  No evidence of vascular congestion or acute focal pneumonia.","Impression: In comparison with the study of ___, there is little change. The aneurysm and dilatation of the descending aorta is unchanged. No evidence of vascular congestion or acute focal consolidation.","['False prediction', 'Add typo', 'False negation']"
"03270807-5e38a815-9e4f8720-08103828-f27bb4e4, 05abb6c4-7cc9ae3c-bc29c9da-5c2f5ab2-8845a3ae",58044051,11307058,"Findings: Compared to prior, there is opacity a partially obscuring the left heart border, concerning for pneumonia or atelectasis.  The right lung is clear.  No pleural abnormality is seen.  Mediastinal contour is consistent with patient's known thoracic aortic dissection and descending aortic dilatation, unchanged from prior. Impression: Possible lingular pneumonia vs. atelectasis.","Findings: Compared to prior, there is opacity a partially obscuring the right heart border, concerning for pneumonia or atelectasis.  The right lung is clear.  The right lung is clear.  No pleural abnormality is seen.  Mediastinal contour is consistent with patient's known thoracic aortic dissection and descending aortic dilatation, unchanged from prior. Impression: No lingular pneumonia.","['Change location', 'Add repetitions', 'False negation']"
"2c1b8528-f39e96b9-54bb89a8-d99d2ec5-472472ce, cbfd7625-9544bc09-c925c328-d7fe32ae-a29d64ef",58651071,11307058,"Findings: The cardiac and mediastinal silhouette appear similar compared to the study from 3 days ago.  There small bilateral pleural effusions which have slightly increased in the interval.  This is particularly apparent on the lateral films.  Otherwise no significant change.  There is no focal infiltrate. Impression: small bilateral effusions, increased compared to prior.","Findings: The cardiac and mediastinal silhouette appear similar compared to the study from 3 days ago. There large bilateral pleural effusions which have slightly increased in the interval. This is particularly apparent on the lateral films. Otherwise no significant change. There is no focal infiltrate. Impression: small bilateral effusions, increased compared to prior. Findings: The cardiac and mediastinal silhouette appear similar compared to the study from 3 days ago. ","['Change severity', 'Add repetitions', 'False negation']"
ca55481f-3895ec03-76a040b8-d0fbd6ec-bcac13eb,51462743,11309915,"Impression: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends into the lower body of the stomach with the side port distal to the esophagogastric junction.  The remainder of the examination is unchanged, except for free gas beneath the hemidiaphragm related to the the recent abdominal procedure.","Impression: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends into the upper body of the stomach with the side port distal to the esophagogastric junction.  The remainder of the examination is unchanged, except for free gas beneath the hemidiaphragm related to the recent abdominal procedure.  A central venous line is noted in the right atrium.","['Change position of device', 'Change to homophone', 'Add medical device']"
09e634af-25dfbe2b-e54ba5f1-0b74a44a-bd670415,52073508,11309915,"Impression: No previous images.  The cardiac silhouette is enlarged but there is no vascular congestion.  Opacification in the retrocardiac region is consistent with volume loss in the left lower lobe and small pleural effusion. However, in the appropriate clinical setting, it would be very difficult to exclude superimposed pneumonia, especially in the absence of a lateral view.","Impression: No previous imgages.  The cardiac silhouette is enlarged but there is no vascular congestion.  Opacification in the retrocardiac region is consistent with volume loss in the left lower lobe and no pleural effusion. However, in the appropriate clinical setting, it would be very difficult to exclude superimposed mild pneumonia, especially in the absence of a lateral view.","['Change severity', 'Add typo', 'False negation']"
"bde3538e-7dd799a6-2e524bd0-78754798-97ab1afa, f086c561-9ee26e41-62786cc5-de4c7709-13df81fa",54889965,11442039,"Impression: No previous images.  Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.  There is mild scoliosis of the thoracic spine convex to the right.","Impression: No previous images.  Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.  There is mild scoliosis of the thoracic spine convex to the left. An enlarged lymph node is seen in the right hilum. ","['Change location', 'Change to homophone', 'False prediction']"
d3a7a4ec-d8c2bf03-e0bd22f1-4c39d667-2b5dd849,59515380,11442039,"Impression: Compared to chest radiographs ___.  Relative elevation of the right hemidiaphragm is more pronounced today, but unexplained.  Lungs are grossly clear.  Normal cardiomediastinal and hilar silhouettes and pleural surfaces.","Impression: Compared to chest radiographs ___.  Relaitve elevation of the left hemidiaphragm is more pronounced today, but unexplained.  No abnormalities seen in the lungs.  Normal cardiomediastinal and hilar silhouettes and pleural surfaces.","['Change location', 'Add typo', 'False negation']"
"01ef5d76-76b24ff8-e3bd287c-b62fa42a-fa7fe5ee, 95c813f7-c3e310da-424bd659-10fb136a-98c4cdb7",54659794,11465247,Impression: Lungs are fully expanded and clear.  Heart size top-normal.  Normal pulmonary vasculature.  Normal mediastinal and hilar contours and pleural surfaces.,Impression: Lungs are fully expanded and clear.  Heart size top-normal.  A nasogastric tube is noted within the stomach.  Normal mediastinal and hilar contours and pleural surfaces.,"['Add medical device', 'Change to homophone', 'False negation']"
"5cd7a101-9ff0c026-fd16c237-8cdcd48d-3c4c342b, 7da61e0c-128804f1-b17951e5-5e34acbe-c01fd2fd",54829511,11465247,Impression: PA and lateral chest compared to ___:  Previous pneumonia in lingula has resolved.  Lungs are now clear.  Heart size is normal.  There is no pleural abnormality or evidence of central lymph node enlargement.  Thoracic aorta is tortuous but not clearly aneurysmal.,Impression: PA and lateral chest compared to ___: No pneumonia. Lungs are now clear. Heart size is normal. There is no pleural abnormality or evidence of central lymph node enlargement. Thoracic aorta is tortuous but not clearly abdominal.,"['Change location', 'Change to homophone', 'False negation']"
"b85ecda1-089e869a-90607e39-84199c93-e66fae7a, e19abbe6-df472023-83481ac8-0a310178-3cdd22d2",56946073,11465247,Findings: PA and lateral views of the chest provided.  There is a vague consolidation in the lateral aspect of the left lung which localizes anteriorly which is concerning for pneumonia.  No large effusion.  Right lung is clear.  Cardiomediastinal silhouette is stable. Impression: Findings concerning for pneumonia within the left upper lobe/lingula.,Findings: PA and lateral views of the chest provided.  There is a vague consolidation in the lateral aspect of the left lung which localizes anteriorly which is concerning for new-monia.  No large effusion.  Right lung is clear.  Cardiomediastinal silhouette is stable.  A central venous line is present. Impression: Findings concerning for severe pneumonia within the left upper lobe/lingula.,"['Change severity', 'Change to homophone', 'Add medical device']"
"0e252b44-7eeee514-f7db5565-5c69c644-9808eb6c, d8e7e260-db17e49d-5a6fdba5-6ae4bb12-73abeec9",50248902,11469724,"Findings: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette.  There is no pneumothorax or pleural effusion.  There is no consolidation. Impression: No acute cardiopulmonary process, including no evidence of pneumothorax.","Findings: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. There are left lower lobe nodules. There is no pneumothorax or pleural effusion. There is no consolidation. Impression: No acute cardiopulmonary process, including no evidence of pneumothorax. There are left lower lobe nodules.","['Change location', 'Add repetitions', 'False prediction']"
"3b825e5c-972cf73b-c9e78f42-2ffb6f80-40fb7b5e, f0220e89-6a3c972d-e6129b54-0f9f801e-8bdeb45e",51499238,11483127,"Findings: No focal consolidation is present.  The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal.  There is no pleural effusion or pneumothorax. Impression: No acute intrathoracic process.","Findings: No foal consolidation is present. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. There is no pleural effusion or pneumothorax. There is a pacemaker visualized in the right atrial region. Impression: No acute intrathoracic process.","['Add typo', 'Add repetitions', 'Add medical device']"
"967b4be7-246fd0d5-0f1f4921-af286d14-001bff69, e739c1f7-c8cb4da6-35a5b19c-c3c44f5c-bde78d3d",55217119,11485848,"Findings: Chest, PA and lateral.  The lungs are clear.  The hilar and cardiomediastinal contours are normal.  There is no pneumothorax or pleural effusion.  Pulmonary vascularity is normal. Impression: No acute cardiopulmonary process.","Findings: Chest, PA and lateral. The lungs are clear. The hilar and cardiomediastinal contours are normal. Bibasilar opacities are present. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. Impression: No acute cardiopulmonary process.","['Change location', 'Change to homophone', 'False prediction']"
c051db46-f8077330-028442f2-35bf5221-fda0ae4f,56446166,11500818,"Findings: Low lung volumes on the AP projection causing crowding of bronchovascular structures.  In addition, the apparent widened mediastinum is likely due to patient positioning and rotation.  No focal consolidation concerning for pneumonia.  No evidence of pneumothorax.  Cardiomediastinal and hilar silhouettes are grossly unremarkable.  No evidence of dispalced rib fractures. Impression: Low lung volumes causing crowding of bronchovascular structures.  No evidence focal consolidation or pneumothorax.  No evidence of dispalced rib fractures.  Please see the subsequent CT torso report from the same date for further findings.","Findings: Low lung volumes on the AP projection causing crowding of bronchovascular structures.  In addition, the apparent widened mediastinum is likely due to patient positioning and rotation.  No focal consolidation concerning for pneumonia.  No evidence of pneumothorax.  Cardiomediastinal and hilar silhouettes are grossly unremarkable.  No evidence of rib fractures. Impression: Low lung volumes causing crowding of bronchovascular structures.  No focal consolidation or pneumothorax.  Evidence of displaced rib fractures.  Please see the CT torso report from the same date for further findings.","['False negation', 'Add typo', 'False prediction']"
da4b16dc-70fac17f-f55577e8-6d7eb687-7777fa17,53036025,11520249,"Findings: Peripheral right upper lobe lung nodule has grown compared to the prior CT chest of ___ and chest radiograph of ___.  On the prior chest radiograph, it measured 1.6 cm in diameter and now measures 1.9 cm.  As AP technique may magnify the nodule, dedicated chest CT may be considered for more accurate assessment of interval growth as well as possible development of lymphadenopathy in the right hilum.  Heart remains enlarged.  Low lung volumes accentuate the pulmonary vascular structures.  Minor bibasilar atelectasis is present.  No definite pleural effusion.  Single-lead pacer remains in place, with lead terminating in right ventricle. Impression: 1.  Slowly growing peripheral right upper lobe lung nodule is concerning for primary lung adenocarcinoma.  Dedicated chest CT may be considered for more accurate assessment as well as to evaluate for possible right hilar lymph node enlargement warranted clinically. 2.  Low lung volumes limit assessment of the lung bases for pneumonia.  Given clinical suspicion for this entity, this could be further evaluated with repeat chest radiograph with improved inspiratory level. Dr. ___ was paged with these results at 8:15 a.m. on ___, at the time of discovery.","Findings: Peripheral right upper lobe lung nodule has grown compared to the prior CT chest of ___ and chest radiograph of ___.  On the prior chest radiograph, it measured 1.6 cm in diameter and now measures 2.3 cm.  As AP technique may magnify the nodule, dedicated chest CT may be considered for more accurate assessment of interval growth as well as possible development of lymphadenopathy in the right hilum.  Heart remains enlarged.  Low lung volumes accentuate the pulmonary vascular structures.  Minor bibasilar atelectasis is present.  No definite pleural effusion.  Single-lead pacer remains in place, with lead terminating in right ventricle. Heart remains enlarged. Impression: 1.  Slowly growing peripheral right upper lobe lung nodule is concerning for primary lung adenocarcinoma.  Dedicated chest CT may be considered for more accurate assessment as well as to evaluate for possible right hilar lymph node enlargement warranted clinically. 2.  Low lung volumes limit assessment of the lung bases for pneumonia.  Given clinical suspicion for this entity, this could be further evaluated with repeat chest radiograph with improved inspiratory level. Dr. ___ was paged with these results at 8:15 a.m. on ___.  Additional line opacification noted which appears to be a possible nasogastric tube. ","['Change measurement', 'Add repetitions', 'Add medical device']"
046d4db0-ce1ff4f2-7995008c-6b054b3f-52e497a8,53508597,11520249,"Findings: Left-sided pacemaker device is noted with single lead terminating in the right ventricle.  Moderate cardiomegaly persists.  Aortic knob is densely calcified. Mediastinal and hilar contours are unchanged.  There is no pulmonary vascular congestion.  Left basilar opacity likely reflects atelectasis.  No large pleural effusion is seen though assessment for left-sided effusion is somewhat limited due to overlying pacemaker generator pack obscuring this region.  And ill-defined 19 mm hazy nodular opacity within the right upper lung field is unchanged from ___.  Calcified granuloma in the left lung apex is unchanged.  No pneumothorax is identified.  Degenerative changes are noted in the thoracic spine. Impression: 1. Retrocardiac opacity likely reflects atelectasis.  Infection is difficult to exclude.  2. Persistent 19 mm subtle ill-defined nodular opacity in the right lung apex. Finding are concerning for a neoplastic process, and further assessment with a chest CT is recommended.","Findings: Left-sided pacemaker device is noted with single lead terminating in the right ventricle.  Moderate cardiomegaly persists.  Aortic knob is densely calcified. Mediastinal and hilar contours are unchanged.  There is no pulmonary vascular congestion.  Left basilar opacity likely reflects atelectasis.  No large pleural effusion is seen though assessment for left-sided effusion is somewhat limited due to overlying pacemaker generator pack obscuring this region.  And ill-defined 29 mm hazy nodular opacity within the right upper lung field is unchanged from ___.  No calcified granuloma in the left lung apex is identified.  No pneumothorax is identified.  Degenerative changes are noted in the thoracic spine. Impression: 1. Retrocardiac opacity likely reflects atelectasis.  Infection is difficult to exclude.  2. Persistent 19 mm subtle ill-defined nodular opacity in the right lung apex. Finding are concerning for a neoplastic process, and further assessment with a chest CT is recommended.  No nodular opacity is seen in the right lung apex.","['Change measurement', 'Add contradiction', 'False negation']"
47095b32-a853ea62-3c44a0f5-18ba6a9d-bf1ef6f9,56831678,11520249,"Findings: A left single lead pacemaker projects over the left lower chest and the lead likely terminates in the right ventricle. Lung volumes are decreased, accentuating the cardiac silhouette which otherwise appears mildly enlarged.  There is a left lower lobe opacity, which may reflect aspiration or pneumonia in the appropriate clinical setting. There is prominence of the right hilum. There is prominence of the pulmonary vasculature. No large pleural effusion identified, although limited examination of the left costophrenic angle. Impression: 1. Left lower lobe opacity which could reflect aspiration or pneumonia. Clinical correlation advised. 2. Mild cardiomegaly with mild pulmonary vascular congestion. 3. Prominent right hilum, concerning for lymphadenopathy. Anterior shallow obliques or a chest CT can be obtained for further evaluation if clinically warranted.","Findings: A left demands attention for a change to single-lead pacer over the left lower chest. Lung volumes are decreased, accentuating the cardiac silhouette which otherwise appears mildly enlarged. There is minimal upper lobe atelectasis, with a left lower lobe opacity that may reflect aspiration or pneumonia in the appropriate clinical setting. There is prominence of the right hilum. There is prominence of the pulmonary vasculature. No large pleural effusion identified, although limited examination of the left costophrenic angle exists. There is prominence of the right hilum. Impression: 1. Left lower lobe opacity which could reflect aspiration or pneumonia. Clinical correlation advised. 2. Mild cardiomegaly with mild pulmonary vascular congestion. 3. Prominent right hilum, concerning for lymphadenopathy. Anterior shallow obliques or a chest CT can be obtained for further evaluation if clinically warranted.","['Change name of device', 'Add repetitions', 'False prediction']"
"79edbc6e-58f13a9d-db0158a9-e1565212-5bdc7e4a, d92fe0aa-f7ceb728-7de56f3f-502cf2b6-1e4ccafc",57610653,11520249,"Findings: Left-sided pacemaker device is noted with single lead terminating in the right ventricle, unchanged.  The heart remains moderately enlarged.  Dense atherosclerotic calcifications are present at the aortic knob.  Mediastinal and hilar contours are unchanged.  Rounded opacity within the right upper lobe appears slightly increased in size compared to the previous exam, which again remains concerning for adenocarcinoma and now measures up to 2.4 cm.  Minimal patchy opacities are noted within the lung bases.  No pleural effusion or pneumothorax is identified.  Multiple ___ are demonstrated within the right upper quadrant of the abdomen. Impression: Patchy bibasilar airspace opacities appear relatively unchanged, and may reflect atelectasis and/or chronic changes.  Slight interval increase in size of right upper lobe rounded opacity which remains concerning for adenocarcinoma.","Findings: Left-sided pacemaker device is noted with single lead terminating in the right ventricle, unchanged.  The heart remains significantly enlarged.  Dense atherosclerotic calcifications are present at the aortic arch.  Mediastinal and hilar contours are unchanged.  Rounded opacity within the right upper lobe appears slightly increased in size compared to the previous exam, which again remains concerning for adenocarcinoma and now measures up to 3.5 cm.  Minimal patchy opacities are noted within the lung bases.  No pleural effusion or pneumothorax is identified.  Multiple gallstones are demonstrated within the right upper quadrant of the abdomen. Impression: Patchy bibasilar airspace opacities appear relatively unchanged, and may reflect atelectasis and/or chronic changes.  Slight interval decrease in size of right upper lobe rounded opacity which remains concerning for adenocarcinoma.","['Change measurement', 'Add contradiction', 'False prediction']"
"b22978a8-b5b4125a-08c7a341-112606a4-cbd852a9, d1969331-194ac1ab-ab92b6ec-10a231e8-8585ed4a",58466105,11520249,"Findings: AP upright and lateral views of the chest provided.  A left chest wall pacer device is seen with catheter extending into the expected location of the right ventricle, unchanged.  There is mild central pulmonary vascular engorgement which could indicate mild increased pulmonary pressures.  The heart is stably enlarged.  Atherosclerotic calcification of the aortic knob noted.  Lung volumes are low, though there is no definite sign of pneumonia.  Bony structures appear intact. Impression: Stable cardiomegaly with mild pulmonary interstitial edema.","Findings: AP upright and lateral views of the chest prvoded. A left chest wall pacer device is seen with catheter extending into the mid right atrium, unchanged. There is no sign of central pulmonary vascular engorgement. The heart is stably enlrged. Atherosclerotic calcification of the aortic knob noted. Lung volumes are low, though there is no definite sign of pneumonia. Bonny structures appear intact. Impression: No cardiomegaly with mild pulmonary interstitial edema.","['Change position of device', 'Add typo', 'False negation']"
"21ff2ec7-c4a60756-1d1937eb-e12dee07-852c4995, a54f4d38-f53d69a4-fe5bb1af-ec0c839c-ca1ea4cf",58792298,11520249,"Findings: AP and lateral views of the chest.  There is a right upper lung, somewhat rounded opacity as seen on previous exam.  Again, this remains concerning for neoplasm.  The lungs are otherwise grossly clear noting some right basilar atelectasis.  Left chest wall single lead pacing device seen with lead tip in the right ventricular apex.  Cardiac silhouette is enlarged but stable in configuration.  Atherosclerotic calcification is seen within the aorta. Impression: No definite acute cardiopulmonary process.  Right upper lung rounded opacity again concerning for malignancy.","Findings: AP and lateral views of the chest. There is a right upper lung, somewhat rounded opacity as seen on previous exam. Again, this remains concerning for neoplasm. The lungs are otherwise grossly clear noting some right basilar atelectasis. Left chest wall single lead ICD device seen with lead tip in the right ventricular apex. Cardiac silhouette is enlarged but stable in configuration. Atherosclerotic calcification is seen within the aorta. A right IJ central venous catheter is present. Impression: No definite acute cardiopulmonary process. Right upper lung rounded opacity not concerning for malignancy.","['Change name of device', 'Add contradiction', 'Add medical device']"
"2bd4b6f8-658cb9f5-939803a8-685c7ce3-356accb5, 8c9534d9-497d5f33-e7f5ab5b-66be897e-2491cd73",59584536,11524266,Findings: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. Impression: Normal chest radiograph.,Findings: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. No pleural effusion or pneumothorax detected. Impression: Normal chest radiograph with NG tube in place.,"['Add medical device', 'Change to homophone', 'False negation']"
"18f9a05f-f2cd30f5-bb92443e-a96e29a2-2d10374b, 8c92d74b-8f6e075a-400a5d87-ae954228-73edbc6b",50677500,11529986,"Findings: As compared to the prior examination dated ___, there has been no significant interval change.  Low lung volumes resultant crowding of the bronchovascular structures.  There is no lobar consolidation, pleural effusion, or pneumothorax.  The heart size is within normal limits.  A large hiatal hernia is again seen.  Multiple known osseous metastases are poorly visualized on today's examination. Impression: Stable appearance of the chest with low lung volumes and a large hiatal hernia.  No evidence for superimposed acute cardiopulmonary process.","Findings: As compared to the prior examination dated ___, there has been trivial significant interval change.  Low lung volumes resultant crowding of the bronchovascular structtures.  There is mild lobar consolidation, pleural effusion, or pneumothorax.  The heart size is within normal limits.  A large hiatal hernia is again seen.  Multiple known osseous metastases are poorly visualized on today's examination with new bilateral pleural effusions. Impression: Stable appearance of the chest with low lung volumes and a large hiatal hernia. Mild cardiomegaly is noted.  No evidence for superimposed acute cardiopulmonary process.","['Change severity', 'Add typo', 'False prediction']"
"4e988876-de35584e-49fde4ca-bfa3f240-b99a8e3a, dfa6aa31-59502aee-a73c4b24-1b369d25-d3f48851",55864646,11529986,"Impression: In comparison with the study of ___, there are even lower lung volumes.  Again there is a large hiatal hernia but no evidence of acute pneumonia or vascular congestion.  Sclerotic metastases again are seen from carcinoma the prostate.","Impression: In comparison with the study of ___, there are even lowr lung volumes.  Again there is a large hiatal hernia but no evidence of acute pneumonia or vascualr congestion.  Sclerotic metastases again are seen from carcinoma the prostate. A central venous line is noted in place.","['Change severity', 'Add typo', 'Add medical device']"
"51bf1504-fd68a1ec-7f7ca477-9736040f-4167a6f0, a4e05e8d-f1cc5629-84b87ad8-9f4c0402-17e6f75e",50995901,11614040,"Findings: In comparison with the study of ___, there has been some decrease in the still substantial left pleural effusion.  There is a small pleural effusion on the right extending into the minor fissure.  The pulmonary vascular congestion has essentially cleared.  Bibasilar atelectatic changes are present.  Port-A-Cath again extends to the cavoatrial junction or right atrium.  The possibility of supervening pneumonia would be difficult to exclude in the appropriate clinical setting. ","Findings: In comparison with the study of ___, there has been some decrease in the still substantial right pleural effusion.  There is a small pleural effusion on the write extending into the minor fissure.  The pulmonary vascular congestion has essentially cleared.  Bibasilar atelectatic changes are present.  Port-A-Cath again extends to the cavoatrial junction or right atrium.  Multiple enlarged lymph nodes are noted in the hilar regions.  The possibility of supervening pneumonia would be difficult to exclude in the appropriate clinical setting.","['Change location', 'Change to homophone', 'False prediction']"
3171e900-87eb21d0-8d960bcd-ae644198-073b1869,52577959,11614040,"Impression: 1.  OG tube placed, with tip over fundus. 2.  Slight interval improvement in CHF findings.","Impression: 1.  OG tube placed, with tip over fundus. 2.  Slight interval improvement in CHF findings. There is noticeable worsening of cardiomegaly. ","['Change position of device', 'Add contradiction', 'False prediction']"
"45707eca-99bf58cc-cefc31b3-28749819-720469b4, bdb97138-b120be67-8b9c2ad3-d5187876-17f2143d",54015727,11614040,"Impression: 1.  Interval placement of ET tube in satisfactory position.  Other lines as described.  2.  Stable cardiomegaly.  3.  Findings suggestive of CHF with interstitial edema.  This is likely superimposed on background COPD.  4.  Small left effusion, with left lower lobe collapse and/or consolidation.  5.  New fluid or atelectasis in the right mid zone.  No fluid seen in the right costophrenic sulcus.","Impression: 1.  Interval placement of ET tube in satisfactory position.  Other lines as described.  Right IJ central venous catheter projects over the right atrium.  2.  Stable cardiomegaly.  3.  Findings suggest CHF without evidence of interstitial edema.  This is likely superimposed on background COPD.  4.  Small left effusion, with left lower lobe collapse and/or consolidation.  No evidence of left effusion.  5.  New fluid or atelectasis in the right mid zone.  Minimal fluid seen in the right costophrenic sulcus.","['Change position of device', 'Add contradiction', 'Add medical device']"
cb4af14c-7c3258e3-157f685e-c1cc0471-fe3eb0ec,54498314,11614040,"Findings: As compared to prior chest radiograph from ___, there has been interval increase of moderate left pleural effusion and increased atelectasis at the left lower lung.  There is a small right pleural effusion. Minimal amount of apical left pneumothorax persists.  A right Port-A-Cath catheter tip terminates at the cavoatrial junction. Impression: 1.  Minimal left apical pneumothorax.  2.  Interval increase of moderate left pleural effusion.  These findings were discussed with ___ ___ by Dr. ___ via telephone on ___ at 2:52 p.m., at time of discovery.","Findings: As compared to prior chest radiograph from ___, there has been absent interval increase of moderate left pleural effusion and increased atelectasis at the left lower lung. No small right pleural effusion. Minimal amount of apical left pneumothorax persists.  A right-sided vascular stent terminates at the cavoatrial junction.  Minimal amount of apical left pneumothorax persists. Impression: No left apical pneumothorax.  2.  Interval increase of moderate left pleural effusion.  These findings were discussed with ___ ___ by Dr. ___ via telephone on ___ at 2:52 p.m., at time of discovery.  These findings were discussed with ___ ___ by Dr. ___ via telephone on ___ at 2:52 p.m., at time of discovery.","['Change name of device', 'Add repetitions', 'False negation']"
003fd23c-264ac00a-8e8225c5-d7f3543f-6ba3ef81,54620855,11614040,"Findings: AP single view of the chest is obtained with patient in sitting semi-upright position.  Analysis is performed in direct comparison with the next preceding similar study of ___.  Cardiac enlargement and right-sided Port-A-Cath system via internal jugular approach as before.  There is now marked congestive pulmonary vascular pattern with distended vessels and perivascular haze.  Centrally located parenchymal densities are indicative of pulmonary edema.  In comparison with the previous study, a sizeable left-sided pleural effusion has developed reaching up to the hilar level. The right-sided lateral pleural sinus, however, remains free. Impression: Acute pulmonary congestion with central pulmonary edema and left-sided pleural effusion.  Report has been issued at 2:15 p.m. as the study remained non-verified for more than 10 hours.","Findings: AP single view of the chest is obtained with patient in sitting semi-upright position.  Analysis is performed in direct comparison with the next preceding similar study of ___.  No cardiac enlargement and right-sided Port-A-Cath system via internal jugular approach as before.  There is now marked congestive pulmonary vascular pattern with distended vessels and perivascular haze.  Centrally located parenchymal densities are indicative of pulmonary edema.  In comparison with the previous study, a sizeable left-sided pleural effusion has developed reaching up to the hilar level. The right-sided lateral pleural sinus, however, remains free. Impression: Mild pulmonary congestion with central pulmonary edema and left-sided pleural effusion.  Report has been issued at two-fifteen p.m. as the study remained non-verified for more than 10 hours.","['Change severity', 'Change to homophone', 'False negation']"
050b0481-40bac9ae-ecbb8c83-6251c674-f8dc69a7,56045322,11614040,"Findings: As compared to the previous radiograph, the effusion on the left has minimally increased in extent.  On the right, the small pleural effusion is constant.  Substantially improved are the signs previously indicative of interstitial lung edema.  Fluid marking of the fissures persists.  Unchanged evidence of moderate cardiomegaly with left basal atelectasis, unchanged position of the right pectoral Port-A-Cath. ","Findings: As compared to the previous radiograph, the effusion on the right has minimally increased in extent.  On the right, the small pleural effushion is constant.  Substantially improved are the signs previously indicative of interstitial lung edema.  No fluid marking of the fissures persists.  Unchanged evidence of moderate cardiomegaly with left basal atelectasis, unchanged position of the right pectoral Port-A-Cath.","['Change location', 'Add typo', 'False negation']"
7fccf9d1-bf743f6f-504039f0-d2709205-699a13cc,56082008,11614040,"Impression: AP chest compared to ___:  Moderately severe pulmonary edema, transiently improved on ___ has recurred, more pronounced today than on ___.  Interval decrease in the volume of moderate left pleural effusions suggests thoracentesis.  No pneumothorax.  Moderate cardiomegaly, not appreciably changed.  Small right pleural effusion stable.  Right supraclavicular central venous infusion port ends close to the superior cavoatrial junction.  A small elliptical opacity projecting over the right mid lung is probably fissural pleural fluid.","Impression: AP chest compared to ___:  Moderately severe pulmonary edema, transiently improved on ___ has recurred, more pronounced today than on ___.  Interval decrease in the volume of mild left pleural effusions suggests thoracentesis.  No pneumothorax.  Moderate cardiomegaly, not appreciably changed.  Small right plural effusion stable.  Right supraclavicular central venous infusion port ends close to the superior cavoatrial junction.  A small elliptical opacity projecting over the left mid lung is probably fissural pleural fluid.  Multiple rounded opacities consistent with metastases are seen in both lungs.","['Change severity', 'Change to homophone', 'False prediction']"
c81743fc-40348d42-c468e36f-0c9077e0-46d24e73,56418467,11614040,"Findings: In comparison with the earlier study of this date, there has been a thoracentesis on the left with removal of substantial fluid from the pleural space.  Specifically, no evidence of appreciable pneumothorax. ","Findings: In comparison with the earlier study of this date, there has been a thoracentesis on the right with removal of substantial fluid from the pleural space.  Specifically, no evidance of appreciable pneumothorax. A central venous line is seen in place.","['Change location', 'Add typo', 'Add medical device']"
"551d7076-32d60564-745ab2a8-624b5317-c6f634f8, ae000d03-91aa28dd-ccd3897d-ceb92206-fba185ff",57214129,11614040,"Findings: Moderate left pleural effusion has slightly increased in the interval with overlying atelectasis.  New right base opacity is seen, may represent combination of pleural effusion and atelectasis with overlying consolidation.  Fluid is seen tracking in the minor fissure on the lateral view.  There is mild pulmonary vascular congestion.  The cardiac silhouette difficult x-ray assessed due to the bibasilar opacities.  The aorta is calcified.  Right-sided Port-A-Cath is seen, with distal tip in the expected location of the right atrium. Impression: Moderate left pleural effusion slightly increased as compared to the prior study.  Interval increase in right base opacity may represent combination of pleural effusion and atelectasis, underlying consolidation is not excluded.  Pulmonary vascular congestion.","Findings: Moderate left pleural effusion has slightly increased in the interval with overlying atelectasis.  New right base opacity is seen, may represent combination of pleural effusion and atelectasis with overlying consolidation.  Fluid is seen tracking in the minor fissure on the lateral view.  There is mild pulmonary vascular congestion.  The cardiac silhouette difficult x-ray assessed due to the bibasilar opacities.  The aorta is calcified.  Right-sided PICC line is seen, with distal tip in the expected location of the right atrium.  An ET tube is located just above the carina. Impression: Moderate left pleural effusion slightly increased as compared to the prior study.  Interval increase in right base opacity may represent combination of pleural effusion and atelectasis, underlying consolidation is knot excluded.  Pulmonary vascular congestion.","['Change name of device', 'Change to homophone', 'Add medical device']"
f7afb1fb-980babb9-17a967f1-4ab852ff-c8ecd2fa,57726913,11614040,"Findings: As compared to the previous radiograph, the patient has newly developed, moderate pulmonary edema.  The changes manifest as increase in interstitial markings, a symmetrically increase in lung density and an increase in diameter of the pulmonary vessels and the heart.  No pleural effusions.  Unchanged right pectoral Port-A-Cath.  At the time of dictation and observation, 10:28 a.m., on ___, the referring physician, ___. ___ was paged for notification. ","Findings: As compared to the previous radiograph, the patient has newly developed, moderate pulmonary edema.  The changes manifest as increase in interstitial markings, a symmetrically increase in lung density and an increase in diameter of the pulmonary vessels and the heart.  No pleural effusions.  Unchanged right pectoral central venous line.  At the time of dictation and observation, 10:28 a.m., on ____, the referring physician, ____.  An ET tube is visible in the trachea and ____. ___ was paged for notification.  ","['Change name of device', 'Add contradiction', 'Add medical device']"
"a421114e-d29d7d27-ca1c3caa-149eff70-e015e6c6, bd9e45d8-e8d6d3fa-e8a8e094-a2a77b14-2b43fddb",58129550,11614040,"Findings: AP and lateral chest radiographs demonstrate stable positioning of the right Port-A-Cath.  There is no pulmonary vascular congestion, pleural effusion, or pneumothorax.  Left apical nodule is unchanged and has been further characterized on prior CT-Torso.  The cardiomediastinal silhouette is normal. Impression: No pneumonia.","Findings: AP and lateral chest radiographs demonstrate stable positioning of the right PICC line.  Their is no pulmonary vascular congestion, pleural effusion, or pneumothorax.  No nodule is seen.  The cardiomediastinal silhouette is normal. Impression: No pneumonia.","['Change name of device', 'Change to homophone', 'False negation']"
"056b228a-40cb1f70-1ae4fc61-78474095-bfb2d962, 172f444a-38c985ed-c8457287-b660b135-cde87b37",58602712,11614040,"Impression: AP chest compared to ___:  Previous pulmonary edema has nearly cleared.  Small right pleural effusion and moderate left pleural effusion, both stable.  Cardiac silhouette is obscured and its size cannot be assessed.  Right subclavian infusion port ends in the right atrium.","Impression: AP chest compared to ___:  Right-sided pulmonary edema has nearly cleared.  Small bright pleural effusion and moderate left pleural effusion, both stable.  Cardiac silhouette is obscured and its size cannot be assessed.  Chronic right-sided atelectasis.  Right subclavian infusion port ends in the left atrium.","['Change location', 'Change to homophone', 'False prediction']"
7252d03a-a20f7bb6-f72983bd-0b4f5591-98efee5e,50955531,11619788,"Impression: Right PICC terminating in the upper SVC, unchanged from prior.  No pneumothorax.","Impression: Right thoracic drain terminating in the upper SVC, unchanged from prior. No pneumothorax. Impression: Right PICC terminating in the lower SVC, unchanged from prior.  There is a small pneumothorax.","['Change name of device', 'Add contradiction', 'False prediction']"
268224a0-f4db4bc6-9f5606f0-6a333f24-ace4e910,52904178,11619788,Findings: A right PICC line has been retracted with the tip now terminating in the proximal right axillary vein.  There is no pneumothorax.  There are increased bibasilar patchy airspace opacities in the bilateral lung bases concerning for developing pneumonia and raising the possibility of aspiration.  Small left pleural effusion is difficult to exclude.  The cardiac silhouette is unchanged in size.  The mediastinum appears unchanged from the prior chest radiograph of ___. Impression: 1.  Right PICC retracted with the tip terminating in the proximal right axillary vein.   2.  Bibasilar patchy airspace opacities new from the most recent prior study are concerning for developing pneumonia and raise the possibility of aspiration.,Findings: A right PICC line has been retracted with the tip now terminating in the mid SVC.  There is no pneumothorax.  There are increased bibasilar patchy airspace opacities in the bilateral lung bases concerning for developing pneumonia and raising the possibility of aspiration.  Moderate bilateral pleural effusions are present.  The cardiac silhouette is unchanged in size.  The mediastinum appears unchanged from the prior chest radiograph of ___. Impression: 1.  Right PICC retracted with the tip terminating in the mid SVC.   2.  No significant bibasilar airspace opacities noted.,"['Change position of device', 'Add contradiction', 'False prediction']"
"63422ad6-e1977068-64602147-0409a128-76499d3c, a305262a-fc35773c-be68cd0d-b834e2ec-80646749",55041813,11619788,"Findings: Semi-upright portable frontal chest radiograph demonstrates interval withdrawal of right-sided PICC line now terminating in the upper SVC. Cardiomediastinal and hilar contours are unremarkable.  Stable platelike atelectasis in the bilateral lung bases.  No focal opacification concerning for pneumonia.  No pleural effusion or pneumothorax. No osseous abnormality present. Impression: Interval withdrawal of PICC line now terminating in the upper SVC.  Otherwise, unchanged exam.  No fluid overload or pneumonia.","Findings: Semi-upright portable frontal chest radiograph demonstrates interval withdrawal of right-sided NG tube now terminating in the upper SVC. Cardiomediastinal and hilar contours are unremarkable.  Stable platelike atelectasis in the bilateral lung bases.  No focal opacification concerning for pneumonia.  No pleural effusion or pneumothorax. No osseous abnormality present. Cardiomediastinal and hilar contours are unremarkable. Impression: Interval withdrawal of PICC line now terminating in the upper SVC.  Otherwise, unchanged exam.  No fluid overload or pneumonia. Presence of left-sided central venous line.","['Change name of device', 'Add repetitions', 'Add medical device']"
"09df9e78-971e1a02-c9968fef-e789e1ff-6ca76ab2, 34ef720b-67dd22ea-ff045347-55244604-8fc95e70",56461985,11619788,"Findings: The cardiac silhouette size is mildly enlarged.  The aorta is unfolded and calcified but unchanged.  The mediastinal and hilar contours are otherwise unremarkable.  Minimal linear opacities in the lung bases are compatible with subsegmental atelectasis.  No focal consolidation, pleural effusion or pneumothorax is present.  There are no acute osseous abnormalities. Impression: Minimal bibasilar atelectasis.","Findings: The cardiac silhouette size is severely enlarged.  The aorta is unfolded and calcified butt unchanged.  The mediastinal and hilar contours are otherwise unremarkable.  Moderate linear opacities in the lung bases are compatible with subsegmental atelectasis.  No focal consolidation, pleural effusion or pneumothorax is present.  There are no acute osseous abnormalities.  An NG tube is seen in place. Impression: Moderate bibasilar atelectasis.  ","['Change severity', 'Change to homophone', 'Add medical device']"
"d468d381-defa9a3f-980dcf37-2507e827-dde4f6c9, ede7dee9-d9fff69d-6b18ffa5-ee83e334-d818bbaa",58277756,11619788,Impression: Low lung volumes with bibasilar atelectasis,Impression: Low lung volumes with bibasilar atelectasis. ET tube is seen in the distal trachea. Impression: Lung volumes are normal with no evidence of atelectasis.,"['Add medical device', 'Add contradiction', 'False prediction']"
"0ec69750-0632a3fd-75f5556a-63efc651-c2d582f3, 36e2ba54-b3a43f54-fe19cfdd-d444c635-f67a3229",57605743,11641663,"Findings: No previous images.  Mild streaks of atelectasis at the left base, but otherwise, there is no evidence of acute pneumonia, vascular congestion, or pleural effusion.  There are low lung volumes and some tortuosity of the aorta. ","Findings: No previous images.  Moderate streaks of atelectasis at the left base, but otherwise, there is no evidence of acute pneumonia, vascular congestion, or pleural effusion.  There are low lung volumes and some tortuosity of the aorta. A right IJ central venous catheter is in place.","['Change severity', 'Add contradiction', 'Add medical device']"
5b7be76e-a4c9feb1-8407dbe4-3d0e8436-c2b49b98,54913015,11644926,"Findings: There is bilateral interstitial edema and pulmonary vascular congestion. The heart is moderately enlarged. Small right and moderate left pleural effusions are seen. Retrocardiac opacity may represent pneumonia in the appropriate clinical setting. Impression: Moderate pulmonary edema, moderate cardiomegaly, and bilateral pleural effusions, small on the right and moderate on the left.  Superimposed pneumonia cannot be excluded.","Findings: There is bilateral interstitial edema and pulmonary vascular congestion. The heart is severely enlarged. Small right and moderate left pleural effusions are seen. Retrocardiac opacity may represent pneumonia in the appropriate clinical setting. Impression: Moderate pulmonary edema, moderate cardiomegaly, and bilateral pleural effusions, small on the right and moderate on the left. Superimposed pneumonia cannot be excluded. The heart is severely enlarged.","['Change severity', 'Add repetitions', 'Add medical device']"
5a32886d-a4653f96-53ae3fbd-4903075b-320b865d,51038639,11662490,"Findings: Portable supine AP view of the chest obtained. There are low lung volumes with bronchovascular crowding. There are subtle lower lobe opacities, may reflect atelectasis, less likely pneumonia.  No supine evidence of pneumothorax or effusion. The cardiomediastinal silhouette is unremarkable. The visualized osseous structures are unremarkable. ","Findings: Portable supine AP view of the chest obtained. There are low lung volumes with bronchovascular crownding. There are subtle lower lobe opacities, may reflect atelectasis, less likely pneumonia. There is a mass lesion in the left upper lobe. No supine evidence of pneumothorax or effusion. The cardiomediastinal silhouette is unremarkable. The visualized osseous structures show mild degenerative changes. ","['Change location', 'Add typo', 'False prediction']"
127c8f18-778f317b-10bde8a4-fb02eba9-e1fcd511,51400794,11662490,"Findings: As compared to the previous radiograph, there is unchanged evidence of mild fluid overload.  In addition, there is an area of increased opacity around the right hilus, further monitoring is required to exclude the presence of perihilar pneumonia.  No pleural effusions.  Borderline size of the cardiac silhouette.  Minimal retrocardiac atelectasis. ","Findings: As compared to the previous radiograph, there is unchanged evidence of mild fluid overload.  In addition, there is an area of increased opacity around the right apex, further monitoring is required to exclude the presence of perihilar pneumonia.  No pleural effusions.  Borderline sighs of the cardiac silhouette.  Minimal retrocardiac atelectasis. There is a suspicious mass in the left lower lung zone.","['Change location', 'Change to homophone', 'False prediction']"
b9ea020d-fe39c08b-1e6f557d-405aa7cb-ce016ba2,51662547,11662490,Findings: The study is somewhat limited by motion.  There is improved aeration at the lung bases with increasing consolidation of the right mid-lung.  There is no pleural effusion or pneumothorax.  Cardiac and mediastinal contours are normal. Impression: Improved aeration of the lung bases with increasing consolidation in the right mid-lung.  These findings would be atypical for aspiration.,Findings: The study is somewhat limited by motion.  There is improved aeration at the lung bases with increasing consolidation of the right mid-lung.  Improved aeration at the lung bases with increasing consolidation of the right mid-lung.  There is a small pleural effusion on the left side.  Cardiac and hilar contours are normal. Impression: Improved aeration of the lung bases with increasing consolidation in the left mid-lung.  These findings would be typical for aspiration.,"['Change location', 'Add repetitions', 'False prediction']"
209d689e-f2bb226e-ab552d0d-9117b227-324c0ac6,53401480,11662490,"Findings: There is prominence of the vasculature which has increased from prior.  Additionaly, patchy opacities at the lung bases is more conspicuous on this study.  There is no pleural effusion or pneumothorax.  The cardiomediastinal contours are normal.    The imaged upper abdomen is unremarkable.  Cervical orthopedic hardware is partially imaged. Impression: Bibasilar patchy opacities are nonspecific but may be due to aspiration given clinical suspicion for this entity.  Worsened vascular congestion.","Findings: There is prominence of the vasculature which has increased from prior. Additionally, patchy opacities at the right lung base is more conspicuous on this study. There is a mild right pleural effusion. The cardiomediastinal contours are normol. The imaged upper abdomen is unremarkable. Lumbar orthopedic hardware is partially imaged. Impression: Bibasilar patchy opacities are nonspecific but may be due to aspiration given clinical suspicion for this entity. Bibasilar atelectasis with probable infectious process.","['Change location', 'Add typo', 'False prediction']"
"372cbd5c-3e859e0a-99848f35-a0ad4c90-72e10f87, c28d6f89-4ca74a2d-2dac60f1-572eb1e1-651e43a4",53288720,11668016,"Findings: Subtle left base streaky opacity most likely represents atelectasis, although in the appropriate clinical setting, an underlying consolidation is not excluded.  The right lung is clear.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable.  Mild degenerative changes are seen along the spine.  No displaced fracture is seen. Impression: Subtle left base streaky opacity most likely represents atelectasis, although in the appropriate clinical setting, an underlying consolidation is not excluded.","Findings: Subtle left base streaky opacity most likely represents atelectasis, although in the appropriate clinical setting, an underlying consolidation is not excluded.  The right lung is clear.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable.  Moderate degenerative changes are seen along the spine.  No displaced fracture is seen. Impression: No opacity most likely represents atelectasis, although in the appropriate clinical setting, an underlying consolidation is not excluded.","['Change severity', 'Add repetitions', 'False negation']"
"86b84bed-d791c470-659a6623-1e13e455-cc83eda7, c681e756-278b3b38-0472808c-ce2344ce-743125ee",50335438,11669319,"Findings: The cardiomediastinal and hilar contours are within normal limits.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax.  Old healed left lateral rib fractures are noted. Impression: No acute cardiopulmonary process.","Findings: The cardiomediastinal and hilar contours are within normal limits.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax.  Old healed right lateral rib fractuers are noted. A central venous line is present. Impression: Ni acute cardiopulmonary process.","['Change location', 'Add typo', 'Add medical device']"
f33f365d-10d1ff5e-228007f3-863aa1cb-63c0c506,54673619,11686207,"Findings: PA and lateral chest views have been obtained with patient in upright position.  There is moderate cardiac enlargement and the thoracic aorta is generally widened and elongated.  Calcium deposits are seen in the wall, mostly at the level of the arch.  The pulmonary vasculature demonstrates an upper zone redistribution pattern, but there is no sign of an advanced interstitial or alveolar edema.  No evidence of acute infiltrates and the lateral pleural sinuses are free.  In the apical area, thickened pleural structures are noted bilaterally and combined with old scar formations and irregular densities in the peripheral portions of the parenchyma in this territory.  When comparison is made with the next previous examination of ___, these changes have not undergone any difference in appearance anf represent  old inactive specific scars.  Comparison demonstrates on the other hand that the cardiac size has increased mildly and so has the upper zone redistribution pattern.  Acute infiltrates are not present. Impression: Old stable, probably specific bilateral apical scar formations, moderate cardiac enlargement with mild degree of chronic CHF but no evidence of acute pulmonary infiltrates or pleural effusions.","Findings: PA and lateral chest views have been obtained with patient in upright position.  There is moderate cardiac enlargement and the thoracic aorta is generally widened and elongated.  Calcium deposits are seen in the wall, mostly at the level of the arch.  The pulmonary vasculature demonstrates an upper zone redistribution pattern, but there is no sign of an advanced interstitial or alveolar edema.  No evidence of acute infiltrates and the lateral pleural sinuses are free.  In the apical area, thickened pleural structures are noted bilaterally and combined with old scar formations and irregular densities in the peripheral portions of the parenchyma in this territory.  When comparison is made with the next previous examination of ___, these changes have not undergone any difference in appearance anf represent  old inactive specific scars.  Comparison demonstrates on the other hand that the cardiac size has increased severely and so has the upper zone redistribution pattern.  Acute infiltrates are present. Impression: Old stable, probably specific bilateral apical scar formations, mild cardiac enlargement with mild degree of chronic CHF but acute pulmonary infiltrates and pleural effusions are evident.","['Change severity', 'Add contradiction', 'False prediction']"
"6e21c3c3-eeed0568-c5827143-dc010d61-a5f5f0bd, c8d7cf11-95b640cd-48eceb73-02f4b390-b9d3f500",58712687,11686207,Findings: Biapical scarring is again seen.  The lungs are otherwise clear.  Cardiomediastinal silhouette is stable.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,Findings: No biapical scarring is seen.  The lungs are otherwise clear.  Cardiomediastinal silhouette is stable.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process. No biapical scarring is seen.,"['Add contradiction', 'Add repetitions', 'False negation']"
dec3e055-ebb80e67-6fe65c6e-de8f0130-d39b8896,50281684,11717909,Impression: Right PICC line tip is at the level of the right atrium and should be pulled back 3 cm to secure it position at the cavoatrial junction or above.  Right basal atelectasis is unchanged associated with minimal amount of pleural effusion.  There is no pneumothorax.  No pulmonary congestion .,Impression: Right chest tube tip is at the level of the right atrium and should be pulled back 3 cm to secure it position at the cavoatrial junction or above. Right basal atelectasis is unchanged associated with minimal amount of pleural effusion. There is no pneumothorax. No pulmonary congestion. There is no pneumothorax.,"['Change name of device', 'Add repetitions', 'False prediction']"
edd6b83c-688ee075-7706abe7-8585945e-88b5d0c7,50309094,11717909,Findings: Lungs:  Continued parenchymal disease is seen in the right chest which has not altered significantly.  There is also left basilar disease.  Pleura: Likely there is a right pleural effusion is well as a small left pleural effusion.  Mediastinum: Surgical clips noted in the mediastinum  Heart:  The heart is not enlarged.  Osseous structures: The osseous structures are normal for age.  Additional findings: Endotracheal tube is in the region of the thoracic inlet. Left-sided PICC line terminates in the satisfactory position.  A new right internal jugular catheter terminates in the right atrium.  Nasogastric tube some stomach.  Monitor leads noted.  There is no pneumothorax. Impression: Right internal jugular catheter terminates in right atrium. Continued bilateral parenchymal disease much worse on the right than the left.  Probable bilateral effusions,Findings: Lungs:  Continued parenchymal disease is seen in the right chest which has not altered significantly.  There is also left basilar disease.  Pleura: Likely there is a right pleural effusion is well as a small left pleural effusion.  Mediastinum: Surgical clips noted in the mediastinum  Heart:  The heart is not enlarged.  Osseous structures: The osseous structures are normal for age.  Additional findings: Endotracheal tube is in the right main bronchus. Left-sided PICC line terminates in the right atrium. A new right internal jugular catheter terminates in the right atrium.  Nasogastric tube some stomach.  Pacemaker noted. There is no pneumothorax. Impression: Right internal jugular catheter terminates in right atrium. Continued bilateral parenchymal disease much worse on the right than the left.  Right internal jugular catheter terminates in right atrium. Probable bilateral effusions,"['Change position of device', 'Add repetitions', 'Add medical device']"
5dfe015d-040fa10d-c7519ab8-abd04b07-2013debb,50703663,11717909,"Impression: Pulmonary edema has not recurred.  Moderate cardiomegaly including substantial left atrial enlargement is comparable to ___ prior to removal of the intra-aortic balloon pump. Pulmonary vasculature is unremarkable. Projecting over the right second anterior rib, there could be a right juxta hilar nodules large as 19 mm across. Conventional radiographs are recommended when feasible.  Pleural effusion small if any. Swan-Ganz catheter ends in standard position at the upper pole of the right hilus.",Impression: Pulmonary edema has not recurred.  Moderate cardiomegaly including substantial left atrial enlargement is comparable to ___ prior to removal of the intra-aortic baloon pump. Pulmonary vasculature is unremarkable. No nodules are seen. Conventional radiographs are recommended when feasible.  Pleural effusion small if any. Swan-Ganz catheter ends in standard position at the upper pole of the right hilus.,"['Change measurement', 'Add typo', 'False negation']"
2d2c3c7d-5f951cb0-24e5522b-c233da94-349dc006,51107651,11717909,Impression: Comparison to ___.  The endotracheal tube has been advanced by approximately 1 cm.  The tip of the tube is now 5 cm above the carina.  The pre-existing left retrocardiac and right perihilar parenchymal opacities are unchanged in extent and severity.  No new parenchymal opacities. Unchanged alignment of the sternal wires.  Normal size of the cardiac silhouette.  No pneumothorax.,Impression: Comparison to ___.  The nasogastric tube has been advanced by approximately 1 cm.  The tip of the tube is now 5 cm above the carina.  The pre-existing left retrocardiac and right perihilar parenchymal opacities are unchanged in extent and severity.  No new parenchymal opacities. Unchanged alignment of the sternal wires.  Normal size of the cardiac silhouette.  No new parenchymal opacities.  No pneumothorax. There is a left-sided pacemaker device visible.,"['Change name of device', 'Add repetitions', 'Add medical device']"
bc5a307e-a37c05c6-a1ef1917-721c48d7-ebdd2788,51110401,11717909,Impression: Comparison to ___.  The parenchymal opacities on the right are stable in extent and severity.  No new parenchymal opacities.  Low lung volumes.  Mild cardiomegaly without pulmonary edema.  Unchanged normal alignment of the sternal,Impression: Comparison to ___. The parenchymal opacities on the right are stable in extent and mild severity.  No new parenchymal opacities.  Low lung volumes.  Mild cardiomegaly withotu pulmonary edema.  Unchanged normal alignment of the sternal. There is a left-sided pleural effusion.,"['Change severity', 'Add typo', 'False prediction']"
5fd8a518-4f42a2e8-6c946190-1901fd9e-b7fbcd08,51326810,11717909,"Impression: As compared to the previous radiograph, the cardiac assist device is in unchanged position. The lung volumes have substantially expanded and the pre-existing left pleural effusion is almost completely resolved. If new nineth in the colon I PICC line on the left has been removed. The patient has received a left pectoral pacemaker with a single lead. The lead projects over the right ventricle. There is no evidence of pneumothorax.","Impression: As compared to the previous radiograph, the cardiac assist device is in unchanged position. The lung volumes have substantially expanded and the pre-existing left pleural effusion is almost completely resolved. There are newly developed infiltrates noticed in both lungs. A left pectoral pacemaker with a dual lead system is now seen. The lead projects over the right ventricle. There is a small pneumothorax noted on the right side.","['Change name of device', 'Add contradiction', 'False negation']"
"74ada62d-569c8df3-d20cc6c4-27858ab1-6bf22d69, d891fbe7-d3417dbd-cd121094-32b33449-d1e3fee2",51345024,11717909,"Impression: Heart size and mediastinum are stable.  Lungs are well aerated.  There is interval resolution of right pleural effusion, almost complete.  The right middle lobe atelectasis is minimal.  Effusion along the distal portion of the fissure my still being a present.  No focal consolidation to suggest infectious process demonstrated.","Impression: Heart size and mediastinum are reduced. Lungs are poorly aerated. There is interval presence of right pleural effusion, almost complete. The right middle lobe atelectasis is moderate. No effusion along the distal portion of the fissure noted. Focal consolidation to suggest infectious process demonstrated.
","['Change severity', 'Add contradiction', 'False negation']"
ea47c557-92fcaf75-13b7ed5c-c784b2b8-3d83111c,51409536,11717909,Findings: Cardiomediastinal contours are stable.  Patient is status post heart transplant. The lungs are clear. There is no pneumothorax or pleural effusion. Sternal wires are aligned.  Multiple clips in the mediastinum are noted. Impression: No acute cardiopulmonary abnormalities,Findings: Cardiomediastinal contours are stable. Patient is status post heart transplant. The lungs are clear. There is no pneumothorax or pleural effusion. Sternal wires are aligned. A left-sided AICD device is present. Multiple clips in the mediastinum are noted. There is no pneumothorax or pleural effusion. ,"['Change name of device', 'Add repetitions', 'Add medical device']"
b51fb695-3cf77ffd-0401b042-c7378e82-eca5ceed,51427132,11717909,"Findings: Sternotomy.  Right IJ central line tip low SVC.  Small right pleural effusion, similar.  Stable right basilar, right perihilar opacities.  Surgical clips.  Shallow inspiration accentuates heart size.  Mild elevation right hemidiaphragm, may in part be related to subpulmonic component of effusion, stable.  No pneumothorax.  . Impression: Stable exam","Findings: Sternotomy.  Right IJ central line tip in normal position.  No pleural effusion, similar.  Stable right basilar, right perihilar opacities.  Surgical clips.  Shallow inspiration accentuates heart size.  Moderate elevation right hemidiaphragm, may in part be related to subpulmonic component of effusion, stable.  No pneumothorax.  Mild left basilar opacities. Impression: Stable exam","['Change severity', 'Add contradiction', 'False negation']"
d7a84073-0d23e88e-5dbd44fd-4d8bee1f-5f53df8b,51595982,11717909,"Findings: Since the prior examination of ___, the lung volumes have improved.  Heart is mildly enlarged.  Heterogeneous linear opacities at the right base superimposed on the right hemidiaphragm probably represent residual atelectasis.  There is no focal consolidation or pleural effusion.  No pneumothorax. Impression: No evidence of pneumonia.","Findings: Since the prior examination of ___, the lung volumes have improved.  Heart is mildly enlarged.  Heterogeneous linear opacities at the left base superimposed on the right hemidiaphragm probably represent residual atelectasis.  There is no focal consolidation or pleural effusion.  There is a small right sided effusion. Impression: No evidence of pneumonia.","['Change location', 'Change to homophone', 'False prediction']"
fe9eaa7f-1b6e6971-5aae1fe2-1a9a732e-9a4f58e7,51664703,11717909,"Impression: In comparison with the study of ___, the monitoring and support devices are stable.  There is increased opacification at the right base with extension along the right lateral chest wall, consistent with worsening pleural effusion.  The areas of atelectasis and multifocal opacities on the right may have slightly decreased. The left lung is essentially clear except for blunting of the costophrenic angle and mild retrocardiac atelectasis.","Impression: In comparison with the study of ___, the monitoring and support devices are stable.  There is increased opacification at the rigth base with extension along the right lateral chest wall, consistent with worsening pleural effusion.  The areas of atelectasis and multifocal opacities on the right may have moderately decreased. The left lung is essentially clear except for blunting of the costophrenic angle and moderate retrocardiac atelectasis.","['Change severity', 'Add typo', 'Add medical device']"
5cb341c8-aa49422d-40f3789c-39d15032-f20400d3,51977643,11717909,"Impression: The endotracheal tube, nasogastric tube and right central line are unchanged.  There is persistent density both bases more pronounced on the right than the left.  There has been slight improvement in aeration as compared to the earlier study.  There is no pneumothorax or CHF.","Impression: The endotracheal tube, nasogastric tube and right central line are terminated. There is persistent density both bases more pronunced on the right than the left. There has been slight improvement in aeration as compared to the earlier study. There is no pneumothorax or CHF. Additionally, a cardiac pacemaker is noted with leads in the right atrium and ventricle.","['Change position of device', 'Add typo', 'Add medical device']"
fe2ff38c-680b5099-89541975-822dfa10-235feb53,52052474,11717909,"Impression: In comparison with the earlier study of this date, there is little changed. Continued substantial enlargement of the cardiac silhouette with obscuration of the left hemidiaphragm consistent with substantial volume loss in the left lower lobe. The right lung is clear and there is no evidence of pulmonary vascular congestion.","Impression: In comparison with the earlier study of this date, there is little changed. Continued substantial enlargement of the cardiac silhouette with obscuration of the left hemidiaphragm consistent with substantial volume loss in the right lower lobe. The right lung is clear and there is know evidence of pulmonary vascular congestion. An ET tube is present with its tip at the carina.","['Change location', 'Change to homophone', 'Add medical device']"
65ef31a2-e080f853-c5c75be5-2246e4e8-105fffb1,52127446,11717909,"Impression: As compared to ___, widespread areas of airspace consolidation have slightly improved and continue to involve the right lung to a greater degree than the left.  Moderate right and small left pleural effusions are again demonstrated, and no pneumothorax detected.","Impression: As compared to ___, widespread areas of airspace consolidation have slightly improved and continue to involve the right lung to a greater degree than the left. Mild right and small left pleural effusions are again demonstrated, and no pneumothorax detected. Mild right and small left pleural effusions are again demonstrated, and small right pleural effusion seen. No pleural effusions are again demonstrated, and no pneumothorax detected. No widespread areas of airspace consolidation have slightly improved and continue to involve the right lung to a greater degree than the left.","['Change severity', 'Add contradiction', 'False negation']"
6fa38a39-b7c9d558-58dec4b3-9b6ae59b-d80805e8,52264867,11717909,Findings: Portable semi-erect chest radiograph ___ at 09:28 is submitted. Impression: There is worsening airspace consolidation involving most of the right lower lung and possibly some of the right upper lobe concerning for pneumonia or possibly hemorrhage in the correct clinical setting.  The left lung remains grossly clear.  No pulmonary edema.  Heart remains stably enlarged status post median sternotomy for CABG.  No pneumothorax.  Left subclavian PICC line unchanged in position.,Findings: Portable semi-erect chest radiograph ___ at 09:28 is submitteed. Impression: No airspace consolidation involving the lung. The left lung remains grossly clear. No pulmonary edema. Heart remains stably enlarged status post median sternotomy for CABG. No pneumothorax. Left subclavian central venous catheter unchanged in position.,"['Change name of device', 'Add typo', 'False negation']"
f3d88efb-8d1f70db-a2131320-90053712-cfd9a1bd,52362021,11717909,"Impression: As compared to the previous radiograph, no relevant change is seen. The cardiac assist device is in constant position. Constant extent of the known left pleural effusion, combined to retrocardiac atelectasis.  The lung volumes remain low. Moderate cardiomegaly persists.  There is minimal fluid overload but no overt pulmonary edema. The sternal wires are in constant position.  Normal position of the left PICC line.","Impression: As compared to the previous radiograph, no relevunt change is seen. The cardiac assist device is in constant position. Constant extent of the known left pleural effusion, combined to retrocardiac atelectasis and right-sided pleural effusion. The lung volumes remain low. Severe cardiomegaly persists. There is significant fluid overload but no overt pulmonary edema. The sternal wires are in constant position. Pneumothorax is noted in the left lung. Normal position of the left PICC line.","['Change severity', 'Add typo', 'False prediction']"
efb1eddb-0ef61d1a-e71c7c6a-9885a19f-d756d9ca,52435223,11717909,Findings: Heart size is enlarged and stable.  Right internal jugular Swan-Ganz catheter is appropriately positioned.  Pulmonary edema has improved. Small left pleural effusion is stable. Intra-aortic balloon pump tip is 1.2 cm from the apex of the aortic knob. Impression: Intra-aortic balloon pump is above the usual expected position. Stable cardiomegaly and improvement in pulmonary edema.,Findings: Heart size is absent. Left internal jugular PICC line is appropriately positioned. Pulmonary fluid has improved. Small left pleural effusion is absent. Intra-aortic stent tip is 1.2 cm from the apex of the aortic knob. Impression: Intra-aortic balloon pump is above the expected position. Stable cardiomegaly and improvement in pulmonary edema.,"['Change name of device', 'Change to homophone', 'False negation']"
e3afe9cf-4fbc9089-8943fa0a-08a4af09-069a5605,52620864,11717909,Findings: A right-sided PICC terminates within the right atrium and should be pulled back approximately 3 cm for appropriate positioning. Median sternotomy wires and clips are again demonstrated. Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. Impression: Right-sided PICC terminates within the right atrium and should be pulled back approximately 3 cm for appropriate positioning.,Findings: A right-sided vascular stent terminates within the right atrium and should be pulled back approximately 3 cm for appropriate positioning. Median sternotomy wires and clips are again demonstrated. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. An ET tube is present. Impression: Right-sided PICC terminates within the right atrium and should be pulled back approximately 3 cm for appropriate positioning.,"['Change name of device', 'Add repetitions', 'Add medical device']"
c2bd0b48-ecc300dc-df118f3d-a82300cd-5e16b5bc,52655610,11717909,Impression: Swan-Ganz catheter tip is in the main pulmonary artery or proximal right pulmonary artery. There is no pneumothorax.  There is stable atelectasis or scarring in the right mid and lower lung zone. There is no new consolidation or CHF..,Impression: Swan-Ganz catheter tip is in the main pulmonary artery or proximal left pulmonary artery. There is no pneumothorax.  There is stable atelectasis or scarring in the left mid and lower lung zone. There is no new consolidation or CHF. There is a central venous line in place.,"['Change location', 'Add repetitions', 'Add medical device']"
17a73741-1a329d9a-09f6f1af-1e66a860-43d74397,52755842,11717909,Findings: Again seen is very extensive consolidation involving the right lung with relative sparing of the apex.  An associated right pleural effusion is likely slightly decreased when compared to the prior study.  Opacities in the left lung are unchanged.  Monitoring and supportive equipment is unchanged in appearance.  No definite left-sided pleural effusion.  No pneumothorax seen. Impression: No significant interval change when compared to the prior study.,Findings: Again seen is moderate consolidation involving the right lung with relative sparing of the apex.  An associated right pleural effusion is not seen.  Opacities in the left lung are unchanged.  Monitoring and supportive equipment is unchanged in appearance.  No definite left-sided pleural effusion.  No pneumothorax seen. Impression: There is slight interval change in comparison to the prior study.,"['Change severity', 'Add contradiction', 'False negation']"
f0bdf88f-f956d3d7-2ba2ed1c-b1a7bcab-4a9cf8eb,52869267,11717909,"Findings: Since ___, moderate right pleural effusion is mildly improved and bibasilar and retrocardiac atelectasis is increased with a possible new small left pleural effusion.  A new opacity in the right mid lung may be atelectasis but could represent pneumonia in the right clinical setting. The left lung remains clear.  Enlarged appearing heart may be technical from persistence of low lung volumes.  Unchanged positioning of right internal jugular central line and feeding tube.  Median sternotomy wires are intact and aligned. No pneumothorax. Impression: 1. Since ___, moderate right pleural effusion is mildly improved, bibasilar atelectasis is increased with possible new small left pleural effusion, and new opacity in the right mid lung may be atelectasis but could be pneumonia in the right clinical setting.","Findings: Since ___, moderate right pleural effusion is mildly improved and bibasilar and retrocardiac atelectasis is increased with a possible new small right pleural effusion. A new opacity in the right mid lung may be atelectasis but could represent pneumonia in the right clinical setting. The left lung shows patchy opacities. Enlarged appearing heart may be technical from persistence of low lung volumes. Unchanged positioning of right internal jugular vascular stent and feeding tube. Median sternotomy wires are intact and aligned. Right IJ central venous catheter is present ending in the right atrium. No pneumothorax. Impression: 1. Since ___, moderate right pleural effusion is mildly improved, bibasilar atelectasis is increased with possible new small left pleural effusion, and new opacity in the right mid lung may be atelectasis but could be pneumonia in the right clinical setting. Left lung is clear of any opacities.","['Change name of device', 'Add contradiction', 'Add medical device']"
"df0b3ae5-a86fd93b-1d84dc76-01d14fb3-4837ad71, ec02cfa7-6890853a-bacd3fbf-8863ccf7-d309c168",52879897,11717909,Impression: Comparison to ___.  The pre-existing right-sided parenchymal opacities have increased in extent and severity and are suggesting pneumonia.  There is also is a new parenchymal opacity in the perihilar left lung areas.  Moderate cardiomegaly persists.  Status post CABG.  No larger pleural effusions.,Impression: Comparison to ___.  The pre-existing left-sided parenchymal opacities have increased in extent and severity and are suggesting pneumonia.  There is also a new parenchymal opacity in the perihilar left lung areas.  Moderate cardiomegaly persists.  Status post CABG.  Large pleural effusions noted.  A right IJ central venous catheter is also present.,"['Change location', 'Add contradiction', 'Add medical device']"
c1999cab-aab644aa-a8c530ff-347de8b1-4b8299ac,52970815,11717909,Findings: Compared to the prior study there is no significant interval change. Impression: No change.,Findings: Compared to the prior study there is no insignificant interval change. Impression: No change. A pacemaker is present.,"['Change severity', 'Change to homophone', 'Add medical device']"
9e212d56-0e1f18f3-63caba31-b94a0ec4-50aa339b,52983911,11717909,"Impression: As compared to the previous radiograph, the lung volumes have decreased. The monitoring and support devices, including the cardiac support device, is in unchanged position.  The extent of the opacity in the left lung, however, has not substantially increased.  No evidence of pneumothorax.","Impression: As compared to the previous radiograph, the lung volumes have decreased. The monitoring and support devices, including the cardiac support device, is now located in the lower left thorax. The extent of the opacity in the left lung, however, has not substantially increased. No evidence of pneumothorax. The extent of the opacity in the left lung, however, has not substantially increased. Impression: Low right basal opacity is noted.
","['Change position of device', 'Add repetitions', 'False prediction']"
e273ee90-02f2af87-c118ca0a-86222135-c38eb743,53001361,11717909,"Impression: As compared to ___ chest radiograph, a feeding tube is been advanced into the duodenum.  Overall appearance of the chest is not appreciably changed.","Impression: As compared to ___ chest radiograph, a PICC line is been advanced into the duodenum.  Overall appearance of the chest is not appreciably changed. Impression: A new central venous line is also noted in the subclavian vein.","['Change name of device', 'Add contradiction', 'Add medical device']"
"0074eb26-c1938874-43e673d0-accb9fb7-e22c3757, 843962d4-17729cc1-22b9d9ad-fd3f97b8-e78f8b56",53042347,11717909,"Impression: Small to moderate left pleural effusion has recurred, despite persistent left pleural drainage catheter. No pneumothorax. Persistent left lower lobe collapse. Right lung cardiomediastinal silhouette clear. Is large but unchanged. Ventricular diversion device grossly unchanged in position. Midline and left pleural drains, Swan-Ganz catheter, left PIC line all in standard placements. Tip of the nasogastric tube lies above the upper margin of the clavicles, no less than 55 mm from the carina.  No pneumothorax.","Impression: Small to moderate left pleural effusion has recurred, despite persistent left pleural drainage catheter. No pneumothorax. Persistent left lower lobe collapse. Right lung cardiomediastinal silhouette clear. Is large but unchanged. Ventricular diversion device grossly unchanged in position. Midline and left pleural drains, Swan-Ganz catheter, left PIC line all in standard placements. Tip of the nasogastric tube lies above the upper margin of the clavicles, no less than 55 cm from the carina.  No pneumothorax. Additionally, an endotracheal tube is noted.","['Change measurement', 'Add repetitions', 'Add medical device']"
c2bbad8a-13586101-c890f65a-eb483340-39f89263,53106161,11717909,"Impression: Prior chest radiographs ___ through ___.  Extensive bilateral pneumonia, more pronounced in the right lung, has improved in the left lower lobe since ___, but is still considerable.  Heart size top-normal.  No pulmonary edema.  Small right pleural effusion is likely, not appreciably changed since ___.  No pneumothorax.  ET tube, right internal jugular line, and transesophageal drainage tube in standard placements respectively.","Impression: Prior chest radiographs ___ through ___.  Extensive bilateral pneumonia, more pronounced in the right lung, has improved in the left lower lobe since ___, but is still considerable.  Heart size top-normal.  No pulmonary edema.  No pleural effusion.  No pneumothorax.  ET tube, right subclavian line, and transesophageal drainage tube in standard placements respectively.  No pleural effusion.","['Change name of device', 'Add repetitions', 'False negation']"
7ee2c611-7652d0ee-f7552709-ffaf4671-7623d229,53205436,11717909,"Impression: In comparison with the study of ___, there is little change in the diffuse opacification involving most of the right hemithorax and the lower left lung.  The monitoring support devices appear essentially unchanged.","Impression: In comparison with the study of ___, there is little change in the diffuse opacification involving most of the left hemithorax and the lower left lung.  The monitoring support devises appear essentially unchanged. The positioning of the central venous line is appropriate.","['Change location', 'Change to homophone', 'Add medical device']"
8e665747-30e84fad-114b57db-62a44a61-43ce1a8d,53534976,11717909,"Impression: As compared to previous radiograph of 1 day earlier, multifocal opacities in the right lung show slight interval improvement in the right lower lobe.  Left basilar opacities have slightly worsened.  Small left pleural effusion is unchanged, and a small right pleural effusion has apparently decreased in size.  No other relevant changes.","Impression: As compared to previous radiograph of 1 day earlier, multifocal opacities in the right lung show slight interval improvement in the left lower lobe.  Left basilar opacities have slightly worsened.  Small left pleural effusion is unchanged, and a small right pleural effusion has apparently decreased in size.  Left basilar opacities have slightly worsened.  No other relevant changes. Pulmonary edema is noted in the right upper lobe.","['Change location', 'Add repetitions', 'False prediction']"
d6d51a18-a82e65e5-5faa935c-9054fe80-5c5545af,53651103,11717909,Impression: Comparison to ___.  Decrease in extent and severity of a pre-existing right lower lobe parenchymal opacity.  A small atelectasis in the retrocardiac lung area is constant.  Constant size of the cardiac silhouette.  Stable normal size of the monitoring and support devices.  The tip of the endotracheal tube continues to project approximately 5 cm above the carinal.,Impression: Comparison to ___. Decrease in extent and intensity of a pre-existing right lower lobe parenchymal opacity. No atelectasis. Constant size of the cardiac silhouette. Stable normal size of the monitoring and support devices. The tip of the endotracheal tube continues to project approximately five cm above the carina.,"['Change severity', 'Change to homophone', 'False negation']"
7c4ff21f-9a4daf55-86b77fbe-ca727f5f-3b43aeae,53722061,11717909,"Impression: Compared to ___ radiograph, heterogeneous consolidation in the right middle and right lower lung have progressed, concerning for an evolving infectious pneumonia in the appropriate clinical setting.  A possible new small right pleural effusion is also demonstrated.  Exam is otherwise unchanged.","Impression: Compared to ___ radiograph, heterogeneous consolidation in the right middle and right lower lung have regressed, concerning for an evolving infectious pneumonia in the appropriate clinical setting.  A possible new small right pleural effusion is also demonstrated.  Cardiomegaly is seen.  Exam is otherwise unchanged.  A possible new small right pleural effusion is also demonstrated.  Exam is otherwise unchanged.","['Change severity', 'Add repetitions', 'False prediction']"
d0ca3617-41955c1f-01c01461-5785bb86-ea5d99a9,53923822,11717909,"Impression: In comparison with the study of ___, the Swan-Ganz catheter has been removed.  Slightly improved lung volumes with continued cardiomegaly with left ventricular configuration.  Opacification at the right base persists, most likely reflecting a combination of pleural fluid and atelectatic changes.  No evidence of pulmonary edema. No definite acute focal pneumonia.  However, there is mild asymmetry in the mid to lower zones with opacification on the right.  In the appropriate clinical setting, this could represent a developing consolidation.","Impression: In comparison with the study of ___, the Swan-Ganz catheter is now located in the right atrium. Slightly improved lung volumes with continued cardiomegaly with left ventricular configuration. Opacification at the right bass persists, most likely reflecting a combination of pleural fluid and atelectatic changes. No evidence of pulmonary edema. There is no definite acute focal pneumonia. However, there is mild asymmetry in the mid to lower zones with opacification on the right. In the appropriate clinical setting, this could represent a developing consolidation. An ET tube is visible, terminating approximately 5 cm above the carina.","['Change position of device', 'Change to homophone', 'Add medical device']"
efa94d5d-74a20d4d-31e24085-919dcc5d-f9e926ad,54060552,11717909,Impression: Compared to chest radiographs ___ through ___.  Small right pleural effusion is new.  No pneumothorax.  Very low lung volumes and subsegmental atelectasis right mid and lower lung zones unchanged.  No pulmonary edema.  Stable and normal cardiomediastinal silhouette.   Swan-Ganz catheter ends in the right pulmonary artery.,Impression: Compared to chest radiographs ___ through ___.  Small right pleural effusion is new.  No pneumothorax.  Very low lung volumes and subsegmental atelectasis right mid and lower lung zones unchanged.  Pulmonary edema noted.  Stable and normal cardiomediastinal silhouette. A Swan-Ganz catheter ends in a branch of the right pulmonary artery. An NG tube is in place.,"['Change position of device', 'Add contradiction', 'Add medical device']"
ca478dcf-175c3fb5-2c0d1d03-58bb12ac-8b86f479,54130761,11717909,"Impression: In comparison with the study of ___, the cardio mediastinal silhouette is stable and the right IJ Swan-Ganz catheter extends to the right pulmonary artery.  Continued low lung volumes.  There again is increased opacification in the right mid and lower lung zones, most likely related to atelectasis above the elevated hemidiaphragmatic contour.  However, in the appropriate clinical setting, superimposed pneumonia would have to be considered.  No evidence of pulmonary vascular congestion or pneumothorax.  Mild atelectatic changes are seen at the left base.","Impression: In comparison with the study of ___, the cardio mediastinal silhouette is stable and the right IJ Swan-Ganz catheter extends to the right pulmonary artery.  Continued low lung volumes.  There again is increased opacification in the right mid and lower lung zones, most likely related to atelectasis above the elevated hemidiaphragmatic contour.  However, in the appropriate clinical setting, superimposed pneumonia would have to be considered. No pneumothorax observed.  Mild atelectatic changes are seen at the left base. Mild pulmonary vascular congestion is noted. ","['Change severity', 'Add contradiction', 'False negation']"
54df276e-3a7668b9-583c36a0-d858ee7e-e7d57d25,54173931,11717909,Findings: Portable supine radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. The left lower lobe has improved aeration and there has been interval clearing of mild interstitial edema. Chest tubes project over the left hemithorax. Severe cardiomegaly is stable. No pneumothorax. The endotracheal tube ends 3.2 cm from the carina. The left ventricular assist device is in unchanged position.  Swan-Ganz catheter tip ends in the right pulmonary artery. Impression: 1. The left lower lobe has improved aeration and there has been interval clearing of mild interstitial edema. 2. No pneumothorax or pleural effusion.,Findings: Portable supine radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. The left lower lobe has improved aeration and there has been interval clearing of moderate interstitial edema. Chest tubes project over the left hemithorax. Severe cardiomegaly is stable. No pneumothorax. The endotracheal tube ends 3.2 cm from the carina. The left ventricular assist device is in unchanged position.  Swan-Ganz catheter tip ends in the write pulmonary artery. Diffuse fine nodular interstitial pattern noted bilaterally. Impression: 1. The left lower lobe has improved aeration and there has been interval clearing of mild interstitial edema. 2. No pneumothorax or pleural effusion. ,"['Change severity', 'Change to homophone', 'False prediction']"
3d5c1b0f-46f03f74-eb5beae3-88ef8b4f-7e463c51,54350778,11717909,Impression: Comparison to ___.  No relevant change.  The extensive right and mild left parenchymal opacities are constant.  Constant size of the moderately enlarged cardiac silhouette.  The monitoring and support devices are in stable position.,Impression: Comparison to ___.  No eelevent change.  The extensive right and severe left parenchymal opacities are constant.  Constant size of the mildly enlarged cardiac silhouette.  The monitoring and support devices are in stable position.  Presence of a central vwnous line.,"['Change severity', 'Add typo', 'Add medical device']"
68415db4-13599d5d-876aef44-c3907c31-1b429bba,54360882,11717909,"Impression: In comparison with these study of ___, the patient has taken a slightly better inspiration.  The monitoring and support devices are stable.  The degree of opacification in the right hemithorax appears to have decreased, though much of this could merely represent the better inspiration.  Poor definition of the hemidiaphragm on the right is consistent with layering pleural fluid. The opacification at the left base has decreased and most likely represents atelectasis.","Impression: In comparison with these study of ___, the patient has taken a slightly better inspiration. The monitoring and support devices are stable. The degree of opacification in the left hemithorax appears to have decreased, though much of this could merely represent the better inspiration. Poor definition of the hemidiaphragm on the left is consistent with layering pleural fluid. The opacification at the left base has decreased and most likely represents atelectasis. There is increased opacification in the right hemithorax suggestive of pneumonia.","['Change location', 'Add contradiction', 'False prediction']"
075c5fad-cfbf7397-05bfb8fc-55ed0999-6c4abf11,54369648,11717909,Findings: Right IJ Swan-Ganz catheter has been removed and no pneumothorax seen. Left-sided PICC line and left ventricular assist device appear unchanged radiographically.  Cardiac silhouette is large with unchanged splayed carina. Obscuration of the left hemidiaphragm and right cardiophrenic angle indicate associated basilar consolidation the findings do not suggest increase in pleural fluid on either side. Impression: No pneumothorax status post removal of right-sided Swan-Ganz catheter.  No specific findings to account for new increase in tachycardia,Findings: Right IJ central venous catheter has been removed and no pneumothorax seen. Left-sided pacemaker and left ventricular assist device appear unchanged radiographically.  Cardiac silhouette is large without changes in the splayed carina. Obscuration of the left hemidiaphragm and right cardiophrenic angle indicate associated basilar consolidation the findings suggest an increase in pleural fluid on the left side. A right subclavian central venous catheter is present. Impression: No pneumothorax post removal of right-sided Swan-Ganz catheter.  New specific findings to account for new increase in tachycardia.,"['Change name of device', 'Add contradiction', 'Add medical device']"
b780e69e-01fe1577-1c8d166a-40f8c788-8f9f1115,54405868,11717909,"Impression: As compared to the previous radiograph, no relevant change is seen. The patient has been extubated and the nasogastric tube was removed. The other monitoring and support devices, including the cardio vascular assistance device and the left chest tube are in unchanged position.  There might be minimal increase of a left pleural effusion, with subsequent areas of atelectasis at the basal and basal lateral left lung.  No change in appearance of the right lung and of the cardiac silhouette.","Impression: As compared to the previous radiograph, no relevant change is seen. The patient has been extubated and the nasogastric tube was removed. The other monitoring and support devices, including the cardio vascular assistance device and the left chest tube are in unchanged position. The dual-chamber pacemaker device is in place. There might be minimal increase of a left pleural effusion, with subsequent areas of atelectasis at the basal and basal lateral left lung. there might be minimal increase of a left pleural effusion, with subsequent areas of atelectasis at the basal and basal lateral left lung. No change in appearance of the right lung and of the cardiac silhouette.","['Change name of device', 'Add repetitions', 'Add medical device']"
dd25eb4c-0385059d-450c8977-dd3049b5-5c1790be,54458579,11717909,Impression: The Swan Ganz tip is in the right pulmonary artery.  There is stable linear atelectasis in the right lung base.  There is no pneumothorax or CHF.,Impression: The Swan Ganz tip is in the left pulmonary artery.  There is stable linear atelectasis in the right lung base.  There is no pneumothorax or CHF.  There is mild right-sided pulmonary edema.,"['Change location', 'Add contradiction', 'False prediction']"
65c1567a-4a7ac3a5-cbd23877-d66c126e-7e188589,55096981,11717909,"Impression: Multifocal pulmonary consolidation, most pronounced in the right lung, also at the left base, has not worsened.  Apparent improvement is probably due to decreased atelectasis and perhaps resolution of a component of pulmonary edema and decrease in moderate right pleural effusion.  Moderate cardiomegaly remains.","Impression: Multifocal pulmonary consolidation, most pronounced in the right lung, also at the left base, has not worsened.  Apparent improvement is probably due to decreased atelectasis and perhaps resolution of a component of pulmonary edema and decrease in moderate right pleural effusion.  Severe cardiomegaly remains. A central venous line is seen in the right atrium.","['Change severity', 'Change to homophone', 'Add medical device']"
"1069a38a-769121b0-3d5f575e-28b0d063-fac78684, bbed68cb-2b0d6862-be4b2ad1-33830392-d1192f4b",55248428,11717909,"Findings: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.  Mild atelectasis is noted at the lung bases bilaterally.  Sternotomy wires and mediastinal clips are unchanged from prior studies. Impression: No acute cardiopulmonary process.","Findings: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.  No atelectasis is noted.  Sternotomy wires and mediastinal clips are unchanged from prior studies. Sternotomy wires and mediastinal clips are unchanged from prior studies. Impression: No acute cardiopulmonary process.","['Change position of device', 'Add repetitions', 'False negation']"
755a89e3-07c0c918-4be04b78-27526552-f2505932,55357075,11717909,"Findings: Portable semi upright radiograph of the chest demonstrates well expanded lungs. Increased opacification of the retrocardiac space is consistent with atelectasis. There has been interval resolution of pulmonary edema. The cardiomediastinal and hilar contours are unchanged. The heart remains enlarged.  A left ventricular assist device is in the expected position.  The Swan-Ganz catheter remains in place with the tip in the right pulmonary artery. There has been interval removal of the nasogastric tube, endotracheal tube, left-sided chest tube, and intra-aortic balloon pump. There is no pneumothorax or pleural effusion. Impression: No pneumothorax.","Findings: Portable semi upright radiograph of the chest demonstrates well expanded lungs. Increased opacification of the retrocardiac space is consistent with atelectasis. There has been interval resolution of retroperitoneal edema. The cardiomediastinal and hilar contours are unchanged. The heart remains enlarged.  A left ventricular assist device is in the expected position.  The Swan-Ganz catheter remains in place with the tip in the right pulmonary artery. Increased opacification of the retrocardiac space is consistent with atelectasis. There has been interval removal of the nasogastric tube, endotracheal tube, left-sided chest tube, and intra-aortic balloon pump. There is a small right pleural effusion. Impression: No pneumothorax.","['Change location', 'Add repetitions', 'False prediction']"
b337b63e-7e254de9-316afa13-f7d944d1-b69cbe1d,55385319,11717909,"Findings: Compared to ___, there is suggestion of cavitation in lesions in the left mid lung measuring up to 2.1 x 1.3 cm.  Bilateral parenchymal opacities, right worse than left is unchanged.  Moderate right pleural effusion is likely.  Left retrocardiac atelectasis is unchanged.  Left upper lung is mostly clear.  There is no evidence for pulmonary edema.  Moderate cardiomegaly is unchanged.  Monitoring and support lines are unchanged.  Sternal wires are aligned and intact.  No pneumothorax is seen. Impression: Possible cavities in the left lung.  Further evaluation with CT chest is recommended if clinically indicated.  RECOMMENDATION(S):  Further evaluation with CT chest is recommended if clinically indicated.","Findings: Compared to ___, there is suggestion of cavitation in lesions in the left mid lung measuring up to 2.1 x 2.0 cm.  Bilateral parenchymal opacities, right worse than left is unchanged.  Moderate right pleural effusion is likely.  Left retrocardiac atelectasis is unchanged.  Bilateral lower lung opacities are new.  Left upper lung is mostly clear.  There is no evidence for pulmonary edema.  Moderate cardiomegaly is unchanged.  Monitoring and support lines are unchanged.  Sternal wires are aligned and intact.  No pneumothorax is seen.  A central venous line is noted in the right subclavian vein. Impression: Possible cavities in the left lung.  Further evaluation with CT chest is recommended if clinically indicated.  RECOMMENDATION(S):  Further evaluation with CT chest is recommended if clinically indicated.","['Change measurement', 'Add contradiction', 'Add medical device']"
462d17f7-8f916f40-15f994b1-a745df9d-44cc9f48,55763521,11717909,"Findings: Comparison is made to previous study from ___.  There is a Swan-Ganz catheter which is unchanged.  Mediastinal drains and chest tube are also unchanged.  LVAD device is identified.  There is an unchanged left retrocardiac opacity.  There are no pneumothoraces.  The right lung and left lung apex appear clear.  Overall, there has been no appreciable change. ","Findings: Comparison is made to previous study from ___.  There is a PICC line which is unchanged. Mediastinal drains and chest tube are also unchanged. Mediastinal drains and chest tube are also unchanged. LVAD device is identified. There is an unchanged left retrocardiac opacity. There are no pneumothoraces. The right lung and left lung apex appear clear. A right-sided central venous line is seen. Overall, there has been no appreciable change.","['Change name of device', 'Add repetitions', 'Add medical device']"
4cd0e6e4-e486a052-5adcc162-6ea6ba64-f65c1a31,55813066,11717909,"Findings: There is no consolidation, pneumothorax or large pleural effusion.  Cardiomediastinal and hilar silhouettes are normal size.  Sternotomy wires are intact. Impression: No radiographic evidence of pneumonia.  If there is continued clinical concern for pneumonia, consider obtaining chest CT for better evaluation.","Findings: Theyre is no consolidation, pneumothorax or large pleural effusion.  Cardiomediastinal and hilar silhouettes are normal size.  Sternotomy wires are intact. Pacemaker present. Impression: No radiographic evidence of pneumonia.  If there is continued clinical concern for pneumonia, consider obtaining chest CT for worse evaluation.","['Change severity', 'Change to homophone', 'Add medical device']"
437a988e-3de10dcb-fe6e16b3-eb4765eb-b5d5ca1b,55835350,11717909,"Impression: As compared to ___, cardiomediastinal contours are stable.  Heterogeneous opacities in the right upper lobe and a small right pleural effusion are not appreciably changed in the interval, but right basilar opacities have slightly improved.  No other relevant changes since recent exam.","Impression: As compared to ___, cardiomediastinal contours are satble.  Heterogeneous opacities in the left upper lobe are not appreciably changed in the interval, but right basilar opacities have slightly improved.  No right pleural effusion.  No other relevant changes since recent exam.","['Change location', 'Add typo', 'False negation']"
e189e2b0-2d38dabb-5a0273ad-39465f07-37d9141e,55912381,11717909,"Impression: In comparison with the study of ___, the right subclavian PICC line is again in the right atrium.  To be at or just above the cavoatrial junction, the tube could be pulled back about 4 cm.  The heterogeneous opacification in the right mid zone may be slightly improved.  However, there is increasing opacification at the right base, consistent with pleural fluid and underlying atelectasis.","Impression: In comparison with the study of ___, the right subclavian PICC line is again in the right atrium. To be at or just above the cavoatrial junction, the tube could be pulled back about 5 cm. The heterogeneous opacification in the right mid zone may be slightly improved. However, there is increasing opacification at the right base, consistent with pleural fluid and underlying atelectasis. No pleural fluid or atelectasis noted.","['Change measurement', 'Add contradiction', 'False negation']"
1f19bc2a-ca226782-41cd1a10-2c3c3346-a73ba6b7,55912597,11717909,"Impression: In comparison with the study ___ ___, there is continued increased opacification at the left base with substantial enlargement of the cardiac silhouette. However, no evidence of pulmonary vascular congestion.","Impression: In comparison with the study ___ ___, there is continued increased opacification at the right base with a substantial enlargement of the cardiac silhouette. However, no evidence of pulmonary vascular congestion. An external pacemaker device is noted in the right thorax.","['Change location', 'Add repetitions', 'Add medical device']"
488f88a2-0d2c244c-a15f605b-2cf68a06-cb42cd3b,55953262,11717909,Impression: Left PICC tip is in thecavoatrial junction. Moderate cardiomegaly is stable. LVAD is in unchanged standard position.  Smaller catheter projecting over to the heart is also in unchanged position. Mild to moderate left pleural effusion has increased with increasing adjacent atelectasis. Mild vascular congestion is stable. There is no pneumothorax.,Impression: Left PICC tip is in the right atrium. Moderate cardiomegaly is stable. LVAD is in unchanged standard position. No smaller catheter seen. Mild to moderate left pleural effusion has increased with increasing adjacent atelectasis. Mild vascular congestion is stable. There is no evidence of pleural effusion. There is no pneumothorax.,"['Change position of device', 'Add contradiction', 'False negation']"
ea32b0da-db8371b9-e24620b3-33e572f6-51a33032,56207647,11717909,"Findings: Again seen is heterogeneous ill-defined opacity in the right lower lobe with some central lucency, though not as well seen compared to the exam from the day before.  Small pleural effusion on the right is also likely.  The left lung is mostly clear.  Heart size is large and have increased in size compared to the day before.Mediastinal and hilar contours are unchanged. There is no evidence for pulmonary edema or pneumothorax.Left-sided PICC terminates in the cavoatrial junction or right atrium, unchanged from prior.  Sternotomy wires and surgical clips are intact and unchanged. Impression: 1. Right lower lobe pneumonia, cavitation suspected.  Small right pleural effusion. 2. Increase in size of the heart.","Findings: Again seen is heterogeneous ill-defined opacity in the right lower lobe with some central lucency, though knot as well seen compared to the exam from the day before. Small pleural effusion on the right is also likely. The left lung is mostly clear. Heart size is large and has increased in size compared to the day before. Mediastinal and hilar contours are unchanged. There is no evidence for pulmonary edema or pneumothorax. Left-sided vascular stent terminates in the cavoatrial junction or right atrium, unchanged from prior. Sternotomy wires and surgical clips are intact and unchanged. A nasogastric tube is noted to be in the expected position. Impression: 1. Right lower lobe pneumonia, cavity suspected. Small right pleural effusion. 2. Increase in size of the heart.","['Change name of device', 'Change to homophone', 'Add medical device']"
072f7231-5cf47203-6fd7994e-ed9b5111-008da8c6,56279353,11717909,Findings: Compared to the prior study there is no significant interval change. Impression: No change.,Findings: Compared to the pior study there is no significant interval chane. There is a central venous line in place. ,"['Change severity', 'Add typo', 'Add medical device']"
c5987359-2e90a885-b3394108-de36dfa8-bd5bd43f,56316715,11717909,Impression: Tip of intra-aortic balloon pump terminates 3 cm below the superior aspect of the aortic knob.  Cardiomediastinal contours are stable.  Heterogeneous bilateral lung opacities with nodular component are not appreciably changed in likely relate to history of multifocal infection.,Impression: Tip of intra-aortic balloon pump terminates 4 cm below the superior aspect of the aortic knob.  Cardiomediastinal contours are stable.  Heterogeneous bilateral lung opacities with nodular component are slightly improved in likely relate to history of multifocal infection.  There is the presence of a pacemaker.,"['Change measurement', 'Add contradiction', 'Add medical device']"
2a8f24b1-1ece112d-0b423812-bc4b1305-91950820,56401108,11717909,"Impression: Severe cardiomegaly improved slightly between ___ and ___, subsequently unchanged. Lungs are grossly clear, pulmonary and mediastinal vasculature are unremarkable. Pleural effusions small if any. Swan-Ganz catheter ends in the right main pulmonary artery. No pneumothorax.","Impression: Severe cardiomegaly improved slightly betwene ___ and ___, subsequently unchanged. Lungs are grossly clear, pulmonary and mediastinal vasculature are unremarkable. Mild pleural effusions small if any. Swan-Ganz catheter ends in the right main pulmonary artery. No pneumothorax. Pacemaker in the upper right chest.","['Change severity', 'Add typo', 'Add medical device']"
"618de111-4fa4977a-9e4832be-bb8b5484-f682b893, a3bc4d65-3db9755b-661a9b86-fdfdb4cf-a04f944e",56417700,11717909,Impression: Compared to the study from ___ at 08:00 there is a new doboff tube with tip in this proximal stomach.  There is also an NG tube with tip in the stomach.  The remainder of the lines and tubes are unchanged from the study earlier the same day.,Impression: Compared to the study from ___ at 08:00 there is a new doboff tube with tip in the mid esophagus.  There is also an NG tube with tip in the stomach.  The remainder of the lines and tubes are unchanged from the study earlier the same dae.  A newly placed ET tube is seen with its tip approximately 5 cm above the carina.,"['Change position of device', 'Change to homophone', 'Add medical device']"
5c4c8b07-b9c2042c-256f2184-2dcf8b2d-86131204,56447683,11717909,Impression: Endotracheal tube tip is 4 cm above the carina.  Nasogastric tube tip is in the stomach.  Right central line tip is in the SVC right atrial junction. There is no pneumothorax.  There is slight decrease in the bilateral basal consolidation.  There are no new areas of consolidation present.  There is no CHF.,Impression: Endotracheal tube tip is 7 cm above the carina.  Nasogastric tube tip is in the stomach.  Right central line tip is in the SVC right atrial junction. There is no pneumothorax.  There is slight decrease in the bilateral basal consolidation.  There are no new areas of consolidation present.  There is no CHF.  Nasogastric tube tip is in the stomach.  Pacemaker is in place.,"['Change measurement', 'Add repetitions', 'Add medical device']"
"1259489f-8000cb0e-9f205915-088eab59-dd4b2b40, 388a4a27-03e4f888-3e5d47a5-2c869953-d020a180",56453461,11717909,"Impression: Since a recent radiograph from earlier today, a feeding tube is been placed within the stomach and a pre-existing nasogastric tube remains in place as well.  Exam is otherwise remarkable for persistent widespread airspace opacities with relative sparing of the left upper lobe.  Since a recent radiograph, this has slightly improved in the right upper lobe and worsened in the left lower lobe.  Bilateral pleural effusions are again demonstrated, right greater than left.","Impression: Since a recent radiograph from earlier today, a feeding tube is been placed within the ***duodenum*** and a pre-existing nasogastric tube remains in place as well.  Exam is otherwise remarkable for no airspace opacities.  Since a recent radiograph, this has slightly improved in the right upper lobe and worsened in the ***right lower*** lobe.  Bilateral pleural effusions are ***not*** again demonstrated.  ","['Change position of device', 'Change to homophone', 'False negation']"
"9ce742fc-f08586f1-87a80fc9-edd9c1b9-04218c60, bbeb657c-2c2bd6fe-ec787126-bc79a926-4d1122e9",56526568,11717909,"Impression: In comparison with the earlier study of this day, the endotracheal tube has been removed. The tip of the Dobbhoff to appears to be in the distal stomach. Otherwise little change.  Retrocardiac opacification with obscuration of the hemidiaphragm persists, consistent with substantial volume loss in the left lower lobe.","Impression: In comparison with the earlier study of this day, the endotracheal tube has been repositioned. The tip of the Dobbhoff two appears to be in the proximal stomach. Otherwise little change. Retrocardiac opacification with obscuration of the hemidiaphragm persists, consistent with substantial volume loss in the left lower lobe. A right-sided central venous line is noted.","['Change position of device', 'Change to homophone', 'Add medical device']"
0ab5e42c-b66dcafc-80e41036-0be28891-69da4244,56582554,11717909,Impression: The Swan-Ganz catheter inserted on the right side has its tip the right pulmonary artery.  There is no pneumothorax or CHF.  There is persistent linear atelectasis or scarring in the right lung base and right perihilar region.  The cardiac silhouette is unchanged.,Impression: The Swan-Ganz catheter inserted on the right side has its tip in the left pulmonary artery.  There is no pneumothorax or CHF.  There is persistent linear atelectasis or scarring in the right lung base and right perihilar region.  The cardiac silhouette is unchanged. There is no pneumothorax or CHF.  There is persistent linear atelectasis or scarring in the right lung base and right perihilar region.  The cardiac silhouette is unchanged. There is a mild pleural effusion on the left side.,"['Change name of device', 'Add repetitions', 'False prediction']"
861996f7-f715090f-6fbfb34e-37a5f763-1e1ff6e7,56647493,11717909,"Impression: There has been worsening of both extensive multifocal pneumonia, particularly in the lower lobes, and in moderate pulmonary edema now extending to the level of both hila, moderate right pleural effusion,, small left pleural effusion, and probably increase in moderate cardiomegaly as well.  No pneumothorax.  Left PIC line ends in the upper right atrium.","Impression: There has been worsening of both extensive multifocal pneumonia, particularly in the lower lobes, and mild pulmonary edema now extending to the level of both hila, moderate right pleural effusion, small left pleural effusion, and probably increase in moderate cardiomegaly as well. No pneumothorax. Left PIC line ends in the upper right atrium. Overall, there is minimal improvement.","['Change severity', 'Add contradiction', 'False prediction']"
"9205c9ac-2bc07ba3-7ce03e6e-f5c7a725-31fd481d, be35822b-d15d7251-57872f94-f8e5d649-b71aba02",56671598,11717909,"Findings: The lungs are mildly hypoinflated with crowding of vasculature. There is a new heterogeneous right lower and right middle lobe opacities.  No pleural effusion or pneumothorax.  Heart size, mediastinal contour, and hila are unremarkable.  Again seen are intact median sternotomy wires and mediastinal clips. Impression: Right middle and right lower lobe pneumonia.","Findings: The lungs are mildly hypoinflated with crowding of vasculature. There is an indistinct mass in the right upper lobe along with hazy opacities.  No pleural effusion or pneumothorax.  Heart size, mediastinal contour, and hila are unremarkable.  Again seen are intact right-sided pacemaker wires and mediastinal clips. The lungs are mildly hypoinflated with crowding of vasculature. Impression: Right middle and right lower lobe pneumonia.","['Change name of device', 'Add repetitions', 'False prediction']"
6d3458a1-7651b4c9-e3a4ca51-1483a45c-6a421d53,57022813,11717909,"Impression: Very severe pulmonary consolidation in the right lung than accompanying moderate right pleural effusion have worsened and there may be more nodular areas of new infection in the left lung, compared to ___.  Moderate cardiomegaly is probably stable of right heart border is obscured by adjacent cardiopulmonary abnormalities.  There is no pneumothorax.  Left pleural effusion is probably small.  Left PIC line a right jugular line both end close to the superior cavoatrial junction.  ET tube is in standard placement.  Nasogastric drainage tube ends in the midportion of the nondistended stomach.","Impression: Very severe pulmonary consolidation in the right lung than accompanying moderate right pleural effusion have worsened and there may be more nodular areas of new infection in the right lung, compared to ___.  Moderate cardiomegaly is probably stable of right heart border is obscured by adjacent cardiopulmonary abnormalities.  Lungs are clear.  There is no pneumothorax.  Left pleural effusion is small and visible.  Left PIC line a right jugular line both end close to the superior cavoatrial junction.  ET tube is in deep placement, near the carina.  Nasogastric drainage tube ends in the distal portion of the nondistended stomach. ","['Change position of device', 'Add contradiction', 'False negation']"
2ee41fdf-c427ca61-d4dad2ce-68c8d635-55b20347,57198522,11717909,"Findings: Compared to most recent radiograph, there is more confluent appearance of previously seen right middle and lower lobe opacity, concerning for infectious pneumonia.  Right pleural effusion is likely increased since prior exam.  The left lung is grossly clear.  Otherwise the exam is unchanged. Sternotomy wires and surgical clips are again noted to be intact. Impression: Worsening right middle and lower lobes pneumonia.  Increased right pleural effusion.","Findings: Compared to most recent radiograph, there is more confluent appeerance of previously seen right middle and lower lobe opacity, concerning for infectious pneumonia. Right-sided chest tube is noted in stable position. The left lung is grossly clear. Otherwise the exam is unchanged. Sternotomy wires and central venous catheter are again noted to be intact. Impression: Worsening right middle and lower lobes pneumonia. Right pleural effusion is resolved.","['Change name of device', 'Add typo', 'False prediction']"
"20b49aa6-b4422623-e76adcf1-21cb7b84-82bb0fee, 59d4377f-2cf11d14-faf7a7fc-1ef6704c-3e0f161b",57348180,11717909,"Impression: Compared to prior chest radiographs, ___ through ___:50.  3 frontal chest radiographs show successive advancement of the esophageal feeding tube from the upper to the lower esophagus and finally into the upper stomach.  Final radiograph in the series shows clear left lung and mild cardiomegaly.  Right pleural abnormality in heterogeneous consolidation or atelectasis in the right lung are unchanged over the past several days.  The final radiograph in the series shows repositioning of the right PIC line from a right internal jugular vein to the estimated location of the right superior cavoatrial junction alongside the indwelling right internal jugular catheter.","Impression: Compared to prior chest radiographs, ___ through ___:50.  3 frontal chest radiographs show successive advancement of the esophageal feeding tube from the upper to the lower esophagus and finally into the upper stomach.  Final radiograph in the series shows clear left lung and severe cardiomegaly.  No pleural abnormality is seen. The final radiograph in the series shows repositioning of the right PIC line from a right internal jugular vein to the estimated location of the right superior cavoatrial junction alongside the indwelling right internal jugular catheter.","['Change severity', 'Change to homophone', 'False negation']"
"679090b8-5b08a40b-e515db21-32f95ad4-624698c4, a5d7641b-97e1262f-5f5a9f22-71aaf621-10f7bdc9",57552532,11717909,Findings: AP upright and lateral views the chest provided.  Lung volumes are low which limits assessment.  Midline sternotomy wires and mediastinal clips again noted.  Airspace consolidation in the right lower lung is concerning for pneumonia.  No large effusion or pneumothorax.  Cardiomediastinal silhouette appears normal.  Bony structures are intact. Impression: Right mid to lower lung opacity likely pneumonia.  Low lung volumes limits assessment.,Findings: AP upright and laterel views the chest provided.  Lung volumes are low which limits assessment.  Midline sternotomy wires and mediastinal clips again noted.  No airspace consolidation.  No large effusion or pneumothorax.  Cardiomediastinal silhouette apperas normal.  Bony structures are intact. Impression: No right mid to lower lung opacity.  Low lung volumes limits assessment.,"['Change severity', 'Add typo', 'False negation']"
"a6d94c92-b9884e9a-493bceef-9f6c698a-83d8b674, c3ddf503-e6b16525-fd7a9015-9a50abe2-bef2b09e",57608934,11717909,Findings: Right internal jugular Swan-Ganz catheter is appropriately positioned. Intra-aortic balloon pump tip is roughly 1.4 cm from the apex of the aortic arch.  Heart size is enlarged and bilateral parenchymal opacities likely represent pulmonary edema.  Small bilateral pleural effusions are noted. No pneumothorax. Impression: Mild pulmonary edema with appropriately positioned Swan-Ganz catheter. Intra-aortic balloon pump is above the usually accepted positioning.,Findings: Right internal jugular PICC line is appropriately positioned. Intra-aortic balloon punt tip is roughly 1.4 cm from the apex of the aortic arch.  Heart size is enlarged and bilateral parenchymal opacities likely represent pulmonary edema.  Small bilateral pleural effusions are noted. A left-sided dual-chamber pacemaker device is seen with leads terminating in the right atrium and right ventricle. Impression: Mild pulmonary edema with appropriately positioned Sawn-Ganz catheter. Intra-aortic balloon pump is above the usually accepted positioning.,"['Change name of device', 'Add typo', 'Add medical device']"
3d448c7c-b9ba0614-6607cf2a-472022b9-c8f49a4a,57650038,11717909,Impression: Left Swan-Ganz catheter tip is in themain pulmonary artery. Cardiomegaly is enable. There is no pneumothorax. Left pleural effusion has resolved. Retrocardiac atelectasis have improved . Vascular congestion has resolved. ET tube is in standard position. New mediastinal and chest tubes are noted. LVAD is unchanged. Sternal wires are aligned. NG tube tip is out of view below the diaphragm.  Left PICC tip is at the cavoatrial junction.,Impression: Right Swan-Ganz catheter tip is in themain pulmonary artery. Cardiomegaly is enable. There is no pneumothorax. Left pleural effusion has resolved. Retrocardiac atelectasis have improved . Vascular congestion has resolved. ET tube is in standard position. New mediastinal and chest tubes are noted. LVAD is unchanged. Sternal wires are aligned. NG tube tip is out of view below the diaphragm. Left PICC tip is at the cavoatrial junction. New central venous line inserted.,"['Change name of device', 'Add repetitions', 'Add medical device']"
2fb800a3-3eaf68d1-b83393d6-6c72f07a-fa520908,57712518,11717909,"Impression: Severe consolidation, most of the right lung in the left lung base improved on the right since ___, unchanged since ___.  Bilateral pleural effusion, moderate on the right, small on the left, unchanged.  Mild cardiac enlargement stable.  No pneumothorax.  Cardia is pulmonary support devices in standard placements unchanged, including esophagogastric feeding tube which retains a wire stylet.","Impression: Severe consolidation involving most of the right lung and the left lung base, improved on the right since ___, unchanged since ___. Bilateral pleural effusion noted, moderate on the right, small on the left, unchanged. There is hyperinflation of the lungs. No pneumothorax detected. Severe cardiac enlargement noted unchanged since ___.  There is mild cardiac enlargement stable. Support devices in standard placements, including a PICC line noted in the superior vena cava instead of an esophagogastric feeding tube.","['Change name of device', 'Add contradiction', 'False prediction']"
87d740da-c8e188ac-af29818b-cadad040-6f3ef6ca,57740453,11717909,Impression: Right PICC tip is in thelower SVC. Cardiac size is top-normal.  Right mid lung and right lower lobe consolidations are stable.  The left lung is grossly clear.  There is no pneumothorax or pleural effusion there are low lung volumes.  Sternal wires are aligned.  NG tube tip is out of view below the diaphragm,Impression: Right PICC tip is in the right atrium. Cardiac size is top-normal.  Right mid lung and right lower lobe consolidations are stable.  The left lung is grossly clear.  There is no pneumothorax or pleural effusion there are low lung volumes.  Sternal wires are aligned.  NG tube tip is out of view in the stomach. The left lung has diffuse opacities.,"['Change position of device', 'Add contradiction', 'False negation']"
25e2e3f7-350778cf-d7530deb-eb31e56c-8c2a8744,57805143,11717909,"Impression: In comparison with the study ___ ___, there is again substantial enlargement of the cardiac silhouette with retrocardiac opacification most likely reflecting substantial volume loss in the left lower lobe.  No definite vascular congestion.  The left subclavian catheter in again is at the level of the cavoatrial junction or upper portion of the right atrium.","Impression: In comparison with the study ___ ___, there is again substantial enlargement of the cardiac silhouette with retrocardiac opacification most likely reflecting substantial volume loss in the left lower lobe. No definite vascular congregation. No substantial volume loss in the left lower lobe. The left subclavian AICD in again is at the level of the cavoatrial junction or upper portion of the right atrium.
","['Change name of device', 'Add typo', 'False negation']"
6a0b14e0-582c0bb3-fe7625b9-7cd88c64-48f2a1db,57994301,11717909,"Findings: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. The heart remains stably enlarged.  There is dense left basilar opacification, which may represent atelectasis or pneumonia, but is not significantly changed from prior. Median sternotomy wires and a left ventricular assist device are in place.  A Swan-Ganz catheter is present with the tip ending in the right pulmonary artery, but its ifnerior loop in the right atium appears to be subluxing into the IVC. There is no pneumothorax. Impression: Stable dense left basilar opacification may represent atelectasis, however pneumonia could be considered in the appropriate clinical setting. No pulmonary edema.","Findings: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. The hart remains stably enlarged.  There is dense left basilar opacification, which may represent atelectasis or pneumonia, but is not significantly changed from prior. Median sternotomy wires and a left ventricular assist device are in place.  A Swan-Ganz catheter is present with the tip ending in the mid SVC, but its inferior loop in the right atrium appears to be subluxing into the IVC. There is no pneumothorax. Impression: Stable dense left basilar opacification may represent atelectasis, however pneumonia could be considered in the appropriate clinical setting. No pulmonary edema. An NG tube is noticed with its tip in the stomach.","['Change position of device', 'Change to homophone', 'Add medical device']"
f4caf2a7-cfab7dcf-4ed18148-2edc0c1d-ec22176f,58279613,11717909,"Findings: Patient is mildly rotated.  Compared to ___, there is worsening of right perihilar parenchymal opacities.  Left lung atelectasis is still present.  Bilateral pleural effusions are likely unchanged.  Sternotomy wires and surgical clips are well aligned and unchanged from prior.  ETT terminates less than 1 cm from the carina, however this may be due to chin-tuck position of the patient.  Otherwise, support lines appear unchanged from prior. Impression: Worsening consolidation in right perihilar region.","Findings: Patient is mildly rotated.  Compared to ___, there is no worsening of perihilar parenchymal opacities.  Left lung atelectasis is still present.  Bilateral plueral effusions are likely unchanged.  Sternotomy wires and surgical clips are well aligned and unchanged from prior.  ETT terminates less than 1 mm from the carina, however this may be due to chin-tuck position of the patient.  Otherwise, support lines appear unchanged from prior. Impression:  No consolidation in right perihilar region. ","['Change measurement', 'Add typo', 'False negation']"
b4c53279-dc6e8b39-fbc566fd-d4cb1bf9-41b39939,58465039,11717909,Impression: Severe cardiomegaly is stable.  There is no pulmonary edema. No pleural effusion.  No pneumothorax.  Right transjugular Swan-Ganz catheter ends in the right pulmonary artery in standard placement.,Impression: Severe cardiomegaly is stable.  There is now pulmonary edema. No pleural effusion.  No neumothorax.  Right transjugular Swan-Ganz catheter ends in the right pulmonary artery in standard placement.,"['Change severity', 'Add typo', 'Add medical device']"
b57584cc-a29bd841-898af146-74374eab-42633a08,58480507,11717909,"Impression: As compared to the previous radiograph, the Swan-___ catheter was removed and the left chest tube was pulled.  Unchanged appearance of the cardiac silhouette. No not visible left-sided pneumothorax. The extent of the retrocardiac atelectasis and small left pleural effusion as well as of the right lung are unchanged. Unchanged position of the cardiac support device. The second more basal positioned tube is also or removed.","Impression: As compared to the previous radiograph, the endotracheal tube was removed and the left chest tube was pulled.  Unchanged appearance of the cardaic silhouette. No not visible right-sided pneumothorax. The extent of the retrocaridiac atelectasis and small left pleural effusion as well as of the right lung are unchanged. Unchanged position of the cardiac support device. The second more basal positioned tube is also not removed.","['Change name of device', 'Add typo', 'False prediction']"
1fb09915-c0059d07-e6cd2be9-857cd031-773f848a,58486262,11717909,"Impression: Comparison to ___.  The feeding tube is now in correct position.  The right internal jugular vein catheter is stable.  Unchanged mild elevation of the right hemidiaphragm, with platelike atelectasis at the right lung basis.  Mild cardiomegaly without overt pulmonary edema.  Likely presence of a minimal right pleural effusion.","Impression: Comparison to ___.  The feeding tube is now in correct position.  The right internal jugular vein catheter is stable.  Unchanged mild elevation of the left hemidiaphragm, with platelike atelectasis at the right lung basis.  Miild cardiomegaly without overt pulmonary edema.  Likely presence of a minimal right pleural effusion.  There are bilateral apical pneumothoraces.","['Change location', 'Add typo', 'False prediction']"
3a02fc54-25995479-f166cf7b-9bf0c201-fe0e3098,58613391,11717909,Impression: Comparison to ___.  No relevant change.  The widespread bilateral parenchymal opacities are constant.  Unchanged monitoring and support devices. Unchanged size of the cardiac silhouette.  The patient shows no new parenchymal opacities.,Impression: Comparison to ___.  No relevant change.  The widespread unilateral parenchymal opacities are constant. Unchanged monitoring and support devise. Unchanged size of the cardiac silhouette.  The patient shows no new parenchymal opacities.   Presence of a central venous line.,"['Change location', 'Change to homophone', 'Add medical device']"
83464977-3248cdf7-dabf04d4-71b78a27-306db131,58628303,11717909,Findings: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. Left lower lobe collapse has recurred.  The cardiomediastinal and hilar contours are unchanged.  The endotracheal tube ends 1.8 cm from the carina. Chest tubes project over the left hemi thorax.  Swan-Ganz catheter ends in the right pulmonary artery. Left ventricular assist device is in unchanged position.  Nasogastric tube courses into the stomach.  Left-sided PICC line ends at the cavoatrial junction. Impression: 1. Nasogastric tube courses into the stomach. 2. Endotracheal tube ends 1.8 cm from the carina. 3. Left lower lobe collapse has recurred.,Findings: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crownding. Mind lobe left-sided opacities noted. The cardiomediastinal and hilar contours are unchanged.  The endotracheal tube ends 1.6 cm from the carina. Chest tubes project over the left hemi thorax and trace pleural effusion is present. Swan-Ganz catheter ends in the right pulmonary artery. Small pleural nodules visualized. Nasogastric tube courses into the stomach.  Left-sided PICC line ends at the cavoatrial contrunction. Impression: 1. Small pleural nodules visualized. 2. Endotracheal tube ends 1.6 cm from the carina. 3. Left lower lobe collapse has improved.,"['Change measurement', 'Add typo', 'False prediction']"
18696db7-7d416236-9375f9b1-cb09447c-cbfb9773,58663147,11717909,Findings: Portable upright chest radiograph ___ at 17:13 Impression: Persistent right airspace disease and interval appearance of increasing opacity at the left base.  Findings are concerning for multifocal pneumonia or aspiration.  The left upper and mid lung remain clear.  No pulmonary edema.  Stable postoperative cardiac and mediastinal contours status post median sternotomy.  Left subclavian PICC line unchanged in position with tip in the distal SVC.  No pneumothorax.,Findings: Portable upright chest radiograph ___ at 17:13 Impression: No right airspace disease and interval appearance of increasing opacity at the left base.  Findings are concerinig for multifocal pneumonia or aspiration.  The left upper and mid lung remain clear.  No pulmonary edema.  Stable postoperative cardiac and mediastinal contours status post median sternotomy.  Left subclavian PICC line unchanged in position with tip in the proximal SVC.  No pneumothorax. ,"['Change position of device', 'Add typo', 'False negation']"
4237ac38-158147e0-87b15115-b3ffc6e6-113d33a5,58964089,11717909,"Findings: In comparison with study of ___, there has been placement of an IABP, which is somewhat high with the tip located only about 1.4 cm below the transverse arch of the aorta.  Swan-Ganz catheter extends beyond the mediastinum into branches of the right pulmonary artery.  Enlargement of the cardiac silhouette persists, though the pulmonary vascularity is essentially within normal limits.  Some retrocardiac atelectasis is noted. ","Findings: In comparison with study of ___, there has been placement of an IABP, which is somewhat high with the tip located only about 1.4 mm below the transverse arch of the aorta.  Swan-Ganz catheter extends beyond the mediastinum into branches of the rgiht pulmonary artery.  Enlargement of the cardiac silhouette persists, though the pulmonary vascularity is essentially within normal limits.  No atelectasis is noted. ","['Change measurement', 'Add typo', 'False negation']"
083f7549-82faf4e6-b108e14f-e1d63399-5e5dc66d,59068375,11717909,"Impression: The right central line, endotracheal tube and nasogastric tubes are unchanged. There is persistent patchy density in both lung bases.  There is no pneumothorax or CHF.  There is no significant interval change.","Impression: The right central line, endotracheal tube and nasogastric tubes are unchanged. There is persistent patchy density in both lung bases. There is no pneumothorax or CHF. There is a significant interval change.","['Change name of device', 'Add contradiction', 'False prediction']"
cd151804-3ba37dc7-1008641f-491929af-f37e6dc5,59105787,11717909,Findings: The cardiomediastinal and hilar contours are within normal limits.  The heart appears smaller in size compared to the prior examination on ___.  Right midlung and right lower lobe opacities are similar in appearance to multiple prior examinations.  The left lung is clear.  There is no pneumothorax or pleural effusion.  Sternal wires are aligned.  There is no evidence of pulmonary edema. Impression: No evidence of pulmonary edema.  Persistent opacities involving the right midlung and base of the right lung are stable from multiple prior exams and likely reflect atelectasis or scarring.,Findings: The cardiomediastinal and hilar contours are within normal limits.  The heart appears smaller in size compared to the prior examination on ___.  Left midlung and left lower lobe opacities are similar in appearance to multiple prior examinations.  The left lung is clear.  There is no pneumothorax or pleural effusion.  No sternal wires are seen. There is no evidence of pulmonary edema. Impression: No evidence of pulmonary edema.  Persistent opacities involving the right midlung and base of the right lung are stable from multiple prior exams and likely reflect atelectasis or scarring. No opacities are seen.,"['Change location', 'Add contradiction', 'False negation']"
7798f90f-d4185983-5f262189-fe7879ae-df20ce5d,59231099,11717909,Findings: Allowing for projection the heart is probably within normal limits in size.  Left lung is clear.  Increased small right effusion is seen.  Increased opacity in the right base may indicate the underlying atelectasis.  Infection cannot be excluded.  Right IJ line in mid SVC Impression: Right base atelectasis/ opacity and small right pleural effusion.,Findings: Allowing for projection the heart is probably within normal limits in size.  Right lung is clear.  Increased small right effusion is seen.  Increased opacity in the right base may indicate the underlying atelectasis.  No infection is noted.  Right IJ line in mid SVC. Impression: Right base atelectasis/ opacity and right-sided pneumothorax.,"['Change location', 'Add contradiction', 'False prediction']"
"86cbbd27-298942a6-03e4baae-97bf2fa6-7959f957, a92dc43d-69675ba1-b327698d-39a479af-fd78fba4",59507971,11717909,Findings: These are two views during Dobhoff placement.  On the second film the feeding tube tip is in the stomach.  NG tube is been removed.  The right IJ line is unchanged.  The appearance the lungs are unchanged. Impression: Dobhoff tube in the stomach,Findings: These are two views during Dobhoff placement.  On the second film the feeding tube tip is in the colon.  NG tube has been removed.  The left IJ line is unchanged.  The appearance of the lungs are the same. Impression: No Dobhoff tube seen in the stomach,"['Change location', 'Change to homophone', 'False negation']"
"1645a8b3-a40b82da-8ea72c55-64a8dfe5-ce6efba4, 5246aaeb-fd4fe4e3-3107d96d-28205321-1fcd4ed8",59535781,11717909,"Findings: Heart size is normal.  The patient is status post previous median sternotomy and coronary bypass surgery.  Right internal jugular catheter terminates in the lower superior vena cava, with no pneumothorax.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear except for linear scar in the lingula.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.","Findings: Heart size is normal.  The patient is status post previous median sternotomy and coronary bypass surgery.  Right internal jugular ventilator terminates in the lower superior vena cava, with no pneumothorax.  The mediastinal and hilar contours are normal. The pulmonary vasculature is abnormal. Lungs are clear except for linear scar in the lingula.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: Mild pulmonary edema.","['Change name of device', 'Add contradiction', 'False negation']"
c25143a2-4277be3e-75e5e1e0-67b10cbb-2386d4ca,59549909,11717909,"Findings: Bilateral lower lobe pneumonia, right greater than left, is stable since ___ but improved since ___.  The cardiac silhouette remains top-normal.  No pneumothorax or pulmonary edema.  The endotracheal to tip is seen 5.4 cm above the carina.  Right internal jugular central line placement is unchanged and transesophageal drainage tube is seen over the stomach and continues had a few. Impression: 1. Unchanged bilateral lower lobe pneumonia, right greater than left, since ___. 2. All support devices are appropriately positioned.","Findings: Bilateral lower lobe pneumonia, right greater than left, is stable since ___ but improved since ___.  The cardiac silhouette remains top-normal.  No pneumothorax or pulmonary edema.  The endotracheal to tip is seen 6.2 cm above the carina.  Right internal jugular central line placement is unchanged and transesophageal drainage tube is seen over the stomach and continues had a few.  A pacemaker is seen in the left upper chest. Impression: 1. Unchanged bilateral lower lobe pneumonia, right greater thaan left, since ___. 2. All support devices are appropriately positioned.","['Change measurement', 'Add typo', 'Add medical device']"
9296d4e5-8c81e5dd-f08e6cfb-658feaeb-fe3cdfa5,59648901,11717909,"Findings: The left chest tube has been removed. There is no new large pleural effusion.  There is no pneumothorax.  There is a persistent left retrocardiac opacity which may be secondary to infection, pleural effusion, or atelectasis. Cardiomegaly is unchanged.  The left PICC, right IJ Swan-Ganz catheter, and LVAD are unchanged in appropriate in position. Impression: Persistent left retrocardiac opacity.  No evidence of large volume left pleural effusion.  No pneumothorax after removal of chest tube.","Findings: The left chest tube has bean removed. There is no new small pleural effusion. There is no pneumothorax. There is a persistent left retrocardiac opacity which may be secondary to infection, pleural effusion, or atelectasis. Cardiomegaly is unchanged. The left PICC, right IJ Swan-Ganz catheter, and LVAD are unchanged in appropriate in position. A nasogastric tube is in place. Impression: Persistent left retrocardiac opacity. No evidence of high volume left pleural effusion. No pneumothorax after removal of chest tube.  ","['Change severity', 'Change to homophone', 'Add medical device']"
c6e3ce13-2009d15c-22403934-c8b0ed0a-84811273,59756989,11717909,"Impression: Swan-Ganz catheter tip is at the level of right main pulmonary artery.  Heart size and mediastinum are stable.  Minimal bibasal atelectasis, right more than left are similar to previous study.  There is no pneumothorax.","Impression: Swan-Ganz catheter tip is at the level of left pulmonary artery.  Heart size and mediastinum are stable.  Minimal bibasal atelectesis, right more than left are similar to previous study.  There is right pleural effusion. There is no pneumothorax.","['Change position of device', 'Add typo', 'False prediction']"
"427b4ab7-9ff413ad-27cb0c6a-12e7de89-7ab26654, 7db9f8cc-6fa31cc8-1a5129e9-9c39ac1c-a1a15416",59872440,11717909,"Impression: No relevant change as compared to the prior image. Sternal wires, pacemaker and a cyst device are in unchanged position. Minimal left pleural effusion and left atelectasis. Otherwise normal lungs. Mild cardiomegaly that is unchanged in severity.","Impression: There is a significant increase in abnormalities as compared to the prior image. Sternal wires, pacemaker, and a cyst device are in unchanged positions. Minimal right pleural effusion and left atelectasis. Otherwise normal lungs. Mild cardiomegaly that is unchanged in severity. ","['Change location', 'Add contradiction', 'False prediction']"
78ed3ced-cd79570f-e1427410-e2202da1-75dd1584,59882746,11717909,"Impression: In comparison with the study of ___,  the there may be even further opacification in the right hemithorax.  Persistent opacification in the retrocardiac region with blunting of the left costophrenic angle.  Monitoring and support devices are essentially unchanged.","Impression: In comparison with the study of ___, the there may be even further opacification in the left hemithorax.  Persistent opacification in the retrocardiac region with blunting of the left costophrenic angle.  Monitoring and support devices are essentially unchained.  A central venous line is noted in proper position.","['Change location', 'Change to homophone', 'Add medical device']"
0df3e21f-5672d561-1479a9a6-bb24d13a-afd4f39e,59956973,11717909,"Findings: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding.  Dense retrocardiac opacification persists, consistent with left lower lobe consolidation and small pleural effusion. Vague haziness projecting over the left upper lobe, in the region of recent chest tube, is stable. The cardiomediastinal and hilar contours are unchanged. Left ventricular assist device is remains in similar position.  Left-sided PICC line ends at the cavoatrial junction.  No pneumothorax or pleural effusion Impression: Stable retrocardiac opacification consistent with left lower lobe consolidation and small pleural effusion.","Findings: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crouding. Dense retrocardiac opacification is absent. Vague haziness projecting over the left upper lobe, in the region of recent chest tube, is stabel. The cardiomediastinal and hilar contours are unchanged. Left ventricular assist device is remains in similar psition. Left-sided PICC line ends in the lower SVC. No pneumothorax or pleural effusion   ","['Change position of device', 'Add typo', 'False negation']"
321f3032-be0e27a3-89aaf76d-79b01d0b-1c4d5b9b,59962763,11717909,"Findings: Comparison is made to previous study from ___.  There is a Swan-Ganz catheter.  There is a left-sided chest tube.  There is an LVAD device.  There are mediastinal drains.  There is a left-sided PICC line.  These are all stable.  The heart size is upper limits of normal, but unchanged.  There remains a left retrocardiac opacity.  There are no signs for overt pulmonary edema.  No pneumothoraces are identified.  Overall, there has been no change. ","Findings: Comparison is made to previous study from ___. There is a Swan-Ganz catheter. There is a left-sided chest tube. There is an LVAD device. There is a left-sided PICC line that terminates in the SVC. There are mediastinal drains. These are all stable. The heart size is upper limits of normal, but unchanged. The heart size is upper limits of normal, but unchanged. There remains a left retrocardiac opacity. There are no signs for overt pulmonary edema. No pneumothoraces are identified. An NG tube is noted. Overall, there has been no change.","['Change position of device', 'Add repetitions', 'Add medical device']"
1c847671-bd632b77-11107efc-969f0d03-ffb45c06,59982171,11717909,Impression: Comparison to ___.  No relevant change.  Mildly increased lung volumes with the subsequent decrease in radiodensity of the pre-existing right parenchymal opacities and consolidations.  The left changes are constant.  Stable correct position of the monitoring and support devices.,Impression: Comparison to ___. No relevant change. Mildly increased lung volumes with the subsequent decrease in radiodesnity of the pre-existing left parenchymal opacities and consolidations.  The right changes are constant. No monitoring and support devices.,"['Change location', 'Add typo', 'False negation']"
9f2d20e8-1c570228-e58b3e93-e6171fd9-2033b28a,55651475,11724488,Impression: AP chest compared to preoperative chest radiograph on ___:  Volumes are quite low.  Heterogeneous opacification involves both lower lungs. Heart is normal size and mediastinal vasculature is not engorged.  Findings include noncardiogenic as well as atypical cardiogenic edema and severe aspiration or diffuse pulmonary hemorrhage.  Dr. ___ was paged at the time of dictation.,Impression: AP chest compared to preoperative chest radiograph on ___: Volumes are quite now. Heterogeneous opacification involves both upper lungs. Heart is normal size and mediastinal vasculature is not engorged. Findings include noncardiogenic as well as non-severe cardiogenic edema and severe aspiration or diffuse pulmonary hemorrhage. Dr. ___ was paged at the time of dictation. A central venous line is present.,"['Change severity', 'Add typo', 'Add medical device']"
"4be77f0f-26020260-0150f74f-f95c85f5-33c47450, 8a2d0c99-d9c16df8-af4a6670-03baa169-48086bb0",55960369,11724488,"Findings: Frontal and lateral views of the chest.  No prior.  Opacity at the left cardiophrenic angle would be compatible with a pericardial fat pad, especially given appearance on the lateral.  Lungs are clear and costophrenic angles are sharp.  The cardiomediastinal silhouette is within normal limits.  Osseous and soft tissue structures are unremarkable.  Degenerative changes noted at the acromioclavicular joints and hypertrophic changes are seen in the spine. Impression: No acute cardiopulmonary process.  No focal consolidation.","Findings: Frontal and lateral views of the chest. No pyre. Opacity at the left cardiophrenic angle would be compatible with a pericardial fat pad, especially given appearance on the lateral. Lungs are clear and costophrenic angles are sharp. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable, but a small pleural effusion is noted on the right side. Degenerative changes noted at the acromioclavicular joints and hypertrophic changes are seen in the spine with a suspected compression fracture at the thoracic level. Impression: No acute cardiopulmonary process. There is evidence of basal atelectasis. ","['Change location', 'Change to homophone', 'False prediction']"
"16e5b1a2-792c2449-d0f46569-a6fc499f-62628542, 21b2ba36-099442f2-f218da36-f0bc8c1a-27305d7c",57834148,11724488,Findings: Frontal and lateral views of the chest were obtained.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable.  No evidence of free air is seen beneath the diaphragm.  Degenerative changes are again seen along the spine. Impression: No acute cardiopulmonary process.  No evidence of free air beneath the diaphragm.,Findings: Frontal and lateral views of the chest were obtained.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable.  Cardiac silhouette is mildly enlarged.  Degenerative changes are again seen along the spine. Impression: No significant cardiopulmonary process.  No evidence of free air beneath the diaphragm.,"['Change location', 'Add typo', 'False prediction']"
3a83d7fe-a10cb175-c0015bff-dc7613f5-2ed928b2,58618080,11724488,"Impression: 1.  Suspect mild CHF, though improved compared with ___.  2.  Bibasilar patchy opacities.  The differential diagnosis includes infectious infiltrates and aspiration.  These are similar to ___, allowing for considerable differences in technique.","Impression: 1.  Suspect moderate CHF, though improved compared with ___.  2.  Bibasilar patchy opacities.  The differential diagnosis includes infectious infiltrates and aspiration.  These are similar to ___, allowing for considerable differences in technique.  The cardiac size is mildly enlarged.","['Change severity', 'Add repetitions', 'False prediction']"
"40dc9290-9a260ee3-d39bc9ca-9a80981a-ca659255, c3fd73cb-5e46b400-0cc3a1d2-8cd95b40-d8ce12df",50523025,11778596,Findings: The lungs are clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,Findings: There is a small left pleural effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,"['False prediction', 'Add contradiction', 'False negation']"
"b1013c9a-72cbbabf-f3f57999-0e872542-c493daa7, e2f8c511-0fc27635-102d25e8-09067cc6-6943c99e",51411261,11778596,"Findings: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable.  No evidence of pneumomediastinum is seen. Impression: No significant interval change.  No acute cardiopulmonary process.","Findings: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable.  No evidence of pneumomediastinum is seen. Impression: Mild interstitial edema.  No acute cardiopulmonary process.","['Change severity', 'Add contradiction', 'False negation']"
c8d5e710-a91b72a0-7854336c-d9636d1e-f30a45fe,51454316,11778596,"Impression: Comparisons ___.  The lung volumes are normal.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal contours.  No pneumonia, no pulmonary edema, no pleural effusions.","Impression: Comparisons ___.  The lung volumes are normal.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal contours. The patient has a pacemaker. No pneumonia, no pulmonary edema, no pleural effusions.  Normal size of the cardiac silhouette. ","['Add contradiction', 'Add repetitions', 'Add medical device']"
"476a3664-0a37f09b-cf422fb1-b96e8af6-b1ff1c8b, 9b3209a1-4f4f10b6-89d60e43-ae5ca330-58720ec8",51493045,11778596,"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.  No free air below the right hemidiaphragm seen. Impression: No acute intrathoracic process.","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.  No free air below the left hemidiaphragm seen.  A central venous line is in place.  The cardiomediastinal silhouette is normal.  Impression: No acute intrathoracic process.","['Change location', 'Add repetitions', 'Add medical device']"
f15e3281-13c23328-e39947d4-33a6882f-dd72ac3c,52620709,11778596,Impression: Normal chest radiographs.,Impression: Normal chest radiographs. Impression: Normal chest radiographs. Impression: Mild pulmonary congestion. Impression: Normal chest radiographs. ,"['Add repetitions', 'Add contradiction', 'Add medical device']"
"07f9f818-19d71d41-fac3dfba-a4307c8e-1804d6ec, 4e2cdbbb-94042b25-3040684e-0c7ff67d-5616031e",55316910,11778596,"Findings: The lungs are well expanded.  There is no focal consolidation, pleural effusion or pneumothorax.  The cardiomediastinal silhouette is normal.  The bones are intact. Impression: No acute cardiopulmonary process.",Findings: The lungs are well expanded.  No focal consolidation is present.  The cardiomediastinal silhouette is normal.  The bones are intact. Impression: Mild pleural effusion on the left. No acute cardiopulmonary process.,"['Add contradiction', 'Change to homophone', 'False negation']"
"0557e604-9479496b-6839fa34-3dfa8788-846e8429, 2ea89aad-3d076a79-425867fa-0370247c-567a9dd5",56643765,11778596,"Findings: As compared to the previous radiograph, there is no relevant change.  Normal lung volumes.  No evidence of pneumonia or other parenchymal lung disease.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal structures. ","Findings: As compared to the previous radiograph, there is no relevant chamge.  Normal lung volumes.  No evidence of pneumonia or other parenchymal lung disease.  No cardiac enlargement is observed.  Normal hilar and mediastinal structures. Impression: There is moderate cardiac enlargement.","['Add contradiction', 'Add typo', 'False negation']"
"013e8b20-1dd181f6-4abba114-5ab4f096-e8a4d186, 15048198-d09e7dbe-22ba5069-9f484be3-8482c96f",57138064,11778596,"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.  Nw pneumonia, vascular congestion, or pleural effusion. No pneumonia, vascular congestion, or pleural effusion. ","['Add repetitions', 'Add typo', 'False negation']"
9f68f784-5188d495-c5803627-37126944-42f904c6,58510004,11778596,"Impression: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease.  No pneumonia, vascular congestion, or pleural effusion.","Impression: In comparison with the study of ___, there is a small left upper lung nodule and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion is present. A central venous catheter tip terminates in the superior vena cava.","['False prediction', 'Add typo', 'Add medical device']"
"571f6fe7-8dfc0bb4-1a799b61-088a701a-55a35ec7, ed6718bd-49c6aaf7-4f16a407-3ce9862f-0961129b",59075390,11778596,"Findings: The lungs are normally expanded and clear.  The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal.  There is no pleural effusion or pneumothorax.  There are few prominent loops of small bowel in the left upper quadrant. Impression: No evidence of acute cardiopulmonary abnormality.","Findings: The lungs are normally expanded and clear.  The cardiomediastinal silhouette, hilar contours and pleural surfaces are usual.  There is no pleural effusion or pneumothorax identified.  There are few prominent loops of small bowel in the left upper quadrant with mild thickening. Impression: No evidence of acute cardiopulmonary abnormality.","['Change severity', 'Change to homophone', 'False prediction']"
c0f09085-246fdee9-571d4688-2450db13-fb67b641,59624830,11805011,"Impression: In comparison with the study of ___, there again is mild enlargement of the cardiac silhouette with tortuosity of the aorta.  No evidence of acute pneumonia, vascular congestion, or pleural effusion.","Impression: In comparison with the study of ___, there again is moderate enlargement of the cardiac silhouette with tortuosity of the aorta.  Vascular congestion is noted, but no evidence of acute pneumonia or pleural effusion.","['Change severity', 'Add contradiction', 'False prediction']"
"36997d16-4f0421af-656978c4-33b5be2d-4bd00de0, 7b10680c-26e6c5fc-a403cd66-97cf2e7d-6578aeff",51164335,11842519,"Impression: In comparison with the study of ___, there is little change in the appearance of the cardiomediastinal silhouette and spinal hardware.  The pulmonary vessels are less engorged, it consistent with improvement in pulmonary vascular status.  Bibasilar atelectatic changes are again seen with probable small pleural effusions on both sides.","Impression: In comparison with the study of ___, there is little change in the appearance of the cardiomediastinal silhouette and spinal hardware.  The pulmonary vessels are more engorged, it consistent with improvement in pulmonary vascular status.  Bibasilar atelectatic changes are again seen with probable small pleural effusions on both sides.  There is no evidence of pleural effusions on either side.","['Change severity', 'Add contradiction', 'False prediction']"
e9977922-0c45547e-2c72b894-91042335-31f132ea,51581083,11842519,Impression: Comparison to ___.  Minimal decrease in extent of the pre-existing right basal parenchymal opacities.  Moderate cardiomegaly.  Stable appearance of the vertebral fixation devices.  A minimal right pleural effusion is unchanged in extent and severity.,Impression: Comparison to ___.  Moderate decrease in extent of the pre-existing right basal parenchymal opacieties.  Severe cardiomegaly.  Stable appearance of the verebral fixation devices.  A mild right pleural effusion is unchanged in extent and severity.  There is the presence of an NG tube.,"['Change severity', 'Add typo', 'Add medical device']"
"e044c941-2f2d494f-0a794f54-a64e76fe-70da04b2, f116ca80-a8af602f-9e093f53-f6f59ad5-7dd5441d",52278905,11842519,"Findings: The heart is enlarged and there is engorgement of the pulmonary vasculature as well as mild pulmonary edema. There is thickening of major fissure on the right, which may represent fissural fluid. Again seen are bilateral pleural effusions with atelectasis at the lung bases. There is no evidence of new focal consolidation. No pneumothorax is seen. Again seen is thoracic spinal fusion hardware, unchanged in appearance. Impression: 1. Mild pulmonary edema with no strong evidence of pneumonia. 2. Bilateral pleural effusions and bibasilar atelectasis.","Findings: The heart is severely enlarged and there is engorgement of the pulmonary vasculature as well as moderate pulmonary edema. There is thickening of major fissure on the right, which may represent fissural fluid. Again seen are no pleural effusions with atelectasis at the lung bases. There is no evidence of new focal consolidation. No pneumothorax is seen. Again seen is thoracic spinal fusion hardware, unchanged in appearance. Impression: 1. Mild pulmonary edema with no evidence of pneumonia. 2. No pleural effusions and bibasilar atelectasis.","['Change severity', 'Change to homophone', 'False negation']"
"87c8d17c-efddd19d-6d6bdf4a-33ac06da-52d1f2ae, cc1a416d-51f3f1eb-f180d40e-0cfd0190-9e7a9a54",52435125,11842519,Findings: The bilateral pleural effusions are again seen right greater than left.  Right lower lobe opacities are unchanged and may be chronic atelectasis related to persistent effusions.  The previously seen pulmonary edema has resolved.  There is mild cardiomegaly.  Orthopedic hardware is seen in the thoracic spine with adjacent surgical clips. Impression: 1. Persistent bilateral effusions and likely chronic atelectasis.  2. Resolution of previous pulmonary edema.,Findings: The bilateral pleural effusions are again scene right greater than left. Left lower lobe opacities are unchanged and may be chronic atelectasis related to persistent effusions. The previously seen pulmonary edema has resolved. There is mild cardiomegaly. Orthopedic hardware is seen in the thoracic spine with adjacent surgical pipettes. An NG tube is noted trailed into the stomach. Impression: 1. Persistent bilateral effusions and likely chronic emphysema. 2. Resolution of previous pulmonary edema.,"['Change name of device', 'Change to homophone', 'Add medical device']"
"065a7a9c-53732182-e1803a70-560a7a03-f85438e2, b4b54fa6-a62cd7a9-4ba6082c-5534bec0-fab033bf",52474377,11842519,"Impression: In comparison with the study of ___, there is little overall change.  Cardiac silhouette remains within normal limits and there is some hyperexpansion of the lungs. Coarse interstitial markings process along with blunting of both costophrenic angles and atelectatic changes at the bases, more prominent on the right.","Impression: In comparison with the study of ___, there is little overall change. Cardiac silhouette remains within normal limits, and there is sum hyperexpansion of the lungs. Coarse interstitial markings process along with blunting of both costophrenic angles and atelectatic changes at the bases, more prominent on the left. There is the presence of an NG tube.","['Change location', 'Change to homophone', 'Add medical device']"
"463855e7-833cbc69-04a5abcb-dda8a693-e6e4e948, 6c74d21c-53fddedf-a2bb1745-bd2de6ee-d9f68f8a",54717070,11842519,"Findings: Stable cardiomegaly. There is worsening pulmonary vascular congestion and mild pulmonary edema.  Pleural effusions are stable.  No pneumothorax is seen.  Right hilar fullness is a manifestation of mild heart failure.  Again seen is chronic posterior pleural thickening and nodulation at the right base. Again seen is thoracic fusion hardware, unchanged. Impression: 1.  Worsening pulmonary vascular congestion and edema.  Mild chronic cardiomegaly. 2.  Chronic small pleural effusions, posterior pleural loculation. 3.  Recommend baseline chest CT to further evaluate chronic pleural thickening and nodulation at the right base.  RECOMMENDATION:  Recommend baseline chest CT to further evaluate chronic pleural thickening and nodulation at the right base.","Findings: Stable cardiomegaly. There is worsening pulmonary vascular congestion and moderate pulmonary edema. Pleural effusions are stable. No pneumothorax is seen. Right hilar fullness is a manifestation of severe heart failure. Again seen is chronic posterior pleural thickening and nodulation at the right base. Again seen is thoracic fusion hardware, unchanged. Impression: 1. No pulmonary vascular congestion or edema. Mild chronic cardiomegaly. 2. Chronic small pleural effusions, posterior pleural loculation. 3. Recommend baseline chest CT to further evaluate chronic pleural thickening and nodulation at the right base. Recommend baseline chest CT to further evaluate mild pleural thickening and nodulation at the left base.","['Change severity', 'Add contradiction', 'False prediction']"
"0fe43549-21617d5c-89c5f44b-affffc13-9409fa39, 66423af7-ad57034e-b950291f-d84abf0a-902afb34",54806621,11842519,"Findings: Pulmonary vascular cephalization is chronic.  Moderate loculated right pleural effusion going into the fissure is stable. 22 mm opacity projects at the left lung base unchanged since ___, but could not be clearly seen before that.  Mild-to-moderate cardiomegaly is unchanged.  The patient is status post fusion with posterior screws at T6 through T9 levels. Impression: Left lower lung opacity could either be a focal area of atelectasis or even a lung nodule.  It could not be seen before the chest x-ray of ___. If warranted, CT scan could be done to assess this abnormality.    There is no significant change since ___ in chronic pulmonary vessel cephalization and loculated pleural effusion on the right.      The results have been posted to Radiology dashboard for direct notification to referring physician.","Findings: Pulmonary vascular cephalization is chronic.  Moderate loculated right pleural effusion going into the fissure is stable. 2.2 cm opacity projects at the left lung base unchanged since ___, but could not be clearly seen before that.  No cardiomegaly is noted.  The patient is status post fusion with posterior screws at T6 through T9 levels. Impression: Left lower lung opacity could either be a focal area of atelectasis or even a lung nodule. Left lower lung opacity could either be a focal area of atelectasis or even a lung nodule.  It could not be seen before the chest x-ray of ___. If warranted, CT scan could be done to assess this abnormality.    There is no significant change since ___ in chronic pulmonary vessel cephalization and loculated pleural effusion on the right.      The results have been posted to Radiology dashboard for direct notification to referring physician.","['Change measurement', 'Add repetitions', 'False negation']"
"293c8608-3a0f3cbd-cea33c07-ea8130b0-2b90fea4, cce40a95-f888ed8b-3d0d8160-c780a8be-dedc172d",55196530,11842519,"Findings: The cardiac, mediastinal and hilar contours are relatively unchanged, with the heart size appearing top normal.  There is mild pulmonary edema, minimally worse when compared to the prior study.  Moderate size right and small left pleural effusions are relatively unchanged.  There are patchy bibasilar airspace opacities, likely reflective of atelectasis though infection cannot be completely excluded.  No pneumothorax is identified.  Thoracic posterior spinal fusion hardware accomplished by two posterior rods and pedicle screws is unchanged.  There are multiple clips also demonstrated within the mid back. Impression: Mild congestive heart failure, with moderate size right and small left pleural effusion.  Bibasilar airspace opacities likely reflect atelectasis though infection is not completely excluded.","Findings: The cardiac, mediastinaal and hilar contours are relatively unchanged, with the heart size appearing top normal.  There is mild pulmonary effusion, minimally worse when compared to the prior study.  Moderate size right and small left pleural effusions are relatively unchanged.  There are patchy bibasilar airspace opacities, likely reflective of atelectasis though infection cannot be completely excluded.  A small pneumothorax is seen.  Thoracic posterior spinal fusion hardware accomplished by two posterior rods and pedicle screws terminates at the L2 vertebra.  There are multiple clips also demonstrated within the mid back. Impression: Mild congestive heart failure, with moderate size right and bilatertal pleural effusions.  Bibasilar airspace opacities likely reflect atelectasis though infection is not completely excluded.","['Change position of device', 'Add typo', 'False prediction']"
"112ad818-aecb7d67-24a87957-b69727eb-b71d395e, 5c411331-4bd0ce00-fa971a77-14b441a9-7988a9a4",55737976,11842519,Impression: Cardiomediastinal silhouette is unchanged.  Spinal hardware is unchanged. Bibasal consolidations appear to be mildly progressed since the prior study as well as there is slightly more pronounced vascular congestion. Right pleural effusion is small but increased since the prior study.,Impression: Cardiomediastinal silhouette is unchanged. Spinal hardware is unchanged. Bibasal consolidations appear to be mildly progressed since the prior study as well as there is slightly more pronounced vascular congestion. Right pleural effusion is small but increased since the prior study. A left pleural effusion is stable since prior study.,"['Change location', 'Add contradiction', 'Add medical device']"
"1daf1add-19e374b0-b8e35d65-58f13e97-acb7ed37, c8e45d42-826148f0-ecddc635-78da1bb8-218f17be",55933985,11842519,"Findings: PA and lateral chest views were obtained with patient in upright position.  Analysis is performed in direct comparison with the next preceding PA and lateral chest examination of ___.  Moderate cardiomegaly as before.  Upper mediastinal structures are obscured by the presence of two ___ rods each with 4 penetrating fixation screws stabilizing the mid portion of the thoracic spine.  Integrity of orthopedic devices appears preserved and is unchanged.  Similar as on the previous examination, there is evidence of bilateral pleural effusion blunting the lateral pleural sinuses.  The pleural effusion is moderately more marked on the right side than the left.  Lateral view indicates extension of fluid into the posteriorly located dependent pleural sinuses.  No evidence of new acute discrete pulmonary infiltrates indicating acute pneumonia.  No pneumothorax seen in the apical area. Impression: Bilateral small pleural effusions and moderate congestive pulmonary vascular pattern.  In comparison with the next previous examination 18 months ago, the patient's pulmonary congestion and pleural effusions were markedly more pronounced than they are now.  Whether the present degree of chronic CHF is related to fluid overload must be judged on clinical grounds.","Findings: PA and lateral chest views were obtained with patient in upright position.  Analysis is performed in direct comparison with the next preceding PA and lateral chest examination of ___.  Severe cardiomegaly as before.  Upper mediastinal structures are obscured by the presents of two ___ rods each with 4 penetrating fixation screws stabilizing the mid portion of the thoracic spine.  Integrity of orthopedic devices appears preserved and is unchanged.  Similar as on the previous examination, there is evidence of bilateral pleural effusion blunting the lateral pleural sinuses.  The pleural effusion is severely more marked on the right side than the left.  Lateral view indicates extension of fluid into the posteriorly located dependent pleural sinuses.  No evidence of new acute discrete pulmonary infiltrates indicating acute pneumonia.  No pneumothorax seen in the apical area.  A pacemaker is in place at the left chest wall.  Impression: Bilateral moderate pleural effusions and mild congestive pulmonary vascular pattern.  In comparison with the next previous examination 18 months ago, the patient's pulmonary congestion and pleural effusions were markedly more pronounced than they are now.  Whether the present degree of chronic CHF is related to fluid overload must be judged on clinical grounds.","['Change severity', 'Change to homophone', 'Add medical device']"
"2b16b5f9-f1b0a358-5bd9e08e-e1f5a385-2a69e8dd, d9247008-190a48a3-02caefc9-e25fb73c-1c3f9dfd",50160109,11888614,"Findings: PA and lateral views demonstrate dilation of the azygos, tiny pleural effursion, and faint interlobular septal thickening.  There is no focal consolidation, pleural effusion, or pneumothorax.  The heart size is normal.  The cardiac, hilar, mediastinal contours are within normal limits. Impression: Mild pulmonary edema.","Findings: PA and lateral views demonstrate dilation of the azygos, tiny pleural effersion, and faint interlobular septal thickening.  There is no focal consolidation, pleural effusion, or pneumothorax.  The heart size is mildly enlarged.  The cardiac, hilar, mediastinal contours are within normal limits with bilateral nodular opacities suspicious for malignancy. Impression: Moderate pulmonary edema.  ","['Change severity', 'Change to homophone', 'False prediction']"
d0e2802e-7ba958f6-7db1cbc3-31f2a1d0-0ac20695,50536002,11888614,"Findings: Frontal and lateral views of the chest demonstrate normal lung volumes.  No pleural effusion, focal consolidation or pneumothorax.  There is no pneumomediastinum.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is normal.  Mild pulmonary vascular congestion is seen on ___ exam has resolved.  Insterstiail markings appear prominent which may reflect underlying small airways disease or interstitial disease.  Clinical correlation is advised. Partially imaged upper abdomen is unremarkable. Impression: Mild pulmonary vascular congestion seen on ___ exam has resolved.","Findings: Frontal and lateral views of the chest demonstrate normal lung volumes. No pleural effusion, focal consolidation, or pneumothorax. There is no pneumomediastinum. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. Severe pulmonary vascular congestion is seen on ___ exam has resolved. Insterstiail markings appear prominent which may reflect underlying small airways disease or interstitial disease. Clinical correlation is advised. Partially imaged upper abdomen is unremarkable. An NG tube is in place. Impression: Mild pulmonary vascular congestion seen on ___ exam has resolved.","['Change severity', 'Change to homophone', 'Add medical device']"
"86eb621b-f9a39d0a-22d3a0de-eeb8000a-f31f0e44, f877eb30-e2155ec8-a0bdcfb3-494d60b8-a0e7c7b7",50561566,11888614,"Findings: There has been little interval change from the prior exam.  The heart size is normal.  The mediastinal and hilar contours are within normal limits.  The pulmonary vascularity is normal without evidence of pulmonary edema.  Again noted are bilateral ill-defined hazy airspace opacities predominantly within a perihilar distribution, not significantly changed in extent compared to the recent chest radiograph and chest CT.  No pleural effusion or pneumothorax is present.  There are no acute osseous abnormalities. Impression: No significant interval change in bilateral predominantly perihilar ill-defined airspace opacities which may reflect a multifocal infectious process, but is nonspecific.","Findings: There has been little interval change from the prior exam.  The heart size is enlarged.  The mediastinal and hilar contours are witnin normal limits.  The pulmonary vascularity is normal without evidence of pulmonary edema.  Again noted are bilateral ill-defined hazy airspace opacities predominantly within a perihilar distribution, with new upper lobe consolidation.  No pleural effusion or pneumothorax is present.  There are no acute osseous abnormalities. Impression: No significant interval change in bilateral predominantly perihilar ill-defined airspace opacities whch may reflect a multifocal infectious process, but is nonspecific.","['Change severity', 'Add typo', 'False prediction']"
65a8e3b5-8552ea89-9bc2e215-fd42bed9-e469687f,50703372,11888614,"Impression: ET tube tip is 3 cm above the carinal. NG tube tip is in the stomach. Pulmonary edema is substantial, bilateral associated with large bilateral pleural effusions. No evidence of pneumothorax expressed",Impression: ET tube tip is 3 mm above the carinal. NG tube tip is in the stomach. No pulmonary edema. No evidence of pneumothorax exprezzed.,"['Change measurement', 'Add typo', 'False negation']"
c3a5cd3a-ef8d5ed2-e9185ad1-5ed385b0-b980a67e,50741129,11888614,"Findings: There are nonspecific bibasilar opacities.  The apices of the lungs are clear. There is no pulmonary edema, pleural effusion, or pneumothorax.  The cardiomediastinal silhouette is normal.  No fracture is identified on this limited supine view. Impression: Nonspecific bibasilar opacities, right worse than left, which are concerning for pneumonia.","Findings: There are nonspecific bibasilar opacities.  The apices of the lungs show mild interstitial thickening. There is no pulmonary edema, pleural effusion, or pneumothorax.  The cardiomediastinal silhouette shows mild enlargement.  No fracture is identified on this limited supine view with a mild suspicion of a left rib fracture. Impression: Nonspecific bibasilar opacities, right worse than left, which are concerning for pneumonia. Impression: The lungs are clear without any nonspecific findings or evidence of pneumonia.  ","['Change location', 'Add contradiction', 'False prediction']"
73e67ffa-4125674a-1c921135-faea72ee-d3a60267,50746880,11888614,"Findings: Since the prior study the endotracheal tube is been removed.  Heterogeneous bilateral opacities predominantly at the lung bases, are essentially unchanged ___.  No pleural effusion or pneumothorax.  Cardiomediastinal silhouette is normal. Impression: Unchanged bilateral parenchymal opacities since ___, concerning for multifocal pneumonia or aspiration.  Consider opportunistic infection given the atypical appearance.","Findings: Since the prior study the endotracheal tube has been removed. Heterogeneous bilateral opacities predominantly at the right apex, are essentially unchanged ___. Mild pleural effusion is present. Cardiomediastinal silhouette shows mild cardiomegaly. Impression: Unchanged bilateral parenchymal opacities since ___, concerning for multifocal pneumonia or aspiration. No evidence of opportunistic infection.","['Change location', 'Add contradiction', 'False prediction']"
"528871d5-6baf82c5-5fd7b922-bbc60517-26d6dc84, 82964865-d4efa996-8d0f5736-16793d59-ca381654",51017937,11888614,Findings: The lungs are well inflated and clear. No focal consolidations identified. The cardiomediastinal silhouette hilar contours are stable. There is no pleural effusion or pneumothorax. Impression: No evidence of acute cardiopulmonary process.,Findings: The loans are well inflated and clear. No focal consolidations identified. The cardiomediastinal silhouette hilar contours are stable. There is a small left pleural effusion. Impression: No evidence of acute cardiopulmonary process. Mild bilateral pleural effusions.,"['Add contradiction', 'Change to homophone', 'False prediction']"
"25b1f581-32a8bccf-ddc5c8cd-f34d16a5-befd4bdc, 973d8700-4120b7b6-d9b4de64-42d4af18-999c914d",51240157,11888614,Findings: The cardiomediastinal and hilar contours are normal. There is no pleural effusion pneumothorax. The lungs are expanded and clear without focal consolidation concerning for pneumonia.  Pulmonary vascularity is within normal limits. The upper abdomen is unremarkable. No acute osseous abnormalities are detected. Impression: No acute cardiopulmonary process.,Findings: The cardiomediastinal and hilar contours are normal. Lymphadenopathy is noted in the hilar region. There is no pleural effusion pneumothorax. The lungs are expanded and clear without focal consolidation concerning for pneumonia.  Pulmonary vascularity is within normal limits. The upper abdomen is unremarkable. Minimal fusiform dilation of the thoracic aorta noted. No acute osseous abnormalities are detected. Impression: No acute cardiopulmonary process.,"['Change location', 'Change to homophone', 'False prediction']"
"7f7f9559-e0020fe2-d818feea-fe3dfc5a-6fe1fdf3, 849bcc13-403bf760-04323271-8223b6e7-a6c8e685",51840085,11888614,"Findings: Again seen are nonspecific bibasilar opacities, which have increased from ___.  The apices of lungs are clear.  There is no evidence of pulmonary edema, pleural effusion, or pneumothorax.  Cardiomediastinal and hilar contours are unremarkable.  No acute displaced rib fracture identified. Impression: Nonspecific bibasilar opacities, right worse than left, are concerning for pneumonia.  These appear progressed from ___.","Findings: Again seen are nonspecific bibasilar opacities, which have increased from ___.  The apices of lungs is clear.  There is no evidence of pulmonary edema, pleural effusion, or pneumothorax.  Cardiomediastinal and hilar contours are unremarkable.  No acute displaced rib fracture identified. Impression: No opacities.  These appear progressed from ___.","['Change location', 'Change to homophone', 'False negation']"
d761d23a-c91f3562-afa919b9-4296a1ca-18a90632,51853599,11888614,"Impression: In comparison with the study of ___, the monitoring and support devices are unchanged. The patient has taken a much poor inspiration. Continued enlargement of the cardiac silhouette with pulmonary edema with pleural effusions and compressive basilar atelectasis.","Impression: In comparison with the study of ___, the monitoring and suport devices are unchanged. The patient has taken a much poorer inspiration. Continued enlargement of the cardiac silhouette with pulmonary edema with pleural effusions and compressive basilar electasis. An ET tube is present.","['Add typo', 'Change to homophone', 'Add medical device']"
"24aaa8b8-bd3cb728-72b4e416-3dca185e-89bad691, 5ff743c4-002fb75b-2bebc8ef-391abb9f-8ecce49c",52249249,11888614,"Findings: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. A rounded, nodular opacity overlies the right lower lung, and cannot be discreetly separated from the ninth posterior rib. The cardiomediastinal silhouette is within normal limits. Impression: 1.  No evidence of acute cardiopulmonary process. 2. Nodular opacity overlying the right lower lung and anterior right fifth rib. TO DETERMINE WHETHER THIS IS A LUNG NODULE OR THE RIGHT NIPPLE OR SCLEROSIS IN THE ANTERIOR RIGHT FIFTH RIB, SHALLOW OBLIQUE VIEWS WITH NIPPLE MARKER SHOULD BE OBTAINED.","Findings: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. No nodular opacity seen. The cardiomediastinal silhouette is within normal limits. A rounded, nodular opacity overlies the right lower lung, and cannot be discreetly separated from the ninth posterior rib. Impression: 1.  No evidence of acute cardiopulmonary process. 2. Nodular opacity overlying the left lower lung and anterior right fifth rib. TO DETERMINE WHETHER THIS IS A LUNG NODULE OR THE RIGHT NIPPLE OR SCLEROSIS IN THE ANTERIOR RIGHT FIFTH RIB, SHALLOW OBLIQUE VIEWS WITH NIPPLE MARKER SHOULD BE OBTAINED.","['Change location', 'Add repetitions', 'False negation']"
436a33ef-05436b90-941301ea-3e5c29aa-85fa6307,52382255,11888614,"Impression: The patient is a currently intubated with the ET tube tip being 4.3 cm above the carinal. NG tube tip is in the stomach. Widespread parenchymal opacities are demonstrated, most likely representing pulmonary edema but reassessment after diuresis is recommended. Underlying infection is a possibility","Impression: The patient is a currently intubated with the ET tube tip being 3.6 cm above the carinal. Pneumothorax is noted. NG tube tip is in the stomach. Widespread parenchymal opacities are demonstrated, most likely representing pulmonary edema but reassessment after diuresis is recommended. Underlying infection is a possibility.","['Change measurement', 'Add contradiction', 'Add medical device']"
"0747fa57-65ee11cc-ed504521-5cfed40f-2a61d9b7, 9cbd3475-8f9f2464-1fbb6aca-f66b1b1e-6f5a46d8",52480192,11888614,Impression: No acute intrathoracic process.,Impression: No acute intrathoric process.,"['Add typo', 'Add repetitions', 'Add medical device']"
"66e06e1a-cbaf78cc-cfb43d10-c93987a3-a12d7bca, f64e7f86-3a69ce7c-1bca8f45-3fb972a4-a7f54583",53383243,11888614,"Findings: The cardiac, mediastinal and hilar contours are within normal limits, and the heart size is normal.  Focal ill-defined opacities are demonstrated predominantly within the perihilar regions of both upper lobes, as was noted on the prior CT, but new when compared to the prior chest radiograph.  No pleural effusion or pneumothorax is present, and there is no pulmonary vascular congestion.  There are no acute osseous abnormalities. Impression: Multifocal opacities in both lungs, predominantly within a perihilar distribution, as demonstrated on the prior chest CT.  Findings again are nonspecific, but concerning for a multifocal infectious process.","Findings: The cardiac, mediastinal and hilar contours are within normal limits, and the heart size is normal. There is a small left pleural effusion. Focal ill-defined opacities are demonstrated predominantly within the perihilar regions of both lower lobes, as was noted on the prior CT, but new when compared to the prior chest radiograph. No pleural effusion or pneumothorax is present, and there is no pulmonary vascular congestion. Focal ill-defined opacities are demonstrated predominantly within the perihilar regions of both upper lobes, as was noted on the prior CT, but new when compared to the prior chest radiograph. There are no acute osseous abnormalities. Impression: Multifocal opacities in both lungs, predominantly within a perihilar distribution, as demonstrated on the prior chest CT.  ","['Change location', 'Add repetitions', 'False prediction']"
c963fac4-7f414f76-1fe5eb83-2bd75a14-f2dcd77e,53769263,11888614,Findings: Supine portable AP view of the chest was provided.  There is an endotracheal tube which is seen terminating approximately 7.6 cm above the carina.  An NG tube tip terminates in the left upper abdomen.  There is mild prominence of the bronchovascular markings which could reflect technique though possibility of aspiration is not excluded.  No definite pneumothorax or effusion is seen.  Cardiomediastinal silhouette appears normal.  No bony deformities are seen. Impression: Appropriately positioned ET and NG tubes.  Mild bronchovascular prominence could reflect an element of aspiration.,Findings: Supine portable AP view of the chest was provided.  There is an endotracheal tube which is seen terminating approximately 3.9 cm above the carina.  An NG tube tip terminates in the left upper abdmonen.  There is mild prominence of the bronchovascular markings which could reflect technique though possibility of aspiration is not excluded.  No definite pneumothorax or effusion is seen.  Cardiomediastinal silhouette appears normal.  No bony deformities are seen.  A central venous catheter is noted.,"['Change position of device', 'Add typo', 'Add medical device']"
"4c484e73-4abd4329-ec10231a-56289fc3-aaed7d86, eaf346b2-804fccf1-7b8edede-5553e418-701f2e75",53774641,11888614,"Findings: The heart is normal in size.  The main pulmonary artery contour is slightly prominent, but stable.  Central pulmonary arteries are also mildly enlarged.  The pulmonary interstitium has a mildly coarsened appearance bilaterally, but without significant change.  There is no pleural effusion or pneumothorax.  Mild rightward convex curvatures centered along the mid thoracic spine appear similar. Impression: Similar central pulmonary artery enlargement, for which the possibility of pulmonary hypertension should be considered in the appropriate clinical setting.","Findings: The heart is normal in size.  The main pulmonary artery contour is slightly prominent, but stable.  Central pulmonary arteries are also mildly large.  The pulmonary interstitium has a mildly coarsened appearance on the left side, but without significant change.  There is no pleural effusion or pneumothorax.  No rightward convex curvatures centered along the mid thoracic spine appear similar. Impression: Similar central pulmonary artery enlargement, for which the possibility of pulmonary hypertension should be considerd in the appropriate clinical setting.","['Change location', 'Add typo', 'False negation']"
394e4fc7-9c032c3f-1bf44214-594a112c-dbf00598,54081752,11888614,"Findings: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. The bones are intact. Impression: No acute cardiopulmonary process.","Findings: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The imaged lower abdomen is unremarkable. The bones are intact. Impression: No acute cardiopulmonary process. The cardiomediastinal silhouette is normal. A central venous line is in place.","['Change location', 'Add repetitions', 'Add medical device']"
"3153b513-aa211ff5-db3a738d-8e4d0c11-9afdadd8, cabb5fa9-d1acd957-85f5de3b-98fe2481-6ebf62bd",55352995,11888614,Findings: There has been interval improvement in aeration in the lower lobes. No focal infiltrate is identified.  The cardiac and mediastinal silhouettes are unchanged ,Findings: There has been interval improvement in aeration in the upper lobes. No focal infiltrate is identified. The cardiac and mediastinal silhouettes are unchaged No pulmonary nodules.,"['Change location', 'Add typo', 'False negation']"
ae6a9c3e-1994f6fc-566936f5-9b51a110-2fb8ea7e,55517450,11888614,"Findings: Since prior, a left PICC has been retracted and now ends at the confluence of the left brachiocephalic vein and superior vena cava. An endotracheal tube has been removed.  There is no pneumothorax or pleural effusion.  Cardiac enlargement is unchanged.  Since prior, there has been increased right greater than left basilar opacity, compatible with worsening pulmonary edema. Impression: 1. Retraction of the left PICC now ending in the left brachiocephalic vein. 2. Worsening pulmonary edema.","Findings: Since prior, a left PICC has been retracted and now ends at the confluence of the left brachiocephalic vein and left subclavian vein. An endotracheal tube has been removed.  There is no pneumothorax or pleural effusion.  Cardiac enlargement is unchanged.  Since prior, there has been increased right greater than left basilar opacity, compatible with worsening pulmonary edema. A right IJ central venous catheter is noted in appropriate position. Impression: 1. Retraction of the left PICC now ending in the superior vena cava. 2. Worsening pulmonary edema. 3. Mild improvement in pulmonary edema.","['Change position of device', 'Add contradiction', 'Add medical device']"
abca1a43-54c24a8a-52ed07b0-5cd250c5-afdc7061,56043754,11888614,"Findings: Portable upright chest radiograph demonstrates clear, well expanded lungs.  There is no focal consolidation, pleural effusion, or pneumothorax.  The cardiac silhouette is normal in size, the mediastinal contours are normal. Impression: Normal view of the chest.","Findings: Portable upright chest radiograph demonstrates clear, well exapnded lungs.  Their is no focal consolidation, pleural effusion, or pneumothorax.  The cardiac silhouette is normal in size, the mediastinal contours are normal. Patchy bilateral opacities suspicious for infection or atelectasis are noted. Impression: Normal view of the chset.","['Add typo', 'Change to homophone', 'False prediction']"
88e154a1-fd82784b-588fbc5a-0649ad57-b12ed9cb,56703975,11888614,Findings: AP portable upright view of the chest.   Interval intubation noted with the endotracheal tube tip residing approximately 6cm above the carina.  The lungs are mostly clear aside from mild lower lung atelectasis.  No large effusion or pneumothorax.  Cardiomediastinal silhouette appear stable.  Bony structures are intact. Impression: Endotracheal tube in place with its tip 6 cm above the carina.  Advancement of endotracheal tube by 1-2 cm may result in more optimal positioning.,Findings: AP portable upright view of the chest.   Interval intubation noted with the nasogastric tube tip residing approximately 6cm above the carina.  The lungs are mostly clear aside from mild lower lung atelectasis.  No large efusion or pneumothorax.  Cardiomediastinal silhouette appear stable.  Interstitial pulmonary edema is present. Bony structures are intact. Impression: Endotracheal tube in place with its tip 6 cm above the carina.  Advancement of endotracheal tube by 1-2 cm may result in more ooptimal positioning.,"['Change name of device', 'Add typo', 'False prediction']"
"3262a2af-cbec2cad-9cd5cba9-7d8623c0-9655977e, c1610076-7344ca52-76ac1da0-6b6e055a-0888a924",56780883,11888614,"Findings: No focal consolidation, pleural effusion, or pneumothorax is seen.  Mild pulmonary vascular redistribution persists.  Interstitial prominence is likely chronic.  Heart and mediastinal contours are within normal limits. Impression: Pulmonary vascular congestion, a little more congested than his best recent chest radiograph on ___.","Findings: No local consolidation, pleural effusion, or pneumothorax is seen. Moderate pulmonary vascular redistribution persists. Interstitial prominence is likely chronic. Heart and mediastinal contours are within normal limits with lower lobe nodular opacity. Impression: Pulmonary vascular congestion, a little more congested than his best recent chest radiograph on ___.","['Change severity', 'Change to homophone', 'False prediction']"
c7d68ac0-4b3a8241-8126525e-1868154e-bfe8aae3,57247661,11888614,"Impression: In comparison with the study of ___, the nasogastric tube has been removed. Diffuse bilateral pulmonary opacifications are again seen, consistent with substantial pulmonary edema.  The cardiac silhouette is within normal limits on this study.  Given the extensive pulmonary changes, superimposed pneumonia would be difficult to exclude, especially in the absence of a lateral view. The left spur PICC line extends only to the brachiocephalic vein just before the junction with the SVC.","Impression: In comparison with the study of ___, the NG tube has been removed. Diffuse bilateral pulmonary opacifications are again seen, consistent with substantial pulmonary edema. The cardiac slhouette is within normal limits on this study. Given the extensive pulmonary changes, superimposed pneumonia would be difficult to exclude, especially in the absence of a lateral view. No PICC line extends to the brachiocephalic vein.","['Change name of device', 'Add typo', 'False negation']"
"31716940-bbbe2182-3ed77c6c-2c4bb3d2-e2d71c0e, 58486732-601a466c-04f4fd39-26bf4291-8cf57364",57386788,11888614,"Findings: AP upright and lateral views the chest.  Subtle prominence of the right hilar bronchovascular markings may reflect AP technique.  No definite consolidation concerning for pneumonia.  No effusion or pneumothorax.  No overt edema.  Cardiomediastinal silhouette appears normal.  No acute bony injuries. Impression: Limited exam, no acute findings.","Findings: AP upright and lateral views the chest.  Subtle prominence of the left hilar bronchovascular markings may reflect AP technique.  No definite consolidation concerning for pneumonia.  No effusion or pneumothorax.  No overt edema.  Cardiomediastinal silhouette appears normal.  No acute bony injuries.  ET tube is noted within the trachea.  No definite consolidation concerning for pneumonia. Impression: Limited exam, no acute findings. ","['Change location', 'Add repetitions', 'Add medical device']"
"8792030f-fa92ef26-20cc8462-d46e5176-1dd9ee64, b4ad1fa1-a7d0c3f5-61065597-401ffc49-7d46d1ed",57547663,11888614,"Findings: PA and lateral views of the chest are obtained.  There is significant interval improvement in lung aeration.  Vague reticular opacities persist in the perihilar regions, possibly representing residual pneumonia.  No definite signs of CHF, pleural effusion, or pneumothorax.  Heart and mediastinal contours appear normal.  Interval removal of the endotracheal and nasogastric tubes.  Bony structures are intact. Impression: Significant improvement in pulmonary aeration with persistent reticular perihilar markings, possibly representing residua of recent pulmonary infection.","Findings: PA and lateral views of the chest are obtained.  There is significant interval improvement in lung aerstion.  No reticular opacities are seen.  No definite signs of CHF, pleural effusion, or pneumothorax.  Heart and mediastinal contours appear normal.  Interval removal of the bronchoscope.  Bony structures are intact. Impression: Significant improvement in pulmonary aeration with no perihilar markings seen.","['Change name of device', 'Add typo', 'False negation']"
"8f21f008-08a83591-c104c6ca-3bc4abf9-5a9a7ccb, 8f587ae6-79663504-c7d6018f-27854479-a30cb057",57933100,11888614,"Findings: The lungs are symmetrically well expanded and well aerated without focal consolidation concerning for pneumonia, pleural effusion or pneumothorax.  There is no overt pulmonary edema.  The cardiomediastinal and hilar contours are within normal limits.  The trachea is midline.  No acute osseous abnormality is detected. Impression: No acute cardiopulmonary process.","Findings: The lungs are symmetrically well expanded and well aerated without focal consolidation, pleural effusion or pneumothorax. There is no overt pulmonary edema. The cardiomediastinal and hilar contours are within normal lmits. The trachea is midline. There is mild scoliosis of the thoracic spine. Impression: No concise cardiopulmonary process.","['False negation', 'Add typo', 'False prediction']"
"380bd914-1c234083-a59c609d-7ebce49b-0a9b6101, 896369e9-0e4e879b-f8fccc40-e58605c2-c1bfaf48",58240183,11888614,"Findings: There is no focal consolidation, pleural effusion or pneumothorax.  Pulmonary edema has resolved. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. Impression: No acute cardiopulmonary process.","Findings: There is no focal consolidation, pleural effusion or pneumothorax. Pulmonary edema has resolved. The cardiomediastinal silhouette is normal. The imaged lower abdomen is unremarkable. There is a centrally inserted central venous line. ","['Change location', 'Add contradiction', 'Add medical device']"
"10313a92-ab9a74d9-00b5cef1-09e6a75f-b95d878d, 971b4bd8-09f04bc5-e43b86b5-dde445a3-5cbfca46",58264635,11888614,"Findings: Frontal and lateral views of the chest were obtained.  Prominence of interstitial markings is similar to prior radiograph particularly that on ___.  The cardiac, mediastinal, hilar contours are stable.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Impression: No significant interval change.","Findings: Frontal and lateral views of the chest were obtained. Prominence of interstitial markings is less prominent compared to prior radiograph particularly that on ___. The cardiac, mediastinal, hilar contours are stable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There is mild pulmonary edema. Impression: Mild interval change.","['Change severity', 'Add contradiction', 'False prediction']"
"1e9ce595-bdd1e282-474eb65a-4f0acade-2ed14cac, 29c6ee6f-aeb1d255-de6cfa22-759fbcea-190bc64d",58444156,11888614,"Impression: No acute cardiopulmonary pathology, especially no pneumothorax detected.","Impression: No acute cardiopulmonary pathology, especially no pulmonary edema detected.","['False negation', 'Add typo', 'False prediction']"
69eca2be-d1ce0c03-915414db-24d5cb14-1a5729b1,58813685,11888614,"Findings: Single AP portable view of the chest was obtained.  Low lung volumes persist.  There is mild central pulmonary vascular engorgement.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  Cardiac and mediastinal silhouettes are stable. ","Findings: Single AP portable view of the chest was otbained.  Low lung volumes persist.  There is moderate central pulmonary vascular engorgement.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  No abnormalities in cardiac and mediastinal silhouettes are seen. ","['Change severity', 'Add typo', 'False negation']"
b200342e-9a78a04c-db63c0f7-725a09b8-0a4f31d5,59174426,11888614,"Impression: In comparison with the study of ___, the patient has taken a better inspiration. The cardiac silhouette is within upper limits of normal or mildly enlarged with continued substantial pulmonary edema. Although there is no definite focal area of consolidation, superimposed pneumonia would be difficult to unequivocally exclude, in view of the pulmonary changes as well as the absence of a lateral projection.","Impression: In comparison with the study of ___, the patient has taken a better inspiration. The cardiac silhouette is within upper limits of normal or mildly enlarged with continued substantial pulmonary edema. Although there is no definite focal area of consolidation, superimposed pneumonia would be difficult to unequivocally exclude, in view of the pulmonary changes. No pulmonary changes are noted.","['Change location', 'Add contradiction', 'False negation']"
"11dec88e-878b57f1-343fb940-c74959b5-0320dab9, 16ba2ebd-2cf0b27a-05a2c9ef-d72cf558-6c0b0bb2",52548540,11890444,"Findings: Heart size is normal.  The aorta is mildly tortuous, as seen previously.  Mediastinal and hilar contours are unchanged.  Pulmonary vasculature is not engorged.  Lungs are clear.  Small bilateral pleural effusions are new in the interval.  No focal consolidation is present.  There is no pneumothorax.  No acute osseous abnormality is visualized. Impression: New small bilateral pleural effusions.  No radiographic evidence for pneumonia.","Findings: Heart size is normal.  The aorta is mildly tortuous, as seen previously.  Mediastinal and hilar contours are unchanged.  Pulmonary vasculature is not endorse.  Lungs are clear.  Small bilateral pleural effusions are new in the interval.  There is a small right-sided hydropneumothorax.  There is no pneumothorax.  No acute osseous abnormality is visualized. Impression: New small bilateral pleural effusions and small right-sided hydropneumothorax.  No radiographic evidence for pneumonia.","['Change location', 'Change to homophone', 'False prediction']"
"a801e9d6-a80c7ee3-f0074930-698b1ee0-eca02fef, edf1e5ad-e7249deb-2d881608-aa2878c8-e22288bd",53685497,11890444,Findings: Heart size is normal.  The aorta is unfolded.  The mediastinal and hilar contours are unchanged.  Pulmonary vasculature is not engorged.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is visualized.  No acute osseous abnormalities detected. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The aorta appears normal.  The mediastinal and hilar contours are unchanged.  Pulmonary vasculature is not engorged.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is visualized.  No pleural effusion or pneumothorax is visualized.  No acute osseous abnormalities detected. Impression: New mild cardiomegaly is seen. ,"['Add contradiction', 'Add repetitions', 'False negation']"
"3409fbb3-3f6323e9-0d72911c-0f62ad8d-ec55cdcb, 975bd9a6-00f17467-7782efe6-857c386d-9d3494b6",59741167,11891514,"Findings: Lung volumes are low. This accentuates the size of the cardiac silhouette which is borderline enlarged with a left ventricular predominance. The aortic knob is calcified. Mediastinal and hilar contours are unremarkable. There is crowding of the bronchovascular structures without overt pulmonary edema. Patchy opacities in the lung bases likely reflect atelectasis. No pleural effusion, pneumothorax, or focal consolidation is present. Moderate multilevel degenerative changes with anterior osteophytic spurring are demonstrated in the thoracic spine. Impression: Low lung volumes with patchy bibasilar airspace opacities, likely atelectasis.","Findings: Lung volumes are low. This accentuates the size of the cardiac silhouette which is moderately enlarged with a left ventricular predominance. The aortic knob is calcified. Mediastinal and hilar contours are unremarkable. There is crowding of the bronchovascular structures with mild pulmonary edema. Patchy opacities in the lung bases likely reflect atelectasis. No pleural effusion, pneumothorax, or focal consolidation is present. Moderate multilevel degenerative changes with anterior osteophytic spurring are demonstrated in the thoracic spine. A right-sided central venous catheter is present. Impression: Low lung volumes with patchy bibasilar airspace opacities, moderate pulmonary edema likely atelectasis.","['Change severity', 'Add contradiction', 'Add medical device']"
"406fe27f-63d23a7d-33fa6a30-181e80d4-a1f38ff4, 5c43dc33-0a06529a-827bf40b-85849e83-977ad483",56893815,11917288,Findings: The heart is normal in size.  The mediastinal and hilar contours appear unchanged.  There is no pleural effusion or pneumothorax.  The lungs appear clear.  Bony structures are unremarkable.  There has been no significant change. Impression: No evidence of acute disease.,Findings: The heart is mildly enlarged. The mediastinal and hilar contours appear unchanged. There is a small pleural effusion. The lungs appear clear. Bony structures show multiple fractures. There has been no significant change. Impression: No evidence of acute disease. Moderate pulmonary congestion present.,"['Change severity', 'Add contradiction', 'False prediction']"
26ee6ee4-e5bb799b-aa5f201b-b27779ab-636db2a4,51087989,11921090,Findings: Lung volumes are low. There is a mild interstitial pulmonary edema and mild cardiomegaly. Mediastinal wires appear intact numerous surgical clips project over the mediastinum. The aortic arch is calcified. There is no large pleural effusion or pneumothorax. Impression: Mild cardiomegaly and interstitial pulmonary edema.,Findings: Lung volumes are low. There is a moderate interstitial pulmonary edema and mild cardiomegaly. Mediastinal wires appear intact numerous surgical clips project over the mediastinum. The aortic arch is calcified. There is no large pleural effusion or pneumothorax. Impression: Severe cardiomegaly and interstitial pulmonary edema.,"['Change severity', 'Add contradiction', 'Add medical device']"
5448e34a-3c48a8c9-74c33e5b-2f85b885-6f094061,56456745,11921090,"Impression: In comparison with the earlier study of this date, there is suggestion of some increasing opacification at the left base that could represent atelectasis or, in the appropriate clinical setting, a developing consolidation. Otherwise little change.","Impression: In comparison with the earlier study of this date, there is suggestion of some increasing opacification at the right base that could represent atelectasis or, in the appropriate clinical setting, a developing consolidation. Otherwise litttle change. An NG tube is present, with its tip at the stomach. ","['Change location', 'Add typo', 'Add medical device']"
"25651b13-d572c28c-5e501292-b096b253-6d6fb63a, 547bf6d9-5959e8be-65d31255-e8e031b4-5a9af9e0",50794292,11925631,"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.  No free air below the right hemidiaphragm. Impression: No acute findings in the chest.","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.  No free air below the left hemidiaphragm.  Bony structures are intact. Impression: No acute findings in the chest.","['Change location', 'Add repetitions', 'False negation']"
4b17550c-25e0500e-c7f5e522-75da40cb-c6e5c492,51003988,11925631,Findings: Improved aeration of the left lower lobe since ___ with residual bibasilar opacities likely atelectasis.  No pleural effusion or pneumothorax.  Normal cardiomediastinal silhouette. Impression: Improving left lower lobe aeration with residual bibasilar atelectasis.   Dr. ___ paged at 11:00 on ___ by Dr. ___ ___ request,Findings: Improved aeration of the left upper lobe since ___ with residual bibasilar opacities likely atelectasis.  No pleural effusion or pneumothorax.  Normal cardiomediastinal silhouette. No pleural effusion or pneumothorax.  Impression: Improving left lower lobe aeration with residual bibasilar atelectasis.   Dr. ___ paged at 11:00 on ___ by Dr. ___ ___ request. There is a central venous line present.,"['Change location', 'Add repetitions', 'Add medical device']"
b6d962de-3c13f291-b994fcea-8f43cab1-4d7bd9e9,51368660,11925631,Impression: No evidence of pneumonia.,Impression: No evidence of pneumonia. There appear to be bilateral infiltrates suggestive of pneumonia.,"['Add contradiction', 'Add repetitions', 'False prediction']"
82c0e7ef-5760c746-e27a81ec-73b19b26-475e8d54,51690906,11925631,"Findings: Upright portable view of the chest demonstrates low lung volumes, which accentuates bronchovascular markings.  There is no pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is normal.  Evidence of free is is seen under the right hemidiaphragm, which may relate to patient's reported recent cholecystectomy. Impression: Evidence of free air under the right hemidiaphragm, may relate to patient's reported cholecystectomy earlier today.","Findings: Upright portable view of the chest demonstrates low lung volumes, which accentuates bronchovascular markings.  There is no pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is normal.  Evidence of free air is seen under the left hemidiaphragm, which may relate to patient's reported recent cholecystectomy. Additionally, a central venous line is noted in the superior vena cava. Impression: Evidence of free air under the right hemidiaphragm, may relate to patient's reported cholecystectomy earlier to day.","['Change location', 'Change to homophone', 'Add medical device']"
"00d187bc-46b2dcc4-dcc3029d-57dedba3-c026f807, 1041a192-952e9875-16fa1c6c-45c39917-f19e5dc2",52715722,11925631,"Findings: PA and lateral views of the chest were obtained.  There is an area of linear opacity representing plate-like atelectasis of the left lower lung.  There is no focal consolidation, pleural effusion, or significant pulmonary edema.  The cardiomediastinal silhouette is unremarkable. Impression: No acute cardiopulmonary disease.","Findings: PA and lateral views of the chest were obtained.  There is no linear opacity seen.  There is no focal consolidation, pleural effusion, or significant pulmonary edema.  The PICC line terminates near the right atrium. Impression: Mild pulmonary edema and small bilateral pleural effusions.","['Change position of device', 'Add contradiction', 'False negation']"
"01b2e505-9d2a75bc-da0a86a7-cb2a2c42-9582f62b, 3b197005-484344a8-d685b5df-3c59c632-aa22411e",53086987,11925631,"Findings: Compared with the most recent prior radiograph, there are new bibasilar opacities which could represent atelectasis, aspiration or consolidation.  There are low lung volumes, which accentuates the cardiomediastinal silhouette.  There is blunting of the left costophrenic angle which may be related to small pleural effusion.  No pneumothorax is present.  A dense round opacity in the left upper abdomen could be barium if the patient had a previous barium swallow; however, none is documented our system. A drain is seen in the left upper abdomen. Impression: New bibasilar opacities could be atelectasis, aspiration or pneumonia.    Findings discussed with Dr. ___ by Dr. ___ at 11:26 a.m. on ___, 5 minutes after discovery.","Findings: Compared with the most recent prior radiograph, there are new bibasilar opacities which could represent atelectasis, aspiration or consolidation.  There are low lung volumes, which accentuates the cardiomediastinal silhouette.  There is blunting of the right costophrenic angle which may be related to small pleural effusion.  No pneumothorax is present.  A dense round opacity in the left upper abdomen could be barium if the patient had a previous barium swallow; however, none is documented in our system. A pacemaker is seen in the chest. Impression: New bibasilar opacities could be atelectasis, aspiration or pneumonia.  The lungs appear clear without any signs of atelectasis, aspiration or pneumonia.  Findings discussed with Dr. ___ by Dr. ___ at 11:26 a.m. on ___, 5 minutes after discovery.","['Change location', 'Add contradiction', 'Add medical device']"
9dbd6a42-6f6b8a99-892e0d7d-b0765810-57292428,54487320,11925631,"Impression: AP chest compared to ___:  There has been little change since ___ except for decrease in previous small right pleural effusion.  Substantial atelectasis persists at the base of the right lung and the left lower lobe is still completely consolidated or collapsed.  Upper lungs are grossly clear.  The extent of gaseous distention of the intestinal tract as seen in the upper abdomen has improved.  No pneumothorax.  Mild-to-moderate cardiomegaly, improved.","Impression: AP chest compared to ___:  There has been little change since ___ except for decrease in previous small left pleural effusion.  Substantial atelectasis persists at the base of the right lung and the left lower lobe is stil completely consolidated or collapsed.  Upper lungs are grossly clear.  No consolidation or collapse is identified.  No pneumothorax.  Mild-to-moderate cardiomegaly, imrpoved.","['Change location', 'Add typo', 'False negation']"
"3e807ef1-89671fba-a42567b3-a1ceb0db-0c056a50, 7036152d-aa6efb97-c67ab87a-cf180d3c-c9a2dfd1",56871970,11925631,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.  No evidence of free air is seen beneath the diaphragms. Right upper quadrant surgical clips are noted. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without edivence of focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are normal.  No evidence of free air is seen beneath the diaphragms. Left upper quadrant surgical clips are noted. Impression: No acute cardiopulmonary process.,"['Change location', 'Add typo', 'False negation']"
"3dd4e4e5-e6793772-9ea89ee4-5984f91b-04184847, f075ce73-c9417eb6-96794bef-5c430ca4-d3026797",58651437,11925631,"Findings: Frontal and lateral views of the chest were obtained.  There are relatively low lung volumes.  There is mild left base atelectasis.  There is slight increase in the interstitial markings bilaterally, which may relate to low lung volumes and minimal interstitial edema; however, an atypical infectious process cannot be excluded.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are stable and unremarkable. ","Findings: Frontal and lateral views of the chest were obtained.  There are relatively lo lung volumes.  No left base atelectasis.  There is moderate increase in the interstitial markings bilaterally, which may relate to low lung volumes and minimal interstitial edema; however, an atypical infectious process cannot be excluded.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are stabel and unremarkable.","['Change severity', 'Add typo', 'False negation']"
"44f46b9b-c9fa5d0e-60b6b805-910142d9-93721971, 7c2f91e9-a7031c70-2a73d302-0080f356-544ae51c",59403702,11925631,"Impression: In comparison with the study of ___ the right heart border is not as sharply seen.  However, there is no evidence of a opacification overlying the cardiac silhouette on the lateral view, and therefore no evidence of acute focal pneumonia. No cardiomegaly or vascular congestion or pleural effusion.","Impression: In comparison with the study of ___ the left heart border is not as sharply seen. However, there is evidence of an opacification overlying the cardiac silhouette on the lateral view, and therefore no evidence of acute focal pneumonia. No cardiomegaly or vascular congestion or pleural effusion. A pacemaker is noted in the left chest region.","['Change location', 'Add contradiction', 'Add medical device']"
"84886842-304fe1cd-e55f7a58-185a5fe3-96e3a8eb, 908b9934-054b6fbb-1a8eddea-5b722b43-2f83d2fb",59932213,11925631,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seeen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process. A central venous line is present.,"['Add medical device', 'Add typo', 'False prediction']"
01064b50-d0d421d9-6fad1834-798ed6d8-d2ef01ac,51819903,11932181,"Findings: As compared to the previous radiograph, the patient has undergone left upper lobectomy.  The patient now displays typical signs of right upper lobe atelectasis with consolidation of the right upper lobe and deviation of the trachea to the right.  The left chest tube is in correct position.  There is no postoperative pneumothorax.  The postoperative rib defect is seen on the left.  Normal size of the cardiac silhouette.  No pleural effusions.  Mild overinflation of the stomach. ","Findings: As compared to the previous radiograph, the patient has undergone left upper lobectomy. The patient now displays typical signs of right upper lobe atelectasis with consolidation of the right upper lobe and deviation of the trachea to the right. The left chest tube is in correct position. No postoperative pneumothorax. No postoperative rib defect. Normal size of the cardiac silhouette. No pleural effusions. Moderate overinflation of the stomach.","['Change severity', 'Change to homophone', 'False negation']"
"6fafcd8d-67ac12fa-a3ce56a6-3557b61f-1fa1d58a, d593896e-25d268b0-0a8ededc-4a4c401c-c72b8357",52153858,11932181,"Findings: Frontal and lateral views of the chest were obtained.  The patient is status post left upper lobectomy with significant volume loss again seen on the left with suggestion of interval increase in volume loss as compared to the prior study.  No definite pleural effusion is seen.  In the visualized left lower lung field, there is a patchy opacity likely present on the prior study and most likely relates to underlying volume loss, although a superimposed infection is not entirely excluded.  The right lung is clear.  There is no pleural effusion or pneumothorax.  Cardiac and mediastinal silhouettes are grossly stable.  Surgical clips in the upper quadrant are from presumed prior cholecystectomy. Impression: Status post left upper lobectomy with left-sided volume loss which is increased as compared to the prior study.","Findings: Frontal and lateral views of the chest were obtained.  The patient is status post left upper lobectomy with significant volume loss again seen on the left with suggestion of interval increase in volume loss as compared to the prior study.  No definite pleural effusion is seen.  In the visualized left lower lung field, there is no opacity.  The right lung is clear.  There is no pleural effusion or pneumothorax.  Cardiac and mediastinal silhouettes are grossly stable.  Surgical sutures in the upper quadrant are from presumed prior cholecystectomy. Impression: Status post left upper lobectomy with left-sided volume loss which is increased as compared to the prior study.  There is no pleural effusion or pneumothorax.","['Change name of device', 'Add repetitions', 'False negation']"
"274d8805-bc393e4a-269a1f8a-ee42d1ae-e8959ff7, b89928d1-52232630-816e0948-e20d92e5-b0d906ab",52901971,11932181,"Findings: Frontal and lateral chest radiographs demonstrate a left chest tube, unchanged in position.  There is persistent right upper lobe atelectasis with collapse of the right upper lobe and rightward tracheal deviation.  The lungs are clear without focal consolidation or pulmonary edema.  There is no pneumothorax.  The cardiomediastinal silhouette is unchanged. Impression: Persistent right upper lobe collapse.","Findings: Frontal and lateral chest radiographs demonstrate a left chest tube, terminating in the mid thorax.  There is persistent right upper lobe atelectasis with collapse of the right upper lobe and rightward tracheal deviation.  No atelectasis.  The lungs are clear without focal consolidation or pulmonary edema.  There is no pneumothorax.  The cardiomediastinal silhouette is unchanged. Impression: Persistent right upper lobe collapse. No atelectasis.","['Change position of device', 'Add repetitions', 'False negation']"
"91310c64-f689bd9a-53a0bb24-83baba02-d33e0c78, a6bfecfe-281e20c1-3d9a3002-ebed7792-aa0c7f47",53058995,11932181,Findings: PA and lateral radiographs were acquired of the chest.  The lungs are clear.  The cardiac and mediastinal contours are normal.  There are no pleural effusions.  No pneumothorax is seen.  Bilateral degenerative changes of the acromioclavicular joints are noted. Impression: No acute cardiac or pulmonary process.,Findings: PA and lateral radiographs were acquired of the chest.  The lungs r clear.  The cardiac and mediastinal contours are normal.  There are no pleural effusions.  No pneumothorax is seen.  Bilateral degenerative changes of the costovertebral joints are noted.  An ET tube is present. Impression: No acute cardiac or pulmonary process.,"['Change location', 'Change to homophone', 'Add medical device']"
"2bcf27dd-d6846a19-17a50f81-e265b7ff-00892752, 6e7d1634-c7ec6214-ab2d08c7-5f964d50-7fcebc90",53371051,11932181,Findings: Frontal and lateral views of the chest.  There is volume loss in the left hemithorax with elevation of left hemidiaphragm and of the left hilum.  Findings are compatible with left upper lobectomy.  The lungs are clear.  The cardiomediastinal silhouette is within normal limits.  Deformity of the posterior left sixth rib is again seen. Impression: Postoperative changes of left upper lobectomy.  No superimposed acute cardiopulmonary process.,Findings: Frontal and lateral views of the chest.  There is volume loss in the left hemithorax with elevation of right hemidiaphragm and of the left hilum.  Findings are compatible with left upper lobectomy.  The lungs are hear.  The cardiomediastinal silhouette is within normal limits.  Deformity of the posterior left sixth rib is again seen.  An NG tube is present. Impression: Postoperative changes of left upper lobectomy.  No superimposed acute cardiopulmonary process.,"['Change location', 'Change to homophone', 'Add medical device']"
"3938b32d-934d824e-3e75f809-d61dd89f-ad22b1a3, 57eb3bc1-e545c54d-119c0054-14d0f8cd-7d46d994",53880874,11932181,Findings: The cardiomediastinal silhouettes are stable and within normal limits.  The hila are within normal limits. There is volume loss of the left upper lung.  The lungs are clear without focal consolidation. There is no pulmonary vascular congestion.  There is no pneumothorax or pleural effusion.  Deformity of the left posterior sixth rib is again noted. Impression: No acute cardiopulmonary process.,Findings: The cardiomediastinal silhouettes are stable and within normal limits. The hila are within normal limits. There is volume loss of the right upper lung. The lungs are clear without focal consolidation. Mild interstitial markings are noted bilaterally. There is no pneumothorax or pleural effusion. Deformity of the left posterior sixth rib is again noted. There is volume loss of the left upper lung. Impression: No acute cardiopulmonary process.,"['Change location', 'Add repetitions', 'False prediction']"
"533e10b2-a8dcfde7-b7e21125-3adb9a2b-ddfde194, 9e73fe4b-87d3e7cf-7daf5e9a-5ec42b51-6f1d44eb",54197091,11932181,"Impression: AP chest compared to ___:  There is still considerable volume loss in the postoperative left hemithorax, with no pneumothorax or appreciable pleural effusion.  Right lung is clear.  Heart is normal size.  Extent of left suprahilar atelectasis and elevation of the left hemidiaphragm unchanged.","Impression: AP chest compared to ___:  There is still considerable volume loss in the postoperative right hemithorax, with no pneumothorax or appreciable pleural effusion. Right lnug is clear. Heart is normal size. There is an NG tube in the stomach. Extent of left suprahilar atelectasis and elevation of the left hemidiaphragm unchanged.  ","['Change location', 'Add typo', 'Add medical device']"
4e25f2e7-4ab07975-e5a9f14c-acc20f75-9fa89750,54296756,11932181,"Findings: Compared to the study from earlier the same day, there is no significant interval change. ","Findings: Compared to the study from earlier the same day, there is no significant interval change. Compared to the study from earlier the same day, there is no significant interval change. A central venous line is present.","['Change severity', 'Add repetitions', 'Add medical device']"
"01426485-8678cd3e-09df30bc-44f2929a-dcae524c, 2e8f09c5-490b580f-3d8c66a1-baec541c-5a0c5908",54496719,11932181,"Findings: Frontal and lateral chest radiographs demonstrate a left chest tube in unchanged position and normal cardiomediastinal silhouette.  There has been interval re-expansion of the right upper lobe, with residual atelectasis adjacent to the fissure.  There is no focal consolidation or pleural effusion. There is a small left apical pneumothorax.  This pneumothorax is more obvious on today's exam and may be minimally bigger, but was likely present on prior radiograph. Impression: 1.  Small left apical pneumothorax.   2.  Interval re-expansion of the right upper lobe, with residual atelectasis adjacent to the fissure.   These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___,  ___ min after discovery.","Findings: Frontal and lateral chest radiographs demonstrate a right chest tube in unchanged position and normal cardiomediastinal silhouette. There has been interval re-expansion of the right upper lobe, with residual atelectasis adjacent to the fissure. There is no focal consolidation or pleural effusion. There is a small left apical pneumothorax. This pneumothorax is more obvious on today's exam and may be minimally bigger, but was likely present on prior radiograph. There is a large mass lesion in the left lower lobe. Impression: 1. Small left apical pneumothorax. 2. Interval re-expansion of the right upper lobe, with residual atelectasis adjacent to the fissure. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___, ___ min after discovery. There is a small left apical pneumothorax.","['Change location', 'Add repetitions', 'False prediction']"
9f4f2d43-83091dbe-aa72f47e-5d7d06a0-6512aa11,55109095,11932181,"Findings: There is a new left-sided chest tube with interval decrease in the left pleural effusion.  On this upright film, the chest tube tip is located high in the thorax, much higher than the majority of the fluid. Post-surgical lobectomy changes are again visualized.  There has been interval decrease in the left pneumothorax.  The right lung is clear. ","Findings: There is a new left-sided catheter with interval decrease in the left pleural effusion.  On this upright film, the chest tube tip is located high in the thorax, much higher than the majority of the fliud. Post-surgical lobectomy changes are again visualized.  No left pneumothorax.  The rigth lung is clear.  ","['Change name of device', 'Add typo', 'False negation']"
"8ddb63f4-106e50f8-38f5b05c-d7f17419-6515de90, c7a2c5af-3b1a64a5-470827fe-ad59bec3-82fa5c9f",55112740,11932181,"Findings: Frontal and lateral chest radiograph again demonstrate a normal cardiomediastinal silhouette and a re-expanded right upper lobe with slight improvement of residual atelectasis adjacent to the fissure.  The left apical pneumothorax is likely unchanged.  Minimal increase may be secondary to changes in patient position.  There is no right pneumothorax.  Again seen are bilateral pleural effusions, the right effusion similar to slightly decreased and the left effusion increased.  There is no focal consolidation. Impression: 1.  Likely unchanged small left apical pneumothorax.   2.  Increased left pleural effusion.  Unchanged to slightly decreased right pleural effusion.   3.  Redemonstration of a re-expanded right upper lobe with slight improvement of residual atelectasis adjacent to the fissure.","Findings: Frontal and lateral chest radiograph again demonstrate a normal cardiomediastinal silhouette and a re-expanded left upper lobe with slight improvement of residual atelectasis adjacent to the fissure.  The left apical pneumothorax is likely unchanged.  Minimal increase may be secondary to changes in patient position.  There is no right pneumothorax.  Again seen are bilateral pleural effusions, the right effusion similar to slightly decreased and the left effusion increased.  There is no focal consolidation. There is moderate cardiomegaly. Impression: 1.  Likely unchanged small left apical pneumothorax.   2.  Increased left pleural effusion.  Unchanged to slightly decreased right pleural effusion.   3. Redemonstration of a re-expanded right upper lobe with slight improvement of residual atelectasis adjacent to the fissure. ","['Change location', 'Add repetitions', 'False prediction']"
e5058ddc-12914e19-41492f3b-9016f745-4333ebfe,55349973,11932181,Findings: AP portable single view of the chest shows stable left lung base opacity due to moderate pleural effusion and left lower lobe atelectasis.  Left pleural drain is unchanged.  Right lung is clear.  The cardiomediastinal silhouette is normal.  There is a small left apical pneumothorax. ,Findings: AP portable single view of the chest shows stable left lung base opacity due to moderate pleural effusion and left lower lobe atelectasis.  Left pleural drain terminates in the mid thoracic cavity.  Right lung reveals diffuse haziness.  The cardiomediastinal silhouette is normal.  There is a complete left apical pneumothorax.  ,"['Change position of device', 'Add contradiction', 'False prediction']"
d82e22a0-b3ce3eec-22bf56ae-9a1fca51-556da100,55392606,11932181,Findings: Left chest tube is again seen.  There is moderate left effusion is slightly larger than on the study from the prior day.  There is pulmonary vascular redistribution and mild cardiomegaly compatible with fluid overload. ,Findings: Left chest tube is seen terminating in the lower thoracic cavity.  There is no effusion present.  There is pulmonary vascular redistribution and mild cardiomegaly compatible with flew'd overload.  ,"['Change position of device', 'Change to homophone', 'False negation']"
"7875fcba-da8aa12e-d091f393-527e729b-65c7d344, 8894a073-a8fc7130-d4c16a1a-200a8663-2f3577f8",55708104,11932181,"Findings: Portable semi-upright radiograph of the chest demonstrates well-expanded, clear lungs.  There is a curvilinear structure in the upper left hemithorax which may represent the  pleural surface, but vessels are seen extending superior to this line, making pneumothorax unlikely.  Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion.  Again seen is a nodular opacity in the left upper lung, consistent with area of biopsy today. Impression: Left apical curvilinear structure may represent pleural surface, but vessels are seen coursing superior to this structure, making pneumothorax unlikely.","Findings: Portable semi-upright radiograph of the chest demonstrates well-expanded, clear lobes in the upper right lung.  There is a curvilinear structure in the upper left hemithorax which may represent the pleural surface, but vessels are seen extending superior to this line, making pneumothorax unlikely.  Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion.  Again seen is a nodular opacity in the left upper lung, consistent with area of biopsy today. Impression: Left apical curvilinear structure may represent pleural surface, but there are nodular dense opacities making pneumothorax likely.  In addition, there is a central venous line in position.","['Change location', 'Add contradiction', 'Add medical device']"
"9244882d-c90352d9-806e731d-e028242b-a619a04c, eab0888d-6b3b2814-4f0e59da-6f0c9408-d4cab1b0",55935470,11932181,"Findings: PA and lateral images of the chest shows stable left lung asymmetry due to left upper lobectomy, the left lung base opacity is minimally improved since ___  due to increased lung ventilation.  There is no pneumothorax.  Cardiomediastinal silhouette is normal.  The posterior left chest wall osteotomy is due to thoracotomy. Impression: Stable left lung asymmetry in a patient who has had left upper lobectomy and thoracotomy.  Improvement of left lung base opacity with improved lung ventilation.","Findings: PA and medial images of the chest shows stable left lung asymmetry due to left upper lobectomy, the left lung base opacity is minimally improved since ___ due to increased lung ventilation. Their is no pneumothorax. Cardiomediastinal silhouette is normal. The posterior right chest wall osteotomy is due to thoracotomy. There is the presence of a central venous line. Impression: Stable right lung asymmetry in a patient who has had left upper lobectomy and thoracotomy. Improvement of left lung base opacity with improved lung ventilation.","['Change location', 'Change to homophone', 'Add medical device']"
397e0897-311459aa-55923dc8-b8d44d58-0a3db1a0,56531569,11932181,Impression: Very small left apical and lateral pneumothorax unchanged since earlier in the day following removal of the left pleural drain.  Very small left pleural effusion has begun to reaccumulate.  The right hemithorax segmental atelectasis adjacent to the minor fissure is stable.  Right lung otherwise clear.  No right pneumothorax.  Tiny right pleural effusion is collected posteriorly.  Heart size normal.  Mediastinal contour is unremarkable.,Impression: Very small left apical and lateral pneumothorax unchanged since earlier in the day following removal of the left pleural catheter.  Very small left pleural effusion has begun to reaccumulate.  The right hemithorax segmental atelectasis adjacent to the minor fissure is stable.  Right lung otherwise clear.  No right pneumothorax.  Tiny right pleural effusion is collected posteriorly.  Heart size normal.  Mediastinal contour is unremarkable.  Left-sided central venous line is noted with its tip in the right atrium.  Very small left pleural effusion has begun to reaccumulate.  ,"['Change name of device', 'Add repetitions', 'Add medical device']"
"83422dab-e3015272-fbf3df24-eb9e1d65-1da5c1dc, 9b4edb71-42dc3068-0b5afbd8-6d1b2b45-34e992a3",59234160,11932181,"Findings: Frontal and lateral views of the chest were obtained.  Increased left basilar opacity has significantly increased likely large left pleural effusion with overlying atelectasis.  Small left pneumothorax persists.  Prominence of the left hilum may relate to left-sided pleural fluid; however, underlying lymphadenopathy or consolidation is not excluded.  Left aspect of the cardiac silhouette is not well assessed due to the left basilar consolidation; however, the remainder of the cardiac and mediastinal silhouettes are grossly stable. Impression: Left hydropneumothorax.  Significant interval increase in left basilar opacity, likely left pleural effusion with overlying atelectasis, underlying consolidation not excluded.  Left perihilar opacity may relate to the above findings.  However, underlying lymphadenopathy or additional consolidation is not excluded.  Air-fluid level seen in the left upper hemithorax, which appears longer in the frontal view than on the lateral view can be seen in bronchopleural fistula.","Findings: Frontal and lateral views of the chest were obtained.  Mild left basilar opacity has significantly increased likely large left pleural effusion with overlying atelectasis.  No left pneumothorax persists.  Prominence of the left hilum may relate to left-sided pleural fluid; however, underlying lymphadenopathy or consolidation is not excluded.  Left aspect of the cardiac silhouette is not well assessed due to the left basilar consolidation; however, the remainder of the cardiac and mediastinal silhouettes are grossly stable. Impression: Left hydropneumothorax.  Significant interval decrease in left basilar opacity, likely left pleural effusion with overlying atelectasis, underlying consolidation not excluded.  No left perihilar opacity may relate to the above findings.  However, underlying lymphadenopathy or additional consolidation is not excluded.  Air-fluid level seen in the left upper hemithorax, which appears longer in the frontal view than on the lateral view can be seen in bronchopleural fistula.","['Change severity', 'Add contradiction', 'False negation']"
"666f0409-83c99213-aec854ff-03da11ef-e191743c, d190c814-1c8598f7-9097eae2-3fa18869-4c3939f0",57818787,11941487,"Findings: AP and lateral views of the chest.  The lungs are clear without focal consolidation, large effusion, or pulmonary vascular congestion.  The cardiomediastinal silhouette is within normal limits for technique.  No acute osseous abnormality is identified. Impression: No acute cardiopulmonary process.","Findings: AP and lateral views of the chest.  The lungs are clear without focal consolidation, large effusion, or pulmonary wascular congestion.  The cardiomediastinal silhouette is within normal limits for technique.  Right-sided pleural effusion is noted. Impression: No acute cardiopulmonary process.","['Change severity', 'Add typo', 'False prediction']"
"1e26851f-86034c0c-3c1b4167-5d391b8b-e57ddc3c, a30106ce-242ee50e-4ce16bef-83e94bda-ce490f7d",50901945,11952678,"Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  The lungs are clear.  Small anterior osteophytes are similar along the mid thoracic spine.  One  finding that is different since ___ is a small ossification interposed between the coracoid process of the left scapula and the nearby clavicle, which may be post-traumatic, but does not appear to represent an acute finding. Impression: No evidence of acute disease.","Findings: The heart is normal in zise.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  The lungs are clear except for moderate scattered nodules.  Large anterior osteophytes are similar along the mid thoracic spine.  One  finding that is different since ___ is a small ossification interposed between the coracoid process of the left scapula and the nearby clavicle, which may be post-traumatic, but does not appear to represent an acute finding. Impression: No evidence of acute disease.","['Change severity', 'Add typo', 'False prediction']"
"0c29ea1e-848c7739-b7f4844c-aac23b7c-cd7ec5f4, 41d5a498-07091ca9-2cd74297-047f091c-c2d1cd58",52887996,11989878,"Impression: Previous marked postoperative widening of the cardiomediastinal silhouette has improved. Moderate left pleural effusion has redistributed, now probably loculated and partially fissural.  Moderate bibasilar atelectasis has improved.  No pneumothorax or pulmonary edema.  Right jugular line ends in the low SVC.","Impression: Previous marked postoperative widening of the cardiomediastinal silhouette has improved. Moderate left pleural effusion has redistributed, now probably loculated and partially fissural. Mild bibasilar atelectasis has improved. No pneumothorax or pulmonary edema. Right jugular lin ends in the low SVC.","['Change severity', 'Add typo', 'False negation']"
1a210276-bc14011e-b4575d45-690d73e9-5a5f4b36,54526426,11989878,"Impression: ET tube and midline and pleural drains have been removed.  Left lower lobe collapse has worsened accompanied by increasing moderate left pleural effusion.  Cardiomediastinal silhouette is slightly wider, including mediastinal vascular engorgement.  There is no pneumothorax or pulmonary edema.  Moderate right basal atelectasis is unchanged.  Right jugular line ends in the low SVC.","Impression: ET tube and midline and pleural drains have been removed.  There is streaky opacity in the right lung apex.  Left lower lobe collapse has worsened accompanied by increasing moderate left pleural effusion.  Cardiomediastinal silhouette is slightly wider, including mediastinal vascular engorgement.  There is no pneumothorax or pulmonary edema.  Moderate right basal atelectasis is unchanged.  Right jugular line ends in the mid SVC.  Moderate right basal atelectasis is unchanged. ","['Change position of device', 'Add repetitions', 'False prediction']"
"6caed164-11e024ad-5d6bb57a-9bf52ee3-2ca67ded, ac093f50-68e5995f-7d538f77-146f8bc4-7f6bd8a2",55750309,11989878,Findings: Mild bibasilar atelectasis without definite focal consolidation seen.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.  No pulmonary edema is seen Impression: Mild basilar atelectasis without definite focal consolidation.,Findings: Moderate bibasilar atelectasis without definite focal consolidation scene. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal sillhouettes are stable. No pulmonary edema is seen Impression: No basilar atelectasis.,"['Change severity', 'Change to homophone', 'False negation']"
218d1c93-0e3c7a85-76dca3b3-1b9ebcc9-e2b4c42d,50120531,12056668,"Impression: Left basilar thoracostomy tube, with interval decrease of a moderate left effusion. Worsening right basilar atelectasis and right effusion.","Impression: Right basilar thoracostomy tube, with interval decrease of a moderate left effusion. Worsening right basilar atelectasis and right effusion. Left basilar atelectasis.","['Change location', 'Add contradiction', 'Add medical device']"
e63e4411-eb57a2b9-50bb9ef0-8f980310-c7fd6f0f,50674125,12056668,"Findings: In comparison with study of earlier in this date, there has been placement of a right pigtail catheter at the base with some decrease in the degree of pleural effusion.  Opacification at the right base is consistent with persistent volume loss in the lower right lung and residual fluid.  Large left pleural effusion persists. ","Findings: In comparison with study of earlier in this date, there has been placement of a right pigtail catheter at the apex with some decrease in the degree of pleural effusion.  Cleaner at the right base is consistent with persistent volume loss in the lower right lung and residual fluid.  No pleural effusion noted.","['Change position of device', 'Change to homophone', 'False negation']"
052e448b-2164ba7d-2a1a5625-94f5bdc2-34f732ab,52167064,12056668,Findings: Portable chest radiograph demonstrates slightly increased large bilateral pleural effusions.  Evaluation of the cardiomediastinal and hilar silhouettes is very limited due to pleural effusions but appears grossly unchanged.  No focal opacification concerning for pneumonia identified. Impression: Slight increase in large bilateral pleural effusions.,Findings: Portable chest radiograph demonstrates slightly increased large bilateral pleural effuisons.  Evaluation of the cardiomediastinal and hilar silhouettes is very limited due to pleural effusions but appears grossly unchanged.  No focal opacification concerning for pneumonia identified.  Presence of a central venous lien. Impression: Slight increase in small bilateral pleural effusions.,"['Change severity', 'Add typo', 'Add medical device']"
4861b3fb-a6f7f90a-54624d89-31cc606f-beab81a7,53195010,12056668,"Findings: In comparison with study of ___, there is again large left pleural effusion and a much smaller right pleural effusion with pigtail catheter in place.  Bibasilar compressive atelectasis.  In the absence of a lateral view, the possibility of supervening pneumonia, especially at the left base, cannot be excluded.  No evidence of vascular congestion. ","Findings: In comparison with study of ___, there is again large left pleural effusion and a much smaller right pleural effusion with chest tube in place.  Bibasilar compressive atelectasis.  The lungs show mild interstitial markings suggesting early fibrosis.  In the absence of a lateral view, the possibility of supervening pneumonia, especially at the left base, cannot be excluded.  No evidence of vascular congestion.  No evidence of vascular congestion. ","['Change name of device', 'Add repetitions', 'False prediction']"
23a5cd3b-6bb29875-b1984d7c-7987bdb4-cff71cef,54161539,12056668,"Findings: As compared to the previous radiograph, the monitoring and support devices are unchanged.  Unchanged bilateral pleural effusions, with a tendency to increase, and resultant areas of atelectasis.  The air collection in the bilateral soft tissues is slightly decreased.  Unchanged right PICC line.  No definite evidence of pneumothorax. ","Findings: As compared to the previous radiograph, the monitoring and support devices ore unchanged.  Unchanged bilateral pleural effusions, with a tendency to increase, and resultant areas of atelectasis.  The air collection in the bilateral soft tissues is slightly decreased.  Unchanged right PICC line terminating in the mid SVC.  No definite evidence of pneumothorax.  A nasogastric tube is seen terminating in the stomach.","['Change position of device', 'Change to homophone', 'Add medical device']"
"3c021d64-a606521a-b5070291-5ec59830-23aad4a7, 3f89e108-89fa407d-26628871-8e8731be-02819429",55757032,12056668,"Findings: AP and lateral views of the chest are compared to previous exam from ___.  When compared to prior, there has been no significant interval change in the size of the bilateral pleural effusions.  There is no significant pulmonary vascular engorgement.  Cardiac silhouette is grossly unchanged but limited due to bibasilar abnormalities.  Hypertrophic changes are again seen in the spine.  G-tube not clearly identified.  No free air identified below the diaphragm. Impression: Moderate bilateral pleural effusions, not significantly changed from prior.  No free air below the diaphragm.","Findings: AP and lateral views of the chest are compared to previous exam from ___.  When compared to prior, there has not been any significant interval change in the size of the bilateral pleural effusions.  Their is no significant pulmonary vascular engorgement.  Cardiac silhouette is grossly unchanged but limited due to bibasilar abnormalities.  Hypertrophic changes are again scene in the spine.  G-tube not clearly terminating in the stomach.  No free air identified below the diaphragm. Impression: no pleural effusions.  No free air below the diaphragm.","['Change position of device', 'Change to homophone', 'False negation']"
c85fee28-66bb150d-3b065b0a-102fe76b-cbe662b0,58168751,12056668,"Findings: AP single view of the chest was obtained with patient in semi-upright position.  Comparison is made with the next preceding similar study of ___.  In the interval, the right-sided pigtail end drainage catheter in the lower pleural space has been removed.  Aeration of the lung is unchanged and no evidence of increasing pleural effusion is present.  Again, however, a small up to 2 cm wide apical pneumothorax cavity persists.  No other new abnormalities.  Left-sided pleural effusion persists and is seen to extend in the posterior pleural space as well as identified on a lateral view in sitting position. ","Findings: AP single view of the chest was obtained with patient in semi-upright position.  Comparison is made with the next preceding similar study of ___.  In the interval, the right-sided pigtail end drainage catheter in the lower pleural space has been removed.  Aeration of the lung is unchanged and no evidence of increasing pleural effusion is present.  Aeration of the lung is unchanged and no evidence of increasing pleural effusion is present. However, a small up to 2 mm wide apical pneumothorax cavity persists.  No other new abnormalities.  Left-sided pleural effusion persists and is seen to extend in the posterior pleural space as well as identified on a lateral view in sitting position. A central venous line is also present. ","['Change measurement', 'Add repetitions', 'Add medical device']"
0bf4ce04-1a1975cb-30d2e4c3-72803b59-f383d941,59247330,12056668,"Impression: 1.  Endotracheal tube has its tip 5 cm above the carina.  Right subclavian PICC line continues to have its tip in the mid SVC.  There has been interval appearance of extensive subcutaneous emphysema.  There continues to be elevation of the left hemidiaphragm with lucency beneath it likely corresponding to distended bowel.  No definite pneumothorax is seen on this supine film, although the sensitivity to detect a pneumothorax is diminished given supine technique.  There are likely small layering effusions and bibasilar patchy opacity which may reflect partial lower lobe atelectasis.  Followup imaging in the upright or semi-erect position may be helpful to exclude an underlying pneumothorax.  No pulmonary edema.","Impression: 1.  Endotracheal tube has its tip 4 cm above the carina.  Write subclavian PICC line continues to have its tip in the mid SVC.  There has been interval appearance of extensive subcutaneous emphysema.  No elevation of the hemidiaphragm is seen.  No definite pneumothorax is seen on this supine film, although the sensitivity to detect a pneumothorax is diminished given supine technique.  There are likely small layering effusions and bibasilar patchy opacity which may reflect partial lower lobe atelectasis.  Followup imaging in the upright or semi-erect position may be helpful to exclude an underlying pneumothorax.  No pulmonary edema.","['Change measurement', 'Change to homophone', 'False negation']"
"3bf027ad-4ea50807-05aa327c-3b30394d-7aa6759b, d57952c1-89986306-f483eb47-8dc115ff-36d4fb7b",59819600,12056668,"Impression: AP chest compared to ___:  Large bilateral pleural effusions and moderate enlargement of the cardiac silhouette are continuing to increase.  It could be a pericardial effusion.  Moderate pulmonary edema is exaggerated by low lung volumes, but also worsened.  No pneumothorax.  Right PIC line follows a course consistent with either the right internal mammary vein or upper right atrium.","Impression: AP chest compared to ___: Large bilateral pleural effusions and moderate enlargement of the cardiac silhouette are continuing to increase. It could bee a pericardial effusion. Mild pulmonary edema is exaggerated by low lung volumes, but also worsened. No pneumothorax. Right PIC line follows a course consistent with either the right internal mammary vein or upper right atrium.","['Change severity', 'Change to homophone', 'False negation']"
daa9c2a1-691a861b-e52b5481-7f9bdd7b-7620fca2,52313236,12085050,Findings: Overlying trauma board limits assessment.  Heart size is normal.  Mediastinal and hilar contours are unremarkable.  There is minimal calcification of the aortic knob.  Pulmonary vascularity is normal and the lungs are grossly clear. No pleural effusion or pneumothorax is seen on this supine exam.  Eventration of the right hemidiaphragm is present.  Multilevel degenerative changes are noted in the thoracic spine.  Marked degenerative changes of both glenohumeral joints are also noted.  No acute osseous abnormalities are seen. Impression: No acute cardiopulmonary abnormality.,"Findings: Overlying trauma board limits assessment. Heart size is normal. Mediastinal and hilar contours are unremarkable. There is minimal calcification of the aortic knob. Pulmonary vascularity is normal and the lungs are grossly clear. There is no pleural effusion, but a left-sided pneumothorax is noted on this supine exam. Eventration of the left hemidiaphragm is present. Multilevel degenerative changes are noted in the cervical spine. Marked degenerative changes of both glenohumeral joints are also noted. No acute fleshy abnormalities are seen. Impression: Bilateral lower lung atelectasis.","['Change location', 'Change to homophone', 'False prediction']"
"54e21088-65a35336-172f8890-a611790f-e6557f83, 6df82632-348a13df-d696e9ad-1f33b79e-86525aab",59125943,12183320,"Findings: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax.  The cardiomediastinal silhouette is normal.  Bony structures are intact.  There is no free air below the right hemidiaphragm. Impression: No acute intrathoracic process.","Findings: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax.  The cardiomediastinal silhouette is abnormal.  Bony structures are not intact.  There is no free air below the right hemidiaphragm. Impression: No acute intrathoracic process.  The left cardiomediastinal silhouette is normal. There is free air below the left hemidiaphragm. ","['Change location', 'Add contradiction', 'False negation']"
4f22a5c8-9c123a46-7ddaa379-f478d129-ebfe7617,51336149,12184969,"Findings: In comparison with study of ___, there is no change or evidence of acute cardiopulmonary disease.  No pneumonia, vascular congestion, or pleural effusion.  As on the previous study, there is mild hyperexpansion of the lungs, raising the possibility of some underlying chronic pulmonary disease. ","Findings: In comparison with study of ___, there is no change or evidence of acute cardiopulmonary disease.  No pneumonia, vascular congestion, or pleural effusion.  As on the previous study, there is moderate hyperexpansion of the lungs, raising the possibility of some underlying chronic pulmonary disease.  There is slight vascular congestion indicated.","['Change severity', 'Add contradiction', 'False negation']"
"bab86a42-05db59f4-454c02e1-0bbe3f31-9cdc1707, dbaeebd4-8edab08d-1bac4c08-b70ae703-e338d747",57098023,12184969,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  No pulmonary edema is seen. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  No pulmonary edema is seen.  The lungs are clear without focal consolidation. Impression: No acute cardiopulmonary process.  Mild pulmonary edema is seen.,"['Add repetitions', 'Add contradiction', 'False prediction']"
"5f911953-51eaaa8a-320221e3-a2cf095f-044ba357, b60f7b52-7c9856fa-65e8bf8a-92264fda-4be20437",54260087,12186603,Findings: AP and lateral views of the chest.  The lungs are clear.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormality detected. Impression: No acute cardiopulmonary process.,Findings: AP and lateral views of the abdomen.  The lungs are cleer.  Cardiomediastinal silhouette is within normal limits. Pacemaker is visible within the chest. No acute osseous abnormality detected. Impression: No acute cardiopulmonary process.,"['Change location', 'Add typo', 'Add medical device']"
2183d638-8f431548-7221c970-340325e1-fae35262,55600141,12216053,"Findings: As compared to the previous radiograph, there is no relevant change.  Moderate cardiomegaly without overt pulmonary edema.  No pleural effusions, no interstitial abnormalities, in particular non-suggestive of chronic fluid overload.  The hilar and mediastinal structures are unremarkable.  No evidence of pneumonia. ","Findings: As compared to the previous radiograph, there is no relative change.  Mild cardiomegaly without overt pulmonary edema.  No pleural effusions, no interstitial abnormalities, in particular non-suggestive of chronic fluid overload.  A small left-sided pneumothorax is noted.  The hilar and mediastinal structures are unremarkable.  No evidence of masses.  ","['Change severity', 'Change to homophone', 'False prediction']"
"7abed310-5c7341f5-b74d2b26-7880d896-1cd5cff0, a07cee97-c744e578-dad89348-abe3886b-efe599ee",51337781,12273883,"Findings: Subtle opacity is seen projecting over the lateral right mid lung which may be due to overlap of structures, but underlying pulmonary opacity is not excluded.  The lungs are relatively hyperinflated, suggesting chronic obstructive pulmonary disease.  Minimal left base atelectasis is seen.  There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.  No displaced rib fracture is definitively identified. However, if clinical concern persists, dedicated rib series or chest CT is more sensitive. Impression: Subtle opacity projecting over the lateral right mid lung may be due to overlap of structures, but underlying pulmonary opacity or even rib fracture is not excluded.  Findings could be further assessed with shallow oblique radiographs or chest CT.  No displaced rib fracture definitively identified. However, if clinical concern persists, dedicated rib series or chest CT is more sensitive.","Findings: Subtle opacity is seen projecting over the lateral right mid lung which may be due to overlap of structures, but underlying pulmonary opacity is not excluded. The lungs are moderately hyperinflated, suggesting chronic obstructive pulmonary disease. Minimal left base atelectasis is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable, with a pacemaker in place. No displaced rib fracture is definitively identified. However, if clinical concern persists, dedicated rib series or chest CT is more sensitive. However, if clinical concern persists, dedicated rib series or chest CT is more sensitive. ","['Change severity', 'Add repetitions', 'Add medical device']"
e4527afd-9522899b-f0226c68-901dccb8-e2d4eff4,53211019,12326452,"Findings: Compared to most recent prior exam, mild pulmonary edema has improved.  Lung volumes are improved with minimal bibasilar atelectasis.  No focal consolidation, pleural effusion, or pneumothorax is detected.  There has been interval extubation.  Right internal jugular catheter is in similar position with tip projecting at the level of the cavoatrial junction. Impression: Interval extubation and improved interstitial edema.","Findings: Compared to mnot recent prior exam, moderate pulmonary edema has improved.  Lung volumes are improved with minimal bibasilar atelectasis.  No focal consolidation, pleural effusion, or pneumothorax is detected.  There has been interval extubation.  No right internal jugular catheter is seen. Impression: Interval extubation and improved interstitial edema.","['Change severity', 'Add typo', 'False negation']"
"162fc277-cbb73b5c-ce81e596-2975a3c2-428c8a21, 53286e62-dc9dc056-5c468ac4-8d4b9a0d-747d77cd",50866812,12329950,"Findings: AP and lateral views of the chest were obtained.  There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax.  The cardiomediastinal and hilar contours are unremarkable.  There is no bony abnormality. Impression: No acute cardiopulmonary process.","Findings: AP and medial views of the chest were obtained.  Their is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax.  The cardiomediastinal and hilar contours are unremarkable.  There is no bony abnormality. Impression: No acute cardiopulmonary process.","['Change location', 'Change to homophone', 'False negation']"
371535d2-66f5cbc5-b9d8abfd-fadeca21-81b0e4a8,53383140,12329950,"Findings: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease.  No pneumonia, vascular congestion, or pleural effusion. ","Findings: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. The patient has an NG tube in place. No pneumonia, vascular congeston, or pleural effusion. In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease.","['Add repetitions', 'Add typo', 'Add medical device']"
6cc81092-d60dc980-f5c8dd41-cc44c43d-09b45cbf,57495790,12329950,"Findings: Single portable view of the chest.  Lower lung volumes seen on the current exam.  Patchy region of opacity identified at the left lung base.  Elsewhere, the lungs are clear.  The cardiomediastinal silhouette is within normal limits.  Tortuosity of the descending thoracic aorta is noted.  Partially visualized apparently chronic deformity of the proximal right humerus is also seen. Impression: Left basilar opacity could be due to atelectasis, although infection cannot be entirely excluded and please correlate clinically.  Otherwise, no acute cardiopulmonary process.  If desired, PA and lateral could be obtained to further characterize.","Findings: Single portable view of the chest.  Lower lung volumes seen on the current exam.  No opacity identified.  Elsewhere, the lungs are clear.  The cardiomediastinal silhouette is within normal limits.  Tortuosity of the ascending thoracic aorta is noted.  Partially visualized apparently chronic deformity of the proximal left humerus is also seen. Impression: There is a clear region in the left basilar area. Otherwise, no acute cardiopulmonary process.  If desired, PA and lateral could be obtained to further characterize.","['Change location', 'Add contradiction', 'False negation']"
"3ae2087f-a1f7a91f-91aa746d-514ea044-0864768e, 84a7d191-154e6207-cabc5be2-201fd84f-0140db07",54341807,12365242,"Impression: Respiratory effort, but likely no acute lung process.  Minimal left costophrenic sulcus is seen and minimal congestive changes are not excluded.  Incidentally noted are multiple distended loops of likely colon.  Please correlate clinically.","Impression: Respiratory effort, but likely no acute lung process. Minimal left costophrenic sulcus is seen and moderate congestive changes are not excluded. No distended loops of colon noted. Please correlate clinically.","['Change severity', 'Add contradiction', 'False negation']"
"25118890-fc44b48b-8e3d2980-31cb3356-13527ea4, c58bc070-f7ebbe78-118de371-eb210cc8-fa6d8df7",53550262,12371823,Findings: The lungs are clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities identified.  Height loss of several mid thoracic vertebral bodies is unchanged from prior. Impression: No acute cardiopulmonary process.,Findings: The lungs are cleer.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities idtentified.  Height loss of several lower thoracic vertebral bodies is unchanged from prior. Impression: No acute cardiopulmonary process.  A pacemaker is present.,"['Change location', 'Add typo', 'Add medical device']"
f8e30069-9a0af2ef-8f97a61a-6081a0f9-043dbf76,54768912,12386201,Impression: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pulmonary edema. No pleural effusions. Borderline size of the cardiac silhouette. Elongation of the descending aorta.,Impression: The lung volumes are normal. No devices are present. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pulmonary edema. No pleural effusions. Borderline size of the cardiac silhouette. No abnormalities in the descending aorta.,"['Add medical device', 'Add repetitions', 'False negation']"
"03b9e3ff-c40f29c1-615fb8e6-0216fe58-613d5825, 064e926b-28021384-d5cb542c-d54a9c5e-691c53eb",51553781,12388581,"Findings: Patient is rotated to the left.  The lungs are clear without focal consolidation, effusion, or pneumothorax.  There is likely at least mild cardiomegaly although evaluation is limited due to patient positioning.  There is no visualized pneumomediastinum.  Right humeral head orthopedic hardware is identified. Impression: Cardiomegaly without definite superimposed acute cardiopulmonary process.",Findings: Patient is rotated to the left.  The lungs show patchy consolidation with an area of focal opacity.  There is likely at least severe cardiomegaly although evaluation is limited due to patient positioning.  There is no visualized pneumomediastinum.  Right humeral head orthopedic hardware is identified.  Central venous line is present. Impression: Cardiomegaly without definite superimposed acute cardiopulmonary process.  No cardiomegaly observed.,"['Change severity', 'Add contradiction', 'Add medical device']"
"87d03f53-dd1465e8-d596008b-79e71d28-8211447b, df851e66-1968ad73-dcc1849a-1cabdfab-cedd0bf1",53379950,12390084,Findings: The cardiomediastinal silhouettes are within normal limits. The bilateral hila are unremarkable. There is no pulmonary vascular congestion. There is no focal lung consolidation. There is no pneumothorax or pleural effusion. Impression: No evidence of acute cardiopulmonary process.,Findings: The cardiomediastinal silhouettes are within normal limits. The right hila are unremarkable. There is no pulmonary vascular congestion. There is no focal lung consolidation. There is no pneumothorax or pleural effusion. There is no focal lung consolidation. Impression: No evidence of acute cardiopulmonary process. A left-sided pacemaker is present.,"['Change location', 'Add repetitions', 'Add medical device']"
"0031401d-0506c0cc-964f493e-c7e40618-2047871e, 881e3b6a-b2732a0c-70171a86-1151699e-8fceefe0",55900756,12424405,"Findings: The lungs are well inflated and clear.  The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal.  There is no pleural effusion or pneumothorax. Impression: No acute cardiopulmonary process.","Findings: The lungs are well inflated and cclear.  The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal.  There is no pleural effusion or pneumothorax. There is no pleural effusion or pneumothorax. A pacemaker is present.  Impression: No acute cardiopulmonary process.","['Add repetitions', 'Add typo', 'Add medical device']"
"17fae21b-681fe7f9-de27ec0b-232f4842-b13d94e9, 5ff8860b-fc277b55-da194e4b-22a5190d-6e95a1aa",57011996,12458098,Impression: No acute cardiopulmonary pathology.,Impression: Now acute cardiopulmonary pathology. There is a central venous line present.,"['Add typo', 'Add repetitions', 'Add medical device']"
"16238d89-58968b0f-5673acd0-1ebef29e-4d339d87, c3a1b629-9780bce6-f4039fd1-f3db7c19-55bbcdb7",51389473,12502618,Findings: Sternal wires are intact except for the inferior most wire.  Heart size is normal.  The lungs are clear and there is no pleural effusion or pneumothorax. Aortic valve replacement is noted.  Central venous stent is noted. Impression: No acute cardiopulmonary process.,Findings: Sternal wires are intact except for the inferior most wire. Heart size is normal. The lungs are clear and there is no pleural effusion or pneumothorax. Pacemaker leads are noted. Central venous dialyzer is noted. Impression: Mild pulmonary edema.,"['Change name of device', 'Add contradiction', 'Add medical device']"
"a8b640d1-c3a81570-baa9d963-cdaa8622-dfb59aa2, e965c6fd-c7c9ed8a-313a8d01-e2761616-b0dda288",51872919,12502618,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable.  The patient is status post median sternotomy.  Vascular stenting appears stable in position. Impression: No acute cardiopulmonary process.  No significant interval change.,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable.  The patient is status post median sternotomy.  Vascular stenting appears stable in position.  The patient is status post median sternotomy. Impression: Mild acute cardiopulmonary process.  No significant interval change.  Minimal right pleural effusion is noted.,"['Change severity', 'Add repetitions', 'False prediction']"
"00c5e8ac-78438bb0-ce44b225-9f9b777a-cb4e468e, f77f2651-184cccdb-7914e653-346dbc48-025f042c",52919818,12502618,"Findings: PA and lateral views of the chest provided. Midline sternotomy wires again noted. There is no focal consolidation, effusion, or pneumothorax. The heart remains mildly enlarged.  Mediastinal contour is stable.  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 provived. Midline sternotomy wires again noted.  There is no focal consolidation, effusion, or pneumothorax. The heart remains mildly enlarged.  Mediastinal contour is stable.  Imaged osseous structures are intact. No free air below the lef hemidiaphragm is seen. Impression: No acute intrathoracic process. A central venous line is present.","['Change location', 'Add typo', 'Add medical device']"
"4350f64d-aeb8882b-534177fb-fd203cf0-30c10a19, e8097fd2-6a5694a1-70f737f9-5d60b4b4-582fa652",53914388,12502618,"Findings: As compared to the previous radiograph, there is no relevant change.  The alignment of the sternal wires is constant.  No change in position.  Normal appearance of the lung parenchyma.  No pneumothorax.  No pleural effusions.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal contours. ","Findings: As compared to the previous radiograph, there is no relevant change.  The alignment of the sternal wires is constant.  There is increased opacity in the right upper lobe.  Normal appearance of the lung parenchyma.  No pneumothorax.  No pleural effusions. A pacemaker is seen in the left chest.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal contours. ","['Add contradiction', 'Add repetitions', 'Add medical device']"
"1d4d38ca-ca23a788-10bb00aa-f4d15995-4fa7389c, cfdff70b-bac19d1e-01b71598-af4a73bc-345ae344",55381986,12502618,"Findings: The patient is status post aortic valve replacement and left subclavian vein stent placement.  There is a fracture through the inferior-most sternotomy wire, which is unchanged since ___.  Otherwise, the remaining sternotomy wires are intact and appropriately aligned.  There is stable enlargement of the cardiomediastinal silhouette.  Lungs are well-expanded and clear.  The pulmonary vasculature is normal.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.","Findings: The patient is status post aortic valve replacement and left subclavian vein stent placement.  There is a fracture through the inferior-most sternotomy wire, which is unchanged since ___.  Otherwise, the remaining sternotomy wires are all displaced.  There is stable enlargement of the cardiomediastinal silhouette.  No condition affecting the lungs.  The pulmonary vasculature is normal.  No pleural effusion or pneumothorax is seen.  There are no acute osseous abnormalities. Impression: No acute abnormality, but there is notable mild pulmonary congestion.","['Change position of device', 'Add contradiction', 'False negation']"
2cd5b0dd-527a6616-cb6ad62f-c8ee94df-0b7ffd5b,52811570,12503812,"Findings: The patient appears to be kyphotic in position.  There are low lung volumes.  Prominence of the central pulmonary vasculature, pulmonary pulmonary arteries may be due to pulmonary arterial hypertension.  Left base streaky opacity is more likely due to atelectasis rather than consolidation.  No large pleural effusion or pneumothorax is seen.  Cardiac silhouette is not well assessed due to patient position, but appears mildly enlarged. ","Findings: The patient appears to be kyphotic in positoin. There are high lung volumes. Prominence of the left pulmonary vasculature, pulmonary pulmonary arteries may be due to pulmonary arterial hypertension. Right base streaky opacity is more likely due to atelectasis rather than consolidation. No large pleural effusion or pneumothorax is seen. Cardiac silhouette is not well assessed due to patient position, but appears mildly enlarged. An ET tube is noted in the trachea.","['Change location', 'Add typo', 'Add medical device']"
421ffb60-9a41bff9-c842e6e6-a31adcbc-d8e5ad64,55747240,12508865,"Findings: AP single view of the chest has been obtained with patient in semi-upright position.  High positioned diaphragms indicate poor inspirational effort and obscure major portion of heart silhouette and result in crowded appearance of pulmonary vasculature.  There is, however, no evidence of any pulmonary vascular congestion, acute infiltrate, or pneumothorax.  The lateral pleural sinuses are free.  No pneumothorax is observed in the apical area. Impression: No evidence of significant cardiovascular or pulmonary abnormalities, no pleural effusion reaching lateral pleural sinuses.  Single view cannot exclude minor pleural effusions and depending posterior pleural sinuses.","Findings: AP single view of the chest has been obtained with patient in semi-upright position. High positioned diaphragms indicate poor inspirational effort and obscure major portion of heart silhouette and result in crowded appearance of pulmonary vasculature. There is, however, no evidence of any pulmonary vascular congestion, acute infiltrate, or pneumothorax. The lateral pleural sinuses are free. No pneumothorax is observed in the apical area. Impression: No evidence of moderate cardiovascular or pulmonary abnormalities, no pleural effusion reaching lateral pleural sinuses. Minor pleural effusions and depending posterior pleural sinuses are observed.","['Change severity', 'Add contradiction', 'False negation']"
"2522581e-ac120282-c9568047-88e5dfff-2e19d8e4, 9ef62dcd-4b3e52d1-80cd9cd2-655e3c3b-b0669fc5",58700633,12521573,"Findings: Assessment is slightly limited due to rotation. Heart size remains mildly enlarged.  Elevation of the left hemidiaphragm is unchanged. Atelectasis within the left lung base is noted, but no focal consolidation, pleural effusion or pneumothorax is present. Mediastinal and hilar contours are unchanged, and no pulmonary vascular congestion is identified. Scarring within the apices is unchanged. Mild to moderate multilevel degenerative changes are present in the thoracic spine. Impression: Chronic elevation of the left hemidiaphragm with left basilar atelectasis. No acute cardiopulmonary abnormality otherwise demonstrated.","Findings: Assessment is slightly limited due to rotation. Heart size remains severely enlarged.  Elevation of the left hemidiaphragm is unchanged. Atelectasis within the left lung base is noted, but no focal consolidation, pleural effusion or pneumothorax is present. Mediastinal and hilar contours are unchanged, and no pulmonary vascular congestion is identified. Scarring within the apices is unchanged. Mild to moderate multilevel degenerative changes are present in the thoracic spine. Scarring within the apices is unchanged. Impression: Chronic elevation of the left hemidiaphragm with left basilar atelectasis. No acute cardiopulmonary abnormality otherwise demonstrated. A central venous line is present.","['Change severity', 'Add repetitions', 'Add medical device']"
78675c97-3d574a7a-21454f9d-2487195b-496a7b4b,52709218,12536467,"Findings: Cardiomediastinal silhouette is within normal limits.  Lung volumes are low.  An endotracheal tube terminates approximately 3 cm above the carina and an enteric tube projects over the stomach with tip excluded from the images.  Linear opacities at the bases likely represent atelectasis in the setting of low lung volumes.  There is no focal consolidation, pleural effusion, or pneumothorax. Impression: Appropriate positioning of endotracheal and nasogastric tubes.","Findings: Cardiomediastinal silhouette is within normal limits.  Lung volumes are low.  An endotracheal tube terminates approximately 4 cm above the carina and an enteric tube projects over the stomach with tip excluded from the imgaes.  Patchy consolidations at the bases likely represent atelectasis in the setting of low lung volumes.  There is a small contralateral pleural effusion, no pneumothorax. Impression: Appropriate positioning of endotracheal and nasogatsric tubes.","['Change measurement', 'Add typo', 'False prediction']"
54dc0bb7-ef174450-8314a8e5-b94f3c64-748fd4a3,56957928,12548159,"Findings: As compared to the previous radiograph, there is no relevant change.  Mild fluid overload.  Cardiomegaly, extensive right pleural effusion with subsequent right middle and lower lung consolidations, likely to represent atelectasis, pneumonia, or a combination of both.  Unchanged right PICC line.  No pneumothorax. ","Findings: As compared to the previous radiograph, there is no relevant change.  No fluid overload.  Cardiomegaly, extensive left pleural effusion with subsequent right middle and lower lung consolidations, likely to represent atelectasis, pneumonia, or a combination of both.  Unchanged left PICC line.  No pneumothorax.  Impression: The right lung parenchyma is clear.","['Change location', 'Add contradiction', 'False negation']"
"53e18b50-2214dd2c-d70345b2-935f26ab-f5128750, b8a96dfd-924e5707-1009e1ac-9f767236-ff131cd4",59548661,12548159,"Findings: There is moderate cardiomegaly and mild pulmonary edema as well as bilateral small pleural effusions. The mediastinum and hila are normal. No focal consolidation. Impression: Mild-to-moderate pulmonary edema, progressed since ___.","Findings: There is moderate cardiomegaly and severe pulmonary edema as well as bilateral small pleural effusions. The mediastinum and hila are normal. There is focal consolidation in the left lower lobe. An NG tube is present, with the tip in the expected location. Impression: Mild-to-moderate pulmonary edema, progressed since ___. No evidence of focal consolidation.","['Change location', 'Add contradiction', 'Add medical device']"
"1312be28-d131f758-783e1a08-1e878cba-6236e5ff, 766b651a-bf318a3c-a6e00002-e595f99a-1a97ffae",54952803,12598684,"Findings: As compared to the previous radiograph, there is status post resection of the eighth right-sided rib.  Moreover, the local pleura is minimally thickened.  The lung parenchyma shows no evidence of acute changes.  No pneumonia, no pulmonary edema.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal contours. ","Findings: As compared to the previous radiograph, there is status post resection of the third left-sided rib.  Moreover, the local pleura is minimally thickened.  The lung parenchyma shows no evidence of acute changes.  No pneumonia, no pulmonary edema.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal contours.  However, there is also evidence of pneumonia.  The local pleura does not show any thickening.","['Change location', 'Add contradiction', 'False negation']"
c211b75b-8161910e-f2e25176-8b940c43-41776603,51383617,12641488,Impression: Feeding tube with the wire stylet in place is curled in the upper stomach.  Right PIC line ends in the mid SVC  Heart is normal size.  Low lung volumes exaggerate mild pulmonary vascular congestion but there is no pulmonary edema or pleural effusion.,Impression: Feeding tube with the biopsy forceps in place is curled in the upper stomach.  Right PIC line ends in the mid SVC  Hart is normal size.  Low lung volumes exaggerate mild pulmonary vascular congestion but there is no pulmonary edema or pleural effusion.,"['Change name of device', 'Change to homophone', 'False negation']"
76c189dd-c9cae85a-af7009fe-25471b3e-172f291c,51982061,12641488,Findings: The NG tube tip is in the stomach.  The.  Left tube is been removed.  There is volume loss at both bases.  There is no focal infiltrate. Impression: NG tube tip in the stomach,Findings: The ETT tip is in the stomach.  The.  Lef tube is been removed.  There is volume loss at both bases.  There is no focal infiltrate with mild pulmonary fibrosis. Impression: NG tube tip in the stomach,"['Change name of device', 'Add typo', 'False prediction']"
14f68fc5-ae8a53c1-5b35d96f-1fb5d709-e09abe35,55748860,12641488,Findings: Lung volumes are low which leads to bronchovascular crowding.  There may be mild pulmonary vascular congestion exaggerated by supine positioning.  No focal consolidation is identified.  The cardiomediastinal silhouette and hilar contours are normal.  There is no pleural effusion or pneumothorax. Impression: Mild pulmonary vascular congestion.  No focal consolidation.,Findings: Lung volumse are low which leads to bronchovascular crowding. There may be moderate pulmonary vascular congestion exaggerated by supine positioning. No focal consolidation is identified. The cardiomediastinal silhouette and hilar contours are normal. There is no pleural effusion or pneumothorax. Impression: No pulmonary vascular congestion. No focal consolidation.,"['Change severity', 'Add typo', 'False negation']"
"1ed2756e-369a930f-ffff5e24-2435499b-1e4603e9, c2e4d2ab-1ef3ec14-f7d2ee88-38430789-e17be20c",56049214,12659391,Findings: Right PICC tip has been somewhat advanced into the upper-to-mid SVC.  The cardiomediastinal and hilar contours are normal.  The lungs are clear.  There is no pleural effusion or pneumothorax. Impression: Right PICC tip at upper-to-mid SVC.,Findings: Right PICC tip has been somewhat advanced into the upper-to-mid IVC.  The cardiomediastinal and hilar contours are normal.  The lungs are clear.  There is no pleural effusion or pneumothorax.  There is mild pleural effusion and pneumothorax. Impression: Right PICC tip at upper-to-mid IVC.  No pleural effusion or pneumothorax.,"['Change name of device', 'Add contradiction', 'False negation']"
3bd7086b-893fe462-f1699be8-dce553d3-1459991d,56143095,12659391,"Findings: As compared to the previous radiograph, the previously well-positioned PICC line has been pulled back.  The tip of the line now projects over the confluence of the brachiocephalic in the superior vena cava. The line should be advanced by approximately 2-3 cm to ensure safe position in the superior vena cava.  No evidence of complications, notably no pneumothorax. ","Findings: As compared to the previous radiograph, the previously well-positioned PICC line has been allowed to advance further.  The tip of the line now projects over the confluence of the brachiocephalic in the superior vena cava. The line should be retracted by approximately 2-3 mm to ensure safe position in the superior vena cava.  Minimal evidence of complications, notably no pneumothorax.  ","['Change measurement', 'Add contradiction', 'False prediction']"
"0486aca2-fd15fa89-51be4de4-01dcddd9-ed8ebf50, 88ccf610-b3c4e8b9-dc228355-6410ee87-1191a63b",58673717,12663605,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is scene. There are no acute osseous abnormalities. No acute osseous abnormalities. Impression: No abnormality. ,"['Add repetitions', 'Change to homophone', 'False negation']"
7b4211fe-def2de24-c6991efa-026a3d44-2e4082f8,51358230,12669344,"Findings: The ET tube terminates in the mid trachea. A nasogastric tube terminates in the stomach. Mild pulmonary edema with small bilateral pleural effusions are unchanged. Moderate cardiomegaly despite the projection is also unchanged. There is no pneumothorax. Impression: Stable mild pulmonary edema, small bilateral pleural effusions, and moderate cardiomegaly.","Findings: The ET tube terminates in the mid esophagus. A nasogastric tube terminates in the stomach. Mild pulmonary edema with no pleural effusions are unchanged. Moderate cardiomegaly despite the projection is also unchanged. There is no pneumothorax. Impression: Stable mild pulmonary edema, small bilateral pleural effusions, and normal heart size.","['Change name of device', 'Add contradiction', 'False negation']"
d88bc850-2681d230-e2d3bc84-ba0996c2-078fe63b,53588397,12669344,"Impression: As compared to previous radiograph of 1 day earlier, endotracheal tube now terminates about 7 cm above the carinal and could be advanced a few cm for standard positioning.  Cardiomegaly is accompanied by pulmonary vascular congestion and improving pulmonary edema. Small bilateral pleural effusions are persistent findings.","Impression: As compared to previous radiograph of 1 day earlier, endotracheal tube now terminates about 7 mm above the carinal and could be advanced a few cm for standard positioning. Cardiomegaly is accompanied by pulmonary vascular congestion and persistent bilateral pneumothoraces. Small bilateral pleural effusions are persistent findings. Small bilateral pleural effusions are persistent findings.","['Change measurement', 'Add repetitions', 'False prediction']"
"b606c5ab-1f7c5020-53941bec-8f32fed0-249da9f6, c3dccd75-321d490b-d282ea11-4da8be1c-6f83adb4",55077682,12669344,Findings: Portable semi-erect chest film ___ at 08:04 is submitted. Impression: Nasogastric tube is seen coursing below the diaphragm with the tip not identified. Endotracheal tube has its tip approximately 5 cm above the carina. The heart remains enlarged. Interstitial edema has slightly improved. Small right pleural effusion.  No pneumothorax.,Findings: Portable semi-erect chest film ___ at 08:04 is submittted. Impression: Nasogastric tube is seen coursing below the diaphragm with the tip not identified. Endotracheal tube has its tip approximately 6 cm above the carina. The heart remains enlarged. Interstitial edema has slightly improved. Small right pleural effusion.  No pneumothorax. An ICD is present in the left upper chest region.,"['Change measurement', 'Add typo', 'Add medical device']"
7062c579-507738d9-ccbbac4a-bcbb9596-7fbc4f31,55678624,12669344,"Impression: Pulmonary vascular congestion improved between ___ and ___, and has remained subsequently stable. There is no pulmonary edema but there is residual small bilateral pleural effusion unchanged. Heart is mildly enlarged given the extent of pulmonary hyperinflation, but it has improved since ___.  ET tube is in standard placement. Nasogastric tube passes into the stomach and although the tip is not seen, the most proximal side port lies above the GE junction. It would need to be advanced 6 cm to move all of the drainage ports into the stomach.","Impression: Pulmonary vascular congestion improved between ___ and ___, and has remained subsequently stable. There is no pulmonary edema but there is worsening large bilateral pleural effusion unchanged. Heart is mildly enlarged given the extent of pulmonary hyperinflation, but it has slightly worsened since ___. ET tube is in standard placement. Nasogastric tube passes into the stomach and although the tip is not seen, the most proximal side port lies above the GE junction. It would need to be advanced 7 cm to move all of the drainage ports into the stomach.","['Change measurement', 'Add contradiction', 'False prediction']"
d54a965f-9fb1b27f-8a1b45a8-87d31707-45c1feb1,57264873,12669344,"Findings: There is moderate cardiomegaly along with widening of the vascular pedicle as well as mild to moderate pulmonary edema. There are probable bilateral pleural effusions, right greater left along with right-sided atelectasis. An endotracheal tube is in appropriate position. An NG tube is seen coursing into the stomach and off the view of the film. Impression: Cardiomegaly and pulmonary edema.","Findings: There is moderate cardiomegaly along with widening of the vascular pedal as well as mild to moderate pulmonary edema. There are probable bilateral pleural effusions, right greater left, along with right-sided atelectasis. An endotracheal tube is terminating 2.5 cm above the carina. An NG tube is seen coursing into the stomach and terminating at the cardia. A right apical pleural thickening is noted. Impression: Cardiomegaly and pulmonary edema.","['Change position of device', 'Change to homophone', 'False prediction']"
efa1c4d4-c6b83e76-71107d37-015f4c79-24aa9e68,58561179,12669344,"Findings: Compared with the prior chest radiograph, there is a new focal consolidation involving the right lower lobe, concerning for pneumonia.  The heart is persistently enlarged, and there is persistent mild interstitial edema.  Left basilar opacity is likely due to atelectasis. Impression: 1.  New right lower lobe consolidation is concerning for pneumonia.  2.  Persistent mild cardiomegaly and interstitial edema.  Left basilar opacity is likely due to atelectasis, as seen on the prior study.","Findings: Compared with the prior chest radiograph, there is a new focal consolidation involving the right lower lobe, concerning for pneumonia.  The heart is persistently enlarged, and there is persistent severe interstitial edema.  Left basilar opacity is likely due to atelectasis. Impression: 1.  New right lower lobe consolidation is concerning for pneumonia.  2.  Persistent moderate cardiomegaly and interstitial edema.  No basilar opacity is seen.","['Change severity', 'Add contradiction', 'False negation']"
8c740b46-36733ece-3c0cf641-1644df78-0219c847,58890484,12669344,"Impression: As compared to ___ chest radiograph, cardiomegaly and pulmonary vascular congestion are accompanied by worsening interstitial edema and persistent small bilateral pleural effusions.","Impression: As compared to ___ chest radiograph, cardiomegaly and pulmonary vascular congestion are accompanied by worsening interstitial edema and persistent small left pleural effusions. There is a nasogastric (NG) tube in place.Impression: As compared to ___ chest radiograph, cardiomegaly and pulmonary vascular congestion are accompanied by worsening interstitial edema and persistent small left pleural effusions.","['Change location', 'Add repetitions', 'Add medical device']"
edd99c90-fa96205f-04b2900c-127c69bd-d632e5c5,59437027,12669344,"Impression: As compared to the previous radiograph, there is an increase in interstitial markings surrounding the medial aspect 's of the right lower lung and the lower aspect of the right hilus. In the appropriate clinical setting, these changes could reflect pneumonia. Increasing retrocardiac atelectasis. Moderate cardiomegaly persists. The monitoring and support devices are in correct unchanged position. No pulmonary edema.","Impression: As compared to the previous radiograph, there is an increase in interstitial markings surrounding the medial aspects of the right lower lung and the lower aspect of the right hilus. In the appropriate clinical setting, these changes could reflect severe pneumonia. Increasing right base atelectasis. Moderate cardiomegaly persists. The monitorring and support devices are in correct unchanged position. No pleural effusion.","['Change severity', 'Add typo', 'False prediction']"
59b7e3c4-05bcf819-da6417fa-60f5b61a-38711e5c,59881207,12669344,Findings: There has been interval removal of an endotracheal tube and enteric tube.  The heart is persistently enlarged but stable in size from the prior exam. Mild interstitial edema persists. Opacities involving the right middle lobe and left lower lobe are again demonstrated and may represent atelectasis or infection in the appropriate setting. Impression: Persistent mild edema.  Multifocal opacities could represent areas of atelectasis or infection in the appropriate setting.,Findings: There has been interval removal of an endotracheal tube and enteric tube. The heart is persistently enlarged but stable in size from the prior exam. Moderate interstitial edema persists. Opacities involving the right middle lobe and left lower lobe are again demonstrated and may represent atelectasis or infection in the appropriate setting. Impression: Persistent mild edema.  No opacities could represent areas of atelectasis or infection in the appropriate setting.,"['Change severity', 'Add repetitions', 'False negation']"
"576ea30f-0b6d676e-4fb00e65-c319c423-7445e215, ea4d9952-427fe1f1-211bede7-853d99dc-eaaa4a79",54253905,12671922,Findings: Compared to the prior radiograph of ___ the lung volumes have improve. The left pleural effusion has decreased and is now small.  Linear opacities in the left lung base represents platelike atelectasis.  There is no new opacity or pneumothorax.  The cardiac and mediastinal contours are normal. Nipple rings are noted. Impression: No new opacity concerning for pneumonia.  Interval improvement in lung volumes and decrease in size of a now small left pleural effusion and atelectasis.,Findings: Compared to the prior radiograph of ___ the lung volumes have improved. The left pleural effusion has decreased and now is large. Linear opacities in the left lung base represents platelike atelectasis. There is no new opacity or pneumothorax. The cardiac and mediastinal contours are nomral. Nipple rings are noted. An NG tube is present.,"['Change severity', 'Add typo', 'Add medical device']"
b7c818c2-bf5dde12-748d7913-48366cba-d787cb7b,56711844,12671922,"Impression: There is a left-sided PICC line with distal tip in the mid SVC. Heart size is prominent, stable. There has been increase in the bibasilar opacities.  Previously felt to represent atelectasis, this may represent developing infiltrate as well. There is a left retrocardiac opacity and left-sided pleural effusion which are stable. There are no pneumothoraces.","Impression: There is a left-sided vascular stent with distal tip in the mid SVC. Heart size is prominent, stable. There has been increase in the bibasilar opacities. Previously felt to represent atelectasis, this may represent developing infiltrate as well. No retrocardiac opacity and pleural effusion. There are no new monothoraces.","['Change name of device', 'Change to homophone', 'False negation']"
"53c74567-293c2bb4-71eb4e1e-7dbc1f94-8eecb92b, aecd487f-89650453-71139ac4-094e3790-910d705d",51746534,12706312,"Findings: Frontal and lateral chest radiograph demonstrates unremarkable mediastinal and hilar contours.  Lung volumes are low with mild bibasilar atelectasis.  Otherwise, lungs are clear.  There is mild pleural thickening adjacent to the right fifth rib with suggestion of a cortical step-off; however, the area of concern is obscured by a crossing sixth rib.  No other fracture is identified. Impression: Possible right fifth rib fracture with small amount of adjacent pleural fluid or hematoma.  ___ discussed with Dr. ___ regarding these findings at 4:50 a.m. on ___ at the time of discovery.","Findings: Frontal and lateral chest radiograph demonstrates unremarkable mediasitnal and hilar contours.  Lung volumes are low with mild bibasilar atelectasis.  Otherwise, lungs are clean.  There is mild pleural thickening adjacent to the right fifth rib with suggestion of a cortical step-off; however, the area of concern is obscured by a crossing fourth rib.  No other fracture is identified. A pacemaker is also present, positioned appropriately. Impression: Possible left fifth rib fracture with small amount of adjacent pleural fluid or hematoma.  ___ discussed with Dr. ___ regarding these findings at 4:50 a.m. on ___ at the time of discovery.","['Change location', 'Add typo', 'Add medical device']"
"48137c2d-eb569f44-d59a0735-091e53b4-ea6f8a26, 78ec02f5-f3419d1a-1733282f-87d9ca09-ae2c9564",52178631,12749849,"Findings: PA and lateral views of the chest were obtained.  Dual-lead pacer is unchanged with proximal lead in the expected location of the right atrium and distal lead in the expected location of the right ventricle.  No focal consolidation, large effusion or pneumothorax.  There is mild vascular redistribution which is likely suggestive of mild pulmonary vascular congestion.  No frank pulmonary edema.  Cardiomediastinal silhouette is stable.  Bony structures appear intact. Impression: Mild pulmonary vascular congestion.","Findings: PA and lateral views of the chest were obtained.  Dual-chamber pacemaker is unchanged with proximal lead in the expected location of the right atrium and distal lead in the expected location of the right ventricle.  No focal consolidation, large effusion or pneumothorax.  There is mild vascular redistribution which is likely suggestive of mild pulmonary vascular congestion.  There is evidence of frank pulmonary edema.  Cardiomediastinal silhouette is stable.  Bony structures appear intact. Impression: No pulmonary congestion noted.","['Change name of device', 'Add contradiction', 'False prediction']"
"09846753-05af835a-0442e67c-97f04c1d-33ff0aa1, e2d8fc47-6b718166-13b4771b-3194dbf7-48168537",53502580,12749849,"Impression: In comparison with study of ___, there again are low lung volumes that accentuate the transverse diameter of the heart.  Mild indistinctness of pulmonary vessels is consistent with elevated pulmonary venous pressure. On 1 frontal view common there is suggestion of some asymmetry of opacification at the bases, more more prominent on the left.  In the appropriate clinical setting, this could represent a developing area of pneumonia.","Impression: In comparison with study of ___, there again are low lung volumes that accentuate the transverse diameter of the heart. Moderate indistinctness of pulmonary vessels is consistent with elevated pulmonary venous pressure. On 1 frontal view common there is suggestion of some asymmetry of opacification at the bases, more more prominent on the left. There is a mild pleural effusion on the right. In the appropriate clinical setting, this could represent a developing area of pneumonia. On 1 frontal view common there is suggestion of some asymmetry of opacification at the bases, more more prominent on the left.","['Change severity', 'Add repetitions', 'False prediction']"
"059f665a-5889b37e-e7cbf507-8afc0524-28836769, 4161e589-009257f1-494801fa-6a9ea19b-e80714a6",58796142,12749849,Impression: Right PICC line tip terminates at the level of superior SVC.  Heart size and mediastinum are stable.  Vascular congestion is demonstrated.  There is no pleural effusion.  There is no pneumothorax.,Impression: Right PICC line tip terminates in the mid SVC.  Heart size and mediastinum are stable.  A pacemaker is noted in situ.  Vascular congestion is demonstrated.  There is no pleural effusion.  There is no pleural effusion. ,"['Change position of device', 'Add repetitions', 'Add medical device']"
"6731c06d-16bbcd4b-74834699-e8808d6b-6f7c74c6, dd78d25b-dc8c3cf2-d7bf6627-14791a61-146846c2",53972858,12751006,"Findings: The cardiac silhouette is top-normal in size.  No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema.  Normal mediastinal and hilar contours.  Unremarkable pleural.  Mild degenerative changes are noted in the thoracic spine. Impression: As above.","Findings: The cardiac sihouette is top-normal in size. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. Noral mediastinal and hilar contours. Unremarkable pleural. Moderate degenerative changes are noted in the thoracic spine. Impression: No degenerative changes.","['Change severity', 'Add typo', 'False negation']"
96ac5d23-fc7ee66f-45c92058-4edaeaf3-87204a92,50730815,12772476,"Findings: The lung volumes are low.  There is a hazy linear opacification at the right base, which is new from the prior exam, and concerning for pneumonia, aspiration, or atelectasis.  There is persistent blunting of the right costophrenic angle, without definite pleural effusion.  There is a moderate left pleural effusion.  The upper lungs are clear.  There is no pneumothorax.  The cardiomediastinal silhouette is unchanged with stable mild cardiomegaly. Impression: 1.  New right lower lung zone opacity, which is nonspecific, and could be due to aspiration, pneumonia and/or atelectasis. 2.  Moderate left pleural effusion. 3.  Stable mild cardiomegaly.","Findings: The lung volumes are high.  There is a hazy linear opacification at the right base, which is new from the prior exam, and concerning for severe pneumonia, aspiration, or atelectasis.  There is persistent blunting of the right costophrenic angle, without definite pleural effusion.  There is a large left pleural effusion.  The upper lungs are not clear.  There is no pneumothorax.  The cardiomediastinal silhouette is unchanged with stable mild cardiomegaly. Impression: 1.  New right lower lung zone opacity, which is nonspecific, and could be due to aspiration, pneumonia and/or atelectasis. 2.  Mild left pleural effusion. 3.  Stable mild cardiomegaly. 4.  Presence of right central venous catheter.","['Change severity', 'Add contradiction', 'Add medical device']"
9cda5d38-795b0046-56155ec6-1f51e537-3f6beee4,58409499,12772476,"Impression: AP chest compared to ___:  Mild pulmonary edema, moderate bilateral pleural effusions are new since ___, increased slightly since ___.  There are no findings strongly suggestive of pneumonia.  A large gastrointestinal hernia or defect in the left hemidiaphragm is responsible for considerable left lower lobe atelectasis.  Heart is not particularly enlarged.  No pneumothorax.","Impression: AP chest compared to ___:  Mild pulmonary edema, moderate bilateral pleural effusions are new since ___, increased slightly since ___.  There are no findings strongly suggestive of pneumonia.  A large gastrointestinal hernia or defect in the right hemidiaphragm is responsible for considerable left lower lobe atelectasis.  Heart is not particularly enlarged.  No pneumothorax.  No pleural effusion.","['Change location', 'Change to homophone', 'False negation']"
"71303414-ba44ef85-a0ecfd3d-987e16a5-878de783, 75da10ed-116cae46-bcce243e-043a0dd8-3b9cd092",54433456,12840185,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are hyperinflated but clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.  Multilevel degenerative changes are noted in the thoracic spine with anterior bridging osteophytes. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is enlarged. The mediastinal and hilar contours are normal. The pulmonary arteries are normal. Lungs are hyperinflated but clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Multilevel degenerative changes are noted in the thoracic spine with anterior bridging osteophytes. Impression: No acute cardiopulmonary abnormality. A right IJ central venous catheter is in place.,"['Change location', 'Add contradiction', 'Add medical device']"
3a6d5658-ef16be63-d3d6c7b6-9da40249-74eb97ed,51485705,12906762,"Impression: As compared to the previous radiograph, all monitoring and support devices, including the left chest tube, are in unchanged position.  On today's image, there is no evidence for the presence of a left-sided pneumothorax.  The appearance of the right lung apex and of the heart is constant.","Impression: As compared to the previous radiograph, all monitoring and support devices, including the left chest tube, are in changeed position.  On today's image, there is no left-sided pneumothorax.  The apearance of the right lung apex and of the heart is unremarkable.","['Change position of device', 'Add typo', 'False negation']"
ec551da7-a02ee2e5-7d9d36c0-ec4ed8c9-d6dee4e5,51923417,12906762,"Impression: Allowing for differences in technique and positioning, there has not been a relevant change in the appearance of the chest since the recent study of 1 day earlier.","Impression: Allowing for differences in technique and positioning, there has not bean a relevant change in the appearance of the chest since the recent study of 1 day earlier. There is a new focal consolidation in the right upper lobe. There is significant change in the appearance of the chest since the recent study of 1 day earlier.","['Add contradiction', 'Change to homophone', 'False prediction']"
699a2526-5b07de66-ef9bc72a-8995b427-76074026,52126280,12906762,"Impression: No relevant change as compared to the previous radiograph, the fibrotic and potentially cavitary changes in the right and left lung apex are of similar appearance.  No new focal parenchymal opacities. Normal size of the cardiac silhouette. No pleural effusions. No pulmonary edema.  The monitoring and support devices are constant.","Impression: No relevant change as compared to the previous radiograph, the fibrotic and potentially cavitary changes in the left and right lung apex are of similar appearance.  There is a small right pleural effusion. No new focal parenchymal opacities. Normal size of the cardiac silhouette. No pleural effusions. No pulmonary edema. No pulmonary edema. The monitoring and support devices are constant.","['Change location', 'Add repetitions', 'False prediction']"
cbd96006-a4b14669-614de320-ba15c1d5-71250057,54899102,12906762,"Impression: Small left pneumothorax with apical and basal lateral components, unchanged.  Left pigtail pleural drainage catheter unchanged projecting over the left lateral chest. Moderately extensive subcutaneous emphysema left chest wall is unchanged.  Heart size normal.  Hyperlucency in the right lung due to emphysema, and to compensatory overinflation due to severe upper lobe scarring.  ET tube and left subclavian line in standard placements respectively.","Impression: Small left pneumothorax with apical and basal lateral components, unchanged.  Left pigtail pleural drainage catheter unchanged projecting over the left lateral chest. Moderately extensive subcutaneous emphysema left chest wall is unchanged.  Heart size normal.  Hyperlucency in the right lung due to emphysema, and to compensatory overinflation due to severe upper lobe scarring. ET tube in standard placement respectively. A large right pleural effusion is noted.","['Change name of device', 'Add repetitions', 'False prediction']"
5871f846-5b267431-2d13d3d5-0c59f8d1-7cebfb38,55236071,12906762,Impression: Left pigtail catheter is in place. Left subclavian line tip is at the level of mid SVC. NG tube tip is in the stomach. Second left pigtail catheter has been removed with no interval development or increase in pneumothorax of subcutaneous air.  Right apical scarring is unchanged,Impression: Left pigtail catheter is in place. Left subclavion line tip is at the level of mid SVC. NG tube tip is in the esophagus. Second left pigtail catheter has been removed with no pneumothorax of subcutaneous air. Right apical scarring is unchanged.,"['Change position of device', 'Add typo', 'False negation']"
c8d25759-11bea40b-02429e0d-4657a4d5-af5a6411,55779897,12906762,"Impression: As compared to previous radiograph of 1 day earlier, left pleural catheter remains in place, with hyperlucency at the left lung base suggestive of a basilar pneumothorax. Exam is otherwise remarkable for slight improved aeration at the lung bases, with no other relevant changes.","Impression: As compared to privious radiograph of 1 day earlier, left pleural catheter remains in place, with hyperlucency at the left lung base suggestive of a basilar pneumothorax. Exam is otherwise remarkable for slight improved aeration at the lung bases, with an infiltrate at the right upper lobe.","['Change position of device', 'Add typo', 'False prediction']"
21e904a4-539c24eb-be580554-4d15ddda-3546386c,56802169,12906762,"Findings: Endotracheal tube tip terminates approximately 5.4 cm from the carina. An enteric tube courses below the left hemidiaphragm, off the inferior borders of the film. Heart size is mildly enlarged. Atherosclerotic calcifications are seen in the aortic arch and descending thoracic aorta. Both hila are slightly enlarged, which can be seen with pulmonary hypertension. Emphysema is noted. Scarring within the lung apices is present, with bullous disease in the right apex. Patchy opacities within the lung bases, more so on the left, may reflect atelectasis though aspiration is not excluded. No pleural effusion or pneumothorax is clearly noted on this supine exam, though the left costophrenic angle is not completely included in the field of view. Impression: 1. Standard positioning of the endotracheal and enteric tubes. 2. Bibasilar patchy opacities, likely atelectasis though aspiration or infection cannot be excluded. 3. Scarring within the lung apices with bullous formation in the right apex.","Findings: Endotracheal tube tip terminates approximately 2.5 cm from the carina. An enteric tube courses above the left hemidiaphragm, off the inferior borders of the film. Heart size is mildly enlarged. Atherosclerotic calcifications are seen in the aortic arch and descending thoracic aorta. Both hila are slightly enlarged, which can be seen with pulmonary hypertension. A cardiac pacemaker is in place. Emphysema is noted. Scarring within the lung apices is present, with bullous disease in the right apex. Patchy opacities within the lung bases, more so on the left, may reflect atelectasis though aspiration is not excluded. No pleural effusion or pneumothorax is clearly noted on this supine exam, though the left costophrenic angle is not completely included in the field of view. Heart size is mildly enlarged. Impression: 1. Standard positioning of the endotracheal and enteric tubes. 2. Bibasilar patchy opacities, likely atelectasis though aspiration or infection cannot be excluded. 3. Scarring within the lung apices with bullous formation in the right apex.","['Change position of device', 'Add repetitions', 'Add medical device']"
"4ee41a42-7f2be473-d7d2e1e9-d72bfb6f-3cddd965, 6cac8a03-a1f3b00a-09c1d825-66854200-c8e9bae0",57147053,12906762,Impression: Left pigtail catheter is in place. NG tube tip is in the stomach on the last radiograph. Rest of the findings are unchanged except for mild interval increase in the opacity in the right apex.,Impression: Left pigtail catheter is in place. NG tube tip is in the stomach on the last radiograph. Rest of the findings are unchanged except for mild interval increase in the opacity in the right apex. There is no change in the opacity in the right apex.,"['Change name of device', 'Add contradiction', 'False prediction']"
ca1ee5db-fd901beb-4e89749e-da081003-404b404f,57213444,12906762,Impression: ET tube tip is 6.7 cm above the carinal. Left subclavian line tip is at the level of mid SVC. Apical scarring is unchanged but there is interval development of right lower lobe opacity that potentially might reflect interval development of infectious process. Left pigtail catheter is in place. Subcutaneous air is extensive. Minimal basal pneumothorax might potentially be present,"Impression: ET tube tip is 2 cm above the carinal. Right subclavian line tip is at the level of mid SVC. Apical scarring is unchanged but there is interval development of right lower lobe opacity that potentially might reflect interval development of infectious process. Left pigtail catheter is in place. Subcutaneous air is absent. Minimal basal pneumothorax might potentially be present. A pacemaker is visualized, with leads in appropriate position.","['Change position of device', 'Add contradiction', 'Add medical device']"
4095996e-f8e2d9b1-6d25ee5b-ba56f785-8cc0eca0,57315471,12906762,Impression: Endotracheal tube tip is nearly 7 cm from the carina an should be advanced 15 mm for more secure seating. Nasogastric tube ends in the upper portion of a nondistended stomach. Heart is top-normal size. There is no evidence of cardiac decompensation.  A cluster of cystic spaces in a severely retracted right lung apex is presumably the residual of tuberculosis.  Comparison with recent prior radiographs would be necessary to confirm that the area is inert.,Impression: Endotracheal tube tip is nearly 5 cm from the carina and should be advanced 15 mm for more secure seating. Nasogastric tube ends in the mid portion of a distended stomach. Heart is top-normal size. There is evidence of mild cardiac decompensation. A cluster of cystic spaces in a severely retracted right lung apex is presumably the residual of tuberculosis. Comparison with recent prior radiographs shows activity in the area.,"['Change position of device', 'Add contradiction', 'False prediction']"
"72fca17c-20ffd75f-4c02967e-021ba0fb-feb01bb7, a8cf2392-a1e39009-f5b6a7ba-7803adc3-0ec7f268",57713214,12906762,Impression: Left pigtail catheter is in place. Subcutaneous air within the left chest wall is demonstrated. Apical scarring on the right is unchanged. Cardiomediastinal silhouette is unchanged as well as the position of tubes and lines.,Impression: Lef pigtail catheter is in place. Subcutaneous air within the rght chest wall is demonstrated. No apical scarring is seen. Cardiomediastinal silhouette is unchanged as well as the position of tubes and lines.,"['Change location', 'Add typo', 'False negation']"
5ce424e3-7e50c3a2-f36da4c7-bc25a2d1-a37fca4f,58695208,12906762,"Findings: Left pleural pigtail catheter has been removed. There is no consolidation, pleural effusion, or pneumothorax. Right apical parenchymal and pleural scarring is unchanged. ET tube is approximately 6-7 cm above the carina. Cardiomediastinal silhouette is normal size and unchanged.  Dobbhoff tube terminates in the stomach.  Left subclavian venous line terminates at superior SVC. Impression: No pneumothorax.","Findings: Left pleural pigtail catheter has been removed. There is no consolidation or pleural effusion, and a small pneumothorax is noted. Right apical parenchymal and pleural scarring is unchanged. ET tube is approximately 5-6 cm above the carina. Cardiomediastinal silhouette is normal size and unchanged. Dobbhoff tube terminates in the stomach. Left subclavian venous line terminates at the mid SVC. An NG tube is also present. Impression: No pneumothorax.","['Change measurement', 'Add contradiction', 'Add medical device']"
a50abdea-4d26d980-2f94499a-cfa66e08-00087752,59091002,12906762,"Impression: As compared to the prior radiograph of earlier the same date, a feeding tube has been advanced or repositioned, now coursing below the diaphragm with tip outside of the field of view of the radiograph.  No other relevant changes since the recent study.","Impression: As compared to the prior radiograhp of earlier the same date, a feeding tube has been advanced or repositioned, now coursing above the diaphragm with tip outside of the field of view of the radiograph.  No other relevnat changes since the recent study.  There is also the presence of a right lower chest ICD.","['Change position of device', 'Add typo', 'Add medical device']"
b6712b07-679e0714-dd203abe-15144208-07b33056,59338798,12906762,"Impression: With the left pigtail catheter on water seal, there is no definite pneumothorax.  Decreasing subcutaneous gas along the left lateral chest wall. Suggestion of an area of increased opacification at the right base, which could represent aspiration. Extensive opacifications at the right apex are essentially unchanged.","Impression: With the left pigtail catheter in the left upper quadrant, there is no definite pneumothorax. Decreasing subcutaneous gas along the left lateral chest wal. Suggestion of an area of increased opacification at the left base, which could represent aspiration or mild pleural effusion. Extensive opacifications at the rigth apex are essentially unchanged.","['Change position of device', 'Add typo', 'False prediction']"
"f3fe398f-bb2b70e1-8ee5b14b-b9a498be-9d923e21, fadf202c-b58902f4-74479a47-d1cb4e1f-f67332ba",53816282,12932866,"Findings: Heart size is normal.  The mediastinal and hilar contours are unremarkable with atherosclerotic calcification of the aortic arch again noted.  A fudicial seed is again seen within a posterior left lower lobe lesion, compatible with known malignancy status post CyberKnife therapy.  Minimal streaky bibasilar opacities likely reflect atelectasis, though infection is difficult to exclude.  There is no new focal consolidation, pleural effusion or pneumothorax.  No pulmonary vascular congestion is present.  Multiple clips are again seen within the upper abdomen.  There are no acute osseous abnormalities. Impression: Left lower lobe lesion containing a fudicial marker, not significantly changed from the prior study.  Probable bibasilar atelectasis though infection is difficult to exclude.","Findings: Heart size is normal.  The mediastinal and hilar contours are unremarkable with atherosclerotic calcification of the aortic arch again noted.  A fiducial needle is again seen within a posterior left lower lobe lesion, compatible with known malignancy status post CyberKnife therapy.  Minimal streaky bibasilar opacities likely reflect atelectasis, though infection is difficult to exclude.  There is no new focal consolidation, pleural effusion or pneumothorax.  No pulmonary vascular congestion is present.  Multiple clips are again seen within the uppe abomen.  There are no acute osseous abnormalities. Impression: No lesion noted.  Probable bibasilar atelectasis though infection is difficult to exclude.","['Change name of device', 'Add typo', 'False negation']"
b6d528ca-2adc0b92-747b8c36-a0e0887d-6b962cec,53814100,12937037,Findings: Single portable frontal chest.  The lungs are well expanded.  There are subtle bibasilar opacities which raise concern for bilateral lower lobe pneumonia.  There is no pleural effusion or pneumothorax.  Cardiomediastinal silhouette is unremarkable. Impression: Subtle bibasilar opacities which raise concern for bilateral lower lobe pneumonia.,Findings: Single portable frontal chest.  The lungs are well expanded.  There are subtle bibasilar opacities which raise concern for bilateral upper lobe pneumonia.  There is no pleural effusion or pneumothorax.  Cardiomediastinal silhouette is unremarkable. Impression: No bibasilar opacities which raise concern for pneumonia.  Bilateral lower lobe pneumonia.,"['Change location', 'Add contradiction', 'False negation']"
"82ed5499-22d93514-a1cced80-066ab639-2066625f, c1e60b7d-0a4e5228-148af355-3f9fcb50-d501908b",54097156,12955039,"Findings: The lungs are well-expanded and clear.  No focal consolidation, effusion, edema, or pneumothorax.  Cardiomediastinal silhouette is normal.  Hila are unremarkable.  No acute osseous abnormality.  Upper abdomen bowel gas pattern is nonspecific. Impression: No pneumothorax.","Findings: The lung is well-expanded and clear. No focal consolidation, effusion, edema, or pneumothorax. Cardiomediastinal silhouette is normal. Hilar are unremarkable. No acute osseous abnormality. Upper abdomen bowel gas pattern is nonspecific. Impression: No pneumothorax.","['Change location', 'Change to homophone', 'False negation']"
"b84fa313-09027c57-7c255b39-f4aed3e3-ff396107, ff3dc06f-f7a97800-fce2758f-0bbeccd1-463d4449",50332797,12977138,"Findings: Frontal and lateral views of the chest were obtained.  No focal consolidation, pleural effusion or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  No pulmonary edema is seen. Impression: No acute cardiopulmonary process.  Please note that PCP may be radiographically occult.","Findings: Frontal and medial views of the chest were obtained.  No focal consolidation, pleural effusion or evidence of pneumothorax is scene.  The cardiac and mediastinal silhouettes are unremarkable.  A central venous line is noted in the right atrium.  No pulmonary edema is seen. Impression: No acute cardiopulmonary process.  Please note that PCP may be radiographically occult.","['Change location', 'Change to homophone', 'Add medical device']"
"2a1e777f-0b658cf0-64aafd5d-0a0d22f8-9bba06d0, f2823f12-bcf8d6c1-6b131e56-5ffb6d36-cbd75947",55273228,12977138,"Findings: Frontal and lateral views of the chest demonstrate normal lung volumes.  Right lung base opacities are slightly more conspicuous since prior, projecting over the spine on the lateral view.  There is no pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unchanged.  Heart size is normal.  There is no pulmonary edema.  Partially imaged upper abdominal visceral organs are unremarkable. Impression: Right lung base opacities, slightly more conspicuous since ___, may represent atelectasis or infection in the appropriate clinical setting.","Findings: Frontal and lateral views of the chest demonstrate normal lung volumes.  Left lung base opacities are slightly more conspicuous since prior, projecting over the spine on the lateral view.  There is no pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unchanged.  Heart size is normal.  There is no pulmonary edema.  Partially imaged upper abdominal visceral organs are unremarkable. Impression: No right lung base opacities. Left lung base opacities, slightly more conspicuous since ___, may represent atelectasis or infection in the appropriate clinical setting.","['Change location', 'Add repetitions', 'False negation']"
"11e48232-807822de-087a2398-ff1998ec-ec7c263e, 4551db74-ad728834-2a629241-9104fd86-6810bfcc",57852146,12985283,"Findings: No focal consolidation or pleural effusion currently pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  There is questionable mild prominence of the left hilum on the frontal view, which may be artifactual, but underlying lymphadenopathy is not entirely excluded. Impression: No focal consolidation.  Equivocal mild prominence of the left hilum on the frontal view may be artifactual but underlying lymphadenopathy is not excluded.  This could be further evaluated with a nonurgent chest CT.","Findings: No focal consolidation or pleural effusion currently pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There is questionable severe prominence of the left hilum on the frontal view, which may be artifactual, but underlying lymphadenopathy is not entirely excluded. Impression: No focal consolidation. Equivocal mild prominence of the left hilum on the frontal view may be artifactual but underlying lymphadenopathy is not excluded. This could be further evaluated with a nonurgent chest CT. Given the appearance, an urgent evaluation might also be necessary to rule out lymphadenopathy.","['Change severity', 'Add contradiction', 'False prediction']"
"03b3c6e9-67123395-f76ddecc-19a10040-10f5b4e9, 3a296121-9fc2bc73-d081dd75-b9ea5164-f49fc528",57172548,12993646,Findings: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable.  The lungs are clear.  There is no pleural effusion or pneumothorax. Impression: No acute intrathoracic abnormality.,"Findings: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. The lungs show hazy opacities bilaterally which may indicate mild pulmonary edema. There is no pleural effusion or pneumothorax. A right-sided central venous catheter is in place. Impression: No acute intrathoracic abnormality, except for mild pleural effusions on both sides.","['False prediction', 'Add contradiction', 'Add medical device']"
"0b2dd972-3c011bed-2c95c910-d16cc4da-65760e65, f88a088b-aad99d7b-cad14019-614d2277-b01bb0bb",58081122,12993646,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Lungs are clear. Impression: Large right pleural effusion.,"['Add repetitions', 'Add contradiction', 'False prediction']"
"14ca8f98-3b8cc136-42e4fd22-e44b2da1-e390b60b, 197a7aed-7ea6e597-f69224f2-04b68fe1-0148a45f",53111457,12998617,"Findings: The cardiac, mediastinal and hilar contours appear within normal limits and unchanged.  Streaky opacities at the left lung base indicate mild atelectasis. A small calcification projecting over the right upper lobe and the course of the right anterior fourth rib as well as the posterior right seventh rib suggests a bone island or parenchymal granuloma but unchanged. Mild pleural thickening appears unchanged at each lung apex.  There is no pleural effusion or pneumothorax.  The chest appears hyperinflated. Impression: No evidence of acute cardiopulmonary disease.","Findings: The cardiac, mediastinal and hilar contours appear within normal limits and uncnahged. Streaky opacities at the left lung base indicate moderate atelectasis. A small calcification projecting over the right upper lobe and the course of the right anterior fourth rib as well as the posterior right seventh rib suggests a bone island or parenchymal granuloma but unchanegd. Moderate pleural thickening appears unchanged at each lung apex. There is no pleural effusion or pneumothorax. An ET tube is present. The chest appears hyperinflated. Impression: No evidence of acute cardiopulmonary disease.","['Change severity', 'Add typo', 'Add medical device']"
4213580d-ac255044-99dbadbe-876a28fe-69c13044,54582114,12998617,"Findings: There is an asymmetric left lower lung opacity, which could be due to infection in the correct clinical setting. The right lung is clear. The cardiomediastinal and hilar contours are normal. No pneumothorax or large effusions. Impression: Left lower lung opacity may be due to pneumonia in the correct clinical setting.","Findings: There is an asymmetric left lower lung opacity, which could be due to infection in the correct clinical setting. The right lung has increased opacity. The cardiomediastinal and hilar contours are normal. No pneumothorax or large effusions. A right IJ central venous catheter is visualized, with its tip terminating in the superior vena cava. Impression: Left lower lung opacity may be due to pneumonia in the correct clinical setting, but the right lung is clear.","['Change severity', 'Add contradiction', 'Add medical device']"
67cde0b0-055d8347-2a99b426-f30ad9ca-db0ade30,55575107,12998617,"Findings: Borderline heart size, similar.  Mildly increased pulmonary vascularity, more prominent.  Segmental elevation left hemidiaphragm.  No effusion.  No pneumothorax.  Tortuous calcified aorta.  Minimal basilar atelectasis.  Probable scarring right costophrenic angle. Impression: Minimal bibasilar atelectasis.","Findings: Borderline heart size, similar.  Mildly increased pulmonary vascularity, more prominent.  Segmental elevation left hemidiaphragm.  No effusion.  No pneumothorax.  Aorta appears normal.  Minimal basilar atelectasis.  Probable scarring right costophrenic angle.  Borderline heart size, similar. Impression: Bibasilar atelectasis not present. ","['Change severity', 'Add repetitions', 'False negation']"
"a5dbfeb9-868150c3-2d9545bd-f01f5543-d4a57638, bb2d16ed-83a9269c-7f1b2130-45116784-a9c8a430",59794043,13022116,"Findings: The lung volumes are normal and the lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia.  Bilateral apical thickening is symmetric and unchanged. Heart is normal size. The mediastinal and hilar contours are unremarkable. Impression: No acute cardiopulmonary process.","Findings: The lung volumes are normal and the lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia.  Bilateral basilar thickening is symmetric and unchanged. Heart is normal size. The mediastinal and hilar contours are unremarkable. Impression: Moderate cardiomegaly and pleural effusion. ET tube is positioned correctly.","['Change location', 'Add contradiction', 'Add medical device']"
"0704b50e-89e04dec-4a699ba3-a4093977-f48109be, 945ba47d-cb1ad056-168ac55e-9b9ba3b6-4b80d1f5",55433920,13034473,"Findings: The lungs are well inflated and clear.  The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal.  There is no pleural effusion or pneumothorax. Impression: No acute cardiopulmonary process.","Findings: The lungs are well inflated and clear.  No cardiomediastinal silhouette, hilar contours, or pleural surfaces are visible.  There is no pleural effusion or pneumothorax. No cardiomediastinal silhouette, hilar contours, or pleural surfaces are visible.  Impression: No acute cardiopulmonary process. There is mild aortic aneurysm noted.","['False negation', 'Add repetitions', 'False prediction']"
f2948447-484794a5-6fb5339c-38ea0630-f00b4d11,51222490,13055950,"Findings: In comparison with study of ___, there is again substantial elevation of the left hemidiaphragmatic contour with mild atelectatic changes at the left base.  No evidence of acute pneumonia or vascular congestion. ","Findings: In comparison with study of ___, there is again substantial elevation of the right hemidiaphragmatic contour with mild atelectatic changes at the left base.  Gnome evidence of acute pneumonia or vascular congestion. A pacemaker is present.","['Change location', 'Change to homophone', 'Add medical device']"
a4d9f542-e5d79dcd-595c393c-1abb2504-53b539fd,58452624,13071559,Impression: Heart size and mediastinum are stable.  Lungs are clear.  There is no pleural effusion or pneumothorax.  There is questionable nodular opacity projecting over the right cardiac border.  Correlation with PA and lateral views recommended and anterior shallow obliques.,Impression: Heart size and mediastinum are stable. Lungs are creal. There is no pleural effusion or pneumothorax. There is questionable nodular opacity projecting over the right clavicle. Correlation with PA and lateral views recommended and anterior shallow obliques. Small bilateral pleural effusions observed.,"['Change location', 'Add typo', 'False prediction']"
"46bbccc4-0de08ebc-a7cb330e-39811a4d-c74d733b, beb1177e-dce3b292-49faa268-a82ce0e0-04d257de",59273362,13097080,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.  Apparent linear lucency along the right heart border is felt to most likely be artifactual and is not substantiated on the lateral view. Impression: No acute cardiopulmonary process.  Apparent linear lucency along the right heart border is felt to be artifactual.,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.  Apparent linear lucency along the left heart border is felt to most likely be artifactual and is not substantiated on the lateral view. Impression: No acute cardiopulmonary process.  Apparent linear lucency along the right heart border is not seen.,"['Change location', 'Add repetitions', 'False negation']"
58597ddf-5c95d260-4911eef3-5907f696-f132c629,50557253,13171410,Impression: Minimal left basilar atelectasis.  Lines and tubes in optimum position.,Impression: Minimal left basilar atelectasis.  Lines and tubes in opportune position.,"['Change severity', 'Change to homophone', 'False negation']"
ed41d65f-590e0bfb-eb73d35c-3096e02f-e29daec8,50794886,13171410,"Findings: AP single view of the chest has been obtained with patient in sitting semi-upright position.  Comparison is made with the next preceding similar study of ___.  The marked pulmonary congestive pattern including bilateral pulmonary edema seen on the preceding examination has improved markedly.  Still pleural densities are present along the lateral walls of the chest, particularly on the left side.  No new infiltrates are seen.  No pneumothorax has developed.  Status post sternotomy and bypass surgery as well as position of right internal jugular approach central venous line unchanged. Impression: Some improvement of pulmonary edema.  No new abnormalities.","Findings: AP single view of the pelvis has been obtained with patient in sitting semi-upright position.  Comparison is maid with the next preceding similar study of ___.  The marked pulmonary congestive pattern including bilateral pulmonary edema seen on the preceding examination is not present.  Still pleural densities are present along the lateral walls of the chest, particularly on the right side.  No new infiltrates are seen.  No pneumothorax has developed.  Status post sternotomy and bypass surgery as well as position of right internal jugular approach central Venus line unchanged. Impression: Some improvement of pulmonary edema.  No new abnormalities.","['Change location', 'Change to homophone', 'False negation']"
08c57c30-cc28a132-c83ff0b6-eb8367f2-8c2eeb06,51053791,13171410,"Findings: Comparison with the earlier study of this date, there is no change. No evidence of acute cardiopulmonary disease.  Monitoring and support devices remain in place following cardiac surgery.  No evidence of substantial effusion. ","Findings: Comparison with the earlier study of this date, there is no change. No evidence of acute cardiopulmonary disease. Monitoring and support devices remian in place following cardiac surgery. There is a small left-sided pneumothorax. No evidence of substantial effusion. No evidence of acute cardiopulmonary disease. ","['Add repetitions', 'Add typo', 'False prediction']"
abbc56f7-3569a197-33b68a76-2649b730-79cbcd28,51163175,13171410,Findings: Small 8-mm right apical pneumothorax is unchanged in this patient who still has a right chest tube.  Left fissural loculation has completely resolved.  The right jugular line ends in upper atrium. Impression: 1.  Unchanged small right apical pneumothorax. 2.  Resolution of left fissural loculation.,Findings: Small 8-mm right apical pneumothorax is unchanged in this patient who still has a right chest tube. Left fissural loculation has completely resolved. A pacemaker is visible with leads in the right ventricle. Impression: 1. Small 8-cm right apical pneumothorax is unchanged. 2. Resolution of left fissural loculation. 3. Left fissural loculation is unchanged.,"['Change measurement', 'Add contradiction', 'Add medical device']"
57007272-9df31ade-7ab87e66-6edccc37-48b62a32,51796411,13171410,"Findings: In comparison with study of ___, there is increasing opacification bilaterally.  This most likely represents a combination of multifocal pneumonia as well as elevated pulmonary venous pressure in this patient who has undergone a prior CABG procedure. ","Findings: In comparison with study of ___, there is increasing opacification bilaterally.  This most likely represents a combination of multifocal pneumonia as well as elevated pulmonary venous pressure in this patient who has undergone a prior CABG procedure.  Additionally, there is noted right lower lobe atelectasis. There is no evidence of multifocal pneumonia or elevated pulmonary venous pressure.","['False prediction', 'Add contradiction', 'False negation']"
"3077d18e-520b03ab-15ec5dd1-21c42a96-58bb1a22, 5710ff39-a6f932de-1547e689-b3864d9b-a9179f5b",51969259,13171410,"Impression: As compared to the previous radiograph, the right internal jugular vein catheter has been removed. The small right pneumothorax is no longer visible. Neither the frontal nor the lateral radiograph show evidence of pleural effusions. Unchanged clips and sternal wires of the CABG. No pneumonia, no pulmonary edema. Normal size of the cardiac silhouette.","Impression: As compared to the previous radiograph, the right internal jugular vein catheter has been repositioned into the right atrium. Neither the frontal nor the lateral radiograph show evidence of pleural effusions. Neither the frontal nor the lateral radiograph show evidence of pleural effusions. No pneumothorax is visible. No clips or sternal wires are seen. No pneumonia, no pulmonary edema. Normal size of the cardiac silhouette.","['Change position of device', 'Add repetitions', 'False negation']"
"e436cfc0-fc21c094-9d4ddd86-bbf65f19-70a2c641, f6a58dfe-8cde9194-a1c915d6-f69e88b3-3437c91e",52850524,13171410,"Findings: A right-sided central venous catheter projects along the right internal jugular vein and its tip is seen proximal to the cavoatrial junction. Surgical clips are projecting along the heart and sternotomy wires are intact. As compared to prior chest radiograph from ___, there has been interval removal of a right-sided chest tube. There is scattered atelectasis and there are tiny bilateral pleural effusions. A residual right apical pneumothorax is identified. Cardiomediastinal silhouette is stable. Impression: 1. Residual tiny right apical pneumothorax.    2. Bilateral tiny pleural effusions.  These findings were discussed with Dr. ___ by Dr. ___ ___ telephone on ___ at 1:30 PM, time of discovery.","Findings: A right-sided central venous catheter projects along the right internal jugular vein and its tip is seen proximal to the cavoatrial junction. Surgical clips are projecting along the heart and sternotomy wires are intact. As compared to prior chest radiograph from ___, there has been interval removal of a right-sided chest tube. There is scattered atelectasis and there are tiny bilateral pleural effusions. A residual right apical pneumothorax is identified. Cardiomediastinal silhouette is stable. There is scattered atelectasis. A residual right apical pleural effusion is identified. Impression: 1. Residual small right apical pneumothorax.    2. Bilateral mild pleural effusions.  These findings were discussed with Dr. ___ by Dr. ___ ___ telephone on ___ at 1:30 PM, time of discovery.","['Change severity', 'Add repetitions', 'False prediction']"
1a93c3ba-b683fe20-b0710462-cf40c34d-136cf408,54238302,13171410,"Findings: As compared to the previous radiograph, there is evidence of a newly appeared parenchymal opacity at both the right lung base and in the left lung, notably in the perihilar areas in the retrocardiac space.  The distribution suggests pneumonia rather than pulmonary edema, notably given the absence of pleural effusions and the absence of other findings indicative of fluid overload.  Borderline size of the cardiac silhouette.  Status post CABG.  No hilar or mediastinal changes.  At the time of dictation the referring physician, ___. ___, was paged for notification at 10:23 a.m., on ___.  Findings were subsequently discussed over the telephone. ","Findings: As compared to the previous radiograph, there is evidence of a newly appeared parenchymal opacity at both the left lung base and in the left lung, notably in the perihilar areas in the retrocardiac space. The distribution suggests pneumonia rather than pulmonary edema, notably given the absence of pleural effusions and the absence of other findings indicative of fluid overload. Evidence of fluid overload and mild pleural effusions are noted. Borderline size of the cardiac silhouette. Status post CABG. No hilar or mediastinal changes. A left IJ central venous catheter projects over the right atrium. At the time of dictation the referring physician, ___. ___, was paged for notification at 10:23 a.m., on ___. Findings were subsequently discussed over the telephone. ","['Change location', 'Add contradiction', 'Add medical device']"
"3a8d14bb-e7b82dd7-5dad553b-e6eb2c41-7a0e3118, 84c08756-e01015c6-65599730-f91d3b83-e4a954d9",55330429,13171410,"Findings: As compared to the previous radiograph, the patient is substantially improved.  Normal size of the cardiac silhouette.  Status post CABG with correct alignment of the sternal wires.  Status post right shoulder surgery.  There currently is no evidence of pneumonia or other acute lung disease.  The frontal and the lateral radiographs show normal appearance of the lung parenchyma.  No pulmonary edema.  Normal postoperative appearance of the mediastinum and hilar structures. ","Findings: As compared to the previous radiograph, the patient is substantially improved.  Normal size of the cardiac silhouette.  Status post CABG with correct alignment of the sternal wires.  Status post right shoulder surgery.  There currently is no evidence of pneumonia or other acute lung disease.  The frontal and the lateral radiographs show normal appearance of the left lung parenchyma.  No pulmonary edema.  Normal postoperative appearance of the mediastinum and hilar structures.  A central venous line is present.","['Change location', 'Add repetitions', 'Add medical device']"
"d4faa158-9dca8977-f02a356f-0897293a-813bc241, d9db020c-127f5d05-0b15114d-f9441c91-1080c498",55806461,13171410,"Impression: AP chest compared to ___ through ___:  Severe pulmonary edema and moderate-to-large bilateral pleural effusion are all increasing, obscuring what might have been an earlier pneumonia in the left lung laterally.  Heart is mildly enlarged.  No pneumothorax.  Right jugular line ends low in the SVC.","Impression: AP chest compared to ___ through ___: Severe pulmonary edema and moderate-to-large right pleural effusion are all increasing, obscuring what might have been an earlier pneumonia in the right lung laterally. Heart is mildly enlarged. Left apical pneumothorax. Left jugular line ends low in the SVC.","['Change location', 'Add contradiction', 'False prediction']"
b141bf84-f515c0d9-96113b11-9349f481-567cb70e,58511483,13171410,"Findings: In comparison with the study of ___, the right hemidiaphragm is more sharply seen.  This could reflect some decreasing effusion or merely be a manifestation of change in patient position.  Remainder of the examination is essentially unchanged, and the right IJ catheter tip remains in good position. ","Findings: In comparison with the study of ___, the left hemidiaphragm is more sharply seen.  This could reflect some decreasing effusion or merely be a manifestation of change in patient position.  Remainder of the examination is essentially unchnaged, and the right IJ catheter tip remains in good position. Small pleural-based nodule is observed in the left mid-lung zone.","['Change location', 'Add typo', 'False prediction']"
01913fe9-f0448eac-8f439832-dc05486f-95545a64,59848394,13171410,"Findings: Right chest tube remains in place with a persistent small right apicolateral pneumothorax.  Cardiomediastinal contours are stable in the postoperative period.  Bibasilar atelectasis persists and is slightly worsened in the left lower lobe.  Moderate partially loculated left pleural effusion has slightly decreased in size, and a small right pleural effusion is unchanged. ","Findings: Right chest tube remains in place with a persistent moderate right apicolateral pneumothorax.  Cardiomediastinal contours are sltbale in the postoperative period.  Bibasilar atelectasis persists and is slightly worsened in the left lower lobe.  Severe partially loculated left pleural effusion has slightly decreased in size, and a small right pleural effusion is unchanged. There is also evidence of right middle lobe pneumonia.","['Change severity', 'Add typo', 'False prediction']"
"379b4718-fca565b4-9fc2566d-ecc473aa-00e09bdd, b89d409f-f86c5bd7-887db0e3-8a997dbf-b16e1142",51891743,13184933,Findings: Interval improvement in mild bibasilar atelectasis.  Small left-sided pleural effusion is new.  There is a trace amount of fluid tracking in the right minor fissure.  No evidence of pulmonary edema.  The degree of cardiomegaly is slightly more than expected after surgery.  Median sternotomy wires are intact. Impression: Slightly more than expected cardiomegaly after surgery.  Follow-up radiographs are recommended.  Small left pleural effusion is new.,Findings: Interval improvement in mild left basilar atelectasis.  No pleural effusions are identified.  There is a trace amount of fluid tracking in the right minor fissure.  No evidence of pulmonary edema.  The degree of cardiomegaly is slightly more than expected after surgery.  Median sternotomy wires are intact. Impression: Slightly more than expected cardiomegaly after surgery.  Follow-up radiographs are recommended.  Small left pleural effusion is new.  Small left pleural effusion is new.,"['Change location', 'Add repetitions', 'False negation']"
651c4169-94a729d0-c106e57b-c9c4864f-da822a8c,51905928,13184933,Impression: Compared to chest radiographs ___ through ___.  There is no pneumothorax and previous small left pleural effusion has decreased since ___ following removal of bilateral thoracostomy tubes.  Mild cardiomegaly has increased mild to moderate bibasilar atelectasis is stable.  There is no pulmonary edema.,Impression: Compared to chest radiographs ___ through ___.  There is no pneumothorax and previous small right pleural effusion has decreased since ___ following removal of bilateral thoracostomy tubes.  Mild cardiomegaly has increased mild to moderate bibasilar atelectasis is staable.  There is a lobar consolidation in the right middle lobe.  There is no pulmonary edema.,"['Change location', 'Add typo', 'False prediction']"
9771b7cd-8a87ee8d-bf9e4546-ec002991-5580c62b,55419902,13184933,"Findings: The patient has been extubated.  The patient is status post CABG with intact sternotomy wires.  Bilateral chest tubes are visualized, which are unchanged in positioning in comparison to the prior examination.  There has been interval removal of the PA catheter.  There are bibasilar opacities, which are largely unchanged in comparison to prior and likely represent a combination of pleural fluid and atelectasis.  The cardiomediastinal silhouette is stable.  The pulmonary vasculature is normal.  No pneumothorax is seen. Impression: 1. Interval extubation and removal of PA catheter. 2. Status post CABG with intact sternotomy wires, and unchanged positioning of the bilateral chest tubes. 3. Bibasilar atelectasis and bilateral small pleural effusions.","Findings: The patient has been extubated.  The patient is status post CABG with intact sternotomy wires.  Bilateral chest tubes are visualized, which are unchanged in positioning in comparison to the prior examination.  No PA catheter is seen.  There are bibasilar opacities, which are mildly unchanged in comparison to prior and likely represent a combination of pleural fluid and atelectasis.  The cardiomediastinal silhouette is unchanged.  The pulmonary vasculature is normal.  No pneumothorax is seen. Findings: The patient has been extubated. Impression: 1. Interval extubation and removal of PA catheter. 2. Status post CABG with intact sternotomy wires, and unchanged positioning of the bilateral chest tubes. 3. No atelectasis.","['Change severity', 'Add repetitions', 'False negation']"
1ad7b193-ec7866e0-b028d0ab-58e2fd05-8da28ddd,50564703,13196707,Impression: 2 catheters are seen projecting over the inferior aspect of the heart.  There is a right sided central venous line with the distal lead tip at the cavoatrial junction.  SVC stent is also seen.  There are low lung volumes due to poor inspiratory effort.  There is some elevation of the left hemidiaphragm. There is again seen numerous parenchymal nodules better assessed on the prior CT scan.,Impression: 2 catheters are seen projecting over the right aspect of the heart.  There is a right sided central venous line with the distal lead tip at the cavoatrial junction.  SVC stent is also seen.  There are normal lung volumes due to good inspiratory effort.  There is some elevation of the left hemidiaphragm. No parenchymal nodules are observed.,"['Change location', 'Add contradiction', 'False negation']"
2d271bb0-b719bae0-a9361b1b-16706831-41fc9798,53814539,13196707,"Findings: Dobhoff tube terminates in the body of the stomach.  Right subclavian line has been removed in the interim.  SVC stent appears unchanged in position.  Bibasilar consolidations may represent a combination of pneumonia and/ or atelectasis, not significantly changed.  Multiple bilateral pulmonary metastases are known to the patient.  Small right pleural effusion has decreased.  No pneumothorax.  Cardiomediastinal contours are stable.  Right hemidiaphragm is persistently elevated. Impression: 1. Slight interval decrease in size of a small right pleural effusion, with persistent bibasilar pneumonia and/or atelectasis. 2. Multiple bilateral pulmonary metastases.","Findings: Dobhoff tube terminates in the body of the stomach.  SVC stent appears unchanged in position.  Bibasilar consolidations may represent a combination of severe pneumonia and/ or atelectasis, not significantly changed.  Multiple bilateral pulmonary metastases are known to the patient.  Small right pleural effusion has decreased.  No pneumothorax.  Cardiomediastinal contours are stable.  Right subclavian line has been removed in the interim.  No metastases. Impression: 1. Slight interval decrease in size of a large right pleural effusion, with persistent bibasilar pneumonia and/or atelectasis. 2. Multiple bilateral pulmonary metastases.  ","['Change severity', 'Add repetitions', 'False negation']"
"1286de61-eb3da8d2-2f6eb5d4-b32deb19-ebe3581d, bdd0f372-e708b3b0-e9328838-c9a7f29f-f68971d0",54072113,13196707,"Findings: AP upright and lateral views of the chest provided.  Elevation of the right hemidiaphragm is again noted.  The heart appears top-normal in size.  There is a SVC stent in place.  Known right suprahilar mass is better assessed on recent prior CT exam.  Multiple pulmonary nodules are also better assessed on prior CT.  There is no new consolidation, large effusion or pneumothorax seen.  Bony structures appear intact. Impression: No convincing signs of pneumonia.","Findings: AP upright and lateral views of the chest prvided. Elevation of the left hemidiaphragm is again noted. The heart appears top-normal in size. There ia a SVC stent in place. No mass is seen. Multiple pulmonary nodules are also better assessed on prior CT. No pulmonary nodules are seen. There is no new consolidation, large effusion or pneumothorax seen. Bony structures appear intact. Impression: No convincing signs of pneumonia.","['Change location', 'Add typo', 'False negation']"
ca7d8827-ea1c412d-b6a0a594-12d32534-52028738,55984720,13196707,Findings: Central line in cavoatrial juncture as previously.  Increased haziness over the right hemithorax and suggesting increased pleural effusion.  Left lower lobe atelectasis.  There may be a small left effusion.  No pneumothorax.  Cardiomegaly as before. Impression: Increased right effusion.,Findings: Central line in cavoatrial junctoin as previously.  Increased haziness over the right hemithorax and suggesting large pleural effusion.  Left lower lobe severe atelectasis.  There may be a sizeable left effusion.  No pneumothorax.  Cardiomegaly as before. The patient has an ICD device. Impression: Mild right effusion.,"['Change severity', 'Add typo', 'Add medical device']"
"73c4f0b3-857d48d6-62f18f50-6000ea9c-43e2d25c, be18562e-74237b2c-c9ebfcb8-ba1b5c02-7b949433",56377178,13196707,Findings: The Dobbhoff tube terminates in the stomach.  The right IJ central venous catheter terminates in caval atrial junction.  Lung volume is small.  The right atelectasis and pleural effusion has increased.  The left atelectasis is unchanged.  The left costophrenic angle is out of view.  The lungs are otherwise clear.  The cardiac silhouette is enlarged and unchanged.  The mediastinum is unchanged. Impression: 1.The Dobbhoff tube terminates in the stomach.  2.  Worsening right atelectasis and pleural effusion.,Findings: The nasogastric tube terminates in the stomach.  The right IJ central venous catheter terminates in caval atrial junction.  Lung volume is small.  The right atelectasis and pleural effusion has increased.  The left atelectasis is unchanged.  The left costophrenic angle is out of view.  The lungs are otherwise clear.  The cardiac silhouette is inlarged and unchanged.  The mediastinum is unchanged with mild left-sided pleural effusion. Impression: 1.The Dobbhoff tube terminates in the stomach.  2.  Worsening right atelectasis and pleural effusion.,"['Change name of device', 'Change to homophone', 'False prediction']"
75872755-7b9a13ad-1980114f-743ec5a7-064e7ac0,56558687,13196707,Impression: Compared to chest radiographs ___ through ___.  Worsening opacification at the base of the left lung with slight ipsilateral mediastinal shift is probably new lower lobe collapse.  Elevation right lung base and multiple right lung nodules due to carcinoma and/or complications.  Previous mediastinal widening has improved.  No pneumothorax.  Mild enlargement of cardiac silhouette has decreased.  Right central venous catheter ends in the region of the superior cavoatrial junction.,Impression: Compared to chest radiographs ___ through ___.  Worsening opacification at the base of the left lung with slight ipsilateral mediastinal shift is probably new lower lobe collapse.  Elevation right lung vase and multiple right lung nodules due to carcinoma and/or complications.  Previous mediastinal widening has improved.  No pneumothorax.  Mildly ennlargement of cardiac silhouette has decreased.  Right central arterial catheter ends in the region of the superior cavoatrial junction.,"['Change name of device', 'Add typo', 'False prediction']"
ea657c75-4d5d227a-c3adf2dc-0bf06970-bfa15f60,59638386,13196707,Impression: Stent is seen projecting over the SVC.  There is a new right subclavian central line with the distal lead tip in the cavoatrial junction.  There are low lung volumes.  There is elevation of the right hemidiaphragm and a small right-sided pleural effusion. Numerous bilateral parenchymal nodules are again seen and better assessed on the prior CT scan.,Impression: Stent is seen projecting over the SVC.  There is a new right subclavian PICC line with the distal lead tip in the cavoatrial junction.  Findings are consistent with normal lung volumes.  There is elevation of the right hemidiaphragm and no pleural effusion.  Numerous bilateral parenchymal nodules are again seen and better assessed on the prior CT scan. Impression: No right hemidiaphragm elevation.,"['Change name of device', 'Add contradiction', 'False negation']"
"34c2aa16-f1f5bd4a-29eb1957-6c3c1668-854aa214, e842a138-69a0ac81-0b138fe6-e13752c2-243955bc",50643047,13238497,"Findings: There is no focal consolidation, pleural effusion or pneumothorax.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities are identified. Impression: No acute cardiopulmonary process.","Findings: There is no focal consolidation, pleural effusion or pneumothorax.  Cardiomediastinal silhouette is within normal limits. There is no pneumothorax.  No acute osseous abnormalities are identified. Impression: No pulmonary process. Impression: No acute cardiopulmonary process.  There is a central venous line in place.","['Add medical device', 'Add repetitions', 'False negation']"
"5cbd768e-5bd7bc33-aff08070-8a3a2de3-bd826608, 8222390f-cdfd6433-74a649ee-a28aeae9-88fd56fe",53169484,13260103,Findings: Blunting of the bilateral costophrenic angles may be due to small bilateral effusions and/or pleural thickening.  Mild bibasilar atelectasis is also seen. There is no definite focal consolidation.  The aorta is somewhat tortuous.  The cardiac silhouette is top-normal.  There may be very minimal pulmonary vascular congestion. Impression: Bilateral pleural thickening with possible small pleural effusions.  Bibasilar atelectasis and possible minimal pulmonary vascular congestion.,Findings: Blunting of the left costophrenic angles may be due to small bilateral effusions and/or pleural thickening. Mild bibasilar atelectasis is also seen. There is no definite focal consolidation. The aorta is somewhat toruous. A large hilar mass is noted. The cardiac silhouette is top-normal. There may be very minimal pulmonary vascular congestion. Impression: Bilateral pleural thickening with possible small pleural effusions. Bibasilar atelectasis and possible minimal plmonary vascular congestion.,"['Change location', 'Add typo', 'False prediction']"
"3779e414-76cf3539-5f0c3634-17dc774e-61e0cdb4, ecb75c7e-8737e1e1-a77376ea-c4b1aea9-7021ccac",55403615,13270675,"Findings: Comparison is made to CT scan from ___.  There is a nasogastric tube whose tip is in the fundus of stomach; however, the side port is above the GE junction.  The catheter could be advanced an additional 10 cm for more optimal placement.  Heart size is within normal limits.  The visualized lung fields are grossly clear. ","Findings: Comparison is made to CT scan from ___.  There is a nasogastric tube whose tip is in the fundus of stomach; however, the side port is above the GE junction.  The catheter could be advanced an additional 10 mm for more optimal placement.  Heart size is within normal limits.  No abnormalities are observed in the visualized lung fields.  Comparison is made to CT scan from ___. ","['Change measurement', 'Add repetitions', 'False negation']"
"58263114-6dffa53e-32047b1a-853e06a0-f5f099fb, edc6ce1c-fc4f414b-85d4b348-397ef133-0cd52d48",50046465,13299965,"Findings: The lung volumes are low which causes crowding of the bronchovascular structures.  No focal opacity, pleural effusion or pneumothorax is identified. The aortic knob is calcified.  The heart size is normal. Impression: No acute cardiopulmonary process.","Findings: The lung volumes are low which causes crowding of the bronchovascular structures.  No focal opacity, pleural effusion or pneumothorax is identified. The aortic nob is calcified.  The heart size is normal. Impression: Small pleural effusion and no acute cardiopulmonary process.","['Change to homophone', 'Add contradiction', 'False negation']"
"7992c68f-11f00489-37aaadc6-6aa3e5c1-f3546cfa, a4e3640a-d1ed5982-b24f0c58-60e77e47-0256fe41",51119268,13299965,"Findings: PA and lateral views of the chest provided.  Right paratracheal opacity likely represents prominent vascular structures and is unchanged from ___.  No new focal consolidation, effusion or pneumothorax.   The hilar contours are stable.  Cardiac and mediastinal silhouettes are stable. Impression: No acute intrathoracic process.","Findings: PA and lateral views of the chest provided.  Left paratracheal opacity likely represents prominent vascular structures and is unchanged from ___.  No new focal consolidation, effusion or pneumothorax.  No new focal consolidation, effusion or pneumothorax. The hilar contours are stable.  Cardiac and mediastinal silhouettes are stable. There are signs of mild pleural thickening. Impression: No acute intrathoracic process.","['Change location', 'Add repetitions', 'False prediction']"
"e5a5b5a2-a2996ae1-5bb987c1-eace885e-862db33c, f1e70f28-5a6e30a4-7f2d7942-6753668e-d6f2ba56",51469366,13299965,"Findings: The lungs are moderately well inflated.  No pleural effusion or pneumothorax.  Heart size and mediastinal contour are unremarkable.  Mild prominence of the right hila is unchanged since ___.  Atherosclerotic calcifications of the aortic arch are noted.  Limited assessment of the osseous structures are notable for multilevel degenerative changes of the thoracic spine. Impression: No acute cardiopulmonary process.  Specifically, no pneumonia.","Findings: The lungs are moderately well inflated.  No pleural effusion or pneumothorax.  Heart size and mediastinal contour are unremarkable.  Moderate prominence of the right hila is unchanged since ___.  Atherosclerotic calcifications of the aortic arch are noted.  Limited assessment of the osseous structures are notable for multilevel degenerative changes of the thoracic spine.  The lungs are moderately well inflated. Impression: No acute cardiopulmonary process.  Specifically, no pneumonia.  There is a central venous line in place.","['Change severity', 'Add repetitions', 'Add medical device']"
"424512f8-2a1c31d2-9ba3a1a4-63c2f669-1232ca66, bc3c796e-6d0d50cb-bbda3fad-e5317feb-9129e16e",52804736,13299965,Findings: Single AP upright portable view of the chest was obtained.  There is bibasilar atelectasis without definite focal consolidation.  Right paratracheal opacity likely relates to prominent vascular structures and has been stable as compared to ___.  The cardiac and mediastinal silhouettes are stable also compared to ___.  No overt pulmonary edema is seen.  No definite fracture is identified. Impression: No acute cardiopulmonary process.  No displaced fracture is seen.,Findings: Singel AP upright portable view of the chest was obtained.  There is bibasilar atelectasis without definite focal consolidation.  Left paratracheal opacity likely relates to prominent vascular structures and has been stable as compared to ___.  The cardiac and mediastinal silhouettes are stable also compared to ___.  No overt pulmonary edema is seen.  No definite fracture is identified. Impression: No acute cardiopulmonary process.  No fracture is seen.,"['Change location', 'Add typo', 'False negation']"
"17d61d08-38d54e3f-a90d2a5a-cc0735ca-16f7c8a9, d654d073-7c55a18f-ede777f5-b8b0cd35-4d8a1782",56837754,13299965,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unchanged.  Prominence of the inferior right hila is similar to prior. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unchanged. Prominence of the inferior left hila is similar to prior. There is an NG tube in place. Impression: No acute cardiopulmonary process. Prominence of the inferior left hila is similar to prior.,"['Change location', 'Add repetitions', 'Add medical device']"
837c2769-c747eb79-c73923fc-29fa11a1-7954345d,53885176,13303439,"Findings: PA and lateral views of the chest provided.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. 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 provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is abnormal. Imaged osseous structures are in tact. There is an NG tube in place. No free air below the left hemidiaphragm is seen. Impression: No acute intrathoracic process.","['Change location', 'Change to homophone', 'Add medical device']"
253a953d-7bebbd7b-cd68e5bc-7c48ae74-fb8a2ccd,51241123,13306067,Impression: Heart size and mediastinum are stable.  Lungs are clear.  There is no pneumothorax.  The evidence of recent spinal surgery is present as surgical clips projecting over the mid spine.,Impression: Heart size and mediastinum are stable.  Lungs are clear.  There is right pneumothorax.  The evidence of recent thoracotomy is present as surgical clips projecting over the mid spine.,"['Change name of device', 'Add contradiction', 'False prediction']"
3d973084-61d4b944-76a7f29f-472d0b0e-74563711,53942433,13306067,Findings: Cardiac size is normal.  The lungs are clear.  There is no pneumothorax or pleural effusion.  Skin ___ are again noted Impression: No acute cardiopulmonary abnormality,Findings: Cardiac size is normal.  The loanes are clear.  There is no pneumothorax or pleural effusion.  Skin nodules are present over the chest. Impression: Moderate cardiomegaly. There is minimal pleural effusion. ,"['Change to homophone', 'Add contradiction', 'False prediction']"
0a13521e-6acfb42d-704d4596-c983baab-5227fbea,57848022,13306067,"Findings: There are surgical ___ in place.  The lungs are clear.  Normal heart size, pulmonary vascularity. Impression: Lungs are clear","Findings: There is a central venous line in place.  The lungs are clear.  Normal heart size, pulmonary vascularity. Impression: The lung fields are no clear.","['Add medical device', 'Add typo', 'False prediction']"
1bd45b4c-a598d499-41f5440f-789618a0-298754d2,58666333,13306067,Impression: Compared to chest radiographs ___.  ET tube in standard placement.  Lungs well expanded and clear.  Normal cardiomediastinal and hilar silhouettes and pleural surfaces.,"Impression: Compared to chest radiographs ___.  ET tube terminating 2.5 cm above the carina.  Lungs well expanded and clear.  Normal cardiomediastinal and hilar silhouettes and small bilateral pleural effusions.  A left central line is noted terminating in the mid SVC.
","['Change position of device', 'Add contradiction', 'Add medical device']"
b29bb966-45c209b8-1dee89af-5f791df9-481fe9f4,54249174,13312840,Findings: The lungs are only partially visualized on this study.  Lower lungs appear unchanged without wall focal consolidations or pleural effusions.  The partially visualized cardiomediastinal contours appear stable.  The NG tube is visualized in the thorax likely coiled in the mid esophagus. Impression: The NG tube is in the midesophagus.  The subsequent film dictated prior to this study shows the NG tube was advanced to the appropriate position.,Findings: The loins are only partially visualized on this study. Lower loins appear unchanged without wall focal consolidations or pleural effusions. The partially visualized cardiomediastinal contours appear stable. The PICC line is visualized in the thorax likely coiled in the mid esophagus. There is also an ET tube present. Impression: The PICC line is in the midesophagus. The subsequent film dictated prior to this study shows the PICC line was advanced to the appropriate position.,"['Change name of device', 'Change to homophone', 'Add medical device']"
8950f771-ba1f85b9-43178d85-6143c89f-ee7be17d,54588794,13312840,"Impression: NG tube tip is in the stomach, with its tip being below the inferior margin of the film.  Heart size and mediastinum are stable.  Lungs are overall clear.  There is no appreciable pleural effusion.  There is no pneumothorax.","Impression: NG tube tip is in the distal portion of the esophagus, with its tip being below the inferior margin of the film.  Heart size and mediastinum are stable.  Lungs are overall clear.  There is no appreciable pleural effusion.  There is no pneumothorax.  Lungs are overall clear.","['Change position of device', 'Add repetitions', 'False negation']"
a1a5ef58-0de8e5da-bc54d948-c5fcfe48-3232203b,55034479,13312840,"Impression: Heart size and mediastinum are stable.  There is a right upper lobe opacity, concerning for right upper lobe pneumonia.  Questionable paramediastinal opacity in the left upper lobe is noted as well.  There is no pleural effusion or pneumothorax.  RECOMMENDATION(S):  Followup of the patient 4 weeks after completion of antibiotic therapy for documentation of resolution although definite a right upper lobe and possible left upper lobe pneumonia.","Impression: Heart size and mediastinum are stable.  There is a right upper lobe opacity, concerning for right upper lobe pneumonia.  Questionable paramediastinal opacity in the right upper lobe is noted as well.  There is no pleural effusion or pneumothorax.  Followup of the patient 4 weeks after completion of antibiotic therapy for documentation of resolution although definite a right upper lobe and possible left upper lobe pneumonia.  Followup of the patient 4 weeks after completion of antibiotic therapy for documentation of resolution although definite a right upper lobe and possible left upper lobe pneumonia.","['Change location', 'Add repetitions', 'False prediction']"
222de94a-617f5cad-684d59ce-8ddd536c-aa8aa84a,57623556,13312840,"Findings: Shallow inspiration.  Bibasilar opacities, likely atelectasis.  Tiny right pleural effusion.  No pneumothorax.  Borderline heart size, pulmonary vascularity, accentuated by shallow inspiration. Impression: Bibasilar opacities, likely represent atelectasis ; pneumonitis cannot be excluded radiographically.","Findings: Shallow inspiration.  Bibasilar opacities, likely atelectasis.  Tiny left pleural effusion.  No pneumothorax.  Borderline heart size, pulmonary vascularity, accentuated by shallow inspiration. There is no evidence of right pleural effusion. Impression: Bibasilar opacities, likely represent atelectasis ; pneumonitis cannot be excluded radiographically. There is no evidence of atelectasis.","['Change location', 'Add contradiction', 'False prediction']"
ad553034-c4992e1a-b1833fab-e0ca9b5c-472e3a59,57625868,13312840,"Impression: In comparison with the study of ___, there is little overall change.  Again there are low lung volumes with bibasilar opacifications most likely representing atelectasis.  In the appropriate clinical setting, superimposed pneumonia could be considered.","Impression: In comparison with the study of ___, there is little overall change. Again there are low lung volumes with bibasilar opacifications most likely representing atelectasis. A central venous line is appropriately positioned with the tip in the lower SVC. In the appropriate clinical setting, superimposed pneumonia could be considered.","['Add medical device', 'Add contradiction', 'False prediction']"
"00b5589c-f5097caa-1b9fc64a-3cbd40d1-aac5eb42, 22df5947-d4f32355-60f7b9aa-d140ddb0-028af26a",57765466,13312840,Findings: The lungs are normally expanded with exception of mild platelike atelectasis in the right mid lung.  There is no focal airspace opacity worrisome for pneumonia.  There is no pleural effusion or pneumothorax. The size of the cardiomediastinal silhouette is within normal limits. Impression: Mild platelike atelectasis in the right lung.  No evidence of pneumonia.,Findings: The lungs are normally expanded with exception of moderate platelike atelectasis in the right mid lung. There is no focal airspace opacity worrisome for pnumonia. There is no pleural effusion or pneumothorax. The size of the cardiomediastinal silhouette is within normal limits. There is a small left-sided pneumothorax. Impression: Mild platelike atelectasis in the right lung. No evidene of pneumonia.,"['Change severity', 'Add typo', 'False prediction']"
"9f3c1525-622b3786-d4ec71b4-0ce69eb7-b8ebd96a, ca27223c-046c7c71-84a448f9-cd2bfe19-fecb7623",50050632,13313381,Findings: Frontal and lateral views of the chest were obtained.  The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable.  No displaced fracture is seen. Impression: No acute cardiopulmonary process.,Findings: Frontal and lateral views of the pelvis were obtained.  The lungs are clear with evidence of focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are enlarged and unremarkable.  No displaced fracture is seen.  A central venous catheter is in place. Impression: No acute cardiopulmonary process. Mild pulmonary congestion noted.,"['Change location', 'Add contradiction', 'Add medical device']"
e87f90e6-bce5fca4-f56f7269-9dda5b46-e2413c48,51193877,13313381,"Findings: The proximal end of the left PICC line is seen approaching the left chest cage, however, the distal end of the PICC line is not clearly visualized within the chest cavity and as such, placement cannot be assessed.  The mediastinal silhouette, hilar contours, and pleural surfaces are normal. No pneumonia or pneumothorax. Impression: The left PICC line is seen approaching the left chest cage, however, the distal end of the PICC line is not clearly visualized within the chest cavity, and placement cannot be assessed.  RECOMMENDATION(S):  Recommend conventional AP and lateral chest radiographs to fully assess PICC line positioning.","Findings: The proximal end of the right PICC line is seen approaching the left chest cage, however, the distal end of the PICC line is not clearly visualised within the chest cavity and as such, placement cannot be assessed.  The mediastinal silhouette, hilar contours, and pleural surfaces are normal. No pneumonia or pneumothorax. Impression: No PICC line is seen. RECOMMENDATION(S):  Recommend conventional AP and lateral chest radiograhps to fully assess PICC line positioning.","['Change location', 'Add typo', 'False negation']"
edf0798f-b3a2fdbf-00c812b0-c8d3b152-10d90abf,54976328,13313381,"Findings: The left PICC line is again seen approaching the chest wall and enters into a smaller axillary vein. The lungs are clear.  The heart size is unchanged.  There is no pneumothorax, pulmonary edema, pneumonia, or pleural effusion. Impression: 1. The tip of the left PICC line is seen in a small axillary vein.  RECOMMENDATION(S):  Recommend the left PICC line be replaced or readjusted.","Findings: The left PICC line is again seen approaching the chest wall and enters into the subclavian vein. The lungs are clear. The heart size is unchanged. There is no pneumothorax, pulmonary edema, pneumonia, or pleural effusion. There is an appropriately placed endotracheal tube. The heart size is unchanged.","['Change position of device', 'Add repetitions', 'Add medical device']"
"438de949-b994cd81-3e038daa-dfe2c09c-e5a3461b, 45164442-e942766a-b268bd24-6807bda5-f1f91440",56614637,13313381,"Impression: Comparison to ___.  In the interval, the right PICC line was removed.  Lung volumes remain low but both the cardiac silhouette and the lung parenchyma are of normal appearance.  No pneumonia, pulmonary edema or pleural effusions.","Impression: Comparison to ___ . In the interval, the right central venous line was removed. Lung volumes remain low but both the cardiac silhouette and the lung parenchyma are of normal appearnace. An ET tube is present with its tip at the level of the carina. No pneumonia, pulmonary edema or pleural effusisons. ","['Change name of device', 'Add typo', 'Add medical device']"
"52e697a7-82a5997c-9983ec74-57da40f9-57b1a5fd, 799a1e79-6391085d-5116aa00-483b59b4-8a776a15",59987091,13313381,Findings: The lungs are clear.  The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. Impression: Normal chest.,Findings: The lungs are clear.  The hilar and cardiomediastinal contours are normal. There is no pneumothorax. Mild pleural effusion is noted. Pulmonary vascularity is normal. There are no lung nodules. Impression: Normal chest.,"['False negation', 'Add contradiction', 'False prediction']"
"81893a7b-25e3ed4b-8debe6d3-38e925f6-ebeb46c7, ab1864d3-39efd23e-186ed260-9dd6e19c-9b5c7043",52837363,13314609,"Findings: In comparison with study of ___, the cardiac silhouette remains within normal limits and there is no evidence of vascular congestion or pleural effusion.  No convincing evidence of acute focal pneumonia. ","Findings: In comparison with study of ___, the cardiac silhouette remains within normal limits and there is no evidence of vascular congestion or pleural effusion. Mild right lower lobe pneumonia identified. No convincing evidence of acute focal pneumonia. ","['False negation', 'Add typo', 'False prediction']"
c3a30ee6-a23b54c0-6b4d9444-3703233d-1f7a5a46,54656635,13318908,"Findings: The tip of the right internal jugular central venous catheter projects over the right atrium.  Low bilateral lung volumes and.  There is a new retrocardiac opacity likely reflective of atelectasis.  No pleural effusion or pneumothorax identified.  The size the cardiac silhouette is enlarged, likely exaggerated by the low lung volumes and AP technique. Impression: The tip of the right internal jugular central venous catheter projects over the right atrium.  Low bilateral lung volumes.  Retrocardiac opacity likely reflects postop atelectasis.",Findings: The tip of the right internal jugular peripheral intravenous catheter projects over the right atrium.  Low bilateral lung volumes and.  There is a new retrocardiac opacity likely reflective of atelectasis.  No pleural effusion or pneumothorax identified.  The size the cardiac silhouette is enlarged with bilateral pleural effusions. Impression: The tip of the right internal jugular central venous catheter projects over the right atrium.  Low bilateral lung volumes.  Retrocardiac opacity likely reflects postop atelectasis.  Low bilateral lung volumes.  ,"['Change name of device', 'Add repetitions', 'False prediction']"
cf34b8b8-d4e13fb9-2d589730-6f402164-0ef8ffdd,55751350,13318908,"Findings: The tip of the right internal jugular central venous catheter extends to the upper SVC.  A retrocardiac opacity may reflect atelectasis or fullness of the left hilum.  No pleural effusion or pneumothorax identified.  The size of the cardiac silhouette is enlarged but unchanged. Impression: Interval retraction of the right internal jugular central venous line, now projecting over the upper SVC.","Findings: The tip of the right internal jugular central venous catheter extends to the mid SVC.  A retrocardiac opacity may reflect atelectasis or fullness of the left hilum.  No pleural effusion or pneumothorax identified.  The size of the cardiac silhouette is normal in size.  Impression: Interval retraction of the right internal jugular central venous line, now projecting over the upper SVC. A portable chest radiograph shows a nasogastric tube in the stomach.","['Change position of device', 'Add contradiction', 'Add medical device']"
"68d8c74c-b5c3c405-4232a5db-964916b5-a79a6594, e6860ce3-b1b0771f-ea2ef31a-bdd9346a-27206777",56402902,13328038,"Findings: The lungs are clear.  The hilar and cardiomediastinal contours are normal.  There is no pneumothorax or pleural effusion.  Pulmonary vascularity is normal.  No displaced rib fracture is seen. Impression: No displaced rib fracture is seen.  If there is further clinical concern, a dedicated rib series with the location of the patient's pain marked with a skin marker is recommended.","Findings: The lungs are clear. The hilar and cardiomediastinal contours are normal. Their is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. No displaced rib fracture is seen. An NG tube is present. Impression: No displaced rib fracture is scene. If there is further clinical concern, a dedicated rib series with the location of the patient's pain marked with a skin marker is recommended.","['Change severity', 'Change to homophone', 'Add medical device']"
d3b50fe0-bdb73c16-16774a7d-bbc6b279-63984407,50457687,13332630,"Findings: Frontal and lateral views of the chest were obtained.  Low lung volumes results in bronchovascular crowding.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax.  Heart size is normal.  Mediastinal silhouette and hilar contours are normal. Impression: No acute intrathoracic abnormality.  Specifically, no pneumothorax.","Findings: Frontal and medial views of the chest were obtained. Low lung volumes results in bronchovascular crowding. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. There is a central venous line in place. Mediastinal silhouette and hilar contours are normal. Frontal and medial views of the chest were obtained. Impression: No acute intrathoracic abnormality. Specifically, no pneumothorax.","['Change location', 'Add repetitions', 'Add medical device']"
"99111a32-995871bd-440828c1-27e28f82-8ee32d3e, c5d04cda-5902b0d3-962ad8a5-23e1fcb3-013d913f",53854807,13332630,Findings: Heart size is normal.  Mediastinal and hilar contours are within normal limits.  Lungs are clear.  Pulmonary vascularity is normal.  No pleural effusion or pneumothorax is present.  No acute osseous abnormalities are present. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  Mediastinal and healer contours are within normal limits.  Lungs are clear. A pacemaker is in place.  Pulmonary vascularity is normal.  No pleural effusion or pneumothorax is present.  Mild pleural effusion is present. Impression: No acute osseous abnormalities are present.  No acute cardiopulmonary abnormality.,"['Add contradiction', 'Change to homophone', 'Add medical device']"
"315d37f7-b61c3e1e-be16af1b-9a2d7783-e2da1d8e, d26f1288-1dbca978-9e778e54-d1b738cd-ee48b9dd",58340245,13332630,"Findings: The cardiomediastinal and hilar contours are within normal limits.  The lung fields are clear. There is no pneumothorax, fracture or dislocation.  Limited assessment of the abdomen is unremarkable. Impression: No acute cardiopulmonary abnormality.","Findings: The cardiomediastinal and hilar contours are within normal limits.  The lung fields are clear. There is no pneumothorax, fracture or dislocatoin.  Limited assessment of the abdomen is unremarkable with evidence of hepatomegaly. Impression: No cardiopulmonary abnormality.","['False negation', 'Add typo', 'False prediction']"
"7a30c54e-efd24c40-62ebd58f-010424a9-6a7200a8, b2ed7529-568134f7-5327275f-c83b91bd-a411f137",57911302,13335223,"Findings: PA and lateral views of the chest provided.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. 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 provided.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. A left IJ central venous catheter is seen terminating in the superior vena cava.  A small pneumothorax is observed on the left side. Impression: No acute intrathoracic process. ","['Change location', 'Add contradiction', 'Add medical device']"
"92b028e1-36a43ec4-b185bbfb-7187e208-3bee4505, c3faa797-8ce7ca41-dfd7d4f1-977729ad-c02062b6",56424846,13340246,Findings: Diffuse peribronchial abnormalities in the right upper lobe as well as the area of consolidation on the lateral margin of the left and right lungs have improved since ___ chest radiograph and ___ chest CT and are likely due to bronchiectasis on the left and pneumonia or possible radiation injury in the left lung.   No new opacification concerning for pneumonia identified.  Multiple calcified granulomas identified.  Cardiomediastinal and hilar contours are normal.  No pleural effusion or pneumothorax. Impression: No evidence of new infection. Chronic mild bronchiectasis; improved radiation or organized pneumonia.,"Findings: Diffuse peribronchial abnormalities in the left upper lobe as well as the area of consolidation on the lateral margin of the left and right lungs have improved since ___ chest radiograph and ___ chest CT and are likely due to bronchiectasis on the left and pneumonia or possible radiation injury in the left lung.  No knew opacification concerning for pneumonia identified.  Multiple calcified granulomas identified.  Cardiomediastinal and hilar contours are normal.  No pleural effusion or pneumothorax. There is also evidence of a small right-sided pleural effusion. Impression: No evidence of new infection. Chronic mild bronchiectasis; improved radiation or organized pneumonia. 
","['Change location', 'Change to homophone', 'False prediction']"
56c0b824-617a7edf-7ad7a6d7-c02e5088-5a22aaa6,52553174,13356814,"Impression: Compared to prior chest radiographs ___ through ___ at 07:32.  Left lower lobe collapse between ___ and ___ and is still airless.  Right middle lobe collapse between ___ and ___ venous partially re-expanded.  Most likely explanation is mucous retention, but CT scanning would be required for confirmation or other explanation.  Upper lungs are clear.  Moderate cardiomegaly stable.  Small pleural effusions are likely, but these are secondary to the atelectasis, not the cause.  No pneumothorax.","Impression: Compared to prior chest radiographs ___ through ___ at 07:32. Left lower lobe collapse between ___ and ___ and is still airless. Right middle lobe collapse between ___ and ___ venous partially re-expanded. The most likely explanation is mucous retention, but CT scanning wood be required for confirmation or other explanation. Upper lungs are clear. Large cardiomegaly stable. Small pleural effusions are likely, but these are secondary to the atelectasis, not the cause. No pneumothorax. There is a central venous line present.","['Change severity', 'Change to homophone', 'Add medical device']"
bf216517-21b42ccc-627f8812-5d889362-f5e78c59,52595455,13356814,Findings: Mild cardiomegaly is a stable.  The aorta is tortuous.  Small bilateral effusions larger on the right have increased.  Bibasilar atelectasis have increased.  There is no evident pneumothorax or pulmonary edema.  The and moderate Degenerative changes in the thoracic spine Impression: Increasing bilateral effusions with adjacent atelectasis,Findings: Mild cardiomegaly is absent.  The aorta is straight.  Small bilateral effusions larger on the riht have increased.  Bibasilar atelectasis has increased.  There is no evident pneumothorax or pulmonary edema.  The and moderate Degenerative changes in the cervical spine. Impression: No effusions or atelectasis have increased.,"['Change location', 'Add typo', 'False negation']"
"a9708514-d13caad4-67a5bd5b-50adf0b1-001133c9, b9e0794f-128bc11f-687abd02-c3068507-8bd8cb3e",52613722,13356814,"Findings: The cardiomediastinal and hilar contours are stable.  The aorta is tortuous.  The lungs are mildly hyperexpanded suggestive of underlying emphysema.  There has been interval development of a right lower lobe opacity which would be concerning for pneumonia or aspiration, less likely atelectasis.  No pneumothorax or pulmonary edema.  Note is made of severe degenerative change involving the right glenohumeral joint. Impression: Interval development of probable right lower lobe pneumonia or aspiration.  Clinical correlation is advised.","Findings: The cardiomediastinal and hilar contours are stable.  The aorta appears normal.  The lungs are moderately hyperexpanded suggestive of underlying emphysema.  There has been interval development of a right lower lobe opacity which would be concerning for pneumonia or aspiration, less likely atelectasis.  No pneumothorax or pulmonary edema.  Note is made of severe degenerative change involving the right glenohumeral joint.  There has been interval development of a right lower lobe opacity which would be concerning for pneumonia or aspiration, less likely atelectasis. Impression: No right lower lobe pneumonia is noted.  Clinical correlation is advised.","['Change severity', 'Add repetitions', 'False negation']"
54ab854c-ec14b27b-d554c385-73da5922-3ea3d6ed,53743846,13356814,Impression: There is new complete collapse of the  right middle lobe.  Atelectasis in the lower lobes have increased.  Small bilateral effusions are probably unchanged. Cardiomegaly cannot be assessed.  There is no evident pneumothorax.,Impression: There is new complete collapse of the left middle lobe.  Atelectasis in the lower lobes have increased.  Small bilateral effusions are probably unchanged. Cardiomegaly cannot be assessed. There is no evident pneumothorax. Small calcified granulomas noted in the upper lobes. Cardiomegaly is seen on this radiograph. ,"['Change location', 'Add contradiction', 'False prediction']"
643b5892-d5755e02-7054a915-f33776d7-b2859fa1,58392527,13356814,"Impression: Compared to prior chest radiographs ___ through ___.  Left lower lobe is still collapsed, less severe atelectasis persists at the right base.  Moderate bilateral pleural effusions may have decreased slightly. Upper lungs clear.  Mild cardiomegaly stable.","Impression: Compared to prior chest radiographs ___ through ___.  Left lower lobe is still collapsed, less severe atelectasis persists at the right bass.  Mild bilateral pleural effusions may have decreased slightly. Upper lungs clear.  Moderate cardiomegaly stable. Additionally, no evidence of an ET tube placement at this time.","['Change severity', 'Change to homophone', 'Add medical device']"
"42fa5a10-17856f17-da125a25-87062ee3-f9e4c296, 4cd0d1cd-237bafa6-1be083d0-17d9d30b-6af8d1b5",51080370,13376876,"Findings: PA and lateral views of the chest are reviewed and compared to the prior study.  Normal heart, lungs, pleural and mediastinal surfaces. Impression: Normal chest radiograph without evidence of all-trans retinoic acid syndrome.","Findings: AP and lateral views of the chest are reviewed and compared to the prior study. Normal hart, lungs, pleural and mediastinal surfaces. There are also streaky opacities consistent with atelectasis. Impression: Abnormal chest radiograph without evidence of all-trans retinoic acid syndrome.","['Change location', 'Change to homophone', 'False prediction']"
53f3ebc2-eccf07d6-246e623d-a4b102ff-79e5b202,51235024,13376876,"Findings: In comparison with the study of ___, the patient has taken a somewhat better inspiration.  No evidence of acute cardiopulmonary disease.  Tip of the right subclavian catheter again is in the mid portion of the SVC. ","Findings: In comparison with the study of ___, the patient has taken a somewhat better inspiration.  No evidence of acute cardiopulmonary disease.  Tip of the right subclavian catheter now is in the distal portion of the SVC.","['Change position of device', 'Add contradiction', 'False negation']"
72b75c31-c89b5e3c-f2a6d852-a3982477-96334886,53410013,13376876,Findings: A right subclavian Port-A-Cath is unchanged in position with the tip terminating in the mid SVC without any kinks or breaks in the line.  Cardiomediastinal silhouette and hilar contours are normal.  Lungs are clear.  There is no pleural effusion or pneumothorax. Impression: No acute cardiopulmonary process.  Right subclavian port intact and unchanged in position.,Findings: A right subclavian Port-A-Cath is unchanged in position with the tip terminating in the mid SVC without any kinks or breaks in the line.  The left hemidiaphragm is intact.  Lungs are cleans.  There is no pleural effusion or pneumothorax.  ,"['Change location', 'Add typo', 'False negation']"
"0b15a853-44ea4dcc-e9dcc745-dc75e138-94628837, 5dfd702f-14822708-67885b79-475de57e-c4f8f0ca",56009674,13376876,"Findings: PA and lateral views of the chest redemonstrates a right subclavian Port-A-Cath, unchanged in position, terminating in the mid SVC.  There is no evidence of pneumothorax, focal consolidation, pleural effusion or pulmonary edema.  The lungs are well expanded and clear.  The cardiomediastinal silhouette is unremarkable. Impression: No acute cardiopulmonary process.  Right-sided Port-A-Cath terminates in the mid SVC.","Findings: PA and lateral views of the chest redemonstrates a right subclavian central venous catheter, unchanged in position, terminating in the mid SVC.  There is no evidence of pneumothorax, focal consolidation, pleural effusion or pulmonary edema.  The lungs are well expanded and clear.  There is mild pleural effusion.  The cardiomediastinal silhouette is unremarkable. Impression: No acute cardiopulmonary process.  Right-sided Port-A-Cath terminates in the mid SVC.  The lungs are well expanded and clear.","['Change name of device', 'Add repetitions', 'False prediction']"
d510b0bf-95986115-d0440448-4733c4af-00c420aa,56885460,13376876,"Findings: A right PICC line ends in the mid SVC.  No focal consolidation, pleural effusion or pneumothorax.  Normal heart size, mediastinal and hilar contours. Impression: New right PICC ends in the mid SVC with no evidence of complication, particularly no pneumothorax.","Findings: A right PICC line ends in the right atrium.  No focal consolidation, pleural effusion or knewmothorax.  Normal heart size, mediastinal and hilar contours with mild pulmonary congestion. Impression: New right PICC ends in the mid SVC with mild right pleural effusion, particularly no pneumothorax.","['Change position of device', 'Change to homophone', 'False prediction']"
"08029b60-763ac6a5-53ccfd4e-3b593a21-cf78ad88, acbef8a3-2a857ff6-2f6778b4-31ddaf28-debde67b",53474190,13378971,Findings: PA and lateral views of the chest.  No prior.  The lungs are clear of focal consolidation.  Left apical calcified scarring is seen as well as a calcified AP window node suggestive of previous granulomatous disease.  There is no effusion or pneumothorax.  Cardiomediastinal silhouette is within normal limits.  Osseous and soft tissue structures are unremarkable. Impression: No acute cardiopulmonary process.,Findings: PA and lateral views of the chest.  No prior.  The lungs are clear of focal consolidation.  Left apical calcified scarring is seen as well as a calcified substernal node suggestive of previous granulomatous disease.  There is no effusion or pneumothorax.  Cardiomediastinal silhouette is within normal limits.  Osseous and soft tissue structures are unremarkable. There is a central venous line in place. Impression: Mild pulmonary edema and small bilateral pleural effusions.,"['Change location', 'Add contradiction', 'Add medical device']"
e830b6f7-d74485cf-a5ab6855-8063ff88-edd2313f,58063777,13380841,"Findings: As compared to the previous radiograph, the pre-existing opacity in the left lung has completely resolved.  On today's image, there is no evidence of infectious changes or other acute lung abnormality.  Borderline size of the cardiac silhouette without pulmonary edema.  Minimal tortuosity of the thoracic aorta. ","Findings: As compared to the previous radiograph, the pre-existing opacity in the right lung has completely resolved. On today's image, there is no evidence of infectious changes or other acute lung abnormality. Borderline size of the cardiac silhouette without pulmonary edema. Minimal tortuosity of the thoracic aorta. Borderline size of the cardiac silhouette without pulmonary edema. An ICD is noted in situ.","['Change location', 'Add repetitions', 'Add medical device']"
"87758a0a-42502f4e-666f7d3f-b75e49a3-243738a3, ce503ee9-43932a5f-76cf3fc3-77fc0303-686fb5c2",50880023,13381744,"Findings: Again, there is no evidence of primary or mediastinal abnormality.  There is no radiographic evidence of adenopathy on this study; please refer to recent CT of the chest dated ___, which demonstrates left hilar findings.  The lungs are well expanded bilaterally with no areas of focal consolidation, masses, lesions, pleural effusion or pneumothorax.  The cardiomediastinal silhouette and hilar silhouettes are within normal limits.  The pleural surfaces are unremarkable. Impression: No evidence of infection or malignancy.","Findings: Again, there is no evidence of primary or mediastinal abnormality.  There is no radiographic evidence of adenopathy on this study; please refer to recent CT of the chest dated ___, witch demonstrates left hilar findings.  The lungs are well expanded bilaterally with no areas of focal consolidation, masses, lesions, pleural effusion or pneumothorax.  The cardiomediastinal silhouette and hilar silhouettes are within normal limits.  The pleural surfaces are unremarkable. A pacemaker is seen in the left chest. ","['Change location', 'Change to homophone', 'Add medical device']"
"bbb2e4df-1d15a889-8564aab3-d508c496-2f8083dd, e50a0991-3848adb7-ad6f8944-80c7d026-4124cf2f",51165747,13381744,"Impression: Cardiac and mediastinal contours appear stable.  Lungs are well inflated.  There is a subtle patchy opacity in the left base which is somewhat linear in configuration which favors partial lobar atelectasis rather than pneumonia.  However, clinical correlation is advised and followup imaging should be performed based on the clinical assessment.  No pleural effusions or pneumothoraces are seen.  The left hilum superiorly remains mildly prominent but is stable and this is known to correspond to the area of a previous malignancy first imaged in ___.  No acute bony abnormality is appreciated.","Impression: Cardiac and mediastinal contours appear stable.  Lungs are well inflated.  Their is a subtle patchy opacity in the left base which is somewhat linear in configuration which favors partial lobar atelectasis rather than pneumonia.  However, clinical correlation is advised and followup imaging should be performed based on the clinic assessment.  No pleural effusions or pneumothoraces are seen.  The right hilum superiorly remains mildly prominent but is stable and this is known to correspond to the area of a previous malignancy first imaged in ___.  No acute bony abnormality is appreciated.  A pacemaker is present.","['Change location', 'Change to homophone', 'Add medical device']"
"2f821554-6b546bda-9be33494-4aa387db-9b020bb1, 33d1d839-1473585f-86e05cdd-4b4ca0f9-c617aefe",54475799,13381744,"Findings: The lungs are clear, there is no evidence of pneumonia and there are no pleural effusions. The cardiomediastinal shilhouette and hila are normal. There is no pneumothorax. Impression: No evidence of pneumonia. Known malignancy not really appreciated","Findings: The lungs are clear, there is no evidence of pneumonia and there are no pleural effusions. The cardiomediastinal shilhouette and hila are normal. There is no pneumothorax. A pacemaker is in place. Impression: No evidence of pneumonia. Known malignancy seen within the right lung.","['Add medical device', 'Add typo', 'False prediction']"
"2bad523a-765916c2-a61d6020-4c5c7a19-42017e45, 8d4c9eb2-984e5879-a822d017-56d518a7-0a75fbd5",55522316,13381744,"Findings: The right lung is clear without consolidation.  The previously seen equivocal opacity was likely from superimposed normal vessels in the setting of low lung volumes.  The left hilum remains mildly prominent due to patient's known tumor, but is much improved from the previous chest radiograph on ___.  There is no pleural effusion or pneumothorax.  The size of the cardiac silhouette is at the upper limits of normal and unchanged. Impression: No evidence of pneumonia.","Findings: The right lung is clear without consolidation.  The previously seen equivocal opacity was likely from superimposed normal vessels in the setting of low lung volumes.  The left hilum remains mildly prominent due to patient's known tumor, but is much improved from the previous chest radiograph on ___.  There is mild right pleural effusion.  The size of the cardiac silhouette is at the upper limits of normal and unchanged. Impression: No evidence of pneumonia.","['Change location', 'Change to homophone', 'False prediction']"
e84c83d4-f03872ee-5fe8ec3b-076ce17a-f7b4f861,55571313,13381744,"Findings: Projecting over the anterior aspect of the ___ right rib along the midclavicular line in the right upper lung is an ill-defined heterogenous opacity approximately 2.1 x 3.0 cm, more readily visible now than it was on ___.  The lungs are otherwise clear.   Cardiomediastinal silhouette is normal.  Pleural surfaces are unremarkable.  Adenopathy is not appreciated on this study. Impression: Likely, small, right upper lung pneumonia.","Findings: Projecting over the anterior aspect of the ___ rigth rib along the midclavicular line in the right upper lung is an ill-defined heterogenous opacity approximately 2.1 x 3.8 cm, more readily visible now than it was on ___.  The lungs are otherwise clear.  ET tube is present.  Cardiomediastinal silhouette is normal.  Pleural surfaces are unremarkable.  Adenopathy is not appreciated on this study. Impression: Likely, small, right upper lung pneumonia.","['Change measurement', 'Add typo', 'Add medical device']"
"4bb0a233-9c375594-652f647f-64f5080f-30112b80, 4e968da7-36d6c5bd-e174cb95-66fa150c-d20ff9b5",58561597,13381744,"Findings: The left hilum remains prominent and is due to the patient's known tumor, and appears stable.  Otherwise, the lungs are clear with no evidence of a consolidation, effusion, or pneumothorax.  Cardiomediastinal silhouette is at the upper limits of normal and stable.  No acute fractures are noted. Impression: No evidence of acute infection.","Findings: The left hilum remains prominent and is due to the patient's known tumor, and appears stable.  The right hilum appears prominent.  Otherwise, the lungs are clear with no evidence of a consolidation, effusion, or pneumothorax.  Cardiomediastinal silhouette is at the upper limits of normal and stable.  No acute fractures are noted. Cardiomediastinal silhouette is at the upper limits of normal and stable. Impression: No evidence of acute infection.","['Change location', 'Add repetitions', 'False prediction']"
"11a4b049-8c3347ae-9833fe58-8d108cd5-e63e1fcc, 482d52f7-7c113961-9abdb524-09269248-cef6708c",59597249,13381744,"Findings: Frontal and lateral views of the chest are obtained.  The left hilum is prominent.  No additional areas of consolidation are seen.  The right lung is clear.  No pleural effusion or pneumothorax is seen.  The cardiac silhouette is not enlarged.  Mediastinum is unremarkable. Impression: Enlarged left hilum; per patient's ED notes, the patient had an outpatient CT revealing a left lung mass.  Reference to that CT recommended.","Findings: Frontal and lateral views of the chest are obtained.  The right hilum is prominent.  No additional areas of consolidaiton are seen.  The right lung is clear.  No pleural efusion or pneumothorax is seen, although mild basilar atelectasis is noted.  The cardiac silhouette is not enlarged.  Mediastinum is unremarkable. Impression: Enlarged left hilum; per patient's ED notes, the patient had an outpatient CT revealing a right lung mass.  Reference to that CT recommended.","['Change location', 'Add typo', 'False prediction']"
7db6c381-43097f53-27747acf-fdd4adc3-1d479213,53692338,13409440,"Impression: As compared to ___ chest radiograph, left chest tubes have been removed with development of a very small left apical pneumothorax.  Cardiomediastinal contours are stable in the postoperative.  Small bilateral pleural effusions are new and accompanied bibasilar atelectasis, right greater than left.","Impression: As compared to ___ chest radiograph, left chest tubes have been removed with development of a very small left apical pneumothorax.  Cardiomediastinal contours are stable in the post o-perative.  Small bilateral pleural effusions are new and accompanied bibasilar atelectasis, right greater than left......","['Change severity', 'Change to homophone', 'Add medical device']"
f82c8dce-08b4a4f3-7e31a017-5d79c194-88f6bf9d,55534282,13409440,"Impression: No previous images.  The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.","Impression: No previous images.  The cardiac silhouette is within normal limits and there is no vascular congestion, garden effusion, or acute focal pneumonia observed.","['False prediction', 'Change to homophone', 'False negation']"
089b48e3-21dd2256-41eb2c07-e7ac0494-da51c1b8,50001612,13421580,"Findings: ET tube is 4 cm below the level of the carina, and is in appropriate position.  NG tube enters in to proximal stomach and is out of field of view.  Left PICC tip is in mid SVC and right IJ tip is in low SVC.  Mild interval decrease in size of multiple bilateral rounded opacities suggestive of septic emboli.  Lung volumes remain low.  No new focal opacity, pneumothorax, pleural effusion, or pulmonary edema.  Heart size, mediastinal contour and hila are normal.  No bony abnormality. Impression: Mild interval decrease in size of bilateral rounded opacities suggestive of septic emboli.","Findings: ET tube is 4 cm below the level of the carina, and is in a slightly elevated position.  NG tube enters into the proximal stomach and is out of the field of view.  Left PICC tip is in the mid SVC and right IJ tip is in the low SVC.  Moderate interval decrease in size of multiple bilateral rounded opacities suggestive of septic emboli.  Lung volumes remain low.  No new focal opacity, pneumothorax, pleural effusion, or pulmonary edema.  Heart size, mediastinal contour and hila are normal.  No bony abnormality. Impression: Mild interval decrease in size of bilateral rounded opacities suggestive of septic emboli. Moderate interval decrease in size of bilateral rounded opacities suggestive of septic emboli.  Pacemaker leads in right atrium and right ventricle.","['Change severity', 'Add contradiction', 'Add medical device']"
e7d5b98a-6610a0fe-de38fcf4-1d68c85e-30f96ae0,50391444,13421580,"Impression: AP chest compared to ___:  Consolidation in the left lower lobe improved between ___ and ___, and has not changed since.  Small right pleural effusion has decreased in that period of time.  New opacification at the right lung base could be either atelectasis or developing pneumonia.  The heart is normal size.  Mild interstitial pulmonary edema persists.  ET tube, right internal jugular line are in standard placements and a feeding tube passes into the stomach and out of view.  No pneumothorax.","Impression: AP chest compared to ___: Consolidation in the left lower lobe improved between ___ and ___, and has not changed since. Small right pleural effusion has decreased in that period of time. New opacification at the right lung base could be either atelectasis or developing pneumonia. The heart is normal size. Mild interstitial pulmonary edema persists. ET tube, right internal jugular line are in standard placements and a feeding tube passes into the stomach and out of view. ET tube, right internal jugular line are in standard placements and a feeding tube passes into the stomach and out of view. Multiple rib fractures noted bilaterally. ","['Change position of device', 'Add repetitions', 'False prediction']"
4c20cd93-cbf30533-1459577c-278ce3b2-46750f47,50575681,13421580,"Findings: As compared to the previous radiograph, there is minimally improved ventilation at the lung apices.  Otherwise, the lung parenchyma has an unchanged appearance.  Unchanged size of the cardiac silhouette.  Unchanged presence of extensive bilateral pleural effusions and subsequent areas of atelectasis.  Unchanged appearance of the cardiac silhouette. ","Findings: As compared to the previous radiograph, there is minimally improved ventilation at the lung bases. Otherwise, the lung parenchyma has an unchanged appearance. Unchanged size of the cardiac silhouettes. Unchanged presence of extensive bilateral pleural effusions and subsequent areas of atelectasis. Unchanged appearance of the cardiac sealhouettes. There is also a left-sided central venous line in place.","['Change location', 'Change to homophone', 'Add medical device']"
c6fe33ff-7cbd847a-01c9e864-447ae08c-a3e2ac73,51749027,13421580,"Impression: AP chest compared to ___ through ___:  Moderate-to-large bilateral pleural effusions and severe, relatively asymmetric pulmonary consolidation, probably due to pulmonary edema, unchanged over the past 48 hours.  Heart size, however, is normal.  Tip of the endotracheal tube is at the upper margin of the clavicles, no less than 4.5 cm from the carina with the chin down.  It should be advanced 2 cm for more secured seating.  Left PIC line ends at the origin of the SVC and a right internal jugular line in the mid-to-low SVC.  No pneumothorax.  Dr. ___ was paged at 11:30 a.m.","Impression: AP chest compared to ___ through ___:  Moderate-to-large bilateral pleural effusions and severe, relatively asymmetric pulmonary consolidation, probably due to pulmonary edema, unchanged over the past 48 ourts.  Heart size, however, is normal.  Tip of the endotracheal tube is at the upper margin of the clavicles, no less than 5.3 cm from the carina with the chin down.  It should be advanced 2 mm for more secured seating.  Left PIC line ends at teh origin of the SVC and a right internal jugular line in the mid-to-low SVC.  No pneumothorax.  A pacemaker is present.  Dr. ___ was paged at 11:30 a.m.","['Change measurement', 'Add typo', 'Add medical device']"
"312bb0ed-2dafb619-a0da3729-5dc19055-53169588, 9b3c6816-5dff0eb0-f54e92d0-805791b2-11c32f0b",51827027,13421580,Impression: Normal chest.,"Impression: Noraml chest. Findings: There is increased opacity in the left lung which may be due to infection.  Additionally, a central venous line is present with the tip in the superior vena cava.","['Add contradiction', 'Add typo', 'Add medical device']"
4912b8ce-70f296a3-b9137775-5da5c93b-74948b5e,52546898,13421580,"Findings: As compared to the previous radiograph, there is a slight increase in lung volumes, likely reflecting increased ventilatory pressures.  The pre-existing parenchymal opacities are slightly less severe than on the previous image, but still relatively advanced and diffuse.  Unchanged presence of a left pleural effusion is likely.  No pneumothorax. ","Findings: As compared to the previous radiograph, there is a moderate increase in lung volumes, likely reflecting increased ventilatory pressures. The pre-existing parenchymal opacities are slightly less severe than on the previous image, but still relatively advanced and diffuse. Unchanged presence of a left pleural effusion is likely. No pneumothorax. Aortic dissection is noted.","['Change severity', 'Add repetitions', 'False prediction']"
"6e39a6e9-bab75ed2-f14cb4c3-af0877ed-05332d75, be3cdb3c-7f8e24b7-df00a412-c41181eb-44d18ada",53340313,13421580,"Impression: AP chest compared to ___:  Large bilateral pleural effusions have increased, generally obscuring most of both lungs, where it is possible, particularly on the left, there is a large pneumonia.  If pleural effusions are not to be drained, I would recommend CT scanning to examine the lungs.  Heart size is normal.  Mediastinum is not widened.  ET tube is in standard placement, bilateral central venous catheters end in the low SVC and a feeding tube passes into the duodenum and out of view.  No pneumothorax.","Impression: AP chest compared to ___:  Large bilateral pleural effusions have increased, generally obscuring most of both lungs, where it is possible, particularly on the left, there is a large pneumonia.  If pleural effusions are not to be drained, I would recommend CT scanning to examine the lungs.  Heart size is normal.  Mediastinum is not widened.  ET tube is positioned 4 cm above the carina, bilateral central venous catheters end in the low SVC and a feeding tube passes into the duodenum and out of view.  No pneumothorax.  If pleural effusions are not to be drained, I would recommend CT scanning to examine the lungs. ","['Change position of device', 'Add repetitions', 'False prediction']"
743258cc-ba82e88d-ec2100af-3da6c655-7afe0682,53500287,13421580,"Impression: AP chest compared to ___:  Bilateral pleural effusion, moderate on the right has improved, slightly less on the left has increased since ___. Mediastinal and pulmonary vascular congestion suggests interstitial abnormalities due to mild edema.  Left lower lobe remains consolidated medially, either atelectasis or pneumonia.  Heart size is normal.  ET tube, right internal jugular line, feeding tube, and left PIC line are in standard placements respectively.  No pneumothorax.","Impression: AP chest compared to ___:  Bilateral pleurall effusion, moderate on the right has improved, slightly less on the left has increased since ___. Mediastinal and pulmonary vascular congestion suggests interstitial abnormalities due to mild edema.  Left lower lobe remains consolidated medially, either atelectasis or pneumonia.  Hearts size is normal.  ET tube, right internal jugular line, feeding tube, and left PICC line are in standard placements respectively.  No incrreased pneumothorax or consolidative process.","['Change name of device', 'Add typo', 'False prediction']"
60999807-e9c65537-0be33d31-e1f2eb09-329bb2a8,53672228,13421580,"Findings: AP single view of the chest has been obtained with patient in semi-upright position.  Analysis is performed in direct comparison with the next preceding similar study obtained four hours earlier during the same day.  During the interval, the patient has been extubated.  Previously described right-sided internal jugular approach central venous line remains.  Again noted is a feeding tube traversing the entire esophagus terminating in the abdomen.  The present image covers the line only about 5 inches below the hiatal area.  The more distal portion of the line could be followed further on the previous chest examination, still the tip of the Dobbhoff line was never included in the image.  Precise location of the line is essential for patient's management.  It is recommended to perform the study under fluoroscopic control.  Comparison of the chest examinations does not reveal any new acute infiltrate.  However, the pulmonary vascular pattern appears to be crowded, probably related to the high positioned diaphragms. Impression: Termination point of Dobbhoff line not identified on this film.","Findings: AP single view of the chest has been obtained with patient in semi-upright position.  Analysis is performed in direct comparison with the next preceding similar study obtained four hours earlier during the same day.  During the interval, the patient has been extubated and re-intubated.  Previously described right-sided internal jugular approach central venous line terminates in the mid SVC.  Again noted is a feeding tube traversing the entire esophagus terminating in the proximal jejunum.  The present image covers the line only about 5 inches below the hiatal area.  The more distal portion of the line could be followed further on the previous chest examination, still the tip of the Dobbhoff line was never included in the image.  Precise location of the line is essential for patient's management, except it is not.  It is recommended to perform the study under fluoroscopic control.  There is no new acute infiltrate.  However, the pulmonary vascular pattern appears to be crowded, probably related to the high positioned diaphragms. Impression: Termination point of Dobbhoff line not identified on this film. ","['Change position of device', 'Add contradiction', 'False negation']"
0b336535-040e4914-3827c41e-c9f96093-d6f5d54a,53870146,13421580,Findings: Comparison is made to previous study from ___.  There has been placement of a left-sided PICC line with distal lead tip in the mid SVC.  There is a nasogastric tube with tip of the side port below the GE junction.  There are low lung volumes.  There is prominence of the pulmonary vascular markings with atelectasis at the lung bases.   No overt pulmonary edema is seen.  There are no pneumothoraces. ,Findings: Comparison is made to previous study from ___.  There has been placement of a left-sided PICC line with distal lead tip in the right atrium.  There is no nasogastric tube identified.  There are low lung volumes.  There is prominence of the pulmonary vascular markings with atelectasis at the lung bases.   Mild pulmonary edema is noted.  No overt pneumothorax is seen.  ,"['Change location', 'Add contradiction', 'False negation']"
3e0c30fb-983b2a9f-80136b8d-f7949f7d-4ee24f04,55493597,13421580,"Findings: As compared to the previous radiograph, there is no relevant change.  The monitoring and support devices are in constant position, except for the endotracheal tube that has been advanced by approximately 1 cm.  The extent of the pleural effusion is constant.  Atelectasis at both lung bases.  Unchanged size of the cardiac silhouette. ","Findings: As compared to the previous radiograph, there is no relevant change.  The monitoring and support devices are in constant position, except for the nasogastric tube that has been advanced by approximately 1 cm.  The extent of the pleural effusion is constant.  Mild pleural effusion at both lung bases.  Enlarged size of the cardiac silhouette. ","['Change name of device', 'Add contradiction', 'False prediction']"
d7f886e4-10b9a3b0-c1cd0403-c6ec2f94-2dfc32db,55692270,13421580,"Findings: Indwelling support and monitoring devices are in standard position, and cardiomediastinal contours are similar to the prior study.  Pulmonary vascular congestion is again demonstrated, with overall improvement in extent of perihilar edema, but a new peripheral focus of airspace opacity in the right upper lobe is demonstrated, and could reflect either shift of asymmetrical pulmonary edema, or a new process such as localized aspiration or developing infection or infarction.  Moderate-to-large right and moderate left pleural effusion appear slightly larger than on the prior study, but positional differences could potentially contribute to this apparent change. ","Findings: Indwelling support and monitoring devices are in standard position, and cardiomediastinal contours are similar to the prior study.  Pulmonary vascular congestion is again demonstrated, with overall improvement in extent of perihilar edema, but a new peripheral focus of airspace opacity in the right upper lobe is demonstrated, and could reflect either shift of asymmetrical pulmonary edema, or a new process such as localized aspiration or developing infection or infarction.  Moderate-to-large right and severe left pleural effusion appear slightly larger than on the prior study, but positional differences could potentially contribute to this apparent change.  Indwelling support and monitoring devices are in standard position, and cardiomediastinal contours are similar to the prior study. ","['Change severity', 'Add repetitions', 'Add medical device']"
83239aeb-423f4884-3030d0a9-5c624588-7b8dca07,56004726,13421580,"Findings: In comparison with the earlier study of this date, the Dobbhoff tube extends at least to the junction of the second and third portions of the duodenum, where it crosses the lower margin of the image.  The tip of the endotracheal tube measures approximately 2.1 cm above the carina.  Low lung volumes with little overall change in the appearance of the heart and lungs. ","Findings: In improvement with the earlier study of this date, the Dobbhoff tube extends at least to the junction of the second and third portions of the duodenum, where it crosses the lower margin of the image. The tip of the endotracheal tube measure approximately 2.1 cm above the carina. Low lung volumes with little overall change in the appearance of the diaphragm and lungs. A central venous line is seen terminating in the superior vena cava.","['Change location', 'Add typo', 'Add medical device']"
840781fb-1fe8a6de-7bd6d463-9943d21f-7716fb40,56608606,13421580,"Impression: AP chest compared to ___ through ___:  The large bilateral pleural effusions have increased substantially over the past four days and may account entirely for greater opacification in both hemithoraces, without any real abnormality in the lungs.  The heart is normal size.  ET tube in standard placement.  Right internal jugular line ends low in the SVC.","Impression: AP chest compared to ___ through ___:  The large bilateral pleural effusions have increased substantially over the past four days and may account entirely for greater opacification in both hemithoraces, without any real abnormality in the lungs.  Bibasilar patchy opacities could reflect atelectasis or infection.  The heart is normal size.  ET tube terminates 1 cm above the carina.  Right internal jugular line terminates in the right atrium.  ","['Change position of device', 'Add contradiction', 'False prediction']"
ca37ce49-8fdec0d6-4dc2466b-44543962-762cad72,56979948,13421580,"Findings: Interval re-positioning of left PICC, now terminating in the proximal superior vena cava.  Other devices are unchanged in position.  Heart size remains normal.  Multifocal pulmonary opacities in the mid and lower lungs appear relatively similar to the prior study allowing for patient rotation. Moderate-to-large pleural effusions are again demonstrated, with apparent slight improvement on the right.  Diffuse haziness of upper abdomen is suggestive of ascites. ","Findings: Interval re-positioning of right PICC, now terminating in the proximal superior vena cava.  Other devices are unchanged in position.  Heart size remains normal.  Multifocal pulmonary opacities in the mid and lower lungs appear worse than the prior study allowing for patient rotation. Moderate-to-large pleural effusions are again demonstrated, with apparent slight improvement on the right.  Diffuse haziness of upper abdomen is suggestive of ascites. A right lower lobe collapse is observed.  Impression: No significant interval changes since the previous study. ","['Change location', 'Add contradiction', 'False prediction']"
05c6f437-00c5dd3e-2c78d21e-40683522-8e9ff770,57044212,13421580,"Findings: All the monitoring and support devices are unchanged and in standard position, in particular right IJ catheter and in lower SVC.  Left subclavian PICC ends in lower SVC.  ET tube ends at 4 cm from carina.  NG tube ends in gastric cavity, but the tip is not visualized.  As compared to yesterday, lung volumes are persistently low with left retrocardiac  consolidation and multiple bilateral nodules in the mid and upper lungs. The largest in the right upper lobe of 25 mm. These bilateral nodules are consistent with septic emboli or new opportunistic infection. The left lower lobe consolidation is suspicious for pneumonia.  Persistent small pleural effusion on the left base.  Cardiomediastinal silhouette is normal.   There is no pneumothorax. Impression: Bilateral multifocal nodules with left lower lobe consolidation and small left base pleural effusion. These bilateral nodules are consistent with septic emboli or new opportunistic infection, while the left lower lobe consolidation might be penumonia. Findings were discussed with Dr ___ at 6:12 pm by Dr ___","Findings: All the monitoring and support devices are unchanged and in standard position, in particular right IJ catheter and in lower SVC. Left subclavian PICC ends in lower SVC. ET tube ends at 5 cm from carina. NG tube ends in gastric cavity, but the tip is not visualized. As compared to yesterday, lung volumes are persistently low with no evidence of consolidation and multiple bilateral nodules in the mid and upper lungs. The largest in the right upper lobe of 25 mm. These bilateral nodules are consistent with septic emboli or new opportunistic infection. The left lower lobe consolidation is suspicious for pneumonia. Persistent small pleural effusion on the left base. Cardiomediastinal silhouette is normal. There is no pneumothorax. Impression: Bilateral multifocal nodules with no evidence of consolidation and small left base pleural effusion. These bilateral nodules are consistent with septic emboli or new opportunistic infection, while the left lower lobe consolidation might be penumonia. Findings were discussed with Dr ___ at 6:12 pm by Dr ___","['Change measurement', 'Add repetitions', 'False negation']"
b9d3c16c-c812c4bf-c62245c0-d8eabccb-5df44b6e,59377628,13421580,"Impression: 1.  Endotracheal tube, right internal jugular central line, and feeding tube and left PICC line do not appear to be significantly changed, although the tip of the nasogastric tube is not identified on the current study.  There continue to be bilateral layering effusions with bibasilar airspace disease, and these findings likely reflect bilateral pleural effusions with compressive atelectasis and superimposed moderate pulmonary edema.   A superimposed infectious process cannot be excluded.  Overall, however, there has been no significant interval change.  Cardiac and mediastinal contours are stable.  No pneumothorax.","Impression: 1.  Endotracheal tube, right internal jugular central line, and feeding tube and left PICC line do not appear too be significantly changed, although the tip of the nasogastric tube is not identified on the current study.  There continue too be bilateral layering effusions with bibasilar airspace disease, and these findings likely reflect bilateral pleural effusions with compressive atelectasis and superimposed mild pulmonary edema.   A superimposed infectious process cannot be excluded.  Overall, however, there has been no significant interval change.  Cardiac and mediastinal contours are stable.  No pulmonary edema.  No pneumothorax.","['Change severity', 'Change to homophone', 'False negation']"
40f27d37-e6a130c7-a8f437de-a7caafc0-1f106075,59568253,13421580,"Impression: 1) Findings consistent with pulmonary edema, slightly worse compared with ___.  The possibility of an underlying infectious infiltrate cannot be excluded.   2) ? mild diffuse narrowing of the left main stem bronchus. Attention to this area on followup films is requested.","Impression: 1) Findings consistent with mild pulmonary edema, slightly worse compared with ___. The possibility of an underlying infectious infiltrate cannot be excluded. 2) ? mild diffuse narrowing of the left main steam bronchus. There is suspicious right-sided pleural effusion. Attention to this area on followup films is requested.","['Change severity', 'Change to homophone', 'False prediction']"
8ed65ad6-239bbf7b-5e6858f2-f00269d0-41305065,59694374,13421580,"Findings: ET tube, Dobbhoff tube, right jugular catheter, left subclavian PICC are all unchanged and in standard position.  Mild pulmonary edema is redemonstrated, stable since prior chest x-ray.  Persist bilateral moderate to large pleural effusion and bibasilar atelectasis.  Cardio mediastinal silhouette is unchanged.   There is no pneumothorax. Impression: All the monitoring devices are unchanged, persist mild pulmonary edema and moderate to large bilateral pleural effusion with atelectasis.","Findings: ET tube, Dobbhoff tube, right jugular catheter, left subclavian central venous line are all unchanged and in standard position.  Mild pulmonary edema is redemonstrated, stable since prior chest x-ray.  Persist bilateral moderate to large pleural effusion and bibasilar atelectasis.  Cardio mediastinal silhouette is unchanged.   There is no pneumothorax. There is a central venous line. Impression: All the monitoring devices are unchanged, persist mild pulmonary edema and moderate to large bilateral pleural effusion with atelectasis.  Persist mild pulmonary edema and moderate to large bilateral pleural effusion with atelectasis.","['Change name of device', 'Add repetitions', 'Add medical device']"
"448e62e9-12a35130-5cc19fc9-f7d8b729-5751bf9c, eee409a3-a4d4b1f1-792bd53f-adbce257-55c2b13d",50285647,13453133,"Findings: In comparison with the study of ___, there again are relatively low lung volumes.  Areas of increased opacification is seen at the bases, suggestive of atelectatic change.  There is evidence of a right pleural effusion.  No definite acute focal pneumonia, though this could be well hidden on the radiographs are presented. ","Findings: In comparison with the study of ___, there again are relatively low lung volumes.  Areas of increased opacification is seen at the apices, suggestive of atelectatic change.  No pleural effusion.  No definite acute focal pneumonia, though this could be well hidden on the radiographs are presented.  No pleural effusion. ","['Change location', 'Add repetitions', 'False negation']"
"669d85b2-5453dc2b-a961b4a5-afa296a7-06a77cd8, d07f3fa4-182c4d9d-459fd2ed-24c6b8be-2802c598",51079737,13453133,"Findings: Lung volumes are low.  Bibasilar atelectatic changes are stable. Bilateral pleural effusions, right greater than left, are unchanged since ___. There is no pneumothorax. The mediastinum and heart are within normal limits.  No acute osseous abnormalities. Impression: No significant change in bilateral pleural effusions, right greater than left.","Findings: Lung volumes are moderate.  Bibasilar atelectatic changes are stable. Bilateral pleural effusions, right greater than left, are unchanged since ___. There is no pneumothorax. The mediastinum and heart are within normal limits.  No acute osseous abnormalities. Bilateral pleural effusions, right greater than left, are unchanged since ___. Impression: No significant change in bilateral pleural effusions, right greater than left.","['Change severity', 'Add repetitions', 'False negation']"
b01ddc40-b80fa234-3533e014-3b0fdf7b-e8c67c6c,51829071,13453133,"Findings: Interval placement of right-sided chest tube with apparent resolution of right pleural effusion but development of a small pneumothorax.  Otherwise, no relevant short interval change since recent study performed earlier the same date.  Please see recently dictated CT torso of ___ for more complete description of cardiothoracic findings, including a pericardial effusion. ","Findings: Interval placement of right-sided chest tube with apparent resolution of right pleural effusion but development of a small pneumothorax.  Otherwise, no relevant short interval change since recent study performed earlier the same date.  Please see recently dictated CT torso of ___ for more complete description of cardiothoracic findings, no pericardial effusion.","['Change position of device', 'Add repetitions', 'False negation']"
386e8915-c0072f29-206ebd92-18525c1d-07c487f4,52354768,13453133,"Impression: In comparison with the earlier study of this day, there has been a thoracentesis with removal of a substantial amount of pleural fluid. Small residual process. Specifically, there is no evidence of appreciable pneumothorax. Remainder of the study is essentially unchanged.","Impression: In comparison with the earlier study of this day, their has been a thoracentesis with removal of a substantial amount of pleural fluid. Large residual process. Specifically, there is no evidence of appreciable pneumothorax. Remainder of the study is essentially unchanged. There is a nasogastric (NG) tube in place.","['Change severity', 'Change to homophone', 'Add medical device']"
"06360ca2-31e36539-fbdf3e11-15fbfaf9-925f3477, d79ce993-34d446c9-a42868d4-53ecd790-f07cb168",54560211,13453133,"Impression: As compared to the previous radiograph, the right chest tube has been removed. There is mild elevation of the right hemidiaphragm but no evidence of right pneumothorax.  Unchanged appearance of the cardiac silhouette.  A pre-existing small retrocardiac atelectasis has resolved.","Impression: As compared to the previous radiograph, the left chest tube has been removed. There is mild elevation of the right hemidiaphragm but no evidence of right pneumothorax.  Unchanged appearance of the cardiac silhouette.  A pre-existing small retrocardiac atelectasis has resolved.  A pre-existing small retrocardiac atelectasis has resolved.  Bibasilar streaky opacities remain unchanged. ","['Change position of device', 'Add repetitions', 'False prediction']"
"3ff7aa6a-fcc94e00-adc8df6a-de85a781-27c9f662, c448141e-083d9d4b-bf1a42bb-1d9de6ab-35d172f8",58917692,13453133,"Findings: There are bilateral pleural effusions, right greater than left.  The right effusion is larger than the prior radiograph on ___.  There is also opacification of the left lung base, which likely represents compression atelectasis, but pneumonia cannot be excluded in the appropriate clinical setting.  No pneumothorax.  There is minimal calcification of the aortic arch. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Impression: There are bilateral pleural effusions, right greater than left.  Right effusion is worse compared to ___.","Findings: There are bilateral pleural effusions, right greater than left.  The right effusion is smaller than the prior radiograph on ___.  No opacification of the left lung base observed.  No pneumothorax.  There is minimal calcification of the aortic archh. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Impression: There are bilateral pleural effusions, right greater than left.  Right effusion is better compared to ___.","['Change severity', 'Add typo', 'False negation']"
1096d9fd-e71aefb9-50874d07-29cb8e86-2da35512,59808069,13453133,"Impression: As compared to the previous radiograph, the right chest tube is in unchanged position. There is unchanged evidence of a small right apical pneumothorax.  The lung volumes have slightly decreased, with development of basal areas of atelectasis. Borderline size of the cardiac silhouette.  No pulmonary edema.  Please see recent CT torso examination for a more detailed description of the findings, in particular the pericardial effusion.","Impression: As compared to the previous radiograph, the right chest tube has shifted slightly downward. There is unchanged evidence of a large right apical pneumothorax.  The lung volumes have slightly increased, with development of basal areas of atelectasis. Borderline enlargement of the cardiac silhouette.  Mild pulmonary edema.  Please see recent CT torso examination for a more detailed description of the findings, in particular the lack of any pericardial effusion.","['Change severity', 'Add contradiction', 'False prediction']"
96734a31-b38490e1-f61e9e78-5db8c8f5-ded5e1df,52791306,13548796,"Findings: On today's examination, no suggestion of mediastinal widening.  The mediastinal reflections are all visualized.  The mild peripharyngeal soft tissue thickening described on a CT examination from ___ is not visible on the current image.  Borderline size of the cardiac silhouette.  No pneumomediastinum.  Normal appearance of the lung parenchyma.  No pleural effusions.  No pneumothorax. ","Findings: On today's examination, no suggestion of mediastinal wiidening.  The mediastinal reflections are all visualized.  The prior peripharyngeal soft tissue thickening described on a CT examination from ___ is not visible on the current image.  No abnormal cardiac silhouette.  No pneumomediastinum.  Normal appearance of the lung parenchyma.  No pleural effusions.  No pneumothorax.","['Change severity', 'Add typo', 'False negation']"
"0d393050-8caaa760-f81a0bdb-da31d259-43e27146, af3bf50e-1730eb8e-1f26e5d5-38881647-62a7fd02",58768886,13548796,"Findings: Right-sided PICC terminates in the upper SVC.  Cardiac silhouette size is normal.  Mediastinal and hilar contours are unchanged.  No pulmonary vascular congestion is seen.  The lungs are clear.  No focal consolidation, pleural effusion or pneumothorax is present.  There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.","Findings: Right-sided PICC terminates in the mid SVC.  Cardiac silhouette sighs is normal.  Mediastinal and hilar contours are unchanged.  No pulmonary vascular congestion is scene.  The lungs are clear.  No focal consolidation, pleural effusion or pneumothorax is present.  There are no acute osseous abnormalities.  A left-sided central venous line is noted. Impression: No acute cardiopulmonary abnormality.","['Change position of device', 'Change to homophone', 'Add medical device']"
664198f0-e4b3fbb9-c7a6f117-980a1fc1-f6fa9a2f,58636898,13558665,"Findings: In comparison with the study of ___, the monitoring and support devices remain in place.  Cardiac silhouette is somewhat prominent with mild tortuosity of the aorta.  Bibasilar atelectatic change without definite vascular congestion or acute focal pneumonia. ","Findings: In comparison with the study of ___, the monitoring and support devices remain in place.  Cardiac silhouette is somewhat prominent with moderate tortuosity of the aorta.  Bibasilar atelectatic change without definite vascular congestion or acute focal pneumonia. A right IJ central venous catheter projects over the right atrium.","['Change severity', 'Add contradiction', 'Add medical device']"
7b232609-e63c02a4-28b79e05-fb02ed28-1facf2f2,59315283,13558665,"Findings: Portable supine view of the chest demonstrates low lung volumes, which accentuates bronchovascular markings.  There is no pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is top normal.  Endotracheal tube terminates 4 cm above the carina.  The patient's known sternal and rib fractures are better seen on the CT exam of same date. Impression: No evidence of acute cardiopulmonary process.","Findings: Portable supine view of the chest demonstrates low lung volumes, which accentuates bronchovascular markings.  The patient's known sternal and rib fractures are better seen on the CT exam of same date.  There is no pleural effusion, focal consolidation or pneumothorax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is top normal.  Endotracheal tube terminates 4 cm above the carina.  There is a small right pleural effusion noted. Impression: No evidence of acute cardiopulmonary process.","['Change location', 'Add repetitions', 'False prediction']"
"f15ca291-081f6d47-5fe46ec7-03874ec4-a58b9780, f635620c-c59587a0-ea69a0e8-2b68825f-8a5e281f",50132992,13565877,"Findings: Frontal and lateral views of the chest were obtained.  The lungs remain hyperinflated with flattening of the diaphragm, suggesting chronic obstructive pulmonary disease.  Evidence of bilateral pleural and diaphragmatic plaques are again seen consistent with prior asbestos exposure.  No focal consolidation is seen.  There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. Impression: Bilateral calcified pleural plaques again seen, consistent with the prior asbestos exposure.  No acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest were obtained.  The lungs remain hyperinflated with flattening of the diaphragm, suggesting chronic obstructive pulmonary disease.  Evidence of unilateral pleural and diaphragmatic plaques are again seen consistent with prior asbestos exposure.  No focal consolidation is seen.  There is no pleural effusion or pneumothorax.  The cardiac and mediastinal silhouettes are stable and unremarkable.  A central venous catheter is present, terminating in the superior vena cava. Impression: Bilateral calcified pleural plaques again seen, consistent with the prior asbestos exposure.  Mild cardiopulmonary edema.","['Change location', 'Add contradiction', 'Add medical device']"
"0314a6ea-9f693c4d-8a4f3f7c-443c0a6f-ee9467f0, 579f0de5-36fac16d-378b2a77-284ac0ff-35abdc14",50756406,13565877,"Findings: Multiple calcified pleural plaques are similar to prior studies suggesting prior asbestos exposure. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Impression: No acute intrathoracic process. Unchanged bilateral calcified pleural plaques consistent with prior asbestos exposure.","Findings: Multiple calcified pleural plaques are similar to prior studies suggesting prior asbestos exposure. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is enlarged. An NG tube is noted terminating in the stomach. Impression: No acute intrathoracic process. Lung consolidation on bilateral lower lobes.","['Change location', 'Add contradiction', 'Add medical device']"
"66cd9f76-7d0e7422-876c51b9-e8f215eb-96091f16, 6f550224-a23be693-b5f671c6-843ca075-5b25df1f",55639373,13565877,Findings: Vague opacities projecting over the mid upper lungs laterally are compatible with calcified pleural plaques seen on prior CT.  No obvious underlying consolidation.  There is no effusion or edema.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,Findings: Vague opacities projecting over the mid upper lungs medially are compatible with calcified pleural plaques seen on prior CT. Minimal consolidation noted in the left lung.  There is no effusion or edema. The cardiomediastinal silhouette is mildly enlarged. No acute osseous abnormalities. Impression: No acute cardiopulmonary process is noticed. There is evidence of left lung consolidation. ,"['Change location', 'Add contradiction', 'False prediction']"
0eca4744-28e28df7-0a6c3a98-dee33b2a-4041ba77,55895988,13565877,"Impression: AP chest compared to ___:  Lung volumes are lower, accounting in part but probably not entirely for slight increase in pulmonary vascular and mediastinal venous caliber.  The poor ventilation at the base of the right lung is most likely due to atelectasis.  Heart is normal size.  Asbestos-related calcified pleural plaques are more readily appreciated on the conventional chest radiograph performed ___.  No pneumothorax.","Impression: AP chest compared to ___: Lung volumes are lower, accounting in part but probably not entirely for slight increase in pulmonary vascular and mediastinal venous caliber. The poor ventilation at the base of the left lung is most likely due to atelectasis. Heart is normal seize. Asbestos-related calcified pleural plaques and bilateral pleural effusion are more readily appreciated on the conventional chest radiograph performed ___. No pneumothorax.","['Change location', 'Change to homophone', 'False prediction']"
"0c59944b-dbd8302b-4562d004-5868ec7a-d84395ad, 9c4f1537-be70f317-6f6e0f3d-5a469592-c26e0b88",56299234,13565877,"Findings: Lung volumes are lower compared to the prior study. This accentuates the size of the cardiac silhouette which is likely mildly enlarged. The aorta is slightly tortuous. There is crowding of the bronchovascular structures, with mild possible mild pulmonary vascular engorgement likely present. Diffuse calcified pleural plaques limits assessment of the pulmonary parenchyma. There are likely patchy opacities in the lung bases reflective of atelectasis. Minimal blunting of the right costophrenic angle appears new compared to the prior study and may be due to a small pleural effusion. No pneumothorax is identified. No acute osseous abnormalities seen. Impression: 1. Bilateral calcified pleural plaques compatible with prior asbestos exposure. 2. Low lung volumes with probable bibasilar atelectasis and possible mild pulmonary vascular congestion.  Blunting of the right costophrenic angle suggests a trace pleural effusion.","Finding: Lung volumes are lower compared to the prior study. This accentuates the size of the cardiac silhouette which is likely severely enlarged. The aorta is slightly tortuous. There is crowding of the bronchovascular structures, with mild possible mild pulmonary vascular engorgement likely present. Diffuse calcified pleural plaques limits assessment of the pumonary parenchyma. No opacities in the lung bases is seen. Minimal blunting of the right costophrenic angle appears new compared to the prior study and may be due to a small pleural effusion. No pneumothorax is identified. No acute osseous abnormalities seen. Impression: 1. Bilateral calcified pleural plaques compatible with prior asbestos exposure. 2. Low lung volumes with probable bibasilar atelectasis and possible mild pulmonary vascular congestion.  Blunting of the right costophrenic angle suggests a trace pleural effusion.","['Change severity', 'Add typo', 'False negation']"
"730db867-d434712a-03e45219-29563ae9-6e57b2f9, 9c885cef-08e9c171-95f0aa12-d19c0858-982a37fa",58461129,13565877,"Findings: The heart size is normal.  The aorta is mildly unfolded.  The mediastinal and hilar contours are unchanged.  Calcified bilateral pleural plaques are re- demonstrated.  The lungs are hyperinflated but clear.  No focal consolidation, pleural effusion or pneumothorax is seen.  The pulmonary vasculature is normal.  There are no acute osseous abnormalities. Impression: Bilateral calcified pleural plaques compatible with prior asbestos exposure.  No acute cardiopulmonary abnormality.","Findings: The heart size is normal.  The aorta is mildly tortuous.  The mediastinal and hilar contours are unchanged.  No bilateral pleural plaques are seen.  The lungs are hyperinflated but clear.  No focal consolidation, pleural effusion or pneumothorax is scene.  The pulmonary vasculature is normal.  There are no acute osseous abnormalities. Impression: No pleural plaques.  No acute cardiopulmonary abnormality.","['Change location', 'Change to homophone', 'False negation']"
"34c60d57-a91b9812-32e246f3-6efe8843-a09ffa27, 7ece76d5-4de53231-dc9bc951-c27b8a9c-00694cc8",50393864,13571108,"Findings: In comparison with the study of ___, there may be small improvement in the degree of pleural effusions since the intervening procedure.  No definite pneumothorax.  Right lung remains clear. ","Findings: In comparison with the study of ___, there may be moderate improvement in the degree of pleural effusions since the intervening procedure.  No definite pneumothorax. Mild right-sided pneumothorax.  Right lung shows some opacities.  ","['Change severity', 'Add contradiction', 'False prediction']"
"9461c88d-83a7702b-d089e66a-73f4da4a-768bc8e7, b3d58529-d16ebe23-04b8237f-13bf09fb-69c9566f",50920453,13571108,"Findings: The lungs are well expanded. An ill-defined nodular opacity projecting over the periphery of the lingula is noted, not seen clearly on the lateral view. Right lung is clear.  The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal.  No pleural effusions or pneumothorax is present. Impression: Ill-defined opacity projecting over the periphery of the lingula is concerning for pneumonia.","Findings: The lungs are well expanded. No nodular opaicty is noted. Left lung is clear. The cardomedadiastinal silhouette, hilar contours and pleural surfaces are normal. No pleural effusions or pneumothorax is present. Impression: Ill-defined opacity projecting over the periphery of the right lower lobe is concerning for pneumonia.","['Change location', 'Add typo', 'False negation']"
"147372cb-a8b13f70-636a3d8e-c2c3672f-e6585376, e5f491e8-7492e07c-44f7e6b7-01e90cc8-5242f410",51737323,13571108,Findings: Cardiac size is top normal.  Moderate right and large left pleural effusions with associated passive atelectasis are unchanged from prior study.  There is new mild vascular congestion.  Right PICC is in the low SVC Impression: New mild vascular congestion,Findings: Cardiac size is top normal.  Moderate left and large left pleural effusions with associated passive atelectasis are unchanged from prior study.  There is new kild vascular congestion.  Right PICC is in the low SVC. A pacemaker is present and appears to be functioning well. Impression: New mild vascular congestion,"['Change location', 'Add typo', 'Add medical device']"
80e656ba-2e0b73a5-6252aa35-12c0df92-f0d566b9,52526223,13571108,"Findings: As compared to the previous radiograph, there is unchanged evidence of a relatively extensive left pleural effusion that occupies approximately half of the left hemithorax.  The true extent of the effusion is, overall, grossly unchanged, although the effusion is distributed in a slightly different way.  Unchanged relatively extensive left lower lung atelectasis and moderate cardiomegaly.  On the right, there is no evidence of pathological changes such as effusions, pneumonia or pneumothorax. ","Findings: As compared to the previous radiograh, there is unchanged evidence of a relatively extensive left pleural effusion that occupies approximately half of the left hemithorax.  The true extent of the effusion is, overall, grossly unchanged, although the effusion is distributed in a slightly different way.  Unchanged relatively extensive left lower lung atelectasis and severe cardiomegaly.  On the right, there is no evidence of pathological changes such as effusions, pneumonia or pneumothorax. An ET tube is present with its tip at the level of the carina.
","['Change severity', 'Add typo', 'Add medical device']"
"08f26428-11618c66-d31e30be-bb3cdba9-7246cdef, 114fc6d8-e46d27e6-617b8079-bc857050-e0982eee",53069779,13571108,Findings: Heart size is top normal with mild tortuosity of the thoracic aorta.  Hilar contours are unremarkable.  There has been interval development of small bilateral right greater than left pleural effusions with mild adjacent bibasilar atelectasis.  Remainder of the lung fields are clear.  There is no pneumothorax.  A Dobbhoff tube remains in place in the very proximal stomach and should be further advanced. Impression: Small right greater than left bilateral pleural effusions.  Dobbhoff tube ends in the very proximal stomach and should be further advanced.,Findings: Heart size is top normal with mild tortuosity of the thoracic aorta.  Hilar countours are unremarkable.  There has been interval development of small bilateral left greater than right pleural effusions with mild adjacent bibasilar atelectasis.  Remainder of the lung fields are clear.  There is no pneumothorax.  A Dobbhoff tube remains in place in the very proximal stomach and should be further advanced.  A central venous line is seen in the right jugular vein. Impression: Small left greater than right bilateral pleural effusions.  Dobbhoff tube ends in the very proximal stomach and should be further advansed.,"['Change location', 'Add typo', 'Add medical device']"
"07623786-8bfec10d-aa286291-61fe86d0-f9371a45, c17d8e88-625a9c75-18f1925a-a3ba291b-a309ebb3",54975015,13571108,"Findings: PA and lateral views of chest demonstrate an extensive left -sided pleural effusion with compressive atelectasis; an underlying pneumonia cannot be excluded. A tiny right pleural effusion may also be present. The cardiac silhouette also appears enlarged, but it is difficult to completely assess the left border given the large pleural effusion.  The right lung is clear of focal opacities worrisome for pneumonia. There is no pneumothorax. Impression: 1. Large left-sided pleural effusion with underlying atelectasis, underlying consolidation is not excluded.   2. Difficult to assess, but possibly enlarging cardiac silhouette; query underlying pericardial effusion","Findings: PA and lateral views of chest demonstrate an extensive left-sided pleural effusion with compressive atelectasis; an underlying pneumonia cannot be excluded. A tiny right pleural effusion may too be present. The cardiac silhouette also appears enlarged, but it is difficult to completely assess the left border given the large pleural effusion. A pacemaker is present. The right lung is clear of focal opacities worrisome for pneumonia. There is mild pneumothorax. Impression: 1. Large left-sided pleural effusion with underlying atelectasis, underlying consolidation is not excluded.  2. Difficult to assess, but possibly mildly enlarging cardiac silhouette; query underlying pericardial effusion","['Change severity', 'Change to homophone', 'Add medical device']"
65cbc543-f6cef27d-ecffe71b-7a1cab1e-28e47ee2,56217740,13571108,"Impression: Moderate right and small left pleural effusions, both increased since ___.  Persistent consolidation at the right lung base, which developed between ___, ___ and ___, persistent, could be pneumonia.  Heart size is top normal.  No pneumothorax.  Feeding tube ends in the stomach.","Impression: Moderate right and small left pleural effusions, both increased since ___.  No consolidation.  Heart size is top normal.  No pneumothorax.  Feeding tube is coiled in the esophagus.","['Change position of device', 'Change to homophone', 'False negation']"
29db2a67-c5b93d1b-9c1638a1-673fda55-77f3d8ba,58074550,13571108,Findings: The lung volumes are low.  The heart size is normal.  Mediastinal and hilar contours are unremarkable.  The pulmonary vasculature is normal.  Lungs are clear.  No pleural effusion or pneumothorax is seen although the left costophrenic angle is excluded from the field of view.  There are no acute osseous abnormalities. Impression: No acute cardiopulmonary process.,Findings: The lung volumes are low. The heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. There is a small right pleural effusion. No pleural effusion or pneumothorax is seen although the right costophrenic angle is excluded from the field of view. There are no acute osseous abnormality. Impression: No acute cardiopulmonary processes.,"['Change location', 'Change to homophone', 'False prediction']"
"e6cd2500-1899413e-d3de528f-a4281a95-460339bf, ffd81c9c-a7f1e1b9-eb6fb574-0066af97-9d20f9a9",58633058,13571108,"Findings: As compared to the previous radiograph, the lung volumes continue to be low.  There is mild hyperexpansion of the stomach and a newly appeared retrocardiac atelectasis.  No pleural effusions.  No pulmonary edema.  The cardiac silhouette continues to be at the upper range of normal. ","Findings: As compared to the previous radiograph, the lung volumes continue to be low.  There is moderate hyperexpansion of the stomach and a newly appeared retrocardiac atelectasis.  No pleural effusions.  Small bilateral pleural effusions.  The cardiac silhouette continues to be at the upper range of normal. Additionally, there is the presence of a right IJ central venous catheter.","['Change severity', 'Add contradiction', 'Add medical device']"
"4a86c9ea-5566c4aa-8107da40-eb3eb0cc-d09f404b, 8b2110cb-ba5ab918-d5113735-96b1a497-ed3eff2d",58671472,13571108,Impression: Improved opacities in the lingula.,Impression: Improved opacities in the lagnula.,"['Change to homophone', 'Add typo', 'False negation']"
"730ac1ff-f9317f93-3bb0bb75-18942eab-a90c43a3, 9952d9b7-35a065ad-cf97e843-5decbb57-aff7212a",55712456,13653377,Findings: The lungs are clear without consolidation or edema.  There is no pleural effusion or pneumothorax.  The cardiomediastinal silhouette is normal. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear eithout consolidation or edema. There is no pleural effusion or pneumothorax. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. A central venous line is present. Impression: No acute cardiopulmonary process.,"['Add repetitions', 'Add typo', 'Add medical device']"
"b55480c5-35f5035f-99072f8f-e543d1e6-5ac76f23, bcf4add2-ac9c300f-e35c9d96-d8462fe4-9d328831",58111167,13653377,Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  The bony structures are unremarkable aside from minimal degenerative changes.  There has been no significant change. Impression: No evidence of acute disease.,Findings: The heart is norml in size.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  The bony structures are unremarkable aside from moderate degenerative changes.  There has been no significant change. Impression: No evidence of acute disease. A pacemaker is present.,"['Change severity', 'Add typo', 'Add medical device']"
"59132f9d-ca07da35-afdde408-a2d7986d-4948d0c3, b57e2fd5-e8efb1d9-46533dc5-2d856c3d-19ab41b4",50457804,13671677,Findings: There is a left-sided dual-lead pacemaker with leads terminating in appropriate position in the right ventricle and atrium.  The heart size is normal.  The lungs are clear.  Hilar contours are normal.  There is no pleural effusion or pulmonary edema.  Descending thoracic aorta is tortuous with no suggestion of aneurysm. Impression: No evidence of acute cardiopulmonary process. Appropriate lead positioning.,Findings: There is a left-sided dual-lead pacemaker with leads terminating in appropriate position in the mid right atrium.  The hart size is normal.  The lungs are clear.  Hilar contours are normal.  There is no pleural effusion but bilateral pulmonary edema.  Descending thoracic aorta is tortuous with no suggestion of aneurysm. Impression: No evidence of acute cardiopulmonary process. There is a large hiatal hernia in the upper esophagus.,"['Change position of device', 'Change to homophone', 'False prediction']"
"7707c2f5-2b806bbd-3f906fe9-e476a733-223553d7, 9e30504e-b946160e-6e57d083-2bd79527-b28f1dc4",54728992,13671677,"Findings: Left cardiac pacemaker with intact leads ending in the right atrium and right ventricle is seen.  Heart size is upper limit of normal with no signs of pleural effusion or pulmonary congestion.  No focal consolidation is seen, and no complications of the procedure including pneumothorax are seen. Impression: Pacemaker with leads ending in the right atrium and right ventricle seen.","Findings: Left cardiac defibrillator with intact leads ending in the right atrium and right ventricle is seen. Heart size is upper limit of normal with no signs of pleural effusion or pulmonary congestion. No focal consolidation is seen, and no complications of the procedure including pneumothorax are seen. Impression: Pacemaker with leads ending in the right atrium and right ventricle seen. Heart size is borderline enlarged with mild bilateral pleural effusions.","['Change name of device', 'Add contradiction', 'False prediction']"
"217bddf4-50e50848-b90e6afd-2a88f6ed-1a208f57, 6bc6645a-9556a008-608aa00b-a4d01254-eb8499be",59005527,13671677,Findings: Dual lead left-sided pacemaker is seen with lead extending the expected positions of the right atrium and right ventricle.  The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Impression: No acute cardiopulmonary process.,Findings: Dual lead left-sided pacemaker is seen with lead extending into the left atrium and right ventricle.  The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. The lungs are clear without focal consolidation. Impression: Mild cardiomegaly noted.,"['Change position of device', 'Add repetitions', 'False prediction']"
"5d5e53a8-06b5826c-f435abd4-e4e4a6e9-41384ae2, 794533ad-f257d046-041dd56e-181a50d3-b5643cd0",57144065,13714536,"Impression: Heart size and mediastinum are stable.  Lungs are clear. There is no pleural effusion or pneumothorax. Overall no evidence of metastatic disease within the limitations of the study technique demonstrated. If clinically warranted, correlation with chest CT is to be considered.","Impression: Heart size and mediazstinum are stable.  Lungs are clear. There is no pleural effusion or pneumothorax. Small pleural effusion is noted. Overall no evidence of metastatic disease within the limitations of the study technique demonstrated. If clinically warranted, correlation with chest CT is not necessary.","['Add typo', 'Add contradiction', 'False negation']"
"78ac2135-485cfc41-1418f7ab-074355ea-d5c44e50, f74bcb32-9100c0a3-afef824e-a1485ea6-f990aa2a",50871707,13722528,Impression: Heart size is top-normal is stable. Apical scarring right more than left as well as right lower lobe linear opacities are stable.  No definitive evidence of new infectious process demonstrated on the current study with similar to known chronic findings seen. No pleural effusion or pneumothorax,Impression: Heart size is top-normal is stable. Apical scarring left more than right as well as right lower lobe linear opacities are stable.  No definitive evidence of new infectious process demonstrated on the current sstudy with similar to known chronic findings seen. No pleural effusion or pneumothorax. A central venous line is present.,"['Change location', 'Add typo', 'Add medical device']"
"3fec4c61-f3e07a20-1bfa9956-78c0e16c-69d76fe2, 4533a58b-b915b5c9-18ce3efd-15d23267-5da8b20b",52066292,13722528,"Impression: PA and lateral chest compared to ___ and ___:  Heterogeneous opacification in the right upper lobe in ___ is most readily explained by pneumonia.  That has largely resolved, but there is still irregular opacification, best appreciated on the lateral view as well as the possibility of a ___-mm wide nodule projecting just anterior to the ascending thoracic aorta.  For that reason, I would recommend chest CT scanning if nothing else to establish baseline appearance of hyperinflated lungs, probably due to emphysema.  Heart size is top normal, but there is no pulmonary or mediastinal vascular engorgement, edema or pleural effusion.","Impression: PA and lateral chest compared to ___ and ___:  Heterogeneous opacification in the rigth upper lobe in ___ is most readily explained by pneumonia.  That has largely resolved, but there is still irregular opacification, best appreciated on the lateral view.  For that reason, I would recommend chest CT scanning if nothing else to establish baseline appearance of hyperinflated lungs, probably due to emphysema.  Heart size is top normal, but there is no pulmonary or mediastinal vascular engorgement, edema or pleural effusion.","['Change measurement', 'Add typo', 'False negation']"
bcfdab4a-41f56a9d-969a736a-88b92d25-0b313cc1,53126282,13722528,Findings: Interval resolution of the left upper lobe pneumonia.  No new areas of airspace consolidation. The cardiomediastinal shadow is unchanged. No pleural effusions. Mild coarsening of the interstitial markings persist. Impression: Interval resolution of the left upper lobe pneumonia.,Findings: Interval resolution of the left lower lobe pneumonia.  No new areas of airspace consolidation. No new areas of airspace consolidation. The cardiomediastinal shadow is unchanged. No pleural effusions are present. Mild coarsening of the interstitial markings persist. Bilateral pleural thickening is noted. Impression: Interval resolution of the left upper lobe pneumonia.,"['Change location', 'Add repetitions', 'False prediction']"
"5b257a97-dad6f2e3-a20a3c51-1c6250d0-7024d6d4, d32f47ef-e58a672f-861f3eff-c37a113c-d426926f",53966206,13722528,"Findings: Increased interstitial markings seen at the periphery of the lung, right greater than left compatible with previously noted subpleural fibrotic changes.  There is no new focal consolidation, effusion, or edema.  Cardiomediastinal silhouette is stable.  No acute osseous abnormalities. Impression: Chronic changes in the lungs without superimposed acute cardiopulmonary process.","Findings: Increased interstitial markings seen at the periphery of the lung, left greater than right compatible with previously noted subpleural fibrotic changes.  There is no new focal consolidation, effusion, or edema.  Cardiomediastinal silhouette is stable.  No acute osseous abnormalities. Major opacity seen in the left lower lung zone. Impression: Chronic changes in the lungs without superimposed acute cardiopulmonary process. Acute pulmonary consolidation noted.","['Change location', 'Add contradiction', 'False prediction']"
"cd910d90-c7ce8292-427f0761-508b8be8-83629e20, db3d74d0-432e6e64-779f03be-e3057859-33eab1d4",54403374,13722528,Findings: Large airspace opacity in the left upper lung is grossly unchanged. Patchy opacities in the right lung are stable as well.  No pleural effusions or pneumothorax.  The hila and cardial mediastinal silhouette are otherwise unchanged. Impression: Persistent severe left lung opacity.  No new consolidation.,Findings: Small airspace opacity in the left upper lung is grossly unchanged. Patchy capacities in the right lung are stable as well. No pleural effusions or pneumothorax. There is a large hiatal hernia. The hila and cardial mediastinal silhouette are otherwise unchanged. Impression: Persistent mild left lung opacity. No new consolidations.,"['Change severity', 'Change to homophone', 'False prediction']"
e6828d47-61cbfa6e-0213c719-e6864bd1-2bd635b9,54669301,13722528,"Findings: PA and lateral chest radiographs show a subtle opacity in the left lung base compatible with pneumonia.  There is no pleural effusion or pneumothorax.  Mild cardiomegaly is unchanged.  The cardiac, hilar, and mediastinal contours are unremarkable. Impression: Right lower lung opacity compatible with pneumonia.","Findings: PA and lateral chest radiographs show a subtle opacity in the left lung base compatible with pneumonia.  Their is no pleural effusion or pneumothorax.  Moderate cardiomegaly is unchanged.  The cardiac, hilar, and mediastinal contours are unremarkable.  There is mild aortic tortuosity. Impression: Right lower lung opacity compatible with pneumonia.","['Change severity', 'Change to homophone', 'False prediction']"
"381625eb-17722acf-958d7213-64604dd3-ee843cb4, 55a14268-88a2935c-2da0561c-338a49af-e83b75cd",55504230,13722528,"Findings: Mild cardiomegaly is stable compared to multiple prior exams dating back at least to ___.  The previously noted subtle opacity in the right lung base is not seen on this exam.  There are no new focal consolidations, pleural effusions or pneumothorax.  The hilar and mediastinal contours are unremarkable. Impression: No evidence of pneumonia.","Findings: Severe cardiomegaly is stable compared to multiple prior exams dating back at least to ___.  The previously noted subtle opacity in the right lung base is not seen on this exam.  There are no new focal consolidations, pleural effusions or pneumothorax.  The hilar and mediastinal contours are unremarkable.  The hilar and mediastinal contours are unremarkable. Impression: No evidence of pneumonia.","['Change severity', 'Add repetitions', 'False negation']"
"96efa075-88b5082c-8576962c-dd1e4238-b16bfefd, bb3f07a8-beb19591-79af0942-6ba135e7-d3e24bb7",55960864,13722528,"Findings: PA and lateral views of the chest provided. There is left lung volume loss with increased left upper lung opacity concerning for pneumonia.  Scarring in the right apex is noted.  The heart is mildly enlarged.  No large effusion is seen.  No pneumothorax.  Mediastinal contour is within normal limits.  Aortic calcification is present.  Bony structures are intact. Impression: COPD with left upper lobe opacity concerning for pneumonia.  Please note, follow-up to resolution is strongly recommended to exclude underlying malignant process.","Findings: PA and lateral viws of the chest provided. There is left lung volume loss with increased left upper lung opacity concerning for pneumonia. No left lung volume loss is seen.  The heart is severely enlarged. No large effusion is seen. No pneumothorax. Mediastinal contour is within normal limits. Aortic calcification is present. Bony structures are intact. Impression: No COPD. Please note, follow-up to resolution is strongly recommended to exclude underlying malignant process.","['Change severity', 'Add typo', 'False negation']"
"3454e89a-58e3895d-8af07967-2786fcd9-72c8fe21, ab3c4c55-cffc7fd2-8e57ccab-4932928c-3527dd56",57880555,13722528,"Findings: Frontal and lateral views of the chest.  There is new consolidation in the right upper lobe and likely within the right middle lobe as well.  The left lung is grossly clear.  There is no effusion.  Cardiac silhouette is enlarged, unchanged.  Atherosclerotic calcifications noted at the aortic arch.  No acute osseous abnormality. Impression: Right upper and potentially middle lobe pneumonia.  Recommend repeat after treatment to document resolution.","Findings: Frontal and lateral views of the chest.  There is new consolidation in the left upper lobe and likely within the right middle lobe as well.  The left lung is grasly clear.  There is no effusion.  Cardiac silhouette is enlarged, unchanged. A central venous line is present.  Atherosclerotic calcifications noted at the aortic arch.  No acute osseous abnormality. Impression: Right upper and potentially middle lobe pneumonia.  Recommend repeat after treatment to document resolution.","['Change location', 'Add typo', 'Add medical device']"
7fb879bd-f49e00bd-91609953-bf71e17f-5a419295,51901233,13731472,"Findings: Portable upright AP views.  There are low lung volumes.  Exam appears stable from prior.  There is a subtle opacity in the right inferior cardiac margin, consistent with known epicardial fat pad.  The lungs are otherwise clear.  Cardiomediastinal silhouette is stable.  There is no pneumothorax or pleural effusion.  Visualized osseous structures are unremarkable. Impression: No acute cardiopulmonary process.","Findings: Portable upright AP views.  Their are low lung volumes.  Exam appears stable from prior.  There is a subtle opacity in the right superior cardiac margin, consistent with known epicardial fat pad.  The lungs are otherwise clear.  Cardiomediastinal silhouette is stable.  There is no pneumothorax or pleural effusion.  Visualized osseous structures are unremarkable.  A central venous line is present.Impression: No acute cardiopulmonary process.","['Change location', 'Change to homophone', 'Add medical device']"
7a12e8a5-770ebdb4-2304e41d-535a3f1c-7409884f,59665820,13731472,Findings: The heart size is moderately enlarged but is less prominent than on the study from ___ years prior.  There is mild pulmonary vascular redistribution.  There is increased opacity at both bases compatible with volume loss/early infiltrate. Impression: Mild fluid overload.  Compared to the study from ___ years prior the amount of CHF is less.,Findings: The heart size is severely enlarged but is less prominent than on the study from ___ years prior.  There is mild pulmonary vascular redistribution.  There is increased opacity at both basis compatible with volume loss/early infiltrate. ET tube is noted in the airway. Impression: Severe fluid overload.  Compared to the study from ___ years prior the amount of CHF is less.,"['Change severity', 'Change to homophone', 'Add medical device']"
ae55293e-607959ee-bf6ea683-731aaf2c-7974ce2c,50023807,13736401,"Impression: In comparison with the earlier study of this date, there has been removal of the left chest tube with no definite pneumothorax.  Little change in the appearance of the heart and lungs.","Impression: In comparison with the earlier study of this date, there has been removal of the left pacemaker wire with no definite pneumothorax.  Little change in the appearance of bibasilar streaky opacities in both lungs. Impression: The presence of pneumothorax is evident. ","['Change name of device', 'Add contradiction', 'False prediction']"
"96c0d4a5-051e3fc3-f672b6ff-77c9b55c-0d6ca4d4, a8a6416c-6e771d64-63dced41-b9cd0570-74de6277",51531649,13736401,"Impression: In comparison with the study of ___, there is little interval change.  Postoperative changes are seen on the left with no evidence of pneumothorax.  Bibasilar atelectatic changes are again seen with the right hemidiaphragm not as well visualized on the current study.","Impression: In comparison with the stduy of ___, there is little interval change.  Postoperative changes are seen on the right with no evidence of pneumothorax.  Bibasilar atelectatic changes are again seen with the right hemidiaphragm not as well visualized on the current study.  An ET tube is present in the trachea.","['Change location', 'Add typo', 'Add medical device']"
7077f691-0bb23d05-5205c77a-f3361d79-90cccad8,57362963,13736401,"Impression: In comparison with the study of ___, there has been a left lower lobectomy with placement of a chest tube.  No definite pneumothorax. There are lower lung volumes with streaks of atelectasis at the bases.  The cardio mediastinal silhouette is stable and there is no evidence of vascular congestion.","Impression: In comparison with the study of ___, there has been a left lower lobectomy with placement of a chest tube.  No definite pneumothorax. There are lower lung volumes with no atelectasis.  The cardio mediastinal silhouette is stable and there is no evidence of vascular congestion.","['Change position of device', 'Change to homophone', 'False negation']"
12b37691-c36ee41a-5e187544-72273a32-86c10904,57950218,13736401,"Impression: Compared to chest radiographs ___ in ___.  Pulmonary vascular congestion, borderline pulmonary edema and slight increase in mild cardiomegaly are new.  Otherwise normal postoperative appearance left hemi thorax following lower lobectomy.  Pleural drainage tube in place.  No pneumothorax or appreciable pleural effusion.","Impression: Compared too chest radiographs ___ in ___.  Pulmonary vascular congestion, borderline pulmonary edema and slight increase in mild cardiomegaly are knew.  Otherwise normal postoperative appearance left hemi thorax following lower lobectomy.  Pleural drainage tube in mid SVC.  No pneumothorax or appreciable pleural effusion.  There is a new presence of an ET tube.","['Change position of device', 'Change to homophone', 'Add medical device']"
"22c9fbff-5f1d28b0-0570d1c7-8a74d7fc-caf1178e, a55585df-edd0377a-0ec6bd01-2ecabdc0-109d0e9c",59148466,13736401,"Impression: Compared to chest radiographs ___ through ___.  Normal postoperative appearance following left lower lobectomy, including anterior herniation of the right upper lobe.  Lungs essentially clear.  Heart size top-normal.  No pleural abnormality.",Impression: Compared to chest radiographs ___ through ___.  No postoperative change.  Lungs essentially clear.  Heart size top-normal.  No pleural abnormality.  Lungs essentially clear.,"['Change location', 'Add repetitions', 'False negation']"
"38c6b526-4a53ddea-3c236e8b-2761544c-90f1c42b, 3c9f4e63-ab782964-b76f1cfd-0ab67396-c2575a4b",51992242,13740705,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without focal consolation. There is mild cardiomegaly. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There is minimal pleural thickening in the left lower lobe. Impression: No acute caardiopulmonary process.,"['Change to homophone', 'Add typo', 'False prediction']"
"cc47427c-c5e9680e-551d3143-58cb46c2-28e82262, d4d8ed91-d54929b5-a7e9fd6e-063cc534-089ceaab",54045900,13740705,"Findings: The heart size is borderline enlarged.  The aorta is tortuous.  Mediastinal and hilar contours are otherwise unremarkable and the pulmonary vasculature is normal.  No focal consolidation, pleural effusion or pneumothorax is seen.  There are no acute osseous abnormalities. Impression: No acute cardiopulmonary process.","Findings: The heart size is borderline enlarged.  The aurora is tortuous.  Mediastinal and hilar contours are otherwise unremarkable and the pulmonary vasculature is noraml.  No focal consolidation, pleural effusion or pneumothorax is seen.  Diffuse interstitial markings are noted. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary process.  ","['Change to homophone', 'Add typo', 'False prediction']"
"b88c89c2-6422d672-c5ec4f6a-afb43481-31f62b0d, ff2d4c1c-22e6a9d1-7e5d6a3b-b1245e1f-f76954a5",55924803,13740705,"Findings: Frontal and lateral views of the chest are obtained.  There are low lung volumes, which accentuate the bronchovascular markings, particularly at the lung bases.  Mild bibasilar atelectasis is seen.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac silhouette is top normal.  The aorta is calcified and tortuous.  Degenerative changes are again seen along the spine. Impression: No significant interval change.  Low lung volumes with no focal consolidation seen.","Findings: Frontal and lateral views of the abdome are obtained. There are low lung volumes, which accentuate the bronchovascular markings, particularly at the ling bases. Mild bibasilar atelectasis is seen with a small pleural effusion present. No focal consolidation, pleural effusion, or evidence of pneumothorax is seena. The cardiac silhouette is top normal. The aorta is calcified and tortuous. Degenerative changes are again seen along the right shoulder. Impression: No significant interval change. Diffuse interstitial markings in the lung is noted. Low lung volumes with no focal consolidation seen.","['Change location', 'Add typo', 'False prediction']"
"7db3c46c-7de7d596-bf39fadf-cb34f915-6fcdd3c0, b39765e1-fc527a21-64309812-6f3eb5c1-1069310d",57708460,13761822,"Findings: Frontal and lateral views of the chest were obtained.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable.  No displaced fracture is seen. Impression: No acute cardiopulmonary process.  No significant interval change.  Please note that dedicated imaging of the spine was not obtained.","Findings: Frontal and lateral views of the chest were obtained.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable.  No displaced fracture is seen.  The cardiac and mediastinal silhouettes are stable and unremarkable. Impression: No acute cardiopulmonary process.  No significant interval change.  Please note that dedicated imaging of the pelvis was not obtained.","['Change location', 'Add repetitions', 'False negation']"
0a10435e-e43147f5-c4986cba-35836a58-b4b70cd6,53622016,13770664,"Findings: Low lung volumes accentuate the cardiac silhouette and bronchovascular structures.  Calcified lymph nodes are present in the right hilar region as well as a calcified granuloma in the right upper lobe.  Patchy opacity in left retrocardiac region is new, and may reflects patchy atelectasis in the setting of low lung volumes.  Acute aspiration is an additional consideration in the appropriate clinical setting.  Note is also made of apparent rightward deviation of the trachea, at the level of the thoracic inlet.  This is difficult to evaluate on a portable radiograph, particularly as the patient's neck appears to be turned towards the right on this exam. Impression: Apparent rightward deviation of trachea. Repeat radiograph with the neck in neutral position may be helpful to differentiate the effects of rotation from tracheal displacement from a fixed abnormality such as an adjacent thyroid mass.","Findings: Low left lung volumes accentuate the cardiac silhouette and bronchovascular structures.  Calcified lymph nodes are present in the right hilar region as well as a calcified granuloma in the right upper loabe.  No opacities noted.  Acute aspiration is an additional consideration in the appropriate clinical setting.  Note is also made of apparent rightward deviation of the trachea, at the level of the thoracic inlet.  This is difficult to evaluate on a portable radiograph, particularly as the patient's neck appears to be turned towards the righ on this exam. Impression: Apparent rightward deviation of trachea. Repeat radiograph with the neck in neutral position may be helpful to differentiate the effects of rotation from tracheal displacement from a fixed abnormality such as an adjacent thyroid mass.","['Change location', 'Add typo', 'False negation']"
"6b5d6ce1-8bcb7314-52203b9f-b287d557-396bee1d, b90f926b-309e71d5-d3572c48-dc0744ec-8b4c6a5e",53343064,13799343,Findings: The heart is mildly enlarged.  The mediastinal and hilar contours appear unchanged.  Patchy calcification is similar along the aortic arch.  There is a vascular stent projecting adjacent to the aortic arch.  There is no pleural effusion or pneumothorax.  The lungs appear clear.  Slight degenerative changes are similar along the thoracic spine.  There is a prior non-displaced right sixth rib fracture with remodeling. Impression: Mild cardiomegaly.  No evidence of acute disease.,Findings: The heart is mildly enlarged.  The mediastinal and hilar contours appear unchanged.  Patchy calcification is similar along the aortic arch.  There is a vascular denver catheter projecting adjacent to the aortic arch.  There is no pleural effusion or pneumothorax.  The lungs appear clear.  Slight degenerative changes are similar along the thoracic spine.  There is a prior non-displaced right sixth rib fracture with remodeling. Impression: Mild cardiomegaly.  No evidence of cute disease.,"['Change name of device', 'Change to homophone', 'False negation']"
69b9e772-540d070d-5e5e948f-cf7cbf37-020b9a69,51619708,13837849,Findings: New left middle and lower lung opacities are concerning for pneumonia.  There is also new mild cardiac congestion.  Cardiac contour is mildly enlarged with tortuous aorta.  There is no pleural effusion or pneumothorax. Impression: 1.  New middle and lower lung consolidation on the left side is consistent with pneumonia. 2.  Mild cardiac congestion.    This was discussed verbally with Dr. ___.,Findings: New left middle and lower lung opacities are concerning for pneumonia.  There is also new moderate cardiac congestion.  Cardiac contour is mildly enlarged with tortuous aorta.  There is now pleural effusion or pneumothorax. Interstitial markings are accentuated in the lower lobes suggestive of fibrosis. Impression: 1.  New middle and lower lung consolidation on the left side is consistent with pneumonia. 2.  Mild cardiac congestion.    New right-sided pleural effusion. This was discussed verbally with Dr. ___.,"['Change severity', 'Add typo', 'False prediction']"
"26bc0e45-db4da615-97dbdebd-e3079c87-ae29c389, a1a11577-09c2a5a2-93a505de-55c0dcb7-cb35e605",57210057,13837849,"Findings: The lungs are relatively hyperinflated, with flattening of the diaphragms, which can be seen in chronic obstructive pulmonary disease.  There is mild left base atelectasis.  No focal consolidation, large pleural effusion or evidence of pneumothorax is seen.  The aorta is calcified and tortuous.  The cardiac silhouette is top-normal to mildly enlarged.  No overt pulmonary edema is seen.  The bones are diffusely osteopenic.  A drain is partially imaged overlying the upper abdomen. Impression: Mild left base atelectasis.  Hyperinflated lungs suggests chronic obstructive pulmonary disease.  No focal consolidation.  Top normal to mildly enlarged cardiac silhouette.","Findings: The lungs are relatively hyperinflated, with flattening of the diaphragms, witch can be seen in chronic obstructive pulmonary disease.  There is mild left base atelectasis.  No focal consolidation, large pleural effusion or evidence of pneumothorax is seen.  The aorta is calcified and tortuous.  The cardiac silhouette is top-normal to mildly enlarged.  No overt pulmonary edema is seen.  The bones are diffusely osteopenic.  A drain is partially imaged overlying the pelvis. A right-sided central venous line is noted. Impression: Mild left base atelectasis.  Hyperinflated lungs suggests chronic obstructive pulmonary disease.  Know focal consolidation.  Top normal to mildly enlarged cardiac silhouette.","['Change position of device', 'Change to homophone', 'Add medical device']"
"39f9904e-3ec17e33-43b75114-cfba9a4d-b85024e9, f42d7dbd-d192327f-ba7c9e5c-8ef226b5-87f58720",50832976,13853261,Impression: No acute intrathoracic process.,Impression: No acute intrathoracic process. The patient has a permanent pacemaker in place. Impression: No acute intrathoracic process.,"['False prediction', 'Add repetitions', 'Add medical device']"
"762a4f20-66c7bb78-c7ed6020-a23e9f73-e13cb70a, 868e32a8-3328f944-3b08f70d-e8ae4554-c649d2d0",54170949,13863916,Impression: No acute cardiopulmonary process.,Impression: No overt cardiopulmonary process.,"['False prediction', 'Add typo', 'False negation']"
"92625849-fd665a5e-0e0ad552-642e6039-6cae5e5e, 984ccf69-a2dacdd1-6ec13d35-3af17fd5-5c583dfa",55385188,13863916,Findings: The lungs are clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities identified. Impression: No acute cardiopulmonary process.,Findings: The lungs are hyperinflated.  The cardiomediastinal silhouette is whithin normal limits.  No osseous abnormalities identified. Impression: No acute rib fractures.,"['False negation', 'Add typo', 'False prediction']"
"e851b139-e2d48dc6-f6d066cb-47cc6c01-1be04ae0, e9366aee-a5070917-b0f7b323-2f2bddbb-a83ce3a8",56979658,13863916,"Impression: Comparison to ___.  Normal lung volumes.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal contours.  No pneumonia, no pulmonary edema, no pleural effusions.  No lung nodules or masses.","Impression: Comparison to ___.  Normal lung volumes.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal counters.  No pneumonia, no pulmonary edema, no pleural effusions.  No lung nodules or masses.  The cardiac silhouette is enlarged.","['Add contradiction', 'Change to homophone', 'False negation']"
"4d4ef5d7-73e11e7a-6f694ce7-0bb5994b-0d7396b2, b8d4de5a-4676a6b1-01f6df7f-f0b072c6-e951dffc",53527138,13866250,Impression: No acute cardiopulmonary process.,Impression: No acute pulmonary vascular congestion identified. Biapical fibrosis is evident.,"['Add medical device', 'Change to homophone', 'False prediction']"
78ed0647-df6522bd-879ef182-28259d9d-79106b33,56260436,13866250,Impression: AP chest compared to ___:  Small left pleural effusion is new.  Lungs are clear.  Heart size is normal.,Impression: AP chest compared to ___:  Large left pleural effusion is new.  Lunges are clear.  Heart size is normal. A central venous line is present.,"['Change severity', 'Add typo', 'Add medical device']"
"cd93f5ed-8955a049-e8718dc7-1ed931f6-00410869, fb523451-49383564-12e28082-ddb7ebd2-b44d13a1",56868936,13866250,"Findings: At the level of the middle lobe, on both the frontal and the lateral radiograph, findings indicating pneumonia are seen.  The right heart border is obliterated, there is increased density in the middle lobe on the lateral radiograph.    No pleural effusions.  No other pathologic findings.  Borderline size of the cardiac silhouette, normal hilar and mediastinal contours.    A wet read was delivered at the time of image acquisition, ___, 6:02 p.m. ","Findings: At the level of the middle lobe, on both the frontal and the lateral radiograph, findings indicating pneumonia are seen.  The left heart border is obliterated, there is increased density in the middle lobe on the lateral radiograph.  No pleural effusions.  No other pathologic findings. Borderline size of the cardiac sihouette, normal hilar and mediastinal contours. No pneumonia.  A wet read was delivered at the time of image acqusition, ___, 6:02 p.m.","['Change location', 'Add typo', 'False negation']"
7ab5ab83-8d6ebc13-5e5217da-8063ac02-612d1066,50227217,13894716,Impression: Mild to moderate pulmonary edema has minimally increased.  Moderate bilateral effusions are again noted.  Cardiac size is top-normal.  There is no evident pneumothorax.  Lines and tubes are in standard position,Impression: Mild to moderate pulmonary edema has minimally increased. Large bilateral effusions are again noted. Cardiac size is top-normal. There is no evident pneumothorax. There is no evident pneumothorax. Lines and tubes are in standard position,"['Change severity', 'Add repetitions', 'False prediction']"
"02264527-37380ab8-55ceb644-ab1a2902-d51da861, b992d83f-9b14d160-93965b3d-de9488c3-3ec16f91",50404152,13894716,Impression: Right middle lobe atelectasis has markedly improved.  Large area of retrocardiac loss of volume and consolidation persist.  Lines and tubes are in unchanged standard position.  Cardiomediastinal contours are stable.  Small left pleural effusion is unchanged.  No other interval change from prior study.,Impression: Right middle lobe atelectasis has mildly improved.  Large area of retrocardiac loss of volume and consolidation persist.  Lines and tubes are in unchanged standard position.  The cardiomediastinal contours are abnormal.  Small left pleural effusion is unchanged.  No other interval change from prior study.,"['Change severity', 'Add contradiction', 'False prediction']"
"42dc981d-4c3414ee-55574b45-e63422d8-81395b98, b9c5fa7a-09bd7ea7-3a8d70e1-294c2963-340a8244",50640883,13894716,"Findings: There are persistent bilateral interstitial infiltrates likely representing edema.  In addition, there is increased density in the retrocardiac area consistent with atelectasis and possibly consolidation.  Streaky density consistent with subsegmental atelectasis in the middle lobe is no longer apparent.  An endotracheal tube nasogastric tube and right internal jugular catheter remain in place.  Mediastinal structures are stable. Impression: Bilateral interstitial infiltrates most consistent with edema.  Continued evidence of left lower lobe atelectasis or consolidation.","Findings: There are persistent bilateral interstitial infiltrates likely representing edema.  In addition, there is increased density in the retrocardiac area consistent with atelectasis and possibly consolidation.  Streaky density consistent with subsegmental atelectasis in the left lower lobe is no longer apparent.  An endotracheal tube nasogastric tube and right internal jugular catheter reamin in place.  Mediastinal structures are stabile.","['Change location', 'Add typo', 'Add medical device']"
f41dc470-8bfd45a8-dd5a735a-b5eeb061-901d46fa,50659512,13894716,Impression: Comparison to ___.  The endotracheal tube was removed and has been replaced by a tracheostomy tube.  Stable low lung volumes with moderate bilateral pleural effusions and mild to moderate pulmonary edema.  Moderate cardiomegaly persists.  No pneumothorax.  The 2 right-sided central access lines are stable.,Impression: Comparison to ___.  The endotracheal tube was removed and has been replaced by a nasogastric tube. Stable low lung volumes with moderate bilateral pleural efsions and mild to moderate pulmonary edema.  Moderate cardiomegaly persists.  No pneumothorax.  The 2 right-sided central access lines are stable.  There is a suspicious left upper lobe nodule.,"['Change name of device', 'Add typo', 'False prediction']"
f524f43e-5a71f3ed-652266ed-dedcd67f-b062298b,50731650,13894716,Impression: Widening mediastinum with the right paratracheal opacity has minimally improved.  Left lower lobe collapse is new.  Mild vascular congestion is grossly unchanged.  Right perihilar atelectasis is unchanged.  Right middle lobe collapse has improved.  Lines and tubes are in unchanged standard position.  There is no pneumothorax.  .  Bilateral effusions are grossly unchanged.  Right perihilar opacity is grossly unchanged.  CT is recommended for further evaluation.,Impression: Widening mediastinum with the right paratracheal opacity has moderately improved.  Left lower lobe collapse is new.  Severe vascular congestion is grossly unchanged.  Right perihilar atelectasis is unchanged.  Right middle lobe collapse has improved.  Lines and tubes are in unchanged standard position.  There is mild pneumothorax.  Beetle effusions are grossly unchanged.  Right perihilar opacity is grossly unchanged.  CT is recommended for further evaluation.,"['Change severity', 'Change to homophone', 'False prediction']"
20fd8602-76e94ccd-74b97075-b4acc96c-22816e41,50814385,13894716,"Findings: A right internal jugular tunneled dialysis catheter is unchanged in position compared to the prior study.  A right internal jugular vascular access catheter is also unchanged.  In the interval since the prior study the tracheostomy has been removed in obtained for an endotracheal tube.  The tip is positioned approximately 3.5 cm above the level the carina.  There is a veil like opacity over the right lung likely representing a layering pleural effusion, this appears to have increased slightly in size compared to the prior study.  Left lower lobe atelectasis persists.  Mild to moderate pulmonary edema again noted.  Moderate cardiomegaly.  No pneumothorax seen. Impression: Probable mild increase in the right-sided pleural effusion.","Findings: A right internal jugular tunneled dialysis catheter is positioned in the right atrium.  A pacemaker is in place and leads are well-positioned.  In the interval since the prior study the tracheostomy has been removed in obtained for an endotracheal tube.  The tip is positioned approximately 4.2 cm above the level the carina.  There is a veil like opacity over the right lung likely representing a layering pleural effusion, this appears to have increased slightly in size compared to the prior study.  Left lower lobe atelectasis persists.  Mild to moderate pulmonary edema again noted.  Left lower lobe atelectasis persists.  Moderate cardiomegaly.  No pneumothorax seen. Impression: Probable mild increase in the right-sided pleural effusion. ","['Change measurement', 'Add repetitions', 'Add medical device']"
0fd8eb66-17575650-50cd8c8c-11dcb1fe-a35ee055,50825078,13894716,Findings: The tip of the endotracheal tube projects over the mid thoracic trachea.  The gastric tube courses below the level the diaphragms but beyond the field of view of this radiograph.  The tube right internal jugular central venous lines are unchanged in position.  Please note the right costophrenic angle and right lateral hemithorax are not included on this x-ray.  There are persistent bilateral layering pleural effusions with bibasilar atelectasis.  No pneumothorax identified.  The size the cardiomediastinal silhouette is enlarged but unchanged. Impression: The right lateral aspect of the chest is not included on this radiograph.  The visualized thorax demonstrates no significant interval change since the prior study.,Findings: The tip of the endotracheal tube projects over the mid thoracic trachea.  The gastric tube courses below the level the diaphragms but beyond the field of view of this radiograph.  The tube right internal jugular central venous lines are unchanged in position.  Please note the right costophrenic angle and write lateral hemithorax are not included on this x-ray.  There are mild bilateral layering pleural effusions with bibasilar atelectasis.  No pneumothorax identified.  The size the cardiomediastinal silhouette is enlarged but unchanged. Impression: The right lateral aspect of the chest is not included on this radiograph.  The visualized thorax demonstrates no significant interval change since the prior study.,"['Change severity', 'Change to homophone', 'False negation']"
5ba240af-dffc7803-22ba7344-9658b496-9e0ce127,51062436,13894716,Impression: ET tube tip is 8.4 cm above the carinal.  Right internal jugular line tip is at the level of mid SVC.  Central venous line tip is at the level of lower SVC.  Interval improvement in pulmonary edema is substantial with small bilateral pleural effusion is present.,Impression: ET tube tip is 9.2 cm above the carinal.  Right internal jugulr line tip is at the level of mid SVC.  Central venous line tip is at the level of lower SVC.  Interval improvement in pulmonary edema is substantial with small bilateral pleural effusion is present. A pacemaker is present.,"['Change measurement', 'Add typo', 'Add medical device']"
"7a799fc7-10d013f4-f1c40969-4ce6ed6f-8f528025, d6aabaed-583edc36-625b39fd-3dc3bdeb-4e46bb0b",51334425,13894716,Findings: Large bilateral pleural effusions (right larger than left) shows interval increase in size.  Suspected associated atelectasis.  Transverse cardiomegaly. Dialysis catheter in situ at the cavoatrial junction.  No new airspace consolidation. Impression: Worsening large bilateral pleural effusions with associated atelectasis.  No new airspace consolidation.,Findings: Large bilateral pleural effusions (right larger than left) shous intervall increase in size. Suspected associated atelectasis. Transverse cardiomegaly. Dialysis catheter in situ at the SVC. No new airspace consolidation. Right PICC line is noted. Impression: Worsening large bilateral pleural effusions with associated atelectasis. No new airspace consolidation.,"['Change position of device', 'Add typo', 'Add medical device']"
"32e45338-60decf52-cb6bda59-49f2a5c0-a17ad0bf, f7bf88df-2734c8dd-dbe15ebe-58fa37e4-329b9d59",51424614,13894716,Impression: Comparison to ___.  No relevant change is seen.  The venous introduction sheet on the right has been removed.  The other monitoring and support devices are stable.  Extensive bilateral pleural effusions with subsequent areas of atelectasis.  Moderate cardiomegaly.  Mild to moderate pulmonary edema.  No pneumothorax.,Impression: Comparison to ___.  No relevant change is seen.  The venous introduction shet on the right has been removed.  The other monitoring and support devices are stable.  Extensive bilateral pleural effusions with subsequent areas of atelectasis.  Severe cardiomegaly.  Mild to moderate pulmonary edema.  Patchy consolidation in the right upper lobe.  No pneumothorax.,"['Change severity', 'Add typo', 'False prediction']"
"01f26c74-75cf3e70-49244b91-f5e77ed8-b3935393, 3cdf934e-b0ece0aa-1c13aaf6-b9518f53-7e7eae10",51850136,13894716,Impression: Mild pulmonary edema is stable.  Bilateral pleural effusions with adjacent atelectasis have improved.  Cardiomegaly is accentuated by the low lung volumes.  Right IJ catheter tip is in the upper SVC.  ET tube is high above the clavicles and should be advanced for more standard position at least 3 cm. NG tube tip is out of view below the diaphragm.,Impression: Mild pulmonary edema is stable.  Bilateral pleural effusions with adjacent atelectasis have improved.  Cardiomegaly is accentuated by the low lung volumes.  Right ventricular lead is in the upper SVC.  ET tube is high above the clavicles and should be advanced for more standard position at least 3 cm.  NG tube tip is out of view below the diaphragm.  Bilateral pleural effusions with adjacent atelectasis have improved.,"['Change name of device', 'Add repetitions', 'False prediction']"
"0d5c7134-11a89847-9dde852c-ebe57412-85ba6640, 12e268f0-0d236069-78811721-d730d468-45aa2598",52221435,13894716,"Impression: In comparison with the study of ___, there is now a tracheostomy tube instead of the endotracheal tube.  Other monitoring and support devices are unchanged. Continued enlargement of the cardiac silhouette with little change in the degree of pulmonary edema and layering bilateral pleural effusions with compressive basilar atelectasis.","Impression: In comparison with the study of ___, there is now a feeding tube instead of the endotracheal tube. Other monitoring and support devices are unchanged. Continued enlargement of the cardiac silhouette with little change in the degree of pulmonary edema and glaring bilateral pleural effusions with compressive basilar atelectasis. Bibasilar interstitial infiltrates present as well.","['Change name of device', 'Change to homophone', 'False prediction']"
dfe7902d-7f50fd3a-34f95cfb-3aeeea63-20d6aa4f,52444140,13894716,Findings: Compared to the prior study there is no significant interval change. Impression: No change.,Findings: Compared to the prior study there is no singificant interval change. Impression: No consolidations.,"['Change severity', 'Add typo', 'False negation']"
"3b44553e-f53c6853-5c8a9814-44129c1e-32509200, e301cf49-ca4e1f54-2aab6551-5bed4849-1cbf5bcf",52923479,13894716,"Impression: Compared to chest radiographs ___ through ___.  There has been no change since earlier in the day moderate pulmonary edema, moderate to large right and small to moderate left pleural effusions all unchanged.  There is quite possibly substantial lower lobe atelectasis, perhaps even collapse.  Heart size mildly enlarged.  No pneumothorax.  Cardiopulmonary support devices in standard placements, unchanged.","Impression: Compared to chest radiographs ___ through ___.  There has been no change since earlier in the day mild pulmonary edema, moderate to large right and small to moderate left pleural effusions all unchanged.  There has been no change since earlier in the day mild pulmonary edema, moderate to large right and small to moderate left pleural effusions all unchanged.  There is quite possibly moderate lower lobe atelectasis, perhaps even collapse. Heart size moderately enlarged.  No pneumothorax. Cardiopulmonary support devices in standard placements, unchanged. Additionally, central venous line is present.","['Change severity', 'Add repetitions', 'Add medical device']"
"36a124b2-816b2e86-561993f7-86f49d6f-f93c3ab0, eca90488-10582fe3-bd30e11d-cca0f4a3-4a7f7367",53010838,13894716,"Impression: Comparison to ___.  All monitoring and support devices, including the endotracheal tube and the to central venous access lines inserted over the right internal jugular vein, are in stable position.  Stable appearance of the bilateral pleural effusions and the moderately enlarged cardiac silhouette.  Mild pulmonary edema is present in unchanged manner.  No pneumothorax.","Impression: Comparison to ___.  All monitoring and support devices, including the endotracheal tube and the to central venous access lines inserted over the mid superior vena cava, are in stable position.  Stable appearance of the bilateral pleural effusions and the moderately enlarged cardiac silohuette.  Mild pulmonary edema is absent.  No pneumothorax.","['Change position of device', 'Add typo', 'False negation']"
1530fc93-5d8daf6b-2fe3d095-226a1abf-d1ee0557,53160255,13894716,"Findings: ET tube is approximately 8.4 cm above the carina.  Right IJ central venous catheter terminates in mid SVC.  The enteric tube loops around and terminates in the stomach.  Moderate pulmonary venous congestion has slightly improved and no pulmonary edema.  Left lower lobe atelectasis is unchanged.  No new consolidation.  No pleural effusions or pneumothorax.  Heart size is top normal but unchanged.  Mediastinal silhouette is unchanged. Impression: 1.  ETT is 8.4 cm above the carina. 2.  Improved pulmonary venous congestion.  RECOMMENDATION(S):  The findings were discussed with ___, RN by ___, M.D. on the telephone on ___ at 11:02 AM, 20 minutes after discovery of the findings.","Findings: ET tube is approximately 7.2 cm above the carina.  Right IJ central venous catheter terminates in mid SVC.  The enteric tube loops around and terminates in the stomach.  Moderate pulmonary venous congestion has slightly improved and know pulmonary edema.  Left lower lobe atelectasis is unchanged.  No new consolidation.  No pleural effusions or pneumothorax.  A pacemaker is noted in the left chest area.  Heart size is too normal but unchanged.  Mediastinal silhouette is unchanged. Impression: 1.  ETT is 9.1 cm above the carina. 2.  Improved pulmonary venous congestion.  RECOMMENDATION(S):  The findings were discussed with ___, RN by ___, M.D. on the telephone on ___ at 11:02 AM, 20 minutes after discovery of the findings.","['Change measurement', 'Change to homophone', 'Add medical device']"
b0cbece6-2b0b1434-9aa88346-46174a88-4cabb89d,53254456,13894716,"Impression: Compared to chest radiographs ___ through ___.  Moderate pulmonary edema, large right pleural effusion, bibasilar atelectasis, severity indeterminate, all unchanged since ___.  The heart is top-normal size.  ET tube, and right jugular catheters ending in the SVC, unchanged.","Impression: Compared to chest radiographs ____ through ___.  Moderate pulmonary edema, large write pleural effusion, bibasilar atelectasis, severity indeterminate, all unchanged since ___.  The heart is top-normal size.  ET tube, and right jugular catheters ending in the right atrium, unchanged. There is also a pacemaker present.  ","['Change position of device', 'Change to homophone', 'Add medical device']"
fa919722-4eea7a12-2806e18f-f9050528-40aa3f3b,53520081,13894716,Findings: A tracheostomy tube is present projecting over the thoracic inlet.  The tip of a right central venous catheter projects over the cavoatrial junction.  No focal consolidation or pneumothorax identified.  A trace right pleural effusion is suspected.  The size of the cardiac silhouette is enlarged but unchanged. Impression: Interval exchange of the tracheostomy tube.  No pneumothorax identified.  Suspected trace right pleural effusion.,Findings: A nasogastric tube is present projecting over the thoracic inlet.  The tip of a right central venous catheter projects over the cavoatrial junction.  No focal consolidation or pneumothorax identified.  No pleural effusion is suspected.  The size of the cardiac silhouette is enlarged but unchanged. Impression: Interval exchange of the tracheostomy tube.  No pneumothorax identified.  Suspected trace right pleural effusion.  Suspected trace right pleural effusion.,"['Change name of device', 'Add repetitions', 'False negation']"
"55c75c58-72cc96b7-ada6940e-272e5b55-0d27a523, 6ebbc752-645a64ed-ac355db9-ccca6ae4-31fbb894",54308320,13894716,Impression: Comparison to ___.  The monitoring and support devices are in stable correct position.  Mild to moderate bilateral pleural effusions with areas of atelectasis at both the left and the right lung basis.  Mild cardiomegaly.  No overt pulmonary edema.  No newly appeared focal parenchymal opacities.,Impression: Comparison to ___.  The monitoring and support devices are in stable correc position.  Mild to moderate bilateral pleural effusions with areas of atelectasis at both the left and the right lung basis.  Mildly cardiomegaly.  No overt pulmonary edemas.  No newly appeared focal parenchymal opacities.,"['Change severity', 'Add typo', 'False negation']"
"31dac8b8-5dfaf3ad-e6f8e77c-78ea6c22-9e1fbc68, 74538a31-cb733388-656f4f32-d5c5a571-959cc764",54449297,13894716,Findings: OG tube tip is not well visualized beyond gastroesophageal junction.  Consider KUB to further evaluate course of NG tube.  No significant interval change in bilateral pleural effusions and atelectasis and pulmonary edema compared to chest radiograph performed earlier on the same day.  Cardiac size is enlarged. There is no pneumothorax. Impression: OG tube tip is not well visualized beyond the upper SVC level.  Consider KUB to further evaluate course of NG tube,Findings: OG tube tip is not well visualized beyond gastroesophageal junction. Consider KUB to further evaluate course of NG tube. Moderate interval increase in bilateral pleural effusions and atelectasis and pulmonary edema compared to chest radiograph performed earlier on the same day. Cardiac size is enlarged. An ICD is present. There is no pneumothorax. Impression: OG tube tip is not well visualized beyond the upper SVC level. No significant interval change in bilateral pleural effusions and atelectasis and pulmonary edema compared to chest radiograph performed earlier on the same day.,"['Change position of device', 'Add contradiction', 'Add medical device']"
"1ffa663e-bd3e31c1-6b2eb6cb-a71e7f12-eaa912c9, 56e374d4-2db2d4a0-e8a846f1-22369f74-8bbc35d2",54690760,13894716,Impression: NG tube tip is not visualized.  No other interval change from prior study.,Impression: NG tube tip is not visualizd.  There is no interval change from prior study.,"['Change position of device', 'Add typo', 'False negation']"
"0cdea8fc-615e607d-965775bb-024cda95-dc791cfc, 9ee1b31b-af06a46c-f0f85a64-b6a302ac-8ab78cee",54846212,13894716,Impression: Comparison to ___.  No relevant change is noted.  Bilateral small to moderate pleural effusions are present.  Subsequent areas of atelectasis are seen at both lung bases.  Mild pulmonary edema persists.  Mild cardiomegaly.  The monitoring and support devices are in stable position.,Impression: Comparison to ___.  No relevant change is noted.  Bilateral small to moderate pleural effusions are present.  Subsequent areas of atelectasis are seen at both lung bases.  Severe pulmonary edema persists.  Mild cardiomegaly.  The monitoring and support devices are in stable position. Bilateral small to moderate pleural effusions are present.,"['Change severity', 'Add repetitions', 'False prediction']"
8eaf1417-a9b5b2b6-bc20c468-6a3f754e-64bd8801,55036314,13894716,"Findings: Endotracheal tube terminates approximately 6.2 cm above the carina. Enteric tube courses below the diaphragm, out of the field of view.  Right perihilar and upper lobe consolidation is seen, worrisome for pneumonia; underlying aspiration, atelectasis, pulmonary contusion not excluded, depending clinical scenario.  Right perihilar wedge-shaped density may be due to atelectasis.  The costophrenic angles are not fully included on the image and pleural effusions are difficult to exclude.  The cardiac silhouette is mild to moderately enlarged. ","Findings: Endotracheal tube terminates approximately 5.0 cm above the carina. Enteric tube courses below the diaphragm, out of the feild of view.  No consolidation seen.  Right perihilar wedge-shaped density may be due to atelectasis.  The costophrenic angles are not fully included on the image and pleural effusions are difficult to exclude.  The cardiac silhouette is mildly enlarged.  ","['Change measurement', 'Add typo', 'False negation']"
"6e3d5d17-01a98d21-6930c329-f9cada6a-03046aa1, 79bd40db-bf313204-172fcd09-3f35be56-19b3b10a",55582331,13894716,"Findings: The ET tube tip lies above the carina.  The NG tube tip is poorly visualized lower mediastinum and beyond due to underpenetration.  A right IJ central line tip overlies distal SVC.  No pneumothorax is detected.  There is cardiomegaly.  There is CHF, with interstitial and alveolar edema.  There is opacification of both lung bases, which could represent a combination of pleural fluid and underlying collapse and/or consolidation.  Allowing for technical differences, the degree of CHF appears increased slightly compared with ___ at 02:48 Impression: CHF with interstitial and alveolar edema.  This appears slightly worse compared with ___  Opacity at both lung bases which likely represents combination of pleural effusions and underlying collapse and/or consolidation.   NG tube not well visualized in lower esophagus and beyond due to underpenetration.","Findings: The ET tube tip lies above the carina.  The NG tub tip is poorly visualized lower mediastinum and beyond due to underpenetration.  A right IJ central line tip overlies the mid SVC. A permanent pacemaker is in place.  There is cardiomegaly.  There is CHF, with interstitial and alveolar edema.  There is opacification of both lung bases, which could represent a combination of pleural fluid and underlying collapse and/or consolidation.  Allowing for technical differences, the degree of CHF appears increased slightly compared with ___ at 02:48 Impression: CHF with interstitial and alveolar edema.  This appears slightly worse compared with ___  Opacity at both lung bases which likely represents combination of pleural effusions and underlying collapse and/or consolidation.   NG tube not well visualized in lower esophagus and beyond due to underpenetration.","['Change position of device', 'Add typo', 'Add medical device']"
"a5ae71de-54cbb819-a5beec7b-4134871f-563b0982, e54e4954-7a3cabf7-4122dcc6-470a5b97-0f7d4bf7",55925366,13894716,"Findings: Allowing for differences in positioning, the ET tube NG tube and 2 right IJ lines are probably similar in position.  Again seen is mild to moderate cardiomegaly and CHF with vascular plethora an interstitial edema.  Small amount of alveolar edema would be difficult to exclude.  Retrocardiac opacity consistent with left lower lobe collapse and/or consolidation is unchanged.  There is increased hazy density over the right over lower half of the right lung and to some degree at the left base.  I suspect this reflects layering pleural effusions.  Presence of progressed collapse and/or consolidation at the right base laterally cannot be excluded. Impression: Lines and tubes essentially unchanged.  No pneumothorax detected.  Mild to moderate cardiomegaly without significant change.  CHF with interstitial and probably some degree of alveolar edema.  Persistent left lower lobe collapse and/or consolidation.  Hazy density at right greater left bases is suggestive of layering pleural effusions, more pronounced than on the prior film.  Possibility of new collapse and/or consolidation at the right base laterally cannot be excluded.","Findings: Allowing for differences in positioning, the ET tube NG tube and 2 right IJ lines are likely in the right atrium.  Again seen is mild to moderate cardiomegaly and CHF with vascular plethora an interstitial edema.  Small amount of alveolar edema would be difficult to exclude.  Retrocardiac opacity consistent with left lower lobe collapse and/or consolidation is unchanged.  There is increased hazy density over the right over lower half of the right lung and to some degree at the left base.  I suspect this reflects layering pleural effusions.  Presence of progressed collapse and/or consolidation at the right base laterally cannot be excluded.  The patient has a central venous line in place. Impression: Lines and tubes essentially unchanged.  No pneumothorax detected.  Mild to moderate cardiomegaly without significant change.  CHF with interstitial and probably some degree of alveolar edema.  Persistent left lower lobe collapse and/or consolidation.  Hazy density at right greater left bases is suggestive of layering pleural effusions, more pronounced than on the prior film.  Possibility of new collapse and/or consolidation at the right base laterally cannot be excluded.  Lines and tubes essentially unchanged.","['Change position of device', 'Add repetitions', 'Add medical device']"
6eb47aae-b9418849-f08de5c5-25a7216a-1f11ca7e,55979282,13894716,"Findings: Lungs are relatively hyperinflated with the cardiac silhouette appearing slightly smaller as compared the prior study.  Mediastinal contours unremarkable.  No overt pulmonary edema.  No focal consolidation, large pleural effusion or pneumothorax.  Subtle streaky left base retrocardiac opacity is likely atelectasis and overlap of vascular structures.  Right-sided central venous catheter terminates in the low SVC.  Tracheostomy tube is re- demonstrated. Impression: No definite acute cardiopulmonary process.","Findings: Lungs are relatively hyperinflated with the cardiac silhouette appearing slightly smaller as compared the prior study. Mediastinal contours unremarkable. No overt pulmonary edema. No focal consolidation, large pleural effusion or pneumothorax. Subtle streaky left base retrocardiac opacity is absent. Right-sided central venous catheter terminates in the mid SVC. Tracheostomy tube is re-demonstrated. Tracheostomy tube is re-demonstrated. Impression: No definite acute cardiopulmonary process.","['Change position of device', 'Add repetitions', 'False negation']"
"54f1e7cd-7a59a911-1d9db135-654666c9-a0da86f2, fb4ed69d-b5eb654c-a8d5d6ad-9555058c-7ad04a6a",56233977,13894716,"Impression: Compared to chest radiographs ___.  Collapse of at least 2 segments of the right upper lobe accompanied with fullness in the right paratracheal station of the mediastinum could be explained by central hilar mass and mediastinal adenopathy.  CT scanning is recommended.  Interstitial abnormality in the remainder of the lungs accompanied by a right pleural effusion is better explained by congestive heart failure, even though heart size is only top-normal.  ET tube in standard placement.  Nasogastric drainage tube passes into the stomach and out of view.  \  RECOMMENDATION(S):  Chest CT, with contrast if tolerated.","Impression: Compared to chest radiographs ___.  No collapse of the right upper lobe is seen.  CT scanning is recommended.  Interstitial abnormality in the remainder of the lungs accompanied by a right pleural effusion is better explained by congestive heart failure, even though heart size is only top-normal.  ET tube terminates 2 cm above the carina.  Nasogastric drainage tube passes into the stomach and out of view.  No collapse of the right upper lobe is seen.\  RECOMMENDATION(S):  Chest CT, with contrast if tolerated.","['Change position of device', 'Add repetitions', 'False negation']"
"4f51aedc-e5b947bb-0240fc59-b91b17f7-ebca4c1e, 81a75b46-6c709fe1-e7e1b309-b733dccf-293aa917",56403155,13894716,Impression: In comparison with the study of ___ the monitoring and support devices are stable.  Again there is scatter radiation relating to the size of the patient that is limiting the examination.  The cardiac silhouette remains enlarged with pulmonary vascularity and bilateral layering pleural effusions with compressive basilar atelectasis.,Impression: In comparison with the study of ___ the monitoring and support devices are stable.  Again there is scatter radiation relating to the sighs of the patient that is limiting the examination.  The cardiac silhouette remains enlarged with pulmonary vascularity and left layering pleural effusions with compressive basilar atelectasis. A central venous line is also noted in the image.,"['Change location', 'Change to homophone', 'Add medical device']"
bb28bb48-5d205700-25fa4499-8d515e45-5cc3286f,56672330,13894716,Impression: Comparison to ___.  Monitoring and support devices are in stable position.  Stable moderate cardiomegaly with mild retrocardiac atelectasis.  Mild fluid overload but no overt pulmonary edema.  Small bilateral pleural effusions are unchanged.,Impression: Comparison to ___. Monitoring and support devices are in stable position. Stable moderate cardiomegaly with mild retrocardiac atelectasis. There is no cardiomegaly. Mild fluid overload but no overt pulmonary edema. Small left pleural effusions are unchanged.  Mild fluid overload but no overt pulmonary edema. The lung fields show overt pulmonary edema. Small bilateral pleural effusions are unchanged.,"['Change location', 'Add contradiction', 'False negation']"
"8da62af3-aa521341-ea84f338-67ebb517-faa5dfa4, aad2398a-abbf972f-aafba03e-75a3e3e3-fb2659e5",56724473,13894716,Impression: ET tube is in standard position.  Dobhoff tube tip isin the stomach.  No other interval change from prior study.,Impression: ET tube is in standard position.  Dobhoff tube tip is in the mid-esophagus.  No other interval change from prior study.  A right-sided central venous catheter is noted in appropriate position.,"['Change name of device', 'Add contradiction', 'Add medical device']"
d9c17256-9db4d22d-cefc39d7-6a9988c7-acf0f806,57233121,13894716,"Impression: In comparison with the study of ___, the monitoring and support devices are unchanged.  The cardiac silhouette remains mildly enlarged with stable pulmonary vascular congestion and bilateral pleural effusions, more prominent on the right. Areas of coalescent opacification, especially at the right base, could represent merely volume loss, though in the appropriate clinical setting superimposed pneumonia would have to be considered.","Impression: In comparison with the study of ___, the monitoring and support devices are unchanged. The cardiac silhouette remains mildly enlarged with stable pulmonary vascular congestion and bilateral pleural effusions, more prominent on the left. There is no coalescent opacification; the findings are essentially clear.","['Change location', 'Add contradiction', 'False prediction']"
71ce8c54-2501a856-f9c44787-8585fef6-a6c8ccc6,57803270,13894716,"Findings: Right IJ tunneled catheter ends in the right atrium.  Two right IJ central venous catheters ending in the high and mid SVC are unchanged.  A endotracheal tube is appropriately positioned ending approximately 7.0 cm above the carina with the patient's chin up.  There bilateral layering pleural effusions, right greater than left.  There is mild pulmonary edema.  Lung bases are not imaged bilaterally.  There is no pneumothorax. Impression: Appropriate positioning of monitoring and support devices.  Unchanged pulmonary edema and bilateral layering pleural effusions.","Findings: Right IJ tunneled catheter ends in the rigth atrium. Two right IJ central venous catheters ending in the high and mid SVC are unchanged. An endotracheal tube is appropriately positioned ending approximately 7.0 cm above the carina with the patient's chin up. There bilateral layering pleural effusions, right greater than left. There is moderate pulmonary edema. Lung bases are not imaged bilaterally. There is no pneumothorax. There is also a pacemaker in place. Impression: Appropriate positioning of monitoring and support devices. Unchanged pulmonary edema and bilateral layering pleural effusions.","['Change severity', 'Add typo', 'Add medical device']"
"5dd96c78-d0278b8e-f1a5bad9-7397a054-c70455d9, 87fd7d6c-e594fbef-10b4ed5d-1956e77e-6fed9bf0",58193028,13894716,"Impression: In comparison with the study of ___, there is little change.  Continued enlargement the cardiac silhouette with pulmonary vascular congestion and bilateral layering pleural effusions with underlying basilar atelectatic changes.  No evidence of pneumothorax.","Impression: In comparison with the study of ___, there is little change.  Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and right layering pleural effusions with underlying basilar atelectatic changes.  No evidence of pneumothorax.  Presence of an endotracheal (ET) tube.   ","['Change location', 'Add repetitions', 'Add medical device']"
ab58d599-83105f84-08a8af4e-48cf3fcf-53f6e5d0,58193110,13894716,"Impression: In comparison with the study of ___, the monitoring and support devices are essentially unchanged.  Continued enlargement of the cardiac silhouette.  Increased haziness of the lungs suggests layering pleural effusions as well as some elevation of pulmonary venous pressure.  Atelectatic changes seen at both bases.","Impression: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Interval resolution of previously noted right pneumothorax. Continued enlargement of the cardiac silhouette. Increased haziness of the lungs suggests no evidence of pleural effusions and reduction in pulmonary venous pressure. Atelectatic changes seen at both bases. There is an endotracheal tube tip at the level of T3.","['False prediction', 'Add contradiction', 'Add medical device']"
"89860a70-14de9cf1-c87805dc-7e50a158-86913513, e2cf84dd-8e0f61bb-4068b19d-3dd7f5f6-454cab9e",58676331,13894716,"Findings: The tip of the endotracheal tube projects over the mid thoracic trachea.  A gastric tube is present, the tip projecting over the stomach.  A right internal jugular central venous catheter extends into the midportion of the SVC.  Unchanged opacity in the right peritracheal region and around the right hilum. The right costophrenic angle is not included on these radiographs.  No pneumothorax identified.  Small left pleural effusion.  The appearance of the cardiac silhouette is unchanged. Impression: No significant interval change since the radiograph from earlier today.","Findings: The tip of the endotracheal tube projects over the lower thoracic trachea. A gastric tube is present, the tip projecting over the stomach. A right internal jugular central venous catheter extends into the midportion of the SVC. Unchanged opacity in the right peritracheal region and around the right hilum. The tip of the endotracheal tube projects over the mid thoracic trachea. The right costophrenic angle is not included on these radiographs. Minimal subpleural nodules in the left lung. No pneumothorax identified. Small left pleural effusion. The appearance of the cardiac silhouette is unchanged. Impression: No significant interval change since the radiograph from earlier today.","['Change position of device', 'Add repetitions', 'False prediction']"
"55dd98d9-43e485f7-ff9024c4-93e7442a-1aaafbc3, cc37ee77-09d0c8aa-9c6a813c-7d3bf233-057edd33",58909423,13894716,"Findings: All enteric tube tip in the mid stomach.  Endotracheal tube tip in good position.  Right IJ central line, introducer sheath in place, similar.  Increased heart size, pulmonary vascularity.  Interstitial prominence, likely edema.  Bilateral pleural effusions, stable.  Bilateral lower lung opacities, likely atelectasis. Impression: New enteric tube tip in the mid stomach. Otherwise stable","Findings: All feeding tube tip in the mid stomach.  Endotracheal tube tip in good position.  Right IJ central line, introducer sheath in place, similar.  Decreased heart size, pulmonary vascularity.  Interstitial prominence, likely edema.  Small bilateral effusions, stable.  Bilateral lower lung opacities, likely atelectasis with superimposed consolidation. Impression: Enteric tube tip in the mid jejunum. Otherwise stable","['Change name of device', 'Add contradiction', 'False prediction']"
f7e47f32-f963529d-65fa70ee-6d4d2e38-71b68d76,58956444,13894716,Impression: Comparison to ___.  Stable moderate right pleural effusion.  No new focal parenchymal opacities.  Bilateral areas of atelectasis are stable.  Moderate cardiomegaly.  Stable monitoring and support devices.,Impression: Comparison to ___. Stable moderate right pleural effusoin. No new focal parenchymal opacities. Bilateral areas of atelectasis are stable. Mild cardiomegaly. Stable monitoring and support devices with signs of bilateral pulmonary fibrosis.,"['Change location', 'Add typo', 'False prediction']"
"55f226b7-2e75d7f3-d849a5c8-a026a657-7d2d4191, b31f247c-3f8d4aad-babc0ea3-36f3333c-37b65cca",58998264,13894716,"Impression: Large right pleural effusion has increased.  Presumed left pleural effusion appears unchanged.  Cardiomediastinal contours stable.  Lines and tubes are in unchanged standard position, the tip of the NG tube is below the diaphragm out of view.  Mild vascular congestion is stable.","Impression: Large right pleural effusion has increased.  Presumed left pleural effusion appears unchanged.  Cardiomediastinal contours stable.  Lines and tubes are in unchanged standard position, the tip of the PICC line is below the diaphragm out of view.  No vascular congestion.","['Change name of device', 'Change to homophone', 'False negation']"
62bb6fb0-c42c5225-7a24e047-cfe72663-6f50a6f8,59179922,13894716,"Impression: Heart size and mediastinum are unchanged as compared to previous study from ___.  Bilateral pleural effusions, right more than left as well as supporting devices are unchanged.  No pneumothorax.  No evidence of pulmonary edema","Impression: ♡ size and mediastinum are unchanged as compared to previous study from ___.  Bilateral pleural effusions, left more than right as well as supporting devices are unchanged.  No pneumothorax.  Evidence of pulmonary edema is observed.  An ET tube is seen in place.","['Change location', 'Change to homophone', 'Add medical device']"
2e0908b4-279ed4d6-7a472d0b-724df717-f35e3948,59573688,13894716,"Findings: Interval placement of an endotracheal tube which projects 1.9 cm from the carina.  Two right internal jugular central venous lines are present, unchanged.  The costophrenic angles are not included on this radiograph.  Unchanged appearance of the visualized lung parenchyma including bilateral layering pleural effusions.  The size of the cardiac silhouette is unchanged. Impression: Interval placement of an endotracheal tube which projects 1.9 cm from the carina.  Findings were communicated to and acknowledged by ___ at ___h___ by ___, MD","Findings: Interval placement of an endotracheal tube which projects 3 cm from the carina.  Too right internal jugular central venous lines are present, unchanged.  The costophrenic angles are not included on this radiograph.  Unchanged appearance of the visualized lung parenchyma including bilateral layering pleural effusions.  The size of the cardiac silhouette is unchanged. There is also a left-sided pacemaker in place. Impression: Interval placement of an endotracheal tube which projects 1.9 cm from the carina.  Findings were communicated to and acknowledged by ___ at ___h___ by ___, MD","['Change position of device', 'Change to homophone', 'Add medical device']"
d0c7e877-8a4b5e21-55d622dd-a6bc538a-9b8b682b,59142924,13947388,Findings: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion.  The osseous structures are unremarkable Impression: No acute cardiopulmonary abnormalities,Findings: Cardiomediastinal contours are noraml. The lungs are clear. Their is no pneumothorax or pleural effusion.  The osseus structures are unremarkable. A NG tube is present.,"['Add typo', 'Change to homophone', 'Add medical device']"
05a331ae-17b42621-787f72cc-ebadd560-6d2586c0,50207397,13970691,"Findings: Single AP upright portable view of the chest was obtained.  There are low lung volumes, which accentuate the bronchovascular markings.  Given this, there appears to be mild central vascular pulmonary engorgement.  Soft tissue overlying the lung base likely causes underpenetration.  The cardiac and mediastinal silhouettes are stable.  No definite focal consolidation or pneumothorax is seen. ","Findings: Single AP upright portable view of the chest was obtained.  There are low lung volumes, which accentuate the bronchovascular markings.  Given this, there appears to be moderate central vascular pulmonary engorgement.  Soft tissue overlying the lung base likely causes underpenetration.  The cardiac and mediastinal silhouettes are stable.  No definite focal consolidation or pneumothorax is seen.  A right IJ catheter tip projects over the right atrium.","['Change severity', 'Add contradiction', 'Add medical device']"
"193b6fbc-20817b64-62a0329b-67b74188-7e664d39, d307bd6f-24992159-2810d7aa-2a48cfc0-7696aa07",57718488,14028959,"Findings: The lungs are clear without evidence of focal consolidation, effusion or pneumothorax.  The cardiomediastinal silhouette is normal.  There is no evidence of pulmonary vascular congestion.  A focal calcification appears to be within the right breast, unchanged.  Surgical clips are noted projecting over the right upper quadrant.  No displaced rib fractures are seen. Impression: 1. No acute intrathoracic process.  2. No displaced rib fractures seen; if continued concern for rib fracture, consider a dedicated rib series.","Findings: The lungs are clear without evidence of focal consolidation, effusion or pneumothroax. The cardiomediastinal silhouette is normal. There is mild upper lobe vascular congestion. A focal calcification appears to be within the right breast, unchanged. Surgical clips are noted projecting over the right lower quadrant. No displaeed rib fractures are seen. Impression: 1. Minimal right-sided pleural effusion. 2. No displaced rib fractures seen; if continued concern for rib fracture, consider a dedicated rab series.","['Change position of device', 'Add typo', 'False prediction']"
"01333584-2ebbca3f-3136e1be-5fd064dc-d79f6e49, c32f537b-1e531bdf-dc94439f-516792e2-c4933220",55856355,14062229,"Findings: Compared with the prior radiograph, cardiomediastinal silhouette is grossly unchanged.  Lungs are hyperinflated, but clear, without evidence of focal consolidation, pleural effusion, or pneumothorax.  Small area of parenchymal sparing in the left upper lobe is unchanged.  Mild degenerative changes of the thoracic spine again seen. Impression: No acute cardiopulmonary process.","Findings: Compared with the prior radiograph, cardiomediastinal silhouette is grossly unchagend. Lungs are hyperinflated, but clear, without evidence of focal consolidation, pleural effusion, or pneumothorax. No area of parenchymal sparing is unchanged. Mild degenerative changes of the thoracic spien again seen. Impression: No acute cardiopulmonary process.","['Change location', 'Add typo', 'False negation']"
"be8b213a-9615a5b7-c62d7a30-aa470915-ac96f7ac, ca4f0e35-a2b35596-46ff395e-f8b1d162-2d199a8f",58210381,14083729,Findings: Frontal and lateral views of the chest.  The lungs are clear of focal consolidation or effusion.  The cardiomediastinal silhouette is within normal limits.   No acute osseous abnormalities detected. Impression: No acute cardiopulmonary process.,Findings: Frontal and lateral views of the chest.  The lungs are clear of focal consolidation or effusion.  The cardiomediastinal silhouette is within normal limits.  There is a pacemaker in place. Impression: There is mild cardiomegaly.,"['Change location', 'Add contradiction', 'Add medical device']"
"9de35640-255ad38e-8307196e-74d8e70f-ad7df48a, bcc05fb7-84c08474-9bd355fe-058b0c86-f1ce565e",51969834,14136683,Findings: The lungs are clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,Findings: No nodular opacities. The cardiomediastinal silhouette is within normal limits. Mild basilar atelectasis is noted. Impression: No acute cardiopulmonary process. Impression: Small pulmonary effusion.,"['False negation', 'Add contradiction', 'False prediction']"
"a55632d0-66917d00-a02a2d21-db611a0e-baeed86e, f845ff66-184e984c-0fa96a41-0c8bfe10-eb5f881a",58108137,14136683,"Findings: The lungs are well-expanded and clear.  No pleural effusion or pneumothorax.  Heart size, mediastinal contour, and hila are unremarkable. Impression: No pneumonia.","Findings: The lungs are well-expnded and clear.  No pleural effusion or pneumothorax.  Heart size, mediastinal contour, and hila are unremarkable. Impression: No pneumonia.  No pleural effusion or pneumothorax.","['Add repetitions', 'Add typo', 'False negation']"
"a0f5a683-e287a03c-6fa57c7c-0e9ea9bb-a7ee872f, a5cf32c4-3e4a200c-106abe0a-19745a35-322de57c",55003488,14158492,"Findings: As compared to the previous radiograph, there is no relevant change.  Relatively low lung volumes without evidence of pneumonia or pulmonary edema.  Neither the frontal nor the lateral radiographs show evidence of pleural effusions.  Borderline size of the cardiac silhouette.  No abnormal hilar or mediastinal contours.  No pneumothorax. ","Findings: As compared to the previous radiograph, there is no relevant change. Relatively low lung volumes with evidence of pulmonary edema. There is an ET tube in place. The lateral radiograph shows evidence of bilateral pleural effusions. Borderline size of the cardiac silhouette. No abnormal hilar or mediastinal contours. Minimal pneumothorax on the left.","['Change location', 'Add contradiction', 'Add medical device']"
"66da37b9-cee79ad9-575d0c12-3258f935-5b252c22, e1777460-6d35822b-a0255c2a-b847d3fe-2b7faeef",56011861,14226251,Impression: Right middle lobe pneumonia. Follow up radiographs are recommended after treatment to ensure resolution of these findings.,Impression: Right upper lobe pneumonia. No evidence of pneumonia is seen. Follow up radiographs are recommended after treatment to ensure resolution of these findings.,"['Change location', 'Add contradiction', 'False negation']"
"dfd0c966-16222e95-18d44dda-67d5390f-5a04af9b, e859a1ab-98acc65b-d8bfb3fd-ae04e11e-f3317290",57317305,14232420,Impression: No evidence of acute cardiopulmonary abnormalities.,Impression: No evidence of acute cardiopulmonary abnormality. There is a small right pleural effusion.,"['False prediction', 'Change to homophone', 'Add medical device']"
"22d4b5a3-c6744296-d4c6b985-335ebb8a-47b33809, 7d6fe30f-42aecf3a-84d0dded-03670447-9991474d",51611847,14235184,"Findings: Moderate cardiomegaly persists.  The mediastinal and hilar contours are within normal limits.  Lungs are clear.  No focal consolidation, pleural effusion or pneumothorax is present.  Calcified granuloma in the left lower lobe is unchanged.  There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.","Findings: Moderate cardiomegaly persists.  The mediastinal and hilar coutours are within normal limits.  Lungs are clear.  No focal consolidation, pleural effusion or pneumothorax is present.  Calcified granuloma in the right lower lobe is unchanged.  There are no acute osseous abnormalities. A central venous line is in place. Impression: No acute cardiopulmonary abnormality.","['Change location', 'Add typo', 'Add medical device']"
"38d09978-1abbe4ef-2d0291f6-b956da6f-733ce57c, 94e2c7bb-a81ac1fe-fce3a631-5677d6b2-605bd1fe",53464266,14235184,Impression: No acute cardiopulmonary process.,Impression: No acute cardiopulmonary processes. The cardiomediastinal silhouette is stable. No acute cardiopulmonary process.,"['False negation', 'Add repetitions', 'False prediction']"
"5da11f5d-ade60ec9-39a0b019-a3db192f-4b1e0bc7, a1debf16-716b5f40-b15944a1-79c490ee-129dff0e",54857381,14235184,"Findings: Frontal and lateral chest radiographs demonstrate mild-to-moderate cardiac enlargement, unchanged compared with prior.  The lungs are clear.  There is no pleural effusion or pneumothorax.  The mediastinal contours appear normal.  The pulmonary vasculature is mildy engorged. Impression: Mild-to-moderate cardiomegaly with borderline cardiac decompensation.","Findings: Frontal and lateral chest radiographs demonstrate severe cardiac enlargement, unchanged compared with prior. The lungs are clear. There is no pleural effusion or pneumothorax. The mediastinal contours appear normal. The pulmonary vasculature is normal. Impression: Mild-to-moderate cardiomegaly with borderline cardiac decompensation. 1. No cardiomegaly is present. ","['Change severity', 'Add contradiction', 'False negation']"
4a28d5a8-85822fbf-29c6a717-9ca89cfa-9a17ae5b,54495813,14235364,"Impression: No previous images.  Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.","Impression: No previous images.  Cardiac silhouette is within normal limits and there is no vase-ular congestion, pleural effusion, or acute focal pneumonia. Annotation: Enlarged Cardiac silhouette, vascular congestion, and left-sided pleural effusion are noted.","['Change to homophone', 'Add contradiction', 'False prediction']"
5908d07a-1a8c8602-444efbb2-1fdd7481-5810665b,51533854,14235841,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are cleur.  No pleural effusion or pneumothorax is seen. Impression: No acute cardiopulmonary abnormality. Impression: Pacemaker is present. No acute cardiopulmonary abnormality. ,"['Add repetitions', 'Add typo', 'Add medical device']"
eb4d38d4-5a42a2ac-f3c8a44d-e78fe3d8-20354de3,52062026,14235841,"Impression: In comparison with the study of mid ___, there is little change and no evidence of acute cardiopulmonary disease.  Given the limitations of plain radiography, there is no evidence of parenchymal or skeletal metastases.","Impression: In comparison with the study of mid ___, there is little change and no evidence of acute cardiopulmonary disease. There is an increase in cardiac size suggesting possible cardiomegaly. Given the limitations of plain radiography, there is no evidence of parenchymal or skeletal metastases. An ET tube is correctly positioned in the trachea.","['Change location', 'Add contradiction', 'Add medical device']"
"809478a0-89ff6933-f8530e59-3f6f75d2-1fc0bb55, d0c696e3-46fcf520-cffb32ef-3f3bda8d-e23dd656",57231052,14235841,Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  The lungs appear clear.  Bony structures are unremarkable. Impression: No evidence of acute disease.,Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  The lungs appear clear.  The heart is normal in size.  Bony structures are unremarkable.  Impression: No evidence of acute disease.  Impression: Large consolidation in the right lower lobe.  NG tube termination at the mid esophagus.,"['Add repetitions', 'Add contradiction', 'Add medical device']"
"0b236a77-c19c7092-6111b0bf-d6e63ea8-507e68cb, 25e1fea3-63c087dd-adb27176-a70687be-f0954a3b",57325562,14235841,"Findings: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are clear.  There is no focal consolidation, pleural effusion, or pneumothorax.  The visualized upper abdomen is unremarkable, without evidence of intraperitoneal free air. Impression: No acute cardiopulmonary process.","Findings: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are clear.  There is no focal consolidation, pleural effusion, or left-sided pneumothorax.  The visualized upper abdomen is unremarkable, without evidence of interperitoneal free air. No bony abnormalities are observed. Impression: Mild cardiomegaly.","['Change location', 'Change to homophone', 'False prediction']"
"0973ab55-e2d9ddb3-e7c364fe-137b0308-177b4795, 136985d4-3b58fc18-a45d8bbf-7d56b225-fffb9e9a",50698639,14255450,Findings: The lungs remain mildly hyperexpanded reflecting COPD. Mild bibasilar atelectasis has progressed. The heart is not enlarged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Impression: 1. Slight worsening of bibasilar atelectasis. 2. COPD. No acute cardiopulmonary abnormality.,Findings: The lungs remain severely hyperexpanded reflecting COPD. Mild bibasilar atelectasis has progressed. The heart is not enlarged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Impression: 1. Slight worsening of bibasilar atelectasis. 2. COPD with massive overexpansion of the lungs. No acute cardiopulmonary abnormality. There is a presence of a pacemaker device in the left thoracic region.,"['Change severity', 'Add contradiction', 'Add medical device']"
"e99fb49b-a1e84657-f75c3b6a-fdb7838a-8c2bfb2b, fbed2763-32e1610b-cb445bc1-49e2d2d9-404f7105",52612877,14255450,"Findings: As compared to the previous examination, there is no relevant change.  Minimal basal areas of atelectasis.  Normal size of the cardiac silhouette without pulmonary edema.  No interval appearance of new parenchymal opacities suggestive of pneumonia.  The contours of the hilar and mediastinal structures are unchanged and normal. ","Findings: As compared to the previous examination, there is no relative change.  Minimal basal areas of atelectasis.  Normal size of the cardiac silhouette without pulmonary edema.  No interval appearance of new parenchymal opacities.  The contours of the hilar and mediastinal structures are unchanged and normal.  ","['Change severity', 'Change to homophone', 'False negation']"
"53dfc274-a8ac41b8-e160c4bf-556a2631-f52cd331, 5f20a219-ce5d1785-0d1ef8d8-0076ce72-f8038b5a",58031591,14255450,"Findings: Frontal and lateral views of the chest were obtained.  The lungs are hyperinflated, with flattening of the diaphragms, consistent with chronic obstructive pulmonary disease.  There is mild left basilar atelectasis.  No focal consolidation is seen.  There is no pleural effusion or pneumothorax.  The cardiac and mediastinal silhouettes are unremarkable.  Degenerative changes are seen along the spine. Impression: COPD and left basilar atelectasis.  Otherwise, no acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest weere obtained. The lungs are hyperinflated, with flattening of the diaphragms, consistent with chronic obstructive pulmonary disease. There is severe left basilar atelectasis. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes show mild cardiomegaly. Degenerative changes are seen along the spine. Impression: COPD and left basilar atelectasis. Right middle lobe infiltrate is also seen. Otherwise, no acute cardiopulmonary process.","['Change severity', 'Add typo', 'False prediction']"
71c5fd1a-6b349ef4-fa30d201-f780545a-a9a5340d,59539063,14255450,"Findings: As compared to the previous radiograph, there is no relevant change.  Limited image quality.  Normal size of the cardiac silhouette, in particular normal contour of the right heart.  Modaerate tortuosity of the thoracic aorta.  Normal hilar and mediastinal structures.  No evidence of pleural effusions or local oligemia.  No peripheral wedge-shaped parenchymal opacities.  No pneumothorax.  No pulmonary edema.  No lung nodules or masses. ","Findings: As compared to the previous radiograph, there is no relevant change. Limited image quality. Normal size of the cardiac silhouette, in particular normal contour of the left heart. No tortuosity of the thoracic aorta. Normal hilar and mediastinal structures. No evidence of pleural effusions or local oligemia. No peripheral wedge-shaped parenchymal opacities. No pneumothorax. No pulmonary edema. No lung nodules or masses.","['Change location', 'Change to homophone', 'False negation']"
"3da8fb2d-0e0a1796-4b98b571-78e0bad7-04a32511, 847c21bb-510fafaf-521bf5df-050341c5-f7275410",51170595,14290919,"Impression: There to prior chest radiographs since ___, most recently ___ and ___.  Mild left lower lobe atelectasis and small left pleural effusion persists.  Upper lungs clear.  Normal postoperative cardiomediastinal silhouette.  No pneumothorax.","Impression: There to prior chest radiographs since ___, most recently ___ and ___. Right lower lobe atelectasis and small left pleural effusion persists. Upper lungs clear. Normal postoperative cardiomediastinal silhouette. No pneumothorax. Upper lungs clear.","['Change location', 'Add repetitions', 'False prediction']"
e5b700c3-c3a48c0c-b4bc2257-c1d5699b-795692cf,54450581,14290919,Impression: Compared to prior chest radiographs  Swan-Ganz catheter is still coiled in the main pulmonary artery.  Normal postoperative cardiomediastinal silhouette.  Lungs clear.  No pneumothorax.  No appreciable pleural effusion.,Impression: Compared to prior chest radiographs  Swan-Ganz catheter is still coiled in the main hepatic artery.  An enlarged postoperative cardiomediastinal silhouette.  Lungs clear.  Lungs clear.  No pneumothorax.  No appreciable pleural effusion noted in this study.  ,"['Change name of device', 'Add repetitions', 'False prediction']"
cf93eaa8-246c2d54-99361712-29f491cb-b5dc78fb,54487013,14290919,"Impression: In comparison with the study of ___, the Swan-Ganz catheter has been removed.  There is a moderate left effusion and minimal right effusion.  No vascular congestion or acute focal pneumonia.","Impression: In comparison with the study of ___, the IJ catheter has been removed.  There is a moderate left effusion and minimal right effusion.  No vascular congestion or acute focal pneumonia. There are bilateral pleural effusions. No vascular congestion or acute focal pneumonia.","['Change name of device', 'Add contradiction', 'False prediction']"
a56cf43f-68487112-6618a5b8-67fe4506-0adbd299,59462065,14290919,Findings: There is moderate retrocardiac and left basilar atelectasis.  A small left pleural effusion is possible.  The right lung is clear.  Heart size is stable. No pulmonary edema or pneumothorax.  No focal consolidations are noted.  Median sternotomy wires are identified. Impression: Moderate retrocardiac and left basilar atelectasis with a possible small left pleural effusion.  No overt pulmonary edema or pneumonia.,Findings: There is severe retrocardiac and left basilar atelectasis.  A small left pleural effusion is possible.  The right lung is clear.  Heart size is stable. No pulmonary edema or pneumothorax.  No focal consolidations are noted.  There are mild bilateral interstitial opacities.  Median sternotomy wires are identified.  The right lung is clear. Impression: Moderate retrocardiac and left basilar atelectasis with a possible small left pleural effusion.  No overt pulmonary edema or pneumonia. Moderate retrocardiac and left basilar atelectasis with a possible small left pleural effusion.  Recurrent The right lung is clear. ,"['Change severity', 'Add repetitions', 'False prediction']"
"1e8bd436-88bbe20f-d1f35238-90fccec2-66ed9ed3, 8a70f2c2-1dc50436-4b6a86ff-ad04bb95-174cc88b",50482534,14293935,"Findings: AP portable views of the chest were obtained.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  Calcification of the aorta is likely present.  There is no widening of the mediastinum.  Degenerative changes are seen at the acromioclavicular joints. Impression: No acute cardiopulmonary process.","Findings: AP portable views of the chest were obtained.  No focal consolidation, pleural infusion, or evidence of pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  Calcification of the aorta is likely present.  Small pleural effusions are seen.  Degenerative changes are seen at the acromioclavicular joints. Impression: Right IJ central venous catheter is in place.","['Change to homophone', 'Add contradiction', 'Add medical device']"
5a8e85f1-3465c903-60688e99-7f50f8b3-a8794171,52648594,14319319,"Findings: Single erect portable view of the chest demonstrates low lung volumes, which accentuate the vasculature. Given the low lung volumes, it's difficult to discern the heart size, but it is likely normal.  No pleural effusion, edema, pneumothorax or evidence of pneumonia.  There is no evidence of free air. Impression: Given low lung volumes, no acute cardiopulmonary process or evidence of free air.","Findings: Single erect portable view of the chest demonstrates low lung volumes, which accentuate the vasculature. Given the low lung volumes, it's difficult to discern the heart size, but it is likely normal.  No pleural effusion, edema, pneumothorax or evidence of nodules.  Their is no evidence of free air. Impression: Given low lung volumes, no acute cardiopulmonary process with evidence of free air and a small granuloma.","['False negation', 'Change to homophone', 'False prediction']"
"23eb13e1-8751185a-481941e8-47440c28-f0b048e1, a7ae0c27-73fe32bb-6d9fd821-4b8a0d03-0ced0365",52885023,14319319,Findings: Frontal and lateral views chest were obtained.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.,Findings: Frontal and lateral views chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and left hilar silhouettes are unremarkable. There are bilateral upper lobe opacities indicating multifocal pneumonia. Impression: No acute cardiopulmonary process.,"['Change location', 'Add contradiction', 'False negation']"
"809c72b2-39df536d-93ec5dbf-ac5f8f71-95414ea7, e544d6d1-92416c58-191077f7-1849aedb-7096c34a",52924184,14319319,"Findings: In comparison with the study of ___, the patient has taken a better inspiration.  There again is some increase in opacification in the perihilar and infrahilar region on the left.  This again could reflect an area of consolidation.  The area of subtle opacity in the right lower lung is again seen, which also could reflect an infectious focus. ","Findings: In comparison with the study of ___, the patient has taken a better inspiration.  There again is some increase in opacification in the perihilar and infrahilar region on the right.  This again could reflect an area of consolidation.  No area of subtle opacity is seen, which could reflect an infectious focus.  ","['Change location', 'Change to homophone', 'False negation']"
80d9b2ed-78a45dda-a5de2d9e-64e077c3-9c07a278,53967898,14319319,"Findings: Heart size, mediastinal and hilar contours are stable compared to prior studies dating back to ___.  Lungs are clear, and there are no pleural effusions or acute skeletal findings. Impression: No radiographic evidence of pneumonia.","Findings: Heart size, mediastinal and hilar coutours are stable compared to prior studies dating back to ___.  Lungs are clear, and there are no pleural effusions or acute skeletal findings. Impression: Naw radiographic evidence of pneumonia.","['Add typo', 'Change to homophone', 'False negation']"
"2ae82330-8aa965f5-a811c7b7-73cf5c80-f2006ab9, ff7c119a-c56d5ce6-ebef3ba0-b55c554f-c89b48ba",54489741,14319319,"Findings: PA and lateral views of the chest were provided.  There is vague opacity in the left perihilar region, which is concerning for pneumonia.  In addition, there is subtle increased opacity in the right lower lobe, which also may represent a focus of pneumonia.  No large effusion or pneumothorax.  Cardiomediastinal silhouette is stable.  A screw is partially imaged in the right humeral head. Impression: Left perihilar and right lower lobe opacities concerning for pneumonia.","Findings: PA and lateral views of the chest were provided.  There is vague opacity in the right perihilar region, which is concerning for pneumonia.  In addition, there is subtle increased opacity in the right lower lobe, which also may represent a focus of pneumonia.  No large effusion or pneumothorax.  Cardiomediastinal silhouette is stable.  A screw is partially imaged in the right humeral head.  Bibasilar patchy opacities could reflect aspiration. Impression: Left perihilar and right lower lobe opacities concerning for pneumonia.  There is no evidence of pneumonia in the left perihilar and right lower lobe.","['Change location', 'Add contradiction', 'False prediction']"
d9d2b934-5af3b11a-2d1bba0d-44da5876-2f409264,55726489,14319319,"Findings: Portable AP chest radiograph again demonstrates low lung volumes, which accentuate the pulmonary vasculature.  This may also mask a pneumonia.  Allowing for this limitation, there is no focal consolidation, pleural effusion, or pneumothorax.  The cardiomediastinal silhouette is difficult to delineate. Impression: Low lung volumes, but no evidence of pneumonia.  PA and lateral views would be helpful, if obtainable.","Findings: Portable AP chest radiograph again demonstrates low lung volumes, which accentuate the pulmonary vasculature. This may also mask a pneumonia. Allowing for this limitation, there is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is difficult to delineate. There is a central venous line in place. The cardiomediastinal silhouette is difficult to delineate. Impression: Low lung volumes, but no evidence of pneumonia in the right lung. PA and lateral views would be helpful, if obtainable.","['Change location', 'Add repetitions', 'Add medical device']"
88827f17-dd2ff5dd-db0d2d89-136a30d8-ca92f929,57957540,14319319,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  No evidence of free air is seen beneath the diaphragms. Impression: No acute cardiopulmonary process.  No evidence of free air beneath the diaphragms.,Findings: The lungs are clera without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  No evidence of free air is seen beneath the diaphragms. Impression: No acute cardiopulmonary process.  No evidence of free air beneath the diaphragms.  There is a centrally placed venous catheter.,"['Add typo', 'Add contradiction', 'Add medical device']"
"f834a63d-bdcd3d6a-6a87cf3f-a7a890c2-5cda7d0e, fc1d35be-cd0afaeb-a6f4acc1-7b0b0b12-82ac6317",59650920,14319319,"Findings: Normal heart size, mediastinal and hilar contours.  No focal consolidation, pleural effusion or pneumothorax.  No displaced rib fracture. Impression: No acute process.","Findings: Normal heart size, mediastinal and hilar contours.  There is a large pleural effusion seen.  No displaced rib fracture. Impression: No acute process.  Normal heart size, mediastinal and hilar contours.","['Add repetitions', 'Add contradiction', 'False prediction']"
"62ada9ed-7166dd46-94661d49-c4fbabd2-b47e7fb7, cac8c5b6-88cc4800-d00fd7b0-cff74781-604110cf",51790365,14323502,"Findings: The lungs, mediastinum, hilar contours, pleural surfaces and heart are all normal. Impression: Normal chest x-ray.","Findings: The lungs, mediastinum, hilar contours, pleural surfaces and hart are all normal. Impression: Nomal chest x-ray.","['Change to homophone', 'Add typo', 'False negation']"
"03d8a81f-29aee625-3260a6f6-c3081ceb-a932dc44, 1c749828-5456ba72-1bfe7323-e247f3a9-bb29875c",51293946,14376938,"Findings: Opacity projecting over the anterior left first rib is likely due to overlapping structures however, this could be confirmed with apical lordotic view. No focal consolidation is seen elsewhere.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.  No pulmonary edema is seen. Impression: Opacity projecting over the anterior left first rib is likely due to overlapping structures however, this could be confirmed with apical lordotic view. No focal consolidation seen elsewhere","Findings: Opacity projecting over the anterior right first rib is likely due to overlapping structures however, this could be confirmed with apical lordotic view. No focal consolidation is seen elsewhere.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. A central venous line is noted.  No pulmonary edema is seen. Impression: Opacity projecting over the anterior left first rib is likely due to overlapping structures however, this could be confirmed with apical lordotic view. No focal consolidation seen elsewhere. No pleural effusion or pneumothorax is seen.","['Change location', 'Add repetitions', 'Add medical device']"
"db537b22-dc6a616a-9ffefaf4-ff2d4311-dd035ac7, f9e77f68-e4b4671a-18f9eacb-bae8e615-f4e42a2a",57601753,14385080,"Findings: The lungs are mildly hyperinflated.  A dual lead pacemaker is unchanged in position.  The cardiomediastinal contour is within normal limits. The heart size is at the upper limits for normal.  No consolidation, pneumothorax or pleural effusion seen.  Mild atherosclerotic calcification in the thoracic aorta. Impression: No acute cardiopulmonary process seen.","Findings: The lungs are mildly hyperinflated.  A dual lead ventricular assist device is unchanged in position.  The cardiomediastinal contour is within normal limits. The heart size is at the upper limits for normal.  No consolidation, pneumothorax or pleural effusion scene.  Mild atherosclerotic calcification in the thoracic aorta. A central venous line is present. Impression: Know acute cardiopulmonary process seen.","['Change name of device', 'Change to homophone', 'Add medical device']"
0bce12a8-a3f59f85-9b4b37d9-21ea3edf-a6a6ad98,58083696,14385080,"Findings: AP view of the chest.  There is a small nodular opacity in the right lung apex. There is no focal consolidation, pleural effusion or pneumothorax.  There is mild cardiomegaly. The mediastinal and hilar contours are normal.  Left pacemaker leads are in appropriate position. Impression: No acute cardiopulmonary process.  Possible nodule in the right lung apex, may be a pulmonary nodule or possibly bone island.  Recommend non-urgent apical lordotic view for further assessment.  These findings were discussed with Dr. ___ by Dr. ___ at 8:07am on ___ by phone.","Findings: AP view of the chest.  There is a large nodular opacity in the right lung apex. There is no focal consolidation, pleural effusion or pneumothorax.  There is moderate cardiomegaly. The mediastinal and hilar contours are normal.  There is an enlarged heart size. Left pacemaker leads are in appropriate position. Impression: No acute cardiopulmonary process.  Possible nodule in the right lung apex, may be a pulmonary nodule or possibly bone island. Mild atelectasis in the left lung base. Recommend non-urgent apical lordotic view for further assessment.  These findings were discussed with Dr. ___ by Dr. ___ at 8:07am on ___ by phone.","['Change severity', 'Add contradiction', 'False prediction']"
"6f2033c5-f3718a4d-092239d8-8a857cfc-651961b6, ab2aaf36-39384bfa-427a821e-2f840195-c542824b",52896510,14392929,Findings: AP and lateral images of the chest.    The lungs are well expanded and clear.  There is no pleural effusion or pneumothorax.  The cardiomediastinal silhouette is unremarkable. Impression: No acute cardiopulmonary process,Findings: AP and lateral images of the chest.    The lungs are well expanded and clear.  There is no pleural effusion or pneumothorax.  The cardiomediastinal silhouette is unremarkable.  A nasogastric tube is present in appropriate position. Impression: Mild pulmonary edema and small bilateral pleural effusions.,"['Change location', 'Add contradiction', 'Add medical device']"
"361c4750-2c4908c8-6102209f-69a347d0-887ee04b, aee9dc7d-9e6d2430-2f04c053-254149b6-e4925a31",51748293,14429763,"Findings: Upright frontal view of the chest is limited by patient rotation.  Within this limitation, there is no acute intrathoracic process.  The mediastinal, pleural and pulmonary structures are unremarkable.  There is no pleural effusion or pneumothorax identified.  Calcifications are noted within the aortic arch.  Degenerative changes of the cervical spine and clips overlying the left neck are seen. Impression: Limited study, however, no acute intrathoracic process.","Findings: Upright frontal view of the chest is limited by patient rotation.  Within this limitation, there is no chronic intrathoracic process.  The mediastinal, pleural and pulmonary structures are unremarkable.  There is no pleural effusion or pneumothorax identified, but there is mild pulmonary edema.  Calcifications are noted within the aortic arch.  Degenerative changes of the cervical spine and central line overlying the left neck are seen. Impression: Limited study, however, there is no acute intrathoracic process.","['Change name of device', 'Change to homophone', 'False prediction']"
2c27614d-df5d18b9-d93249b6-10178a5f-05a69b81,56968110,14429763,"Findings: In comparison with the earlier study of this date, there has been placement of an enteric catheter.  Although the tip is not well seen, it appears to extend at least to the lower stomach.  Remainder of the study is essentially unchanged with some retrocardiac opacification consistent with volume loss in the left lower lobe. ","Findings: In comparison with the earlier study of this date, there has been placement of a dialysis catheter.  Although the tip is not well seen, it appears to extend at least to the lower stomach.  Remainder of the study is essentially unchanged with some retrocardiac opacification consistent with volume loss in the left lower lobe.  A right-sided central venous line is also present.","['Change name of device', 'Add repetitions', 'Add medical device']"
"49e22f6a-47611804-900ef8eb-08909fff-59836d66, 4ec320f1-f6ed092b-c749d300-8124dd63-d98d10c4",58711037,14437159,Findings: PA and lateral views of the chest were obtained.  Cardiomediastinal silhouette is within normal limits.  Lungs are clear.  There is no pleural effusion or pneumothorax. Impression: No evidence of pneumonia.,Findings: PA and lateral views of the abdomen were obtained.  Cardiomediastinal silhouette is within normal limits.  Lungs are clear.  There is no pleural effusion or pneumothorax. Impression: No evidence of pneumonia. Small left-sided pleural effusion noted.,"['Change location', 'Add contradiction', 'Add medical device']"
e7267408-50278738-19fb9b1a-0e194253-046fa395,56003480,14473057,"Findings: Low lung volumes are present.  Heart size is accentuated as result, appearing mildly enlarged.  Mediastinal and hilar contours are grossly unremarkable.  Crowding of bronchovascular structures is present without overt pulmonary edema.  Minimal patchy opacities within the lung bases likely reflect areas of atelectasis.  No focal consolidation, large pleural effusion or pneumothorax is detected on this supine exam.  There are no acute osseous abnormalities. Impression: Low lung volumes with probable bibasilar atelectasis.","Findings: Low lung volumes are prsent.  Heart size is accentuated as result, appearing severely enlarged.  Mediastinal and hilar contours are grossly unremarkable.  No crowding of bronchovascular structures is present without overt pulmonary edema.  Minimal patchy opacities within the lung bases likely reflect areas of atelectasis.  No focal consolidation, large pleural effusion or pneumothorax is detected on this supine exam.  There are no acute osseous abnormalities. Impression: Low lung volumes with probable bibasilar atelectasis.","['Change severity', 'Add typo', 'False negation']"
"10848775-a37a1df3-15920443-b4c024fb-f364928e, 4b6ce9a4-dac125b5-896d3f40-992de147-21d01a2b",51222003,14482820,"Findings: No focal consolidation is seen.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.  Subtle deformity projecting over the anterior right fourth rib rib may be artifactual however, correlate with site of pain for possible nondisplaced subacute rib fracture. Impression: No focal consolidation, pneumothorax, or pleural effusion.  Subtle irregularity projecting over the anterior right fourth rib could be artifactual versus a subacute fracture.  Correlate with site of point tenderness.","Findings: No focal consolidation is seen.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.  Subtle deformity projecting over the anterior left fourth rib rib may be artifactual however, correlate with site of pain for possible nondisplaced subacute rib fracture. There is evidence of a right pleural effusion. Impression: No focal consolidation, pneumothorax, or pleural effusion.  Subtle irregularity projecting over the anterior right fourth rib could be artifactual versus a subacute fracture.  Correlate with site of point tenderness. Moderate right pleural effusion present.","['Change location', 'Add contradiction', 'False prediction']"
86ab6668-1230eeac-ba4ca749-b4cf6c76-9bbae0dd,52063223,14482820,"Findings: Since ___, mild pulmonary congestion with small bilateral pleural effusions and mild bibasilar atelectasis is appreciated.  A focal opacity is seen in the left mid-lung which, given clinical concerns, could represent a pneumonia.  Lung volumes remain low.  Heart size is unchanged.   No pneumothorax. Impression: 1. A focal opacity is seen in the left mid-lung which, given clinical concerns, could represent a pneumonia. 2. Mild pulmonary vascular congestion with small bilateral pleural effusions and mild bibasilar atelectasis is new since ___.","Findings: Since ___, mild pulmonary congestion with small bilateral pleural effusions and mild bibasilar atelectasis is appreciated. No focal opacity is seen.  Lung volumes remain low.  Heart size is unchanged.   No pneumothorax. Impression: 1. A focal opacity is seen in the right mid-lung which, given clinical concerns, could represent a pneumonia. 2. Mild pulmonary vascular congestion with small bilateral pleural effusions and mild bibasilar atelectasis is new since ___. A focal opacity is seen in the left mid-lung which, given clinical concerns, could represent a pneumonia.","['Change location', 'Add repetitions', 'False negation']"
bbe7847a-18f0d974-62009a61-82ad2ee0-91ca809e,53870816,14482820,"Findings: Since ___, with tip of a new endotracheal tube is a 1.5 cm above the carina.  Mild pulmonary congestion, small left pleural effusion, and left basilar atelectasis is unchanged.  Heart size is top normal.  Positioning of the right internal jugular venous line is unchanged.  No pneumothorax. Impression: 1. New ETT is seen 1.5 cm above the carina and should be pulled back.  RECOMMENDATION(S):  ETT should be pulled back by about 1-2 cm for appropriate positioning.","Findings: Since ___, with tip of a new endotracheal tube is a 1.2 cm above the carina.  Mild pulmonary congestion, small left pleural effusion, and left basilar atelectasis is unchanged.  Heart size is top normal.  Positioning of the right internal jugular venous line is unchagned.  No pneumothorax observed. The heart is mildly enlarged. Impression: 1. New ETT is seen 1.5 cm above the carina and should be pulled back.  RECOMMENDATION(S):  ETT should be pulled back by about 10 mm for appropriate positioning.","['Change measurement', 'Add typo', 'False prediction']"
d71ef3af-b2cb314a-8a4c01c9-4b18f430-14207ae6,55715115,14482820,Impression: The ET tube is 3.5 cm above the carina.  Right IJ line tip is in the right atrium.  NG tube tip is in the stomach.  Heart is mildly enlarged.  There is volume loss at both bases. There is no focal infiltrate.  There is no pneumothorax. .,Impression: The ET tube is 5.1 cm above the carina.  Right IJ line tip is in the mid SVC.  NG tube tip is in the stomach.  Heart is mildly enlarged.  There is volume loss at both bases. Tall R waves in the anterior leads.  There is no pneumothorax.,"['Change measurement', 'Add contradiction', 'False prediction']"
"2602a49c-e35b125f-82408969-f68eb85c-9735bc8b, ee48c72c-d6d0aae4-5c6a3951-8146574b-9683d5c4",55772608,14482820,Findings: The right lung is clear.  There is linear atelectasis in the lingula.  No focal consolidation is seen.  The cardiomediastinal silhouette and hilar contours are within normal limits.  Calcifications of the aortic arch is again noted.  There is no pleural effusion or pneumothorax.  Degenerative changes are seen at the bilateral acromioclavicular joints. Impression: Linear atelectasis in the lingula.  No focal consolidation.,Findings: The right lung is clear.  There is linear atelectasis in the lingula.  No focal consolidation is seen in the right lower lobe.  The cardiomediastinal silhouette and hilar contours are within normal limits.  Calcifications of the aortic arch is again noted.  There is no pleural effusion or pneumothorax.  Degenerative changes are seen at the bilateral acromioclavicular joints.  There is a small right pleural effusion. Impression: Linear atelectasis in the lingula.  No focal consolidation.  Bibasilar opacities suggestive of atelectasis.,"['Change location', 'Change to homophone', 'False prediction']"
ec1d6381-e9419e88-73976f03-de6d851b-3691ae4f,56645801,14482820,Impression: There is a right IJ line with tip at the cavoatrial junction.  There is no pneumothorax.  Lung volumes are slightly low.  There is increased patchy opacity in both lower lungs.  Is unclear if this is due to volume loss or early infiltrate. The ET tube and NG tube are unchanged,Impression: There is a left IJ line with tip at the cavoatrial junction.  Their is no pneumothorax.  Lung volumes are slightly low.  Bilateral pleural effusions are noted.  There is increased patchy opacity in both lower lungs.  Is unclear if this is due to volume loss or early infiltrate. The ET tube and NG tube are unchanged,"['Change location', 'Change to homophone', 'False prediction']"
6df752dd-d96e8fa1-d902d33c-4797e505-97594e40,56986284,14482820,"Findings: Endotracheal tube terminates 5 cm above the level of the carina.  Enteric tube courses below the level of the diaphragm, terminating in the left abdomen, in the expected location of the stomach.  No pneumothorax is seen.  There is no focal consolidation or pleural effusion.  The cardiac silhouette is top-normal.  The aorta is calcified.  No pulmonary edema is seen.  Degenerative changes are seen at the left glenohumeral and acromioclavicular joints. Impression: Endotracheal tube terminates 5 cm above the level of the carina.  Enteric tube in appropriate position.  No pneumothorax.","Findings: Central venous catheter terminates 5 cm above the level of the carina.  Enteric tube courses below the level of the diaphragm, terminating in the right abdomen, in the expected location of the stomach.  No pneumothorax is seen.  There is mild bilateral pleural effusion.  The cardiac silhouette is top-normal.  The aorta is calcified.  No pulmonary edema is seen.  Degenerative changes are seen at the left glenohumeral and acromioclavicular joints. Impression: Endotracheal tube terminates 5 cm above the level of the carina.  Enteric tube malposition.  No pneumothorax with small bilateral pleural effusions.","['Change name of device', 'Add contradiction', 'False prediction']"
36069cc6-7d9f5869-00a6ddd9-a1ff1b73-3df3c8f7,58199894,14482820,"Impression: In comparison with the study of ___, the monitoring and support devices are essentially unchanged.  Continued low lung volume accentuates the transverse diameter of the heart.  Mild indistinctness of pulmonary vessels is consistent with mild elevation in pulmonary venous pressure.  Retrocardiac opacification is consistent with volume loss in the left lower lobe and probable small effusion.","Impression: In comparison with the study of ___, the monitoring and support devices are essentially unchanged.  Continued low lung volume accentuates the diaphragmatic diameter of the heart.  Mild indistinctness of pulmonary vessels is consistent with mild elevation in pulmonary venous pressure.  Retrocardiac opacification is consistent with volume loss in the left lower lobe and probable small affusion.  The presence of a central venous line is noted.","['Change location', 'Change to homophone', 'Add medical device']"
35f30547-a26ab9ec-f5962b41-1e1d9b3a-2a9b5f50,58257481,14482820,Findings: Compared to the prior study there is no significant interval change. Impression: No change.,Findings: Compared to the prior study there is no significant interval change. A right IJ central venous catheter is seen. Impression: No change. There is a significant interval change.,"['Change severity', 'Add contradiction', 'Add medical device']"
2e02cb7f-ec012b6d-6af65d55-6a0a4c93-160776e8,58693812,14482820,"Impression: In comparison with study of ___, there are improved lung volumes.  Monitoring and support devices are unchanged.  Cardiac silhouette is enlarged, but there is no evidence of vascular congestion.  Retrocardiac opacification has improved, consistent with atelectatic changes and possible small effusion.","Impression: In comparison with study of ___, there are improved lung volumes. Monitoring and support devices are unchanged. Cardiac silhouette is enlarged, but there is no evidence of vascular congestion. No retrocardiac opacification seen.","['Change severity', 'Change to homophone', 'False negation']"
0d46b39d-93186b93-afd0e40f-7e41e72b-54caf402,58766220,14482820,Impression: Compared to prior chest radiographs ___ through ___.  Lungs are low in volume but grossly clear.  Heart size top-normal.  No pneumothorax.  Pleural effusions small on the left if any.  ET tube has been withdrawn to standard position.  Right jugular line ends in the low SVC.  Esophageal drainage tube ends in the upper nondistended stomach.,Impression: Compared to prior chest radiographs ___ through ___.  Lungs are low in volume but grossly clear.  Heart size top-normal.  No pneumothorax.  Small pleural effusion on the right.  ET catheter has been withdrawn to standard position.  Right jugular line ends in the low SVC.  Esophageal drainage tube ends in the upper nondistended stomach.,"['Change name of device', 'Change to homophone', 'False prediction']"
"0d67ef39-edbb640d-072f3da3-4325786c-b61cc9ba, b6bf7b6f-86a45cf5-a4fe0214-329758df-c141acdf",59257496,14482820,"Impression: Compared to prior chest radiographs ___ through ___.  Esophageal feeding tube ends in the lower esophagus and would need to be advanced at least 15 cm to end in the stomach.  Wire stylet is no longer in place.  Lungs are low in volume and aside from linear atelectasis at the left base, clear.  Heart is top-normal size.  Pleural effusions small if any.  No pneumothorax.","Impression: Compared to prior chest radiographs ___ through ___.  Esophageal feeding tube ends in the lower esophagus and would need to be advanced at least 150 mm to end in the stomach.  Wire stylet is no longer in place.  Lungs are low in volume and aside from linear atelectasis at the left base, clear.  Heart is top-normal size.  Pleural effusions small if any.  No pneumothorax.  Wire stylet is no longer in place.  Furthermore, an enteric tube is noted crossing the diaphragmatic line.","['Change measurement', 'Add repetitions', 'Add medical device']"
efa280b4-ab9921dd-e10b0695-dea0c2f9-925ee947,59283708,14482820,"Impression: In comparison with the study of ___ the monitoring and support devices are unchanged.  Continued enlargement of the cardiac silhouette without definite vascular congestion.  Basilar atelectatic changes are seen bilaterally, especially on the left.","Impression: In comparison with the study of ___ the monitoring and support devices are unchanged. Continued enlargment of the cardiac silhouette without definite vascular congestion. Basilar atelectatic changes are seen bilaterally, especially on the right. There is a small pleural effusion seen on the right side.","['Change location', 'Add typo', 'False prediction']"
"34ea4862-69b56c27-eea2acfb-63230bb2-63c5d575, cfc5f6b6-2c7ddc4f-f34bdcc8-2880d8b7-54333272",51916515,14501307,"Findings: PA and lateral views of the chest are provided.  The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax.  The heart appears top normal in size.  Mediastinal contours are normal.  Bony structures are intact.  No free air below the right hemidiaphragm is seen. Impression: Top normal heart size.  Otherwise, unremarkable.  Clinical correlation is advised given patient's age.","Findings: PA and lateral views of the chest are provided.  The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax.  The heart appears normal in size.  Mediastinal contours are normal.  Bony structures are intact.  No free air below the hemidiaphragm is seen.  There is a left-sided pacemaker. Impression: Mild cardiomegaly.  Otherwise, unremarkable.  Clinical correlation is advised given patient's age.","['Change location', 'Add contradiction', 'Add medical device']"
"b0b8e02d-88bd77bb-b09b3efa-158cbedf-6f1e0f2f, f12aeb4b-97ac02a5-ca00f34c-0eba166e-714a951e",52575559,14501307,"Findings: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. Impression: No acute cardiopulmonary process.","Findings: There is no focul consolidation, pleural effusion or pneumothorax. An NG tube is present terminating in the stomach. The cardiomediastinal and hilar contours are normal. Impression: Mild pleural effusion and mild pulmonary edema.","['Add typo', 'Add contradiction', 'Add medical device']"
"15ad38d1-1b385c79-9b4ecf28-d3257ab1-6c474573, f4d7124a-97e34422-3896bcd4-fb0af1d2-4cfb07dd",50068096,14517112,Impression: Dense consolidation in the right upper lobe is probably pneumonia.  This needs to be followed to exclude another condition such as bronchogenic carcinoma.  Tiny right pleural effusion may be present.  There is no left pleural effusion or pneumothorax.  Heart is normal size and pulmonary vasculature is not engorged.  Thoracic aorta is tortuous but not clearly dilated.  There is narrowing of the airway at an below the colitis suggesting local edema.  This may be due to recent intubation or laryngitis.  Clinical correlation is advised.,Impression: Dense consolidation in the right upper lobe is possibly pneumonia. This needs to be followed to exclude another condition such as bronchogenic carcinoma. Tiny right pleural effusion is not present. There is no left pleural effusion or pneumothorax. Heart is normal seize and pulmonary vasculature is not engorged. Thoracic aorta is tortuous but not clearly dilated. There is narrowing of the air weigh at and below the colitis suggesting local edema. This may be due to recent intubation or laryngitis. Clinical correlation is suggested.,"['Change severity', 'Change to homophone', 'False negation']"
"35c2f8b5-d2b7c4d7-40723bd1-b8b319b1-81c109bd, f9b94529-baeec146-110c6f2c-ac0f07c8-2bf2a00b",55170845,14528802,Findings: The lungs are clear.  Cardiomediastinal silhouette and hilar contours are unremarkable.  There is no pleural effusion or pneumothorax.  No fractures are noted. Impression: No acute cardiopulmonary process.,Findings: The lungs are cleer.  Cardiomediastinal silhouette and hilar contours are unremarkable.  There is no pleural effusion or pneumothorax.  An NG tube is present.  No fractures are noted. There is no pleural effusion or pneumothorax. Impression: No acute cardiopulmonary process.,"['Add repetitions', 'Add typo', 'Add medical device']"
"0296c965-747a37f9-3ac114b7-bbbc8820-43ca361b, a36da46a-b0b626ad-30087869-bf846180-f0bddb0f",56333260,14538897,Findings: Frontal and lateral views of the chest.  The lungs are clear of focal consolidation or effusion.  Opacities at the cardiophrenic angles bilaterally are thought to represent prominent fat pads.  Cardiomediastinal silhouette is within normal limits.  Descending thoracic aorta is tortuous.  Atherosclerotic calcifications noted at the aortic arch.  No acute osseous abnormality is detected. Impression: No acute cardiopulmonary process.,Findings: Frontal and lateral views of the abdomen.  The lungs are clear of focal consolidation or effusion.  Opacities at the cardiophrenic angles bilaterally are thought to represent prominent fat pads.  Cardiomediastinal silhouette is within normal limits.  ET tube noted.  Descending thoracic aorta is tortuous.  Atherosclerotic calcifications noted at the aortic arch.  No acute osseous abnormality is detected. Impression: Prominent lobar opacities suggesting pneumonia. No acute cardiopulmonary process.,"['Change location', 'Add contradiction', 'Add medical device']"
1e200bbf-a4a3f4ef-5f5971f8-e0280c38-c5d317ef,53498120,14544801,"Findings: Frontal semi-erect view of the chest was obtained.  Left internal jugular central catheter terminates in stable position, across the midline, in either the upper SVC or the left brachiocephalic vein.  Known right upper lung abscess is not clearly visualized on this radiograph due to semi-erect position.  Diffuse right hemithorax opacification remains, though aeration of the right lung appears slightly improved.  The left costophrenic angle is excluded on this study. Impression: Slight improvement in aeration of the right hemithorax, although diffuse opacification of the right hemithorax persists.  Known cavitary lung abscess is not clearly visualized on this semi-upright radiograph.","Findings: Frontal semi-erect view of the chest was obtaine. Left internal jugular dialysis catheter terminates in stable position, across the midline, in either the upper SVC or the left brachiocephalic vein.  Known right upper lung abscess is not clearly visualized on this radiograph due to semi-erect position.  Diffuse right hemithorax opacification remains, though aeration of the right lung appears slightly improved.  The left costophrenic angle is excluded on this study.  An ICD is seen in the right upper thorax. Impression: Slight improvement in aeration of the right hemithorax, although diffuse opacification of the right hemithorax persists.  Known cavitary lung abscess is not clearly visualized on this semu-upright radiograph.","['Change name of device', 'Add typo', 'Add medical device']"
d1311bd6-e306d59e-a79f3f57-df18a30e-bf78423b,55084779,14544801,"Findings: There has been interval placement of a left internal jugular central line, which is seen crossing the midline.  Given patient rotation, position of the catheter tip is limited although it appears to terminate in the region of the left brachiocephalic vein or the superior SVC.  Otherwise, there has been no significant interval change with prior study. Impression: New left IJ central line seen crossing the midline and terminating either within the left brachiocephalic or the upper SVC. Evaluation limited due to rotated position.","Findings: There has been interval placement of a left internal jugular PICC line, which is seen crossing the midline.  Given patient rotation, position of the catheter tip is limited although it appears to terminate in the region of the left brachiocephalic vein or the superior SVC.  Otherwise, there has been no significant interval change with prior study. Impression: New left IJ central line seen crossing the midline and terminating either within the left brachiocephalic or the upper SVC. Moderate left pleural effusion noted. Evaluation limited due to rotated position.","['Change name of device', 'Change to homophone', 'False prediction']"
b3d3f351-2f2c324c-963ca19b-fb5f5df2-0d7e9a31,55332401,14544801,"Findings: There is complete opacification of the right lower lung with air bronchograms suggestive of pneumonia. The large cavity in the upper lung field is partially opacified by adjacent effusion, which appears intervally increased.    Increased interstitial thickening in the left lung is unchanged. There is no pleural effusion or pneumothorax in the left. Impression: Increased opacification in the right lung suggesting pneumonia in the right lower lobe and increased effusion. Cavity in the RUL slightly obscured to to adjacent increased pleural effusion.","Findings: There is complete opacification of the right lower lung with air bronchograms suggestive of pneumonia. The large cavity in the upper lung field is partially opacified by adjacent effusion, which appears intervally decreased.    Increased interstitial thickening in the left long is unchanged. There is no pleural effusion or pneumothorax in the right. Calcification within the left upper lobe is noted. Impression: Increased opacification in the right lung suggesting pneumonia in the right lower lobe and increased effusion. Cavity in the RUL slightly obscured too to adjacent increased pleural effusion.","['Change severity', 'Change to homophone', 'False prediction']"
d60e5ebe-9d77544b-9235b2f7-13e5bf44-06974f41,58556039,14544801,"Impression: AP chest compared to ___ and ___.  Lung volumes are lower today than on ___, but there is no evidence of pneumonia or pulmonary edema. Suprahilar right upper lobe mass appears larger, attributable to differences in radiographic technique although some interval growth is possible.  There is no pneumothorax or pleural effusion.  Heart size is top normal.","Impression: AP chest compared to ___ and ___. Lung volumes are lower today than on ___, but there is evidence of pneumonia along with pulmonary edema. Suprahilar left upper lobe mass appears larger, attributable to differences in radiographic technique although some interval growth is possible. There is no pneumothorax or pleural effusion. Heart size is normal. There is definite presence of a small right-sided pneumothorax. ","['Change location', 'Add contradiction', 'False prediction']"
d44811b4-e337ad4c-3db89276-a24ae31a-5364e1fb,58798839,14544801,Findings: Non-displaced anterior fifth left rib fracture is new.  Necrotic cavitating right upper lobe mass with air-fluid level was better assessed in previous chest CT.  Bibasilar opacities are mostly compatible with aspiration or pneumonia.  Pleural effusion is small if any.  There is no pneumothorax. Impression: 1.  The patient is known with right upper lobe lung cancer that has cavitated with bilateral basal opacities that could be compatible with aspiration or pneumonia. 2.  Left fifth anterior rib fracture is new.,"Findings: Non-displaced anterior fifth left rib fracture is knew. Necrotic cavitating right upper lobe mass with air-fluid level was better assessed in previous chest CT. Mild bibasilar opacities are mostly compatible with aspiration or pneumonia. Pleural effusion is large if any. There is no pneumothorax. Impression: 1. The patient is known with right upper lobe lung cancer that has cavitated with bilateral basal opacities that would be compatible with aspiration or pneumonia. 2. Left fifth anterior rib fracture is new. Also, a central venous line is noted in the superior vena cava.","['Change severity', 'Change to homophone', 'Add medical device']"
"341c96bc-87783d40-8abc20ab-fa3645e4-b5f56f36, ab122ca9-c693ab2c-cd9f74ef-04ecb782-231fdfe6",50892292,14583397,"Findings: AP and lateral views of the chest.  Again, low lung volumes are noted.  There is secondary crowding of the bronchovascular markings but no confluent consolidation The cardiomediastinal silhouette is stable.  Eventration of the right hemidiaphragm again noted.  Degenerative changes noted at the left shoulder. Impression: Low lung volumes without definite superimposed acute process.","Findings: AP and lateral views of the chest.  Agian, low lung volumes are noted.  There is secondary crowding of the bronchovascular markings but no confluent consolidation The cardiomediastinal silhouette is stable.  Eventration of the left hemidiaphragm again noted.  Degenerative changes noted at the left shoulder. Impression: Low lung volumes without definite superimposed acute process. A pacemaker is present.","['Change location', 'Add typo', 'Add medical device']"
d3a1d9e4-94eb4b4c-537cbd71-da0ad8c6-d974a241,51893215,14583397,Impression: New right internal jugular line ends at the cavoatrial junction. No pneumothorax.,Impression: New right internal jugular line ends in the superior vena cava. No pneumothorax. There is a questionable pneumothorax in the left lung apex. ,"['Change name of device', 'Add contradiction', 'False prediction']"
"225bb728-6155e5c7-1d5756c7-629c2d3f-308f2408, 97c9620b-d57b73e6-50f4d0bb-e014ebb1-2d10729b",52416075,14583397,Findings: The lungs are hypoinflated with crowding of vasculature.  Heterogeneous right lower lobe opacity is most consistent with atelectasis.  No pleural effusion or pneumothorax.  Persistent mild cardiomegaly is noted.  Mediastinal contour and hila are unremarkable. Impression: New right basilar opacities suggestive of atelectasis.  Followup PA and lateral radiographs may be helpful to ensure resolution and to exclude the possibility of an early infectious pneumonia in the appropriate clinical setting.,Findings: The lungs are hypoinflated with crowding of vasculature.  Mild right lower lobe opacity is most consistent with atelectasis.  No pleural effusion or pneumothorax.  Persistent mild cardiomegaly is noted.  Mediastinal contour and hila are unremarkable.  Mild right lower lobe opacity is noted. Impression: No evidence of atelectasis.  Followup PA and lateral radiographs may be helpful to ensure resolution and to exclude the possibility of an early infectious pneumonia in the appropriate clinical setting.,"['Change severity', 'Add contradiction', 'False negation']"
7fdf802e-9067de1e-6698cf2a-402439f4-e909e8f3,56437925,14583397,"Findings: AP view of the chest.  A left internal jugular central venous line ends in the upper-to-mid SVC.  There are no pleural effusions, focal consolidation or pneumothorax.  The cardiomediastinal and hilar contours are normal. Impression: Left internal jugular central venous line ends in the upper-to-mid SVC.  Otherwise unchanged.","Findings: AP view of the chest.  A left internal jugular central venous line ends in the upper-to-mid IVC.  There are no pleural effusions, focal consolidation or pneumothorax.  The cardiomediastinal and hilar contours are normal. A nasogastric tube is in place.","['Change location', 'Add repetitions', 'Add medical device']"
c0b0c295-64487928-71fd50de-3c50dbdd-08360437,57524173,14583397,"Findings: AP view of the chest. There is no focal consolidation, pleural effusion or pneumothorax.  The cardiomediastinal and hilar contours are normal.  There are low lung volumes. Impression: Low lung volumes but no evidence of pneumonia.","Findings: AP view of the chest. There is no focal consolidation, pleural effusion or pneumothorax. There is mild pulmonary edema. The cardiomediastinal and hilar contours are normal. Lungs are clear. There are low lung volumes. Impression: Lungs are clear with no evidence of pneumonia.","['False prediction', 'Add repetitions', 'False negation']"
"0f7b8c3b-7c10a4d0-859cab1a-c8fb4b4d-86f8b7b5, 93ae0d43-dfe717a3-a03e8350-04ddffc9-106280f3",58334557,14632685,"Findings: Frontal and lateral views of the chest were obtained.  There are relatively low lung volumes, which accentuate the bronchovascular markings.  Minimal left base atelectasis is seen which is less apparent on the second image.  The aorta is calcified and tortuous.  The cardiac silhouette is not enlarged.  There may be minimal anterior wedging of a thoracic vertebral body at the thoracolumbar junction, of indeterminate age.  Very minimal pulmonary vascular congestion may be present.  There is gaseous distention of what appears to be the stomach under the left hemidiaphragm. Impression: Possible minimal pulmonary vascular congestion.  No definite focal consolidation seen.  Gaseous distention of what appears to be the stomach vs represent splenic flexure.  Correlate clinically.","Findings: Frontal and lateral views of the chest were obtained.  There are relatively low lung volumes, which accentuate the bronchovascular markings.  No atelectasis is seen.  The aorta is calcified and tortuous.  The cardiac silhouette is not enlarged.  There may be minimal anterior wedging of a thoracic vertebral body at the thoracolumbar junction, of indeterminate age.  Very minimal pulmonary vascular congestion may be present.  There is gaseous distention of what appears to be the stomach under the right hemidiaphragm. Impression: Possible minimal pulmonary vascular congestion.  No definite focal consolidation seen.  Gaseous distention of what appears to be the stomach vs represent splenic flexor.  Correlate clinically.
","['Change location', 'Change to homophone', 'False negation']"
"0c62a8e0-fa47177a-d5a6df96-e1bb986f-bafebb7c, 69de2378-c6459058-c5e4a744-30e9cf68-1a0a8390",51971463,14650196,Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  The lungs appear clear.  There are no pleural effusions or pneumothorax.  Bony structures appear normal. Impression: No evidence of acute disease.,Findings: The heart is normal in size.  A central venous line is noted projecting over the right superior mediastinum.  The lungs appear clear.  There are no pleural effusions or pnemothorax.  Bony structures appear normal. Impression: There is a small left-sided pleural effusion identified.,"['Add medical device', 'Add typo', 'False prediction']"
"b16c6c8b-37296ed9-9ea6fb0b-c9f5c94a-2026dfc3, c96c675f-acb71a31-a7bdf067-4c742d16-6093e033",59853610,14702127,"Findings: PA and lateral chest radiographs demonstrate clear lungs bilaterally.  The lungs are symmetrically expanded.  Cardiomediastinal and hilar contours are within normal limits.  There is no evidence of pulmonary edema, pneumothorax, or pleural effusion. Impression: No acute cardiopulmonary process.","Findings: PA and lateral chest radiographs demonstrate clear lungs unilaterally.  The lungs are symmetrically expanded.  Cardiomediastinal and hilar contours are within normal limits.  Cardiomediastinal and hilar contours are within normal limits.  There is no evidence of pulmonary edema, pneumothorax, or pleural effusion. Biapical scarring is noted. Impression: No acute cardiopulmonary process.","['Change location', 'Add repetitions', 'False prediction']"
"451a20c9-4cebf6f8-2b833fda-30b69220-dca29a9d, 707adba4-b7367857-642b3047-ed140bd8-5a905de2",57096268,14720011,"Findings: Frontal and lateral views of the chest were obtained.  Lungs are clear without focal consolidation, pleural effusion, or pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.","Findings: Frontal and medial views of the chest were obtained.  Lungs are clear without focal consolidation, pleural effusion, or pneumothorax is ssen.  Cardiac and mediastinal silhouettes are unremarkable. Impression: There is no cardiopulmonary process.","['Change location', 'Add typo', 'False negation']"
"5c1673ac-8ada2590-ddf3d88a-82c6d4fb-7faeebfb, 8abf5ff4-0a62823f-8bd0c4f8-3bdf0dd9-69c2e270",55315754,14725077,Findings: Lower lung volumes seen on the current exam with bibasilar atelectasis.  The lungs are otherwise clear.  There is no effusion or pneumothorax.  Cardiomediastinal silhouette is within normal limits.  Atherosclerotic calcifications are noted at the aortic arch.  Thoracolumbar S-shaped scoliosis is noted. Impression: No acute cardiopulmonary process.,Findings: Lower lung volumes seen on the currnet exam with bibasilar atelectasis.  The lungs are otherwise clear.  There is no effusion or pneumothorax.  Cardiomediastinal silhouette is within normal limmits.  Atherosclerotic calcifications are noted at the right aortic arch.  Thoracolumbar S-shaped scoliosis is noted. An ICD is in place. Impression: No acute cardiopulmonary process.,"['Change location', 'Add typo', 'Add medical device']"
"07c709ae-9325464f-1dce6632-5d710b99-c9abd81e, f9631c4d-13fad799-9c72bca5-c380fc8b-59d730ed",51496052,14764320,"Findings: Frontal and lateral radiographs of the chest were acquired.  The lungs are clear.  The heart size is normal.  The mediastinal contours are normal.  There are no pleural effusions.  No pneumothorax is seen.  The bony thorax is grossly intact. Impression: 1.  No acute cardiac or pulmonary findings.  2.  No definite rib fracture identified.  If there is continued clinical concern for a rib fracture, further evaluation can be performed with a dedicated rib series, including an appropriately positioned radiopaque skin marker.","Findings: Frontal and lateral radiographs of the chest were acquired. No abnormalities in the lungs are noted. The heart size is normal. The mediastinal contours are normal. No pleural effusions are present. No pneumothorax is seen.  The bony thorax appears normal. Impression: 1.  No acute cardiac or pulmonary findings.  Mild cardiac enlargement. 2.  Rib fracture identified. If there is continued clinical concern for a rib fracture, further evaluation can be performed with a dedicated rib series, including an appropriately positioned radiopaque skin marker.","['Change location', 'Add contradiction', 'False negation']"
"0fbe8114-ff995f07-3913f67d-f95ff2a3-bee737dd, 10183281-0e48a980-d8b20af2-8fb2878b-86f14605",56024419,14783430,Impression: 1.  Moderate right pleural effusion with possible underlying consolidation or atelectasis.  2.  Consolidation within the left lung base concerning for pneumonia in the appropriate clinical circumstance.    3.  Mild pulmonary vascular congestion.,Impression: 1. Moderate left pleural effusion with possible underlying consolidation or atelectasis.  2.  Consolidation within the left lung base concerning for pneumonia in the appropriate clinical circtumstance.  3.  Mild pulmonary vascular congestion. There is a centrally positioned central venous line.  ,"['Change location', 'Add typo', 'Add medical device']"
61e6ad42-674b9c48-684abad1-83ce16d3-0188f603,57078506,14790859,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are unremarkable.  No displaced fracture is seen. Impression: No acute cardiopulmonary process.,Findings: No focal consolidation is noted. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. Impression: Evidence of significant pleural effusion. No acute cardiopulmonary process.,"['Add contradiction', 'Change to homophone', 'False negation']"
"4c558e55-5b795db7-3088bb34-cf6d4bc2-1407cae0, 5f8b833a-b5c56bb4-c61a72ba-61c0a0ce-9fa8c10a",58364828,14793590,"Findings: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation, or pneumothorax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is normal.  There is no pulmonary edema. Impression: No evidence of acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation, or pneumothroax.  Hilar and mediastinal silhouettes are unremarkable.  Heart size is normal.  No consolidation.  There is no pulmonary edema. Impression: No evidence of acute cardiopulmonary process.","['Change location', 'Add typo', 'False negation']"
"4a88af4c-72fac00c-58343875-b13bd191-0cc77d0f, e5cf035a-e203a9f5-8d1942e2-e8b87b94-68462325",51735069,14795241,"Findings: The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. Impression: No acute cardiopulmonary process.","Findings: The loan are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. The lungs are clear. Impression: No acute cardiopulmonary process. There are moderate bilateral pleural effusions.
","['Change to homophone', 'Add repetitions', 'False prediction']"
79632435-0693e0d0-9f3a1293-1663b451-127421df,50078606,14798972,"Findings: Mild mediastinal widening on the right side is from an air-filled neoesophagus which has an unchanged appearance since ___.  Both lungs are well expanded and clear.  No evidence to suggest aspiration or pneumonia.  There is no pneumothorax.  Heart size is normal, mediastinal and hilar contours are unremarkable. Impression: Stable appearance of the mediastinum with the neoesophagus.  Lungs are clear.  No pneumonia/aspiration.","Findings: Mild mediastinal widening on the left side is from an air-filled neoesophagus which has an unchanged appearance since ___.  Both lungs are well expanded and clear.  No evidence to suggest aspiration or pneumonia.  There is no pneumothorax.  Heart size is normal, mediastinal and hilar contours are unremarkable. Impression: Stable appearance of the mediastinum with the neoesophagus.  No neoesophagus seen.  No pneumonia/aspiration.","['Change location', 'Add repetitions', 'False negation']"
da9bcd9f-310e0f89-ef56f5ed-330d4f9e-c7c83601,51882341,14798972,"Findings: Postoperative alterations of the mediastinum appear unchanged in this patient status post esophagectomy procedure.  Indwelling lines and tubes are unchanged in position, and there is no evidence of a pneumothorax.  Bibasilar atelectasis has worsened, particularly in the left retrocardiac region.  Otherwise no relevant short interval change. ","Findings: Postoperative alterations of the mediastinum appear unchanged in this patient status post esophagectomy procedure.  Indwelling lines and tubes are unchanged in position, and there is no evidence of a pneumothorax. An ICD is present.  Bibasilar atelectasis has worsened, particularly in the right retrocardiac region.  Otherwise no relevant short interval change.  Findings: Bibasilar atelectasis has improved, particularly in the right retrocardiac region.","['Change location', 'Add contradiction', 'Add medical device']"
e6b4ccd3-0795f625-2acad01a-72101d69-4ade2ad7,52353675,14798972,"Findings: Compared to the previous radiograph, the right-sided pigtail catheter has been removed.  There is an unchanged right apical pneumothorax without evidence of tension and a relatively extensive soft tissue air collection right laterally.  The position and course of the right Port-A-Cath is unchanged.  Unchanged appearance of the left lung with areas of basal plate-like atelectasis. ","Findings: Compared to the previous radiograph, the right-sided pigtail catheter has been removed.  There is an unchanged right apical pneumothorax without evidence of tension and a relatively extensive soft tissue air collection right laterally.  The position and course of the right Port-A-Cath is changed.  Unchanged appearance of the left lung with no atelectasis.  ","['Change position of device', 'Change to homophone', 'False negation']"
0159eb74-f5b69f73-6e0faa67-ccf3e55c-474da4bb,53079362,14798972,Findings: Indwelling support and monitoring devices are unchanged in position.  Increased widening of right mediastinal contour is consistent with distention of the patient's neoesophagus in this patient status post recent esophagectomy procedure.  Increasing moderate left pleural effusion is present with adjacent left retrocardiac atelectasis. ,Findings: Indwelling support and monitoring devices are unchanged in positron.  Increased widening of right mediastinal contour is consistent with distention of the patient's neoesophagus in this patient status post recent esophagectomy procedure.  Increasing severe left pleural effusion is present with adjacent left retrocardiac atelectasis.,"['Change severity', 'Add typo', 'False prediction']"
"b5379d3a-84715e82-c0b8a323-4bae9a9b-15125251, c1baddfe-c5fb89e0-f89fcd8e-46d628ca-81ab567f",53647601,14798972,"Findings: As compared to the previous radiograph, the extent of the pre-existing pneumothorax has decreased.  The apical part of the pneumothorax has now a diameter of 1 cm.  The right pigtail catheter is in unchanged position.  Slightly increasing amounts of right lateral air collection in the soft tissues.  No evidence of tension.  No other relevant changes. ","Findings: As compared to the previous radiograph, the extent of the pre-existing pneumothorax has decreased.  The apical part of the pneumothorax has now a diameter of 2 cm.  The right pigtail catheter is in unchanged position.  The pacemaker is positioned appropriately.  Slightly increasing amounts of right lateral air collection in the soft tissues.  No evidence of tension.  However, moderate right pleural effusion is noted.  No other relevant changes.  ","['Change measurement', 'Add contradiction', 'Add medical device']"
f353557c-c5c77676-0355d9f8-f6ec8a6a-15084cd3,53979892,14798972,"Findings: As compared to the previous radiograph, pre-existing right pneumothorax appears to have completely resolved.  No pneumothorax is seen on today's image.  Unchanged course and position of the right Port-A-Cath, decreasing extent of the pre-existing right lateral soft tissue air collection.  The cardiac silhouette and the left lung are normal. ","Findings: As compared to the previous radiograph, pre-existing right pneumothorax appears to have increased.  No pneumothorax is seen on today's image.  Right Port-A-Cath tip is now located in the right atrium, decreasing extent of the pre-existing right lateral soft tissue air collection.  The cardiac silhouette and the left lung show mild abnormalities.","['Change position of device', 'Add contradiction', 'Add medical device']"
feeb7dc4-beddb481-54e49f5e-f8d3d074-dde2412d,54849350,14798972,"Findings: Nasogastric tube has been repositioned or replaced, with tip now terminating at approximately the T10 vertebral body level, with the side port at approximately the T7 level with an intrathoracic neoesophagus in this patient status post esophagectomy.  Subcutaneous emphysema in right chest wall has slightly improved.  Lung volumes are slightly increased compared to the prior study with associated improved aeration at lung bases.  Otherwise, no relevant change. ","Findings: Nasogastric tube has been repositioned or replaced, with tip now terminating at approximately the T10 vertebral body level, with the side port at approximately the T7 level with a gastric band in this patient status post esophagectomy.  Subcutaneous emphysema in right chest wall has slightly improved.  Lung volumes are slightly increased compared to the prior study with associated improved aeration at lung bases.  However, subcutaneous emphysema in the chest wall has worsened.  Otherwise, no relevant change.","['Change name of device', 'Add contradiction', 'False negation']"
92939d3d-d0e1a594-0a87af91-b703fa06-a20a1b46,55149101,14798972,"Impression: AP chest compared to ___:  Previous bibasilar atelectasis and moderate left pleural effusion have cleared.  Lungs are fully expanded.  Right apical pleural tube still in place with no appreciable right pleural abnormality.  Heart size normal.  Mediastinum has a normal postoperative appearance following esophagectomy and gastric pull-up.  Heart size normal.  Nasogastric tube has been partially withdrawn and now ends 6 cm above the level of the diaphragm, projecting over a midline drain.  No pneumothorax.","Impression: AP chest compared to ___:  Previous bibasilar atelectasis and a small right pleural effusion have cleared.  Lungs are fully expanded.  Right apical pleural tube still in place with no appreciable right pleural abnormality.  Heart size normal.  Mediastinum has a normal postoperative appearance following esophagectomy and gastric pull-up.  Heart size normal.  Nasogastric tube has been partially withdrawn and now ends 6 mm above the level of the diaphragm, projecting over a midline drain.  No right-sided pneumothorax.  Right apical pleural tube still in place with no appreciable right pleural abnormality.","['Change measurement', 'Add repetitions', 'False prediction']"
3a839f77-7d3beba4-cd7263f9-55cea333-3d6908b7,56978673,14798972,"Findings: A right chest tube terminates in the stadnard position.  An, epidural catheter overlies the patient.  A nasoenteric tube terminates below the diaphragm.  Right perihilar opacity likely represents neoesophagus.  There is some subcutaneous emphysema along the right lateral thorax.  There is no pneumothorax.  Low lung volumes, mild pulmonary vascular congestion, and top normal heart size are consistent with recent surgery. ","Findings: A right chest tube terminates in the midline position.  An, epidural catheter overlies the patient.  A nasoenteric tube terminates below the diaphragm.  Right perihilar opacity likely represents neoesophagus.  There is some subcutaneous emphysema along the right lateral thorax.  There is no pneumothorax.  Low lung volumes, mild pulmonary vascular congestion, and top normal heart size are consistent with recent surgery.  Right perihilar opacity likely represents neoesophagus.  Low lung volumes, mild pulmonary vascular congestion, and top normal heart size are consistent with recent surgery.  A pacemaker is in place.","['Change position of device', 'Add repetitions', 'Add medical device']"
"7c43e78d-ab1bda95-4c4e1601-f5dbfd62-b4890b04, a43ab9e2-2dd2e9ec-032d589e-7b6ae886-941838aa",57788036,14798972,"Impression: PA and lateral chest compared to ___:08 p.m.:  Moderate-to-large right pneumothorax has increased over the past five hours, now surrounds the entire right lung, previously basal.  New leftward mediastinal shift despite persistent right lower lobe collapse, which would be expected to move the mediastinum rightward, suggests the pneumothorax is accumulating under pressure.  Left lung grossly clear.  Heart size normal.  Findings were discussed by Dr. ___ with Dr. ___ at 6:45 p.m. on ___.","Impression: PA and lateral chest compared to ___:08 p.m.:  Moderate-to-large left pneumothorax has increased over the past five hours, now surrounds the entire right lung, previously basal.  New leftward mediastinal shift despite persistent right lower lobe collapse, which would be expected to move the mediastinum rightward, suggests the pneumothorax is accumulating under pressure.  Left lung grossly clear. Heart sise normal.  Prominent peribronchial cuffing is noted. Findings were discussed by Dr. ___ with Dr. ___ at 6:45 p.m. on ___.","['Change location', 'Add typo', 'False prediction']"
"72550433-6fe53947-edefc714-62955b1d-5210cb16, 7e8d9d50-584d2cd7-560f5d23-e406dc42-686f01fc",58049883,14798972,"Findings: There is a new left mid and lower lung zone parenchymal opacity which is highly suggestive of an infectious process.  There is also a small left-sided pleural effusion.  The right basilar opacity present on prior chest x-rays is not as extensive on today's chest x-ray.  There is retrocardiac atelectasis.  The mediastinal and hilar contours are normal, and the heart size is normal. Impression: 1.  New left mid and lower lung zone opacity with small left pleural effusion consistent with pneumonia. 2.  Improved right basilar opacity. 3.  Retrocardiac atelectasis.  Wet read was called to ___ by Dr. ___ ___ telephone at 10:51, 10 minutes after the time of discovery.","Findings: There is a new left mid and upper lung zone parenchymal opacity which is highly suggestive of an infectious process.  There is also a small left-sided pleural efusion.  The left basilar opacity present on prior chest x-rays is not as extensive on today's chest x-ray.  There is retrocardiac atelectasis.  The mediastinal and hilar contours are normal, and the heart size is normal.  An NG tube is seen in the stomach.","['Change location', 'Add typo', 'Add medical device']"
f10984d9-b7e843e6-ebb071e2-68fe6b30-930a5e31,59874624,14798972,"Findings: There is a single right chest tube with its tip terminating near the right lung apex.  No pneumothorax. Widening on the right side of the mediastinum is attributed to the neoesophagus.  Otherwise, cardiomediastinal silhouette is stable in appearance.  Minimal bibasilar atelectasis is present, unchanged on the right side and minimal increase on the left side.  There is no pleural effusion or pneumothorax. ","Findings: There is a single dual-lumen central catheter with its tip terminating near the right lung apex.  No pneumothorax. Widening on the right side of the mediastinum is attributed to the neoesophagus.  Otherwise, cardiomediastinal silhouette is stable in appearance.  Minimal bibasilar atelectasis is present, unchanged on the right side and minimal increase on the left side.  There is no pleural effusion or pneumothorax. There is a central venous line noted in the right-sided superior vena cava. ","['Change name of device', 'Add repetitions', 'Add medical device']"
"50ea0803-d3a44a0f-3a2b4d09-b548d47b-a0e81c90, 588def2d-500ceb2b-4f6ba7d2-538d584d-1b6e3093",50743847,14880886,Findings: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax.  No overt traumatic abnormality. Impression: 1. No acute cardiopulmonary abnormality. 2. No overt traumatic abnormality.,Findings: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. No overt traumatic abnormality. There is an NG tube present. No overt traumatic abnormality. Impression: 1. No acute cardiopulmonary abnormality. 2. No over traumatic abnormality.,"['Change to homophone', 'Add repetitions', 'Add medical device']"
"272ca8f3-c19b4186-d9b66363-3b20f14f-a6cec2b6, bb47b3eb-ca29a1f0-571cfe7f-a5f99cf4-7e570c71",53267993,14930750,"Findings: Heart size is normal. The mediastinal contour is unchanged with mild atherosclerotic calcifications noted at the aortic arch.  Hilar contours are similar compared to the prior chest CT with an infrahilar opacity re- demonstrated.  The lungs are hyperinflated with severe emphysematous changes again seen. While scarring within the lung apices is again noted, there is a new patchy opacity seen within the left upper lobe concerning for an area of infection. No pleural effusion or pneumothorax is identified. No acute osseous abnormality seen. Impression: 1.  New patchy opacity in the left upper lobe concerning for an area of pneumonia. 2. Severe emphysema with scarring within the lung apices. 3. Right infrahilar opacity is re- demonstrated, and previously characterized on chest CTA as an area concerning for possible malignancy. Again bronchoscopy of this area is recommended if not done in the interval.","Findings: Heart size is normal. The mediastinal contour is unchanged with mild atherosclerotic calcifications noted at the aortic arch. Hilar contours are similar compared to the prior chest CT with an infrahilar opacity reademonstrated. The lungs are hyperinflated with mild emphysematous changes again seen. While scaring within the lung apices is again noted, there is a new patchy opacity seen within the left upper lobe concerning for an area of infection. No pleural effusion or pneumothorax is identified. No acute osseous abnormality seen. A central venous line is noted in the right subclavian vein. Impression: 1. New patchy opacity in the left upper lobe concerning for an area of pneumonia. 2. Moderate emphysema with scarring within the lung apices. 3. Right infrahilar opacity is redemonstrated, and previously characterized on chest CTA as an area concerning for possible malignancy. Again bronchoscopy of this area is recommended if not done in the interval.","['Change severity', 'Change to homophone', 'Add medical device']"
"8e7e354e-77af2af7-3cf0db1f-e0d3671a-fc75ea03, a45898be-7a277064-b3338345-c2044677-1b9cffa4",53597344,14954732,Findings: Cardiac silhouette size is top normal.  The mediastinal and hilar contours are unremarkable.  Pulmonary vasculature is not engorged.  Moderate size right pleural effusion is new from the previous radiograph with associated right basilar atelectasis.  Left lung is clear.  No pneumothorax is present.  There are no acute osseous abnormalities. Impression: Moderate size right pleural effusion with right basilar compressive atelectasis.,Findings: Cardiac silhouette size is top normal.  The mediastinal and hilar contours are unremarkable.  Pulmonary vasculature is not engorged.  Mild size right pleural effusion is new from the previous radiograph with associated right basilar atelectasis.  Left lung is clear.  No pneumothorax is present.  There are no acute osseous abnormalities.  An ET tube is in place.Impression: Moderate size right pleural effusion with right basilar compressive atelectasis.  There is no pleural effusion.,"['Change severity', 'Add contradiction', 'Add medical device']"
8e719f66-0c603da9-c93cc5c7-41574b5d-7e6cf099,53957652,14954732,Findings: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion.  The osseous structures are unremarkable Impression: No acute cardiopulmonary abnormalities,Findings: Cardiomediastinal contours are normal. The lung are clear. There is no pneumothorax or pleural effusion.  The osseous structures are unremarkable Impression: No acute cardiopulmonary abnormalities. The osseous structures are unremarkable Impression: No acute cardiopulmonary abnormalities.,"['Add typo', 'Add repetitions', 'False negation']"
"4d00dd83-4db65b59-cb9eb0c2-5b70a148-82334ea6, 7e009c56-a431fd3d-61f9ac9c-c67bebaa-04316f10",57011081,14962059,"Findings: AP upright and lateral views of the chest provided.There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with top-normal heart size again noted.  Imaged osseous structures are intact.  No definite acute osseous injury.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process.","Findings: AP upright and lateral views of the chest provided.There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with top-normal heart size again noted.  Imaged costal structures are intact.  No definite acute osseous injury.  No free air below the right hemidiaphragm is seen. An NG tube is present.Impression: No acute intrathoracic process. There is no focal consolidation, effusion, or pneumothorax. ","['Change location', 'Add repetitions', 'Add medical device']"
d7117501-555c94b2-e493d25e-ac1f3433-09e7204e,58838012,14971109,"Impression: No acute intrathoracic process.  An opacity inferior to the right mainstem bronchus could represent resolving changes secondary to superior segmental abnormality, however direct comparison with the chest CT from Atrius is recommended.  These findings were communicated to ___ ___ MD via telephone at 11 am on ___.","Impression: No acute intrathoracic process.  An opacity inferior to the left mainstem bronchus could represent resolving changes secondary to superior segmental abnormality, however direct comparison with the chest CT from Atruis is recommended. A pacemaker is present.  These findings were communicated to ___ ___ MD via telephone at 11 am on ___.","['Change location', 'Add typo', 'Add medical device']"
"2aea6da8-c43d911f-f1ffde22-323a0ea8-ae72787f, b0e5bce9-f997f76a-229b93fa-ef4fc028-bdcaba10",53482463,14995285,"Findings: No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. Impression: No acute cardiopulmonary process.","Findings: No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. There is a small left pleural effusion. Impression: No acute cardiopulmonary process. There is a small left pleural effusion.","['False prediction', 'Add repetitions', 'Add medical device']"
"93caa05e-f8a3f919-ee78818f-04d801af-3c445791, a6fb266b-ccca366f-9385bd8b-45c8e10e-bff19574",59315725,14998466,"Findings: No interval change.  The lungs are well inflated and clear.  No pleural effusion or pneumothorax.  Heart size, mediastinal contour, and hila are unremarkable.  A left pacer device is seen with lead tips in the right atrium and right ventricle.  EKG leads overlie the chest wall. Impression: No acute cardiopulmonary process.  Specifically, no pneumonia.","Findings: Know interval change.  The lungs are well inflated and clear.  No pleural effusion or pneumothorax.  Hart size, mediastinal contour, and hila are unremarkable.  A left pacer device is seen with lead tips in the mid SVC.  EKG leads overlie the chest wall. An NG tube is present in the stomach. Impression: No acute cardiopulmonary process.  Specifically, no pneumonia.","['Change position of device', 'Change to homophone', 'Add medical device']"
"47f219cd-ee0df4e1-99b8c50c-fb71ca0a-bebff3ec, cf47d683-e828be31-85e2c295-1ee43e48-9663dfba",55294938,14998555,"Findings: There are bibasilar opacities that may reflect atelectasis or aspiration in the appropriate clinical setting.  No other focal consolidation. There is no pleural effusion or pneumothorax.  Mild cardiomegaly.  No acute osseous abnormalities are identified.  Subcutaneous emphysema is partially imaged along the right lateral chest/upper abdominal wall. Impression: 1. Bibasilar opacities may represent atelectasis or aspiration. 2. Subcutaneous emphysema along the right lateral chest/upper abdominal wall, which should be correlated with site of recent surgery/instrumentation.",Findings: There are bibasilar opacities that may reflect atelectasis or aspiration in the appropriate clinical setting.  No other focal consolidation. There is no pleural effusion or pneumothorax.  Mild cardiomegaly.  No acute osseous abnormalities are identified.  Subcutaneous emphysema is partially imaged along the left lateral chest/upper abdominal wall. Impression: 1. Bibasilar opacities may represent atelectasis or aspiration. Mild cardiomegaly is absent. 2. No subcutaneous emphysema detected.,"['Change location', 'Add contradiction', 'False negation']"
3e286a0f-e9daa593-c7a41a0e-9e3594d6-d8f7394f,54652992,15004141,"Findings: The inspiratory lung volume is improved from the most recent prior study.  There is persistent pulmonary vascular congestion/interstitial edema.  A moderate-to-large right and small left pleural effusion are unchanged with underlying bibasilar opacification most likely reflecting atelectasis.  The cardiomediastinal silhouette remains enlarged but stable. Impression: Unchanged pulmonary vascular congestion, bilateral pleural effusions and underlying atelectasis.",Findings: The inspiratory lung volume is improved from the most recent prior study.  There is persistent pulmonary vascular congestion/interstitial edema.  A moderate-to-large left and small left pleural effusion are unchanged with underlying bibasilar opacification most likely reflecting atelectasis.  The cardiomediastinal silhouette remains enlarged but stable.  Right-sided central venous catheter terminates in the superior vena cava. Impression: No evidence of pulmonary vascular congestion. bilateral pleural effusions and underlying atelectasis.,"['Change location', 'Add contradiction', 'Add medical device']"
dfd9a06c-2994892e-f4a6bc1c-f6ec4803-283e5005,55606773,15004141,"Findings: Heart size remains at least moderately enlarged, though assessment is somewhat limited due to the presence of a moderate-to-large right pleural effusion.  A small left pleural effusion is also noted.  Bibasilar airspace opacities could reflect atelectasis, though infection is difficult to exclude. There appears to be mild pulmonary vascular congestion.  No pneumothorax is demonstrated.  Fusion hardware within the lumbar spine is partially imaged. Impression: Mild pulmonary edema and bilateral pleural effusions, moderate to large on the right and small on the left.  Bibasilar airspace opacities could reflect atelectasis, but infection cannot be excluded.","Findings: Heart size remains at least severely enlarged, though assessment is somewhat limited due to the presence of a moderate-to-large rigth pleural effusion. No left pleural effusion is noted. Bibasilar airspace opacities could reflect atelectasis, though infection is difficult to excludee. There appears to be moderate pulmonary vascular congestion. No pneumothorax is demonstrated. Fusion hardware within the lumbar spine is partially imaged. Impression: Mild pulmonary edema and no pleural effusions. Bibasilar airspace opacities could reflect atelectasis, but infection cannot be excluded.","['Change severity', 'Add typo', 'False negation']"
"56dc99f0-d1acfa2e-471d1c57-97a8acd0-0d3ca1f7, 68eb5585-b507f6a7-22aec032-5da34d2f-86b95ee6",52434635,15020971,Findings: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. Impression: No acute cardiopulmonary process.,Findings: The lungs are well expanded and clear. There is no pleural effusino or pneumothorax. The cardiomediastinal silhouette is unremarkable. A pacemaker is present. Impression: No acute cardiopulmonary process.,"['False negation', 'Add typo', 'Add medical device']"
"378e771d-beb3849e-e10d8369-ebbbdc98-48ae076e, 9edfbe81-f4663dcd-3a8cef29-c4ae3ebf-34eaf330",54651539,15020971,"Findings: The lungs are clear without focal consolidation, effusion, or edema. Cardiac silhouette is top normal. No acute osseous abnormalities.  There is no free intraperitoneal air. Impression: No acute cardiopulmonary process.","Findings: The lungs are clear without focal consolidation, effusion, or edema. Cardiac silhouette is tolp normal. Addition of a left-sided pacemaker is seen. No acute osseous abnormalities.  There is no free intraperitoneal air. Impression: Findings consistent with mild pulmonary edema.","['Add contradiction', 'Add typo', 'Add medical device']"
"2e44f83c-54689c28-6a55b93e-8d0b1498-dbbd97b9, 35658ef4-5934c0f8-01618c93-7ccfd737-dc81f89a",59195119,15020971,"Findings: Extremely low lung volumes without definite consolidation.  Heart size is likely normal, allowing for low lung volumes.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.  There are multilevel degenerative changes of the visualized thoracolumbar spine. Impression: No acute cardiopulmonary abnormality.","Findings: Extremely low lung volumes without definite consolidation. The hart size is likely normal, allowing for low lung volumes. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. Their are no acute osseous abnormalities. There are multilevel degenerative changes of the visualized thoracolumbar spine. Impression: No acute cardiopulmonary abnormality. Impression: Mild cardiopulmonary abnormalities.","['Change to homophone', 'Add contradiction', 'False negation']"
"b2d5d5d0-0f2ce3c9-7c098cea-a08ae5c5-c4c9c1c1, ffba75f5-67f885c5-448f97ff-7eee3a54-454b3310",56870153,15051804,"Findings: Cardiac, mediastinal and hilar contours are normal.  Lungs are clear.  Pulmonary vascularity is normal.  No pleural effusion or pneumothorax is seen. No acute osseous abnormalities are visualized. Impression: Normal chest radiograph.","Findings: Cardiac, mediastinal and hilar contours are normal.  Lungs are clear.  Pulmonary vascularity is normal.  No pleural effusion or pneumothorax is seen. Cardiac, mediastinal and hilar contours are normal. No acute osseous abnormalities are visualized.  There is a right IJ central venous catheter positioned in the right atrium. Impression: Normal chest radiograph. Impression: Small bilateral pleural effusions are detected.","['Add repetitions', 'Add contradiction', 'Add medical device']"
"1e05ca1d-9916266c-c58cb1a6-0acf8d1c-bf213534, f2a8d6d9-5425eaf4-1261d395-319e1538-edf854d9",50137061,15072866,"Findings: Frontal and lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours.  Clear lungs.  No pneumothorax or pleural effusion. Impression: Normal chest radiograph","Findings: Frontal and lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours.  Clear lungs.  No pneumothorax or pleural effusion is observed in the left upper lobe.  No pneumothorax or pleural effusion. Impression: Suspected right-sided pleural effusion with consolidation.  ","['Change location', 'Add contradiction', 'False prediction']"
16590c25-c0e530cb-6447694b-ed2dcc9d-04bc1b33,53328177,15072866,"Findings: The heart is at the upper limits of normal size.  The mediastinal and hilar contours appear within normal limits.  There is mild upper zone re-distribution of pulmonary vascularity and indistinctness, suggesting slight vascular congestion or fluid overload, although not striking.  There is no pleural effusion or pneumothorax. Impression: Mild vascular prominence which could be seen with pulmonary venous hypertension or slight congestion.","Findings: The heart is at the upper limits of normal size.  The mediastinal and hilar contours appear within normal limits.  There is mild upper zone re-distribution of pulmonary vascularity and indistinctness, suggesting slight vascular congestion or fluid overload, although not striking.  There is a small right pleural effusion present. Impression: Mild vascular prominence witch could be seen with pulmonary venous hypertension or slight congestion.","['Change location', 'Change to homophone', 'False prediction']"
"2be53082-f806f1da-98837406-6ee69de5-63b79cad, a7410e8e-caf81e04-e39bb33b-40b28719-9689b592",53513169,15127156,Findings: The cardiomediastinal and hilar contours are normal.  There is no pleural effusion or pneumothorax.  Lungs are well-expanded and clear without focal consolidation concerning for pneumonia.  Pulmonary vasculature is within normal limits.  There is no abnormality in the visualized upper abdomen. Impression: No focal consolidation concerning for pneumonia.,Findings: The cardiomediastinal and hilar contours are normal.  There is no pleural effusion or pneumothorax.  Lungs are well-expanded and clear without focal consolidation concerning for pneumonia.  Pulmonary vasculature is within normal limits.  There is a small opacity noted in the right lower lobe.  There is no abnormality in the visualized upper abdomen. Impression: No focal consolidation concerning for pneumonia and possible interstitial edema.,"['Change location', 'Change to homophone', 'False prediction']"
"1be43e00-4990eafa-bc749a86-97e6962e-e2fbaad6, 7524e142-0147cd8b-c4f41ff3-0d8d5792-49a48a77",50281282,15153582,Findings: PA and lateral views of the chest.  No prior.  The lungs are clear. There is no effusion or pneumothorax.  The cardiomediastinal silhouette is normal.  Osseous and soft tissue structures are unremarkable. Impression: No acute cardiopulmonary process.  No pneumothorax.,Findings: PA and lateral views of the chest.  No prior.  The lungs are clear. Their is no effusion or pneumothorax.  The cardiomediastinal silhouette is normal.  Osseous and soft tissue structures are unremarkable. Impression: No acute cardiopulmonary process.  No pneumothorax.,"['Change location', 'Change to homophone', 'False negation']"
"0517bdf0-af54f3aa-559609d8-b886767d-0c994e31, 11d552f5-4943c301-a27f94ec-9e425669-487ef789",50588876,15153582,Impression: No acute cardiopulmonary process,Impression: No acute cardiopulmonary process. New onset of minimal basal atelectasis is noted.,"['False negation', 'Change to homophone', 'False prediction']"
"1a7db0e0-3c536032-768780b1-c802d8c1-5f8e51d0, 3c0a4d68-b8908b62-f58d67d3-41ef7412-48a81c42",53105805,15153582,Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  The lungs appear clear. Impression: No evidence of acute cardiopulmonary disease.,"Findings: The hart is normal in size.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  The lungs appear clear. The lungs appear clear. Impression: Cardiac silhouette is enlarged, suggestive of cardiomegaly. ","['Change to homophone', 'Add repetitions', 'False prediction']"
"3cbdb4bd-f8ea5752-da55affe-f3e77959-40803c29, 55e52c5f-c236740e-08081433-c4f293de-c83b178e",56121507,15153582,"Findings: The cardiomediastinal and hilar contours are within normal limits.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Impression: No acute cardiopulmonary abnormality.","Findings: The cardiomediastinal and hilar contours are within normal limits. A pacemaker is present.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Impression: Mild focal consolidation in the right lung base. Impression: No acute cardiopulmonary abnormality.","['False negation', 'Add contradiction', 'Add medical device']"
475a6219-7057587b-12a770b0-665a9510-cbf49fdf,57311421,15153582,Impression: No acute intrathoracic process.,"Impression: Bibasilar patchy opacities could reflect aspiration, atelectasis or infection. No acute intrathoracic process.","['Add contradiction', 'Add repetitions', 'False prediction']"
"0531fdb8-04856772-413738e9-e9c6e619-b6c5dd42, 72d57d0a-8b8b1b36-e930bc66-8244f92c-a8c8e5c3",57783859,15153582,"Impression: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease or old tuberculous disease.","Impression: In comparison with the study of ___, there is now change or evidence of acute cardiopulmonary disease or no old tuberculous disease.  ","['False prediction', 'Add typo', 'False negation']"
"2d2ff304-3025174d-ae262933-da20379a-0b089143, e6c88a15-a5b7b338-c97e55d1-8325a80f-0c40bb9c",59088085,15153582,"Findings: PA and lateral chest radiographs were obtained.  The lungs are clear and well expanded.  There is no consolidation, effusion, pneumothorax.  Cardiac and mediastinal contours are normal. Impression: No acute cardiopulmonary process.","Findings: PA and lateral chest radiographs were obtained. The lungs are clear with hyperinflation noted. There is no consolidation, effusion, pneumothorax. Cardiac and mediastinal contours are normal. Lungs are clear and well expanded. Impression: No acute cardiopulmonary process. ","['Change location', 'Add repetitions', 'False prediction']"
"57a2a4bb-f9cbac16-93c8460c-76e2ee36-3b62b5fd, a3de483f-15711cf1-0123d198-14a34d08-69b4eca8",58371143,15154281,"Findings: PA and lateral views of the chest are obtained.  Low lung volumes somewhat limit evaluation.  Likely mild atelectasis or bronchovascular crowding accounts for subtle opacities in the lower lungs.  There is no definite sign of pneumonia, CHF, pleural effusion, or pneumothorax.  Cardiomediastinal silhouette appears normal.  Bony structures are intact.  There is no free air below the right hemidiaphragm. Impression: No acute intrathoracic process.  Subtle opacities in the lower lungs likely atelectasis or bronchovascular crowding.  If needed, a repeat study with more optimized inspiratory effort may be performed to confirm.","Findings: PA and lateral views of the chest are obtained.  Low lung volumes somewhat limit evaluation.  Likely mild atelectasis or bronchovascular crowding accounts for subtle opacities in the lower lungs.  There is no definite sign of pneumonia, CHF, pleural effusion, or pneumothorax.  Cardiomediastinal silhouette appears normal.  Bony structures are intact.  There is no free air below the right hemidiaphragm.  There is no definite sign of pneumonia, CHF, pleural effusion, or pneumothorax. Impression: No acute intrathoracic process.  No opacities.  If needed, a repeat study with more optimized inspiratory effort may be performed to confirm.","['Change severity', 'Add repetitions', 'False negation']"
"3d94f5e0-24d15a0d-03dfa926-7bab6be7-90cc1c34, de407a93-6c22805f-d6794e2e-886fa9b0-bdf28c9c",52093968,15167936,"Impression: In comparison with the study of ___, allowing for the PA and lateral projections, the right mediastinal border of the heart is slightly less prominent.  No evidence of acute focal pneumonia or vascular congestion.There is loss of height of several vertebral bodies in the thoracic region, not appreciated on the most recent available study in ___.","Impression: In comparison with the study of ___, allowing for the PA and lateral projections, the left mediastinal border of the heart is slightly less prominent. No evidence of acute focal pneumonia or vascular congestion. Their is no loss of height of vertebral bodies. ","['Change location', 'Change to homophone', 'False negation']"
6f1d8e56-81ec34dd-4f80edfc-98c577db-9db1f26e,57549616,15167936,Findings: AP single view portable chest x-ray in upright position shows low lung volume without consolidation or nodules.  Bulging of the right mediastinal border is due to known right paraspinal mass.  Heart size is normal.  There is no pleural effusion or pneumothorax. ,Findings: AP single view portable chest x-ray in upright position shows low lung volume without consolidation or nodules.  Bulging of the left mediastinal border is due to known right paraspinal mass.  There is no paraspinal mass.  Heart size is normal.  There is no pleural effusion or pneumothorax.  There is no pleural effusion or pneumothorax.  ,"['Change location', 'Add repetitions', 'False negation']"
3b81c9d8-c4ba9c06-8a83c02f-3bb8e8f0-328485e0,57724934,15167936,"Impression: In comparison with the study of ___, there is little overall change. Again there are low lung volumes that accentuate the transverse diameter of the heart.  Central catheter tip is in the mid to lower SVC. Some streaks of atelectasis are noted. Again, the extensive malignant bone destruction seen on the chest CT of ___ is not appreciated on conventional chest radiographs.","Impression: In comparison with the study of ___, there is little overall change. Again there are low lung volumes that accentuate the transverse diameter of the heart. Central stent tip is in the mid to lower SVC. Some streaks of atelectasis are noted. Again, the extensive malignant bone destruction seen on the chest CT of ___ is not appreciated on conventional chest radiographs. Some fluid collection is noted in the pleural space. Again, the extensive malignant bone destruction seen on the chest CT of ___ is not appreciated on conventional chest radiographs.","['Change name of device', 'Add repetitions', 'False prediction']"
"d17fd0d1-e11075c5-ac1d9055-dbea28a9-b09480ec, e0f060fd-48f99877-e59be55f-f3ff2bba-0228b638",57698298,15175883,"Findings: Frontal and lateral chest radiograph demonstrates hypoinflated lungs with crowding of vasculature and bilateral lower lobe atelectasis. No pleural effusion or pneumothorax. No pneumomediastinum. Subtle blunting of the left cardiophrenic angle is most consistent with scarring.  Prosthetic valves are noted, most likely mitral and aortic.   Intact median sternotomy wires. A mildly calcified, tortuous aorta is present. The heart is mildly enlarged.  Limited assessment of the upper abdomen is within normal limits. Impression: No acute cardiopulmonary process. No pneumomediastinum or pneumoperitoneum.","Findings: Frontal and lateral chest radiograph demonstrates hypoinflated lungs with crowding of vasculature and right lower lobe atelectasis. No pleural effusion or pneumothorax. No pneumomediastinum. Subtle blunting of the left cardiophrenic angle is most consistent with scarring. Subtle blunting of the left cardiophrenic angle is most consistent with scarring. Prosthetic valves are noted, most likely mitral and aortic. There are coarse interstitial markings. Intact median sternotomy wires. A mildly calcified, tortuous aorta is present. The heart is mildly enlarged. Limited assessment of the upper abdomen is within normal limits. Impression: No acute cardiopulmonary process. No pneumomediastinum or pneumoperitoneum.","['Change location', 'Add repetitions', 'False prediction']"
"1e308b9d-7b5ab795-6b0bcdb4-47f0778c-10bf984a, bf1b59cc-4f1aa853-6d18a4ee-64fdcf8d-fea466de",58119115,15175883,"Findings: The lungs are hyperinflated with linear streaky opacities at the lung bases, likely representing atelectasis.Heart size is moderately enlarged but stable. Aortic and tricuspid valve prostheses are in unchanged location. Moderate calcification of the aortic knob is again noted. No focal consolidation concerning for pneumonia. No evidence of pulmonary edema, pleural effusion, or pneumothorax.  Median sternal wires are intact. Impression: Moderate cardiomegaly and bibasilar atelectasis are stable from ___.  No evidence of pulmonary edema or pneumonia.","Findings: The lungs are hyperinflated with linear streaky opacities at the lung bases, likely representing atelectasis.Heart size is moderately enlarged but stable. Aortic and tricuspid valve prostheses are now seen in a different location. Moderate calcification of the aortic knob is again noted. No focal consolidation concerning for pneumonia. Evidence of severe pulmonary edema, pleural effusion, and pneumothorax. A new right internal jugular central venous catheter is present. Median sternal wires are intact. Impression: Moderate cardiomegaly and bibasilar atelectasis are stable from ___. Mild pulmonary edema and pleural effusion noted.   ","['Change position of device', 'Add contradiction', 'Add medical device']"
b4e881ec-b2dbe4eb-824d9649-07862804-17af7264,59475713,15176968,Findings: There has been interval decrease in the bilateral pleural effusions with small residual pleural effusions left greater than right there is some volume loss at the left base heart is mildly increased in size. Impression: Improvement in CHF.,Findings: There has been interval decrease in the bilateral pleural effusions with small residual pleural effusions left greater than right there is some volume loss at the left base heart is severely increased in size pacemaker is noted in place. there is some volume loss at the left base. Impression: Improvement in CHF.,"['Change severity', 'Add repetitions', 'Add medical device']"
5bf38a0d-d30e0de1-37c34461-92633fb0-d208538e,59642952,15176968,"Findings: Right and moderate bilateral pleural effusions, mild cardiomegaly, pulmonary vascular redistribution consistent with CHF.  Compared to prior exam there is no significant interval change. Impression: CHF","Findings: Rigth and moderate bilateral pleural effusions, severe cardiomegaly, pulmonary vascular redistribution consistent with CHF. Compared to prior exam there is now significant interval change. A pacemaker is present. Impression: CHF","['Change severity', 'Add typo', 'Add medical device']"
fa879b10-e59b6500-0f17b51e-22c2d961-29242fa0,59647298,15176968,"Findings: There has been improvement in the pulmonary edema, now moderate.  Small bilateral pleural effusions are unchanged.  The cardiac silhouette remains mildly enlarged.  The mediastinal contours at the hilar structures are unremarkable.  There is no pneumothorax or focal airspace consolidation. Impression: Improving pulmonary edema, now moderate.","Findings: There has been improvement in the pulmonary edema, now mild.  Small bilateral pleural effusions are unchanged.  The cardiac silhouette remains severely enlarged.  The mediastinal contours at the hilar structures are unremarkable.  There is no pneumothorax or focal airspace consolidation.  There is no pneumothorax or focal airspace consolidation. Impression: Improving pulmonary edema, now moderate. There is a central venous line in place.","['Change severity', 'Add repetitions', 'Add medical device']"
"834becd5-de7cc7de-4f498574-c769c7a2-c31ee980, b478446e-3a6b9edb-b60dfd6a-d173894d-cc7f116d",50734654,15187487,"Findings: There has been interval placement of a left-pectoral cardiac device with one lead terminating in the right ventricle.  Lung volumes are low and there is a small amount of right middle lobe atelectasis.   Otherwise, no significant interval change.   Stable prominence of the cardiomediastinal silhouette, which may be secondary to slight apical lordotic technique and low lung volumes.  Stable appearance of the hila and pleura.  No focal consolidation, pleural effusion, pulmonary vascular congestion, or pneumothorax. Impression: No acute intrathoracic process.","Findings: There has been interval placement of a left-pectoral vascular stent with one lead terminating in the right ventricle.  Lung volumess are low and there is no small amount of right middle lobe atelectasis.  Otherwise, no significant interval change.   Stable prominence of the cardiomediastinal silhouette, which may be secondary to slight apical lordotic technique and low lung volumes.  Stable appearance of the hila and pleura.  No focal consolidation, pleural effusion, pulmonary vascular congestion, or pneumothorax. Impression: No acute intrathoracic process.","['Change name of device', 'Add typo', 'False negation']"
ce90119b-f1d03bb8-42218616-235c6432-9277af77,53945155,15187487,"Findings: Left-sided pacer defibrillator and single lead are in unchanged position.  Cardiomediastinal and hilar contours are within normal limits unstable.  Lung volumes are low.  There is no focal consolidation, effusion or pneumothorax.  Left costophrenic pleural thickening is stable. Impression: No acute cardiopulmonary abnormality.","Findings: Right-sided pacer defibrillator and single lead are in unchanged position.  Cardiomediastinal and hilar contours are within normal limits.  Lung volumes are low.  There is no focal consolidation, effusion or pneumothorax.  Left costophrenic pleural thickening is stable.  There is no focal consolidation, effusion or pneumothorax.  Impression: No pleural thickening.","['Change location', 'Add repetitions', 'False negation']"
"67cee155-ea0e64cf-a4ca82ce-781deea9-b7bb25ad, 93d7f4a0-4ecb302c-972b3d65-e37fe54d-0c1e5f27",59454021,15187487,"Findings: In comparison with the study of ___, there are again low lung volumes that accentuate the transverse diameter of the heart and tortuosity of the aorta.  No evidence of acute focal pneumonia, vascular congestion, or pleural effusion. ","Findings: In comparison with the study of ___, there are again low lung volumes that accentuate the transverse diameter of the heart and tortuosity of the aorta. No lung volumes detected. No evidence of acute focal pneumonia, vascular congestion, or pleural effusion. Moderate pleural effusion noted.","['False negation', 'Add contradiction', 'False prediction']"
"2694726b-b64f21d1-40b204a6-b4106d63-e6e4af86, 5ad2e9f0-2e4ae7f2-0d6cbcb3-ae978122-0abd2385",52317337,15195289,Findings: Heart size is normal and without change.  Mediastinal and hilar contours are also normal.  Lungs and pleural surfaces are clear.  No acute skeletal findings. Impression: Stable radiographic appearance of the chest with no acute cardiopulmonary radiographic abnormalities.,Findings: Heart size is normal and without change.  Mediastinal and hilar contours are also normal.  Lungs and pleural surfaces are clear.  No acute skeletal findings.  Findings: Heart size is normal and without change. Impression: Stable radiographic appearance of the chest with no acute cardiopulmonary radiographic abnormalities.  Mild pulmonary edema noted.,"['Add contradiction', 'Add repetitions', 'False negation']"
89db0697-aa26530a-d451eb99-319b8e78-39a6aeb0,52950410,15195289,"Findings: In comparison to the chest radiographs obtained ___, no significant changes are appreciated. Lungs are fully expanded and clear without consolidations or suspicious pulmonary nodules. No pleural abnormalities. Heart size is top normal. Cardiomediastinal and hilar silhouettes are normal.  Cervical fusion hardware is incompletely evaluated on this study. Impression: No radiographic evidence of pneumonia or other significant cardiopulmonary abnormalities.","Findings: In comparison to the chest radiographs obtained ___, no significant changes are appreciated. Lungs are fully expanded and clear without consolidations or suspicious pulmonary nodules. No pleural abnormalities. Heart size is moderately enlarged. Cardiomediastinal and hilar silhouettes are normal.  Cervical fusion hardware is incompletely evaluated on this study. Lungs are fully expanded and clear without consolidations or suspicious pulmonary nodules. Airspace opacities are present in the right lower lobe. Impression: No radiographic evidence of pneumonia or other significant cardiopulmonary abnormalities. ","['Change severity', 'Add repetitions', 'False prediction']"
"63cbc1ba-9c1c2426-1afe0a5d-efc95e28-826f383a, ca6270f2-04c17d88-cd4d219a-ba2ce815-f95b4e51",58574233,15195289,"Findings: Heart size is at upper limits of normal or slightly enlarged, similar to ___.  Aorta is minimally unfolded.  Possible minimal upper zone redistribution, but no overt CHF.  No focal infiltrate or effusion. No pneumothorax detected.  Mild eventration of the right hemidiaphragm is unchanged.  Borderline low inspiratory lung volumes.  In the extreme upper aged these films, the lower portion of his cervical spine fixation hardware is noted. Impression: Heart size at the upper limits of normal or slightly enlarged, unchanged compared with ___.  Mild upper zone redistribution, also similar to prior, without overt CHF.  Otherwise, no acute intrathoracic process.","Findings: Heart size is at upper limits of normal or slightly enlarged, similar to ___.  Aorta is minimally unfolded.  Possible minor upper zone redistribution, but no overt CHF.  No focal infiltrate or pleural effusion seen.  No pneumothorax detected.  Moderate eventration of the right hemidiaphragm is unchanged.  Borderline low inspiratory lung volumes.  In the extreme upper aged these films, the lower portion of his cervical spine fixation hardware is noted. Impression: Heart size at the upper limits of normal or slightly enlarged, unchanged compared with ___.  No upper zone redistribution, also similar to prior, without overt CHF.  Otherwise, know acute intrathoracic process.","['Change severity', 'Change to homophone', 'False negation']"
97665b53-8da96eef-00829a6c-105f445c-be77a88d,59968677,15195289,"Findings: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease.  Cardiac silhouette is at the upper limits of normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia.  Cervical fusion device is again seen. ","Findings: In comparison with the study of ___, there is evident change and evidence of acute cardiopulmonary disease.  Cardiac silhouette is at the upper limits of normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia.  Cervical pacemaker is again seen.  ","['Change name of device', 'Add contradiction', 'False negation']"
"05117c5b-38b2c0de-a50c051e-f0303117-192f843c, 0825ee1f-87c4a68b-20dbe092-f3f397a5-67e49d7e",59548617,15198284,"Findings: Lung volumes are normal.  Note is made of a faint opacity at the left lung base and projecting over the spine on the lateral view, concerning for developing infection.  Remainder of the lungs are otherwise clear of focal consolidation, pleural effusion or pneumothorax.  Cardiomediastinal contours are normal.  No acute osseous abnormalities identified. Impression: Left lower lobe opacity, concerning for developing infection.","Findings: Lung volumes are normal. Note is made of a faint opacity at the left lung apex and projecting over the spine on the lateral view, concerning for developing infection. Remainder of the lungs are otherwise clear of focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal contours are normal. No acute osseous abnormalities identified. No left lower lobe opacity.","['Change location', 'Add repetitions', 'False negation']"
9299fa90-c463e69b-c74b271b-8e905160-ed906c51,55387859,15275519,"Impression: As compared to the previous radiograph, no relevant change is seen. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures.  No pleural effusions.  No pneumonia, no pulmonary edema.","Impression: As compared to the previous radiograph, no relevant change is seen. Normal sighs of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions.  No pneumonia, no pulmonary edema. Normal sighs of the cardiac silhouette.","['Change to homophone', 'Add repetitions', 'False negation']"
"c31e4875-3a3a1bad-e483f76f-14252862-55b2ec2e, cff48e01-d2db0222-9bbd6a26-6d30a9ba-b91e3ffa",52226505,15295867,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.,Findings: The lungs are claer without focal consolidation. A large pleural effusion is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.,"['Add typo', 'Add contradiction', 'False prediction']"
"5e51bc45-dc8103d5-a9d121eb-6921584e-03711aad, b2dcef8d-c2328b84-d47a7ecc-042df2f7-4aab73c7",55911809,15303282,Findings: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal contours.  The lungs are clear.  No pleural effusion or pneumothorax identified.  No osseous abnormality. Impression: Normal chest radiograph.  No evidence of active tuberculosis.,Findings: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal contours.  The lungs are clear.  No pleural effusion or pneumothorax identified.  No osseous abnormality. There is a nasogastric (NG) tube in place. Impression: There is some evidence of active tuberculosis.  No evidence of active tuberculosis.,"['Change location', 'Add contradiction', 'Add medical device']"
"50a472b5-45d0d214-091175cf-318c75f7-54e5007e, 91b36d79-326b86ae-773d6a6f-2d9a9401-bfe405dc",58133024,15343139,Findings: Linear right upper lung opacity most likely represents atelectasis. No definite focal consolidation is seen.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: Linear right upper lung opacity most likely represents atelectasis rather than consolidation due to pneumonia.,Findings: Linear left upper lung opacity most likely represents atelectasis. No definite focal consolidation is seen.  No pleural effusion or pneumothorax is seen. The cardiac and meddystinal silhouettes are unremarkable. Also noted is the presence of a central venous line. Impression: Linear right upper lung opacity most likely represents atelectasis rather than consolidation due to pneumonia.,"['Change location', 'Change to homophone', 'Add medical device']"
"80affc57-c634ad36-7566ba24-ac44787d-46dfc160, 8ac669b7-9257e87a-4a9a70ee-6cbc9515-eacfcabb",50457124,15361393,"Findings: Heart size is top normal.  The mediastinal and hilar contours are unremarkable.  Pulmonary vasculature is normal.  Patchy opacity in the left lower lobe most likely reflects atelectasis.  A small left pleural effusion is likely present.  The right lung is clear.  No pneumothorax is identified.  Remote left third anterior rib fracture is identified, but no acutely displaced fractures are otherwise seen. Impression: Left lower lobe patchy opacity, likely atelectasis with small left pleural effusion.  No displaced fractures are visualized.  If there is continued concern for a rib fracture, consider a dedicated rib series.","Findings: Heart size is top normal.  The mediastinal and hilar contours are unremarkable.  Pulmonary vasculature is normal.  Patchy opacity in the left lower lobe most likely reflects atelectasis.  No left pleural effusion is likely present.  The left lung is clear.  No pneumothorax is identified.  Remote right third anterior rib fracture is identified, but no acutely displaced fractures are otherwise seen. Impression: Left lower lobe patchy opacity, likely atelectasis with small left pleural effusion.  No displaced fractures are visualized.  Multiple displaced fractures are seen.","['Change location', 'Add contradiction', 'False negation']"
"4b900027-eae3a3b7-e4d8b930-1b7322f7-2efeef42, 9e4af146-8c53d6c5-1cd2d8ed-67351f6f-d34a1ffe",50319609,15413165,"Findings: Frontal and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion or pneumothorax.  Heart size is normal.  Mediastinal silhouette and hilar contours are normal. Impression: Normal chest radiographs.  Dr. ___ ___ a preliminary report to Dr. ___ by phone at 12:15pm on ___.","Findings: Frontal and lateral views of the chest were obtained. No conslidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. Impression: Normal chest raadiographs. Dr. ___ ___ a preliminary report to Dr. ___ by phone at 12:15pm on ___.","['Change location', 'Add typo', 'False negation']"
"127bf93a-197127b6-f778134c-daa7bac1-f104f57e, 85486c2d-0d140a05-993029bf-23923f68-061805ea",58171899,15413165,Findings: PA and lateral views of the chest.  No prior.  The lungs are clear of focal consolidation or effusion.  Cardiomediastinal silhouette is within normal limits.  Osseous and soft tissue structures are unremarkable. Impression: No acute cardiopulmonary process.   ],Findings: PA and lateral views of the chest.  No prior.  The lungs are clear of focal consolidation or effusion.  Cardiomediastinal silhouette is within normal limits.  Osseous and soft tissue structures are unimpressive. Impression: No acute cardiopulmonary process.   ,"['Change location', 'Change to homophone', 'False negation']"
"08dad1a1-e0d9aa0c-43bcb6c8-8038d5ce-3430cd47, 2bf97d91-aeecb635-55ed5060-aea787be-5271de06",56734350,15436594,Findings: The cardiomediastinal contours are within normal limits.  The bilateral hila are unremarkable.  There is a right lower lobe opacity which is concerning for developing infection.  The remainder of the lungs are clear.  There is no evidence of pulmonary vascular congestion.  There is no pneumothorax or pleural effusion. Impression: Right lower lobe pneumonia.,Findings: The cardiomediastinal contours are within normal limits.  The bilateral hila are unremarkable.  There is a left lower lobe opacity which is concerning for developing infection.  The remainder of the lungs are clear.  There is no evidence of pulmonary vascular congestion.  There is no pneumothorax or pleural effusion. Impression: No pneumonia.,"['Change location', 'Change to homophone', 'False negation']"
cbdfc009-8a46e75c-5ef74a6c-63e9ee1d-fe7b9093,53648454,15452020,Findings: Cardiomediastinal contours are within normal limits.  Lungs demonstrate no focal areas of consolidation to suggest the presence of pneumonia.  Ventriculoperitoneal shunt catheter is noted and has been more fully evaluated on the recent shunt series. ,Findings: Cardiomediastinal contours are within normal limits.  Lungs demonstrate no focal areas of consolidation too suggest the presence of pneumonia.  Ventriculoperitoneal shunt catheter is noted and terminates in the lateral ventricle.  A new central venous line is present in the right atrium.  ,"['Change position of device', 'Change to homophone', 'Add medical device']"
ccd3c424-dd412a6c-654dc449-bc1aa2c0-43dd4d8c,52187725,15452636,"Impression: The lung volumes are normal.  Borderline size of the cardiac silhouette.  No pulmonary edema.  No pneumonia, no pleural effusions.  No pneumothorax.","Impression: The lung volumes are normal. Borderline size of the cardiac silhouette. No pulmonary edema. Pneumonia noted in both lungs, with effusions present. No pneumothorax. An ET tube is noted in place.","['Change to homophone', 'Add contradiction', 'Add medical device']"
"8219e4f1-2f72e956-229a4257-3824daa6-56b96e5d, ccbd2311-fc323e32-01acc861-6baf59d1-7fac2f5b",51937974,15456033,"Findings: Heart size is normal.  The mediastinal and hilar contours are unremarkable.  Pulmonary vasculature is normal.  Scarring within the lung apices is unchanged.  No focal consolidation, pleural effusion or pneumothorax is present.  Mild degenerative changes are again noted in the imaged thoracic spine. Impression: No acute cardiopulmonary abnormality.","Findings: Heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Scarring within the lung apices is unchanged. No focal consolidation, pleural effusion or pneumothorax is present. Moderate degenerative changes are again noted in the imaged thoracic spine. Impression: No acute cardiopulmonary abnormality.","['Change severity', 'Add typo', 'False negation']"
"48a3dd16-508ca270-0ecb3a7d-02364e43-519dbf97, 594e57f9-194d110f-0b8fea6d-aa7e6958-a09d432a",57184085,15457431,Findings: The lungs are well expanded and clear.  Cardiomediastinal and hilar contours are unremarkable.  There is no pleural effusion or pneumothorax. Impression: No evidence of acute cardiopulmonary process.,Findings: The lungs are well expanded and clear.  Cardiomediastinal and hilar contours are unremarkable.  There is no declaring effusion or pneumothorax.  The heart is enlarged. Impression: Evidence of acute cardiopulmonary process.,"['Add contradiction', 'Change to homophone', 'False negation']"
"31974755-9e36b005-a5864f33-563d64d2-76bcd471, cfce55c4-645f48d5-67d2eb78-e6c3fe6e-9489f536",57395944,15461483,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The aorta is calcified and tortuous. The cardiac silhouette is top-normal. Mild biapical pleural thickening is seen. Impression: No focal consolidation to suggest pneumonia.,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The aorta is caclified and tortuous. The cardiac silhouette is ennlarged. Mild to moderate biapical pleural thickening is seen. There is an osteolytic lesion in the left rib. Impression: No focal consolidation to suggest atelectasis.,"['Change severity', 'Add typo', 'False prediction']"
"d8b7273b-a7fcc609-c3282bbb-34e43194-ff77283e, fdd10576-222e8177-96e5f4ff-ecd5413a-66d01a79",50384009,15479108,"Findings: Heart size, mediastinal and hilar contours are within normal limits and without change.  Lungs are clear except for a small linear focus of atelectasis of scar at the left lung base.  No pleural effusion or acute skeletal findings. Impression: No radiographic findings to suggest the presence of sarcoid or tuberculosis.","Findings: Heart size, mediastinal and hilar contours are within normal limits and without change.  Lungs are clear except for a small linear focus of atelectasis of scar at the left lung base.  No pleural effusion or acute skeletal findings. Impression: No radiographic findings to suggest the presence of sarcoid or tuberculosis but moderate pulmonary edema.","['Change severity', 'Add contradiction', 'False negation']"
ae0d26cc-42f554c9-d591c1f3-0d0de89a-895ffeef,50719061,15480043,"Impression: No relevant change as compared to the previous image.  Low lung volumes.  Moderate cardiomegaly with mild fluid overload but no overt pulmonary edema.  No pneumonia, no pleural effusions.","Impression: No relevant change as compared to the previous image.  Low lung volumes.  Mild cardiomegaly with mild fluid overload but no overt pulmonary edema.  No pneumonia, no pleural effusions.  No pneumonia, no pleural effusions.  A central venous line is observed.","['Change severity', 'Add repetitions', 'Add medical device']"
5e840cc8-fa36ed6d-7367856a-7e0328be-7e9a9ccf,55884194,15480043,Impression: Heart size top-normal. Lungs clear.  No pleural abnormality.,"Impression: Heart size top-normal. Streaky linear opacities noted in the lungs. No pleural abnormality. No cardiomegaly identified, and heart size is within normal limits.","['False prediction', 'Add repetitions', 'False negation']"
"23268708-bb681a69-9d7f6685-bf0877d4-0ea495b0, ed6fc46d-125a2981-0a4df024-4a7e34f9-d87b7c6a",58155175,15480043,"Findings: AP upright and lateral views of the chest provided.  Low lung volumes cause bronchovascular crowding.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is similar to prior. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process.","Findings: AP upright and lateral views of the chest provieded.  Low lng volumes cause bronchovascular crowding.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is similar to prior. Imaged osseous structures are intact. There is a pacemaker present. No free air below the left hemidiaphragm is seen. Impression: No acute intrathoracic process.","['Change location', 'Add typo', 'Add medical device']"
5e754211-f7ae671d-f26bc9e0-5fabd237-73978d1c,59554791,15568945,Findings: There is discontinuation in the shunt at the cervicalthoracic junction measuring approximately 8 mm. The shunt traverses along the right lateral aspect of the upper chest and is no longer visualized.  The lungs are unremarkable.  The cardiomediastinal contours are within normal limits. Impression: There is discontinuation in the shunt at the cervical thoracic junction measuring approximately 8 mm. The shunt traverses along the right lateral aspect of the upper chest and is no longer visualized.,Findings: There is discontinuation in the shunt at the cervicalthoracic junction measuring approximately 8 cm. The shunt traerses along the right lateral aspect of the upper chest and is no longer visualized.  The lungs are unremarkable.  The cardiomediastinal contours are within normal limits. A pacemaker is seen in the upper thorax. Impression: There is discontinuation in the shunt at the cervical thoracic junction measuring approximately 8 cm. The shunt traverses along the right lateral aspect of the upper chest and is no longer visualized. ,"['Change measurement', 'Add typo', 'Add medical device']"
"04d4bb7c-3e524bc2-dddbd274-58c7a633-e72d0a37, cdbb816d-5149649c-ae5f5de6-9c97c843-aeb02508",52078228,15585360,Findings: No focal consolidation is seen.  Small pulmonary nodules reported on prior chest CT from ___ were better assessed on that more sensitive study and follow-up recommendation per that study remains.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Impression: No acute cardiopulmonary process.  No focal consolidation to suggest pneumonia.  Small pulmonary nodules reported on prior chest CT from ___ were better assessed on that more sensitive study and follow-up recommendation per that study remains.,Findings: No focal consolidation is seen.  Small pulmonary nodules reported on prior chest CT from ___ were better assessed on that more sensitive study and follow-up recommendation per that study remains.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Impression: No acute cardiopulmonary process.  No focal consolidation to suggest pneumonia.  No pulmonary nodules.,"['Change severity', 'Add repetitions', 'False negation']"
05ae2a75-03fa91ad-ba0cb001-198c6cdb-b5cc4267,51354049,15620736,"Impression: AP chest compared to ___, 12:22 a.m.:  Nasogastric tube ends in the stomach.  Normal cardiomediastinal silhouette.  Right jugular line ends low in mid SVC.  Lungs clear.  No pleural abnormality.","Impression: AP chest compared to ___, 12:22 a.m.:  Nasogastric tube ends in the esophagus.  Normal cardiomediastinal silhouette.  Left jugular line ends low in mid SVC.  Lungs clear.  Mild pleural effusion.","['Change location', 'Add contradiction', 'False negation']"
8510d3ca-b0426e32-7dd8e6f5-6e0bc0d6-3f439a43,53793106,15634260,"Impression: As compared to the previous radiograph, no relevant change is seen.  The lung volumes have minimally increased, potentially reflecting improved ventilation. The monitoring and support devices are constant. Moderate cardiomegaly with mild fluid overload persists. Moderate retrocardiac atelectasis is unchanged.  No evidence of pneumonia.","Impression: As compared to the previous radiograph, no relevant change is seen. The lung volumes have moderately increased, potentially reflecting improved ventilation. The monitoring and support devices are constant. Moderate cardiomegaly with mild fluid overload persists. Mild retrocardiac atelectasis is unchanged. Small bilateral pleural effusions. There is a right-sided central venous line.","['Change severity', 'Add contradiction', 'Add medical device']"
57f11ad7-668a8ca8-2fd8f02d-44a9a593-0eb9ac6d,54799576,15634260,"Impression: ET tube tip is 6 cm above the Carina.  Dobbhoff tube passes below the diaphragm terminating in the stomach. Cardiomediastinal silhouette is unchanged. Vascular congestion is re- demonstrated, unchanged. There is no pleural effusion or pneumothorax developed in the interim.",Impression: ET tube tip is 6 cm above the Carina.  Dobbhoff tube passes below the diaphragm terminating in the jejunum. Cardiomediastinal silhouette is unchanged. Vascular congestion is not re-demonstrated. There is no pleural effusion or pneumothorax developed in the interim. Mild bilateral pulmonary congestion is observed.,"['Change name of device', 'Add contradiction', 'False negation']"
"6251d8df-ca3dc2ab-d1bc3776-7ebce2ce-7992de95, e78e7e56-3b76bfbe-c0647f3a-c8b5a476-fc847dad",58248665,15634260,Findings: No previous images.  The tip of the endotracheal tube measures approximately 4 cm above the carina.  Nasogastric tube extends to the upper stomach where it crosses the lower margin of the image.  There is enlargement of the cardiac silhouette in a patient with intact midline sternal wires.  Poor definition of pulmonary vessels is consistent with some elevation of pulmonary venous pressure.  Retrocardiac opacification with obscuration of the hemidiaphragm is consistent with volume loss in the left lower lobe and probable small pleural effusion. ,Findings: No previous images. The tip of the endotracheal tube measures approximately 5 cm above the carina. Nasogastric tube extends to the upper stomach where it crosses the lower margin of the image. There is enlargement of the cardiac silhouette in a patient with intact midline sternal wires. Poor definition of pulmonary vessels is consistent with some elevation of pulmonary venous pressure. Retrocardiac opacification with obscuration of the hemidiaphragm is consistent with volume loss in the left lower lobe and probable small pleural effusion.,"['Change measurement', 'Change to homophone', 'False negation']"
bb01346b-489ad7a1-de494939-c17e4691-af4f04af,50971251,15655633,Impression: Heart size is within normal limits. There is elevation of the left hemidiaphragm. There is also atelectasis and increased bronchovascular markings at the left base which suggests bronchiectasis an was suggested on the prior study. There has been improved aeration of the right base with apparent resolution of the small pleural effusion. No pneumothoraces are identified. There are no signs for pulmonary edema.,Impression: Heart size is marginally increased. There is elevation of the left hemidiaphragm. There is also atelectasis and incresed bronchovascular markings at the left base which suggests bronchiectasis as was suggested on the prior study. There has been improved aeration of the right base with apparent resolution of the small pleural effusion. Left rib fractures are noted. No pneumothoraces are identified. There are minimal signs for pulmonary edema.,"['Change severity', 'Add typo', 'False prediction']"
b3c095eb-d16fb25c-87e49ad2-ddbe4e2e-2e2e1f55,57179351,15655633,"Impression: Left hemidiaphragm has been considerably higher than the right since at least ___.  New findings on today's study are mild cardiomegaly, moderate mediastinal venous engorgement and bibasilar interstitial abnormality probably edema.  Appearance of the left lung base suggests bronchiectasis, which could be a primary cause of volume loss in the left lower lobe or the result of chronically retained lower lobe secretionsdue to diminished diaphragmatic function.","Impression: Left hemidiaphragm has been considerably higher than the right since at least ___.  New findings on today's study are mild cardiomegaly, moderate mediastinal venous engorgement and bibasilar patchy opacities probably edema.  Appearance of the right lung base suggests bronchiectasis, which could be a primary cause of volume loss in the left lower lobe or the result of chronically retained lower lobe secretions due to diminished diaphragmatic function. Moderate cardiomegaly and prominent upper lobe vessels suggesting vascular congestion.","['Change location', 'Add contradiction', 'False prediction']"
"06b6a3e0-208c063d-2c0b4f80-9348ff49-d46e8591, 22af58d7-30892703-e9699647-89e52ade-df1be193",50006562,15658321,Findings: PA and lateral chest radiograph demonstrate clear lungs bilaterally.  There is no pleural effusion or pneumothorax.  Cardiomediastinal and hilar contours are within normal limits. No overt pulmonary edema.  A large hiatal hernia is again identified.  Osseous structures are without an acute abnormality. Impression: Large hiatal hernia. No acute intrathoracic abnormality.,Findings: PA and lateral chest radiograph demonstrate clear lungs bilaterally.  There is no pleural effusion or pneumothorax.  Cardiomediastinal and hilar contours are within normal limits. Small patchy opacities in the right middle lobe suggest atelectasis.  A large hiatal hernia is again identified.  Osseous structures are without an acute abnormality. Impression: Large hiatal hernia. Mild intrathoracic abnormality.,"['Change severity', 'Change to homophone', 'False prediction']"
"123fc641-feb28310-ea95c2e3-ba1f1635-bc669e55, eea74349-5461aadf-23d886d2-2d1cc279-a753eb82",53093195,15658321,"Findings: Chest, PA and lateral.  The lungs are clear.  Nodular opacities over the lung bases most consistent with nipple shadows.  A large hiatal hernia is redemonstrated.  Otherwise, the hilar and cardiomediastinal contours are normal.  There is no pneumothorax or pleural effusion.  Pulmonary vascularity is normal. Impression: 1. No acute cardiopulmonary process.  2. Large hiatal hernia.","Findings: Chest, PA and lateral.  The lungs are clear.  No nodular opacities.  A large hiatal hernia is redemonstrated.  Otherwise, the hilar and cardiomediastinal contours are normal.  There is no pneumothorax or pleural effusion.  Pulmonary vascularity is normal. Impression: 1. No acute cardiopulmonary process.  A large hiatal hernia is redemonstrated.  2. Large hiatal hernia.","['Change location', 'Add repetitions', 'False negation']"
"08705aac-020b2766-2515394a-84a9a685-4fab305b, 2334929e-1e2a581e-82ff2163-5a51b1f9-316bc604",54415831,15658321,"Findings: A very large hiatal hernia is again demonstrated, unchanged in configuration since the ___ radiographs.  The heart size remains within normal limits.  The hilar and mediastinal contours are normal.  There is no focal consolidation, pneumothorax, or pleural effusion. Impression: No acute intrathoracic process.  Unchanged large hiatal hernia.","Findings: A very large hiatal hernia is again demonstrated, unchanged in configuration since the ___ radiographs.  The heart size remains slightly enlarged.  The hilar and mediastinal contours are normal.  There is no focal consolidation, pneumothorax, or pleural effusion.  There is chronic scarring in the right lower lobe. Impression: No acute intrathoracic process.  Unchanged large hiatal hernia.","['Change severity', 'Change to homophone', 'False prediction']"
"2a76f69a-7be37463-26a4305d-43c7b2aa-969572ad, 593ece09-48ef4c41-fea2a357-67004038-0e886e64",58254317,15658321,"Findings: There is no focal consolidation, pleural effusion or pneumothorax.  Cardiomediastinal silhouette is within normal limits.  A large hiatal hernia is noted.  No acute fractures are seen.  No free air under the right hemidiaphragm. Impression: 1.  No acute intrathoracic process. 2.  Large hiatal hernia.","Findings: There is no focal consolidation, pleural effusion or atelectasis.  Cardiomediastinal silhouette is within normal limits.  A large hiatal hernia is noted. There is a right-sided pleural effusion. No free air under the right hemidiaphragm. Impression: 1.  No acute intrathoracic infection. 2.  Large hiatal hernia.","['Change location', 'Change to homophone', 'False prediction']"
"787e7af6-b1d3f2a1-81b39649-9ac3a846-1380d48f, af93629c-67d952a4-9dec1e9b-2a85b2bf-350fe109",54417884,15659017,Findings: The cardiomediastinal and hilar contours are normal.  There is no pleural effusion or pneumothorax.  There is no focal consolidation concerning for pneumonia.  Pulmonary vasculature is within normal limits.  The upper abdomen is unremarkable. Impression: No acute cardiopulmonary process.,Findings: The cardiomediastinal and hilar contours are normal.  There is no pleural effusion or pneumothorax.  There is no focal consolidation concerning for new-moan-ya.  Pulmonary vasculature is within normal limits.  The upper right abdomen is unremarkable.  An NG tube is in place. Impression: No acute cardiopulmonary process.,"['Change location', 'Change to homophone', 'Add medical device']"
ce085ac9-380a3af0-26189a25-67e34038-82954f13,51055127,15693523,Impression: Concern for developing right upper lobe and unchanged left lower lobe opacities concerning for multifocal infectious process.,Impression: Concern for developing left upper lobe and unchanged left lower lobe opacities concerning for multifocal infectious process.,"['Change location', 'Change to homophone', 'False negation']"
"06a14fd9-8f89607b-b20836e4-7b3477f4-8434d888, 116fcb38-1309dd16-16643cd1-262b2801-bcc0a0bf",52654474,15693523,Findings: Better delineated on recent CT scan is a left hilar mass compatible with patient's known malignancy with complete left lower lobe collapse is again seen. Scattered opacity in the aerated left upper lobe are compatible with opacity seen on recent CT. The right lung is grossly clear. Mediastinal shift to the left is as seen on prior. Left chest wall dual lead pacing device and right Port-A-Cath are again seen. Widespread metastatic disease is better seen on prior CT scan. Impression: No significant interval change noting left perihilar mass with subsequent left lower lobe collapse and opacities in the aerated left upper lobe.,Findings: Better delineated on recent CT scan is a right hilar mass compatible with patient's known malignancy with complete left lower lobe collapse is again seen. Scattered opacity in the aerated left upper lobe are compatible with opacity seen on recent CT. The right lung is grossly clear. Mediastinal shift to the left is as seen on prior. Left chest wall dual lead pacing device and right Port-A-Cath are again seen. Right-sided pleural effusion not previously noted. Widespread metastatic disease is better seen on prior CT scan. Impression: No significant interval change noting left perihilar mass with subsequent left lower lobe collapse and opacities in the aerated left upper lobe noting left perihilar mass with subsequent left lower lobe collapse and opacities in the aerated left upper lobe.,"['Change location', 'Add repetitions', 'False prediction']"
32b62c2a-3374dbc2-f1fe4be4-9119f9a8-af2df168,54302400,15693523,"Impression: Support lines and tubes are unchanged in position.  The left-sided airway stent is unchanged. There is again seen complete collapse of the left lung with shifting of mediastinal structures to the left. Known pulmonary nodules in the right side are better characterized on prior CT scan. The right lung appears well aerated. There are no pneumothoraces. Overall, the findings appear unchanged.","Impression: Support lines and tubes are moved in position. The left-sided arway stent is unchanged. There is again no collapse of the left lung with shifting of mediastinal structures to the left. Known pulmonary noddes in the right side are better characterized on prior CT scan. The right lung appears well aerated. There are no neumothoraces. Overall, the findings appear unchanged.","['Change position of device', 'Add typo', 'False negation']"
"39623822-10ce4ab6-684d8f03-25ca8526-4136f1fb, 7fb96c7d-d8af1662-ce79f836-f9b8bef5-cacea9ba",57108434,15693523,Findings: Left-sided pacemaker device with leads terminating in the right atrium and right ventricle is noted.  Heart size is normal.  Mediastinal and hilar contours are unremarkable. Apical predominant emphysema is noted. There is no pulmonary edema. Linear scarring within the left upper lobe is seen. Left lower lobe ill-defined opacity is concerning for pneumonia.  No pleural effusion or pneumothorax is seen.  Scarring within the apices is demonstrated. Several clips are demonstrated within the posterior mediastinum superiorly.  Additionally there appears to have been prior resection of the right ___ posterior rib. Impression: Left lower lobe ill-defined opacity concerning for pneumonia.  Followup radiographs after treatment are recommended to ensure resolution of this finding.,Findings: Left-sided dual-chamber permanent catheter device with leads terminating in the right atrium and right ventricle is noted.  Heart size is norml.  Mediastinal and hilar contours are unremarkable. Apical predominant emphysema is noted. There is no pleural effusion. Linear scarring within the left upper lobe is seen. Left lower lobe ill-defined opacities with possible small effusion are concerning for pneumonia.  No pleural effusion or pneumothorax is seen.  Scarring within the apices is demonstrated. Several clips are demonstrated within the posterior mediastinum superiorly.  Additionally there appears to have been prior resection of the right ___ posterior rib with a small pleural effusion on the left. Impression: Left lower lobe ill-defined opacity concerning for pneumonia.  Followup radiographs after treatment are recommended to ensure resolution of this finding.,"['Change name of device', 'Add typo', 'False prediction']"
5ec03a5b-72a566fb-de027ea9-bb847032-a0282268,58243808,15693523,"Impression: Complete opacification of the left hemi thorax due to and atelectasis, with subsequent displacement of the mediastinum. Postoperative appearance of the right lung with postoperative rib defect.  No evidence of acute right lung changes.  Pacemaker in left pectoral position.","Impression: Complete opacification of the left hemi thorax due to and atelectasis, with subsequent displacement of the mediastinum. Postoperative appearance of the right lung with postoperative rib defect.  No evidence of acute right lung changes. Pacemaker in right pectoral position.","['Change position of device', 'Add contradiction', 'False prediction']"
7b66482b-c6de4d3a-04ee2e45-67142f2c-51801f38,59577259,15693523,"Impression: Since the recent CT of ___, a left airway stent has been placed.  There is now complete collapse of the left lung with associated worsened leftward shift of the cardiomediastinal contours and hyper expansion of the right lung.  Known pulmonary nodules in the right lung have been more fully characterized by a recent CT as well as multifocal pleural abnormalities.","Impression: Since the recent CT of ___, a left airway stent has been placed.  There is now complete collapse of the left lung with associated worsened leftward shift of the cardiomediastinal contours and hyper expansion of the right lung.  Known pulmonary nodules in the right lung have been more fully characterized by a recent CT as well as multifocal pleural abnormalities.  There is now complete collapse of the left lung with associated worsened leftward shift of the cardiomediastinal contours and hyper expansion of the right lung.  Known pulmonary nodules in the right lung have been more fully characterized by a recent CT as well as multifocal pleural abnormalities. No pulmonary nodules.","['Change position of device', 'Add repetitions', 'False negation']"
"2475d419-36bd3605-ce47decf-c2d3ebce-4f860c29, 4d2afd84-14eebd01-d0d9aab5-248a2e02-250a8f87",52552455,15718331,"Findings: The heart is mildly enlarged but not significantly changed since earlier examinations.  The cardiac, mediastinal, and hilar contours appear similar.  The lungs are clear.  There are no pleural effusions or pneumothorax.  Mild-to-moderate degenerative changes are similar along the thoracic spine. Impression: No evidence of acute disease.","Findings: The heart is severely enlarged but not significantly changed since earlier examinations.  The cardiac, mediastinal, and hilar contours appear simialr.  The lungs are clear.  There are no pleural effusions or pneumothorax.  Large-to-moderate degenerative changes are similar along the thoracic spine.  An external ET tube is in place. Impression: No evidence of acute disease.","['Change severity', 'Add typo', 'Add medical device']"
59c6d360-9e96b2ab-750786c3-b6bfac43-ba99775a,53534550,15718331,Impression: No acute intrathoracic process.,Impression: No acute intrathoracic process. Impression: No acute intrathoracic process. Impression: There is an NG tube present.,"['Add contradiction', 'Add repetitions', 'Add medical device']"
"041edb3b-ccbe6942-fc19c0f4-cbed6880-a76a50e5, 1112d683-19c810c8-39aead7a-ebf7cff2-5b946e2f",53441107,15732468,"Findings: The lungs remain hyperinflated consistent with patient's history of underlying emphysema.  Areas of calcified pleural plaques previously demonstrated on CT account for the focal calcific densities overlying bilateral lungs.  There are no focal consolidations, effusions, or pneumothoraces.  The cardiomediastinal silhouette is normal.  No acute fractures are identified. Impression: No acute cardiopulmonary process.","Findings: The lungs remain hyperinflated consistent with patient's history of underlying emphysema.  Areas of calcified pleural plaques previously demonstrated on CT account for the focal calcific densities overlying medial lungs.  Their are no focal consolidations, effusions, or pneumothoraces.  The cardiomediastinal silhouette is normal.  No acute fractures are identified. A central venous line is present. Impression: Noh acute cardiopulmonary process.","['Change location', 'Change to homophone', 'Add medical device']"
"a9e93c6f-04f9e839-999c9508-6890b550-8f0ee880, d11dac47-eb411965-10a6bda4-51bf83b2-47e0aa38",53686865,15732468,"Findings: Heart size is normal.  Cardiomediastinal silhouette and hilar contours are unremarkable.  Multiple scattered calcified pleural plaques are suggestive of prior asbestos exposure.  Lungs are otherwise clear.  There is no pleural effusion or pneumothorax.  The bony structures are grossly unremarkable with fracture. Impression: 1.  No acute intrathoracic process, specifically no evidence of rib fracture. 2.  Asbestos-related pleural plaques.","Findings: Heart size is normal.  Cardiomediastinal silhouette and hilar contours are unremarkable.  Multiple scattered calcified pleural plaques are suggestive of prior asbestos exposure.  A right-sided chest tube is seen extending into the pleural space.  There is no pleural effusion or pneumothorax.  The bony structures are grossly unremarkable with fracture. Impression: 1.  No acute intrathoracic process, specifically no evidence of rib fracture. 2.  Mild left pleural effusion. 3.  Asbestos-related pleural plaques.","['Add medical device', 'Add contradiction', 'False prediction']"
"2da4bc59-601fa386-1d07436a-cbde67df-54495e0d, 3c38c379-9e5cc827-771ffeb4-b5d722d4-127b3224",53862674,15732468,"Findings: Stable small calcified granuloma in the right lower lung. The lungs are hyper-expanded with associated flattening of the diaphragms.  No focal consolidation, pneumothorax, pleural effusion, or pulmonary edema. Stable normal-appearing cardiomediastinal silhouette and hila. Calcified pleural plaques are unchanged from the prior exam. No acute rib fracture. Impression: 1.  Hyper-expanded lungs, consistent with emphysema.  2.  No definite rib fracture on chest radiograph.  3.  No acute cardiopulmonary process.","Findings: No calcified granuloma seen. The lungs are hyper-expanded with associated flattening of the diaphragms.  No focal consolidation, pneumothorax, pleural effusion, or pulmonary edema. Stable normal-appearing cardiomediastinal silhouette and hila. Calcified pleural plaques are unchanged from the prior exam. No acute rip fracture. Impression: 1.  Hyper-expanded lungs, consistent with mild emphysema.  2.  No definite rib fracture on chest radiograph.  3.  No acute cardiopulmonary process.","['Change severity', 'Change to homophone', 'False negation']"
"00768144-dfeb6fc1-56e7b784-7441d569-b86bc4fa, 858530aa-6e3aea34-0f6130c3-fe8639af-225e59a5",52545368,15768537,"Findings: PA and lateral views of the chest.  The lungs are clear without consolidation, effusion or pulmonary vascular congestion.  Cardiomediastinal silhouette is normal.  No acute osseous abnormality is identified. Impression: No acute cardiopulmonary process.","Findings: PA and lateral views of the wrist.  The lungs are clenr without consolidation, effusion or pulmonary vascular congestion.  Cardiomediastinal silhouette is normal.  No acute osseous abnormality is identified. Impression: No cardiopulmonary process.","['Change location', 'Add typo', 'False negation']"
0adba4e9-74bf6877-3500bd46-d395ecc6-75dcdc60,50930348,15780880,"Findings: Lung volumes are decreased compared to the prior study.  The heart size is likely top normal, but is accentuated by low inspiratory volumes.  There is crowding of the bronchovascular structures.  Mild pulmonary vascular engorgement is present.  No focal consolidation, pleural effusion or pneumothorax is identified.  There are no acute osseous abnormalities. Impression: Mild pulmonary vascular congestion.","Findings: Lung volumes are decreased compared to the prior estudo.  The heart size is likely top normal, but is accentuated by low inspiratory volumes.  There is crowinding of the bronchovascular structures.  Moderate pulmonary vascular engorgement is present.  No focal consolidation, pleural effusion or cardiomegaly is identified.  There are no acute osseous abnormalities. Impression: Mild pulmonary vascular congestion.","['Change severity', 'Add typo', 'False prediction']"
5d8300fe-3a3aaed5-ec3f9f49-769dcb99-a7ffa174,51766103,15780880,"Findings: As compared to the previous radiograph, the bilateral perihilar opacities have decreased in extent and severity.  However, there is unchanged blunting of the left costophrenic sinus, potentially suggesting a small pleural effusion.  Normal appearance of the cardiac silhouette, but more central pulmonary arteries are still slightly dilated.  Unchanged monitoring and support devices. ","Findings: As compared to the previous radiograph, the bilateral perihilar opacities have decreased in extent and severitty. However, there is unchanged blunting of the right costophrenic sinus, potentially suggesting a small pleural effusion. Normal appearance of the cardiac silhouette, but more central pulmonary arteries are still slightly dilated. Unchanged monitoring and support devices. An ET tube is present. ","['Change location', 'Add typo', 'Add medical device']"
77d12f34-7559e3b5-ca659cda-05d2e515-b0726d99,52459455,15780880,"Findings: As compared to the previous radiograph, the pre-existing parenchymal opacities have slightly decreased in extent and severity but are still clearly visible, notably in the region of the right apex.  The bilateral pleural effusions, better visualized on the lateral than on the frontal radiograph, persist.  Unchanged normal hilar structures and normal size of the cardiac silhouette, with minimal calcification of the aortic wall and minimal tortuosity of the aorta.  No pneumothorax.  Mild degenerative right shoulder disease. ","Findings: As compared to the previous radiograph, the pre-existing parenchymal opacities have moderately decreased in extent and severity but are still clearly visible, notably in the region of the right apex.  The bilateral pleural effusions, better visualized on the lateral than on the frontal radiograph, persist.  The bilateral pleural effusions, better visualized on the lateral than on the frontal radiograph, persist.  Unchanged normal hilar structures and normal size of the cardiac silhouette, with minimal calcification of the aortic wall and minimal tortuosity of the aorta. An ICD is present in the left chest.  Mild degenerative right shoulder disease.  ","['Change severity', 'Add repetitions', 'Add medical device']"
c46e168d-041b2bfd-39d02b61-186fb589-eb881241,57081361,15780880,"Findings: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is not engorged. Curvilinear opacity in the right apex appears unchanged compared to the prior exams, compatible with an area of scarring as seen on the prior CT. No new focal consolidation, pleural effusion or pneumothorax is present. Multilevel degenerative changes are demonstrated in the thoracic spine. Impression: No acute cardiopulmonary abnormality.","Findings: The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is not engorged. Curvilinear opacity in the left apex appears unchanged compared to the prior exams, compatible with an area of scarring as seen on the prior CT. No new focal consolidation, pleural effusion or pneumothorax is present. Multilevel degenerative changes are demonstrated in the thoracic spine. Impression: No acute cardiopulmonary abnormality.","['Change location', 'Change to homophone', 'False negation']"
e73cd1d5-5e0bf9d7-abf87afe-b9825e7f-6786a135,52734390,15787214,"Findings: In comparison with the study of ___, there is a little overall change in the degree of bilateral pulmonary opacifications that is more prominent on the right.  Although some of this may reflect asymmetric pulmonary edema, a multifocal pneumonia is also present.    Subclavian PICC line is difficult to assess, though it appears to extend to the mid-to-lower portion of the SVC. ","Findings: In comparison with the study of ___, there is a small overall change in the degree of bilateral pulmonary opacifications that is more prominent on the right.  Although some of this may reflect asymmetric pulmonary edema, a multifocal pneumonia is also proesent.    Subclavian PICC line is difficult to assess, though it appears to extend to the right atrium.  ","['Change position of device', 'Add typo', 'False prediction']"
"6046f679-3f7b627a-75ed0041-e83000f4-d459e30b, d28b38cf-926d0e19-852a101e-ee126190-42253668",55339794,15787214,"Findings: Frontal portable radiographs of the chest demonstrate normal heart size.  The cardiomediastinal silhouette and hilar contours are normal.  There is diffuse opacity in the right lung more prominently in the right lower and mid lung.  Compared to the prior study, opacities in the right lower lung appear similar; however, there may be slight increased opacity in the right mid lung.  There is mild left base atelectasis.  There are probable small bilateral pleural effusions.  A left internal jugular approach central venous catheter ends in the mid SVC.  No pneumothorax.  No displaced rib fracture identified. Impression: Diffuse opacities in the right lung concerning for multifocal pneumonia.  Recommend followup radiograph after treatment to ensure resolution. Probable small pleural effusions.","Findings: Frontal portable radiographs of the chest demonstrate normal heart size.  The cardiomediastinal silhouette and hilar contours are enlarged.  There is diffuse opacity in the right lung more prominently in the right lower and mid lung.  Compared to the prior study, opacities in the right lower lung appear similar; however, there may be slight decreased opacity in the right mid lung.  There is mild left base atelectasis.  There are probable small bilateral pleural effusions.  A left internal jugular approach PICC line ends in the mid SVC.  No pneumothorax seen.  No displaced rib fracture identified. Impression: Diffuse opacities in the right lung concerning for multifocal pneumonia.  Recommend followup radiograph after treatment to ensure resolution. No pleural effusions noted.","['Change name of device', 'Add contradiction', 'False prediction']"
ba26edda-e207b86b-665afaa9-47ddab28-78dd3c6e,55726526,15787214,"Findings: As compared to the previous radiograph, the left venous access line has been removed.  The right internal jugular vein catheter is in unchanged position.  The pre-existing opacities in the right lung are substantially improved but still clearly visible.  The appearance of the left lung is unchanged.  Unchanged moderate cardiomegaly.  No pleural effusions.  No pneumothorax. ","Findings: As compared to the previous radiograph, the right venous access line has been removed.  The right internal jugular vein catheter is in unchanged position.  The pre-existing opacities in the left lung are substantially improved but still clearly visible.  The appearance of the right lung is unchanged.  New moderate cardiomegaly.  No pleural effusions.  No pneumothorax. There is an ET tube in satisfactory position.","['Change location', 'Add contradiction', 'Add medical device']"
9234b389-6451e413-d153fc6d-87004f87-bbfa50c1,56563719,15787214,Findings: Portable AP chest radiograph.  Diffuse opacities throughout the right lung and left lower lobe are unchanged.  There are probably small bilateral pleural effusions.  There is no pneumothorax. Impression: Multifocal pneumonia with possibly a component of asymmetric pulmonary edema.,Findings: Portable AP chest radiograph. Diffuse opacities throughout the left lung and left lower lobe are unchanged. There are no pleural effusions. There is no pneumothorax. There are no pleural effusions. Impression: Multifocal pneumonia with no component of pulmonary edema.,"['Change location', 'Add repetitions', 'False negation']"
c710e145-280390c3-5b9ddcf7-faa611b8-b39e60c8,57153575,15787214,Findings: The heart size is top normal with unchanged mediastinal silhouette and hilar contours.  There is a large heterogeneous consolidation of the right lower lung with air bronchograms compatible with pneumonia.  There also increased reticulonodular opacities in the upper right lung field likely as a component of asymmetric pulmonary edema or multifocal pneumonia. Small right pleural effusion may be present.  There is also a small left-sided effusion with subtle opacities at the left lung base which could be atelectasis or a further component of pneumonia.  There is no pneumothorax. Impression: Right lung base pneumonia with further reticulonodular densities in the right upper lung field which could be asymmetric pulmonary edema or multifocal pneumonia. Additional component of a small left-sided pleural effusion with adjacent opacity which is either atelectasis or additional site of pneumonia. Probable small right pleural effusion.,Findings: The heart size is top noormal with unchanged mediastinal silhouette and hilar contours. There is a large heterogeneous consolidation of the right lower lung with air bronchograms compatible with pneumonia.  There also increased reticulonodular opacities in the upper right lung field likely as a component of asymmetric pulmonary edema or multifocal pneumonia. Small right pleural effusion may be present.  There is also a small left-sided effusion with subtle opacities at the left lung base which could be atelectasis or a further component of pneumonia.  There is no pneumothorax. Impression: Right lung base pneumonia with further reticulonodular densities in the right upper lung field which could be asymmetric pulmonary edema or multifocal pneumonia. Additional component of a small left-sided pleural effusion with adjacent opacity which is either atelectasis or additional site of pneumonia. Probable small right pleural effusion. There is an indwelling central venous line present.,"['Change severity', 'Add typo', 'Add medical device']"
"03d334ab-a0fdbf1a-a53d02d5-426a2ec2-80fa45d0, b7067dad-3c9c3cc2-595cc8fc-fc6e7efa-6f3eaece",58410337,15791567,"Findings: PA and lateral views of the chest.  The lungs are clear without consolidation, effusion, or pneumothorax.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities detected. Impression: No acute cardiopulmonary process.","Findings: PA and lateral views of the chest.  The lunjs are clear without consolidation, effusion, or pneumothorax.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities detected. A central venous line is present. Impression: No acute cardiopulmonary process.","['Change location', 'Add typo', 'Add medical device']"
aeaf352b-20abe2c1-7d09855e-8dcde264-c8dae3b5,50728268,15793456,Impression: Compared to chest radiographs ___ through ___.  ET tube in standard placement.  Left PIC line ends in the low SVC.  Esophageal drainage tube can be traced as far as the lower esophagus but the tip is indistinct.  Emphysema is severe.  Small region of left perihilar consolidation developed on ___ is unchanged.  This could be atelectasis or pneumonia.  There is no pleural abnormality.,Impression: Compared to chest radiographs ___ throught ___.  ET tube in standard placement.  No PIC line noted. Esophageal drainage tube can be traced as far as the lowwer esophagus but the tip is indistinct.  Emphysema is mild.  Small region of left perihilar consolidation developed on ___ is unchanged.  This could be atelectasis or pneumonia.  There is pleural abnormality.  ,"['Change severity', 'Add typo', 'False negation']"
"319af308-51ad7fad-89c3611c-c92198db-c17ace3a, 8a8be78a-d43d9b42-88872556-82809128-fd11d507",50776361,15793456,"Impression: Compared to chest radiographs since ___, most recently ___ through ___.  Patient has been extubated.  New region of left perihilar opacification could be early pneumonia or the first manifestation of pulmonary edema since mild cardiomegaly has recurred and pulmonary vasculature mildly engorged.  Radiographic follow-up advised.  No appreciable pleural effusion or evidence of pneumothorax.","Impression: Compared to chest radiographs since ___, most recently ___ through ___.  Patient has been extubated.  New region of left perihilar opacification could be early pneumonia or the first manifestation of mild pulmonary edema since severe cardiomegaly has recurred and pulmonary vasculature moderately engorged.  Radiographic follow-up advised.  No appreciable pleural effusion or evidence of pneumothorax.  However, there is a small bilateral pleural effusion.  A central venous catheter is observed in place.","['Change severity', 'Add contradiction', 'Add medical device']"
c7318b14-8802035b-2b793a84-2206a58b-ff64d1a6,51587887,15793456,"Impression: Focal left basilar lucency remains similar in appearance to the ___ examination.  This likely represents bullae given known history of emphysema, though differentiation from focal pneumothorax remains difficult.  The cardiac and mediastinal contours remain unchanged, and there is no mediastinal shift. There is no focal consolidation or pleural effusion.  A left PICC terminates at the cavoatrial junction.  The endotracheal tube terminates 5.0 cm above the carina.","Impression: Focal left basilar lucency remains similar in appearance to the ___ examination.  This likely represents bullae given known history of emphysema, though differentiation from focal pneumothrrax remains difficult.  The cardiac and mediastinal contours remain unchanged, and there is no mediastinal shift. There is no focal consolidation or pleural effusion.  A left PICC terminates in the distal SVC.  The endotracheal tube terminates 3.0 cm above the carina.","['Change position of device', 'Add typo', 'False negation']"
85fdecbd-e6066ee2-2b534974-6cf4108f-ea355efd,51861010,15793456,"Impression: Compared to chest radiographs since ___, most recently ___ through ___ at 01:43.  Heart size has returned to new chronic normal caliber.  Right mediastinal shift persists despite interval clearance of transient right lower lobe consolidation, presumably atelectasis.  It might be due to acute hyperinflation of the already dominant bullae in the left lung, particularly in the lower lobe.  No pneumothorax or pleural effusion.  ET tube in standard placement.  Nasogastric drainage tube passes into the stomach and out of view.","Impression: Compared to chest radiographs since ___, most recently ___ through ___ at 01:43.  Heart size has returned to new chronic normal caliber.  Right mediastinal shift persists despite interval clearance of transient right lower lobe consolidation, presumably atelectasis.  It might be due to acute hyperinflation of the already dominant bullae in the left lung, particularly in the lower lobe.  No pneumothorax or pleural effusion.  ET tube seen terminating 2 cm above the carina.  Nasogastric drainage tube passes into the duodenum and out of view.  Presence of an ICD noted.","['Change position of device', 'Add contradiction', 'Add medical device']"
"328c4898-15a54df3-c97f1134-fd048ae3-d95c0107, add46527-df788627-5e7db26e-09b0fd71-16a29aa1",52887977,15793456,"Findings: The lungs are hyperexpanded. There are bullous emphysematous changes in the lower lobes increased since ___. There is no focal consolidation, pleural effusion or pneumothorax. The ascending aorta is dilated and tortuous but unchanged since ___. The imaged upper abdomen is unremarkable. Impression: 1. Bullous emphysematous changes in the lower lobes increased since ___. Consideration to alpha-1- antitrypsin deficiency should be given.","Findings: The lungs are hyperexpanded. There are bullous emphysematous changes in the right upper lobe increased since ___. There is no focal consolidation, pleural effusion or pneumothorax. The ascending aorta is normal. The imaged upper abdomen is concerning for abnormality. Impression: 1. No emphysematous changes. Consideration to alpha-1- antitrypsin deficiency should be given.","['Change location', 'Add contradiction', 'False negation']"
ddb6d871-83f1673f-96525527-40edfaa8-32689e38,53169528,15793456,"Findings: Portable semi supine chest radiograph ___ 04:13 is submitted. Impression: Again seen is extensive emphysema with prominent bullous changes particularly at the bases.  However, there is increased lucency at the left base with slight elevation of the left hemidiaphragm as well as increasing infrahilar opacity.  Findings therefore raise the possibility of a loculated pneumothorax.  Followup imaging is recommended.  Endotracheal tube has its tip approximately 6 cm above the carina.  A left subclavian PICC line has its tip in the distal SVC near the cavoatrial junction and a nasogastric tube is seen coursing below the diaphragm with the tip not identified.  No pulmonary edema.","Findings: Portable semi supine chest radiograph ___ 04:13 is submitted. Impression: Again seen is extensive emphysema with prominent bullous changes particularly at the bases.  However, there is decreased lucency at the left base with slight elevation of the left hemidiaphragm as well as increasing infrahilar opacity.  Findings therefore raise the possibility of a loculated pneumothorax.  Followup imaging is recommended.  Endotracheal tube has its tip approximately 6 cm above the carina.  A left subclavian PICC line terminates in the mid SVC and a nasogastric tube is seen coursing below the diaphragm with the tip not identified.  No pulmonary edema is noted, yet there is mild pleural effusion.","['Change severity', 'Add contradiction', 'False prediction']"
5100714a-7795bb79-6d9a8ab9-2ec22e74-610e28ef,53694115,15793456,Impression: Left PICC line tip is at the level of lower SVC.  Heart size and mediastinum are stable.  NG tube tip is in the stomach.  Bibasal lucencies concerning for bullous disease are unchanged.  No new consolidations.,Impression: Left PICC line tip is at the level of the upper SVC.  Heart size and mediastium are stable.  NG tube tip is in the stomach.  There is a small pleural effusoin on the right.  No new consolidations.,"['Change location', 'Add typo', 'False prediction']"
"07c73a03-a9bda92e-7ca2562e-9c47a7bc-1de9e5a8, 86b7942d-6aafab5f-acb47e68-1fff0868-437f35ea",54148272,15793456,"Impression: Compared to chest radiographs since ___, most recently ___.  Bullous emphysema is extremely severe, with basal predominance raising possibility of panacinar emphysema due to alpha one antitrypsin deficiency.  There is a very small region of possible peribronchial opacification projecting over the lower pole of the left hilus on the frontal view, and over the descending thoracic aorta on the lateral.  This could be a very small pneumonia.  Oblique views would be helpful in evaluation.  Blunting of the pleural sulci is due to inversion of the displaced diaphragm, not pleural effusion.  Cardiomediastinal silhouette is normal.","Impression: Compared to chest radiographs since ___, most recently ___.  Bullous emphysema is moderately severe, with basal predominance raising possibility of panacinar emphysema due to alpha one antitrypsin deficiency.  There is a vrey small region of possible peribronchial opacification projecting over the lower pole of the left hilus on the frontal view, and over the descending thoracic aorta on the lateral.  This could be a very small pneumonia.  Oblique views would be helpful in evaluation.  Blunting of the pleural sulci is due to inversion of the displaced diaphragm, not pleural effusion.  Cardiomediastinal silhouette is normal. A pacemaker is present.","['Change severity', 'Add typo', 'Add medical device']"
"4d72f890-5a8da612-a2cde4cf-35c04b76-3f62548f, d3b11384-e58823ae-545b2484-70475db9-e638bd89",54257177,15793456,"Impression: Compared to chest radiographs since ___, most recently ___ at 05:45.  Emphysema is severe ; distribution suggests alpha one antitrypsin deficiency.  .  There is no definite focal pulmonary abnormality.  Heart size normal.  No pleural effusion or pneumothorax.","Impression: Compared to chest radiographs since ___, most recently ___ at 05:45. Large pleural effusion is severe ; distribution suggests alpha one antitrypsin deficiency.  There is no definite focal pulmonary abnormality. Heart size normal. No pleural effusion or pneumothorax.  Heart size normal.","['Change severity', 'Add repetitions', 'False prediction']"
"0b542921-dd8714bb-fe11de66-1509d729-207dc1f6, 89c1cb10-0f3f0d50-cdd7903e-91acfc37-51d468d3",54805725,15793456,Findings: Cardiac size is normal.  The hilum are enlarged as before.  The lungs are hyperinflated and clear.  There is no pneumothorax or pleural effusion.  Lines and tubes are in unchanged standard position Impression: Severe emphysema.  No acute cardiopulmonary abnormality,"Findings: Cardiac size is normal.  The hilum are enlarged as before.  The lungs are hyperinflated and clear.  There is no pneumothorax or pleural effusion.  Lines and tubes are in unchanged standard position, including a right IJ central venous catheter. Impression: Mild emphysema.  Severe acute cardiopulmonary abnormality","['Change severity', 'Add contradiction', 'Add medical device']"
7e937bf5-c1220033-6a807ba6-449a1342-c75570f2,54908622,15793456,"Impression: Compared to chest radiographs ___ through ___ at 03:13.  No recent radiographic change in severe emphysema and mild left perihilar consolidation.  No pulmonary edema, pleural effusion, pneumothorax.  Heart size normal.  Ascending thoracic aorta tortuous or dilated but unchanged.  ET tube and left PIC line in standard placements respectively.","Impression: Compared to chest radiographs ___ through ___ at 03:13. One recent radiographic change is severe emphysema and mild left perihilar consolidation. No pulmonary edema, pleural effusion, pneumothorax. Heart sighs normal. Ascending thoracic aorta tortuous or dilated but unchanged. ET tube and left central venous catheter in standard placements respectively.","['Change name of device', 'Change to homophone', 'False prediction']"
d10e0fbd-0e8714e0-da3f58e7-a4f2c13e-a6635080,55164257,15793456,"Impression: No substantial change in the cardiomediastinal contour or and severe emphysema with predominance in the lower lobes demonstrated.  As previously mentioned, alpha 1 antitrypsin deficiency at the possibility.  No definitive pneumothorax is seen.  Pulmonary hypertension is suspected based on the substantial enlargement of the pulmonary arteries.","Impression: No substantial change in the cardiomediastinal contour or and severe emphysema with predominance in the lower lobes demonstrated. As previously mentioned, alpha 1 antitrypsin deficiency eight the possibility. No definitive pneumothorax is seen. Pulmonary hypertension is suspected based on the mild enlargement of the pulmonary arteries. A central venous line is present.  ","['Change severity', 'Change to homophone', 'Add medical device']"
30ee840e-4c41e9b0-23303f79-e117a2f5-3a93632d,56959421,15793456,"Findings: Lungs are hyperexpanded.  Increased lucency in the left base is more prominent than on previous chest radiographs.  Increased lucency in the right base is stable and likely represents sequela of emphysema.  The mediastinal contours, hila, and cardiac borders are normal.  Endotracheal tube terminates 6.3 cm above the carina.  Left PICC is stable terminating in the low SVC.  No pleural effusion.  Enteric tube is unchanged with distal tip coursing out of view. Impression: 1. Endotracheal tube in appropriate position. 2. Increased lucency in the left base is more prominent than on previous chest radiographs and likely represents emphysematous bulla although if there is any clinical concern for pneumothorax, CT of the chest is recommended to further characterize.","Findings: Lungs are hyperexanded.  No increased lucency.  Increased lucency in the right base is stable and likely represents sequela of emphysema.  The mediastinal cotours, hila, and cardiac borders are normal.  Endotracheal tube terminates 1 cm above the carina.  Left PICC is stable terminating in the mid SVC.  No pleural effusion.  Enteric tube is unchanged with distall tip coursing out of view. Impression: 1. Endotracheal tube in appropriate position. 2. No increased lucency.","['Change position of device', 'Add typo', 'False negation']"
d8a656ef-21f15997-459800a0-5d6f4b41-9340d5f9,56965263,15793456,"Impression: Compared to chest radiographs since ___, most recently ___ and ___.  Bullous emphysema is severe.  Today's study shows possible rightward mediastinal shift and new opacification in the right lower lobe, possibly atelectasis.  This is commonly due to aspiration or retention of secretions.  Follow-up chest radiograph available at the time of this review, performed 04:09 showed improvement in right lower lobe consolidation and decrease in rightward mediastinal shift suggesting interval clearing of the airway.  Followup advised.","Impression: Compared to chest radiographs since ___, most recently ___ and ___.  Bullous emphysema is moderate.  Today's study shows possible rightward mediastinal shift and knew opacification in the right lower lobe, possibly atelectasis.  This is commonly due to aspiration or retention of secretions.  Follow-up chest radiograph available at the time of this review, performed 04:09 showed improvement in right lower lobe consolidation and decrease in rightward mediastinal shift suggesting interval clearing of the airway.  Followup advised. ICD placement noted.","['Change severity', 'Change to homophone', 'Add medical device']"
ae25ab53-728bd61d-0b368ab8-cb45d8ea-8d6cf993,58627159,15793456,"Impression: In comparison with the study of ___, there appears to be a tracheostomy tube in place.  Otherwise, little change.  Prominence of central pulmonary arteries is consistent with pulmonary arterial hypertension.  Severe emphysema with lucency especially involving the left lower lung.  As previously noted, this could be consistent with prominent bullous formation in the region or possibly alpha 1 antitrypsin deficiency.","Impression: In comparison with the study of ___, there appears to be a tracheostomy tube in place.  Otherwise, little change.  Prominence of central pulmonary arteries is consistent with pulmonary arterial hypertension.  No signs of emphysema.  As previously noted, this could be consistent with prominent bullous formation in the right lung or possibly alpha 1 antitrypsin deficiency.  As previously noted, this could be consistent with prominent bullous formation in the right lung or possibly alpha 1 antitrypsin deficiency.","['Change location', 'Add repetitions', 'False negation']"
e42b4605-f902c4ae-7379b10b-bb8897a0-0a74f22a,58666598,15793456,"Impression: In comparison with the study of ___, there is again substantial hyperexpansion of the lungs consistent with chronic pulmonary disease.  There is increased prominence of the hila, which appears to represent vascular structures and raises the possibility of pulmonary artery hypertension. No evidence of acute pneumonia or vascular congestion.","Impression: In comparison with the study of ___, there is again substantial hyperexpansion of the lungs consistent with chronic pulmonary disease. There is increased prominence of the hila, which appears to represent vascular structures and raises the possibility of pulmonary artery hypertension. No evidence of acute pneumonia or vascular congestion. Cardiac pacemaker is in place. No evidence of acute pneumonia or vascular congestion. There is acute pneumonia present in the lower lobes.","['Add contradiction', 'Add repetitions', 'Add medical device']"
"2ff56cb4-34295633-6d7f37de-def5c897-97e56f55, b1c89b98-a8652b78-b91909d9-858c38d3-cf9a6962",59873577,15793456,"Impression: Compared to chest radiographs ___ through ___ at 03:35.  Patient has severe emphysema, with most severe vascular deficiency in the lower lungs, especially the left, a distribution which suggests alpha one antitrypsin deficiency.  There are no focal pulmonary findings to suggest either pneumonia or edema.  However there has been substantial interval increase in the ___ of the left hilus, some of which is due to substantial enlargement of the pulmonary artery proximally, and perhaps the descending pulmonary artery or supra be needing atelectasis.  The importance of a CTA to exclude a large central pulmonary embolus has been discussed with the clinical care team.  No pleural abnormality.  ET tube and left PIC line are in standard placements.","Impression: Compared to chest radiographs ___ through ___ at 03:35.  Patient has severe emphysema, with most severe vascular deficiency in the lower lungs, especially the left, a distribution which suggests alpha one antitrypsin deficiency.  There are no focal pulmonary findings to suggest either pneumonia or edema.  There has been no significant change in the size of the left hilus. The importance of a CTA to exclude a large central pulmonary embolus has been discussed with the clinical care team.  No pleural abnormality.  ET tube is seen terminating 1 cm above the carina, and the left PICC line extends into the right atrium.","['Change position of device', 'Add contradiction', 'False negation']"
"189951de-c5c0b41a-d14bcfd4-1e257166-1f89b5d0, f7a0c24f-477f3d1d-14dd5cde-6a3195b2-e0728197",55127146,15846912,"Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  Mildly prominent opacity in the right infrahilar region appears unchanged and is suspected to represent normal descending vascularity, which is unchanged and associated with slight leftward rotation of the heart.  There are no pleural effusions or pneumothorax. Impression: No evidence of acute disease.","Findings: The heart is normal in size.  The mediastinal and hilar contours appear enlarged.  Mildly prominent opacity in the left infrahilar region appears unchanged and is suspected to represent normal descending vascularity, which is unchanged and associated with slight leftward rotation of the heart.  There are no pneumothorax or pleural effusions present.  A left-sided pacemaker is noted in place. Impression: No evidence of acute disease. Evidence of potential acute disease in the form of new mild consolidation in the right upper lobe.","['Change location', 'Add contradiction', 'Add medical device']"
"61d53449-02330de6-e967c099-549e42a6-3346afad, d275e1c7-ddf3bda8-85dc221d-4c9b4fc3-17f8a621",56587661,15846912,"Findings: The lungs are clear.  There is no pleural effusion, pneumothorax or focal airspace consolidation.  The cardiac and mediastinal contours are normal.  The hilar structures are unremarkable. Impression: No acute cardiopulmonary process.","Findings: The lnugs are clear.  There is no pleural effusion, pneumothorax or focal airspace consolidation.  The cardiac and mediastinal contours are normal.  The hilar structures are unremarkable. The lnugs are clear. Impression: No acute cardiopulmonary process.","['Add typo', 'Add repetitions', 'False negation']"
41cd0cf2-1993dfdd-7f6bf2e5-a1f49826-59bd4a84,50591741,15902493,Impression: 1.  Grossly stable thyroid goiter causing widening of the right paratracheal stripe. 2.  Unchanged elevation of the right hemidiaphragm and bibasilar atelectasis. 3.  No evidence of pneumonia or acute pulmonary edema.,Impression: 1.  Grossly stable thyroid goiter causing widening of the left paratracheal stripe. 2.  Unchanged elevation of the left hemidiaphragm and bibasilar atelectasis. 3.  No evidence of pneumonia or acute pulmonary edema. 4.  The presence of an ICD is noted. 5.  Signs of acute pulmonary edema are evident.,"['Change location', 'Add contradiction', 'Add medical device']"
9bc476e8-b785474e-426b2c50-084edab4-725c2fdb,50974871,15902493,"Impression: AP chest compared to ___:  The right hemidiaphragm became elevated between ___, even more pronounced today.  Some of this could be due to subpulmonic pleural effusion but I would investigate either phrenic nerve palsy or complete right lower lobe and perhaps middle lobe collapse.  Moderate cardiomegaly is stable with the mediastinum midline.  A large cervicothoracic mass presumably a goiter displaces the trachea to the left.  Left lung is clear.  A left PIC line ends roughly at the origin of the SVC.","Impression: AP chest compared to ___: The right hemidiaphragm became elevated between ___, even more pronounced today. Some of this could be due to subpulmonic pleural effusion but I would investigate either phrenic nerve palsy or complete right lower lobe and perhaps middle lobe collapse. Mild cardiomegaly is stable with the mediastinum midline. No cervicothoracic mass noted. Left lung is clear. A left PIC line ends roughly at the origin of the SVC. AP chest compared to ___: The right hemidiaphragm became elevated between ___, even more pronounced today.","['Change severity', 'Add repetitions', 'False negation']"
6e7ae597-2cce5608-801fc546-b49044de-8b5fb4c7,51112760,15902493,"Findings: As compared to the previous radiograph, there is no relevant change.  The bases of the right lung are minimally better ventilated than before.  The monitoring and support devices are constant, constant size of the cardiac silhouette, constant appearance of the left lung. ","Findings: As compared to the previous radiograph, there is no relevant change.  The bases of the left lung are minimally better ventilated than before.  The monitoring and support devices are constant, constant size of the cardiac silhouette, constant appearance of the right lung.  Bibasilar opacities may reflect atelectasis or infection.  Impressions: Moderate pulmonary edema noted.","['Change location', 'Add contradiction', 'False prediction']"
f73e6a43-f6ec9972-190a4db6-83b00895-bd737150,51395345,15902493,"Findings: The patient is rotated to the left.  The endotracheal tube sits just below the clavicular heads; the carina is not well seen, and while chest radiography is not ideal to assess for such, the trachea distal to the ET tube appears narrowed.  The endogastric tube side port is well below the GE junction.  The left-sided central line tip in the mid SVC.  The heart size is within normal limits.  Mediastinal contours again demonstrate calcified atherosclerotic disease at the aortic knob and a large mass approximately 8.5 x 6 cm in the coronal plane dominating the right upper mediastinum (better characterized on prior CT).  Right middle lobe atelectasis is new.  There is no large pleural effusion or pneumothorax. Impression: 1.  Lines and tubes as described above. 2.  Stable right upper mediastinal mass. 3.  Right middle lobe atelectasis. 4.  Question of narrowed trachea beyond the ET tube - CT may be considered is clinical concern for poor aeration exists.","Findings: The patient is rotated to the left.  The endotracheal tube sits just below the clavicular heads; the carina is not well seen, and while chest radiography is not ideal to assess for such, the trachea distal to the ET tube appears widened.  The endogastric tube side port is well above the GE junction.  The left-sided central line tip in the mid SVC.  The heart size is within normal limits.  Mediastinal contours again demonstrate calcified atherosclerotic disease at the aortic knob and a small nodule approximately 7.2 x 5 cm in the coronal plane dominating the right upper mediastinum (better characterized on prior CT).  Right middle lobe atelectasis is new.  There is a large pleural effusion and pneumothorax. Impression: 1.  Lines and tubes as described above. 2.  Stable right upper mediastinal mass. 3.  Right middle lobe atelectasis. 4.  Question of widened trachea beyond the ET tube - CT may be considered is clinical concern for poor aeration exists. 5. No indication of large pleural effusion or pneumothorax.","['Change measurement', 'Add contradiction', 'False prediction']"
4cceece9-8400f980-a48fb232-e92e5441-6745b601,52040420,15902493,"Findings: The feeding tube has been repositioned and is seen coursing below the diaphragm into the stomach; however, the distal end is off radiographic view.  Tracheostomy tube is in standard position.  Left-sided PICC line ends at mid SVC.  Bilateral lung volumes are low and Bibasal atelectasis is similar.  There are no new lung opacities of concern.  Cardiomediastinal silhouette is stable in appearance.  Heart size is normal. Impression: 1.  After repositioning of the feeding tube, it extends into the stomach; however, the distal end is off the radiographic view.  2.  Bibasal atelectasis is similar.  No other relevant changes.","Findings: The feeding tube has been repositioned and is seen coursing below the stomach into the diaphragm; however, the distal end is off radiographic view.  Tracheostomy tube is in standard position.  Left-sided PICC line ends at mid SVC.  Bilateral lung volumes are low and no Bibasal atelectasis is noted.  There are no new lung opacities of concern.  Cardiomediastinal silhouette is stable in appearance.  Heart size is normal. Impression: 1.  After repositioning of the feeding tube, it extends into the stomach; however, the distal end is of the radiographic view.  2.  No atelectasis noted.  No other relevant changes.","['Change location', 'Change to homophone', 'False negation']"
dd5485e4-d3c509f7-b7f8ea8c-70c26a6b-efe68e57,52253665,15902493,Impression: 1.  Interval placement of a nasogastric tube with its tip coursing below the diaphragm and projecting over the expected location of the stomach.  An endotracheal tube is seen with its tip approximately 2 cm above the carina and coursing to the left of the cervical and upper thoracic spine due to the presence of a right superior mediastinal mass which may represent a thyroid goiter when correlated with a CTA of the head and neck dated ___.    2. Lungs appear well inflated without evidence of focal airspace consolidation or pleural effusions.  No evidence of pulmonary edema.  Overall cardiac and mediastinal contours are within normal limits given portable technique and rotation on the current examination.,Impression: 1.  Interval placement of a nasogastric tube with its tip coursing below the diaphragm and projecting over the expected location of the sotmach.  An endotracheal tube is seen with its tip approximately 1.8 cm above the carina and coursing to the left of the cervical and upper thoracic spine due to the presence of a right superior mediastinal mass which may represent a thyroid goiter when correlated with a CTA of the head and neck dated ___.  A central venous line is noted on the right side.  2. Lungs appear well inflated without evidence of focal airspace consolidation or pleural effusions.  No evidence of pulmonary ededma.  Overall cardiac and mediastinal contours are within normal limits given portable technique and rotation on the current examination.,"['Change measurement', 'Add typo', 'Add medical device']"
2174bfb6-9645eac0-eb4a2c83-0e62dc14-94b436ab,52681987,15902493,"Findings: As compared to the previous radiograph, the monitoring and support devices are in unchanged position.  Unchanged coiling of the nasogastric tube in the pharynx.  The pre-existing small right pleural effusion is distributing in a slightly different manner than on the previous image, its overall extent, however, is unchanged.  The right-sided upper mediastinal mass is unchanged in appearance.  No pulmonary edema.  No pneumonia.  Unchanged size of the cardiac silhouette. ","Findings: As compared to the previous radiograph, the nasogastric tube is in unchanged position.  Unchanged coiling of the endotracheal tube in the pharynx.  The pre-existing small right pleural effusion is distributing in a slightly different manner than on the previous image, its overall extent, however, is unchanged.  The right-sided upper mediastinal mass is unchanged in appearance.  No pulmonary edema.  No pneumonia.  Unchanged size of the cardiac silhouette.  No masses are seen in the mediastinum.","['Change name of device', 'Add contradiction', 'False prediction']"
75590e00-ed59b5d5-547eea97-30378a27-3389c2d4,52684400,15902493,"Findings: There is no focal consolidation, pleural effusion or pneumothorax.  The tracheostomy tube now appears midline.  There are ___ in the neck.  There is bibasilar atelectasis.  The previously elevated right hemidiaphragm is now in normal position.  The cardiomediastinal silhouette is unremarkable. Impression: 1.  No evidence of pneumothorax.  Basilar atelectasis. 2.  Previously noted elevation of the hemidiaphragm is no longer seen on this radiograph.","Findings: There is no focal consolidation, pleural effusion or pneumothorax.  The endotracheal tube now appears midline.  There are ___ in the neck.  There is bibasilar atelectasis.  The previously elevated right hemidiaphragm is still elevated.  The cardiomediastinal silhouette is unremarkable. Impression: 1.  No evidence of pneumothorax.  Mild pleural effusion. 2.  Previously noted elevation of the hemidiaphragm is no longer seen on this radiograph.","['Change name of device', 'Add contradiction', 'False prediction']"
386d944b-f1474a69-668285cb-f25d2ef9-56c1ebea,52849859,15902493,"Findings: A VP shunt is seen coursing through the right hemithorax into the right abdomen.  Tracheostomy tube is noted. Though this study is not intended for evaluation of the airway, the trachea does not appear much larger than the tracheostomy tube.  A Dobbhoff feeding tube is seen coursing into the proximal duodenum.  IVC filter projects over the right border of the L2 and L3 vertebral bodies.  Large mass in the right upper lung causes rightward tracheal deviation but is better assessed on the prior chest CT.  Marked elevation of the right hemidiaphragm is again noted, with resultant right basal atelectasis.  There is no pleural effusion or pneumothorax.  Mild cardiomegaly is noted. Impression: Right hemidiaphragmatic elevation with resultant atelectasis, perhaps a result of phrenic nerve paralysis secondary to the large right mediastinal mass.","Findings: A VP shunt is seen coursing through the right hemithorax into the right abdomen. Tracheostomy tube is noted. Though this study is not intended for evaluation of the airway, the trachea does not appear much larger than the tracheostomy tube. A feeding tube is inserted through the esophagus into the stomach. IVC filter projects over the right border of the L2 and L3 vertebral bodies. Mildly sized mass in the right upper lung causes rightward tracheal deviation but is better assessed on the prior chest CT. Marked elevation of the right hemidiaphragm is again noted, with resultant right basal atelectasis. There is small pleural effusion and pneumothorax. Moderate cardiomegaly is noted. Impression: Right hemidiaphragmatic elevation with resultant atelectasis, perhaps a result of phrenic nerve paralysis secondary to the large right mediastinal mass. Normal hemidiaphragm position without any evidence of atelectasis.","['Change severity', 'Add contradiction', 'False prediction']"
6acb1d9f-c6550f88-03c6298f-563395d2-fbb64a14,53302727,15902493,"Findings: In comparison with the study of ___, there is increasing opacification at the right base consistent with effusion and atelectasis.  Mild atelectatic changes are seen at the right base.  Continued enlargement of the cardiac silhouette with evidence of increased pulmonary venous pressure.  The large mass in the right upper zone displacing the trachea to the left is again seen. ","Findings: In comparison with the study of ___, there is increasing opacification at the right base consistent with effusion and atelectasis.  Moderate atelectatic changes are seen at the right base.  Continued enlargement of the cardiac silhouette with evidence of increased pulmonary venous pressure.  A right-sided IJ catheter is in place.  The large mass in the right upper zone displacing the trachea to the left is again seen.  Impression: There is no evidence of increased pulmonary venous pressure.","['Change severity', 'Add contradiction', 'Add medical device']"
f9036335-d38187db-397f1b39-3e749eed-e4c6307c,53465460,15902493,"Findings: In comparison with the study of ___, the large right superior mediastinal mass is again seen displacing the trachea to the left.  Monitoring and support devices remain in place.  The right hemidiaphragm is not as sharply seen as on prior images.  This could merely reflect atelectasis and effusion, though pneumonia would have to be considered in the appropriate clinical setting. ","Findings: In comparison with the study of ___, the large left superior mediastinal mass is again seen displacing the trachea to the left. Monitoring and support devices remain in place. The right hemidiaphragm is not as sharply seen as on prior images. This could merely reflect atelectasis and effusion, though pneumonia would have to be considered in the appropriate clinical setting. The large left superior mediastinal mass is again seen displacing the trachea to the left. A heterogenous opacity concerning for pneumonia is seen in the left lower lobe.","['Change location', 'Add repetitions', 'False prediction']"
6b0e4cdc-b802b8a7-386a0412-cb6b2489-8015a3e9,53501812,15902493,"Impression: AP chest compared to ___:  Since ___, the volume of consolidation in the right mid and lower lung zone has decreased and mild pulmonary edema has largely cleared.  The large cervicothoracic mass to the right of the trachea at the midline might be smaller, although this could be a function of patient rotation.  Moderate cardiomegaly is stable.  Pleural effusions are small if any.  Nasogastric tube passes into the stomach and out of view.  Left subclavian line ends in the upper SVC.  ET tube tip is at the level of the aortic arch, unchanged.","Impression: AP chest compared to ___:  Since ___, the volume of consolidation in the left mid and lower lung zone has decreased and mild pulmonary edema has largely cleared.  The large cervicothoracic mss to the right of the trachea at the midline might be smaller, although this could be a function of patient rotation.  Moderate cardiomegaly is stable.  Pleural effusions are small if any.  Nasogastric tube passes into the stomach and out of view.  Left subclavian line ends in the upper SVC.  ET tube tip is at the level of the aortic arch, unchanged. A pacemaker is present in the right chest.","['Change location', 'Add typo', 'Add medical device']"
f67ab78a-c83676b8-efebc7a0-7b79e9df-d200dca1,54664886,15902493,"Findings: As compared to the previous radiograph, the monitoring and support devices are unchanged.  Unchanged appearance of a right apical mass and right basal opacity likely to suggest atelectasis.  Unchanged elevation of the right hemidiaphragm.  Borderline size of the cardiac silhouette with tortuosity of the thoracic aorta.  No substantial fluid overload.  No pleural effusions. ","Findings: As compared to the previous radiograph, the monitoring and support devices are unchanged.  Unchanged appearance of a left apical mass and right basal opacity likely to suggest atelectasis.  Unchanged elevation of the right hemidiaphragm.  Borderline size of the cardiac silhouette with tortuosity of the thoracic aorta.  There are also signs of marked pulmonary edema. No pleural effusions.  Bilateral pleural effusions are present.","['Change location', 'Add contradiction', 'False prediction']"
2daf4706-acb0e111-7c1f165a-1b733130-32f98a94,55687082,15902493,"Findings: In comparison with the study of ___, there is little change in the appearance of the right superior mediastinal mass arising that was shown to arise from the thyroid gland and descend inferiorly into the medial mediastinum on CT.  Narrowing and displacement of the trachea is again seen.  Monitoring and support devices remain in place and there is little change in the appearance of the heart and lungs. ","Findings: In comparison with the study of ___, there is little change in the appearance of the left superior mediastinal mass arising that was shown to arise from the thyroid gland and descend inferiorly into the medial mediastinum on CT.  Norrowing and displacement of the trachea is again seen.  Monitoring and support devices remain in place and there is little change in the appearance of the heart and lungs.  Additionally, a central venous line is noted on the right side.","['Change location', 'Add typo', 'Add medical device']"
84e51680-738978f2-ce0ca7b3-037c1468-d96d0c03,56835560,15902493,"Impression: AP chest compared to ___ read in conjunction with the chest CT on ___:  Previous moderate right pleural effusion and right basal atelectasis have improved since ___, mild pulmonary edema has cleared and small left pleural effusion has resolved.  ET tube in standard position in the trachea which is displaced leftward by large thyroid mass.  Moderate cardiomegaly stable.  Left subclavian line ends in the low SVC.  No pneumothorax.  Small right pleural effusion.  Persistent elevation of the right hemidiaphragm may be due to phrenic nerve palsy.","Impression: AP chest compared to ___ read in conjunction with the chest CT on ___:  Previous moderate right pleural effusion and right basal atelectasis have improved since ___, mild pulmonary edema has cleared and small left pleural effusion has resolved.  ET tube in standard position in the trachea which is displaced leftward by large thyroid mass.  Moderate cardiomegaly stable.  Right subclavian line ends in the low SVC.  No pneumothorax.  Small right pleural effusion has improved since ___.  Persistent elevation of the left hemidiaphragm may be due to phrenic nerve palsy.  Pacemaker leads are present.","['Change location', 'Add repetitions', 'Add medical device']"
f6ec06b9-ba98953f-8182f840-4698435b-61296fb9,57081697,15902493,"Impression: AP chest compared to ___ through ___:  Lung volumes are stable, with relative elevation of the right hemidiaphragm, reflecting persistent right lower lobe atelectasis.  Left lung is grossly clear.  Moderate cardiomegaly is stable.  ET tube ends in standard position at the level of the aortic arch and the trachea is severely displaced and narrowed by a large right-sided goiter.  Nasogastric tube passes into the stomach and out of view.  Left subclavian line ends in the SVC.  No pneumothorax or appreciable pleural effusion.","Impression: AP chest compared to ___ through ___:  Lung volumes are stable, with relative elevation of the right hemidiaphragm, reflecting persistent right lower lobe atelectasus.  Left lung is grossly clear.  No cardiomegaly.  ET tube ends 3 inches above the trachea and the trachea is severely displaced and narrowed by a large right-sided goiter.  Nasogastric tube passes into the stomach and ends in the duodenum.  Left subclavian line ends in the right atrium.  No pneumothorax or appreciable pleural effusion.","['Change position of device', 'Change to homophone', 'False negation']"
1d8209cf-367611d8-dedd4a43-a8026be1-e639022d,57545492,15902493,Findings: Overall little change in comparison to the prior study with continued elevation of the right hemidiaphragm and silhouetting of the right heart border as well as increased opacity in the right retrocardiac region. There is at least partial right lower and middle lobe atelectasis. Cardiomegaly remains stable.  Left PICC is visualized in the left brachiocephalic vein.  Tracheostomy tube is shifted to the left due to a large superior mediastinal mass shown to be related to the thyroid gland on prior CT scan. Ventriculoperitoneal shunt traversing over the right hemithorax appears stable. ,Findings: Overall little change in comparison to the prior study with continued elevation of the left hemidiaphragm and silhouetting of the right heart border as well as increased opacity in the right retrocardiac region. There is at least partial right lower and middle lobe atelectaxis. Cardiomegaly remains stable.  Left PICC is visualized in the left brachiocephlioac vein.  Tracheostomy tube is shifted to the left due to a large superior mediastinal mass shown to be related to the thyroid gland on prior CT scan. Ventriculoperitoneal shunt traversing over the right hemithorax appears stable. An NG tube is seen in the stomach.,"['Change location', 'Add typo', 'Add medical device']"
d25c2722-019731e2-c9ae4392-b74b52cb-7459ec6d,58199247,15902493,"Impression: 1.  Endotracheal tube courses to the left of the spine and has its tip approximately 3.5 cm above the carina.  Subclavian central line has its tip in the mid-to-distal SVC.  A nasogastric tube is seen coursing below the diaphragm with the tip likely located within the stomach.  Overall, cardiac and mediastinal contours are stable.  There is a persistent right superior mediastinal mass, which is felt to most likely correspond to a thyroid goiter as evident on a CTA of the head and neck performed on ___.  Lung volumes are slightly decreased with interval appearance of a patchy opacity at both bases, likely reflecting patchy atelectasis.  There is no evidence of pulmonary edema or pneumothorax.","Impression: 1. Endotracheal tube courses to the left of the spine and has its tip approximately 3.5 cm above the carina. Subclavian vascular stent has its tip in the mid-to-distal SVC. No nasogastric tube is seen. Overall, cardiac and mediastinal contours are stable. There is no persistent right superior mediastinal mass. Lung volumes are slightly decreased with interval appearance of a patchy opacity at both bases, likely reflecting patchy atelectasis. There is no evidence of pulmonary edema or pneumothorax.","['Change name of device', 'Add contradiction', 'False negation']"
dd7f98a8-f0bd8f93-d89e5076-48b04556-0792d3c6,58289892,15902493,"Findings: The endotracheal tube tip is between the clavicular heads.  The endogastric tube courses inferiorly through the expected region of the stomach.  The heart size is likely within normal limits, exaggerated by the patient's leftward rotation.  The mediastinal and hilar contours are also within normal limits.  Again prominent soft tissue density in the right superior mediastinal space displaces the normal midline structures towards the left; this mass likely represents a goiter.  The lungs demonstrate mild bibasilar atelectasis.  There is no large pleural effusion or pneumothorax. Impression: Mild bibasilar atelectasis.","Findings: The endotracheal tube tip is between the clavicular he'ds.  The endogastric catheter courses inferiorly through the expected region of the stomach.  The heart size is likely within normal limits, exaggerated by the patient's leftward rotation.  The mediastinal and hilar contours are also within normal limits.  Again prominent soft tissue density in the right superior mediastinal space displaces the normal midline structures towards the left; this mass likely represents a goiter.  An NG tube is present, with its tip in the stomach.  The lungs demonstrate mild bibasilar atelectasis.  There is no large pleural effusion or pneumothorx. Impression: Mild bibasilar atelectasis.","['Change name of device', 'Add typo', 'Add medical device']"
"3c875623-94264ee2-c1bfb66e-6a05bc14-ceb81702, 4aeba39a-be4ef35d-83b25701-9af40c72-5130f3eb",58443677,15902493,"Impression: AP chest submitted for review on ___ at 4 p.m. compared to ___ through ___ at 4:25 a.m.:  Previous mild pulmonary edema is improving, but moderate bilateral pleural effusions persist and may have increased, and there is more atelectasis at both lung bases.  The ET tube is in standard placement, and the trachea which is markedly displaced and, by CT report, severely narrowed by large right-sided goiter.  No pneumothorax.  Left subclavian line ends in the mid SVC.  The heart size top normal, unchanged.","Impression: AP chest submitted for review on ___ at four p.m. compared to ___ through ___ at 4:25 a.m.:  Previous mild pulmonary edema is improving, but no pleural effusions, and there is more atelectasis at both lung bases.  The bougie is in standard placement, and the trachea which is markedly displaced and, by CT report, severely narrowed by large right-sided goiter.  No pneumothorax.  No subclavian line.  The heart size top normal, unchanged.  ","['Change name of device', 'Change to homophone', 'False negation']"
5514784e-680e830d-5dd03b8a-fff3c159-26e51f27,58517313,15902493,"Findings: Unchanged from the prior exam with tracheostomy, ventriculoperitoneal shunt and prominence of the mediastinum due to goiter.  No evidence of pneumonia, pleural effusion or pneumothorax.  The cardiac silhouette and hila are normal. Impression: No evidence of pneumonia.","Findings: Unchanged from the prior exam with the tracheostomy tube seen entering the left main bronchus, ventriculoperitoneal shunt and prominence of the mediastinum due to goiter.  No evidence of pneumonia, pleural diffusion or pneumothorax.  The cardiac silhouet and hila are normal. There is a mild right pleural effusion. Impression: No evidence of atelectasis.","['Change position of device', 'Change to homophone', 'False prediction']"
"41811dc3-c03a8c6d-a316dd7f-5733949b-00331055, 5cd9a16f-bb23b3f4-472f8d63-0cb675ed-dce9d747",50329542,15911529,"Findings: Since prior, there has been interval enlargement of a right-sided pleural effusion which is now moderate to large with associated atelectasis.  Left chest wall triple lead pacing device is again noted. There is no left-sided effusion. Linear opacity in the left lower lung is likely atelectasis versus scarring. There is vascular congestion, lungs are otherwise clear of consolidation.  Previously seen pneumothorax is no longer visualized. Impression: Interval enlargement of the right pleural effusion and pulmonary vascular congestion.  Please note that underlying infection at the right lung base cannot be excluded.","Findings: Since prior, there has been interval enlargement of a right-sided pleural effusion which is now moderate to large with associated atelectasis. Left abdominal wall triple lead pacing device is again noted. There is no left-sided effusion. Linear opacity in the left lower lung is likely atelectasis versus scarring. There is vascular congestion, lungs are otherwise clear of solidification. Multiple nodular opacities in the right upper lobe suggest possible metastasis. Previously seen pneumothorax is no longer visualized. Impression: Interval enlargement of the left pleural effusion and pulmonary vascular congestion. Please note that underlying infection at the left lung base cannot be excluded.","['Change location', 'Change to homophone', 'False prediction']"
b280f564-593c9a51-09521aea-53d9b9fd-0bd0ab38,50817664,15911529,Findings: Frontal lateral views of the chest.  Compared to prior there has been decrease in size of the right pleural effusion which is now small and resolution of previously seen left effusion.  The lungs are otherwise clear.  Triple lead pacing device is again seen with its lead tips in stable position.  Cardiomediastinal silhouette is unchanged.  Osseous and soft tissue structures are unremarkable. Impression: Interval decrease in size of right pleural effusion which is now small.  No acute cardiopulmonary process.,Findings: Frontal lateral views of the chest.  Compared to prior there has been decrease in size of the right pleural effusion which is now small and resolution of previously seen left effusion.  The lungs are otherwise clear.  Triple lead vascular stent is again seen with its lead tips in stable position.  Cardiomediastinal sillhouette is unchanged.  Osseous and soft tissue structures are unremarkable. Impression: No pleural effusion.  No acute cardiopulmonary process.  ,"['Change name of device', 'Change to homophone', 'False negation']"
0deb7ec1-84b1f3d7-f5ac9938-3054c9dd-3caf0634,51122529,15911529,"Impression: As seen on the frontal view, there may have been some improvement in the component of right pleural effusion in the lower posterior chest, while the fissural components are slightly larger. PA and lateral views are recommended because they are more informative. The right basal pleural pigtail drainage catheter is unchanged in position.  Right lung abnormality is relatively mild, probably basal atelectasis.  Left lung is clear and there is no left pleural abnormality. Heart is moderately enlarged, chronically.  Transvenous right atrial and biventricular pacer leads continuous from the left pectoral generator.  No pneumothorax","Impression: As seen on the frontal view, there may have been some improvement in the component of right pleural effusion in the lower posterior chest, while the fissural components are slightly weigh. AP and lateral views are recommended because they are more informative. The right basal pleural pigtail drainage catheter is out of position. No lung abnormality. Left lung is clear and there is no left pleural abnormality. Heart is moderately enlarged, chronically. Transvenous right atrial and biventricular pacer leads continuous from the left pectoral generator. No pneumothorax","['Change position of device', 'Change to homophone', 'False negation']"
"d06dafbf-e8490fee-797a1c31-810d944e-b0943aea, e28c7a89-1ca9c509-df37f40f-ff6c6493-8ed702ff",51209889,15911529,Impression: Improving failure.,Impression: Improving flair.,"['Add contradiction', 'Change to homophone', 'False negation']"
93a34018-658089f0-17050a39-8b8e1b48-554f4cb7,51322181,15911529,"Impression: AP chest compared to ___:  Small right pleural effusion has decreased since ___.  Moderate cardiomegaly is chronic.  There is no pulmonary edema or pulmonary vascular congestion, or indication of left pleural effusion.  Transvenous right atrial and ventricular pacer leads are unchanged in position, as far as one can tell from frontal view alone.  No pneumothorax.","Impression: AP chest compared to ___: Small right pleural effusion has increased since ___. Moderate cardiomegaly is chronic. There is no pulmonary edema or pulmonary vascular congestion, or indication of left pleural effusion. Transvenous right atrial and ventricular pacer leads terminate in the right ventricle. No pneumothorax. Mild pulmonary edema and small bilateral pleural effusions.","['Change position of device', 'Add contradiction', 'False prediction']"
df8d7e2f-54c17397-730c6a12-e6f95950-a64b3f5d,51358209,15911529,Findings: The small right pleural effusion with adjacent compressive atelectasis is unchanged compared with the prior study of ___.  A right-sided pigtail catheter is in unchanged position. There is no pneumothorax. The left chest wall biventricular pacemaker leads are in unchanged position. There may be a small left pleural effusion. There is stable moderate cardiomegaly. Impression: Unchanged small right pleural effusion.,Findings: The small left pleural effusion with adjacent compressive atelectasis is unchanged compared with the prior study of ___. A right-sided pigtail catheter is in unchanged positions. There is no pneumothorax. The left chest wall biventricular pacemaker leads are in unchanged position. There is no pleural effusion. There is stable moderate cardiomegaly. Impression: No pleural effusion.,"['Change location', 'Add typo', 'False negation']"
d3649518-b1379ecd-2740eee0-1ed2da79-392e0086,51385148,15911529,"Findings: Persistent cardiomegaly and upper zone vascular redistribution but no overt pulmonary edema.  Moderate right pleural effusion has increased in size since the prior study and is accompanied by adjacent atelectasis.  Small left pleural effusion is similar to the prior study, and a new area of linear atelectasis is present in the left mid lung. ","Findings: Persistent cardiomegaly and upper zone vascular redistribution but no overt pulmonary edema.  Moderate left pleural effusion has increased in size since the prior study and is accompanied by adjacent atelectasis.  Moderate left pleural effusion has increased in size since the prior study and is accompanied by adjacent atelectasis.  Small left pleural effusion is similar to the prior study, and a new area of linear atelectasis is present in the left lower lung.","['Change location', 'Add repetitions', 'False prediction']"
"00e2018e-dac15125-72be8d6c-b6f1f0e6-feecb404, afedd930-9d244c0b-0a2edbe6-2ceb376a-23bc266b",51562372,15911529,"Findings: The patient is rotated to the left.  There has been interval removal of a right-sided PICC.  Left-sided pacer device is similar in position, with 3 leads seen.  There is a moderate to large right pleural effusion with overlying atelectasis, underlying consolidation is difficult to exclude.  No pleural effusion is seen on the left.  The cardiac silhouette is enlarged.  The aortic knob is calcified.  There is mild pulmonary edema. Impression: Moderate to large right pleural effusion with overlying atelectasis, underlying consolidation not excluded.  Mild to moderate pulmonary edema.  Enlarged cardiac silhouette.","Findings: The patient is rotated to the right.  There has been interval removal of a right-sided PICC.  Left-sided pacer device is similar in position, with 3 leads seen.  No pleural effusion is seen.  No pleural effusion is seen on the left.  The cardiac silhouette is enlarged.  The aortic knob is calcified.  There is mild pulmonary edema. Impression: Moderate to large right pleural effusion with overlying atelectasis, underlying consolidation not excluded.  Mild to moderate pulmonary edema.  Enlarged cardiac silhouette. ","['Change location', 'Add repetitions', 'False negation']"
ef150859-52757bb3-74733e58-ff402137-15580586,51747240,15911529,Impression: Substantial interval improvement in the loculated right pleural effusion has been demonstrated after readjustment of the pigtail catheter with no definitive loculation seen. Minimal amount of fissure all pleural effusion is still notable. Cardiomediastinal silhouette and position of the pacemaker leads is unchanged. Mild vascular congestion is present.  There is no change in minimal right apical pneumothorax.,Impression: Substantial interval improvement in the loculated right pleural effusion has been demonstrated after readjustment of the pigtail catheter with no definitive loculation sein. No pleural effusion is notable. Cardiomediastinal silhouette and position of the pacemaker leads is unchangeu. No vascular congestion is present.  There is no change in minimal right apical pneumothorax.,"['Change position of device', 'Add typo', 'False negation']"
ccdac225-47c7b48e-79a78b1c-a6ac307c-ae6bea97,52561076,15911529,Impression: Right pleural effusion has resolved since ___ following insertion of a right basal pigtail pleural drainage catheter. There is no pneumothorax. Lungs are clear. Mild cardiomegaly is stable and pulmonary vasculature borderline engorged,"Impression: Right pleural effusion has resolved since ___ following insertion of a left basal pigtail pleural drainage catheter. Their is no pneumothorax. Lungs are clear. Mild cardiomegaly is stable, and there is a left lower lobe infiltrate.","['Change name of device', 'Change to homophone', 'False prediction']"
6e3a9cd5-91eb5828-ac10bc10-24dfa7c0-0e536576,52646931,15911529,"Impression: Small fissural component of right pleural effusion is new.  Dependent pleural effusion is probably small and they are still atelectasis at the right base, with the right pigtail pleural drainage catheter unchanged in position. Moderate cardiomegaly is stable.  Left lung is grossly clear. There is no pneumothorax.  Transvenous right atrial, biventricular pacer leads are in standard positions continuous from the left pectoral generator.","Impression: Small fissural component of right pleural effusion is new.  Dependent pleural effusoin is probably small and they are still atelectasis at the right base, with the right pigtail pleural drainage catheter unchanged in position. Moderate cardiomegaly is stable.  Left lung is grossly clear with a small nodule. There is no pneumothorax.  Transvenous right atrial, triple-chamber ICD leads are in standard positions continuous from the left pectoral generator.","['Change name of device', 'Add typo', 'False prediction']"
070db2df-2c7004d2-26b8d90f-9fd165dc-7eefd70c,53060481,15911529,"Impression: No change in the position of the right pigtail catheter, loculated pleural effusion, cardiomediastinal silhouette and pacemaker leads demonstrated.","Impression: No change in the position of the right pigtail catheter, loculated pleural effusion, cardiomediastinal slhoutte and pacemaker leads demonstrated. ","['Change position of device', 'Add typo', 'False negation']"
5063d302-87f10189-f63cd435-f9628cbb-ea776d10,53140692,15911529,Findings: Single portable view of the chest is compared to previous exam from ___.  The lungs are clear of confluent consolidation.  Cardiac silhouette is enlarged but stable.  Hypertrophic change is seen in the spine.  Osseous and soft tissue structures are otherwise unremarkable. Impression: Cardiomegaly without acute cardiopulmonary process.,Findings: Single portable view of the chest is compared to previous exam from ___.  The lungs are clear of confluent consolidation.  Cardiac silhouette is enlarged but stable.  There is a small left pleural effusion.  Hypertrophic change is seen in the spine.  Osseous and soft tissue structures are otherwise unremarkable.  The lungs are clear of confluent consolidation. Impression: Cardiac silhouette is enlarged but stable.  Cardiomegaly without acute cardiopulmonary process.,"['Add repetitions', 'Change to homophone', 'False prediction']"
7ada4149-42025581-bd61e461-9719e7ba-1954ef82,53784524,15911529,"Impression: As compared to the previous image, a part of the right pleural effusion, notably in the intrafissural space, has Re accumulated. As a consequence, the lung volume on the right has decreased and atelectasis have. At the right lung base. Moderate cardiomegaly persists.  No overt pulmonary edema.  No change in appearance of the left lung.","Impression: As compared to the previous image, a part of the right pleural effusion, notably in the intrafissural space, has Re accumulated. As a consequence, the lung volume on the right side remains normal. Mild cardiomegaly persists. Nodular opacities are present in the left lung. ","['Change severity', 'Change to homophone', 'False prediction']"
a8cb181d-36d8820a-91ffab5c-09e53515-1aaf369c,53878159,15911529,"Findings: Portable AP upright chest film ___ 807 is submitted. Impression: Right basilar pleural pigtail catheter remains in place. There is a tiny right apical pneumothorax.  The heart remains enlarged. Mediastinal contours are stable. A left-sided pacer remains in place.  There is patchy opacity at the right base which may reflect re-expansion pulmonary edema, although patchy ateclectasis or pneumonia should also be considered.  A rounded contour to the right medial lung base may reflect prominent epicardial fat when correlated with abdominal CT studies from ___ and ___, although a medial lung nodule cannot be entirely excluded.  This can be re-assessed on followup imaging.  No large effusions.","Findings: Portable AP upright chest film ___ 807 is submitted. Impression: Right basilar pleural pigtail catheter terminates at the right mid-lung. There is no pneumothorax.  The heart remains enlarged. Mediastinal contours are stable. A left-sided pacer remains in place.  There is patchy opacity at the right base which may reflect re-expansion pulmonary edema, although patchy ateclectasis or pneumonia should also be considered.  A rounded contour to the right medial lung base may reflect prominent epicardial fat when correlated with abdominal CT studies from ___ and ___, although a medial lung nodule cannot be entirely excluded.  This can be re-assessed on followup imaging.  No large effusions. No large effusions.","['Change position of device', 'Add repetitions', 'False negation']"
09f9cee5-f285e400-c4fe605a-dde10cac-e5d3eb0e,54190932,15911529,Impression: No relevant change in extent and distribution of the known pleural effusion on the right.  The position of the right pigtail catheter is also unchanged. Moderate cardiomegaly and low lung volumes persist.  No pulmonary edema.  No pneumothorax.,Impression: No relevant change in extend and distribution of the known pleural effusion on the right.  The position of the right pigtail catheter is also unchanged. Severe cardiomegaly and low lung volumes persist.  No pulmonary edema. There is a right pneumothorax.,"['Change severity', 'Add typo', 'False prediction']"
5817a4b8-c4f832fb-7a33cc26-b05e9ff5-80a03cbc,54252168,15911529,"Findings: Since a recent radiograph of 1 day earlier, a right pigtail pleural catheter has been removed. Small right apical pneumothorax is not changed, but a small right pleural effusion has increased in size following tube removal. No additional relevant change since recent study ","Findings: Since a recent radiograph of 1 day earlier, a right pigtail pleural catheter has been repositioned to the left side. Small right apical pneumothorax is knot changed, but a small right pleural effusion has increased in size following tube removal. No additional relevant change since recent study. There is bibasilar atelectasis present.","['Change position of device', 'Change to homophone', 'False prediction']"
51314394-a4c9c16e-9c4046f5-27fb7589-de68759f,54368456,15911529,"Impression: As compared to the previous radiograph, there is no change in position of the right chest tube.  No pneumothorax. A minimal right pleural effusion is constant.  Mild right basilar atelectasis. Unchanged moderate cardiomegaly. Unchanged left pectoral pacemaker.","Impression: As compared to the previous radiograph, there is no change in position of the right chest tube. No pneumothorax. A minimal right pleural effusion is constant. Moderate right basilar atelectasis. Unchanged moderate cardiomegaly. Unchanged left pectoral pacemaker. There is a small left lung nodule.","['Change severity', 'Add repetitions', 'False prediction']"
4f1666fe-eb70e076-c045bd55-4a13ebea-89f70922,55017393,15911529,"Impression: In comparison with the study of ___, there has been placement of a right pigtail catheter with substantial reduction in the amount of fluid within the right pleural space. No evidence of pneumothorax. Remainder of the study is unchanged.","Impression: In comparison with the study of ___, there has been placement of a right chest tube with substantial reduction in the amount of fluid within the right pleural space. No evidence of pneumothorax. Remainder of the study is unchanged. The cardiac and mediastinal silhouettes are stable.","['Change name of device', 'Add repetitions', 'False prediction']"
3f54680b-15217393-27fff50f-aeb78433-c51498b7,55211188,15911529,"Findings: The right-sided pigtail catheter is unchanged in position. A left-sided biventricular pacer partially obscures the left mid lung. The loculated right pleural effusion has increased, and is now moderate in size.  A rounded airspace opacity in the right upper lung zone likely reflects fluid in the major fissure.  Cardiomegaly is unchanged. Lingular linear atelectasis is again noted. New blunting of the left costophrenic angle may be due to a small pleural effusion. Impression: Interval increase in loculated right pleural effusion, which is now moderate in size. New small left pleural effusion. Stable cardiomegaly.","Findings: The right-sided central venous catheter is unchanged in position. A left-sided biventricular pacer partially obscures the left mid lung. The loculated right pleural effusion is not present. A rounded airspace opacity in the right upper lung zone likely reflects fluid in the major fissure. Cardiomegaly is unchanged. Lingular linear atelectasis is again noted. New blunting of the left costophrenic angle may be due to a small pleural effusion. Impression: Interval increase in loculated right pleural effusion, which is now moderate in size. No pleural effusion. Stable cardiomegaly.","['Change name of device', 'Add repetitions', 'False negation']"
"69a50a5b-ad0ca148-ae58ef27-a1d7b4be-cbde70fe, f58ceea9-b65ddd7a-210c3c5d-64f6f523-e898d9d7",55296778,15911529,"Findings: The heart is again mild-to-moderately enlarged.  The mediastinal and hilar contours appear unchanged, again noting calcifications along the aortic arch.  The lungs are clear.  There are no pleural effusions or pneumothorax.  Mild rightward convex curvature is centered along the mid thoracic spine with mild degenerative anterior osteophyte formation. Impression: No evidence of acute disease.","Findings: The heart is again severely enlarged. The mediastinal and hilar contours appear unchanged, again noting calcifications along the aortic arch. The lungs show bilateral patchy opacities. There are no pleural effusions or pneumothorax. Mild rightward convex curvature is centered along the mid thoracic spine with moderate degenerative anterior osteophyte formation. Impression: No evidence of acute disease. There is an ET tube in place.","['Change severity', 'Add contradiction', 'Add medical device']"
"50f387b8-7d09f146-8c5f7b53-5595f2e7-ef1ff2a9, c8a6f765-ffcff546-a4d433d1-fe00ebbf-978fb111",55387962,15911529,"Findings: There is a left pectoral pacemaker with 3 leads, unchanged in position. A moderate right pleural effusion has reaccumulated since the most recent prior study, which is similar in appearance to ___.  There is mild pulmonary vascular congestion/ interstitial edema. No left pleural effusion or pneumothorax is seen.  The cardiac silhouette remains enlarged.  There is mild calcification of the aortic knob. Impression: 1.  Moderate left pleural effusion, which is re-accumulated since ___ but appears similar to ___.  2.  Mild pulmonary vascular congestion/ interstitial edema.","Findings: There is a left pectoral pacemaker with 3 leads, unchanged in position. A mild right pleural effusion has reaccumulated since the most recent prior study, which is similar in appearance to ___.  There is mild pulmonary vascular congestion/ interstitial edema. A mild right pleural effusion has reaccumulated since the most recent prior study, which is similar in appearance to ___.  No pulmonary vascular congestion/ interstitial edema. No left pleural effusion or pneumothorax is seen.The cardiac silhouette remains enlarged. There is moderate calcification of the aortic knob.   Impression: 1. No left pleural effusion. 2. Moderate pulmonary vascular congestion/ interstitial edema.","['Change severity', 'Add repetitions', 'False negation']"
5f752c85-93a983b0-ac44e646-e4f71e52-f7d6b934,55431093,15911529,Findings: There has been interval increase in the loculated right pleural effusion. This is seen as multiple smoothly marginated opacities projecting over the right lung. There is a small left effusion that is also increased in size.  The appearance of the pacemaker is unchanged Impression: Increase in loculated right effusion.,Findings: There has been interval decrease in the loculated right pleural effusion. This is seen as multiple smoothly marginated opacities projecting over the left lung. No small left effusion is seen. The appearance of the pacemaker has shifted to the right. Impression: Increase in the loculated right effusion. There has been a reduction in loculated right effusion.  ,"['Change position of device', 'Add contradiction', 'False negation']"
6ba26b3a-5314e906-7366a48a-0598d3bd-73c3ca0f,56521428,15911529,"Findings: Allowing for changes in positioning and lung volumes, the small right pleural effusion and adjacent compressive atelectasis is probably unchanged compared with ___. The right-sided pigtail catheter is in unchanged position.  The left chest wall atrial and biventricular pacemaker leads are in standard position. There is moderate stable cardiomegaly. Impression: Unchanged small right pleural effusion.","Findings: Allowing for changes in positioning and lung volumes, the small right pleural effusion and adjacent compressive atelectasis is probably unchanged compared with ___. The right-sided pigtale catheter is in unchanged position.  The left chest wall atrial and biventricular pacemaker leads are in standard position. There is mild stable cardiomegaly. Patchy consolidation in the left lower lobe. Impression: Unchanged large right pleural effusion.","['Change severity', 'Change to homophone', 'False prediction']"
7ea66041-8955dc19-d570afcf-8b34d01a-f3ecff9a,56889086,15911529,"Impression: In comparison with the study of ___, there is little overall change. The right pigtail catheter remains in place, somewhat away from the area of loculated fluid along the right lateral chest wall inferiorly and to the more rounded opacification that probably represents fluid in the major fissure. The remainder the study is unchanged.","Impression: In comparison with the study of ___, there is little overall change. The right chest tube remains in place, somewhat away from the area of loculated fluid along the right lateral chest wall inferiorly and to the more rounded opacification that probably represents fluid in the major fissure. There is significant left pleural effusion. The remainder of the study is unchanged.","['Change name of device', 'Add contradiction', 'False prediction']"
54096c14-0109abb4-f9341bfb-ee3fe012-50d75838,57882477,15911529,"Findings: The new right chest wall pigtail catheter is in appropriate position. There is no pneumothorax. The large right pleural effusion has decreased somewhat, but a moderate pleural effusion still remains in spite of drainage catheter placement. There is probably no left pleural effusion. Pulmonary vascular congestion has improved, now mild. There is stable cardiomegaly. The left chest wall pacemaker leads are in unchanged stable position. Impression: 1. New right chest wall pigtail catheter in appropriate position with moderate residual right pleural effusion PE 2. Interval improvement of pulmonary vascular congestion, now mild.","Findings: The new right chest wall pigtail catheter ends near the right atrium. There is probably no pneumothorax. No pleural effusion remains in spite of drainage catheter placement. There is probably no left pleural effusion. Pulmonary vascular congestion has improved, now mild. There is probably no cardiomegaly. The left chest wall pacemaker leads terminate in the mid SVC. There is probably no pulmonary vascular congestion. Impression: 1. New right chest wall pigtail catheter in appropriate position with moderate residual right pleural effusion PE 2. Interval improvement of pulmonary vascular congestion, now mild.","['Change position of device', 'Add repetitions', 'False negation']"
69bc2b07-10cc7789-3cc5f3af-4c3c6ba3-992abb1d,57922122,15911529,Findings: New left pectoral pacemaker has three leads in adequate position.  There is no pneumothorax.  Small bilateral pleural effusions are unchanged.  Minimal lung haziness and cephalization of pulmonary vessel are consistent with stable mild pulmonary edema. Impression: 1.  New left-sided pectoral pacemaker is in adequate position.  There is no pneumothorax.  2.  Pulmonary edema is mild and stable.,"Findings: New left pectoral pacemaker has three leads in suboptimal position.  There is now pneumothorax.  Small bilatreal pleural effusions are unchanged.  Minimal lung haziness and cephalization of pulmonary vessels are consistent with stable mild pulmonary edema.  Also, there are patchy opacities in the lower lobes indicative of possible infection. Impression: 1. New left-sided pectoral pacemaker is in adequate position. There is no pneumothorax. 2. Pulmonary edema is mild and stable.","['Change position of device', 'Add typo', 'False prediction']"
10127a8b-7bfe476a-de96870b-d51d4890-34ca977b,58322412,15911529,"Impression: Cardiomegaly is unchanged. Right pigtail catheter is in place but there is a gain interval accumulation, substantial of pleural effusion along the chest wall as well as in the major fissure.  Minimal right apical pneumothorax is noted.","Impression: Cardiomegaly is unchanged. Right picjtail catheter is in place but there is a gain interval accumulation, substantial of pleural effusion along the chest wall as well as in the major fissure. No pneumothorax is noted.","['Change severity', 'Add typo', 'False negation']"
0042757a-03a7b183-0e56404f-f82c7d1d-cf93667a,58350152,15911529,Impression: A small left and possibly trace right pleural effusion and accompanying atelectasis with mild cardiomegaly.,Impression: A large left and possibly trace right pleural effusion and accompanying atelectasis with mild cardiomegaly. A large left and possibly trace right pleural effusion and accompanying atelectasis with mild cardiomegaly. A small bowel tube is also noted.,"['Change severity', 'Add repetitions', 'Add medical device']"
"196485f6-66508452-3f992f30-5e0c4182-53d9d2d0, 442695c7-33bbfd97-387bc062-28a11538-d366fc24",58807131,15911529,"Findings: In comparison with the study of ___, the patient has taken a better inspiration.  Pacer leads are essentially unchanged and there is no evidence of pneumothorax. ","Findings: In comparison with the study of ___, the patient has taken a better inspiration.  Pacer leads are now seen terminating in the atrium and there is no evidence of pneumothorax.  ","['Change position of device', 'Change to homophone', 'False negation']"
ff1a21e7-453d4f60-95aaa2f2-76bcd93e-8debb861,59373190,15911529,"Impression: Right basal pigtail pleural drainage catheter unchanged in position.  Small right pleural effusion is smaller, revealing atelectasis or persisting consolidation in the right lower lobe.  Upper lungs are clear. Mild cardiomegaly stable. Transvenous right atrial and biventricular pacer leads continuous from the left pectoral generator.  Left lung clear. Mild pulmonary vascular engorgement persists.  No pneumothorax.","Impression: Right basal pigtail pleural drainage catheter unchanged in position.  Large right pleural effusion is smaller, revealing atelectasis or persisting consolidation in the right lower lobe.  Upper lungs are clear. Mild cardiomegaly stable. Transvenous right atrial and biventricular pacer leads continuous from the left pectoral generator.  Left lung clear. Mild pulmonary vascular engorgement persists.  No pleural effusion noted. There is evidence of mild interstitial edema.  No pneumothorax.","['Change severity', 'Add contradiction', 'False prediction']"
0184704e-f5d6feff-cbe7f37e-d6c77a0f-db1e7472,59474704,15911529,"Findings: Interval removal of the right pigtail catheter.  Otherwise, no overall change since the previous exam. The loculated right pleural effusion, which demonstrates some tracking in the minor fissure is grossly stable. Mild right lateral pleural thickening. Small left pleural effusion. No pneumothorax or pulmonary edema. Stable cardiomegaly and cardiomediastinal contours.  No changes in the position of the 3 lead cardiac device. Impression: No overall change in the size of the right pleural effusion after removal of the right pigtail catheter.  No pneumothorax.","Findings: Interval removal of the right gastrostomy tube.  Otherwise, no overall change since the previous exam. There is now no loculated right pleural effusion. Mild right lateral pleural thickening. Small left pleural effusion. No pneumothorax or pulmonary edema. Stable cardiomegaly and cardiomediastinal contours.  There are changes in the position of the 3 lead cardiac device. Impression: No overall change in the size of the right pleural effusion after removal of the right pigtail catheter.  Pneumothorax is present.","['Change name of device', 'Add contradiction', 'False negation']"
6f7c8371-2e3b25ff-83624c4e-2be20956-b6845eca,59868000,15911529,"Impression: Substantial right pleural effusion collected laterally and in the inter lobar fissures has reaccumulatied  since ___, after previous drainage of the lateral collection after a new or repositioned right pigtail pleural drainage catheter.  Moderate atelectasis at the base the right lung is stable.  Pulmonary vascular engorgement has improved since ___, but severe cardiomegaly has not.  Transvenous atrioventricular pacer leads are unchanged in their respective positions.  Tiny residual right apical pneumothorax remains.","Impression: Substantial right pleural effusion collected laterally and in the inter lobar fissures has reaccumulatied since ___, after previous drainage of the lateral collection after a new or repositioned right central venous line.  Moderate atelectasis at the base the right lung is stable.  Pulmonary vascular engorgement has improved since ___, but severe cardiomegaly has not.  Transvenous atrioventricular pacer leads are unchanged in their respective positions.  Tiny residual right apical pneumothorax remains. There is an ET tube present.","['Change name of device', 'Add repetitions', 'Add medical device']"
"c46a9297-9c4fae50-d9821fee-6a6d4d13-2111948e, dd5c0bf7-9ba91c35-38f3e4bc-f5a63497-a975f89f",58123697,15914007,"Findings: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease or old granulomatous disease. ","Findings: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease or old granulomatous disease. Pulmonary artery catheter is in correct place. In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease or old granulomatous disease. There is a left upper lobe mass detected.","['Add medical device', 'Add repetitions', 'False prediction']"
9c117d65-7622dfb8-8d925586-8a37e8c7-aaa535de,53163844,15936884,"Impression: As compared to the previous radiograph, the nasogastric tube was removed. The right PICC line is in unchanged position. Unchanged appearance of the cardiac silhouette and of the lung parenchyma. The alignment of the sternal wires is constant.","Impression: As compared to the previos radiograph, the nasogastric tube was removed. The right PICC line is positioned in the mid SVC. Unchanged appearance of the cardiac silhouette and of the lung parenchymaa. The alignment of the sternal wires is constant. An endotracheal (ET) tube is seen with its tip just above the carina.","['Change position of device', 'Add typo', 'Add medical device']"
e3d64e22-fb22f834-a727b3ff-c6c4c66f-5a5d4b5c,53561431,15936884,Impression: Dobhoff tube tip iscoiled in the stomach.  Mild cardiomegaly and widened mediastinum are unchanged. Right PICC tip is in the upper to mid SVC. The lungs are clear. There is no pneumothorax or pleural effusion. . Sternal wires are aligned,Impression: Dobhoff tube tip iscoiled in the distal esophagus. Mild cardiomegaly and widened mediastinum are unchanged. Right PICC tip is in the right atrium. The lungs are clear. There is a left-sided pleural effusion. Sternal wiers are aligned,"['Change position of device', 'Add typo', 'False prediction']"
fab89071-f6543b70-eaff3eb7-558c223b-f40a6d6f,55390875,15936884,"Findings: The patient is status post CABG and the mediastinum continues to demonstrate the expected postoperative appearance. A right IJ catheter terminates within the upper-mid SVC. A nasogastric tube courses into the stomach and out of view of the radiograph. As compared to the prior examination, the patient's bilateral pulmonary edema has improved and is now mild. Bilateral small pleural effusions with adjacent atelectasis are noted. The upper lung fields are grossly clear. Impression: Status post CABG with interval improvement in now mild bilateral pulmonary edema. Small bilateral pleural effusions with adjacent atelectasis.","Findings: The patient is status post CABG and the mediastinum continues to demonstrate the expected postoperative appearance. A right IJ catheter terminates within the upper-mid SVC. A nasogastric tube coarse into the stomach and out of view of the radiograph. As compared to the prior examination, the patient's bilateral pulmonary edema has improved and is now moderate. Bilateral small pleural effusions with adjacent atelectasis and a subtle middle lobe consolidation are noted. The upper lung fields are generally clear. Impression: Status post CABG with interval improvement in now moderate bilateral pulmonary edema. Small bilateral pleural effusions with adjacent atelectasis. ","['Change severity', 'Change to homophone', 'False prediction']"
ccb976bd-fe7110eb-f5b9e68c-74886c88-c2d95f6c,55850018,15936884,"Findings: The lung volumes are very low.  A Swan-Ganz catheter appears slightly retracted, remaining within a right pulmonary artery. There has been interval extubation and removal of mediastinal drain and left thoracostomy tube. Multiple intact sternal wires and mediastinal clips are unchanged in orientation. Moderate central pulmonary vascular congestion and pulmonary edema are unchanged since ___. New small bilateral pleural effusions are present.  There is no pneumothorax. Impression: 1.  New small bilateral pleural effusions. 2.  Unchanged moderate pulmonary edema. 3.  No pneumothorax.","Findings: The lung volumes are very low. A Swan-Ganz catheter appears slightly retracted, remaining within a left pulmonary artery. There has been interval extubation and removal of mediastinal drain and left thoracostomy tube. Multiple intact sternal wires and mediastinal clips are unchanged in orientation. Moderate central pulmonary vascular congestion and pulmonary edema are unchanged since ___. Knew small bilateral pleural effusions are present. There is no pneumothorax. An ET tube is seen in the trachea. Impression: 1. New small bilateral pleural effusions. 2. Unchanged moderate pulmonary edema. 3. No pneumothorax.","['Change location', 'Change to homophone', 'Add medical device']"
7e069d55-1e0ebee8-f2c1d7d5-371f7b08-28536c80,57105691,15936884,Impression: Dobhoff tube tip iscoiled in the stomach.  No other interval change from prior study.,Impression: Dobhoff tube tip terminates in the distal esophagus.  No other interval change from prior study.,"['Change position of device', 'Add contradiction', 'False prediction']"
5b038a10-d2936918-06b01d36-d6b919fc-be5e03b4,59347638,15936884,"Findings: The heart is enlarged, and there is moderate pulmonary edema. There are no pneumothoraces. An endotracheal tube terminates in appropriate position, and the nasogastric tube terminates below the view of this radiograph. Impression: Congestive heart failure with cardiomegaly and moderate pulmonary edema.","Findings: The heart is enlarged, adn there is moderate pulmonary edema. There are no pneumothoraces. An endotracheal tube terminates 3 cm above the carina, and the nasogastric tube terminates below the view of this radiograph. A right IJ central venous catheter is present. Impression: Congestive heart failure with cardiomegaly and moderate pulmonary edema.","['Change position of device', 'Add typo', 'Add medical device']"
"71138932-dc73f0d5-fa8be28c-a2925dc4-648b9e72, c03267f8-f0900e7f-f768fa2d-8ba19ccf-5d5cbc99",55454745,16029766,"Findings: The heart size is top normal.  The mediastinum is stable in appearance.  There is redemonstration of the neoesophagus contour.  There has been interval increase in bilateral pleural effusions compared to the most recent prior exam from ___.  There is adjacent mild compressive atelectasis.  There is no evidence of a pneumothorax.  Post-sternotomy wires are unremarkable.  Surgical rib fracture of the right 5th rib is again noted. Impression: Slight interval increase in known bilateral pleural effusions, right greater than left.  Compared to the prior exam from ___, there is adjacent mild compressive atelectasis; a superimposed infectious process cannot be excluded.","Findings: The heart size is top normal.  The mediastinum is stable in appearance.  There is redemonstration of the neoesophagus contour.  There has been interval increase in bilateral pleural effusions compared to the most recent prior exam from ___.  There is adjacent mild compressive atelectasis.  There is no evidence of a pneumothorax.  Post-sternotomy wires are unremarkable.  Surgical rib fracture of the left 5th rib is again noted.  A central venous line is properly positioned. Impression: Slight interval increase in known bilateral pleural effusions, write greater than left.  Compared to the prior exam from ___, there is adjacent mild compressive atelectasis; a superimposed infectious process cannot be excluded.","['Change location', 'Change to homophone', 'Add medical device']"
2b6058ea-1a457571-ebed852c-b6879996-ac8b1622,57386813,16029766,"Findings: In comparison with study of ___, there has been extensive increase in opacification at both bases, consistent with pleural effusion and compressive atelectasis at the bases.  Continued enlargement of the cardiac silhouette with pulmonary vascular congestion. ","Findings: In comparisson with study of ___, there has been large increase in opacification at both bases, consistent with pleural effusion and compressive atelectasis at the bases.  Continued enlargement of the cardiac silhouette with pulmonary vascular congestion. A pacemaker is present in the left thorax.","['Change severity', 'Add typo', 'Add medical device']"
f5749890-f4250cdd-2292cfd3-615f2be0-8af3bc3a,53444094,16030469,Impression: No previous images. Low lung volumes accentuate the transverse diameter of the heart.  No evidence of acute pneumonia or old tuberculous disease.,Impression: No previous images. Low lung volumes accentuate the transverse diameter of the heart. No evidence of acute pneumonia or old tuberculous disease. The pacemaker is correctly placed.,"['False negation', 'Add contradiction', 'Add medical device']"
"66e97c1d-0fa3fcaf-2a0046b8-80ee76c8-99993f04, fd4d1714-ea5c562c-917ab796-b83f8aa8-6b82f80e",55136339,16030469,"Findings: Frontal and lateral chest radiographs demonstrate a dual-lumen right chest wall dialysis line, terminating in the right atrium.  The cardiomediastinal silhouette is normal and the lungs fairly well-aerated, without focal consolidation, pleural effusion, or pneumothorax.  The visualized upper abdomen is unremarkable. Impression: No acute cardiopulmonary process.","Findings: Frontal and lateral chest radiographs demonstrate a dual-lumen left chest wall dialysis line, terminating in the right atrium.  The cardiomediastinal silhouette is normal and the lungs fairly well-aerated, without focal consolidation, pleural effusion, or pneumothorax.  The visualized upper abdomen is unremarkable. The cardiomediastinal silhouette is normal and the lungs fairly well-aerated, without focal consolidation, pleural effusion, or pneumothorax.  Small left-sided pleural effusion noted. Impression: No acute cardiopulmonary process.","['Change location', 'Add repetitions', 'False prediction']"
0b9a1d90-0d4e09e2-e651a638-81738947-249b3e35,50369062,16033763,"Findings: Compared to the previous radiograph, the patient has undergone a VATS procedure.  A left chest tube is in situ.  No pneumothorax.  No other left-sided findings, except for soft tissue air inclusion in the lateral chest wall.  Unchanged position and course of the pacemaker.  Moderate cardiomegaly, plate-like atelectasis at the right lung base. ","Findings: Compared to the previous radiograph, the patient has undergone a VATS procedure.  A left chest tube is in situ.  No pneumothorax.  No other left-sided findings, except for soft tisue air inclusion in the lateral chest wall.  Unchanged position and course of the pacemaker.  Mild cardiomegaly, plate-like atelectasis at the right lung base.  No plate-like atelectasis.  ","['Change severity', 'Add typo', 'False negation']"
3568ad06-c4d7640e-57033b28-70d178fd-c2dd3c78,50853877,16033763,"Findings: In comparison with the study of ___, the Pleurx catheter remains in place while the chest tube has been removed.  No evidence of pneumothorax.  Multiple pulmonary lesions are again seen. ","Findings: In comparison with the study of ___, the drainage catheter remains in place while the chest tube has been removed.  No evidence of pneumothorx.  No pulmonary lesions are noted.","['Change name of device', 'Add typo', 'False negation']"
883a73c4-7165e6cd-0d076fa5-7e573f4c-ab9a9523,51278946,16033763,"Impression: 1.  Two left chest tubes and a single-lead left-sided pacer remain in place.  There are multiple bilateral pulmonary nodules consistent with known metastases.  In addition, there is more focal patchy opacity at the left base in the setting of an effusion, which may reflect compressive atelectasis, although superimposed pneumonia or aspiration should be considered as this appears to be worsening.  Overall cardiac and mediastinal contours are stable. No pneumothorax appreciated.","Impression: 1.  Two left chest tubes and a single-lead left-sided pacer remain in place.  There are multiple bilateral pulmonary nodules consistent with known metastases.  In addition, there is more focal patchy opacity at the left base in the setting of an effusion, which may reflect compressive atelectasis, although superimposed pneumonia or aspiration should be considered as this appears to be worsening.  Two left chest tubes and a single-lead left-sided pacer remain in place. No pneumothorax appreciated.","['Change position of device', 'Add repetitions', 'False negation']"
ed31f48a-f429773b-c9704fad-15c7dc2f-1ad59b8f,51507991,16033763,"Findings: Portable semi-upright radiograph of the chest demonstrates persistent small bilateral pleural effusions with adjacent atelectasis, not significantly changed from the prior study.  Again seen are multiple bilateral pulmonary nodules, consistent with metastatic disease.  The cardiomediastinal and hilar contours are unchanged.  Two chest tubes project over the left hemithorax.  Left-sided oral pacemaker is present with the leads in the appropriate position.  There is no pneumothorax. Impression: Bilateral pleural effusions with adjacent atelectasis are not significantly changed from the prior study.","Findings: Portable semi-upright radiograph of the chest demonstrates persistent small bilateral pleural effusions with adjacent atelectasis, not significantly changed from the prior study. Again seen are multiple bilateral pulmonary nodules, consistent with metastatic disease. The cardiomediastinal and hilar contours are unchanged. Two chest tubes project over the left hemithorax. Left-sided dual-chamber pacemaker is present with the leads in the appropriate position. There is no pneumothorax. Left-sided NG tube is noted in the stomach proper. Impression: Bilateral pleural effusions with adjacent atelectasis are not significantly changed from the prior study. Bilateral pleural effusions with adjacent atelectasis are not significantly changed from the prior study.","['Change name of device', 'Add repetitions', 'Add medical device']"
"09524e08-b43253ba-752c8e69-fc1908b0-54cbd712, 4969ed80-b6f01bb1-09bc5a19-c44bb4c5-70597525",51599066,16033763,"Findings: AP and lateral radiographs were acquired.  There is a left-sided pacemaker with an associated right ventricular lead, appropriately positioned. The lungs are hyperexpanded and there is flattening of the hemidiaphragms with enlargement of the retrosternal airspace, consistent with chronic obstructive pulmonary disease.  There is a right lower lung granuloma, as before.  The lungs are otherwise clear.  The heart size is top normal.  The mediastinal contours are normal.  There are no pleural effusions.  No pneumothorax is seen. Impression: 1.  No acute process. 2.  Findings consistent with chronic obstructive pulmonary disease.","Findings: AP and lateral radiographs were acquired. There is a left-sided atrial fibrillation monitor with an associated right ventricular lead, appropriately positioned. The lungs are hyperexpanded and there is flattening of the hemidiaphragms with enlargement of the retrosternal airspace, consistent with chronic obstructive pulmonary disease. There is no granuloma. The lungs are otherwise clear. The heart size is top normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Impression: 1. No acute process. 2. Findings consistent with chronic obstructive pulmonary disease. 3. Presence of right lung granuloma.","['Change name of device', 'Add contradiction', 'False negation']"
"36b80f83-181f47f3-7f54839c-4f80a1f3-60de306a, c90cae1c-784836db-33abc09e-f4490bd5-bd1f64fd",52447787,16033763,"Findings: Frontal and lateral radiographs of the chest show a left pectoral pacemaker with a single lead unchanged in position within the right ventricle. Bilateral apical pleural thickening is unchanged.  A right lower lung granuloma is stable from the preceding radiograph.  The lungs are otherwise clear without pleural effusion, focal consolidation or pneumothorax.  No new pulmonary nodule is detected by radiography.  The pulmonary vasculature is not engorged.  The cardiac silhouette is top normal in size but stable.  The mediastinal and hilar contours are within normal limits and unchanged from ___. Impression: 1.  No evidence of intrathoracic malignancy by radiography.   2.  Stable right lower lung granuloma.","Findings: Frontal and lateral radiographs of the chest show a left pectoral pacemaker with a single lead terminating in the right atrium. Bilateral apical pleural thikening is unchanged. No granuloma is seen.  The lungs are otherwise clear without pleural effusion, focal consolidation or pneumothorax.  No new pulmonary nodle is detected by radiography.  The pulmonary vasculature is not engorged.  The cardiac silhouette is top normal in size but stable.  The mediastinal and hilar contours are within normal limits and unchanged from ___. Impression: 1.  No evidence of intrathoracic malignancy by radiography.   2.  Right lower lung granuloma not seen.","['Change position of device', 'Add typo', 'False negation']"
574a4800-1bd863fc-41b229b6-7e737994-5232ce8a,53153262,16033763,"Findings: Portable semi-upright radiograph of the chest demonstrates persistent small left-sided pleural effusion, which is not significantly changed.  A small right-sided pleural effusion is also seen, and is slightly increased in size over the interval.  Again seen are multiple bilateral nodules in the lungs consistent with metastatic disease.  The cardiomediastinal and hilar contours are unchanged.  Two chest tubes project over the left hemithorax. Impression: Persistent small left-sided pleural effusion with adjacent atelectasis, and slight interval increase in size in the small right pleural effusion.","Findings: Portable semi-upright radiograph of the chest demonstrates persistent small right-sided pleural effusion, which is not significantly changed.  A small right-sided pleural effusion is also seen, and is decreased in size over the interval.  Again seen are multiple bilateral nodules in the lungs consistent with metastatic disease.  The cardiomediastinal and hilar contours are unchanged.  Two chest tubes project over the left hemithorax. A central venous line is present. Impression: Persistent small left-sided pleural effusion with adjacent atelectasis, and no interval increase in size in the small right pleural effusion.","['Change location', 'Add contradiction', 'Add medical device']"
12592f0d-a371e425-2f68a639-fe69e7f1-e085f4c4,53452442,16033763,"Findings: In comparison with study of ___, there is some increasing opacification at the left base consistent with some reaccumulation of pleural fluid.  Diffuse nodular opacification persist. ","Findings: In comparison with study of ___, there is some increasing opacification at the right base consistent with some reaccumulation of pleural fluid.  No nodular opacification is seen.  Diffuse nodular opacification persist.","['Change location', 'Add repetitions', 'False negation']"
"0c7700b8-19401338-187bcaf9-bf35ab7d-5ffed660, 2f2f1da0-4c2671bd-4b0324fd-ac4b0e0e-de4884ec",53913303,16033763,Findings: Frontal and lateral chest radiograph demonstrate new large left pleural effusion with diffuse bilateral pulmonary nodules better seen on CT dated ___.  There is additional shift of the mediastinum to the right with an enlarged heart.  Question pleural effusion.  No evidence of tamponade. There is collapse of the left lower lobe.  There is no pleural effusion on the right.  There is no pneumothorax.  A single chamber pacemaker is identified with its tip terminating in the  right ventricle in standard position. Impression: New left large pleural effusions with pulmonary nodules bilaterally.  Question enlarged heart with pleural effusion.  No evidence to suggest tamponade.    These findings were communicated to the ordering physician ___. ___ by Dr. ___ at 15:20 on ___.,Findings: Frontal and lateral chest radiograph demonstrate new large left pleural effusion with diffuse bilateral pulmonary nodules better seen on CT dated ___.  There is additional shift of the mediastinum to the right with an enlarged heart.  No diffuse bilateral pulmonary nodules.  No evidence of tamponade. There is collapse of the left lower lobe.  There is no pleural effusion on the right.  There is no pneumothorax.  A left-sided AICD device is noted with single lead terminating in the right ventricle in standard position. Impression: New left large pleural effusions with pulmonary nodules bilaterally.  No enlarged heart with pleural effusion.  No evidence to suggest tamponade.    These findings were communicated to the ordering physician ___. ___ by Dr. ___ at 15:20 on ___.,"['Change name of device', 'Add contradiction', 'False negation']"
d330d6ff-0193072b-e04fbffe-53b12b62-596738d1,54161955,16033763,"Impression: 1.  Two left chest tubes and a single-lead left-sided pacer remain in place.  There are multiple parenchymal pulmonary nodules consistent with known metastatic disease.  Small bilateral effusions, left greater than right again are seen.  In addition, there is a more focal patchy opacity at the left base which could reflect compressive atelectasis but also raises the possibility of pneumonia or aspiration.  Overall cardiac and mediastinal contours are stable. No pneumothorax is appreciated.","Impression: 1.  Two left chest tubes and a dual-chamber left-sided pacer remain in place.  There are no multiple parenchymal pulmonary nodules.  Small bilateral effusions, left greater than right again are seen.  In addition, there is a more focal patchy opacity at the left base which could reflect compressive atelectasis but also raises the possibility of pneumonia or aspiration.  Overall cardiac and mediastinal contours are stable. No pneumothorax is appreciated. Trace ascending aortic dilatation is noted.","['Change name of device', 'Add contradiction', 'False prediction']"
"a6c52f01-34a7d3e3-2a99de86-82d9a4b5-e07086f7, e345b77a-fc55fbb9-01aa8bc4-55067082-884ea7ba",55332727,16033763,"Findings: Frontal and lateral radiographs of the chest demonstrate diffuse bilateral pulmonary nodules which are unchanged from ___.  There has been interval increase in the size of the large left pleural effusion, now with some adjacent atelectasis in the left upper lung zone.  There is no pleural effusion in the right lung.  Again seen is a single-chamber pacemaker with tip terminating in the right ventricle, in the standard position.  No pneumothorax. Right-ward shift of the mediastinum is unchanged. Impression: Interval increase in size of large left-sided pleural effusion with adjacent  atelectasis.","Findings: Frontal and lateral radiographs of the chest demonstrate diffuse bilateral pulmonary nodules which are unchanged from ___.  There has been interval increase in the sze of the large left pleural effusion, now with some adjacent atelectasis in the left upper lung zone.  There is no abnormality in the right lung.  Again seen is a single-chamber ICD with tip terminating in the right ventricle, in the standard position.  No pneumothorax. Right-ward shift of the madiastinum is unchanged. Impression: Interval increase in size of large left-sided pleural effusion with no atelectasis.","['Change name of device', 'Add typo', 'False negation']"
377df2cf-286c0596-c5183178-7edd53f5-50475885,55725686,16033763,"Findings: As compared to the previous radiograph, the two left-sided chest tubes are in unchanged position.  Unchanged appearance of the small left pleural effusion and the multiple bilateral metastatic lung nodules.  Unchanged size of the cardiac silhouette.  The right costophrenic sinus is also blunted by a small effusion. ","Findings: As compared to the previous radiograph, the two left-sided cheers tubes are in unchanged position.  Unchanged appearance of the moderate left pleural effusion and the multiple bilateral metastatic lung nodules.  Unchanged size of the cardiac silhouette with new signs of coronary artery calcification.  The right costophrenic sinus is also blunted by a large effusion.  ","['Change severity', 'Add typo', 'False prediction']"
25142c57-f3723dbf-b7bd3225-66ec6472-ddc1c56c,56607012,16033763,"Findings: As compared to the previous radiograph, the patient has undergone thoracocentesis on the left.  The pleural effusion has slightly decreased in extent but still occupies approximately two-thirds of the left hemithorax.  There is no evidence of pneumothorax.  Unchanged appearance of the known bilateral extensive pulmonary nodules. ","Findings: As compared to the prvious radiograph, the patient has undergone thoracocentesis on the left.  The pleural effusion has slightly decreased in extent but still occupies approximately half of the left hemithorax. There is now evidence of pneumothorax.  Unchanged appearance of the known bilateral extensive pulmonary nodues.  A central venous line is present.","['Change severity', 'Add typo', 'Add medical device']"
4aec4b05-d210e192-896bee34-0cbe5e5a-634a75d2,56831830,16033763,"Findings: Portable semi-upright radiograph of the chest demonstrates interval decrease in the size of the left pleural effusion, which now occupies approximately half of the left hemithorax.  There is improved aeration of the left upper lobe.  Cardiomediastinal and hilar contours are unchanged.  Persistent rightward shift of the mediastinum.  Stable diffuse bilateral pulmonary nodules.  No pneumothorax. Impression: No pneumothorax.","Findings: Portable semi-upright radiograph of the chest demonstrates interval decrease in the size of the left pleural effusion, which now occupies approximately half of the right hemithorax.  There is improved eration of the left upper lobe.  Cardiomediastinal and hilar contours are unchanged.  Persistent rightward shift of the mediastinum.  A pacemaker is present. Stable diffuse bilateral pulmonary nodules.  No pneumothorax. ","['Change location', 'Add typo', 'Add medical device']"
91148fbd-f4022f33-a996798f-03c3a1fe-69f478ce,57627815,16033763,"Impression: PA and lateral chest compared to ___ through ___:  Small left pleural effusion has decreased since ___, basal pleural tube still in place.  Very large cardiac silhouette may have decreased slightly in size.  There is also the suggestion that some of the lung nodules in the right lung may be slightly smaller, but this determination is better made, particularly if there is substantial clinical significance, by CT scanning measurements.  Transvenous right ventricular pacer lead unchanged in position. No appreciable pneumothorax.","Impression: PA and lateral chest compared to ___ through ___:  Small left pleural effusion has decreased since ___, basal pleural tube still in place.  Very large cardiac silhouette may have decreased slightly in size.  Their is also the suggestion that some of the lung nodules in the right lung may be slightly smaller, but this determination is better made, particularly if there is substantial clinical significance, by CT scanning measurements.  Transvenous right ventricular pacer lead terminates in the right atrium. No appreciable pneumothorax.  Trace bilateral pleural effusions evident.","['Change position of device', 'Change to homophone', 'False prediction']"
"6127f936-4c93476d-3d0cb4aa-85926f79-3d24a610, d143c4e0-d50a23bf-396d59b8-12310813-0965c112",57701612,16033763,"Findings: There is a new 1.5 cm nodule within the left lower lobe, abutting the heart border on the AP view.  The lungs are otherwise clear.  There is no effusion, or pneumothorax.  There is unchanged hyperexpansion of the lungs.  The cardiac silhouette is unchanged in size, top normal.  A left pectoral pacemaker is unchanged in appearance, with a single ventricular lead remaining intact. Impression: New 1.5 cm nodule in the left lower lobe, in a patient with history of melanoma is concerning for metastasis.  Findings were discussed with ___ at 9:40 a.m. by phone.","Findings: There is a new 5.8 cm nodule within the left lower lobe, abutting the heart border on the AP view. The lungs are otherwise clear. There is no effusion, or pneumothorax. There is unchanged hyperexpansion of the lungs. The cardiac silhouette is unchanged in size, top normal. A left pectoral pacemaker is unchanged in appearance, with a single ventricular lead remaining intact. Impression: New 1.5 cm nodule in the left lower lobe, in a patient with history of melanoma is concerning for metastasis. Findings were discussed with ___ at 9:40 a.m. by phone. There is no evidence of nodules in the left lower lobe.","['Change measurement', 'Add contradiction', 'False prediction']"
81549ff4-37400bfe-77ebb7f7-9bf5005b-2a9a6381,58499222,16033763,"Findings: Frontal and lateral radiographs of the chest demonstrate persistent massive left-sided pleural effusion, occupying at least two-thirds of the left hemithorax.  Minimal aeration of the left upper lobe.  Slight interval increase in rightward shift of the mediastinum. Trace pleural effusion at the right base.  Again seen are diffuse bilateral pulmonary nodules which are unchanged from the prior study.  A single-chamber pacemaker is present with the tip terminating in the right ventricle. No pneumothorax. Impression: Large left pleural effusion with minimal aeration of the left upper lobe, and slight interval increase in rightward shift of the mediastinum.","Findings: Frontal and lateral radiographs of the chest demonstrate persistent massive left-sided pleural effusion, occupying at least two-thirds of the left hemithorax.  No aeration of the left upper lobe.  Slight interval increase in rightward shift of the mediastinum. Trace pleural effusion at the right base.  Again seen are diffuse bilateral pulmonary nodules which are unchanged from the prior study.  A dual-chamber pacemaker is present with the tip terminating in the right ventricle. No pneumothorax. Impression: Large left pleural effusion with minimal aeration of the left upper lobe, and slight interval increase in rightward shift of the mediastinum. Impression: Large left pleural effusion with minimal aeration of the left upper lobe, and slight interval increase in rightward shift of the mediastinum.","['Change name of device', 'Add repetitions', 'False negation']"
dedbcf5c-540d2883-d85fbcfd-dfec626d-9621d11b,59137251,16033763,"Findings: PA and lateral chest views were obtained with patient in upright position.  There is moderate cardiac enlargement.  The configuration suggests prominence of the left ventricular contour to the left and posteriorly as well as a moderate enlargement of the left atrium with some right-sided intracardiac double contour straightening of the left heart border.  A permanent pacer is in left anterior axillary position, seen to be connected to a single intracavitary electrode terminating in a position compatible with the right ventricle.  The pulmonary vasculature shows a mild upper zone redistribution pattern; however, no interstitial or alveolar edema is identified.  On the other hand, the marked irregular distribution of the pulmonary vessels in the periphery, coinciding with local areas of increased translucency and low position, flattened diaphragms is suggestive of COPD.  Acute parenchymal infiltrates, however, cannot be identified.  There is no pneumothorax in the apical areas.  In comparison with the next preceding chest examination of ___, the at that time postoperative existing left-sided chest wall emphysema has absorbed.  Also, the left basal postoperative linear small atectatic densities have normalized.  Also, noteworthy in comparison with the previous study is that the, at that time existing more marked cardiac enlargement and the bilateral small amount of pleural effusions have disappeared. ","Findings: PA and lateral chest views were obtained with patient in upright position.  There is no evidence of cardiac enlargement.  The configuration suggests prominence of the right ventricular contour to the left and posteriorly as well as a moderate enlargement of the right atrium with some right-sided intracardiac double contour straightening of the right heart border.  A permanent pacer is in the right anterior axillary position, seen to be connected to a single intracavitary electrode terminating in a position compatible with the left ventricle.  The pulmonary vasculature shows a mild upper zone redistribution pattern; however, there is evidence of interstitial or alveolar edema.  On the other hand, the marked irregular distribution of the pulmonary vessels in the periphery, coinciding with local areas of increased translucency and low position, flattened diaphragms is suggestive of COPD.  Diffuse parenchymal infiltrates, however, cannot be identified.  There is no pneumothorax in the apical areas.  In comparison with the next preceding chest examination of ___, the at that time postoperative existing left-sided chest wall emphysema has absorbed.  Also, the left basal postoperative linear small atectatic densities have normalized.  Also, noteworthy in comparison with the previous study is that the, at that time existing more marked cardiac enlargement and the bilateral small amount of pleural effusions have disappeared.  ","['Change position of device', 'Add contradiction', 'False negation']"
907d02e0-45812902-cf944cc5-0b4c93de-bfbab9ea,59614205,16033763,"Impression: AP chest compared to ___ through ___:  Small residual left pleural effusion or pleural thickening is unchanged since at least ___, now with only a single left drain in place at the base of the left hemithorax.  Left lower lobe is largely consolidated or collapsed.  Multiple pulmonary metastases are longstanding.  The heart moderately enlarged, whether due to cardiomegaly alone or in combination with pericardial effusion has not changed for several days.  The upper lobe pulmonary vasculature is engorged, but there is no pulmonary edema.  Transvenous right ventricular pacer lead unchanged in longstanding position.","Impression: AP chest compared to ___ through ___:  Small residual left pleural effusion or pleural thickening is unchanged since at least ___, now with only a single left drain in place at the base of the left hemithorax.  Left lower lobe is largely consolidated or collapsed.  Multiple pulmonary metastases are longstanding.  The heart severely enlarged, whether due to cardiomegaly alone or in combination with pericardial effusion has not changed for several days.  The upper lobe pulmonary vasculature is engorged, but there is know pulmonary edema.  Transvenous right ventricular pacer lead unchanged in longstanding position.  ET tube seen in the midline.","['Change severity', 'Change to homophone', 'Add medical device']"
052836b8-b02d3f46-3faf7e36-07ce1ba1-1052a8a6,50146664,16034181,"Findings: Cardiac silhouette has increased in size and is accompanied by widening of vascular pedicle, pulmonary vascular congestion, and moderate pulmonary edema.  Additionally, there small pleural effusions are present bilaterally, left greater than right. ","Findings: Cardiac silhouette has increased in size and is accompanied by widening of vascular pedicle, pulmonary vascular congestion, and mild pulmonary edema.  Additionally, there small pleural effusions are present bilaterally with a small left effusion.  There is no trace of any pleural effusions bilaterally.","['Change severity', 'Add contradiction', 'False prediction']"
"77e5731e-4cd67ee6-56cf33fa-772c6c6b-4e25a333, 9c83a18d-e7c2386f-1b090c1f-9d7c949f-ded90c8f",53395975,16034181,"Findings: Interval improvement in pulmonary edema with residual interstitial edema remaining.  Cardiac silhouette is stable in size, and note is made of a moderate hiatal hernia.  Bilateral small pleural effusions are also present.  Increased lung volumes are suggestive of COPD. Impression: 1.  Improving pulmonary edema with residual interstitial edema remaining as well as small bilateral pleural effusions. 2.  Moderate hiatal hernia.","Findings: Interval improvement in pulmonary edema with residual interstitial edema remaining. Cardiac silhouette is stable in size, and note is made of a small hiatal hernia. Bilateral small pleural effusions are also present. Increased lung volumes are suggestive of COPD. There is evidence of a right lower lobe nodule.  Impression: 1. Improving pulmonary edema with residual interstitial edema remaining as well as small bilateral pleural effusions. 2. Small hiatal hernia. ","['Change severity', 'Add typo', 'False prediction']"
"6bcf583e-601a494a-f8d72edd-76f3c0b7-1d606076, 739fbdc0-688ff77c-e70070b7-1e88db74-4482ae5c",56393323,16034181,Impression: AP chest compared to ___:  Pulmonary and mediastinal vascular engorgement have improved substantially since ___ and pleural effusions have nearly resolved.  Residual consolidation in both lower lobes is more pronounced than it was on ___ and therefore might well be pneumonia.  Extent of central adenopathy is underestimated by these conventional radiographs.  Calcified pleural plaques are visible to some extent.  Heart is normal size.  Emphysema distorts vascular pattern in the upper lobes.  Moderate size hiatus hernia accounts for fluid collection in the lower midline mediastinum.,Impression: AP chest compared to ___:  Pulmonary and mediastinal vascular engorgement have improved slightly since ___ and pleural effusions have nearly resolved.  Residual consolidation in both lower lobes is less pronounced than it was on ___ and therefore might well be pneumonia.  Extent of central adenopathy is underestimated by these conventional radiographs.  Calcified pleural plaques are not visible.  Heart is normal size.  Emphysema distorts vascular pattern in the upper lobes.  Mild size hiatus hernia accounts for fluid collection in the lower midline mediastinum.  Pulmonary and mediastinal vascular engorgement have significantly worsened and pleural effusions have nearly resolved entirely.,"['Change severity', 'Add contradiction', 'False negation']"
"7692121e-81594620-38286eb8-1059dec5-06a3d2b9, d64662cd-8c2f0d44-6c22f2a5-0ea0b918-cbc0c3f3",56963809,16034181,"Findings: There is slight increase in interstitial markings involving the right lung, particularly the right lung base, to a lesser extent the left lung base which may be due to chronic lung disease; however, atypical infection is not excluded.  No lobar consolidation is seen.  There is no large pleural effusion or pneumothorax.  The cardiac silhouette is top normal.  Aortic knob calcification is again seen.  Mediastinal contours are relatively stable. ","Findings: There is slight increase in interstitial markings involving the right lung, particularly the left lung base, to a lesser extent the left lung base which may be due to chronic lung disease; however, atypical infection is not excluded.  No lobar consolidation is seen.  There is no large pleural effusion or pneumothorax.  The cardiac silhouette is top normal.  Aortic knob calcification is again seen.  Mediastinal contours are relatively stable.  There is no large pleural effusion or pneumothorax.","['Change location', 'Add repetitions', 'False prediction']"
84f30297-39be3e30-021f9ceb-c14a866a-ff7053d3,58175663,16034181,"Findings: Mild cardiomegaly has increased in size compared to ___ with increased pulmonary vascular engorgement.  Small bilateral pleural effusions are unchanged, and the lungs are clear of focal consolidation. Impression: Increasing cardiomegaly and vascular congestion. Unchanged small bilateral pleural effusions.","Findings: Severe cardiomegaly has increased in size compared to ___ with increased pulmonary vascular engorgement.  Small bilateral pleural effusions are unchanged, and the lungs are clear of focal consolidation. The small bilateral pleural effusions are unchanged. Impression: Increasing cardiomegaly and vascular congestion. Unchanged small bilateral pleural effusions. A pacemaker is present.","['Change severity', 'Add repetitions', 'Add medical device']"
"95f4c351-08ade2e1-786e44a0-8d53ac86-c22dc8c7, bfa3140e-43c1a4f9-ad9f9649-57f9f1bd-08070a23",58564406,16034181,"Findings: Comparison is made to prior study from ___.  Heart size is upper limits of normal but is stable.  There is no focal consolidation, pleural effusion or signs for acute pulmonary edema.  There is likely a small pleural effusion on the left side, best seen on the lateral view. ","Findings: Comparison is made to prior study from ___.  Heart size is upper limits of normal but is stable.  There is no focal consolidation, pleural effusion or signs for acute pulmonary edema.  There is likely a small pleural effusion on the right side, best seen on the lateral view. Impression: No acute findings.","['Change location', 'Add contradiction', 'False negation']"
b399bd52-4c8c5e61-6bb23031-5843f7ed-c1134475,59599710,16034181,Findings: There appears to be slight interval increase in opacification overlying the right lower lobe.  There is stable mild-to-moderate cardiomegaly with mild pulmonary vascular engorgement.  There is no evidence of pulmonary edema.  There are small bilateral pleural effusions.  There is a stable hiatal hernia.  There is no evidence of pneumothorax.  The visualized osseous structures are unremarkable. Impression: Slight interval increase in consolidation overlying the right lower lobe concerning for pneumonia.,"Findings: There appears to be slight interval increase in pacification overlying the right lower lobe.  There is stable mild-to-moderate cardiomegaly with moderate pulmonary vascular engorgement.  There is no evidence of pulmonary edema.  There are no pleural effusions.  There is a stable hiatal hernia.  There is no evidence of pneumothorax.  The visualized osseous structures are remarkable. Impression: Slight interval increase in consolidation overlying the right lower lobe concerning for pneumonia.
","['Change severity', 'Change to homophone', 'False negation']"
e2ae7d0f-49a52396-70e65939-9f855049-f071b61c,55504968,16049879,"Findings: AP view of the chest demonstrates low lung volumes, which accentuate bronchovascular markings.  Retrocardiac opacity is noted.  There is no pleural effusion or pneumothorax.  The descending aorta appears tortuous.  The hilar and mediastinal silhouettes are unremarkable.  The heart size is top normal.  There is no pulmonary edema. Impression: Retrocardiac opacity may represent atelectasis or infection in the appropriate clinical setting.","Findings: AP view of the chest demonstrates low lung volumes, which accentuate bronchovascular markngs.  No opacity is noted.  There is no pleural effusion or pneumothorax.  The descending aorta appears normal.  The hilar and mediastinal silhouettes are unremarkable.  The heart size is top normal.  There is no pulmonary edema. An ICD is seen in the left upper chest. Impression: Retrocardiac opacity may represent atelectasis or infection in the appropriate clinical setting.","['False negation', 'Add typo', 'Add medical device']"
e04746db-68c79c74-d16fbc0d-489249c6-aa7df779,56784795,16126373,"Impression: Heart size is normal. Tortuous aorta is noted.  Mediastinal contours is unremarkable.  Lungs are hyperinflated.  No definitive evidence of lobectomy demonstrated. Questionable right upper lobe opacity might represent asymmetric emphysema or potentially other lung abnormality.  Left basal linear opacity most likely represent atelectasis.  Sclerotic lesion in the left humeral 's is partially imaged. Compression fractures in the thoracic spine and lumbar spine are multiple.  No pleural effusion or pneumothorax is seen.  Comparison to previously images as well as assessment with dedicated left shoulder and left humerus radiographs is required.  If prior imaging is not available, chest CT is required at current point.","Impression: Heart size is normal. Tortuous aorta is noted.  Mediastinal contours is unremarkable.  Lungs are hyperinflated.  No definitive evidence of lobectomy demonstrated. Questionable right lower lobe opacity might represent asymmetric emphysema or potentially other lung abnormality.  Left basal linear opacity most likely represent atelectasis.  Sclerotic lesion in the left humeral 's is partially imaged. Compression fractures in the thoracic spine and lumbar spine are multiple.  No pleural effusion or pneumothorax is seen.  Comparison to previously images as well as assessment with dedicated left shoulder and left humerus radiographs is required.  If prior imaging is not available, chest CT is required at current point. An ET tube is seen in the trachea. Compression fractures in the thoracic spine and lumbar spine are multiple.","['Change location', 'Add repetitions', 'Add medical device']"
"06d9c32d-19cead96-b9b762ac-207c77aa-8c6c7b93, f0cf07bf-52eaa447-3c2c74a7-55295a62-a962b099",56242356,16136825,"Findings: The lungs are clear. There is no effusion, consolidation, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. Impression: Normal chest x-ray.","Findings: The lungs are clear. There is no effusion, consolidation, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. There is a central venous line in place. Impression: Normal chest x-ray.","['False prediction', 'Add repetitions', 'Add medical device']"
"4dd888d7-5b44d24e-8c4900e9-9cdfc9ca-955574e9, aeeedb41-57ddfc8b-adfe8c04-c411349c-697bf972",54215495,16139394,Findings: PA and & lateral views of the chest were provided.  The lung volumes are low limiting assessment with bronchovascular crowding atelectasis in the lower lungs.  No convincing evidence of pneumonia.  No effusion or pneumothorax is seen.  The heart and mediastinal contours stable.  Bony structures are intact. Impression: No acute findings.,Findings: PA and & lateral views of the chest were provided. The lung volumes are low limiting assessment with bronchovascular crowding atelectasis in the upper lungs. Evidence of pneumonia. No effusion or pneumothorax is seen. The heart and mediastinal contours are stable. Bony structures reveal multiple fractures. Impression: No acute findings. Acute findings of pneumonia and multiple fractures.,"['Change location', 'Add contradiction', 'False prediction']"
"befedeee-9f8df55c-4957be6a-81c9d6ff-3f641e1c, f42f943b-33ff540e-c7e2236b-8b3315e2-4f3ad1d9",57198860,16139394,Findings: Cardiomediastinal contours are normal.  Small bilateral effusions are associated with adjacent atelectasis left greater than right. There is no pneumothorax. Impression: No evidence of pneumonia. Small bilateral effusions with adjacent small atelectasis,Findings: Cardiomediastinal contours are normal. Small bilateral effusions are associated with adjacent atelectasis right greater than left. There is no pneumothorax. There is no pneumothorax. Impression: No evidence of pneumonia. Small bilateral effusions with adjacent large atelectasis,"['Change location', 'Add repetitions', 'False prediction']"
"0eb9ee33-ffd77386-6061cb30-c7531616-16a975c7, f2d4b82f-bbc3f47a-ffa13252-797ba37a-e52591b3",57800025,16143638,Findings: The lungs are well inflated and clear.  Heart size is normal and mediastinal contours are unremarkable.  No pleural effusion or pneumothorax.  Osseous structures are intact. Impression: No acute cardiopulmonary process.,Findings: The lungs are well inflated and clear. Heart size is normal and mediastinal contours are unremarkable. No pleural effusion or pneumothorax. Osseous structures are in tack. Impression: No acute cardiopulmonary process. Small bilateral pleural effusions are present. Consider interval placement of an ICD.,"['Change to homophone', 'Add contradiction', 'Add medical device']"
"0cc44261-ed5a16ac-1b5e4caa-120d5908-ecdef9aa, 6c4ce28b-408c6a59-f54ae6fe-dc6b0ebf-c5c1cc34",52402962,16145265,Findings: Cardiomediastinal silhouette is normal.  There is no pleural effusion or pneumothorax.  There is no focal lung consolidation. Impression: No evidence of pneumonia.,Findings: Cardiomediastinal seelhouette is normal. Their is no pleural effusion or pneumothorax.  There is no focal lung consolidation. Impression: No evidence of pneumonia. A central venous line is noted in the right atrium.,"['Change to homophone', 'Add typo', 'Add medical device']"
964b2018-3d3a8dc6-c637225e-16e9a8f8-dabd5c4c,55123749,16145265,Findings: Cardiac silhouette is upper limits of normal in size.  Mediastinal and hilar contours as well as pulmonary vascularity are within normal limits.  Lungs and pleural surfaces are clear.  No acute skeletal findings. Impression: No acute cardiopulmonary radiographic abnormality.,Findings: Cardiac silhouette is upper limits of normal in size.  Mediastinal and hilar contours as well as pulmonary vascularity are within normal limits.  Lungs and pleural surfaces are clear.  No acute skeletal findings. There is an NG tube in place.  Mediastinal and hilar contours as well as pulmonary vascularity are within normal limits. Impression: No acute cardiopulmonary radiographic abnormality.,"['Change location', 'Add repetitions', 'Add medical device']"
"b8d59f8b-a58efaf2-9c361139-8ce4f7c1-6f948185, d33d3e27-8bcf7569-af70ab28-bf25119c-49421ca2",52514999,16159370,"Findings: There is a persistent nodular opacity projecting over the right mid lung measuring approximately ___ x 15 mm for which CT is recommended to further assess. In addition, there is right basal atelectasis. The possibility of additional nodules is difficult to entirely exclude. There is subtle opacity adjacent to left heart border on the frontal projection which could represent a prominent fat pad versus a very early pneumonia.  No large effusions are present. Calcified pleural plaque is noted on the lateral projection along the posterior pleural surface. The cardiomediastinal silhouette is stable. Bony structures are intact. Impression: 1. Nodular opacity projecting over the right mid lung, as seen previously and chest CT is again recommended to further assess. 2. Additional subtle opacities in the right and left lower lungs which could represent atelectasis though the possibility of pneumonia is difficult to entirely exclude.","Findings: There is a persistent nodular opacity projecting over the right mid lung measuring approximately ___ x 20 mm for which CT is recommended to further assess. In addition, there is right bassal atelectasis. The possibility of additional nodules is difficult to entirely exclude. There is subtle opacity adjacent to left heart border on the frontal projection which could represent a prominent fat pad versus a very early pneumonia. No large effusions are present. Calcified pleural plaque is noted on the lateral projection along the posterior pleural surface. The cardiomediastinal silhouette is stable. Bony structures are intact. Pacemaker leads are present overlying the cardiac silhouette. Impression: 1. Nodular opacity projecting over the right mid lung, as scene previously and chest CT is again recommended to further assess. 2. Additional subtle opacities in the right and left lower lungs which could represent atelectasis though the possibility of pneumonia is difficult to entirely exclude.","['Change measurement', 'Change to homophone', 'Add medical device']"
"0e520ceb-6ba1ce12-002ff44a-de5c0d2f-ea9aa2b7, 9f1b0e81-d1968ae2-d78e5c31-fb737c29-9ef07a21",59479332,16159370,Impression: Small right pleural effusion.  Right lower lobe lung nodules.  CT is recommended.,Impression: Large right pleural effusion.  No lung nodules.  CT is recomended.,"['Change severity', 'Add typo', 'False negation']"
"6f4705d9-33c6c0d9-d5c126c5-2710e4b6-1738c4bb, 95cfd9d1-1dc7b97a-63def69d-8bf200f9-46598573",50937713,16172396,Findings: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Impression: No evidence of acute cardiopulmonary process.,Findings: The lungs are whale expanded and clear. Cardiomediastinal and hilar counters are unremarkable. There is no pleural effusion or pneumothorax. Impression: No evidence of acute cardiopulmonary process.,"['Add typo', 'Change to homophone', 'False negation']"
"515940a1-1597d869-4cd954d5-3c00a8fd-91659a8f, fe24eab1-ee7ade48-c989c10b-512e9081-036b7c17",51932011,16172396,"Findings: No focal consolidation, pleural effusion, pneumothorax or pulmonary edema is seen.  Heart and mediastinal contours are within normal limits. Impression: No radiographic evidence for acute cardiopulmonary process.  Sensitivity of routine chest radiography for rib fracture is low.  This study is not tailored for evaluation of the left shoulder.","Findings: No focal consolidation, pleural effusion, pneumothorax or pulmonary edema is seen.  Heart and mediastinal contours are within normal limits. No radiographic evidence for acute cardiopulmonary process.  Sensitivity of routine chest radiography for rib fracture is low.  This study is not tailored for evaluation of the shoulder.","['Change location', 'Add repetitions', 'False negation']"
81363533-9fe25452-24a77836-eecde8c5-555eff61,54875360,16172396,"Findings: Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. Chronic left rib fracture is stable. Impression: No acute cardiopulmonary process.","Findings: Heart size and cardiomediastinal contours are nomral. Lungs are clear without focal consolidation, pleural effusion, or pnumothorax. Chronic right rib fracture is stable. A central venous line is present. Impression: No acute cardiopulmonary process.","['Change location', 'Add typo', 'Add medical device']"
"69993378-c937a43f-67393866-a501ac76-1a78ed84, c5f10e5a-dbd419da-3540dd16-cd0fd3e3-90769d0d",55812319,16172396,"Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  There is no pleural effusion or pneumothorax.  Minimal left basilar opacity suggests minor atelectasis.  Otherwise, the lungs appear clear.  Small osteophytes are noted along the lower thoracic spine. Impression: No evidence of injury.","Findings: The heart is normal in signs.  The mediastinal and hilar contours appear within normal limits.  There is mild pleural effusion.  Minimal left basilar opacity suggests severe atelectasis.  Otherwise, the lungs appear clear.  Small osteophytes are noted along the lower thoracic spine. The right lung shows a large nodule. Impression: No evidence of pneumonia.","['Change severity', 'Change to homophone', 'False prediction']"
"47bc92de-7c76c78d-2af6018d-6625e000-3f694250, f7dc11e5-43c374d7-48d89864-86815a5f-388045ef",58362071,16172396,"Findings: Since prior, there is no significant interval change.  Heart size and cardiomediastinal contours are normal.  The lungs are clear without focal consolidation. There is no pneumothorax or pleural effusion.  Chronic left rib fracture, again seen. Impression: No radiographic explanation for chest pain.","Findings: Since prior, there is no significant interval change. Heart size and cardiomediastinal contours are normal. The lungs show a focal consolidation in the left lower lobe. There is no pneumothorax or pleural effusion. Chronic right rib fracture, again seen. Impression: Chronic left rib fracture, again seen. There is a subtle pneumothorax present on the right side. Impression: No radiographic explanation for chest pain. ","['Change location', 'Add contradiction', 'False negation']"
"2a8b4162-428841d5-78833596-19ea5555-bfe4701b, c2fc9ae4-da3745b6-66a1c465-1739af85-f61fa22d",59945120,16172396,Findings: Lung volumes are somewhat low but clear.  The cardiomediastinal silhouette and contour are within normal limits.  There is no pleural effusion or pneumothorax.  Old lateral left eighth rib fracture is again noted.  There is atelectasis at the left lung base. Impression: No acute cardiopulmonary process.,Findings: Lung volumes are somewhat low but deer. The cardiomediastinal silhouette and contour are within normal limits. There is no pleural effusion or pneumothorax. No rib fracture is noted. There is atelectasis at the right lung base. Impression: No acute cardiopulmonary process.,"['Change location', 'Change to homophone', 'False negation']"
"25b7b359-8e6a6c36-b65ed616-8a74bb54-a2ff39b0, 604f38a3-9910dd87-7fff1923-fd7b0ea5-228ab209",50957128,16185004,"Findings: PA and lateral views of the chest are obtained.  The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax.  Heart and mediastinal contours appear normal.  The imaged osseous structures are intact. Bony structures are intact.  No free air below the right hemidiaphragm. Impression: No signs of pneumonia or other acute intrathoracic process.","Findings: PA and lateral views of the test are obtained.  The lungs are clear unilaterally without focal consolidation, effusion, or pneumothorax.  Heart and mediastinal contours appear normal.  The imaged osseous structures are intact. No imaged bony structures are seen.  No free air below the hemidiaphragm. Impression: No signs of pneumonia or other acute intrathoracic process.","['Change location', 'Change to homophone', 'False negation']"
"26ef2bde-ae5cf661-f6e14469-48db7dad-b0df367b, ad7d1cde-f67b3e6f-3420f812-641b1b2f-b2441e48",52663873,16197098,"Findings: The mediastinum appears widened especially comparatively to the most recent prior chest x-ray however some of this may be due to low lung volumes. The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Impression: Widened mediastinum which could be secondary to many factors including low lung volumes however acute aortic pathology cannot be ruled out on the basis of this radiograph.  On attending readout comment is also noted that the tissue posterior to the sternum was thickened. All these findings are probably due to low lung volumes and a repeat PA and lateral radiograph with full inspiration would be able to better assess the situation.  Updated findings after attending readout discussed with ___ at 8:36 AM via telephone. Initial findings discussed with ___ at 5:20 AM via telephone.","Findings: The mediastinum appears widened especially comparatively to the most recent prior chest x-ray however some of this may be due to low lung volumes. The left lung is clear. There is evidence of pneumonia, pneumothorax, or pleural effusion. Impression: Clear mediastinum which could be secondary to many factors including low lung volumes however acute aortic pathology cannot be ruled out on the basis of this radiograph. On attending readout comment is also noted that the tissue posterior to the sternum was not thickened. All these findings are probably due to low lung volumes and a repeat PA and lateral radiograph with full expiration would be able to better assess the situation. Updated findings after attending readout discussed with ___ at 8:36 AM via telephone. Initial findings discussed with ___ at 5:20 AM via telephone.","['Change location', 'Add contradiction', 'False prediction']"
"650516b3-439d0dea-680516d1-3c26e80b-256331d6, 94559fca-c712619f-88d28bb4-241c950e-94d1d4a5",59563273,16265536,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. Heart size is normal. Impression: Heart size is normal.,Findings: The lungs are clear without focal consolidation. There is a right pleural effusion noted. No pleural effusion or pneumothorax is seen. There is a pacemaker wire in the right atrial. Heart size is normal. Impression: Heart sighs is normal.,"['False prediction', 'Change to homophone', 'Add medical device']"
"54f34ace-b673e34d-666a3e31-c6a5c29c-522115e8, 918b3685-2e9bcd30-3df57797-5bff4c65-4437c8b5",50092703,16287857,"Findings: Frontal and lateral views of the chest were obtained.  The lung volumes are slightly low.  No focal consolidation, pleural effusion or evidence of pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest were otbained.  The lung volumes are slightly low.  No focal consolidation, pleural effusion or evidence of pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable. Impression: There is no cardiopulmonary process.","['Change location', 'Add typo', 'False negation']"
"6335e62d-9f32c216-fe6daed7-0a47391b-37301bf0, 81578882-b1396f5d-136ebceb-d7043f2c-1a9b6643",50020535,16288388,Findings: Lungs are clear.  Cardiac silhouette is normal.  There is no pleural effusion or pneumothorax. Impression: No evidence of acute cardiopulmonary process.,Findings: Lungs are clear.  Cardiac silhouette is normall.  There is no pleural effusion or pneumothorax. A central venous line is seen in place. Impression: No evidence of acute cardiopulmonary process.,"['Add medical device', 'Add typo', 'False negation']"
"88848743-c43a0962-5d8b16f5-85267238-f8d9cd7e, d72d1448-74360537-0c5320ca-23c189dc-6d06a97a",50432710,16289688,Findings: Left pectoral pacemaker has a lead terminating in the right ventricle.  There are small bilateral pleural effusions and right lung base atelectasis.  Cardiomediastinal silhouette is normal size.  No evidence of pulmonary edema is identified. Impression: Small bilateral pleural effusions and right lung base atelectasis.,Findings: Left pectoral pacemaker has a lad terminating in the right ventricle.  There are no pleural effusions or right lung base atelectasis.  Cardiomediastinal silhouette is normal size.  No evidence of pulmonary edema is identified. Impression: Large bilateral pleural effusions and right lung base atelectasis.,"['Change severity', 'Add typo', 'False negation']"
9b254c46-2e16d5a7-6017b84a-9c1de7d5-43037945,56891018,16289688,Impression: No evidence of acute cardiopulmonary abnormalities.,Impression: No evidence of acute cardiopulmonary abnormalities. There is a small right-sided pleural effusion.,"['Change to homophone', 'Add typo', 'False prediction']"
b3e3432f-8de35a57-84779127-6d36d4db-a8e9317f,50173042,16306599,"Findings: Single AP upright portable view of the chest was obtained.  The right costophrenic angle is not fully included on the image.  Given this, no definite focal consolidation is seen.  There is left base atelectasis.  No large pleural effusion or evidence of pneumothorax is seen.  The cardiac silhouette is top normal to mildly enlarged.  The aorta is somewhat tortuous.  No overt pulmonary edema is seen. Impression: Left costophrenic angle not fully included on the image.  Otherwise, aside from top normal to mildly enlarged cardiac silhouette, no acute cardiopulmonary process seen.","Findings: Single AP upright portable view of the chest was obtained.  The right costophrenic angle is not fully included on the image.  Given this, no definite focal consolidation is seen.  There is left base atelectasis.  No large pleural effusion or evidence of pneumothorax is scene.  The cardiac silhouette is top normal to severely enlarged.  The aorta is somewhat tortuous.  No overt pulmonary edema is seen.  A central venous line is present.  Impression: Left costophrenic angle not fully included on the image.  Otherwise, aside from top normal to mildly enlarged cardiac silhouette, no acute cardiopulmonary process seen.","['Change severity', 'Change to homophone', 'Add medical device']"
1e7c453c-c31a14f7-14ffd1e5-de7ac337-07746c5f,57547177,16307530,Findings: There is mild pulmonary vascular engorgement.  Moderate compressive atelectasis and pregnancy may be contributing to slight enlarged appearance of the heart on this portable film.  No pneumothorax or pulmonary edema. Impression: Mild pulmonary vascular engorgement without pulmonary edema.  No chest x-ray findings suggestive of aortic dissection.,Findings: There is moderate pulmonary vascular engorgement.  Moderate compressive atelectasis and pregnancy may be contributing to slight enlarged appearance of the hart on this portable film.  No pneumothorax or pulmonary edema. A central venous line is seen in the superior vena cava. Impression: Moderate pulmonary vascular engorgement without pulmonary edema.  No chest x-ray findings suggestive of aortic dissection.,"['Change severity', 'Change to homophone', 'Add medical device']"
"04f641c1-61030285-70b766ad-7189c11b-64101452, 374b061d-8ac364d9-175a127c-5c6cff5a-98e8a57c",51991869,16319384,"Findings: PA and lateral views of the chest.  Moderate cardiomegaly is unchanged.  Calcification in the aortic knob is unchanged.  Compared to study of ___, the pulmonary edema has resolved.  There is no focal consolidation or pleural effusion or pneumothorax.  There is mild scarring at the apices. Impression: No acute cardiopulmonary process.  Moderate cardiomegaly.","Findings: PA and lateral views of the chest. Mild cardiomegaly is unchanged. Calcification in the aortic knob is unchanged. Compared to study of ___, the pulmonary edema has resolved. There is no focal consolidation or pleural effusion or pneumothorax. There is mild scarring at the apices. Calcification in the aortic knob is unchanged. There is a central venous line in place. Impression: No acute cardiopulmonary process. Mild cardiomegaly.","['Change severity', 'Add repetitions', 'Add medical device']"
"804b8d22-6d1eb472-77b4a9b3-2a62bd27-a1d390a9, ada0238f-cfaaf77c-c0ff1c4c-fcb44ece-427e82d7",52386935,16319384,"Findings: In comparison with study of ___, there is now a dual-channel pacer device in place with leads extending to the right atrium and region of the apex of the right ventricle.  Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. ","Findings: In comparison with study of ___, there is now an aortic stent in place with leads extending to the right atrium and region of the apex of the right ventricle.  Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.  Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.","['Change name of device', 'Add repetitions', 'False negation']"
"69fad06e-4d630395-0c622820-20e6af98-5a01aaa4, a564f5aa-11095b55-eb10d3ee-29363be4-e6a39536",53447884,16319384,Findings: Subtle heterogeneous opacity in the right lower lobe could reflect pneumonia in the appropriate clinical situation.  Small amount of left lower lobe atelectasis.  No pleural effusion or pneumothorax.  The heart is normal in size.  Aortic knob calcifications are unchanged.  No acute osseous abnormality.  Left-sided pacemaker wires are unchanged with 1 tip projecting over the right atrium and the other over the right ventricle. Impression: Subtle heterogeneous opacity of the right lower lobe could reflect pneumonia or aspiration in the appropriate clinical situation.  Short term follow-up radiograph may be helpful to ensure resolution.,Findings: Subtle heterogeneous opacity in the left lower lobe could reflect pneumonia in the appropriate clinical situation. Small amount of left lower lobe atelectasis.  No pleural effusion or pneumothorax.  The heart is small in size.  Aortic knob calcifications are unchanged.  No acute osseous abnormality.  Left-sided pacemaker wires are unchanged with 1 tip projecting over the right atrium and the other over the mid SVC. Impression: Subtle heterogeneous opacity of the right lower lobe could reflect pneumonia or aspiration in the appropriate clinical situation. Short term follow-up radiograph may be helpful to ensure resolution. Mild pulmonary edema and small bilateral pleural effusions.,"['Change position of device', 'Add contradiction', 'False prediction']"
"192b6e3d-ec405303-9b315b5d-1dd90a9c-e6310078, 37641a6c-936a1ec4-1d6a445f-5c18d5b0-23f15501",55608147,16319384,"Findings: There are no focal opacities.  The patient has prominent epicardial fat pads with blunting of the left pleural sulcus and the right cardiophrenic angle, but this is unchanged compared with ___.  Mild-to-moderate cardiomegaly is present, but the cardiomediastinal contour is unremarkable otherwise.  There is no pleural effusion or pneumothorax. Impression: No evidence of acute cardiopulmonary process.","Findings: There are no focal opacities.  The patient has prominent epicardial fat pads with blunting of the left pleural sulcus and the right cardiophrenic angle, but this is unchanged compared with ___.  Mild-to-moderate cardiomegaly is present, but the cardiomediastinal contour is unremarkable otherwise.  Mild-to-moderate cardiomegaly is present, but the cardiomediastinal contour is unremarkable otherwise.  There is no pleural effusion or pneumothorax. An NG tube is present and terminates in the stomach. Impression: No evidence of acute cardiopulmonary process.","['Change location', 'Add repetitions', 'Add medical device']"
17cf7f7c-b27bc3f4-e902bbcb-b4c608b1-5984f415,58022694,16319384,"Findings: Single frontal portable view of the chest was obtained.  The heart is moderately enlarged, similar to prior.  There is calcification of the aortic knob.  The pulmonary vasculature is indistinct, compatible with mild pulmonary edema.  Small bilateral pleural effusions are present.  No pneumothorax.  Osseous structures are unremarkable.  No radiopaque foreign body. Impression: Mild pulmonary edema with small bilateral pleural effusions.","Findings: Single frontal portable view of the mid-abdomen was obtained.  The heart is normal in size.  There is calcification of the left aortic knob.  The pulmonary vasculature is indistinct, compatible with mild pulmonary edema.  No pleural effusions are present.  No pneumothorax.  Osseous structures are unremarkable.  No radiopaque foreign body. Impression: No signs of pulmonary edema.","['Change location', 'Change to homophone', 'False negation']"
"0a74b069-d42f7547-3e94c466-f893a9b5-926affec, 5efde2e0-1abd8e7b-6640d706-7a336bf2-cc8b21b0",58808936,16319384,"Findings: Frontal and lateral chest radiographs demonstrate cardiomediastinal contours are unchanged.  Appearance of a left lower lung opacification on the frontal view appears to correspond with a prominent pericardial fat pad, better assessed on the lateral view and stable across multiple prior chest radiographs.  Overall, lungs appear clear.  No pleural effusion or pneumothorax is identified.  Aortic knob calcifications again identified. Impression: No acute intrathoracic process. No overt pulmonary edema.","Findings: Frontal and medial chest radiographs demonstrate cardiomediastinal contours are unchanged.  Appearance of a left lower lung opacification on the frontal view appears to correspond with a prominent pericardial fat pad, better assessed on the lateral view and stable across multiple prior chest radiographs.  Overall, lungs appear clear.  No pleural effusion or pneumothorax is identified.  Aortic knob calcifications again identified. Impression: No acute intrathoracic process.  No overt pulmonary addema. There is a presence of a central venous line.","['Change location', 'Change to homophone', 'Add medical device']"
"4a0e4892-05ce6193-0cd30bb3-2ab7b697-539ea57d, f90a985b-e0ebbe62-bfe40107-e99c6162-7df4b246",59369376,16319384,"Findings: PA and lateral views of the chest.  Left-sided pacemaker wires are stable.  There is no focal consolidation, pleural effusion or pneumothorax.  The cardiomediastinal and hilar contours are normal. Impression: No acute cardiopulmonary process.","Findings: PA and lateral views of the chest. Left-sided pacemaker wires are projecting near the right atrium. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. Impression: No acute cardiopulmonary process.","['Change position of device', 'Change to homophone', 'False negation']"
"bb5c15b8-775b1e4a-d704d49b-19215671-ce9ffb25, c06025b9-935d32ff-0efabf34-2f711ce7-e4fc7000",59631748,16319384,"Findings: PA and lateral chest radiographs demonstrate a left chest dual pacing device, its leads which appear intact and stable in position.  Heart size is mildly enlarged.  There is central vascular engorgement without overt evidence of pulmonary edema.  Blunting of the left costophrenic angle is likely atelectatic in etiology.  There is no pleural effusion or pneumothorax. There is no evidence to suggest pneumonia. Impression: Mild central vascular engorgement without overt pulmonary edema or pneumonia.","Findings: PA and lateral chest radiographs demonstrate a left chest dual defibrillator device, its leads which appear intact and stable in position.  Heart size is mildly enlarged.  There is central vascular engorgement without overt evidence of pulmonary Ada.  Blunting of the left costophrenic angle is likely atelectatic in etiology.  No blunting is noted.  There is no pleural effusion or pneumothorax. There is no evidence to suggest pneumonia. Impression: Mild central vascular engorgement without overt pulmonary edema or nodules.","['Change name of device', 'Change to homophone', 'False negation']"
"7c8ae529-1be1249d-ea74aa33-e2075e92-d36b66f3, 8e6a0848-5eb51eaf-ff31f21a-a030a9fb-daef4652",59964362,16319384,"Findings: Heart size remains moderately enlarged but unchanged.  The aortic knob is diffusely calcified.  Pulmonary vascularity is not engorged.  No focal consolidation, pleural effusion or pneumothorax is present.  There are mild degenerative changes within the thoracic spine.  Surgical clip is seen within the upper abdomen on the lateral view. Impression: No acute cardiopulmonary abnormality.","Findings: Heart size remains mildly enlarged but unchanged. The aortic knob is diffusely calcified. Pulmonary vascularity is slightly engorged. No focal consolidation, pleural effusion or pneumothorax is present. Impression: Mild right pleural effusion and thoracic vertebral degeneration persist. There are moderate degenerative changes within the thoracic spine.  Surgical clip is seen within the upper abdomen on the lateral view. Impression: No acute cardiopulmonary abnormality.","['Change severity', 'Add contradiction', 'False prediction']"
"35ab1e49-b049f284-ba901484-a52ba49e-053d2c10, 680b5549-8b23749a-6d908684-c364b8db-473d4e7e",50825553,16346354,Findings: The lungs are hyperinflated.  Blunting of the right lateral costophrenic angle is chronic and likely due to component pleural scarring.  Superimposed trace effusions are also possible.  Streaky left basilar opacities are likely atelectasis.  There is mild pulmonary vascular congestion without overt edema. Cardiac enlargement is stable compared to prior.  Atherosclerotic calcifications noted at the aortic arch.  No acute osseous abnormalities. Impression: Cardiomegaly with mild vascular congestion without overt edema or focal consolidation.,Findings: The lungs are hyperinflated. Blunting of the right lateral costophrenic angle is chronic and likely due to component plural scarring. Large superimposed trace effusions are also possible. Streaky left basilar opacities are likely atelectasis. There is moderate pulmonary vascular congestion without overt edema. Cardiac enlargement is stable compared to prior. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities. Presence of a pacemaker with leads projecting over the right heart border. Impression: Cardiomegaly with moderate vascular congestion without overt edema or focal consolidation.,"['Change severity', 'Change to homophone', 'Add medical device']"
e0ffdf00-50f31921-d4eb21c6-2f9c26c8-fa5a40e8,52144904,16346354,"Findings: Interval placement of a left chest wall biventricular pacemaker/AICD is noted.  Calcification of the aortic arch  Recommend PA and lateral radiographs to evaluate for lead positioning.  Cardiac silhouette is enlarged  Lungs are clear  No pneumothorax.   This preliminary report was reviewed with Dr. ___, ___ radiologist. Impression: As above.  RECOMMENDATION(S):  Lateral radiograph is recommended","Findings: Interval placement of a left chest wall biventricular pacemaker/AICD is noted.  Calcification of the aortic arch  Recommend PA and lateral radiographs to evaluate for lead positioning.  Cardiac silhouette shows mild cardiomegaly.  Left base opacity noted.  No pneumothorax.   This preliminary report was reviewed with Dr. ___, ___ radiologist. Impression: As above.  RECOMMENDATION(S):  Lateral radiograph is recommended.  Lateral radiograph is recommended","['Change position of device', 'Add repetitions', 'False prediction']"
"92a5d6c1-3f56ede1-91a82ea3-97a0a28c-b540ac54, e0a6f265-a3ad624e-1a24c5ee-d4931cd9-612caad9",55299733,16346354,"Findings: Mild cardiomegaly is present with left ventricular configuration of the heart. Aorta is tortuous, and pulmonary vascularity is normal.  Focal linear scar in the lingula is present as well as localized appear pleural and parenchymal scarring at the right base, with latter unchanged since the prior study.  There is no pleural effusion Impression: Cardiomegaly without evidence of congestive heart failure.","Findings: Severe cardiomegaly is present with left ventricular configuration of the heart. Aorta is tortuous, and pulmonary vascularity is normal.  Focal linear scar in the lingula is present as well as localized appear pleural and parenchymal scarring at the right base, with latter unchanged since the prior study.  There is no pleural effusion A pacemaker is noted in the left upper chest. Impression: Cardiomegaly without evidence of congestive heart failure.","['Change severity', 'Change to homophone', 'Add medical device']"
"195e59ff-99dfa45c-784404dd-c284ed2f-d30e03e4, 4dd14141-717a2a23-ca41af2c-d7723505-840e9c37",55956507,16346354,Findings: The cardiac and mediastinal silhouettes are stable.  Hilar contours are stable.  There is persistent blunting of the right costophrenic angle.  There is mild increased interstitial markings bilaterally suggesting interstitial edema.  Left mid lung atelectasis is linear.  No pneumothorax is seen. Impression: Cardiomegaly and interstitial pulmonary edema.  Persistently prominent hila may be due to pulmonary are partial hypertension.  .,Findings: The cardiac and mediastinal silhouettes are stable.  Hilar contours are massively abnormal.  There is persistent blunting of the right costophrenic angle.  There is severe increased interstitial markings bilaterally suggesting interstitial edema.  Left mid lung atelectasis is not present.  Pneumothorax is seen. Impression: Cardiomegaly and interstitial pulmonary edema.  Persistently prominent hila may be due to pulmonary are partial hypertension. Fractured right third rib..,"['Change severity', 'Add contradiction', 'False prediction']"
"9e908d18-6a7658db-5a1fbbaa-b26ea86f-ce549cba, f58f13fc-5e0dd5d2-eb74ea1e-e45cb8dd-be5cda6e",56181168,16346354,"Findings: The cardiac, mediastinal and hilar contours appear stable including mild to moderate cardiac enlargement including a left ventricular configuration.  The aorta is mildly tortuous and calcified.  The cardiac, mediastinal and hilar contours appear stable.  Streaky scarring in the lingula is unchanged.  Fissures are  slightly thickened, which is somewhat increased suggesting mild vascular congestion.  There is a new trace pleural effusion on the left.  Slight pleural thickening of the right is probably unchanged.  Increased interstitial opacity in the right lower lung, although regional, may represent vascular congestion.  There is no pneumothorax.  No definite fracture is seen. Impression: Findings suggest mild vascular congestion.  No definite rib fracture identified.  Dedicated rib series would be more sensitive to detect rib fracture if needed clinically.","Findings: The cardiac, mediastinal and hilar contours appear stable including mild to moderate cardiac enlargement including a right ventricular configuration.  The aorta is mildly tortuous and calcified.  The cardiac, mediastinal and hilar contours appear stable.  Streaky scarring in the lingula is unchanged.  Fissures are slightly thickened, which is somewhat increased suggesting mild vascular congestion.  There is no pleural effusion.  Slight pleural thickening of the left is probably unchanged.  Increased interstitial opacity in the right lower lung, although regional, may represent vascular congestion.  There is no pneumothorax.  No definite fracture is seen. Impression: Findings suggest mild vascular congestion.  No definite rib fracture identified.  Dedicated rib series would be more sensitive to detect rib fracture if needed clinically.","['Change location', 'Change to homophone', 'False negation']"
"0b54a128-2cfacc36-cc674a81-fd5c16c5-78bc9882, 81352ea3-46dd9764-71a8e980-798f84b0-45f4f3e5",59889283,16346354,"Findings: An ICD is in place.  1 lead overlies right atrium AND AN other overlies the right ventricle.  The third lead courses posteriorly and lies in the expected location of the coronary sinus.  There is a small effusion at the right costophrenic angle.  There is probable atelectasis with a small curvilinear sliver of air in between.  This is less likely to represent a RIGHT LUNG BASE pneumothorax, as there is no corresponding abnormality on the lateral view.  Left costophrenic sulcus is clear.  No overt CHF or focal infiltrate identified.  No apical pneumothorax detected.  Background hyperinflation likely present, similar to prior Impression: ICD leads over right atrium, right ventricle, and in region of coronary sinus.  Probable atelectasis and small right pleural effusion new or more pronounced than on ___.  Right lung base pneumothorax is considered much less likely.  Attention to this area on followup films is requested.","Findings: An AICD is in place.  1 lead overlies rigth atrium and another overlies the right ventricle.  The third lead courses posteriorly and lies in the expected location of the coronary sinus.  There is a large right lower lobe consolidation.  There is probable atelectasis with a small curvilinear sliver of air in between.  This is less likely to represent a right lung base pneumothorax, as there is no corresponding abnormality on the lateral view.  Left costophrenic sulcus is clear.  No overt CHF or focal infiltrate identified.  No apical pneumothorax detected.  Background hyperinflation likely present, similar to prior Impression: AICD leads over right atrium, right ventricle, and in region of coronary sinus.  Probable atelectasis and small right pleural effusion new or more pronounced than on ___.  Right lung base pneumothorax is considered much less likely.  Attention to this area on followup films is requested.","['Change name of device', 'Add typo', 'False prediction']"
"83695c6b-ee90db45-0662a38e-4f2ccb17-6bd5ab83, cc802574-9ed7ecb7-b29eaa57-59092e24-9e774cdf",55304215,16389477,"Findings: On the second image, the ET tube tip is 4.4 cm from the carina.  Enteric tube seen with tip in the gastric body.  Low lung volumes seen with crowding of the bronchovascular markings and bibasilar atelectasis.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: ET and enteric tubes appropriately positioned.","Findings: On the second image, the ET tube tip is 5.3 cm from the carina.  Enteric tube seen with tip in the gastric body.  Low lung volumes scene with crowding of the bronchovascular markings and bibasilar atelectasis.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities.  There is a presence of a central venous line. ","['Change measurement', 'Change to homophone', 'Add medical device']"
e139be8f-a49d5442-2bd59848-b929b102-ab36ea25,53036112,16413061,"Impression: An NG tube terminates in the stomach with side port beyond the expected location the gastroesophageal junction.  Partially visualized diffusely dilated air-filled loops of small bowel appear likely represent ileus or obstruction.  A left Port-A-Cath terminates in the right atrium, unchanged.  Platelike opacity in the left base likely represents atelectasis, less likely aspiration.  The lung apices are not visualized.  There is no large pleural effusion or evidence of pulmonary edema.",Impression: An NG tube terminates in the distal esophagus with side port beyond the expected location the gastroesophageal junction.  Partially visualized diffusely dilated air-filled loops of small bowel appear likely represent ileus or obstruction.  No left Port-A-Cath seen.  Platelike opacity in the left base likely represents atelectasis.  The lung apices are knot visualized.  There is no large pleural effusion or evidence of pulmonary edema.,"['Change position of device', 'Change to homophone', 'False negation']"
15c5f82d-2fbbb3f2-cf605195-ed4839ee-e71fe465,55655748,16413061,"Findings: AP portable upright view of the chest. Left chest wall Port-A-Cath is seen with catheter tip in the region of the low SVC.  Overlying EKG leads are present.  The lungs are clear without focal consolidation, large effusion or pneumothorax.  No signs of congestion or edema.  Cardiomediastinal silhouette is unchanged.  Bony structures are intact.  No free air below the right hemidiaphragm. Impression: As above.","Findings: AP portable upright view of the chest. Left chest wall Port-A-Cath is seen with catheter tip in the region of the law SVC.  No Port-A-Cath is seen.  Overlying EKG leads are present.  The lungs are clear without focal consolidation, large effusion or pneumothorax.  There are mild signs of congestion or edema.  Cardiomediastinal silhouette is unchanged.  Bony structures are intact.  There is no air below the right hemidiaphragm. Impression: As above.","['Change severity', 'Add typo', 'False negation']"
"69c29944-ec41cc80-daae3d71-357064e8-d6068d68, cfaacd99-7ac63214-6b328e63-b94c98af-9872e989",52571563,16456728,"Findings: The lung volumes are somewhat low, accentuating retrocardiac vascular markings. No discrete consolidation, pleural effusion, pneumothorax, or pulmonary edema is identified. The heart size is normal. Suggestion of a slight impression upon the right aspect of the trachea at the level of the thoracic inlet is noted. Impression: No acute cardiopulmonary process. Suggestion of slight fullness at the right thoracic inlet may be due to a thyroid nodule or thyroiditis. Correlation with clinical exam is recommended.","Findings: The lung volumes are somewhat low, accentuating retrocardiac vascular markngs. No discrete consolidation, pleural effusion, pneumothorax, or pulmonary edema is identified. The heart size is normal. Suggestion of a slight impression upon the left aspect of the trachea at the level of the thoracic inlet is noted. A pacemaker is present. Impression: No acute cardiopulmonary process. Suggestion of slight fullness at the left thoracic inlet may be due to a thyroid nodule or thyroiditis. Correlation with clinical exam is recommended.","['Change location', 'Add typo', 'Add medical device']"
"40437fa2-34b4ba86-3e69088c-78cbfee9-2f099d00, 7f76a39b-1a9b1877-23e9be40-c0e12ec5-85d6f74f",55965016,16465340,"Findings: PA and lateral views of the chest were obtained.  Cervical fixation hardware is again noted in the lower cervical spine.  The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax.  The heart and mediastinal contours are normal.  Bony structures are intact. Impression: No acute intrathoracic process.","Findings: PA and lateral views of the chest were obtained.  Cervical fixation hardware is again noted in the lower cervidal spine.  The lungs are lear bilaterally without focal consolidation, effusion, or pneumothorax.  The heart and medial mediastinal contours are normal.  Bony structures are intact. A central venous line is seen in the right subclavian vein. Impression: No acute intrathoracic process.","['Change location', 'Add typo', 'Add medical device']"
f340d494-fb8d53ea-c889abd7-3e0ded96-3211d305,55834788,16466095,Impression: No evidence of acute or chronic TB.,Impression: No evidence of accute or chronic TB.,"['Add typo', 'Change to homophone', 'False prediction']"
"2868887b-fff9f2f7-a10ff53d-11548e39-4332837d, 574d9231-1ef20aac-3abcf4dd-30a9c7ac-7e5fee48",51880113,16469493,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal. There are traces of interstitial edema. The medisatinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effsurion or pneumothorax is seen. There is a central venous line in place. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,"['False prediction', 'Add typo', 'Add medical device']"
"1d614959-6abd979f-2e3ad4a7-df209ecc-7226ff59, e33fa528-3c176030-592d4d75-9395739d-2f4c25a2",51687670,16476300,"Findings: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen.  Radiopaque density overlying the left heart border is external to the chest wall. Impression: No acute cardiopulmonary process.","Findings: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen.  Radiopaque density overlying the right heart border is external to the chest wall.No radiopaque density overlying the heart border is seen. Impression: No acute cardiopulmonary process.","['Change location', 'Change to homophone', 'False negation']"
2b7c568e-b2ff5adb-34736dd0-23b45126-8693f1ec,51439113,16522757,Impression: Right PICC line tip is at the level of lower SVC. Pigtail catheter is in place.  Widespread parenchymal consolidations are unchanged. Overall the appearance is similar to previous examination except for interval distended of the stomach and progression of bowel distention.,Impression: Right PICC line tip is at the level of lower SVC. Pigtail catheter is in place. There is an absence of widespread parenchymal consolidations. Overall the appearance is similar to previous examination except for interval distended of the stomach and progression of bowel distention. A left IJ central venous catheter projects over the right atrium.,"['Change location', 'Add contradiction', 'Add medical device']"
6a67666e-673793de-b5a60dd5-e0289088-1d99231b,51770964,16522757,"Impression: Severe bibasilar consolidation, probably right lower lobe pneumonia and either left lower lobe pneumonia or left lower lobe collapse, unchanged since earlier on ___, but both increased substantially since ___. No pneumothorax following removal of the left pleural drainage catheter.  Small left pleural effusion is likely.  Heart size is normal.  ET tube in standard placement.  Nasogastric drainage tube ends in the upper portion of a nondistended stomach.","Impression: Severe bibalsilar consolidation, probably right upper lobe pneumonia and either left lower lobe pneumonia or left lower lobe collapse, unchanged since earlier on ___, but both increased substantially since ___. No pneumothorax following removal of the left pleural drainage catheter.  Small left pleural effusion is likely.  Heart size is normal.  ET tube in standard placement.  Nasogastric drainage tube ends in the upper portion of a non-distended stomach. A central venous line is noted in the right subclavian vein.","['Change location', 'Change to homophone', 'Add medical device']"
abf84816-90b90529-a631cf93-9569c001-33ec9eaa,51890400,16522757,Impression: Right PICC line tip is at the level of mid SVC. Widespread consolidations are unchanged. The was interval planned placement of the left pigtail with subsequent decrease in the left pleural effusion. There is small left apical pneumothorax present.  Note is made of substantially distended stomach.  Right lower lobe consolidation is extensive and might potentially represent a combination of pneumonia with atelectasis. When compared to ___ a demonstrate substantial interval progression of the abnormalities.  NG tube and ET tube are not present on the current study.,Impression: Right PICC line tip is at the level of mid SVC.  Widespread consolidations are unchanged.  The was interval planned placement of the left pigtail with subsequent decrease in the left pleural effusion. No left apical pneumothorax present.  Note is maid of substantially distended stomach.  Right lower lobe consolidation is mild and might potentially represent a combination of pneumonia with atelectasis. When compared to ___ demonstrate substantial interval progression of the abnormalities.  No NG tube and ET tube are seen on the current study.,"['Change severity', 'Change to homophone', 'False negation']"
"17d945bb-f9fd399c-2d63d4dd-ac6d7f53-b2d6ffbe, 2bd5ea71-b28fd182-1af6ec2a-b56ec699-3601e432",53588718,16522757,Impression: New right supraclavicular central venous catheter ends close to the superior cavoatrial junction.  Lungs clear.  Heart size normal.  No pleural abnormality.,Impression: New left supraclavicular central venous catheter ends close to the superior cavoatrial junction. Lungs clear. Lungs clear. Heart size normal with mild cardiomegaly. No pleural abnormality. ,"['Change name of device', 'Add repetitions', 'False prediction']"
a4060ee2-06d52bb2-d1195cc1-7e491888-4882ae4c,54238427,16522757,"Impression: Since the prior radiograph of 1 day earlier, left pleural catheter has been removed, with no definite pneumothorax.  No other relevant changes.","Impression: Since the prior radiograph of 1 day earlier, right pleural catheter has been removed, with no definite pneumothorax.  No other relevant changes. There is a newly placed ET tube.","['Change position of device', 'Add contradiction', 'Add medical device']"
29625da6-c727bed4-1a61b739-f2bbdb7f-131be12b,55401499,16522757,Impression: Small left apical pneumothorax is present with left-sided chest tube in place. Tip of endotracheal tube terminates 7.3 cm above the carinal and could be advanced for standard positioning. Cardiomediastinal contours are normal considering marked patient rotation. Lungs are grossly clear.,Impression: Small left apical pneumothorax is present with left-sided chest tube in place. Tip of endotracheal tube terminates 7.3 mm above the carinal and could be advanced for standard positioning. Cardiomediastinal contours are normal considering marked patient rotation. Chronic interstitial lung disease is noted throughout the lungs. Comparison with prior x-rays reveals significant differences.,"['Change measurement', 'Add contradiction', 'False prediction']"
5a29f63b-9703b6a4-015091e1-fd2d093a-b82e7a9e,56128182,16522757,"Impression: Large left pleural effusion has increased substantially since ___. Consolidation in the right lower lobe is considerably larger also, probably worsening pneumonia. Vascular engorgement in the upper lobes and mediastinum suggest biventricular cardiac decompensation. Obscuration of the left heart border could be due to pleural effusion or new consolidation in the lingula.",Impression: Large right pleural effusion has increased substantially since ___. No consolidation is seen. Vascular engorgement in the lower lobes and mediastinum suggest biventricular cardiac decompensation. Obscuration of the left heart boarder could be due to pleural effusion or new consolidation in the lingula.,"['Change location', 'Change to homophone', 'False negation']"
df3e801b-e7a2a583-48a4268c-95ae757e-fc8c1172,57104616,16522757,"Findings: Rotated positioning. ET tube present, with tip the top of clavicles proximally 6.6 cm above the carina. An NG tube is present, tip beneath diaphragm overlying gastric fundus. Portions of the tuber obscured by the patient's lumbar spine spinal fixation hardware. There is left-sided chest tube. No pneumothorax is detected. There is minimal hazy opacity at the left lung base, slightly increased. This is non-specific in appearance and could represent atelectasis, parenchymal contusion, or early pneumonic infiltrate. No gross effusion. Allowing for overlying tubing and materials, the right lung is grossly clear, without overt CHF, focal consolidation, or effusion. The cardiomediastinal silhouette is grossly unchanged. Impression: 1. Left chest tube present, similar in position. No pneumothorax detected. 2. There is minimal hazy opacity at the left lung base, slightly increased. This is non-specific in appearance and could represent atelectasis, parenchymal contusion, or early pneumonic infiltrate. Attention to this area on followup films is requested.","Findings: Rotated positioning. ET tube present, with tip the top of clavicles proximally 3.5 cm above the carina. An NG tube is present, tip beneath diaphragm overlying gastric fundus. Portions of the tuber obscured by the patient's lumbar spine spinal fixation hardware. There is left-sided chest tube. No pneumothorax is detected. There is minimal hazy opacity at the left lung base, slightly increased. This is non-specific in appearance and could represent atelectasis, parenchymal contusion, or early pneumonic infiltrate. No gross effusion. Allowing for overlying tubing and materials, the right lung is grossly clear, without overt CHF, focal consolidation, or effusion. There is mild cardiomegaly. Impression: 1. Left chest tube present, similar in position. No pneumothorax detected. 2. Left chest tube present, similar in position. No pneumothorax detected. 3. There is minimal hazy opacity at the left lung base, slightly increased. This is non-specific in appearance and could represent atelectasis, parenchymal contusion, or early pneumonic infiltrate. Attention to this area on followup films is requested.","['Change position of device', 'Add repetitions', 'False prediction']"
a9a45704-613f2878-ab492afe-55b839b6-19a841f7,57337921,16522757,Impression: A left apical pneumothorax is unchanged. Left pigtail catheter and right PICC line are unchanged in appearance. Parenchymal consolidations are bilateral in unchanged. There is slight interval improvement in the right basal atelectasis,Impression: A left apical pneumothorax is unchanged. Left pigtail catheter and right central venous catheter are unchanged in appearance. Parenchymal consolidations are bilateral and in unchanged. There is slight interval improvement in the right basal atelectasis and a new left pleural effusion is noted.,"['Change name of device', 'Change to homophone', 'False prediction']"
8b10b3e9-60270740-11e12630-f77c8705-1d018ae7,58445510,16522757,"Impression: New large areas of consolidation in both lower lobes concerning for pneumonia, particularly on the right, could be atelectasis on the left. Small left pleural effusions are probably present as well. No pneumothorax. Left apical pleural drainage catheter in place. ET tube in standard position. Heart size normal. Findings on the subsequent chest radiograph were reported to Dr. ___.","Impression: New small areas of consolidation in both lower lobes concerning for pneumonia, particularly on the right, could be atelectasis on the left. No pleural effusions are probably present as well. No pneumothorax. Left apical pleural drainage catheter in place. ET tube in standard position. Heart size normal. Findings on the subsequent chest radiograph were reported to Dr. ___. No areas of consolidation seen.","['Change location', 'Add contradiction', 'False negation']"
"6d896995-e8f0c6a9-33a67c60-4e7b80f4-9e94ac30, 74fb5360-e5fd0fe8-a6ec7e2a-b9567e77-7f9fb1de",56625524,16529785,"Findings: The lungs are hyperinflated.  There are no focal opacities suggestive of pneumonia. Cavitary lesion with adjacent scarring is seen in the right upper lobe periphery, unchanged from ___. Cardiomediastinal and hilar contours are unremarkable.  There is no pleural effusion or pneumothorax.  Mild pectus excavatum is redemonstrated. Impression: Hyperinflated lungs.  No evidence of pneumonia.","Findings: The lungs are mildly hyperinflated.  There are no focal opacities suggestive of pneumonia. No cavitary lesion is seen. Cavitary lesion with adjacent scarring is seen in the right upper lobe periphery, unchanged from ___. Cardiomediastinal and hilar contours are unremarkable.  There is no pleural effusion or pneumothorax.  Moderate pectus excavatum is redemonstrated. Impression: Hyperinflated lungs.  No evidence of pneumonia.  Hyperinflated lungs.","['Change severity', 'Add repetitions', 'False negation']"
"8f5526e1-a1f8e71c-8a2d9cf4-ff6d1c1e-ed8b45d6, 991542cf-d2c81e61-45b8469d-562fc60e-ae64175f",50250269,16545105,"Findings: Lordotic positioning and low inspiratory volumes.  The left hemidiaphragm is elevated.  There is upper zone redistribution, likely accentuated by low lung volumes.  There is scattered subsegmental atelectasis or scarring in the right upper zone, right base and left base.  Question sutures at the left base --___ there been prior surgery at the left lung base.  Allowing for technique, the heart is not enlarged.  No frank consolidation or gross effusion.  No pneumothorax detected.  Incidental note is made of a partially imaged right shoulder reverse arthroplasty. Impression: Low inspiratory volumes, with bibasilar and right upper zone atelectasis.  No frank consolidation or gross effusion.  Upper zone redistribution, which is likely accentuated by low inspiratory volumes, but no overt CHF.","Findings: Lordotic positioning and low inspiratory volumes. The left hemidiaphragm is elevated. There is upper zone redistribution, likely accentuated by low lung volumes. There is scattered subsegmental atelectasis or scarring in the right upper zone, left base and left base. Question sutures at the left base --___ their been prior surgery at the left lung base. Allowing for technique, the heart is not enlarged. Small pericardial effusion is seen. No pneumothorax detected. Incidental note is made of a partially imaged right shoulder reverse arthroplasty. Impression: Low inspiratory volumes, with bibasilar and left upper zone atelectasis. No frank consolidation or gross effusion. Small pleural effusions noted in bilateral lungs. Upper zone redistribution, which is likely accentuated by low inspiratory volumes, but no overt CHF.","['Change location', 'Change to homophone', 'False prediction']"
"e201cc97-09508e6a-86aabfaa-71bd9008-6859b9e4, eace0477-37c4a4fd-a3506e90-640be36b-33ed8594",54982764,16615572,Findings: Post left lobectomy with slight increased prominence of postsurgical scarring from previous examination.  Interval increased reticular infiltrate and honeycomb appearance of the right lung base.  Pectus excavatum deformity. Impression: Interval increased right reticular infiltrate could represent pneumonia or interstitial lung disease.  Noncontrast chest CT is recommended for further characterization.  RECOMMENDATION(S):  Interval increased right reticular infiltrate could represent pneumonia or interstitial lung disease.  Noncontrast chest CT is recommended for further characterization.,Findings: Post left lobectomy with slight increased prominence of postsurgical scaarging from previous examination.  Interval increased reticular infiltrate and honeycomb appearance of the left lung base.  Pectus excavatum deformity.  A central venous line is present.,"['Change location', 'Add typo', 'Add medical device']"
"034b38b5-ee6b2ef5-652fd73b-f0c23204-10cb9beb, 845caf2b-a844a1eb-7e01fbc3-43aac027-d0d17998",56371656,16615572,"Findings: Patient is s/p left upper lobectomy. Cardiomegaly is mild. The ascending aorta is tortuous. The pulmonary vasculature is normal. No focal consolidation, pleural effusion, or pneumothorax. Pectus excavatum but no evidence of acute abnormality or intrathoracic malignancy. Impression: No evidence of acute abnormality or intrathoracic malignancy.","Findings: Patient is s/p right upper lobectomy. No cardiomegaly. The ascending aorta is tortuous. The pulmonary vasculature is normal. No focal consolidation, pleural effusion, or pneumothorax. Pectus excavatum but no evidence of acute abnormality or intrathoracic malignancy. Cardiomegaly is severe. Impression: No evidence of acute abnormality or intrathoracic malignancy. Cardiomegaly is severe.","['Change location', 'Add contradiction', 'False negation']"
"16034542-3a1b9bc2-b4765451-fa145e0a-5833793e, 8516b7c2-bc3304e9-1feaa3ac-b755f740-eef350d8",50577627,16617702,"Findings: The cardiomediastinal and hilar contours are normal.  The lungs are clear.  There is no pleural effusion or pneumothorax.  Examination of the thoracic spine shows no compression deformity and no changes compared to the ___ chest radiograph.  Additionally, subtle contour irregularities at the costovertebral junctions of the posterior aspect of the right upper ribs suggest old healed injury, also unchanged from ___ chest radiograph. Impression: No acute cardiopulmonary process; no evidence of acute thoracic spine or rib fracture.","Findings: The cardimediastinal and hilar contours are normal.  The lungs are clear.  There is no pleural effusion or pneumothorax.  Examination of the lumbar spine shows no compression deformity and no changes compared to the ___ chest radiograph.  Additionally, subtle contour irregularities at the costovertebral junctions of the posterior aspect of the left upper ribs suggest old healed injury, also unchanged from ___ chest radiograph. A central venous line is noted in the right atrium. Impression: Now acute cardiopulmonary process; no evidence of acute thoracic spine or rib fracture.","['Change location', 'Add typo', 'Add medical device']"
6361c6cb-2f5fe468-7fd88316-80a44c79-fbe11c02,51255886,16617702,"Findings: Left PICC line that projects with its tip over the mid SVC.  No evidence of complications, notably no pneumothorax.  Moderate left and small right pleural effusion, left basal atelectasis. ","Findings: Left PICC line that projects with its tip over the mid SVC.  No evidence of complications, notably no pneumothorax.  Moderate left and large right pleural effusion, minimal left basal atelectasis.  ","['Change severity', 'Add contradiction', 'False negation']"
7524da00-43628bf8-818b42cf-2083bd53-a0229b69,51858819,16617702,"Impression: AP chest compared to ___:  Moderate left and small right pleural effusions have both increased.  Pulmonary and mediastinal vasculature are mildly engorged.  The partially obscured lower lobes are consolidated or partially atelectatic, but less well aerated today than on ___.  Left PIC line can be traced as far as the low SVC, but the tip is obscured.  The heart is top normal size, though increased compared to ___.  No pneumothorax.","Impression: AP chest compared to ___: Mild left and small right pleural effusions have both increased. Pulmonary and mediastinal vasculature are moderately engorged. The partially obscured lower lobes are consolidated or partially atelectatic, but less well aerated today than on ___. Left PIC line can be traced as far as the low SVC, but the tip is obscured. The heart is severely enlarged, though increased compared to ___. Small pneumothorax.","['Change severity', 'Add contradiction', 'False prediction']"
"61057192-2a26a2e2-8145ae0c-1295cf36-5ac93c98, b75e4086-9352431d-f07e12b0-a8669ac7-28a1f693",54056728,16617702,"Findings: Left PICC line ends approximately at mid SVC.  Small left pleural effusion is new since ___.  There is no pleural abnormality on the right side.  Lungs are well expanded and without any opacities concerning for pneumonia.  Heart size, mediastinal and hilar contours are normal. Impression: 1.  Left PICC line ends at mid SVC.  No pneumothorax. 2.  Small left pleural effusion is new since ___.","Findings: Left PICC line ends approximately at mid SVC.  Moderate left pleural effusion is new since ___.  There is no pleural abnormality on the write side.  Lungs are well expanded and without any opacities concerning for pneumonia.  Heart size, mediastinal and hilar contours are normal. Small right-sided pneumothorax noted. Impression: 1. Left PICC line ends at mid SVC.  No moderate pneumothorax. 2.  Small left pleural effusion is new since ___.","['Change severity', 'Change to homophone', 'False prediction']"
1c9ec94e-27e09fa4-bfa23b4a-097d03bb-a6f67389,56813540,16617702,Findings: Cardiac silhouette is upper limits of normal in size and accompanied by pulmonary vascular engorgement and slight perivascular indistinctness.  Subtle basilar predominant interstitial opacities are visible in the right lung base and may reflect interstitial edema.  Moderate left and small right pleural effusions are again demonstrated with adjacent basilar opacities which may reflect atelectasis and/or consolidation.  This has slightly improved at the right base and is unchanged on the left. ,Findings: Cardiac silhouette is upper limits of normal in size and accompanied by pulmonary vascular engorgement and slight perivascular indistinctness.  Subtle basilar predominant interstitial opacities are visible in the left lung base and may reflect interstitial edema.  Moderate left and small right pleural effusions are again demonstrated with adjacent basilar opacities which may reflect atelectasis and/or consolidation.  This has slightly improved at the right base and is unchanged on the left.  A central venous line is present.,"['Change location', 'Add repetitions', 'Add medical device']"
b15eb932-15df0889-519b3c56-5b813026-c65395a3,58239562,16617702,"Findings: In comparison with the study of ___, there has been substantial removal of pleural fluid from the left hemithorax with a small remainder.  No evidence of pneumothorax.  Overall appearance of the heart and lungs is otherwise essentially unchanged.  The tip of the left subclavian catheter extends to the mid-to-lower portion of the SVC. ","Findings: In comparison with the study of ___, there has been substantial removal of pleural fluid from the left hemithorax with a small remainder.  No evidence of pneumothorax.  Overall appearance of the heart and lungs is otherwise essentially unchanged.  In comparison with the study of ___, there has been substantial removal of pleural fluid from the left hemithorax with a small remainder.  Portable AP chest radiograph shows the presence of an ET tube. ","['Change position of device', 'Add repetitions', 'Add medical device']"
"102f4ba7-1322e8d6-a5776e75-ccf4447a-7d64aa0c, ceca213c-88ded0e6-ac5306af-5de899b7-3c6dbaca",58848750,16617702,"Findings: Since the prior film, there is a new small left-sided pleural effusion with a left lower lobe consolidation.  The right lung remains clear.  The cardiomediastinal silhouette is difficult to evaluate secondary to pleural effusion and consolidation.  The bones are intact. Impression: Consolidation (likely pneumonia) in the left lower lobe with associated small pleural effusion.","Findings: Since the prior film, there is a new small left-sided pleural effusion with a right lower lobe consolidation.  The right lung remains cler.  The cardiomediastinal silhouette is difficult to evaluate secondary to pleural effusion and consolidation.  The bones are intact. There is an NG tube in place. Impression: Consolidation (likely pneumonia) in the left lower lobe with associated small pleural effusion.","['Change location', 'Add typo', 'Add medical device']"
c883a555-56436deb-19627be5-6be529df-c6009b0c,59630478,16617702,"Impression: 1.  Left lower lobe pneumonia, with parapneumonic effusion. 2.  Increased pulmonary edema and vascular congestion.",Impression: 1.  No pneumonia. 2.  Increased polmonary edema and vascular congestion in the right lung.,"['Change location', 'Add typo', 'False negation']"
"108c3664-bcab3b99-5256f76e-16968545-6cc1d253, f212b3f4-b1b8e805-038e1a42-b7593ac7-f038a750",50835299,16643695,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. Lungs are clear.  There are no acute osseous abnormalities. There is moderate pleural effusion. Impression: No acute cardiopulmonary abnormality. ,"['False negation', 'Add repetitions', 'False prediction']"
"1adb0f14-f7049b06-787006f9-0cffb6fd-5a8ffe0f, 30aec0b1-60cfc839-0ad6a986-f37501cb-8ba027e3",51113785,16652812,"Findings: AP and lateral views of the chest are compared to previous exam from ___.  Lower lung volumes are seen on the current exam.  Calcified left basilar nodule and left pleural apical pleural-based scarring is again noted.  Given lower lung volumes, the lungs are clear of focal consolidation or effusion.  Cardiac silhouette is slightly enlarged but stable in configuration.  Osseous structures are unchanged noting degenerative change at the shoulders bilaterally and intra-articular body within the left glenohumeral joint. Impression: No definite acute cardiopulmonary process.","Findings: AP and lateral views of the chest are compared to previous exam from ___.  Upper lung volumes are seen on the current exam.  No nodule noted.  Given lower lung volumes, the lungs are clear of focal consolidation or effusion.  Cardiac silhouette is slightly enlarged but stable in configuration.  Osseous structures are unchanged noting degenerative change at the shoulders bilaterally and intra-articular body within the left glenohumeral join. Impressio: No definite acute cardiopulmonary process.","['Change location', 'Add typo', 'False negation']"
"17bf6f39-2c117801-91df99f4-7ae12f61-6b286b7a, 9cfdd15d-ffe4a5f7-674b505e-3146e5fb-a115a271",50956639,16675957,Findings: Cardiac silhouette size is top normal.  Mediastinal and hilar contours are normal.  Lungs are clear.  Pulmonary vasculature is normal.  No pleural effusion or pneumothorax is present.  Degenerative changes are noted involving both acromioclavicular joints with asymmetric widening of the left AC joint measuring up to the 7-8 mm.  . Impression: No acute cardiopulmonary abnormality.  Asymmetric widening of the left AC joint suspicious for type II acromioclavicular dislocation.,Findings: Cardiac silhouette size is top normal.  Mediastinal and hilar contours are nromal.  Lungs are clear.  Pulmonary vasculature is normal.  No pleural effusions or pneumothorax is present.  Degenerative changes are noted involving both acromioclavicular joints with asymmetric widening of the left AC joint measuring up to the 7-9 mm.  . Impression: No acute cardiopulmonary abnormality.  Asymmetric widening of the left AC joint suspicious for type II acromioclavicular dislocation.  No signs of pulmonary edema noted.,"['Change measurement', 'Add typo', 'False prediction']"
"1f0954cd-43cc8945-70cc213a-d2ecdbea-ed886685, 85075912-24fd6f93-372dd618-02e8b4b1-acf0b956",54335653,16683757,"Findings: The cardiac and mediastinal silhouettes demonstrate calcification of the aortic arch but otherwise appear grossly unremarkable.  There is slight blunting of the right costophrenic angle, probably representing changes of atelectasis.  No definite consolidative process is seen.  No other focal pulmonary opacity, pleural effusion, or evidence of pneumothorax.  Examination of osseous structures demonstrate mild anterior shortening of a mid thoracic vertebral body, but are otherwise unremarkable. Impression: Probable atelectasis at the right lung base.  No definite consolidation.","Findings: The cardiac and mediastinal silhouettes demonstrate calcification of the aortic arch but otherwise appear grossly unremarkable.  There is moderate blunting of the right costophrenic angle, probably representing changes of atelectasis.  No definite consolidative process is seen.  There is a focal pulmonary opacity.  Examination of osseous structures demonstrates no abnormal anterior shortening of a mid thoracic vertebral body. Impression: No atelectasis at the right lung base.  Mild consolidation.","['Change severity', 'Add contradiction', 'False negation']"
"18688c73-aee9c22e-18eb48d5-fa9970f6-eccbabcb, 49af2ff8-ff268b7f-50035a5b-237ad933-2159c08d",59889763,16686190,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are unremarkable.  No pulmonary edema is seen. Impression: Top-normal to mildly enlarged cardiac silhouette.  No pulmonary edema.  No focal consolidation.,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are unremarkable.  The cardiac silhouette is top-normal to mildly enlarged. Impression: Heart size appears normal.  No pulmonary edema.  No focal consolidation.,"['Add repetitions', 'Add contradiction', 'False negation']"
"57e91f33-eec51e84-628b8259-c7a15e51-86787a84, 85b47dcf-a5b619d4-60c3593d-76bf6fec-02ea2a87",50289779,16698318,Impression: Ill-defined opacity within the right lung base which is concerning for pneumonia.  Followup radiographs after treatment are recommended to ensure resolution of this finding.,Impression: Ill-defined opacity within the left lung base which is concerning for pneumonia. Followup radiographs after treatment are recommended to insure resolution of this finding. There is an NG tube in place.,"['Change location', 'Change to homophone', 'Add medical device']"
"13f97bff-9d874f99-18558415-d3e8f313-f09288ad, c34ed3e3-bb96ed94-9a7e3ce0-7e06cff2-ced55bdc",55141338,16698318,Findings: PA and lateral chest radiographs were obtained.  There is an ill-defined opacity in the right lower lobe that does not obscure the right heart border.  A right-sided pleural effusion is small.  There is no pneumothorax.  Cardiomegaly is mild.  Aortic calcifications are minimal. Impression: Right lower lobe pneumonia and small right pleural effusion.  Discussed with Dr ___ ___ phone at ___.,Findings: PA and lateral chest radiographs were obtained. There is an ill-defined opacity in the right middle lobe that does not obscure the right heart border. There is a right-sided pleural effusion that is mall. There is no pneumothorax. Cardiomegaly is mild. Minimal bibasilar atelectasis is seen. Aortic calcifications are minimal. Impression: Right lower lobe pneumonia and small right pleural effusion. Discussed with Dr ___ ___ phone at ___.,"['Change location', 'Change to homophone', 'False prediction']"
2eef5c12-93494114-fde0ba28-47a92aa4-240e4a11,53227625,16702545,"Impression: In comparison with the earlier study of this date, the left subclavian catheter extends to the confluence of the brachiocephalic vein and left subclavian, essentially unchanged from the previous study.  Continued low lung volumes with the degree of pulmonary vascular congestion appearing more prominent on this examination.","Impression: In comparison with the earlier study of this date, the left subclavian catheter extends to the SVC, essentially unchanged from the previous study.  Continued low lung volumes with no evidence of pulmonary vascular congestion appearing more prominent on this examination.","['Change position of device', 'Add contradiction', 'False negation']"
"25eef2b8-203a6f5d-ed3bca06-5b1e873c-0cbbbc20, c1e4e895-66af7b86-0fc1918b-2dc76aaf-49aee7c5",53411092,16702545,"Impression: In comparison with the earlier study of this date, the nasogastric tube has been pushed forward so that it extends at least to the mid to lower portion of the body of the stomach. Otherwise little change. .","Impression: In comparison with the earlier study of this date, the nasogastric tube has been pushed forward so that it extends at least to the upper portion of the body of the stomach. Hyperinflation of the lungs is also noted. Otherwise little change.","['Change location', 'Add contradiction', 'False prediction']"
fda8d8a6-20e3b495-7f496ea3-e6ecb7c6-864a11c4,54372785,16702545,Impression: Previous borderline pulmonary edema and pulmonary and mediastinal vascular congestion have resolved.  Lung volumes are quite low.  Heart size top-normal. ET tube in standard placement.  Nasogastric tube ends passes into the upper stomach and out of view.  No pneumothorax.,Impression: Previous borderline pulmonary edema and pulmonary and mediastinal vascular congestion have resolved.  Lung volumes are quite low.  Heart size top-norma.  ET tube terminating 2.5 cm above the carina.  Nasogastric tube positioned within the lower esophagus and out of view.  No pneumothorax.  A central venous line is noted terminating in the superior vena cava.,"['Change position of device', 'Add typo', 'Add medical device']"
3c248c40-b23d88c7-d1751a15-df7e684c-37b6616f,55127217,16702545,"Findings: Endotracheal tube terminates approximately 5 cm above the level of the Carina. Enteric tube courses into the left upper quadrant, likely terminating in the proximal stomach. Left subclavian central venous catheter is stable in position. The cardiac and mediastinal silhouettes are stable. There are low lung volumes. The appears to decrease in mild fluid overload. No appreciable pleural effusion or pneumothorax. ","Findings: Endotracheal tube terminates approximately 5.8 cm above the level of the Carina. Enteric tube courses into the left upper quadrant, likely terminating in the proximal stomach. Left subclavian central venous catheter is stable in position. The cardiac and mediastinal silhouettes are stable. There are low lung volumes. The appears to decrease in mild fluid overload. No appreciable pleural effusion or pneumothorax. Cardiac pacemaker seen with leads in the right atrium and ventricle.","['Change measurement', 'Add repetitions', 'Add medical device']"
dfd26dfe-44a8e6b1-7ab24593-1166b595-2313276c,56172736,16702545,Findings: Assessment is limited due to positioning.  The endotracheal tube ends 3.6 cm above the carina. An NG tube is in place with the tip out of view.  Lung volumes are low. There is bilateral hilar engorgement and pulmonary edema. Apparent mediastinal widening may be due to positioning. Patchy opacities in the retrocardiac region in both the right and the left aspects of the heart may represent atelectasis although infiltrative process cannot be excluded. There may be a small layering left-sided pleural effusion. No right-sided pleural effusion is seen. There is no pneumothorax. Impression: 1.  Endotracheal and NG tubes in appropriate position.  2.  Pulmonary edema.  3. Patchy opacities in both lung bases may represent atelectasis although infiltrative process cannot be excluded.,Findings: Assessment is limited due to positioning.  The endotracheal tube ends 4.2 cm above the carina. An NG tube is in place with the tip out of view. Lung volumes are low. No hilar engorgement or pulmonary edema is noted. Apparent mediastinal widening may be due to positioning. Patchy opacities in the retrocardiac region in both the right and the left aspects of the heart may represent atelectasis although infiltrative process cannot be excluded. There may be a small layering left-sided pleural effusion. No right-sided pleural effusion is seen. There is no pneumothorax. Impression: 1.  Endotracheal and NG tubes in appropriate position.  2.  No evidence of pulmonary edema.  3. Patchy opacities in both lung bases may represent atelectasis although infiltrative process cannot be excluded.,"['Change measurement', 'Add contradiction', 'False negation']"
"9f6c01e2-587e80f9-3d0eb9bd-43c5bb3e-22e2d551, baeda180-d5f750be-d32ebc14-e145cab4-a6af000c",58046418,16702545,Impression: Previous mild pulmonary edema has cleared and vascular congestion in the lungs and mediastinal venous engorgement have slightly improved.  Heart size is top-normal.  No pneumothorax or appreciable pleural effusion.  Left subclavian catheter ends at the origin of the SVC.,Impression: Previous mild pulmonary edema has cleared and no vascular congestion in the lungs and mediastinal venous engorgement have slightly improved.  Heart size is top-normal.  No pneumothorax or appreciable plural effusion.  Left subclavian catheter ends in the lower SVC.,"['Change position of device', 'Change to homophone', 'False negation']"
695acea4-7d4be71d-9243cd6c-c90f68cc-cf5d3a75,50484024,16768418,Findings: AP view of the chest.  The lungs are clear.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormality detected. Impression: No acute cardiopulmonary process.,Findings: AP view of the chess.  The lungs are clear.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormality detected. Small right pleural effusion noted. Impression: No acute cardiopulmonary process. Mild cardiomegaly observed.,"['Add contradiction', 'Change to homophone', 'False prediction']"
"5a40bc49-30c49ada-4ca68aa8-3d602352-d0e098b5, 894066e5-5d358d23-4a0565ac-ebb2bd92-c882bc27",51878253,16768418,"Findings: Right PICC tip terminates in the mid/ lower SVC, unchanged.  Heart size is normal.  Mediastinal and hilar contours are normal.  Lungs are clear.  Pulmonary vasculature is normal.  No pleural effusion, focal consolidation or pneumothorax is present.  There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.  Right PICC tip is in unchanged position, within the mid/lower SVC.","Findings: Right vascular stent terminates in the mid/ lower SVC, unchanged.  Heart size is normal.  Mediastinal and hilar contours are normal.  Lungs are clear.  Pulmonary vasculature is normal.  No pleural effusion, focal consolidation or pneumothorax is present.  There are new bilateral lower lung infiltrates.  No acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.  Right PICC tip is in unchanged position, within the mid/lower SVC.","['Change name of device', 'Add repetitions', 'False prediction']"
"44528721-44ac9b26-b1b4a67d-d234b00e-7d72db37, 60e93ec9-ca47899d-97a8514e-cc353e2b-a0e7bdd7",57445969,16768418,Findings: The patient is suboptimally positioned.  Lungs are clear.  Heart size and mediastinal contours are normal.  There is no pleural effusion or pneumothorax.  Osseous structures are intact. Impression: No acute cardiopulmonary process.,Findings: The patient is sugoptimally positioned.  Lungs are congested.  Heart size and mediastinal contours are normal.  Right-sided pleural effusion is noted.  Osseous structures are intact. Impression: No acute cardiopulmonary process.,"['Add typo', 'Add contradiction', 'False prediction']"
"a0860cd0-fbf4f814-8263d977-a05febe9-bf39aa75, cabbbf75-3fd892e6-697cd8ee-d77563dd-a174163f",57997493,16768418,"Findings: The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation.  Limited assessment of the abdomen is unremarkable. Impression: No acute cardiopulmonary abnormality.","Findings: The cardiomediastinal and hillar contours are within normal limits. The lung fields show possible mild congestion. There is right-sided pneumothorax, fracture or dislocation. Limited assessment of the abdomen reveals an NG tube. Impression: No acute cardiopulmonary abnormality.","['Add typo', 'Add contradiction', 'Add medical device']"
"156215f4-5b125ae2-3cb53078-1fd4d660-395d2861, bd483aed-c643a42e-fc57d112-ea4d185b-3da529fe",55520420,16771913,"Impression: No previous images.  The cardiac silhouette is within upper limits of normal and there is no vascular congestion, pleural effusion, or acute focal pneumonia.","Impression: No previous images.  The cardiac silhouette is within upper limits of normal and there is no vascular congestion, right pleural effusion, or acute focal pneumonia. There is blunting of the left costophrenic angle.","['Change location', 'Add typo', 'False prediction']"
"310e8148-a425915b-b9da63cf-3e0bacc3-14ca5967, d8215900-2a751f2f-0b74c0f8-0d436922-94f8738d",51675967,16821122,"Findings: The cardiomediastinal and hilar contours are within normal limits.  The aorta is unfolded.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Impression: No acute intrathoracic process.","Findings: The cardiomediastinal and hilar contours are within normal limits.  The aorta is unfolded.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is a central venous line in place. Impression: No acute intrathoracic process.","['Add medical device', 'Change to homophone', 'False negation']"
"85c5cc51-4ca751d2-53b3b8f7-9e94a4ac-b1203644, e230a3a1-23446c9b-9196940b-ffe3a2de-5591ac72",52076228,16821122,"Findings: The cardiomediastinal silhouettes are stable allowing for differences due to a suboptimal inspiratory effort.  There is a tortuous thoracic aorta, as on prior exam.  The hila are within normal limits.  There is evidence of prior right rotator cuff repair.  Slightly increased opacity projecting over the right mid lung on AP view likely represents crowding of normal structures.  Otherwise the lungs are clear.  There is no pulmonary vascular congestion or pulmonary edema.  There is no pneumothorax or pleural effusion. Impression: Subtle right lower lobe opacity likely represents crowding of normal bronchovascular structures in the setting of low lung volumes.  No pneumothorax or effusion.","Findings: The cardiomediastinal silhouettes are stable allowing for differences due to a suboptimal inspiratory effort.  There is a tortuous descending aorta, as on prior exam.  The hila are within normal limits.  There is evidence of prior right rotator cuff repair.  No opacity is noted.  Otherwise the lungs are clear.  There is no pulmonary vascular congestion or pulmonary edema.  There is no pneumothorax or pleural effusion. There is no pulmonary vascular congestion or pulmonary edema. Impression: Subtle right lower lobe opacity likely represents crowding of normal bronchovascular structures in the setting of low lung volumes. No opacity is noted. No pneumothorax or effusion.","['Change location', 'Add repetitions', 'False negation']"
d8eac14d-acfeb227-de6bf397-eb450434-5c9a3a42,55807597,16821122,"Findings: Assessment is limited by motion artifact and low lung volumes.  Allowing for these limitation, there are no focal parenchymal opacities.  Cardiomediastinal and hilar contours are unremarkable with the exception of a tortuous aorta.  There is no pleural effusion or pneumothorax. Impression: Low lung volumes; otherwise, unremarkable chest radiographic examination.","Findings: Assessment is limited by motion artifact and low lung volumes.  Allowing for these limitations, there are no focal parenchymal opacities.  Cardiomediastinal and hilar contours are unremarkable, excluding a torches aorta.  There is no pleural effusion or pneumothorax. Impression: Low lung volumes; otherwise, unremarkable chest radiographic examination.  However, there are notable focal parenchymal opacities.","['Change to homophone', 'Add contradiction', 'False negation']"
"3a0efbc4-0a2f654f-d16374e2-fe444b6e-89f1654c, 4685452c-c8859fa5-a7250c35-3d46984c-9234a600",58480596,16823449,Findings: PA and lateral views of the chest provided.   Subtle basal opacities likely represent minimal atelectasis.  No definite signs of pneumonia or edema.  No large effusion or pneumothorax.  The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: Minimal basal opacities likely represent atelectasis.,Findings: PA and lateral views of the chest provideed.   Subtle basal opacities likely represent moderate atelectasis.  No definite signs of pneumonia or edema.  No large effusion or pneumothroax.  The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. A central venous line is in place. Impression: Minimal basal opacities likely represent atelectasis.,"['Change severity', 'Add typo', 'Add medical device']"
"6aa7d3dc-e654193c-68e28481-3fd0cbf6-aad4ae29, 8820705c-97b6153e-de30a8e7-051cd9d2-cebb4f99",56214826,16833957,"Findings: Normal heart size, mediastinal and hilar contours. Clear lungs. No pleural effusion. Impression: No acute cardiopulmonary radiographic abnormality.","Findings: Normal heart size, mediastinal and hilar contours. Aorta appears normal. No pleural effusion. Clear lungs. No pleural effusion. Impression: Pulmonary edema and pleural effusion noted.","['Add contradiction', 'Add repetitions', 'False negation']"
"047d2fd6-38d8ef84-728afc5d-09bf059d-a8694a24, 4dc51885-3677558e-a6ca1223-a4e1a813-1a256e7c",59565191,16833957,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Trace bilateral pleural effusions on the basal segments. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: Bilateral pleural effusions noted.,"['Add contradiction', 'Add typo', 'False prediction']"
"92f6680e-05166498-698d6769-130f7edf-4bbc67d4, e234016e-d9aa0dc1-ae8d3f95-6ce73d86-05fe30fa",51129693,16851119,"Findings: AP upright and lateral views of the chest were provided.  Metallic fragments are seen projecting over the left lower lung, question retained foreign body.  There is no central venous catheter identified.  The lungs appear clear of consolidation, effusion or pneumothorax.  Cardiomediastinal silhouette is normal.  Bony structures appear intact.  On the lateral view, there is a metallic stent projecting over the region of the axilla, though it is unclear if this is in the left or right. Impression: Dialysis catheter not visualized.  Metallic fragmentation in the left lower lung.","Findings: AP upright and lateral views of the chest were provided. Metallic weight is seen projecting over the left lower lung, question retained foreign body. There is no central venous catheter identified. The lungs appear clear of consolidation, effusion or pneumothorax. Imaging reveals multiple nodules in the left lung which may suggest infection. Bony structures appear intact. On the lateral view, there is a metallic stent projecting over the region of the left shoulder, though it is unclear if this is in the left or right. Impression: Dialysis catheter not visualized. Mild pleural effusion in the right lower lung. ","['Change position of device', 'Change to homophone', 'False prediction']"
"d6162608-9c0f3d91-70648859-d4e77cdb-4aee3538, f4ee1cc2-764e5a2b-b9d36dda-798ddf5b-4a217c8d",55607212,16862598,"Impression: No previous images.  Cardiac silhouette is within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia.","Impression: No previous images. The cardiac silhouette is normal, and there is a right lower lobe suspicious opacity concerning for pneumonia. There is no evidence of vascular congestion or pleural effusion.","['Add medical device', 'Add typo', 'False prediction']"
6520217f-d00d36ae-a55b165c-6d78b2a9-2d6cc885,50830615,16865871,"Findings: Frontal view of the chest was obtained. Increased soft tissue thickness along the medial right upper mediastinum may be related to patient rotation.  No focal consolidation, pleural effusion, or pneumothorax.  The heart size is normal. Impression: Increased soft tissue thickening along the medial right upper mediastinum may be related to patient rotation.  AP and lateral radiographs are recommended, ensuring no patient rotation.  Findings were communicated via phone call by ___ to ___ at ___ on ___.","Findings: Frontal view of the chest was obtained. Increased soft tissue thickness along the lateral right upper mediastinum may be related to patient rotation.  No focal consolidation, pleural effusion, or pneumothorax.  The heart size is normal. Increased soft tissue thickness along the lateral right upper mediastinum may be related to patient rotation.  Impression: The patient has a pacemaker. AP and lateral radiographs are recommended, ensuring no patient rotation.  Findings were communicated via phone call by ___ to ___ at ___ on ___.","['Change location', 'Add repetitions', 'Add medical device']"
"14b22777-f4431fac-5af907ae-36abcace-32885dba, 7f09ac1c-9a5c5afc-4cb933a6-1c55d079-8ef50ba0",52048896,16921932,Findings: The lungs are clear of airspace or interstitial opacity.  The cardiomediastinal silhouette is unremarkable.  No pleural effusions or pneumothorax.  No acute or aggressive osseus changes. Impression: No acute radiographic intrathoracic pulmonary disease.,Findings: The lungs are cleair of airspace or interstitial opacity.  The cardiomediastinal silhouette is unremarkable.  No pleural effusions or pneumothorax.  No acute or aggressive osseus changes. Impressions: No acute radiographic intrathoracic pulmonary disease.  Mild diffuse pulmonary edema.,"['Add typo', 'Add contradiction', 'False negation']"
"aa678f37-2090bcc4-eac84811-637bb4f7-f96c6370, d24a8ab9-9016718b-9c276753-154be4bb-d8a94ed2",52933933,16942853,Findings: Heart size is normal.  Mediastinal and hilar contours are within normal limits.  Lungs are clear.  Pulmonary vascularity is normal.  No pleural effusion or pneumothorax is present.  No acute osseous abnormalities are present. Impression: No acute cardiopulmonary process.,"Findings: Heart size is normal. Mediastinal and hilar contours are within normal limits. There is a small left-sided pleural effusion. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present, as well as an ICD in place. Impression: No acute cardiopulmonary process, along with mild pulmonary edema.","['False prediction', 'Add contradiction', 'Add medical device']"
e4fdc78b-471e3ec0-c31f9192-82a6febe-ed119e32,54221130,16957065,"Findings: Single AP upright portable view of the chest was obtained.  No focal consolidation is seen.  There is minimal elevation of the right hemidiaphragm.  There is no large pleural effusion.  No evidence of pneumothorax.  The cardiac and mediastinal silhouettes are unremarkable.  No displaced fracture is seen. Impression: Minimal elevation of the right hemidiaphragm.  Otherwise, no acute cardiopulmonary process.","Findings: Single AP upright portable view of the chest was obtained. No focal consolidation is seen. There is a pacemaker in place. There is minimal elevation of the right hemidiaphragm. There is a large pleural effusion. No evidence of pneumothorax. The cardiac and mediastinal silhouettes are significantly altered. No displaced fracture is seen. Impression: Minimal elevation of the right hemidiaphragm. Otherwise, severe acute cardiopulmonary process.","['Change severity', 'Add contradiction', 'Add medical device']"
"afa7b0ef-ab36331f-40216eed-b9cb4a50-b937d72b, b382715f-507e867b-6b379590-4fdbbb24-df4d2116",55173284,16959871,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. Cardiac silhouette is top-normal.  No overt pulmonary edema is seen. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without focal consultation.  No plural effusion or pneumothorax is seen. Cardiac silhouette is tip-normal.  No overt pulmonary edema is seen. An NG tube is present in the gastrointestinal tract. Impression: Know acute cardiopulmonary process.,"['Change to homophone', 'Add typo', 'Add medical device']"
"68061713-5fff1c59-90ebb853-44566d77-ae9fe3c9, 9bbce2c8-90534017-445931b8-8f207173-2068749c",53093135,17002995,Findings: Heart size is normal. Mediastinal and hilar contours are unremarkable.  Pulmonary vasculature is normal. An ___ x 12 mm nodule is demonstrated projecting over the left upper lobe. Remainder of the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen.  There are no acute osseous abnormalities. Impression: 12 mm pulmonary nodule projecting over the left upper lobe. Further assessment with chest CT is recommended as this could reflect a malignancy.,Findings: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. An ___ x 12 cm nodule is demonstrated projecting over the left upper lobe. Remainder of the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. A central venous line is noted in the right jugular vein. Impression: 12 mm pulmonary nodule projecting over the left upper lobe. Further assessment with chest CT is recommended as this could reflect a malignancy. 12 mm pulmonary nodule projecting over the left upper lobe. Further assessment with chest CT is recommended as this could reflect a malignancy.,"['Change measurement', 'Add repetitions', 'Add medical device']"
"2467e1fa-601fff83-f7ee16a8-fa135c0c-e9d15320, 24d67d52-b980751d-ff001839-ec1fe0d5-494dd5ac",54961891,17002995,"Findings: The lungs are well inflated and grossly clear.  The cardiomediastinal silhouette is unremarkable.  Known left upper lobe nodule has been persistently decreasing in size on sequential exams, and is not perceptible on the current study. Impression: No acute cardiopulmonary process.",Findings: The lungs are well inflated and grossly clear.  The cardiomediastinal silhouette is unremarkable.  No nodule has been seen on the current study. Impression: No acute cardiopulmonary process.,"['Change location', 'Change to homophone', 'False negation']"
"a630e6f1-a760573b-d0a05341-d9831a18-a8de22c3, f428c50b-ff3f758f-7ec7be0b-831ee404-7190d0ed",57260304,17002995,"Findings: There are bibasilar opacities, left greater than right, likely corresponding to findings on recent CT which were felt to most likely represent atelectasis. The dominant left upper lobe pulmonary nodule is re-demonstrated. No other areas of focal consolidation suspicious for pneumonia. No pleural effusions or pneumothorax. Cardiomediastinal silhouette is within normal limits. No free air under in the hemidiaphragms. Impression: Left greater than right bibasilar opacities, felt to most likely represent atelectasis on the recent CT. Re-demonstration of dominant left upper lobe pulmonary nodule.","Findings: There are bibasilar opacities, right greater than left, likely corresponding to findings on recent CT which were felt to most likely represent atelectasis. No pulmonary nodules are re-demonstrated. No other areas of focal consolidation suspicious for pneumonia. No pleural effusions or pneumothorax. Cardiomediastinal silhouette is within normal limits. No free air under in the hemidiaphragms. Impression: Left greater than right bibasilar opacities, felt to most likely represent atelectasis on the recent CT. Re-demonstration of dominant left upper lobe pulmonary nodule. Dominant right upper lobe pulmonary nodule is absent.","['Change location', 'Add contradiction', 'False negation']"
df414677-421c5571-a5711a01-a5a598b8-a8a439dd,58538849,17002995,"Impression: As compared to the previous radiograph, no relevant change is seen. The lung volumes are low. There is no evidence of pneumonia or pulmonary edema.  No pneumothorax or larger pleural effusions. Normal size of the cardiac silhouette. The pre described left upper lobe 1 cm pulmonary nodule is no longer clearly identified but might be obscured by the ECG cable.","Impression: As compared to the previous radiograph, no relevant change is seen. The lung volumes are low. There is no evidence of pneumonia or pulmonary edema. No pneumothorax or larger pleural effusions. Normal size of the cardiac silhouette. The location of a cavitary lesion is suspected in the right upper lobe. The pre described left upper lobe 1.1 cm pulmonary nodule is no longer clearly identified but might be obscured by the ECG cable.","['Change measurement', 'Add repetitions', 'False prediction']"
"830c370a-a1f80137-f014ce2f-875aac45-4ead0285, f6903ec6-d68cd572-11a44700-84d1d724-3af57b2a",51182510,17052080,"Findings: Frontal and lateral views of the chest were obtained.  Mild cardiomegaly is new since ___.  There is calcification of the aortic knob.  Increased interstitial lung markings are compatible with mild pulmonary edema.  Patchy opacities at the lung bases may represent atelectasis, but infection cannot be excluded.  Minimal costophrenic blunting on lateral view suggests small bilateral pleural effusions.  There is no pneumothorax.  Osseous structures are unremarkable.  No radiopaque foreign bodies are seen. Impression: 1.  Patchy bibasilar opacities may represent atelectasis but cannot exclude infection.   2.  New mild cardiomegaly with mild pulmonary edema and small bilateral pleural effusion.","Findings: Frontal and lateral views of the chest were obtained.  Mild cardiomegaly is new since ___.  There is calcification of the left aortic knob.  Increased interstitial lung markings are compatible with mild pulmonary edema.  A pacemaker is present in the left upper chest.  Patchy opacities at the lung bases may represent atelectasis, but infection cannot be excluded.  Minimal costophrenic blunting on lateral view suggests small bilateral pleural effusions.  There is no pneumothorax.  Osseous structures are unremarkable.  Patchy opacities at the lung bases may represent atelectasis, but infection cannot be excluded. Impression: 1.  Patchy bibasilar opacities may represent atelectasis but cannot exclude infection.   2.  New mild cardiomegaly with mild pulmonary edema and small bilateral pleural effusion.","['Change location', 'Add repetitions', 'Add medical device']"
77dab00f-4b12bcda-d0dfea2c-e540bb9e-fe5b3114,50058197,17055995,"Findings: Single portable view of the chest.  Again, low lung volumes are seen.  Increased interstitial markings on the current exam suggestive of vascular congestion.  Left costophrenic angle is now more blunted potentially due to atelectasis, although effusion is also possible.  Linear retrocardiac opacity persists.  Cardiomediastinal silhouette is stable.  There is a new right IJ central venous catheter whose tip is in the right atrium and could be withdrawn 4.5 cm to be at the lower SVC.  No visualized pneumothorax.  Lower cervical fixation hardware is identified. Impression: New right IJ central venous line with tip likely within the right atrium and could be withdrawn to be in the lower SVC.  Pulmonary vascular congestion.","Findings: Single portable view of the chest. Again, low lung volumes are seen. Mild interstitial markings on the current exam suggestive of vascular congestion. Left costophrenic angle is now sharply defined, with no evidence of atelectasis or effusion. Linear retrocardiac opacity persists. Cardiomediastinal silhouette is stable. Moderate right IJ central venous catheter whose tip is in the right atrium and could be withdrawn 5.2 cm to be at the lower SVC. No visualized pneumothorax. Lower cervical fixation hardware is identified. A nasogastric tube is in place. Impression: New right IJ central venous line with tip likely within the right atrium and could be withdrawn to be in the lower SVC. Pulmonary congestion.","['Change measurement', 'Add contradiction', 'Add medical device']"
55a0e030-4bb997bd-b5d19ede-c9996085-f874501a,50152901,17055995,"Findings: Single portable view of the chest.  Right PICC line is no longer seen.  The patient is rotated to the left.  The lungs however are clear.  Calcified granuloma seen at the right lung base.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormality detected, lower cervical fixation hardware is again seen. Impression: No acute cardiopulmonary process.","Findings: Single portable view of the chest.  No PICC line is seen.  The patient is rotated to the right.  The lungs however are clear.  Calcified granuloma seen at the left lung base.  Cardiomediastinal silhouette is within normal limits.  No acute osseous abnormality detected, lower cervical fixation hardwear is again seen. Impression: No acute cardiopulmonary process.","['Change location', 'Change to homophone', 'False negation']"
"17c32bbc-a11cc59d-e3beafe6-d339e5f3-fd85e41e, fe3e3ba7-b7222cb7-bce60f53-58872f01-f8d40bcc",51169502,17055995,"Findings: The lung volumes are low.  The cardiac, mediastinal and hilar contours appear stable allowing for differences in technique.  There is fairly substantial retrocardiac opacification, although predominantly linear and streaky.  Elsewhere, the lungs appear clear.  There is no pleural effusion or pneumothorax. Impression: Retrocardiac opacity at the left lung base, somewhat striking although suggestive atelectasis; an infectious process is difficult to exclude, however.","Findings: The lung volumes are low.  The cardiac, mediastinal and hilar contours appear stable allowing for differences in technique.  There is no opacification.  Elsewhere, the lungs appear clear.  There is no pleural effusion or pneumothorax.  There is no pleural effusion or pneumothorax. Impression: Retrocardiac opacity at the right lung base, somewhat striking although suggestive atelectasis; an infectious process is difficult to exclude, however.","['Change location', 'Add repetitions', 'False negation']"
"1fbaa97f-bf02c806-cdfb8891-8e156d0d-35b03261, 77cc407a-183efd69-41f0301c-20bdabc5-8e4e57c8",51310684,17055995,"Findings: Frontal and lateral views of the chest were obtained.  The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax.  Heart size is normal.  Mediastinal silhouette and hilar contours are normal.  A 6-mm nodule in the right lower lung is unchanged since ___, compatible with a calcified granuloma.  Cervical spinal hardware is incompletely evaluated on this study. Impression: No acute intrathoracic process.","Findings: Frontal and lateral views of the chest were obtained.  The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax.  Heart size is normal.  Mediastinal silhouette and hilar contours are normal.  A 6-mm nodule in the left lower lung is unchanged since ___, compatible with a calcified granuloma.  No nodule seen. Impression: No acute intrathoracic process.Ill-defined 1-cm opacity in the left upper lung.","['Change location', 'Add contradiction', 'False negation']"
7300ed3f-578b9a92-0404bfde-931d53a6-03d1907c,52484430,17055995,"Findings: A few scattered calcified granulomas are seen at these right mid to lower lung.  Subtle patchy opacity at the medial right lung base may represent atelectasis, less likely pneumonia.  No pleural effusion is seen.  There is no pneumothorax.  The cardiac and mediastinal silhouettes are unremarkable.  Cervical surgical hardware is noted. Impression: Subtle patchy opacity at the medial right lung base may represent atelectasis, less likely pneumonia, however, pneumonia is not excluded in the appropriate clinical setting.","Findings: A few scattered calcified granulomas are seen at these left mid to lower lung.  Subtle patchy opacity at the medial right lung base may represent atelectasis, less likely pnuemonia.  No pleural effusion is seen.  There is no pneumothorax.  The cardiac and mediastinal silhouettes are unremarkable.  Cerivcal surgical hardware is noted. Impression: No atelectasis, however, pneumonia is not excluded in the appropriate clinical setting.","['Change location', 'Add typo', 'False negation']"
63a73093-e2949a4b-c2a38b30-87805d05-9375c863,52698656,17055995,"Impression: AP chest compared to ___, 9:54 a.m.:  Lung volumes are low, making it difficult to distinguish right basal vascular crowding from mild interstitial edema.  Heart is normal size and there is no mediastinal vascular engorgement or any pleural effusion, so edema is less likely.  There is a new left perihilar pulmonary opacity partially obscured by overlying EKG leads, but I suspect there is substantial atelectasis or new pneumonia.  Left PICC line ends in the mid to low SVC as before and an upper enteric tube ends in the stomach, which is not particularly distended despite severe gaseous distention of the rest of the intestinal tract in the upper abdomen.  No pneumothorax.  Dr. ___ was paged at 10:35 a.m. and I discussed the findings by telephone with the house officer covering the patient at 10:50 a.m.","Impression: AP chest compared to ___, 9:54 a.m.:  Lung volumes are low, making it difficult to distinguish right basal vascular crowding from mild interstitial edema.  Heart is normal size and there is no mediastinal vascular engorgement or any pleural effusion, so edema is less likely.  No pulmonary opacity seen.  Left PICC line ends in the left brachiocephalic vein as before and an upper enteric tube ends in the stomach, which is not particularly distended despite severe gaseous distention of the rest of the intestinal tract in the upper abdomen.  No pneumothorax.  Dr. ___ was paged at 10:35 a.m. and I discussed the findings bye telephone with the house officer covering the patient at 10:50 a.m.  ","['Change position of device', 'Change to homophone', 'False negation']"
8b0af9e3-cf03e510-2238b168-0fcfeaaa-379dac24,53400904,17055995,Impression: New mild peribronchial opacification right lower lobe could be due to recent aspiration or developing pneumonia.  Lungs otherwise clear.  No pleural abnormality.  Normal cardiomediastinal silhouette.  Left jugular line ends in the mid SVC.,Impression: New moderate peribronchial opacification right lower lobe could be due to recent aspiration or developing pneumonia. Lungs otherwise clear.  Know pleural abnormality.  Normal cardiomediastinal silhouette. A left jugular line ends in the mid SVC.  A pacemaker is present.,"['Change severity', 'Change to homophone', 'Add medical device']"
84c6ebfe-211d33d7-178a645a-3526f767-a15ec657,53437515,17055995,Findings: Comparison is made to previous study from ___.  The right IJ central line has been removed.  There is hardware within the lower cervical spine.  The heart size is unchanged and stable.  There is some atelectasis at the lung bases.  There are no signs for overt pulmonary edema or definite consolidation.  No pneumothoraces are present. ,Findings: Comparison is made to previous study from ___.  The left IJ central line has been removed.  There is hardware within the lower crevical spine.  The heart size is unchanged and stable.  There is no atelectasis.  There are no signs for overt pulmonary edema or definite consolidation.  No pneumothoraces are present.,"['Change location', 'Add typo', 'False negation']"
906e0eaa-60dfa37d-c7be4868-5d9613b9-f49fd253,53609513,17055995,"Findings: Left IJ central line stable.  Lung volumes are low compared to the prior radiograph.  The previously identified right peribronchial consolidation has increased in density, likely secondary to new edema and vascular congestion. Heart size and mediastinal contours are stable. No pleural effusion. Impression: New mild edema may obscure the previously questioned right aspiration/pneumonia.","Findings: Left IJ central line stable. Lung volumes are elevated compared to the prior radiograph. The previously identified right peribronchial consolidation has increased in density, likely secondary to new edema and vascular congestion. Heart size and mediastinal contours are stable. No pleural effusion. The lungs are clear.","['Change severity', 'Add contradiction', 'False prediction']"
d3640fc5-3d1186eb-94869353-5395e806-1c89a1fe,53624824,17055995,"Impression: As compared to ___ chest radiograph, cardiomediastinal contours are stable.  Previously present opacities in the periphery of the right mid and lower lung have nearly resolved, more as opacities in the left suprahilar in retrocardiac region have worsened.  Findings may reflect multifocal aspiration and or developing aspiration pneumonia.  No other relevant","Impression: As compared to ___ chest radiograph, cardiomediastinal contours are stable.  Previously present opacities in the periphery of the left mid and lower lung have nearly resolved, more as opacities in the left supraphilar in retrocardiac region have worsened.  Findings may reflect multifocal aspiration and or developing aspiration pneumonia, moderate left pleural effusion is noted.  No other relevan ","['Change location', 'Add typo', 'False prediction']"
"503519a9-27880621-f7f5d51c-348734b7-d6b70e30, 639a09fa-d71c9ec9-825e615e-eabc6326-ddd33f2e",54026889,17055995,"Findings: AP semi-upright and lateral views of the chest were obtained.  There are low lung volumes, though allowing for this, the lungs are clear bilaterally with no focal consolidation, effusion, or pneumothorax.  A small calcified granuloma in the right lower lung is re-demonstrated with a stable appearance.  There is no evidence of CHF.  Cardiomediastinal silhouette is normal.  Fixation hardware is noted in the lower C-spine.  Bony structures appear intact. Impression: No acute intrathoracic process.","Findings: AP semi-upright and lateral views of the chest were optained.  There are low lung volumes, though allowing for this, the lungs are clear unilaterally with no focal consolidation, effusion, or pneumothorax.  A small calcified granuloma in the right upper lung is re-demonstrated with a stable appearance.  A central venous line is noted in the right subclavian vein.  There is no evidence of CHF.  Cardiomediastinal silhouette is normal.  Fixation hardware is n0ted in the lower C-spine.  Bony structures appear intact. Impression: No acute intrathoracic process.  ","['Change location', 'Change to homophone', 'Add medical device']"
c6ba4cd5-16b6db55-ebf864d7-0988ad61-6d88b72a,54149564,17055995,Impression: No relevant change as compared to the previous image.  Low lung volumes.  Mild cardiomegaly.  Platelike atelectasis at the left lung bases.  New left internal jugular vein catheter in correct position.  No pneumothorax.,Impression: Referent change as compared to the previous image. Low lung volumes. Mild cardiomegaly. Platelike atelectasis at the left lung bases. New left internal jugular vein catheter in the mid SVC. There is a small right pleural effusion. No pneumothorax.,"['Change position of device', 'Change to homophone', 'False prediction']"
"2c2d37dc-72ce751c-11056009-510e46bd-65967968, 66e87912-67944022-478d3e89-9e031955-97e93818",54167022,17055995,"Findings: In comparison to the prior x-ray and CT, the predominantly left upper and mid lung zone opacities have resolved.  There is no definite consolidation.  There is no pleural effusion, pneumothorax, or pulmonary edema.  The cardiomediastinal silhouette is mildly enlarged.  A right PICC terminates in the low SVC.  Cervical hardware is present in the neck and incompletely evaluated.  Prominent air-filled loops of bowel are noted below the hemidiaphragms, and not significantly changed from the prior exam. Impression: 1.  No acute cardiopulmonary process. 2.  PICC terminates in the low SVC. 3.  Stable mild cardiomegaly. 3.  Prominent loops of air-filled bowel are partially imaged, and stable.  If further evaluation is necessary, could obtain a dedicated abdominal radiograph.","Findings: In comparison to the prior x-ray and CT, the predominantly left upper and mid lung zone opacities have resolved.  There is no definite consolidation.  There is no pleural effusion, pneumothorax, or pulmonary edema.  The cardiomediastinal silhouette is severely enlarged.  A right PICC terminates in the low SVC.  Cervical hardware is present in the neck and incompletely evaluated.  Prominent air-filled loops of bowel are noted below the hemidiaphragms, and not significantly changed from the prior exam. Impression: 1.  No acute cardiopulmonary process. 2.  No PICC line is noted. 3.  Stable mild cardiomegaly. 3.  Prominent loops of air-filled bowel are partially imaged, and stable.  If further evaluation is necessary, could obtain a dedicated abdominal radiograph. 4.  Mild cardiomegaly.","['Change severity', 'Add contradiction', 'False negation']"
d3b0b262-df43c83c-79c07524-fa37aa2e-c76d7762,54934752,17055995,Findings: Previously seen multifocal opacities in bilateral lungs have resolved since ___.  No focal consolidation suggestive of pneumonia is identified.  Linear opacity at lateral left lung base is likely atelectasis.  5 mm ovoid opacity at the right lung base is stable.  There is no pneumothorax or large pleural effusion.  Cardiomediastinal silhouette is normal size.  An apparent ___ scar pericardium is an artifact as the patient went on to have a CT urogram which include the heart and does not demonstrate a pneumopericardium.  Cervical spine hardware is again noted. Impression: No radiographic evidence of pneumonia.,Findings: Previously seen multifocal opacities in bilateral lungs have resolved since ___.  No focal consolidation suggestive of pneumonia is identified.  Linear opacity at lateral left lung base is likely atelectasis.  5 cm ovoid opacity at the right lung base is stable.  There is no pneumothorax.  Cardiomediastinal silhouette is normal size.  An apparent ___ scar pericardium is an artifact as the patient went on to have a CT urogram which include the heart and does not demonstrate a pneumopericardium.  Cervical spine hardware is again noted.  No radiographic evidence of pneumonia.  Cervical spine hardware is again noted.,"['Change measurement', 'Add repetitions', 'False negation']"
04ac83c1-740154cd-378f0bed-f4615e94-8e883aaa,55045318,17055995,"Findings: Single portable frontal chest radiograph demonstrates well-expanded lungs.  Heart is normal in size, and cardiomediastinal contours are unremarkable.  There is no pleural effusion or pneumothorax.  Small calcified granulomas are again noted.  The lungs are otherwise clear.  Lower cervical fusion hardware noted. Impression: No evidence of pneumonia.","Findings: Single portable frontal chest radiograph demonstrates well-expanded lungs.  Heart is enlarged, and cardiomediastinal contours are unremarkable.  There is no pleural effusion or pneumothorax.  Small calcified granulomas are again noted.  The lungs are otherwise clear.  Lower cervical fusion hardware noted.  An ET tube is in place, with the tip projected over the carina. Impression: Moderate pulmonary edema.","['Change location', 'Add contradiction', 'Add medical device']"
40b1972f-2f6feba2-c5ac00f1-9149a247-96ff94e9,55954897,17055995,"Impression: As compared to the previous radiograph, no relevant change is seen.  Low lung volumes.  Mild cardiomegaly.  No pneumonia, no pulmonary edema, minimal platelike atelectasis at the left lung bases.  Cervical fixation devices are in unchanged position.","Impression: As compared to the previous radiograph, no revelant change is seen. Low lung volumes. Mild cardiomegaly. Right lung shows minimal platelike atelectasis at the bases. No pneumonia, no pulmonary edema, minimal platelike atelectasis at the left lung bases. Cervical fixation devices are in unchanged position. Minimal right pleural effusion is noted.","['Change location', 'Add typo', 'False prediction']"
"3f8cc507-ca77e676-30fe438e-cee4bdae-7e09709e, 45cbf41b-9e484305-b9f7cb3b-331ed033-9a492278",56285032,17055995,Impression: No acute cardiopulmonary abnormality.,Impression: Mildly enlarged cardiomediastinal silhouette present.,"['Add medical device', 'Change to homophone', 'False prediction']"
"11765dae-ae3497e6-acedc8e9-0f57d4de-4c07c9c7, 4cbadab1-19a3f1d7-924d71a9-80bd338b-860e33bc",56479192,17055995,"Findings: AP upright and lateral views of the chest is obtained.  Cervical fusion hardware is partially imaged in the lower C-spine.  A calcified granuloma is again noted in the right lower lung.  The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax.  The heart and mediastinal contours appear normal.  No bony abnormality is seen.  No free air below the right hemidiaphragm. Impression: No acute intrathoracic process.","Findings: AP upright and lateral views of the chest is obtained.  Cervical fusion hardware is partially imaged in the lower C-spine.  No calcified granuloma is noted.  The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax.  The heart and mediastinal contours appear normal.  No bony abnormality is scene.  No free air below the left hemidiaphragm. Impression: No acute intrathoracic process.  ","['Change location', 'Change to homophone', 'False negation']"
18b5326b-5b4f4980-614310d4-32ef9bce-f33707f6,56991914,17055995,"Impression: As compared to the previous radiograph, the patient has received a nasogastric tube.  The tip of the tube projects over the pre-pyloric parts of the stomach. No complications, notably no pneumothorax.  The left internal jugular vein catheter is in unchanged position.  In the interval, the patient has developed a new parenchymal opacity at the bases of the right upper lobe, likely reflecting pneumonia.  The cardiac silhouette and the left lung are normal.","Impression: As compared to the previous radiograph, the patient has received an endotracheal tube. The tip of the tube projects over the pre-pyloric parts of the stomach. No complications, notably a mild pneumothorax. The right internal jugular vein catheter is in unchanged position. In the interval, the patient has developed a new parenchymal opacity at the bases of the right upper lobe, likely reflecting pneumonia. The placement of a pacemaker is noted.","['Change position of device', 'Add contradiction', 'Add medical device']"
63f3fead-8f7067d8-b703f056-7e6d61c7-4ccfad95,57722086,17055995,"Impression: AP chest compared to ___:  Right PIC line passes into the right atrium at least as far as a level 8.5cm lower than the carina.  As such, it could safely be withdrawn 4 cm and still lie in the low SVC.  Lungs are clear.  Heart size is normal.  There is no pneumothorax or pleural effusion.","Impression: AP chest compared to ___: Left PIC line passes into the right atrium at least as far as a level 8.5cm lower than the carina. As such, it could safely be withdrawn 4 cm and still lie in the low SVC. Lungs show diffuse opacities. Heart size is mildly enlarged. There is no pneumothorax or pleural effusion. A right-sided central venous line is noted.","['Change location', 'Add contradiction', 'Add medical device']"
9af43e05-bffaf881-a1c5987f-1e921b28-07fdccc9,57916180,17055995,"Impression: AP chest compared to ___:  What was relatively limited left perihilar consolidation on ___, now involves a good deal more of the left lung.  There may also be new cavitary lesions in the right lung, suggesting sepsis.  Pleural effusion is small if any.  Heart size top normal.  No pulmonary edema.  Dr. ___ was paged at 2:30 p.m. when the findings were recognized.","Impression: AP chest compared to ___:  What was relatively limited left perihilar consolidation on ___, now involves a moderate amount of the left lung.  There may also be new cavitary lesions in the right lung, suggesting sepsis.  Pleural effusion is small if any.  Heart size top normal.  No pulmonary edema.  Dr. ___ was paged at 2:30 p.m. when the findings were recognized.  There may also be new cavitary lesions in the right lung, suggesting sepsis.  An NG tube is in place.","['Change severity', 'Add repetitions', 'Add medical device']"
3e243490-c68adc7d-d56b5b8c-9435acf8-7d6b5338,57953511,17055995,"Impression: As compared to ___, no relevant change is seen.  Normal lung volumes.  Normal size of the cardiac silhouette.  No pleural effusions.  No pulmonary edema.  No pneumonia.","Impression: As compared to ___, nor relevant change is seen.  Normal lung volumes.  Normal size of the cardiac silhouette.  Right pleural effusion is noted.  No pulmonary congestion.  Clinical findings support pneumonia.","['Add typo', 'Add contradiction', 'False prediction']"
5b884d40-dbd3f418-77c8b6b7-eecb5a18-035015c0,58952124,17055995,"Findings: As compared to the most recent prior examination, there has been no significant interval change. Redemonstrated is a small degree of linear atelectasis at the left lung base. Lung volumes remain low. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema.  The cardiomediastinal silhouette is within normal limits.  The patient is status post cervical spine fixation with hardware noted in unchanged position. Impression: No evidence of acute cardiopulmonary process.","Findings: As compared to the most recent prior examination, there has been no significant interval change. Redemonstrated is a moderate degree of linear atelectasis at the left lung base. Lung volumes remain low. Their is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. Cardiac silhouette appears mildly enlarged. The cardiomediastinal silhouette is within normal limits. Abnormal opacity in the right upper lobe likely represents early pneumonia. The patient is status post cervical spine fixation with hardware noted in unchanged position. Impression: No evidence of acute cardiopulmonary process.","['Change severity', 'Change to homophone', 'False prediction']"
"78c48cee-1c2a502c-9a948c79-770c6b18-1c0335bf, abc5956e-8aef8550-9f0b9742-9da0df9a-e1a0c7cf",58971922,17055995,Impression: 1.  No acute intrathoracic process. 2.  Distended loops of large bowel.  Correlate with abdominal examination.,Impression: 1.  Mild acute intrathoracic process. 2.  Distended loops of large bowel.  Correlate with abdominal examination. 3.  Presence of a right-sided pacemaker.,"['Change severity', 'Add contradiction', 'Add medical device']"
66b3064a-b52efc14-63d86d5a-2ca784fb-c9d916a7,59405581,17055995,"Impression: As compared to ___ chest radiograph, cardiomediastinal contours are within normal limits and without change. Lungs are clear except for linear left basilar atelectasis.  No concerning pleural abnormality.","Impression: As compared to ___ chest radiograph, cardiomediastinal contours are within normal limits and without change. Lungs are clear except for linear left apical atelectasis.  No concerning plural abnormality. A pacemaker is noted in place.","['Change location', 'Change to homophone', 'Add medical device']"
"9ec31391-5cb6e49a-03c0288f-469b0fea-cff8d6c8, e8d69f7c-a0a4aaaf-1fffa003-792382cb-c70f248e",51468217,17063660,"Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are normal.  There is a rounded radiopaque structure with the appearance of the ring seen projecting over the left upper quadrant on the frontal view, not included on the lateral view. Impression: Rounded radiopaque structure with the appearance of a ring projects over the left upper quadrant on the frontal view, not seen/included on the lateral view.","Findings: The lunhs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  The cardiac and mediastinal silhouettes are normal.  There is a rounded radiopaque structure with the appearance of the ring seen projecting over the right upper quadrant on the frontal view, not included on the lateral view. An NG tube is present and properly positioned.","['Change location', 'Add typo', 'Add medical device']"
"581bd51a-61e5b86c-e90de29e-d6f1eaf5-f42cd0ff, 7ae4351b-7e72e14c-eb8194a8-855b4a50-9f496411",53103953,17063660,"Findings: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, pneumothorax, or radiopaque foreign body.  The cardiomediastinal silhouette is normal. ","Findings: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. There is a radiopaque foreign body in the lower left thorax. The cardiomediastinal silhouette is normal. ","['Change location', 'Add contradiction', 'False prediction']"
"1ad714a9-437bbce6-a694ad02-05512130-333e99af, 89c1162a-5fa4ed9c-c008cc39-f0bdb24c-2fe6296b",52544664,17079101,"Findings: Frontal and lateral views of the chest were obtained.  Lateral views are suboptimal due to patient positioning and underpenetration.  It is difficult to exclude bilateral pleural effusions.  Low lung volumes persist on the frontal view, with elevated right hemidiaphragm.  There is prominence of the interstitium, suggesting interstitial edema.  The cardiac and mediastinal silhouettes are stable.  Surgical clips project over the right aspect of the mediastinum. ","Findings: Frontal and lateral views of the chest were obtained.  Lateral views are suboptimal due to patient positioning and underpenetration.  It is difficult to exclude left pleural effusions.  Low lung volumes persist on the frontal view, with elevated left hemidiaphragm.  There is prominence of the interstitium, suggesting interstitial edema.  The cardiac and mediastinal silhouettes are stable.  Surgical clips project over the right aspect of the mediastinum.  There is a central venous line.","['Change location', 'Add repetitions', 'Add medical device']"
83cada44-22eeaa71-e5622be6-dd3eb0ad-9b1ccc68,55257270,17079101,"Findings: The right PICC has been retracted with the tip now terminating in the upper-to-mid SVC.  The appearance of the chest is otherwise unchanged from chest radiograph performed earlier the same day with evidence of right-sided volume loss, mild pulmonary vascular congestion and mild bibasilar atelectasis. Impression: Right PICC retracted with tip terminating in the upper-to-mid SVC.  Findings were reported by Dr. ___ to IV nurse, ___, via telephone at 10:40 a.m. on ___.","Findings: The right PIC-line has been retracted with the tip now terminating in the lower-to-mid SVC.  The appearance of the chest is otherwise unchnaged from chest radiograph performed earlier the same day with evidence of right-sided volume loss, mild pulmonary vascular congestion and mild bibasilar atelectasis.  There is also the presence of a nasogastric tube. Impression: Right PICC retracted with tip terminating in the upper-to-mid SVC.  Findings were reportd by Dr. ___ to IV nurse, ___, via telephone at 10:40 a.m. on ___.  
","['Change position of device', 'Add typo', 'Add medical device']"
b6d980d3-b586c166-d29fa9de-6a7335ae-35148194,58066330,17079101,"Findings: The inspiratory lung volumes remain low.  Elevation of the right hemidiaphragm is unchanged, compatible with prior right lung resection.  There is improved aeration of the left lung base without blunting of the costophrenic angle to suggest pleural effusion.  There is increased opacification of the right lung, predominantly affecting the lower lung zone, which silhouettes the right hemidiaphragm and the right heart border.  There is mild pulmonary vascular congestion.  The cardiomediastinal silhouette remains prominently enlarged but stable compared to the remote prior study of ___.  Surgical clips are noted projecting over the right upper mediastinum.  Hypertrophic degenerative changes of the thoracic spine are also noted. Impression: Increased opacification of the right lung, likely a combination of pleural fluid and underlying atelectasis.  Given the mild pulmonary vascular congestion, this may represent fluid overload but given the recent history of trauma, injury is not excluded.  If there is clinical concern for trauma, a non-contrast chest CT would be recommended for further evaluation.","Findings: The inspiratory lung volumes remain low. No elevation of the right hemidiaphragm.  There is improved aeration of the left lung base without blunting of the costophrenic angle to suggest pleural effusion. There is increased opacification of the right lung, predominantly affecting the lower lung zone, which silhouettes the right hemidiaphragm and the right heart border. There is mild pulmonary vascular congestion. The cardiomediastinal silhouette remains prominently enlarged but stable compared to the remote prior study of ___. Surgical clips are noted projecting over the right upper mediastinum. There is mild pulmonary vascular congestion. Hypertrophic degenerative changes of the thoracic spine are also noted. Impression: Increased opacification of the right lung, likely a combination of pleural fluid and underlying atelectasis. Given the mild pulmonary vascular congestion, this may represent fluid overload but given the recent history of trauma, injury is not excluded. If there is clinical concern for trauma, a non-contrast chest CT would be recommended for further evaluation.","['Change name of device', 'Add repetitions', 'False negation']"
c192e7be-3c9c15d0-ae8a7d3d-a117f975-65afe9ad,59546763,17079101,"Findings: In comparison to the most recent prior study, there is improved aeration at the right lung base with improved definition of the right hemidiaphragm and right heart border suggesting decreased atelectasis and pleural fluid.  The left lung remains clear without pleural effusion or focal consolidation.  No pneumothorax is present.  The right hemidiaphragm remains elevated compatible with prior right lung resection.  There is decreased but persistent mild pulmonary vascular congestion.  The cardiomediastinal silhouette remains prominently enlarged but stable.  Surgical clips project to the right of the trachea, compatible with prior lung resection. Impression: 1.  Improved aeration of the right lung base compatible with decreased atelectasis and pleural fluid. 2.  Improved but persistent mild pulmonary vascular congestion. 3.  Stable appearance status post right partial lung resection.","Findings: In comparison to the most recent prior study, there is improved aeration at the right lung base with improved definition of the right hemidiaphragm and right heart border suggesting decreased atelectasis and pleural fluid.  The left lung remains clear without pleural effusion or focal consolidation.  No pneumothorax is present.  The right hemidiaphragm remains elevated compatible with prior right lung resection.  There is decreased but persistent mild pulmonary vascular congestion.  The cardiomediastinal silhouette remains prominently enlarged but stable.  Surgical stapler project to the right of the trachea, compatible with prior lung resection. Impression: 1.  Improved aeration of the right lung base compatible with decreased atelectasis and pleural fluid. 2.  Improved but persistent mild pulmonary vascular congestion. 3.  Stabkle appearance status post right partial lung resection.","['Change name of device', 'Add typo', 'False negation']"
40fa80dc-953c68e3-cbcf1c09-d87a60a4-d82a5ae8,52468610,17093296,"Impression: In comparison with the study of ___, there again are bilateral pleural effusions with compressive atelectasis at the bases, more prominent on the left.  Following apparent thoracentesis, there is no evidence of pneumothorax. Cardiomediastinal silhouette is unchanged.  Mild indistinctness of pulmonary vessels suggests some elevated pulmonary venous pressure.","Impression: In comparison with the study of ___, there again are large bilateral pleural effusions with compressive atelectasis at the bases, more prominent on the left. Following apparent thoracentesis, there is no evidence of pneumothorax. Cardiomediastinal silhouette is unchanged.  Mild indistinctness of pulmonary vessels suggests some elevated pulmonary venous pressure. No pleural effusion is detected. Cardiomediastinal silhouette is severely enlarged.","['Change severity', 'Add contradiction', 'False prediction']"
fb12f610-81c4f11d-89fa082e-653ba4ff-ae31e112,55434052,17093296,Findings: Interval removal of endotracheal tube and nasogastric tube as well chest tubes.  Right IJ catheter persists at the cavoatrial junction.  No visualized pneumothorax or pleural effusion.  Lungs are clear. Impression: No pneumothorax.,Findings: Interval removal of endotracheal tube and nasogastric tube as well chest tubes.  Right IJ catheter terminates in the mid SVC.  No visualized pneumothorax or pleural effusion.  Lungs are hyperinflated. Impression: No pneumothorax. There are bilateral diffuse interstitial opacities with a perihilar predominance.,"['Change position of device', 'Add contradiction', 'False prediction']"
"0aa50d1d-a705af1d-2ae94264-d816f57d-7bf020dc, 14a371c8-e698a492-073190b7-4a94b510-d22fbe78",57108303,17093296,"Impression: Compared to chest radiographs ___ through ___.  Small bilateral pleural effusions are new or larger.  Moderate left basal atelectasis still present.  No pneumothorax.  No pulmonary edema.  Moderate cardiomegaly unchanged.  Normal postoperative mediastinum, including small retrosternal air collection appreciated on the lateral view.  This also shows small volume of pre sternal subcutaneous emphysema, probably not clinically significant.","Impression: Compared to chest radiographs ___ through ___. Small bilateral pleural effusions are new or larger. Moderate left basal atelectasis still present. No pneumothorax. No pulmonary edema. Moderate cardiomegaly unchanged. Normal postoperative mediastinum, including small retrosternal air collection appreciated on the lateral view. A pacemaker is present. This also shows small volume of pre sternal subcutaneous emphysema, probably not clinically significant. No pneumothorax.","['Change location', 'Add repetitions', 'Add medical device']"
92846817-78ec0a2e-50265c40-0e7cad3b-6d912f6e,50056854,17096560,"Impression: 1.  Left-sided subclavian Port-A-Cath continues to have its tip in the distal SVC, near the cavoatrial junction.  Heart remains enlarged, which may reflect cardiomegaly, although pericardial effusion should also be considered.  Mediastinal contours are unchanged.  There is persistent minimal blunting the left costophrenic angle, which may represent a tiny effusion or chronic pleural thickening.  Streaky linear opacities at the left base may reflect areas of atelectasis or scarring.  No focal airspace consolidation is seen to suggest pneumonia.  No pneumothorax.  No evidence of pulmonary edema.  Linear density overlying the left upper quadrant is likely external to the patient, but clinical correlation would be recommended.","Impression: 1.  Left-sided subclavian Port-A-Cath continues to have its tip in the distal SVC, near the cavoatrial junction.  Heart remains severely enlarged, which may reflect cardiomegaly, although pericardial effusion should also be considered.  Mediastinal contours are unchanged.  There is persistent minimal blunting the left costophrenic angle, which may represent a tiny effusion or chronic pleural thickening.  Streaky linear opacities at the left base may reflect areas of atelectasis or scarring.  No focal airspace consolidation is seen to suggest pneumonia.  A nasogastric (NG) tube is present.  No pneumothorax.  No evidence of pulmonary edema.  Linear density overlying the left upper quadrant is likely external to the patient, but clinical correlation would be recommended.  No focal airspace consolidation is seen to suggest pneumonia.","['Change severity', 'Add repetitions', 'Add medical device']"
"0615d7dd-3b5b225b-dfe7b687-a299a0e3-7dcfae33, c6ff3b8e-07a7eb38-b89bf998-27af7b34-4c8df007",51658352,17096560,"Impression: As compared to the previous radiograph, no relevant change is seen.  Left pectoral Port-A-Cath. Moderate cardiomegaly with tortuosity of the thoracic aorta and slightly enlarged aortic knob.  The lung parenchyma is unchanged in radiographic appearance.  No pneumonia or other parenchymal opacities.  No pleural effusions.","Impression: As compared to the previous radiograph, no rilevant change is seen.  Left pectoral Pacemaker. No cardiomegaly.  The lung parenchyma is unchanged in radiographic appearance.  No pneumonia or other parenchymal opacities.  No pleural effusions.","['Change name of device', 'Add typo', 'False negation']"
1d8b6f1b-f2623043-0b88aff3-36ffde7e-aba0484f,54159511,17096560,"Findings: As compared to the previous radiograph, the distribution of the left pleural effusion is slightly changed, but the overall extent is not.  The bases of the right lung are better ventilated than on the previous image.  The size of the cardiac silhouette continues to be enlarged.  No evidence of pneumothorax.  Unchanged left pectoral Port-A-Cath. ","Findings: As compared to the previous radiograph, the distribution of the right pleural effusion is slightly changed, but the overall extent is not.  The bases of the right lung are better ventilated than on the previous image.  The size of the cardiac silhouette continues to be enlarged.  No evidence of pneumothorax.  The bases of the right lung are better ventilated than on the previous image.  Bilateral mild pleural effusion is noted.","['Change position of device', 'Add repetitions', 'False prediction']"
b3cc74ec-d3bd5172-abf56e57-6a47cce6-7e7a9b99,57222183,17096560,"Findings: As compared to the previous radiograph, no relevant change is seen. A pre-existing small left pleural effusion is smaller than on the previous image.  Mild cardiomegaly without pulmonary edema.  No pneumonia.  No pneumothorax.  The left pectoral Port-A-Cath is in unchanged position. ","Findings: As compared to the previous radiograph, no relevant change is seen. A pre-existing small left pleural effusion is smaller than on the previous image. Mild cardiomegaly without pulmonary edema. No pneumonia. No pneumothorax. The left pectoral vascular stent is in unchanged position.","['Change name of device', 'Add repetitions', 'False prediction']"
382be4ba-6b111a62-d9907d36-c84223b9-6dedb3a8,53147687,17123098,"Findings: Compared to chest radiographs from ___, there is been interval removal of an endotracheal tube.  Lung volumes remain low.  Moderate cardiomegaly with mild central vascular congestion and possible new mild interstitial pulmonary edema.  Probable small bilateral pleural effusions with associated atelectasis, left greater than right, are unchanged.  No new focal consolidation.  No pneumothoraces.  Mediastinal widening has slightly improved and may reflect mild congestion of mediastinal veins. Impression: 1. Persistent probable small bilateral effusions with associated atelectasis. 2. Stable moderate cardiomegaly with central vascular congestion and possible new mild interstitial pulmonary edema. 3. No new focal consolidation concerning for infection or aspiration.","Findings: Compared to chest radiographs from ___, there has been interval removal of an endotracheal tube.  Lung volumes remain low.  Moderate cardiomegaly with mild central vascular congestion and possible new mild interstitial pulmonary oedema.  Probable small bilateral pleural effusions with associated atelectasis, left greater than right, are unchanged.  No new focal consolidation.  No pneumothoraxes.  Mediastinal widening has slightly improved and may reflect mild congestion of mediastinal veins.  A right IJ central venous catheter tip terminates in the right atrium. Impression: 1. Persistent probable small bilateral effusions with associated atelectasis. 2. Stable moderate cardiomegaly with central vascular congestion and possible new mild interstitial pulmonary edema. 3. No new focal consolidation concerning for infection or aspiration.","['Change position of device', 'Change to homophone', 'Add medical device']"
14bbb4e5-1b3f6563-a2dd6104-100f4a33-0719fe11,54687111,17123098,"Findings: Compared to chest radiographs from ___, lung volumes have worsened and retrocardiac opacity has increased, consistent with left lower lobe collapse.  Small left pleural effusion is new.  No large effusion on the right.  Right basilar opacities have improved.  Vascular congestion has improved and there is no overt pulmonary edema.  Heart size, which is difficult to assess in the setting of effusion, is mildly enlarged and unchanged.  ET tube is in standard placement, unchanged.  Right PIC line terminates at the cavoatrial junction. Impression: 1. Retrocardiac opacification reflects new left lower lobe collapse.  New small left pleural effusion. 2. Improved right basilar opacities, likely atelectasis. 3. Stable mild cardiomegaly.","Findings: Compared to chest radiographs from ___, lung volumes have worsened and retrocardiac opacity has increased, consistent with left lower lobe collapse. Small left pleural effusion is knew. No large effusion on the right. Right basilar opacities have improved. Vascular congestion has improved and there is moderate overt pulmonary edema. Heart size, which is difficult to assess in the setting of effusion, is severely enlarged and unchanged. ET tube is in standard placement, unchanged. Right PIC line terminates at the cavoatrial junction. NG tube is visualized coiled in the stomach. Impression: 1. Retrocardiac opacification reflects new left lower lobe collapse. New small left pleural effusion. 2. Improved right basilar opacities, likely atelectasis. 3. Stable mild cardiomegaly.","['Change severity', 'Change to homophone', 'Add medical device']"
7a63f567-e729a4cb-1392efd5-a3130267-c02dcb1d,55293550,17123098,Impression: NG tube has been removed.  ET tube is in standard position.  Right PICC tip is at the cavoatrial junction.  There is no evident pneumothorax.  Vascular congestion has improved.  Bibasilar opacities have improved still large in the left lower lobe.  No other interval change,"Impression: NG tube has been inserted.  ET tube is 3 cm above the carina.  Right PICC tip is in the mid SVC.  There is no evident pneuumothorax.  Vascular congestion has improved.  Bibasilar opacities have improved, still large in tne left lower lobe.  No other interval change","['Change position of device', 'Add typo', 'Add medical device']"
46aa0c3b-dfb23768-f0c1ea37-80bf872e-01459617,55374533,17123098,"Findings: Endotracheal tube tip is 3.5 cm above carina.  Right PICC low-lying tip is in the mid to low SVC, overlie spine and is difficult to see.  Postoperative changes in the spine.  There are bilateral pleural effusions, similar.  Improved lung aeration since prior.  Improved pulmonary vascularity. Heart is mildly enlarged.  Left basilar opacity, mildly worsened, in part from atelectasis given volume loss, consider pneumonia or aspiration if clinically appropriate.  Improved right basilar opacity.  No pneumothorax. Impression: Left basilar opacity has mildly worsened, in part atelectasis, consider aspiration or pneumonia if clinically appropriate.","Findings: Endotracheal tube tip is 3.9 cm above carina.  Right PICC low-lying tip is in the mid to low SVC, overlie spine and is difficult to see.  No postoperative changes are seen.  There are bilateral pleural effusions, similar.  Improved lung aeration since prior.  Improved pulmonary vascularity. Heart is mildly enlarged.  Left basilar opacity, mildly worsened, in part from atelectasis given volume loss, consider pneumonia or aspiration if clinically appropriate.  Improved right basilar opacity.  No pneumothorax. Impression: No left basilar opacity.","['Change measurement', 'Add contradiction', 'False negation']"
2225b7e3-b00d512a-593b4836-fb3e6b4a-fa2b1ae5,55665898,17123098,"Impression: In comparison with the study of ___, the endotracheal tube tip lies approximately 4.5 cm above the carina.  Otherwise little change. Continued enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure.  Probable bilateral layering pleural effusions with underlying compressive atelectasis, more prominent on the left.","Impression: In comparison with the study of ___, the endotracheal tube tip lies approximately 5.3 cm above the carina.  Otherwise little change. Continued enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure.  Otherwise little change. Probable bilateral layering pleural effusions with underlying compressive atelectasis, more prominent on the left. There is a centrally placed pacemaker.","['Change measurement', 'Add repetitions', 'Add medical device']"
ce5a7d22-9e290fa1-b2beb2a9-b96c795f-0e1a66a0,59311887,17123098,"Impression: In comparison with the study of ___, there has been a cervical fusion procedure.  Endotracheal tube tip is at the clavicular level, approximately 6 cm above the carina. The patient has taken a better inspiration though there again is enlargement of the cardiac silhouette.  Mild indistinctness of pulmonary vessels could reflect minimal elevation of pulmonary venous pressure.  The left hemidiaphragm is obscured, consistent with volume loss left lower lobe and pleural fluid.","Impression: In comparison with the study of ___, there has been a cervical fusion procedure.  Endotracheal tube tip is at the clavciular level, approximately 6 cm above the carina. The patient has taken a better inspiration though there again is severe enlargement of the cardiac silhouette.  Mild indistinctness of pulmonary vessels could reflect moderate elevation of pulmonary venous pressure.  The left hemidiaphragm is obscured, consistent with volume loss left lower lobe, pleural fluid, and right-sided consolidation.","['Change severity', 'Add typo', 'False prediction']"
"498d4233-b79acb1f-5f5d9e8b-d128016a-377264e0, bb9f6308-e8b75c46-eb75bea5-d3da1b42-7b1ddf12",59109176,17123238,Impression: No acute intrathoracic process.  Right pulmonary metastases have increased in size.,Impression: No actue intrathoracic process.  Left pulmonary metastases have increased in size.  There is a central venous line in place.,"['Change location', 'Add typo', 'Add medical device']"
526a62c7-2062d35d-cde3cc73-7934b77c-256c9a3c,50124571,17223574,"Impression: AP chest compared to ___:  Mild pulmonary edema is improving, moderate cardiomegaly and low lung volumes are also improved.  Pleural effusions are small if any.  No pneumothorax.","Impression: AP chest compared to ___:  Mild pulmonary edema is improving, severe cardiomegaly and low lung volumes are also improved.  Pleural effusions are small if any.  No pneumothorax.  Mild pulmonary edema is improving.","['Change severity', 'Add repetitions', 'Add medical device']"
"2dca8086-7691c675-6078acc9-e190d786-24ed5466, 3e1d14ba-fe736cda-ebd2ef10-3dbcdb89-da6f2980",51511763,17223574,"Findings: Lung volumes are low.  The heart is normal in size, and there is no overt edema.  No focal consolidation, pleural effusion or pneumothorax is seen. Impression: No acute cardiopulmonary process.","Findings: Lung volumes are llow. The heart is normal in size, and there is no overt edema. No focal consolidation, pleural effusion or pneumothorax is seen. No focal consolidation, pleural effusion or pneumothorax is seen. Impression: No acute cardiopulmonary process. No acute cardiopulmonary process is seen.","['Add repetitions', 'Add typo', 'False negation']"
"4036f736-4f89546f-95a68b44-55bb97d3-fa07a45b, 80394587-5cae6c52-0e47c884-fc81d7a5-aa49039a",52530059,17223574,"Findings: ETT tip ends above the clavicles, 55 mm above the carina.  Decreased lung volumes.  Cardiomegaly.  Marked interval progression of the bilateral mid and lower lung zone airspace opacification with bilateral pleural effusions. Impression: ET tip 55 mm proximal to the carina, but please note that the patient has a relatively short trachea and no more than 2 - 3cm advancement is advised. This was telephoned to the referring physician. Marked progression of the bilateral mid to lower lung zone airspace opacification which most likely represents pulmonary edema but superimposed infection or aspiration cannot be excluded.","Findings: ETT tip ends above the clavicles, 63 mm above the carina.  Decreased lung volumns.  No cardiomegaly.  Marked interval progression of the bilateral mid and lower lung zone airspace opacification with bilateral pleural effusions. Impression: ET tip 55 mm proximal to the carina, but please note that the patient has a relatively short trachea and no more than 2 - 3mm advancement is advised. This was telphoned to the referring physician. No airspace opacification which may represent pulmonary edema.","['Change measurement', 'Add typo', 'False negation']"
8af200b2-6d16d8b6-7cf5ca1c-30dfcdce-74779c42,53272126,17223574,"Findings: As compared to the previous radiograph, patient has been intubated. The tip of the endotracheal tube projects 5 cm above the carina.  The patient has also received a nasogastric tube, the course of the tube can be followed through the upper and mid third of the esophagus but is not visible more peripherally than that.  Decreased lung volumes and increased diameter of the pulmonary vasculature, combined with blunting of the left costophrenic sinus, potentially reflecting moderate pulmonary edema and a small pleural effusion.  In addition atelectases are seen at both lung bases.  Moderate cardiomegaly.  No evidence of pneumonia. ","Findings: As compared to the previous radiograph, patient has been intubated. The tip of the nasogastric tube projects 5 cm above the carina.  The patient has also received a nasogastric tube, the course of the tube can be followed through the upper and mid third of the esophagus but is not visible more peripherally than that.  Decreased lung volumes and increased diameter of the pulmonary vasculature, combined with blunting of the left costophrenic sinus, potentially reflecting moderate pulmonary edema and a small pleural effusion.  In addition atelectases are scene at both lung bases.  Moderate cardiomegaly.  No evidence of pneumonia.  A right-sided PICC line ends in the mid SVC.","['Change name of device', 'Change to homophone', 'Add medical device']"
3999a847-88ce9e99-f417c320-d26274e2-e47cd770,53660624,17223574,"Impression: Compared to chest radiographs since ___, most recently ___.  Increased pulmonary vascular and mediastinal venous caliber suggests volume overload and/or biventricular cardiac decompensation.  No focal pulmonary abnormality or pleural effusion.",Impression: There is a slight enhancement in pulmonary vasculature that may indicate early signs of edema. Increased pulmonary vascular and mediastinal venous claliber suggests volume overload and/or biventricular cardiac decompensation.  No focal pulmonary abnormality or pleural effusion.,"['Add contradiction', 'Add typo', 'False negation']"
"45f4bdf0-94ec8ad6-63252991-1a72f5bf-92cbbefe, b058bdb1-6a9896e5-00708569-5736cf87-151a9cd3",53855769,17223574,"Findings: Low lung volumes are noted with secondary bibasilar atelectasis, more so on the left.  The lungs are otherwise grossly clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.","Findings: Low lung volumes are noted with secondary bibasilar atelectasis, more so on the right.  The lungs are otherwise grossly clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No atelectasis.","['Change location', 'Change to homophone', 'False negation']"
"1ae239ae-c49b335a-2053350f-d1cc2db8-ae676e6d, 64b12f28-e1b71b36-adbe4920-76807755-1fa29f3b",56094876,17223574,Impression: Compared is radiographs dated ___ through ___.  Borderline interstitial edema persists along with moderate cardiomegaly and mediastinal vascular engorgement.  No focal pulmonary abnormality.  No pleural abnormality.   Tracheostomy tube midline.,Impression: Compared is radiographs dated ___ through ___. Borderline interstitial edema persists along with mild cardiomegaly and mediastinal vascular engorgement. No focal pulmonary abnormality. No pleural abnormality. Tracheostomy too midline.,"['Change severity', 'Change to homophone', 'False negation']"
6231218a-08114abf-f7126f7b-47637bda-23592f97,56459009,17223574,"Findings: Evaluation is limited by body habitus.  There is a tracheostomy in similar position.  Lung volumes are low causing accentuation of the central bronchovascular structures.  The heart is enlarged, and there is no pulmonary edema.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Impression: 1.  Cardiomegaly. 2.  If clinical concern for positioning of the tracheostomy, a lateral chest radiograph would be helpful.","Findings: Evaluation is limited by body habitus.  There is a nasal cannula in similar position.  Lung volumes are low causing accentuation of the central bronchovascular structures.  The heart is enlarged, and pulmonary edema is noted.  The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Impression: 1.  No cardiomegaly. 2.  If clinical concern for positioning of the tracheostomy, a lateral chest radiograph would be helpful.","['Change name of device', 'Add contradiction', 'False negation']"
"0310ac4a-6a3d539e-8a9a8d70-191de66a-68379772, 1832c94a-dc3c5e5e-670d683b-9cea6356-c7b26521",57443673,17223574,"Impression: Comparison to ___.  No relevant change.  Relatively low lung volumes.  Borderline size of the cardiac silhouette.  Minimal retrocardiac atelectasis.  No overinflation, no pneumonia, no pulmonary edema, no pleural effusions.","Impression: Comparison to ___. No relevant change. Relatively low lung volumes. Borderline size of the cardiac silhouette. Minimal retrocardiac atelectasis with a subtle left lower lobe consolidation. No overinflation, no pneumonia, no mild pulmonary edema, no pleural effusions. ","['Change severity', 'Change to homophone', 'False prediction']"
7875b25f-a66526e3-18d0bf41-b6c02def-fecc262f,57523955,17223574,"Impression: Comparison to ___, 04:30.  Further increase in extent of the right pleural effusion.  Otherwise no relevant change.  Severe cardiomegaly with mild to moderate pulmonary edema.  Extensive areas of atelectasis at the left lung basis.  No pneumothorax.  Stable position of the tracheostomy tube.","Impression: Comparison to ___, 04:30.  Further increase in extent of the rigth pleural effusion.  Otherwise no relevant change.  Severe cardiomegaly with moderate to severe pulmonary edema.  Extensive areas of atelectasis at the left lung basis.  No pneumothorax.  Stable position of the tracheostomy tube.  Central venous line is present.","['Change severity', 'Add typo', 'Add medical device']"
"23da6a40-206b0fe5-4430f35c-da1bde03-162f435d, ce3497c0-922d4dd2-08069cc3-2a7c30c2-b8169070",57575964,17223574,Impression: Comparison to ___.  The patient has received a tracheostomy tube.  The tube appears to be in correct position.  No evidence of pneumothorax or other complication.  Low lung volumes.  Massive cardiomegaly with bilateral moderate pleural effusions and subsequent areas of atelectasis.  Mild pulmonary edema.,Impression: Comparison to ___.  The patient has received a tracheostomy tube.  The tube appears to be positioned too low.  No evidence of pneumothorax or other complication.  Low lung volumes.  No signs of cardiomegaly or pleural effusions.  Mild pulmonary edema.,"['Change position of device', 'Change to homophone', 'False negation']"
6eb8281f-7dcfeab5-b9e25878-92be8a26-531519ea,57690878,17223574,"Findings: As compared to the previous radiograph, the monitoring and support devices are in unchanged position.  There is unchanged moderate cardiomegaly at low lung volumes, but evidence suggesting mild-to-moderate pulmonary edema is more tangible than on the previous image.  Small bilateral pleural effusions could be present.  There is relatively extensive bilateral basal atelectasis.  No evidence of pneumothorax. ","Findings: As compared to the previous radiograph, the monitoring and support devices are in unchanged position.  There is unchanged severe cardiomegaly at low lung volumes, but evidence suggesting mild-to-moderate pulmonary edema is more tangible than on the previous image.  Small bilateral pleural effusions could bee present.  There is relatively extensive bilateral basal atelectasis.  A left lower lobe infiltrate is noted.  ","['Change severity', 'Change to homophone', 'False prediction']"
"09f76ca2-07de6658-6d7fc2c9-12690ff3-a34915f1, 32669e3a-7cb50378-471dabe1-a85d90ce-332159a5",59919455,17223574,Findings: Lung volumes are low which accentuates bronchovascular markings.  There is pulmonary vascular congestion and mild pulmonary edema.  A more focal consolidation at the base of the right lung could reflect an area of infection in the appropriate clinical setting.  No pleural effusions are seen.  There is no pneumothorax. Impression: Mild pulmonary vascular congestion and pulmonary edema. More focal consolidation at the base of the right lung may reflect an area of infection though is likely related to pulmonary edema.,Findings: Lung volumes are low which accentuates bronchovascular markings.  There is pulmonary vascular congestion and moderate pulmonary edema.  A more focal consolidation at the base of the left lung could reflect an area of infection in the appropriate clinical setting.  No pleural effusions are seen.  There is a small left pneumothorax. Impression: Mild pulmonary vascular congestion and pulmonary edema. More focal consolidation at the base of the right lung may reflect an area of infection though is likely related to pulmonary edema.  No evidence of pneumothorax.,"['Change location', 'Add contradiction', 'False prediction']"
"28f9743e-efd1d49e-a076e33b-55ff41c5-4ffe3a44, cef536f7-4e642cbb-62068854-95acc1eb-ff276ffa",53874691,17230915,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal. There is a small pleural effusion on the left. The mediastinal and hilar contours are normal. There is mild cardiomegaly noted. The pulmonary vasculature is normal. Lungs are clear. The tip of an endotracheal (ET) tube is positioned above the carina. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality. ,"['False prediction', 'Add contradiction', 'Add medical device']"
"07455488-3fc54c14-ee5c25d1-ce6e6897-03ddef23, c5a10c55-fe2fbefc-135e4b8e-337a3279-db03af87",58226444,17230915,Findings: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion.  The osseous structures are unremarkable Impression: No acute cardiopulmonary abnormalities,Findings: Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are outer markableImpression: Extensive acute cardiopulmonary abnormalities,"['Add contradiction', 'Change to homophone', 'False negation']"
d6f297e0-277785b9-0dade959-c098d1a4-1d5c202a,50572758,17257394,Findings: Heart size is normal with mild tortuosity of thoracic aorta.  Hilar contours are unremarkable.  Lungs are clear.  Pleural surfaces are clear without large effusion or pneumothorax. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal with moderate tortuosity of thoracic aorta.  Hilar counters are unremarkable.  Lungs are clear.  Pleural surfaces are clear without large effusion or pneumothorax.  A central venous line is noted in the right atrium. Impression: No acute cardiopulmonary abnormality.,"['Change severity', 'Change to homophone', 'Add medical device']"
"620e390e-9859fe21-06a3d4f4-5234159a-3a7615ba, f6238a46-332ae5d8-ea99fed8-fb2466b2-20299e40",51500297,17257394,Findings: Heart size is normal.  The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.  Moderate degenerative changes are seen in the thoracic spine. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is scene. There are no acute osseous abnormalities. Moderate degenerative changes are seen in the thoracic spine. An NG tube is in place. Impression: No acute cardiopulmonary abnormality.,"['Change severity', 'Change to homophone', 'Add medical device']"
"256d4a58-b4233463-d61ffb45-16099de5-b37ef7e6, 8e49dc4a-7e939e0c-5f132e57-0b646bd8-4a2d7a60",51589952,17257394,"Findings: The heart size is top normal, slightly increased since the prior study, likely due slightly lower lung volumes and patient rotation.  The lungs are clear aside from a small amount of left basilar atelectasis. Apparent right lower lobe nodular opacities are most likely due to vessels on end. No pleural effusion or pneumothorax; minimal left posterior pleural scarring is chronic.  Hilar contours are within normal limits. Impression: No evidence of pneumonia.","Findings: The heart size is top normal, moderately increased since the prior study, likely due slightly lower lung volumes and patient rotation. The lungs are clear aside from a small amount of left basilar at3lectasis. Apparent right lower lobe nodular opacities are most likely due to vessels on end. No pleural effusion or pneumothorax; minimal left posterior pleural scarring is chronic. Small bilateral pleural effusions noticed. Hilar contours are within normal limits. Impression: Moderate evidence of pneumonia.","['Change severity', 'Add typo', 'False prediction']"
"428c7b1c-097b77b2-e92655c6-0fba9227-1ad7dafe, a0860942-8c5f7179-e8e25dd3-d9e62675-f66844bd",51686968,17257394,"Findings: Lungs are clear.  There is no focal consolidation, effusion, or edema.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.","Findings: Lungs have small ground-glass opacities.  There is no focal consolidation, effusion, or edima.  The cardiomediastinal silhouette is within normal limits.  No osseous abnormalities. Impression: No cardiopulmonary process.","['False prediction', 'Add typo', 'False negation']"
"cd819cfc-04a987a2-bc398e86-02babb97-64a9b785, d1943b3d-7739ba1b-6774964a-990c66a8-9e0db49e",57891982,17257394,"Findings: The lungs are hyperinflated and clear.  The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal.  There is no pleural effusion or pneumothorax.  Degenerative changes are seen in the thoracic spine. Impression: No acute cardiopulmonary process.","Findings: The lungs are hyperinflated and clear. There are bilateral patchy infiltrates that might represent pneumonia. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. The presence of a central venous catheter in the superior vena cava is noted. Degenerative changes are seen in the thoracic spine. Impression: Right-sided pleural effusion and evidence of pneumothorax.","['False prediction', 'Add contradiction', 'Add medical device']"
"1f74f7c8-d728f398-72d444e8-2d41431b-e5678e43, 8b6ea4f6-89ae50df-87c1a2b5-dfcfcf4e-43d511e1",58095545,17257394,Findings: Frontal and lateral views of the chest were obtained.  The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are stable and unremarkable.  No overt pulmonary edema is seen.  No displaced fracture is identified. Impression: No acute cardiopulmonary process.,Findings: Frontal and medial views of the chest were obtained.  The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is scene.  Cardiac and mediastinal silhouettes are stable and unremarkable.  No overt pulmonary edema is noted.  No displaced fracture is identified. Impression: No acute cardiopulmonary process.,"['Change location', 'Change to homophone', 'False negation']"
"354d5dcb-120323c7-1f89b9fb-7756a75d-aa2cd395, ec080570-5a1cbee6-0f62cc62-5b4bcf5e-da1a8c2c",58216412,17257394,"Findings: Cardiac, mediastinal and hilar contours are normal. Mild atherosclerotic calcifications are seen at the aortic knob. The pulmonary vasculature is normal. Lungs are hyperinflated but clear. No focal consolidation, pleural effusion or pneumothorax is present. Moderate multilevel degenerative changes are present in the thoracic spine. Impression: No acute cardiopulmonary abnormality.","Findings: Cardiac, mediastinal and hilar contours are normil. Moderate atherosclerotic calcifications are seen at the aortic knob. The pulmonary vasculature is normal. Lungs are hyperinflated but clear. No focal consolidation, pleural effusion or pneumothorax is present. Severe multilevel degenerative changes are present in the thoracic spine. There is a small right-sided pleural effusion.Impression: No acute cardiopulmonary abnormality.","['Change severity', 'Add typo', 'False prediction']"
"09e51f9b-6149243e-70660f6d-66092f8e-b5342668, c21ee586-84ee8466-fb0b0020-2c9730df-4f04867f",54668084,17266832,"Findings: Lung volumes are low.  The cardiac, mediastinal and hilar contours appear stable including stable cardiomegaly and tortuosity of the thoracic aorta.  There is again mild relative elevation of the right hemidiaphragm.  Calcified nodule in the right lower lobe is again visible.  The lungs appear otherwise clear.  There are no pleural effusions or pneumothorax.  Surgical clips project over each axillary region.  There has been no definite change. Impression: No evidence of acute cardiopulmonary disease.","Findings: Lung volumes are high.  The cardiac, mediastinal and hilar contours appear to have mild pleural effusion including stable cardiomegaly and tortuosity of the thoracic aorta.  There is again mild relative elevation of the right hemidiaphragm.  Calcified nodule in the right lower lobe is again visible. There is again mild relative elevation of the right hemidiaphragm.  The lungs appear otherwise clear.  There are no pleural effusions or pneumothorax.  PE remains a consideration with these findings.  Surgical stapler project over each axillary region.  There has been no definite change. Impression: No evidence of acute cardiopulmonary disease.","['Change name of device', 'Add repetitions', 'False prediction']"
"3ddb84d9-7f9422cf-299f2e01-d271cb45-0de2ed3d, 7040c81a-7489e2f9-9e6f51a9-f0745c64-d937fa22",51281091,17290008,"Findings: Frontal and lateral views of the chest were obtained.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable.  A chronic-appearing deformity is seen at the distal right clavicle, correlate for site of pain. Impression: 1.  No acute cardiopulmonary process. 2.  Chronic-appearing deformity at the distal right clavicle.  Correlate with site of pain.","Findings: Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. A chronic-appearing deformity is seen at the distal right clavicle, correlate for site of pain. Lungs are clear without focal consolidation. Impression: 1. No acute cardiopulmonary process. 2. Chronic-appearing deformity at the distal left clavicle. Correlate with site of pain. There is a small right pleural effusion.","['Change location', 'Add repetitions', 'False prediction']"
a7b2360a-51a1d662-06afece8-5d11b64b-088479bb,54886667,17302021,Impression: No acute intrathoracic process.,Impression: Know acute intrathoracic process.,"['Change to homophone', 'Add typo', 'False negation']"
"29298227-0321faea-eb32079a-ac75e1e1-5bb9d26b, dda541da-8ccc3f68-97aa6c6a-6d7a5498-db3ca231",54407863,17313406,"Findings: PA and lateral chest radiographs demonstrate clear lungs.  The heart size is normal.  The cardiac, hilar, and mediastinal contours are normal. Impression: Normal chest radiographs.",Findings: PA and lateral chest radiographs demonstrate mild left pleural effusion.  The heart size is normal.  An NG tube is seen with its tip in the mid esophagus. Impression: Normal chest radiographs. There is evidence of a moderate right pleural effusion.,"['Change location', 'Add contradiction', 'Add medical device']"
"1abe49d1-355250d3-cea6e169-6e098201-104352ba, c53d4662-f55d3ef5-6178259b-9e374870-79aa413b",59048448,17346035,"Findings: The lungs are clear.  There is no pleural effusion or pneumothorax. Lobulation of the mediastinal contour of the main pulmonary artery and the left hilus could be due to mild adenopathy.  Any prior radiographs should be obtained to see if this is a new finding. If stability cannot be determined, I recommend repeat CXR in 4 weeks. Impression: No pneumonia.  Possible mild central adenopathy requires follow ___ ___ ___ was paged.","Findings: The lungs are clear.  There is no pleural effusion or pneumothorax. There is normal mediastinal contour with no signs of adenopathy.  Any prior radiographs should be obtained to see if this is a new finding. If stability cannot be determined, I recommend repeat CXR in 4 weeks. Impression: No pneumonia.  No signs of adenopathy noted.  ___ ___ ___ was paged.","['Change location', 'Add contradiction', 'False negation']"
44cacbf6-9d96a84b-4fe9670d-106a3b5d-ac3ae803,52711234,17387103,"Findings: In comparison to ___ portable chest radiograph, there is mild improvement of the pulmonary vascular congestion and bilateral interstitial edema.  Blunted left costophrenic angle is likely due to an obscuring bowel lobe rather than a true left pleural effusion.  Heart size is moderately enlarged but stable.  No consolidation, masses nor nodules are seen. Impression: 1.  Mild improvement of pulmonary vascular congestion and bilateral interstitial edema since ___ without complete resolution. 2. No radiographic evidence of pneumonia.","Findings: In comparison to ___ portable chest radiograph, there is moderate improvement of the pulmonary vascular congestion and bilateral interstitial edema.  Blunted left costophrenic angle is likely due to an obscuring bowel lobe rather than a true left pleural effusion.  Heart size is moderately enlarged but stable.  No consolidation, masses nor nodules are seen.  No consolidation, masses nor nodules are seen.  Severe lower lobe consolidation noted. Impression: 1.  Moderate improvement of pulmonary vascular congestion and bilateral interstitial edema since ___ without complete resolution. 2. No radiographic evidence of pneumonia.","['Change severity', 'Add repetitions', 'False prediction']"
3f158a92-aa819c5e-ed04bbfe-c4cd87bd-11325ff1,53005482,17387103,Findings: Lung volume is low.  Mild bibasilar opacities are consistent with atelectasis. Pulmonary vascular congestion is mild.  There is no pneumothorax or large pleural effusion.  Cardiac silhouette is mildly enlarged. Impression: Mild pulmonary vascular congestion.,Findings: Ling volume is low. Moderate bibasilar opacities are consistent with atelectasis. Pulmonary vascular congestion is mild.  There is no pneumothorax or large pleural effusion.  No cardiac silhouette abnormality. Impression: Mild pulmonary vascular congestion.,"['Change severity', 'Add typo', 'False negation']"
5414ab29-3dace40f-aa5394d0-7ae927a5-8feb219e,58616139,17408386,Impression: AP chest compared to ___:  Lung volumes are appreciably lower and large bands of atelectasis have appeared in both lower lungs.  Upper lungs are clear.  There is no pulmonary edema or pleural effusion.  No pneumothorax or mediastinal abnormality.,Impression: AP chest compared to ___:  Lung volumes are appreciably lower and large bands of atelectasis have appeared in both upper lungs.  Upper lungs are cler.  There is no pulmonary edema or pleural effusion.  No pneumothorax or mediastinal abnormality.  An ET tube is in place.,"['Change location', 'Add typo', 'Add medical device']"
560a1b2f-765df9cb-b8def580-05ad8ebd-d6edc6b3,50987704,17437534,"Impression: No comparison.  A minimal left-sided pneumothorax, previously visualized on the CT examination from ___, is not visible on the chest radiograph.  Minimal atelectasis at the left lung basis.  Normal size of the heart.  No pneumonia, no pulmonary edema.","Impression: No comparison.  A minimal left-sided pneumothorax, previously visualized on the CT examination from ___, is not visible on the chest radiograph.  Minimal atelectasis at the left lung basis.  A central venous line is present. Normal size of the heart.  No pneumonia, no pulmonary edema.  Minimal atelectasis at the left lung basis.","['Change severity', 'Add repetitions', 'Add medical device']"
f1ea5a2c-ce5a610d-aff80fde-8392148f-39f4982a,52493039,17483408,"Findings: There are confluent bilateral parenchymal opacities with a lower lobe predominance. The cardiomediastinal silhouette is within normal limits for technique.  No displaced fractures identified. Impression: Diffuse bilateral parenchymal opacities with a lower lobe distribution. Findings may represent bilateral infection, edema or ARDS.","Findings: There are confluent bilateral parenchymal opacities with an upper lobe predominance. The cardiomediastinal silhouette contains spinal deformities. No displaced fractures identified. Impression: Diffuse bilateral parenchymal opacities with a lower lobe distribution. Findings may represent bilateral infection, edema or ARDS. Cardiomegaly is observed.","['Change location', 'Add contradiction', 'Add medical device']"
aaff472f-e41c0470-87efd349-ba763de2-55568bd8,52798138,17483408,"Findings: There is a new endotracheal tube seen with tip approximately 6.7 cm from the carina. Otherwise, there has been no significant interval change of diffuse bilateral parenchymal opacities. Impression: Endotracheal tube seen with tip between the clavicular heads, 6.7 cm from the carina.","Findings: There is a new endotracheal tube seen with tip approximately 6.4 cm from the carina. Otderwise, there has been no significant interval change of diffuse bilateral parenchymal opacities including right upper lobe consolidation. Impression: Endotracheal tube seen with tip between the clavicular heads, 6.7 mm from the carina.","['Change measurement', 'Add typo', 'False prediction']"
7ab4bbe7-3b408b7e-6b04c772-f84f0465-402304a0,53694670,17483408,Impression: The patient was extubated in the meantime interval. The right internal jugular line tip is at the level of lower SVC. Heart size and mediastinum are unchanged in appearance. Bilateral pleural effusions and bibasilar areas of consolidation are unchanged.  There is no evidence of pulmonary edema.,Impression: The patient was exutbated in the meantime interval. Right internal jugular line tip terminates in the upper SVC. Heart size and mediastinum are unchanged in appearace. Bilateral pleural effusions and bibasilar areas of consolidation are unchanged. A thoracic pacemaker is observed. There is no evidence of pulmonary edema.,"['Change position of device', 'Add typo', 'Add medical device']"
"5998dcca-a12ec446-fdfa60b9-3a06b23e-b2d12bf6, fe0ef5cf-90e3c227-e3b3602a-280add66-27988ed3",57650946,17483408,"Findings: Endotracheal tube is seen with tip between the clavicular heads, 6.8 cm from the carina. Enteric tube seen with tip in the gastric body however the side port is likely proximal to the GE junction. Confluent bilateral parenchymal opacities are grossly unchanged. Impression: ET tube 6.8 cm from the carina and could be advanced 2 cm for optimal positioning. Enteric tube tip in the gastric body however side-port proximal to the GE junction and should be advanced.","Findings: Endotracheal tube is seen with tip between the clavicular heads, 2.5 cm from the carina. Enteric tube scene with tip in the gastric body however the side port is likely proximal to the GE junction. No parenchymal opacities are noted. Impression: ET tube 2.5 cm from the carina and could be advanced 2 cm for optimal positioning. Enteric tube tip in the gastric body however side-port proximal to the GE junction and should be advanced.","['Change position of device', 'Change to homophone', 'False negation']"
"a105a3d9-7ee8bcfd-6682d246-26c97cb4-e6caa2d5, f9f2ec75-f28ac7f6-8e57221d-248fc115-82a9a1e0",54238531,17528941,"Findings: Frontal and lateral chest radiographdemonstrates well expanded lungs.  No CHF, focal infiltrate,  pleural effusion or pneumothorax detected. Heart size, mediastinal contour, and hila are unremarkable.  Limited assessment of the upper abdomen is within normal limits. Impression: Normal chest radiograph.  No pneumothorax or pneumomediastinum.","Findings: Frontal and lateral chest radiograph demonstrates well expanded lungs with a calcified nodule in the right apex. No CHF, focal infiltrate, pleural effusion or pneumothorax detected. Heart size, mediastinal contour, and hila is unremarkable. Limited assessment of the upper abdomen is within normal limits. Impression: Normal chest radiograph. No pneumothroax or pneumomediastinum. ","['Change location', 'Add typo', 'False prediction']"
"73e0e7b4-4ffbe566-feb48f1c-6201bc17-363b1bbf, 93f0b74b-e85bf537-5e436a11-2b94dec1-614a4270",58987039,17551032,"Findings: Frontal and lateral views of the chest are obtained.  Mild bibasilar atelectasis is seen.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac silhouette is top normal.  The aorta remains calcified and tortuous.  There is diffuse osteopenia.  Degenerative changes are seen at bilateral shoulder and acromioclavicular joints.  There are also degenerative changes along the spine along with severe compression again seen in the lower thoracic vertebral body. Impression: No acute cardiopulmonary process.","Findings: Frontal and lateral views of the chest are obtained.  Mild bibasilar atelectasis is seen.  No focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac silhouette is top normal.  The aorta remains calcified and torteous.  There is diffuse osteopenia.  Degenerative changes are seen in the right shoulder and acromioclavicular joints.  There are also degenerative changes along the spine along with severe compression again seen in the lower thoracic vertebral body.  A central venous line is present. Impression: No acute cardiopulmonary process.","['Change location', 'Add typo', 'Add medical device']"
55d65e1e-1812835f-30e06612-c15a1621-fddc8581,50750948,17559288,"Impression: AP chest compared to ___ through ___:  Tiny right apical pneumothorax is slightly smaller today, with the apical visceral pleural line rising from the level of the third posterior rib to the second posterior interspace.  The obliquely inclined right pleural tube is unchanged in position.  There is no appreciable pleural effusion.  Severe residual infiltrative pulmonary abnormality looks slightly improved compared to ___, probably residual of PCP infection and diffuse alveolar damage. Heart size is normal.  Left PIC line ends in the mid SVC.  Findings discussed by telephone with Dr. ___ at the time of dictation.","Impression: AP chest compared to ___ through ___:  Tiny right apical pneumothorax is slightly smaller today, with the apical visceral pleural line rising from the level of the third posterior rib to the second posterior interspace.  The obliquely inclined right pleural tube is unchanged in position.  There is no appreciable pleural effusion.  Severe residual infiltrative pulmonary abnormality looks slightly improved compared to ___, probably residual of PCP infection and diffuse alveolar damage. Heart size is normal.  Left central venous catheter ends in the mid SVC.  There is a large left pleural effusion.  Findings discussed by telephone with Dr. ___ at the time of dictation.  There is a large left pleural effusion. ","['Change name of device', 'Add repetitions', 'False prediction']"
03f20727-d42b6bb8-d53cb13f-c3eb462e-fb257484,51039446,17559288,"Impression: AP chest compared to ___ through ___, 4:13 p.m.:  Moderately severe widespread infiltrative pulmonary abnormality has improved.  Heterogeneity in the right lower lobe may represent cavitation or a region of pneumonia.  Pleural effusion is presumed, but not substantial.  No pneumothorax.  Heart size normal.  ET tube and right jugular line in standard placements.  Nasogastric tube would need to be advanced 15 cm to move all the side ports into the stomach.  Dr. ___ was paged.","Impression: AP chest compared to ___ through ___, 4:13 p.m.:  Moderately severe widespread infiltrative pulmonary abnormality is no longer noted.  Heterogeneity in the right lower lobe may represent cavitation or a region of new-moan-ia.  Pleural effusion is presumed, but not significant.  No pneumothorax.  Heart size normal.  ET tube and right jugular line in standard placements.  Nasogastric tube would need to be advanced 25 cm to move all the side ports into the stomach.  Dr. ___ was paged.","['Change measurement', 'Change to homophone', 'False negation']"
f3f33b0e-fe7c9ba5-dad10964-bc8ce4a1-b74ebb51,51757784,17559288,"Impression: Right internal jugular line ends at upper SVC.  OGT is seen to course below the diaphragm into the stomach, however the distal end is beyond the view of radiograph.  Bilateral, diffuse, ground-glass opacities concerning for infection per clinical history are unchanged since ___.  Heart size is normal.  Mediastinal and hilar contours are normal.  No pleural effusion.","Impression: Left internal jugular line ends at upper SVC.  OGT is seen to course below the diaphragm into the stomach, however the distal end is beyond the view of radiograph.  Bilateral, diffuse, ground-glass opacities concerning for infection per clinical history are unchanged since ___.  Heart size is normal.  Mediastinal and hilar contours are normal.  There is pleural effusion.","['Change location', 'Add contradiction', 'False negation']"
f30ac310-feddb6e1-a0bf1a2c-4311961b-74a32eed,51790690,17559288,"Findings: As compared to the previous radiograph, the extent of the known right apical pneumothorax is unchanged.  No signs of tension.  Correct position of the right chest tube.  Unchanged monitoring and support devices.  Unchanged extensive bilateral parenchymal opacity, caused by the known pneumocystis carinii pneumonia. ","Findings: As compared to the previous radiograph, the extent of the known right apical pneumothorax is unchanged.  No signs of tension.  Correct position of the right endotracheal tube.  Unchanged monitoring and support devices.  There is also a mild pleural effusion observed.  Unchanged extensive bilateral parenchymal opacity, caused by the known pneumocystis carinii pneumonia.  ","['Change name of device', 'Add repetitions', 'False prediction']"
888f3658-e541329c-5c12b9b9-10185f6d-11f0cd6c,51910000,17559288,Impression: Right internal jugular central line continues to have its tip in the mid SVC.  A feeding tube is seen coursing below the diaphragm with the tip not identified.  There continues to be bilateral airspace disease with more focal patchy areas in the left mid and the right mid and lower lung consistent with a diffuse pneumonia in this immunocompromised patient.  No pleural effusions.  No evidence of pneumothorax.,Impression: Right internal jugular central line coninutes to have its tip in the mid SVC.  A urinary catheter is seen coursing below the diaphragm with the tip not identified.  There continues to be bilateral airspace disease with more focal patchy areas in the left mid and the right mid and lower lung consistent with a diffuse pneumonia in this immunocompromised patient.  No pleural effusions.  No evidence of pneumothorax. A tracheostomy tube is in place.,"['Change name of device', 'Add typo', 'Add medical device']"
2365d0ef-d1cafbfe-24afa38d-5390baed-46e9e9ef,52177147,17559288,"Findings: Since the prior examination, there are low lung volumes.  Even accounting for decreased lung volumes, there is increased diffuse opacification, more prominent within the lower lobes, compatible with worsening disease.  An enteric feeding tube is demonstrated coursing below the diaphragm.  There is no evidence of pleural effusions or pneumothorax.  The cardiomediastinal and hilar contours are stable.  Pulmonary vascularity is not increased. Impression: Increasing diffuse opacification compatible with continued progression of disease.  No evidence of pneumothorax.","Findings: Since the prior examination, there are low lung volumes.  Even accounting for decreased lung volumes, there is increased diffuse opacification, more prominent within the lower lobes, compatible with worsening disease.  An NG tube is demonstrated coursing below the diaphragm.  There is no evidence of pleural effusions or pneumothorax.  The cardiomediastinal and hilar contours are stable.  Pulmonary vascularity is not increased.  A central venous line is seen terminating in the superior vena cava. Impression: Increasing diffuse opacification compatible with continued progression of disease.  Moderate pleural effusions noted.  No evidence of pneumothorax.","['Change name of device', 'Add contradiction', 'Add medical device']"
d68e61e0-f41d1489-ba3b0c4c-ae35171f-1abd4615,52265333,17559288,"Findings: Single portable view of the chest is compared to previous exam from ___.  Left-sided PICC is no longer seen.  The lungs have shown interval resolution of the perihilar parenchymal opacities, they are now clear.  Cardiomediastinal silhouette is within normal limits. Impression: No acute cardiopulmonary process, resolution of previously seen bilateral parenchymal opacities.  Stable mild prominence of the left hila.","Findings: Single portable view of the chest is compared to previous exam from ___. Left-sided PICC is no longer scene. The lungs have shown interval resolution of the perihilar parenchymal opacities, they are now clear. Cardiomediastinal silhouette is within normal limits. Impression: No acute cardiopulmonary process, resolution of previously seen bilateral parenchymal opacities. Pacemaker is present. Stable moderate prominence of the left hila.","['Change severity', 'Change to homophone', 'Add medical device']"
78b0f724-759138a6-255f6ef3-48d0690c-4d9405cf,52289887,17559288,"Findings: In comparison with the study of ___, the monitoring and support devices remain in place.  Diffuse bilateral pulmonary opacifications are seen bilaterally, though with some mild improvement in aeration.  Although this could represent pulmonary edema, the absence of cardiac enlargement raises the possibility of a noncardiogenic cause.  In the appropriate clinical setting, widespread pneumonia would have to be considered, as well as ARDS. ","Findings: In comparison with the study of ___, the monitoring and support devices remain in place.  Diffuse bilateral pulmonary opacifications are seen bilaterally, though with some worsening in aeration.  Although this could represent pulmonary edema, the presence of cardiac enlargement raises the possibility of a noncardiogenic cause.  In the appropriate clinical setting, widespread pneumonia would have to be considered, as well as ARDS.  There is clear evidence of heart failure.","['Change severity', 'Add contradiction', 'False negation']"
56381c64-278c220e-719702c4-6e5d4bf7-193da1ab,52687222,17559288,"Findings: Comparison is made to prior study from ___.  Endotracheal tube, feeding tube, right-sided central venous catheters are unchanged in position.  There are again seen diffuse airspace opacities bilaterally likely due to worsening of the pulmonary edema.  Heart size is within normal limits.  There is prominence of the vascular pedicle, consistent with the edema.  No pneumothoraces are present. ","Findings: Comparison is made to prior study from ___.  Nasogastric tube, feeding tube, right-sided central venous catheters are unchanged in position.  There are again seen diffuse airspace opacities bilaterally likely due to worsening of the pulmonary edema.  Heart size is within normal limits.  There is prominence of the vascular pedicle, consistent with the edema.  No pneumothoraces are present.  There is a large pleural effusion on the left.","['Change name of device', 'Add repetitions', 'False prediction']"
0cae2952-def96aa7-1e84fd97-cf21d3d3-341189c9,54071279,17559288,"Impression: New Dobbhoff tube extends into the stomach, coiled within.  Little other interval change.","Impression: New Dobbhoff tube extends into the duodenum, coiled within.  Little other interval change.  Mild left pleural effusion is noted.   We appreciate your clinical consideration.","['Change position of device', 'Change to homophone', 'False prediction']"
7e6df081-ae0880f5-c5c3aba7-77eaa2c1-d46f09a8,54614197,17559288,"Findings: As compared to the previous radiograph, the nasogastric tube has been removed.  Internal jugular vein catheter remains in unchanged position.  The pre-existing bilateral diffuse parenchymal alveolar opacities with air bronchograms show a further slight increase in severity.  There is no evidence of interval pleural effusions.  Minimal bilateral, left more than right areas of atelectasis.  No pneumothorax, no pneumomediastinum. ","Findings: As compared to the previous radiograph, the nasogastric tube has been removed.  Internal jugular vein stent remains in unchanged position.  The pre-existing bilateral diffuse parenchymal alveolar opacities with air bronchograms show a further slight increase in severity.  Their is no evidence of interval pleural effusions.  No atelectasis.  No pneumothorax, no pneumomediastinum.","['Change name of device', 'Change to homophone', 'False negation']"
"23f1864b-dcf3fec5-0cf991ab-bbc31dd0-ba40ddfc, cb254c2a-704a6902-121ca734-a8fdc3e1-b5111cb3",56246644,17559288,"Findings: Since the prior examination there is little relevant change.  A small to moderate right apical pneumothorax is unchanged.  There is no evidence of tension.  A right chest tube is in standard unchanged position.  A right subclavian approach central venous catheter tip projects in the cavoatrial junction.  An enteric feeding tube courses below the diaphragm out of field of view.  There is unchanged diffuse asymmetrically distributed parenchymal opacification, compatible with known pneumocystis carinii pneumonia. Impression: No significant change. Unchanged extent of a small-to-moderate right apical pneumothorax.","Findings: Since the prior examination there is minor interval improvement. A small to moderate right apical pneumothorax is unchanged.  There is no evidence of tension.  A right chest tube is in the lower right lung field.  A right subclavian approach central venous catheter tip projects in the mid SVC.  An enteric feeding tube is seen coiling in the upper stomach.  There is persistent diffuse asymmetrically distributed parenchymal opacification, compatible with known pneumocystis carinii pneumonia.  A small right-sided pleural effusion is also noted. Impression: No significant change. Unchanged extent of a small-to-moderate right apical pneumothorax. Impression: No significant change. Unchanged extent of a small-to-moderate right apical pneumothorax.","['Change position of device', 'Add repetitions', 'False prediction']"
7438cd11-ca6cba83-c3d0b14e-b4f04d84-cdd824b4,56336499,17559288,Impression: 1.  Worsening diffuse parenchymal opacities in the lungs concerning for worsening PCP.  More focal consolidation in the right lung base may represent a secondary pneumonic process. 2.  Previously noted small right apical pneumothorax is not visualized on the current exam.,Impression: 1.  Worsening diffuse parenchymal opacities in the lungs concerning for mild PCP.  More focal consolidation in the right lung base may represent a secondary pneumonic process. 2.  Previously noted small right apical pneumothorax is still visualized on the current exam. There is a left-sided pacemaker in place and the leads terminate in the right ventricle.,"['Change severity', 'Add contradiction', 'Add medical device']"
a3b20c27-ba0b465e-3eab2b86-991f3d46-80a07aee,56488515,17559288,"Findings: A left-sided PICC line has been removed.  The cardiac, mediastinal, and hilar contours appear unchanged.  Aside from streaky left basilar opacity suggesting minor atelectasis, the lungs appear clear.  There is no pleural effusion or pneumothorax.  No free air is demonstrated.  A partly imaged catheter projects over the left upper quadrant of the abdomen, compatible with a gastrostomy tube. Impression: No evidence for free air or acute cardiopulmonary disease.","Findings: A left-sided central venous catheter has been removed.  The cardiac, mediastinal, and hilar contours appear unchanged.  Aside from streaky left basilar opacity suggesting minor atelectasis, the lungs appear clear.  There is no pleural effusion or pneumothorax.  No free air is demonstrated.  A partly imaged catheter projects over the left upper quadrant of the abdomen, compatible with a gastrostomy tube.  There is no pleural effusion or pneumothorax. Impression: No evidence for free air or acute cardiopulmonary disease.","['Change name of device', 'Add repetitions', 'False negation']"
a8d102b8-6cc0e5e7-21fc3831-79e95011-003fc4f9,56995004,17559288,"Findings: As compared to the previous radiograph, the monitoring and support devices are in unchanged position.  Unchanged bilateral diffuse parenchymal opacities, that are unchanged in extent.  No newly appeared parenchymal opacities.  No pleural effusions.  Borderline size of the cardiac silhouette without substantial areas of basal atelectasis. ","Findings: As compared to the previous radiograph, the monitoring and support devices are in unchanged position.  Unchanged bilateral diffuse parenchymal opacities, that are unchanged in extent.  Circumferential pleural effusions are seen.  No pleural effusions.  Borderline size of the cardiac silhouette without substantial areas of apical atelectasis.  ","['Change location', 'Add typo', 'False prediction']"
494f62af-2213616c-20174f23-c3d781fd-fed10e18,57177744,17559288,"Findings: Bilateral, diffuse, confluent pulmonary opacities is concerning for severe pulmonary edema/ARDS/hemorrhage; although a concurrent infection cannot be excluded.  Heart size is normal.  Because of the diffuse pulmonary opacities obscuration the margins of the mediastinal and hilar contours, assessment was. Impression: Bilateral, diffuse, confluent pulmonary opacities. Differential diagnosis include  severe pulmonary edema or ARDS or hemorrhage. Concurrent lung infection cannot be ruled out.","Findings: Bilateral, diffuse, confluent pulmonary opacities is concerning for severe pulmonary edema/ARDS/hemorrhage; although a concurrent infection cannot be excluded.  Heart size is enlarged.  Because of the diffuse pulmonary opacities obscuration the margins of the mediastinal and hilar contours, assessment was. Impression: No pulmonary opacities present. Concurrent lung infection cannot be ruled out. ","['Change location', 'Add contradiction', 'False prediction']"
464448a4-f1229c37-3a509617-2edb4a04-cef4335c,57820639,17559288,"Findings: Status post removal of a right chest tube, the known small right apical pneumothorax is decreasing in extent.  No evidence of tension.  The parenchymal opacities have substantially improved, particularly in the right middle and lower lung.  No pleural effusions.  Normal size of the cardiac silhouette. ","Findings: Status post removal of a right chest tube, the known large right apical pneumothorax is decreasing in extent. The previously noted large right apical pneumothorax has nearly resolved. The parenchymal opacities have substantially improved, particularly in the right middle and lower lung. No parenchymal opacities are observed. No pleural effusions. Normal size of the cardiac silhouette. ","['Change severity', 'Add contradiction', 'False negation']"
8cca0878-51f27942-9aec337b-398ae7fd-2014bdcb,58408693,17559288,"Findings: In the interval, the patient has received a Dobbhoff catheter.  The catheter is coiled in the stomach, and the tip points upwards towards the proximal parts of the stomach.  There is no evidence of complications, notably no pneumothorax.  The pre-existing diffuse parenchymal opacities have minimally decreased in severity. ","Findings: In the interval, the patient has received a Swan-Ganz catheter.  The catheter is coiled in the stomach, and the tip points upwards towards the proximal parts of the stomach.  There is no evidence of complications, notably no pneumothorax.  There are extensive parenchymal opacities throughout the lungs.  ","['Change name of device', 'Add contradiction', 'False prediction']"
7178c919-44dfb11d-9c099d27-1eb09d58-3cc6cb14,58500412,17559288,"Impression: AP chest compared to ___:  Greater consolidation in the right mid lung of the diffuse infiltrative pulmonary abnormality could be due to progression of pneumonia, mild edema or local pulmonary hemorrhage.  No pneumothorax or appreciable pleural effusion.  Normal cardiomediastinal and hilar silhouettes.  Feeding tube ends in the stomach.  Right jugular line ends in the low SVC.","Impression: AP chest compared to ___:  Greater consolidation in the right mid lung of the diffuse infiltrative pulmonary abnormality could be due to progression of pneumonia, mild edema or local pulmonary hemorrhage.  No pneumothorax or appreciable pleural effusion.  Normal cardiomediastinal and hilar silhouettes.  Feeding tube ends in the mid esophagus.  Right jugular line ends in the right atrium.","['Change position of device', 'Add contradiction', 'False prediction']"
bf8bed6d-ee8d4d92-df4bc99c-0733597b-e4a90442,59217802,17559288,"Findings: Since prior radiograph acquired ___ hours apart, bilateral, diffuse and confluent opacities show asymmetric changes with mild improvement in the right and worsening in left lung, overall unchanged in severity. Heart size and mediastinal contours are normal. Impression: Since prior radiograph acquired ___ hours apart, bilateral, extensive, pulmonary opacities concerning for pulmonary edema/ARDS/hemorrhage is overall unchanged in severity. A concurrent infection cannot be ruled out.","Findings: Since prior radiograph acquired ___ hours apart, bilateral, diffuse and confluent opacities show asymmetric changes with moderate improvement in the right and worsening in left lung, overall unchanged in severity. Heart size and mediastinal contours are normal. Impression: Since prior radiograph acquired ___ hours apart, bilateral, extensive, pulmonary opacities concerning for pulmonary edema/ARDS/hemorrhage is overall unchanged in severity. A concurrent infection cannot be ruled out. There are no pulmonary opacities noted.","['Change severity', 'Add contradiction', 'False negation']"
293051c7-fe34be87-e9c6cd58-0e979833-3f579639,59397370,17559288,"Findings: In comparison with the study of earlier in this date, there has been placement of a right chest tube with some decrease in the still moderate apical pneumothorax.  Remainder of the study is unchanged. ","Findings: In comparison with the study of earlier in this date, there has been placement of a right IV catheter with some decrease in the still moderate apical pneumothorax. The reminder of the study is unchanged. An NG tube is in expected position.","['Change name of device', 'Change to homophone', 'Add medical device']"
8bae8ab0-e159b156-5842575c-b4b8c1ae-e9c64339,59460245,17559288,"Findings: Endotracheal tube ends approximately 4 cm above the carina and is appropriate. Right internal jugular line terminates at mid SVC.  An orogastric tube is seen to course below the level of the diaphragm into the stomach; however, distal end is beyond the view of radiograph.  Bilateral, diffuse, lung opacities reflecting moderate-to-severe pulmonary edema, improved between ___ and ___, but since then has minimally worsened.  Top normal sized heart, mediastinal and hilar contours are stable in appearance. Impression: Bilateral moderate-to-severe pulmonary edema has worsened over last 24 hours.","Findings: Endotracheal tube ends approximately 4 mm above the carina and is appropriate. Right internal jugular line terminates at mid SBC.  An orogastric tube is seen to course below the level of the diaphragm into the stomach; however, distal end is beyond the view of radiograph.  Bilateral, diffuse, lung opacities reflecting moderate-to-severe pulmonary edema, improved between ___ and ___, but since then has minimally worsened.  Enlarged heart, mediastinal and hilar contours are stable in appearance. There is also left basal atelectasis noted. Impression: Bilateral moderate-to-severe pulmonary edema has worsened over last 24 hours.","['Change measurement', 'Change to homophone', 'False prediction']"
7cd4e7d0-69d6bb9f-93a8c61e-941e3664-68a658d2,59602068,17559288,"Impression: Persistent widespread pulmonary opacities, slightly increased at the right base possibly reflecting interval extubation.","Impression: Persistent widespread pulmonary opacities, slightly increased at the left base possibly reflecting interval extubation.","['Change location', 'Add repetitions', 'False prediction']"
94cf13e6-4ce08671-ed55ba8e-42a83718-37c56071,59762894,17559288,"Findings: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 3.1 cm above the carina.  Diffuse bilateral pulmonary opacifications are again seen, possibly even more intense than previously on the right. ","Findings: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 3 mm above the carina. Diffuse bilateral pulmonary opacifications are again seen, possibly even more intense than previously on the right. A right-sided central venous line is in place.","['Change measurement', 'Add contradiction', 'Add medical device']"
5c817d58-918d46f3-7e31bce6-2a7e7cd8-f30eaae6,59847097,17559288,"Findings: In comparison with the study of ___, there is little change in the diffuse primarily reticular changes involving both lungs, consistent with the diagnosis of PCP ___.  The endotracheal tube has been removed.  The other monitoring and support devices are essentially unchanged. ","Findings: In comparison with the study of ___, there is little change in the diffuse primarily reticular changes involving both lungs, consistent with the diagnosis of PCP ___.  The orogastric tube has been removed.  A right-sided vascular stent is seen within the brachiocephalic vein. Impression: No acute cardiopulmonary process. Mild pulmonary edema and small bilateral pleural effusions.","['Change name of device', 'Add contradiction', 'Add medical device']"
24849e83-f5ccffbb-364e8c3a-9c1bcd91-dd0d628f,53913349,17561996,"Findings: The lungs are well inflated and clear. The cardiomediastinal silhouette, hila contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. There is no pneumoperitoneum. Impression: No evidence of pneumoperitoneum. Clear lungs.","Findings: The lungs are well inflated and clear. The cardiomediastinal silhouette, hila contours, and pleural surfaces are normal. The cardiomediastinal silhouette, hila contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Their is no pneumoperitoneum. A central venous line is present. Impression: No evidence of pneumoperitoneum. Clear lunchs. Clear lungs.","['Change to homophone', 'Add repetitions', 'Add medical device']"
"bc6cec9d-539f6cb9-0e023225-38e77aa8-0f61b4bb, f762bf98-b2141d3c-a5c0a0b1-4fb662f7-fce29b8d",53572658,17614057,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normla. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Lungs are clear. Impression: No acute cardiopulmonary abnormality. A pacemaker is noted in the left chest.,"['Add repetitions', 'Add typo', 'Add medical device']"
d3e8fc04-74fae9fb-787da683-4705e3a6-8e7dd7a6,53371757,17617589,"Findings: An endotracheal tube terminates at the orifice of right mainstem bronchus.  An enteric tube passes far into the stomach.  Evaluation of the chest is limited due to multiple overlying lines and tubes.  Within this limitation, there are widespread interstitial opacities throughout the right lung with a basilar predominance as well as the left lung base.  There is mild pulmonary vascular congestion and subtle Kerley B lines suggesting interstitial edema.  A small right pleural effusion cannot be excluded.  No pneumothorax is detected on this semi-erect view.  The cardiac silhouette is incompletely visualized in the setting of bibasilar opacities.  The mediastinal contours are prominent due to tortuosity of the thoracic aorta with partial calcification of the aortic knob. Densities projecting over the right humerus and soft tissues of the upper arm are likely external to the patient. Impression: 1.  Right mainstem intubation.  Recommend re-positioning. 2.  Asymmetric pulmonary interstitial edema and vascular congestion on the right greater than the left.  Superimposed infection cannot be excluded in the appropriate clinical context.","Findings: An endotracheal tube terminates at the mid trachea.  An enteric tube passes far into the stomach.  Evaluation of the chest is limited due to multiple overlying lines and tubes.  Within this limitation, there are widespread interstitial opacities throughout the right lung with a basilar predominance as well as the left lung base.  Bilateral pleural effusions are seen on this semi-erect view.  There is mild pulmonary vascular congestion and subtle Kerley B lines suggesting interstitial edema.  A small right pleural effusion cannot be excluded.  No pneumothorax is detected on this semi-erect view.  There are subsegmental atelectasis at the lung bases.  The cardiac silhouette is incompletely visualized in the setting of bibasilar opacities.  The mediastinal contours are prominent due to tortuosity of the thoracic aorta with partial calcification of the aortic knob. Densities projecting over the right humerus and soft tissues of the upper arm are likely external to the patient. Impression: 1.  Right mainstem intubation.  Recommend re-positioning. 2. Asymmetric pulmonary interstitial edema and vascular congestion on the right greater than the left.  Superimposed infection cannot be excluded in the appropriate clinical context.","['Change position of device', 'Add repetitions', 'False prediction']"
51356fab-8f076a2e-2d204a97-8c47b3ca-0b015c10,57385565,17617589,"Findings: As compared to the previous radiograph, the previously malpositioned endotracheal tube has been pulled back.  The tip of the tube now projects approximately 3.5-4 cm above the carina.  The course of the nasogastric tube is unchanged.  Unchanged appearance of the moderately enlarged cardiac silhouette and of the preexisting parenchymal opacities.  These have not changed in extent and severity. ","Findings: As compared to the previous x-ray, the previously malpositioned endotracheal tube has been pulled back.  The tip of the tube now projects approximately 3.5-4 mm above the carina.  The coarse of the nasogastric tube is unchanged.  Unchanged appearance of the moderately enlarged cardiac silhouette and of the preexisting parenchymal opacities with mild pleural effusion in the right lung.  These have not changed in extent and severity.  ","['Change measurement', 'Change to homophone', 'False prediction']"
cf1b8e9d-4f84cf87-e2281943-859fbd1a-ec648bdf,50758668,17622916,"Findings: AP single view of the chest has been obtained with patient in sitting upright position.  Analysis is performed in direct comparison with the next preceding similar study of ___.  High-positioned diaphragms conceal major portion of cardiac silhouette, but significant cardiac enlargement is unlikely.  The thoracic aorta is mildly widened and elongated but does not demonstrate any local contour abnormalities.  The pulmonary vasculature is not congested.  There exists bilateral plate thin atelectasis.  There is no evidence of any new discrete pulmonary parenchymal infiltrate of pneumonic nature.  Also, the lateral pleural sinuses are free, which excludes major pleural effusion.  No pneumothorax identified in right apical area.  A right internal jugular approach central venous line remains similar as on the preceding study. Impression: Bilateral basal plate atelectasis, high-positioned diaphragms, no evidence of new acute parenchymal infiltrates or pleural effusion.  No pneumothorax.","Findings: AP single view of the chest has been obtained with patient in sitting upright position.  Analysis is performed in direct comparison with the next preceding similar study of ___.  High-positioned diaphragms conceal major portion of cardiac silhouette, but significant cardiac enlargement is unlikely.  The thoracic aorta is mildly widened and elongated but does not demonstrate any local contour abnormalities.  There exists bilateral plate thin atelectasis.  There is no evidence of any new discrete pulmonary parenchymal infiltrate of pneumonic nature.  Also, the lateral pleural sinuses are free, which excludes major pleural effusion.  A midline subclavian approach central venous line remains similar as on the preceding study.  No pneumothorax identified in right apical area.  There exists bilateral plate thin atelectasis. Impression: There is no plate atelectasis, high-positioned diaphragms, no evidence of new acute parenchymal infiltrates or pleural effusion.  No pneumothorax.","['Change name of device', 'Add repetitions', 'False negation']"
9ab97962-156e4dae-c1188f7d-7dae9ea4-c5a69d40,54905271,17622916,"Findings: As compared to prior chest radiograph from ___, patient has been extubated, and there are lower lung volumes.  Bibasilar opacities have increased, likely reflecting a combination of pleural effusion and atelectasis.  However, an underlying early infectious process cannot be excluded.  Right IJ central venous catheter tip lies at the level of the cavoatrial junction.  Nasogastric tube extends into the gastric fundus. Impression: Worsening bibasilar opacities which likely reflect a combination of pleural fluid and volume loss.  However, in the appropriate clinical setting, an underlying early infectious process cannot be excluded.","Findings: As compared to the prior chest radiograph from ___, patient has been extubated, and there are lower lung volumes.  Bibasilar opacities have increased, likely reflecting a combination of pleural effusion and atelectasis.  However, an underlying early infectious process cannot be excluded.  Right IJ dialysis catheter tip lies at the level of the cavoatrial junction.  Nasogastric tube extends into the gastric fundus.  However, right IJ central venous catheter lies at the level of the right atrium.  No opacities seen. Impression: Worsening bibasilar opacities which likely reflect a combination of pleural fluid and volume loss.  However, in the appropriate clinical setting, an underlying early infectious process cannot be excluded.","['Change name of device', 'Add contradiction', 'False negation']"
2e1cd5e0-fd2c7f50-176e7b18-1f7ac651-bcf8152a,55309653,17622916,"Findings: In comparison with study of ___, there is now an endotracheal tube in place with its tip approximately 6 cm above the carina.  Right IJ Swan-Ganz catheter tip lies at the level of the cavoatrial junction.  Nasogastric tube extends well into the stomach.  Continued low lung volumes with bibasilar atelectatic changes.  Blunting of the costophrenic angles is consistent with pleural fluid. ","Findings: In comparison with study of ___, there is now an endotracheal tube in place with its tip approximately 7 cm above the carina.  Right IJ Swan-Ganz catheter tip lies at the level of the cavoatrial junction.  Nasogastric tube extends well into the stomach, right pneumothorax noted.  Continued low lung volumes with bibasilar atelectatic changes.  Blunting of the costophrenic angles is consistent with pleural fluid.  Nasogastric tube extends well into the stomach.","['Change measurement', 'Add repetitions', 'False prediction']"
468df880-10005e8e-d4fa6433-d08fa89c-7b141448,57419136,17622916,"Findings: In comparison with the study of ___, there again are bilateral pleural effusions with evidence of pulmonary vascular congestion and compressive atelectasis at the bases.  In the appropriate clinical setting, superimposed pneumonia would have to be considered.  The right IJ catheter extends at least to the cavoatrial junction and quite probably into the upper portion of the right atrium. ","Findings: In comparison with the study of ___, there again are bilateral pleural effusions with evidence of pulmonary vascular congestion and compressive atelectasis at the bases.  In comparison with the study of ___, there again are bilateral pleural effusions with evidence of pulmonary vascular congestion and compressive atelectasis at the bases.  In the appropriate clinical setting, superimposed consolidation would have to be considered.  The left IJ catheter extends at least to the cavoatrial junction and quite probably into the upper portion of the right atrium.  ","['Change location', 'Add repetitions', 'False prediction']"
"2fe28638-604a0402-b60fe5ec-6d13a376-e5a4412a, 30d0c13b-a8dcf71f-618ddb30-3d8864d7-491b08e1",57478580,17622916,"Findings: Chest, PA and lateral.  The lung volumes are low causing crowding of the pulmonary vasculature at the bases.  The hilar and cardiomediastinal contours are normal.  There is no pneumothorax or pleural effusion.  Pulmonary vascularity is normal. Impression: Crowding of vasculature at the bases due to low lung volumes makes it difficult to differentiate between microatelectasis and mild interstitial abnormality.","Findings: Chest, PA and lateral.  The lung volumes are low causing crowding of the pulmonary vasculature at the bases.  The hilar and cardiomediastinal contours are normal.  Large pneumothorax seen.  Pulmonary vascularity is normal. Impression: Crowding of vasculature at the bases due to low lung volumes makes it difficult to differentiate between microatelectasis and moderate interstitial abnormality.","['Change severity', 'Add contradiction', 'False prediction']"
"313ea739-0a9a0ae2-1c998dba-cdecfea2-567819cd, cc198721-5005f76e-8d179a23-7af3ea54-446e924b",56393977,17657668,Findings: The lungs are clear.  Heart size and mediastinal contours are normal.  There is no pleural effusion or pneumothorax.  Degenerative changes are noted at the shoulders. Impression: No acute cardiopulmonary process.,Findings: The lunngs are clear.  Heart size and mediastinal contours are normal.  There is no pleural effusion or pneumothorax.  There is no acute cardiopulmonary process.  Degenerative changes are noted at the shoulders. Impression: No acute cardiopulmonary process.,"['Add typo', 'Add repetitions', 'False negation']"
bb6dd3b1-bf62aa24-b39fba26-f00d7c46-fe9658a3,50363438,17660889,"Impression: The tip of dual-lumen hemodialysis catheter through the right internal jugular approach is partially curled and unchanged since prior study.  Monitoring and supporting devices are in standard position.  Bilateral diffuse, lung opacities representing mild to moderate pulmonary edema has improved. Opacity in right lower has progressed and it is likely due to aspiration.  Small right pleural effusion is unchanged.","Impression: The tip of dual-lumen hemodialysis catheter through the right internal jugular approach is partially curled and unchanged sense prior study.  Monitoring and supporting devices are in standard position.  Bilateral diffuse, lung opacities representing mild to moderate pulmonary edema has improved. Opacity in right lower has progressed and it is likely dew to aspiration.  Small right pleural effusion is unchanged.  There is also an endotracheal tube in place with the tip approximately 3.5 cm above the carina.","['Change position of device', 'Change to homophone', 'Add medical device']"
dfef7b7e-62b05c07-d04db5b0-e12181ec-ab79f1d0,51233577,17660889,"Impression: AP chest compared to ___ through ___, 4:52 p.m.:    A newly placed endotracheal tube ends at the thoracic inlet.  Dual-channel right supraclavicular central venous dialysis catheter ends low in the SVC.  Nasogastric tube passes into the stomach and out of view.  No pneumothorax or pleural effusion.  Moderate-to-severe enlargement of the cardiac silhouette is longstanding.  Pulmonary edema which worsened from ___ to ___ has subsequently improved, but is mild and slightly worse compared to earlier in the day.","Impression: AP chest compared to ___ through ___, 4:52 p.m.:    A newly placed endotracheal tube ends 0.5 cm above the carina.  Dual-channel right supraclavicular central venous dialysis catheter ends in the right atrium.  Nasogastric tube passes into the sotmach and out of view.  Moderate-to-severe enlargement of the cardiac silhouette is longstanding.  Pulmonary edema which worsened from ___ to ___ has subsequently improved, but is mild and slightly worse compared to earlier in the day. A left-sided central venous catheter is also visible. ","['Change position of device', 'Add typo', 'Add medical device']"
c5e117fa-2d2eb000-fb83fe99-ba779346-4bafd663,52206316,17660889,"Findings: The endotracheal tube tip is 4.1 cm above the carina.  A left internal jugular approach catheter tip terminates within the lower SVC.  A large-bore venous catheter via right internal jugular approach is in stable position curving into the azygous.  A Dobbhoff feeding is demonstrated within the stomach.  Diffuse severe pulmonary edema is worsened since the prior examination.  There is bibasilar atelectasis.  There are no pleural effusions or pneumothorax. Impression: Mild interval worsening of now severe interstitial pulmonary edema.  Otherwise, stable standard positions of hardware.","Findings: The endotracheal tube tip is 4.3 cm above the carina.  A left internal jugular approach catheter tip termnates within the lower SVC.  A large-bore venous catheter via right internal jugular approach demonstrates subtle nodular opacity projecting over the right lung.  A Dobbhoff feeding is demonstrated within the diaphragn.  Diffuse severe pulmonary edema is worsened since the prior examination.  There is bibasilar atelectasis.  There are no pleural effusions or pneumothoarx. Impression: Mild interval worsening of now severe interstitial pulmonary edema.  Otherwise, stable standard positions of hardware with incidental finding of a small pulmonary nodule.","['Change measurement', 'Add typo', 'False prediction']"
"0c83ebb9-3b2d3376-23088ab5-17419c9b-b7f42c1f, 8e974cb3-d8d829a1-1c0c5cce-714549df-c626020e",54535542,17660889,"Findings: Frontal and lateral views of the chest are obtained.  A right-sided central venous dialysis catheter is again seen without significant change in position, terminating in the right atrium, without evidence of pneumothorax.  The patient is status post median sternotomy and mitral valve repair.  Curvilinear structure projecting over the left hilum has been present since at least ___, unchanged.  No new focal consolidation, pleural effusion, or evidence of pneumothorax is seen.  The cardiac silhouette remains enlarged.  The aorta is calcified and tortuous. Impression: 1.  No acute cardiopulmonary process.  Persistent cardiac silhouette enlargement.  Central dialysis catheter terminates in the right atrium.","Findings:  Frontal and laterla views of the chest are obtained.  A right-sided central venous dialysis catheter is again seen without significant change in position, terminating in the mid SVC, without evidence of pneumothorax.  The patient is status post median sternotomy, with a pacemaker in place after mitral valve repair.  Curvilinear structure projecting over the left hilum has been present since at least ____, unchanged.  No new focal consolidation, pleural effusion, or evidense of pneumothorax is seen.  The cardiac silhouette remains enlarged.  The aorta is calcified and tortuous. Impression: 1.  No acure cardiopulmonary process.  Persistent cardiac silhouette enlargement.  Central dialysis catheter terminates in the mid SVC.","['Change position of device', 'Add typo', 'Add medical device']"
569f137a-5df7c2fe-e17acef1-d50a45fc-affedf84,54956015,17660889,"Impression: AP chest compared to ___ through ___:  Moderately severe pulmonary edema has improved minimally since ___.  A large region of opacification in the right lower chest could be loculated pleural fluid or consolidation in the right lower lobe, a concern for pneumonia.  Uniform opacification in the left lower lobe, obscuring the entire diaphragmatic interface has worsened appreciably and could be due to pneumonia or dramatic worsening of atelectasis.  ET tube and left internal jugular line are in standard placements.  A large bore right-sided central venous catheter may hook into the azygos vein.  No pneumothorax.","Impression: AP chest compared to ___ through ___:  Mildly severe pulmonary edema has improved minimally since ___.  A large region of opacification in the right lower chest could be locuated pleural fluid or consolidation in the right lower lobe, a concern for pneumonia.  Uniform opacification in the left lower lobe, obscuring the entire diaphragmatic interface has worsened appreciably and could be due to pneumonia or dramatic worsening of atelectasis.  ET tube and left internal jugular line are in standard placements.  A large bore right-sided central venous catheter may hook into the azygos vein.  No pnemothorax is noted.  Additionally, there is a pacemaker present.","['Change severity', 'Add typo', 'Add medical device']"
2bba3f51-24971b01-0e8a666e-dedf8909-61742c95,54985815,17660889,"Impression: The distal end of the right-sided hemodialysis catheter is partially looped, unchanged from prior radiographs from ___ and ___.  Tip of endotracheal tube ends 6.5 cm above the carina and is appropriate. Patient is status post medial sternotomy with intact sternal sutures.  Orogastric tube is seen to course below the diaphragm into the stomach, however, the distal end is beyond the radiograph view.   Mild-to-moderate pulmonary edema, moderately enlarged heart, mediastinal and hilar contours are stable.  Increased retrocardiac density reflecting left lower lung atelectasis is new.  Mild right infrahilar atelectasis has minimally worsened.","Impression: The distal end of the right-sided hemodialysis catheter is partially looped, unchanged from previous radiographs from ___ and ___. Top of endotracheal tube ends 6.5 mm above the carina and is appropriate. Patient is status post medial sternotomy with intact sternal sutures. Orogastric tube is seen to course below the diaphragm into the stomach, however, the distal end is beyond the radiograph view. Mild-to-moderate pulmonary edema, moderately enlarged heart, mediastinal and hilar controus are stable. Increased retrocardiac density reflecting left lower lung atelectasis is new and possible pneumothorax in the right lung. Mild right infrahilar atelectasis has minimally worsened. ","['Change measurement', 'Add typo', 'False prediction']"
84f56140-5f674b67-4431f058-4752511b-24be0d89,55083011,17660889,"Findings: There is moderate-to-severe cardiomegaly with moderate pulmonary edema, slightly improved compared to yesterday.  There is minimal blunting of the costophrenic angles, consistent with small pleural effusions.  A right subclavian hemodialysis catheter is at the distal SVC.  No pneumothorax.  There are no concerning lung consolidations. Impression: Moderate-to-severe cardiomegaly and mild pulmonary edema, slightly improved since yesterday.","Findings: There is moderate-to-severe cardiomegaly with mild pulmonary edema, slightly improved compared to yesterday. There is moderate blunting of the costophrenic angles, consistent with small pleural effusions. A right subclavian hemodialysis catheter is at the distal SVC. No pneumothorax. There is moderate-to-severe bilateral pleural effusion. Impression: Moderate-to-severe cardiomegaly and mild pulmonary edema slightly improved since yesterday.","['Change severity', 'Change to homophone', 'False prediction']"
"e9993aa3-51eb4a8b-349f7984-ef76541a-4aab169c, f2cdfb35-5e55a845-072cade1-37104e77-15844094",55570682,17660889,"Impression: Mild congestive heart failure, slightly worse in the interval.","Impression: Severe congestive heart failure, slightly worse in the interval.","['Change severity', 'Add repetitions', 'False prediction']"
a680d992-08c800c8-27ab9581-4d70707a-cb5d31db,56605758,17660889,"Findings: In comparison with the study of ___, there is continued substantial cardiomegaly with mild-to-moderate pulmonary edema.  Hemodialysis catheter again extends to the mid-to-lower portion of the SVC.  Mild basilar atelectasis without frank pneumonia. ","Findings: In comparison with the study of ___, there is continued substantial cardiomegaly with mild-to-moderate pulmonary edema.  Hemodialysis catheter again terminates in the right atrium.  Mild basilar atelectasis without frank pneumonia, and a left upper lobe mass.","['Change position of device', 'Change to homophone', 'False prediction']"
ec28f7bb-28ea31db-2380e13d-96518c46-1c3b59d4,57078296,17660889,"Impression: AP chest compared to ___:  Pulmonary edema worsened from ___ through ___, and has remained relatively stable since although there is more opacification in the right lower hemithorax which could be posterior pleural effusion layering in the supine patient.  Supine positioning probably accounts for some increase in pulmonary vascular congestion in the upper lungs though moderate cardiomegaly is stable and there is no mediastinal vascular engorgement to speak of.  A large bore catheter still cannulates the azygous vein.  ET tube is in standard placement and a nasogastric feeding tube passes into the stomach and out of view.  No pneumothorax.",Impression: AP chest compared to ___:  No pulmonary edema noted.  Supine positioning probably accounts for some increase in pulmonary vascular congestion in the upper lungs though moderate cardiomegaly is stable and there is no mediastinal vascular engorgement to speak of.  A large bore catheter terminates in the right atrium.  ET tube terminates 1 cm above the carina and a nasogastric feeding tube passes into the duodenum and out of view.  Small right-sided pneumothorax.,"['Change position of device', 'Add contradiction', 'False negation']"
13875055-a92c44c3-772d6e38-332cff16-3ed6380f,58199826,17660889,"Impression: AP chest compared to ___:  Previous mild pulmonary edema has improved, but moderate pulmonary vascular engorgement persists.  Moderate cardiomegaly is chronic.  There is no appreciable pleural effusion.  A dual-channel right supraclavicular central venous dialysis catheter ends in the low SVC, as before.","Impression: AP chest compared to ___: Previous moderate pulmonary edema has improved, but severe pulmonary vascular engorgement persists. Mild cardiomegaly is chronic. There is no appreciable pleural effusion. Negative for dual-channel right supraclavicular central venous dialysis catheter ends in the low SVC, as before. New left lower lobe consolidation noted.","['Change severity', 'Add contradiction', 'False prediction']"
904cd93c-1da40b8a-14194a57-7ba145c9-66af87e3,58789604,17660889,"Findings: In comparison with the study of ___, the monitoring and support devices remain in place.  Continued enlargement of the cardiac silhouettes with some improvement in pulmonary edema.  The area of increased opacification at the right base is not definitely appreciated.  Poor definition of the left hemidiaphragm is consistent with some volume loss in the left lower lobe or possible supervening pneumonia. ","Findings: In comparison with the study of ___, the monitoring and support devices remain in place.  Continued enlargement of the cardiac silhouettes with some worsening in pulmonary edema.  The area of increased opacification at the right apex is not definitely appreciated.  Poor definition of the right hemidiaphragm is consistent with some volume loss in the left lower lobe or possible supervening pneumonia.  There is a large pleural effusion on the left.","['Change location', 'Add contradiction', 'False prediction']"
425c4fa7-0d48e151-0758d818-9e8b1ea9-e9074977,58965143,17660889,"Findings: As compared to the previous radiograph, the bilateral parenchymal opacities have minimally increased.  No other changes.  Moderate cardiomegaly without pleural effusions.  Unchanged monitoring and support devices.  The double-lumen right-sided central venous access line might have its tip positioned in the azygos vein. ","Findings: As compared to the previosu radiograph, the bilateral parenchymal opacities have minimally increased.  No other changes.  Mild cardiomegaly without pleural effusions.  Unchanged monitoring and support devices.  The double-lumen right-sided central venous access line might have its tip positioned in the azygos vein.   A nasogastric tube is present.","['Change severity', 'Add typo', 'Add medical device']"
2a88d2ea-b4df4439-14b9c286-c0e29650-2acedd69,59218047,17660889,"Findings: In comparison with the study of ___, the tip of the endotracheal tube is approximately 6.5 cm above the carina.  There is continued enlargement of the cardiac silhouette with continued pulmonary edema.  No acute focal pneumonia or pleural effusion.  Dual-channel right supraclavicular central venous dialysis catheter again extends to the mid-to-lower portion of the SVC. ","Findings: In comparison with the study of ___, the tip of the endotracheal tube is approximately 7.3 cm above the carina.  There is continued enlargement of the cardiac silhouette with resolved pulmonary edema.  Mild pulmonary edema and no acute focal pneumonia or pleural effusion.  Dual-channel right supraclavicular central venous dialysis catheter again extends to the mid-to-lower portion of the SVC and minimal right-sided pneumothorax. ","['Change measurement', 'Add contradiction', 'False prediction']"
015ea7fc-c85de02a-66fb71f2-6ba30068-7bc3cd06,59585133,17660889,"Impression: AP chest compared to ___, 6:19 p.m.:  Moderately severe pulmonary edema has changed in distribution but not in overall severity.  Previous right lower lobe collapse has substantially improved.  Small right pleural effusion is presumed.  Severe cardiomegaly has decreased.  ET tube, left internal jugular line, and nasogastric feeding tube are in standard placements.  The dual-channel right-sided central venous line still cannulates the azygous vein.  No pneumothorax.","Impression: AP chest compared to ___, 6:19 p.m.:  No evidence of pulmonary edema is noted.  Previous right lower lobe collapse has substantially improved.  Small right pleural effusion is presumed.  Severe cardiomegaly has decreased.  ET tube, left internal jugular line, and nasogastric feeding tube are in standard placements.  The dual-channel right-sided central venous line still terminates in the superior vena cava.  No pneumothorax.  ","['Change position of device', 'Add contradiction', 'False prediction']"
442f2cb0-2fcd458a-939733cf-ba72f0cc-0fed5672,59588714,17660889,"Findings: Right Port-A-Cath ends at upper SVC, left internal jugular line terminates at lower SVC, and an endotracheal tube terminates approximately 6.1 cm above the carina; all are in appropriate position.  Feeding tube is seen to course below the diaphragm into the stomach; however, its distal end is off radiographic view.  Mild to moderate bilateral pulmonary edema is unchanged since ___, however pulmonary vascular congestion appear little more than before.  Mild to moderately enlarged heart, mediastinal and hilar contours are stable. Impression: Mild to moderate pulmonary edema, unchanged since ___.","Findings: Right Port-A-Cath ends at upper SVC, left internal jugular line terminates at lower SVC, and an endotracheal tube terminates approximately 5.8 cm above the carina; all are in appropriate position.  Feeding tube is seen to coarse below the diaphragm into the stomach; however, its distal end is off radiographic view.  Mild to moderate bilateral pulmonary edema is unchanged since ___, however no pulmonary vascular congestion appears.  Mild to moderately enlarged heart, mediastinal and hilar contours are stable. Impression: No pulmonary edema.","['Change measurement', 'Change to homophone', 'False negation']"
7c25c976-41dc34c9-ccd3aa02-da854aa5-27de7109,59755997,17660889,"Impression: 1. Right internal jugular hemodialysis catheter is unchanged in position.  Left internal jugular central line with its tip in the superior vena cava.  Endotracheal tube has its tip approximately 4.5 cm above the carina.  A nasogastric tube is seen coursing below the diaphragm with the tip not identified.    2. There has been interval worsening of the diffuse bilateral airspace process, likely representing worsening pulmonary edema, less likely superimposed infectious process.  No pleural effusions.  No evidence of pneumothorax.  Heart remains borderline enlarged.  Aorta is calcified.","Impression: 1. Right internal jugular hemodialysis catheter is unchanged in position.  Left internal jugular central line with its tip in the superior vain cava.  Endotracheal tube has its tip approximately 3.6 cm above the carina.  No nasogastric tube seen.    2. There has been interval worsening of the diffuse bilateral airspace process, likely representing worsening pulmonary edema, less likely superimposed infectious process.  No pleural effusions.  No evidence of pneumothorax.  Heart remains borderline enlarged.  No calcification seen.","['Change measurement', 'Change to homophone', 'False negation']"
"2c953c16-8d811ce5-80404b0b-859c9b9b-87a3260e, f5acc5b4-1e6fd282-3453001f-e9d68af4-af0a8782",52103847,17665558,"Findings: PA and lateral views of the chest provided.   Left chest wall pacer device is seen with leads extending into the right heart.  Midline sternotomy wires are also noted.  The lungs are clear.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process.  Pacemaker in place.","Findings: PA and lateral views of the chest provided. Left chest wall AICD device is seen with leads extending into the right heart. Midline sternotomy wires are also noted. The loans are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process. Pacemaker in place. An ET tube is also noted in position.","['Change name of device', 'Change to homophone', 'Add medical device']"
"6096e9b5-86463a35-ae11e747-b6c244b6-e79d1436, 74d17d6d-60d470c5-aa3e0790-ca26bda1-02853db1",58897524,17667438,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without focal consolidation or pleural effusion. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable with slight upper lobe vascular redistribution. Impression: There is a moderate pleural effusion. ET tube terminates above the carina. Impression: No acute cardiopulmonary process.,"['False prediction', 'Add contradiction', 'Add medical device']"
e0355e24-3d8b8030-c4db843f-a7f08492-b9b58e2c,51149106,17680905,"Impression: Heart size is prominent and unchanged. There is a persistent right sided basilar pleural effusion. There is no pulmonary edema. There is some atelectasis at the left lung base, stable. There are no pneumothoraces.","Impression: Heart size is prominent and unchanged. There are streaky opacities at the right sided basile areas. There is no pulmonary edema. There is some atelectasis at the left lung base, stable. There is some atelectasis at the left lung base, stable. There are no pneumothoraces. Hyperinflation consistent with COPD.","['Change location', 'Add repetitions', 'False prediction']"
aec99028-85963e75-247669dd-f5c64825-6802b7c4,57350348,17680905,"Findings: PA and lateral views of the chest provided.  Left-sided chest tube, endotracheal tube, Swan-Ganz catheter, and nasogastric tubes have been removed. There is a small pneumothorax in the left apex. There is increased hazy opacity in the right lower lung, likely reflecting layering effusion combined with loss of lung volume. Compared to prior study, there is slightly more pulmonary vascular congestion. Heart size has increased in size. Impression: Small pneumothorax in the right apex.","Findings: PA and lateral views of the chest provided. Left-sided chest tube, endotracheal tube, dialysis catheter, and nasogastric tubes have been removed. There is a small pneumothorax in the left apex. There is increased hazy opacity in the right lower lung, likely reflecting layering effusion combined with loss of lung volume. Compared to prior study, there is pulmonary edema. Heart size has increased in size. Impression: Small pneumothorax in the left apex. Small pneumothorax in the right apex.","['Change name of device', 'Add repetitions', 'False prediction']"
231fd0bd-bf21c178-9c9bbc5a-d859a30c-7086f6a6,59156144,17680905,Findings: The heart is mildly enlarged. The aorta is mildly tortuous and calcified. There is a intra-aortic balloon pump with the tip obscured. An exact measurement below the aortic knob cannot be obtained. It is at least in the upper descending aorta.  There is patchy areas of alveolar edema. There is mild pulmonary vascular redistribution.  There is no pleural effusion.  There is no focal infiltrate. Impression: Intra aortic balloon pump in the upper to mid descending thoracic aorta. No pleural effusion. No convincing findings for pneumonia,Findings: The heart is mildly enlarged. There is patchy areas of alveolar edema. The aorta is mildly tortuous and calcified. There is a intra-aortic balloon pump with the tip obscured. An exact measurement below the aortic knob cannot be obtained. It is at least in the upper descending aorta. There is patchy areas of alveolar edema. There is mild pulmonary vascular redistribution. There is no focal infiltrate. There is mild pulmonary vascular redistribution. There is a pleural effusion. Impression: Intra aortic balloon pump in the upper to mid descending thoracic aorta. No pleural effusion. No convincing findings for pneumothorax.,"['Change location', 'Add repetitions', 'False prediction']"
52d0b1e8-13061056-a5c5ab19-2b06aa45-a87d4502,59435140,17680905,Impression: No relevant change as compared to the previous radiograph.  Improved ventilation of the lung bases. No evidence for the presence of a pneumothorax. A minimal right pleural effusion might be present. No pulmonary edema. Unchanged alignment of the sternal wires. Unchanged postoperative appearance of the cardiac silhouette.,Impression: Lung hyperinflation as compared to the previous radiograph. Improved ventilation of the lung bases. No evidence for the presents of a pneumothorax. A large right pleural effusion might be present. No pleural congestion. Unchanged alignment of the sternal wires. Unchanged postoperative appearance of the cardiac silhouette.,"['Change severity', 'Change to homophone', 'False prediction']"
5706865f-64746402-2e5c6bfb-943aa9c1-3e276a08,59578157,17680905,Findings: The intra-aortic balloon pump tip is 11 mm below the aortic knob the remainder the appearance of the chest is unchanged ,Findings: The intra-aortic balloon pump tip is 11 cm below the aortic knob the remainder the appearance of the chest is unchanged ,"['Change measurement', 'Add contradiction', 'False negation']"
"9456c6be-efcc7327-7779a283-832262af-935183ba, e63c6663-176a47bc-a0c8f2b2-68d9fe3f-a02b4dfa",53404686,17691303,Findings: PA and lateral radiographs demonstrate clear lungs.  Markedly dextroconvex S-shaped scoliosis of the thoracolumbar spine is noted.  Heart size is normal.  There is no pneumothorax or pleural effusion.  Pulmonary vascularity is normal. Impression: No acute cardiopulmonary process.,Findings: PA and lateral radiographs demonstrate clear lunks.  No scoliosis is noted.  Heart size is normal.  There is no pneumothorax or pleural effusion.  Pulmonary vascularity is noraml. Impression: No acute cardiopulmonary process.,"['Change location', 'Add typo', 'False negation']"
"440953b1-efb8e185-cb50c4a5-18e15241-4b1a4941, a7a8a61e-714d4a79-e86852f1-39f627a4-153a8e9f",50218097,17709047,Impression: No acute cardiopulmonary process.,"Impression: No acute cardiopulmonary proses.
","['Change to homophone', 'Add repetitions', 'False negation']"
"1f7ba140-b003ee99-5b0b5d7d-af4aa6b4-a212ee2d, 2714ef6c-7b5f7b38-83da9bd7-3e7765be-9cd30bcc",58802826,17709047,"Findings: The cardiac, mediastinal and hilar contours are normal.  The pulmonary vascularity is normal.  The lungs are clear.  No pleural effusion or pneumothorax is present.  No acute osseous abnormality is seen.  Surgical sutures are demonstrated within the left upper quadrant of the abdomen. Impression: No acute cardiopulmonary abnormality.","Findings: The cardiac, mediastinal and hilar contours are normal. The pulmonary vasculairty is normal. There is a small basal opacity on the right side. No pleural effusion or pneumothorax is present. Minimal splay of the right rib is noted. Surgical sutures are demonstrated within the left upper lobe of the lung. Impression: No acute cardiopulmonary abnormality.","['Change location', 'Add typo', 'False prediction']"
"32495489-162fe31d-e0bdd6f7-adf001a8-203e9655, 9dbec9b8-85e97046-6ed0693b-0756a0c9-2d7d42ea",51450693,17778323,Impression: No acute cardiopulmonary process.,Impression: No acute cardiopulmonary process. An ET tube is seen extending to the mid-thoracic region.  ,"['Add medical device', 'Add repetitions', 'False negation']"
"2dea019a-3238b00f-3b099b6d-d9a59d7e-9a34765f, bb7b1e88-c2f3b1bd-8d48cc78-62117964-b18a89aa",55621374,17797518,Findings: The lungs are clear.  There is no consolidation or pneumothorax.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear.  Their is no consolidation or pneumothorax.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities.  There is a pacemaker in place. Impression: No acute cardiopulmonary process.,"['False negation', 'Change to homophone', 'Add medical device']"
"0927598f-e24da99d-ec445ee7-e5470dfc-978d2780, 0a3b3e2e-35122c1a-97114ab6-a227fd83-e5af5c17",57652627,17802612,"Findings: Frontal radiographs of the chest demonstrate normal heart size.  The aorta is tortuous.  There is an 8 mm round opacity projecting over the right lower lung, which was further evaluated on subsequent chest CT and found to be a nipple shadow.  The lungs are otherwise clear.  No pleural effusion or pneumothorax.  No displaced rib fracture identified. Impression: No evidence of acute process.","Findings: Frontal radiographs of the chest demonstrate normal heart size.  The aorta is tortuous.  There is an 8 cm round opacity projecting over the right lower lung, which was further evaluated on subsequent chest CT and found to be a nipple shadow.  The lungs are otherwise clear.  No pleural effusion or pneumothorax.  No displaced rib fracture identified. Impression: No evidence of acute process.  Mild pulmonary edema and small bilateral pleural effusions.","['Change measurement', 'Add contradiction', 'False negation']"
"5f80a35d-198e9b95-a1b7c84d-d982ae5d-58d1e672, e1ce5809-b1cbeb24-fde041d3-54a42f81-043462f0",53304221,17847770,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.  No focal consolidation to suggest pneumonia.,Findings: The luings are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. A pacemaker is present in the left chest. No pleural effution or pneumothorax is seen. ,"['Add typo', 'Add repetitions', 'Add medical device']"
"547c1419-90bc4319-c6808ba5-6fe0463d-a8f1e508, a200c4d9-39de37d9-f20906a3-87b342f8-59b476da",56451780,17847770,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.  Hilar contours are stable. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.  Hilar contours are stable. The lungs are clear without focal consolidation. Impression: Mild pulmonary edema and small bilateral pleural effusions.  Subclavian central venous line is present.,"['Add repetitions', 'Add contradiction', 'Add medical device']"
"27a25899-ff86a8aa-e4233c75-794e0118-c17d38ea, 82ca8995-dd37a31a-02d18a47-a0a6c734-0f8bb665",51201285,17933711,Findings: Cardiomediastinal contours are stable with moderate cardiomegaly. The lungs are clear. There is no pneumothorax or pleural effusion.  There are moderate degenerative changes in the thoracic spine Impression: No acute cardiopulmonary abnormalities,Findings: Cardiomediastinal contours are stable with severe cardiomegaly. The lungs are clear. There is no pneumothorax or pleural effusion.  There are no degenerative changes in the thoracic spine There are no degenerative changes in the thoracic spineImpression: No acute cardiopulmonary abnormalities,"['Change severity', 'Add repetitions', 'False negation']"
262aec66-02c3d815-9e02b897-1f697799-42735ce8,53605255,17933711,Findings: AP portable upright view of the chest.   Cardiomegaly is again seen.  The mediastinal contour is unchanged from prior.  The hila appear congested though there is no frank edema.  No large effusion or pneumothorax.  No convincing evidence for pneumonia.  Bony structures are intact. Impression: Cardiomegaly and hilar congestion.  No frank edema or pneumonia.,Findings: AP portable upright vew of the chest. Mild cardiomegaly is again seen. The mediastinal contour is unchanged from prior. The hila appear moderately congested though there is no frank edema. No large effusion or minimal pneumothorax. No convincing evidence for pneumonia. Bony structures have a fracture. Impression: Moderate cardiomegaly and hilar congestion. No frank edema or pneumonia.,"['Change severity', 'Add typo', 'False prediction']"
6c9b8bc4-94ef9ac4-cd7187f1-d90c32b0-75b2e5a5,58596812,17933711,"Impression: In comparison with study of ___, there is again prominence of the cardiac silhouette with left ventricular configuration.  No vascular congestion, pleural effusion, or acute focal pneumonia.","Impression: In comparison with study of ___, there is again prominence of the cardiac silhouette with right ventricular configuration. No vascular congestion, pleural effusion, or acute focal pneumonia. No vascular congestion, pleural effusion, or acute focal pneumonia.","['Change location', 'Add repetitions', 'False negation']"
"76b89f70-52ebf792-8b3a551f-ea727bca-0170ec15, c9490237-d2939ebb-637bda9a-e5a0039f-284b489b",59614080,17933711,"Findings: There are relatively low lung volumes.  Mild pulmonary edema is seen.  No definite focal consolidation is seen.  There may be trace pleural effusions posteriorly, but no large pleural effusion is seen.  Cardiac and mediastinal silhouettes are stable.  . Impression: Low lung volumes and mild pulmonary edema.  No focal consolidation to suggest pneumonia.  Possible trace pleural effusions but no large pleural effusion.","Findings: There are relatively low lung volumes.  Severe pulmonary edema is seen.  No definite focal consolidation is seen.  There may be trace pleural effusions posteriorly, but no pleural effusion is seen.  Cardiac and mediastinal silhouettes are stable.  . Impression: Low lung volumes and moderate pulmonary edema.  No focal consolidation to suggest pneumonia.  Possible trace pleural effusions but no pleural effusion.","['Change severity', 'Change to homophone', 'False negation']"
"1421aadb-056057cf-459c8a3b-f595759b-60a22305, 424f08cc-824e5954-cd4cd47b-b96a37f8-29649294",50363621,17934731,"Findings: Marked rotary levoscoliosis slightly limits assessment.  The cardiac and mediastinal contours are unchanged, with the heart size within normal limits.  Pulmonary vasculature is normal.  No focal consolidation, pleural effusion or pneumothorax is seen.  Mild bronchial wall thickening is noted in the right lung base, compatible with bronchiectasis as seen on the prior chest CT. Impression: No acute cardiopulmonary abnormality.","Findings: Marked rotary levoscoliosis slightly limits assessment.  The cardiac and mediastinal contours are unchanged, with the hearth size within normal limits.  Pulmonary vasculature is normal.  No focal consolidation, pleural effusion or pneumothorax is seen.  No bronchial wall thickening is noted. Impression: No acute cardiopulmonary abnormality.","['Change location', 'Add typo', 'False negation']"
b08aaf75-27433984-2f2fe0d6-12a22932-c87cc8d7,52852563,17934731,"Findings: Single frontal view of the chest demonstrates marked levoconvex thoracic scoliosis, distorting cardiomediastinal contours.  Allowing for such the heart is normal in size.  An air-fluid level projecting over the heart is consistent with a large hiatal hernia.  The lungs are clear, without evidence of pneumothorax, consolidation, or pleural effusion. Impression: 1.  No definite evidence of acute cardiopulmonary process, including pneumonia or pulmonary edema as queried. 2.  Marked thoracic scoliosis and moderate to large hiatal hernia.","Findings: Single frontal view of the chest demonstrates marked levoconvex thoracic scoliosis, distorting cardiomediastinal contours. Allowing for such the heart is immensely in size. An air-fluid level projecting over the heart is consistent with a large hiatal hernia. The lungs are clear, without evidence of pneumothorax, consolidation, or pleural effusion. An ET tube is noted in the trachea. Impression: 1. No definite evidence of acute cardiopulmonary process, including pneumonia or pulmonary edema as queried. 2. Marked thoracic scoliosis and small to moderate hiatal hernia.","['Change severity', 'Change to homophone', 'Add medical device']"
"04358d55-af10b770-d5efc878-5cb699d1-4c208ccc, ac273887-927e791a-6efc8cbb-9e16bd27-f2fc65cc",54358600,17934731,"Findings: Compared with most recent prior radiographs, pleural effusions and associated atelectasis have resolved.  There is no change in severe leftward thoracic scoliosis and hiatal hernia.  Lungs are clear.  No pleural effusion or pneumothorax. Impression: No evidence suspicious for intrathoracic metastatic disease.","Findings: Compared with most recent prior radiographs, pleural effusions and associated atelectasis have resolved.  There is no change in moderate leftward thoracic scoliosis and hiatal hernia.  Lungs are hyperinflated.  No pleural effusion or pneumothorax. Impression: No evidence suspicious for intrathoracic metastatic disease. There are new bilateral pleural effusions.","['Change severity', 'Add contradiction', 'False prediction']"
"62f76a9c-ad970999-824b1a18-304d5277-9d7467ca, dbb5d5c8-c8b687af-eb581dc3-69916e4d-16dcdc9e",54981405,17934731,"Findings: PA and lateral upright chest radiograph demonstrates severe scoliosis of the thoracic spine, convex to the left. As demonstrated on CT obtained on the same day, there is a large hiatal hernia accounting for retrocardiac opacity. No focal opacities identified concerning for pneumonia. When compared to prior chest radiograph obtained on a ___, there is been little interval change with stable appearance of cardiomediastinal contour, allowing for differences in patient positioning. Impression: No convincing opacity concerning for pneumonia.","Findings: PA and lateral upright chest radiograph demonstrates severe scoliosis of the lumbar spine, convex to the left. As demonstrated on CT obtained on the same day, there is a large hiatal hernia accounting for retrocardiac opacity. No focal opacities identified concerning for pneumonia. When compared to prior chest radiograph obtained on a ___, their is been little interval change with stable appearance of cardiomediastinal contour, allowing for differences in patient positioning. Impression: No convincing opacity concerning for pneumonia. A pacemaker is present in the left chest.","['Change location', 'Change to homophone', 'Add medical device']"
"1c493af8-170d3211-d1a0da94-92ced558-f2b893d8, 8d3642d4-efc7352b-cad3fe46-94b15206-23bb6f02",56305857,17934731,"Findings: In comparison with the study of ___, there is no change in the appearance of the heart and lungs and the severe scoliosis of the thoracic spine convexed to the left.  Specifically, no evidence of pulmonary metastases. ","Findings: In comparison with the study of ___, there is no change in the appearance of the heart and lungs and the moderate scoliosis of the thoracic spine convexed to the left. Specifically, no evidence of pulmonary nodules. Specifically, no evidence of pulmonary metastases.","['Change severity', 'Add repetitions', 'False negation']"
"abc19309-ae3abcce-b79cc9e9-7b84b6a2-e61602d6, ff867e1d-44fedef5-73b75a68-22afab50-565ca517",50752160,17945610,"Impression: The left-sided pacemaker and wires are unchanged in position.  There is a persistent right middle lobe opacity, stable.  There is also prominence of the pulmonary interstitial markings which have worsened. There are no pleural effusions or pneumothoraces.  There is extensive thoracic aortic calcification.  Heart size is enlarged.",Impression: The left-sided pacemaker and wires are unchanged in position.  No right middle lobe opacity is observed.  There is also prominence of the pulmonary interstitial markings which has worsened.  There are no pleural effusions or pneumothoraces.  There is extensive thoracic aortic calcification.  Heart size is enlarged.,"['Change location', 'Change to homophone', 'False negation']"
53aeee8a-c2f7a428-34ede058-f7d0aa79-183fc763,51154172,17945610,"Findings: ETT tip is in standard position.  An enteric tube traverses the diaphragm with its tip not seen.  The stomach is non-distended.  Left jugular line is appropriately positioned. Dual lead cardiac device is overall unchanged in position with 1 tip ending in the right atrium and the other in the right ventricle.  Right-sided pigtail catheter projects over the right hemithorax and right mediastinum and appears intact.  Right upper lobe opacity persists, but lower lung opacities are significantly improved. The right pleural effusion appears resolved.  Hazy opacification of the left costophrenic angle and the left lung base suggests persistent layering small pleural effusion.  No change in retrocardiac opacity which may represent atelectasis, although focal consolidation cannot be excluded in appropriate clinical setting.  No pneumothorax.  Stable appearance of the cardial mediastinal silhouette without cardiomegaly. Impression: 1.  Improved edema with persistent right upper lobe opacity concerning for concurrent pneumonia. 2.  Resolved right pleural effusion.","Findings: ETT tip is in low position. An enteric tube traverses the diaphragm with its tip in the duodenum. The stomach is distended. Left jugular line is misplaced. Dual lead cardiac device is overall unchanged in position with 1 tip ending in the superior vena cava and the other in the right ventricle. Right-sided pigtail catheter projects over the left hemithorax and right mediastinum and appears intact. Right upper lobe opacity persists, but lower lung opacities are significantly improved. The right pleural effusion appears resolved.  Hazy opacification of the left costophrenic angle and the left lung base suggests persistent layering small pleural effusion. No change in retrocardiac opacity which may represent atelectasis, although focal consolidation cannot be excluded in appropriate clinical setting. Patchy consolidations in both lower lobes. Pneumothorax on the right side. Stable appearance of the cardial mediastinal silhouette without cardiomegaly. Impression: 1.  Improved edema with persistent right upper lobe opacity concerning for concurrent pneumonia. 2. Increased right pleural effusion.","['Change position of device', 'Add contradiction', 'False prediction']"
4f0b2afa-30cb00e2-18711010-d4bc3f13-84cc4f7a,51234546,17945610,"Impression: PREVIOUS MODERATE RIGHT PLEURAL EFFUSION IS SMALLER.  HETEROGENEOUS OPACIFICATION RIGHT LUNG LOOKS UNCHANGED SINCE ___, BUT MORE ABNORMAL THAN EARLIER IN THE DAY WHICH MAY BE DUE TO RECENT HEMOPTYSIS.  LEFT LUNG IS GROSSLY CLEAR.  MODERATE CARDIOMEGALY IS CHRONIC.  ATRIOVENTRICULAR PACER LEADS IN STANDARD PLACEMENTS.","Impression: PRREVIOUS MODERATE RIGHT PLEURAL EFFUSION IS SMALLER.  HETEROGENEOUS OPACIFICATION RIGHT LUNG LOOKS UNCHANGED SINCE ___, BUT MORE ABNORMAL THAN EARLIER IN THE DAY WHICH MAY BE DUE TO RECENT HEMOPTYSIS.  LEFT LUNG IS GROSSLY CLEAR EXCEPT FOR MINIMAL BASAL ATELECTASIS.  MODERATE CARDIOMEGALY IS ACUTE.  ATRIOVENTRICULAR PACER LEADS IN THE LEFT SUBCLAVIAN VEIN.","['Change position of device', 'Add typo', 'False prediction']"
3845e98f-500b7d8f-b2376aa8-3355c4fa-074d73d0,51621842,17945610,"Impression: As compared to ___ radiograph, cardiac silhouette remains markedly enlarged.  Right heart border and majority of right hemidiaphragm now obscured, likely due to worsening consolidation and or atelectasis in this region, accompanied by a small to moderate pleural effusion.  Pulmonary vascular congestion is accompanied by resolving edema.  No other relevant changes.","Impression: As compared to ___ radiograph, cardiac silhouette remains markedly enlarged.  Left heart border and majority of right hemidiaphragm now obscured, likely due to worsening consolidation and or atelectasis in this region, accompanied by a small to moderate pleural effusion.  Pulmonary vascular congestion is accompanied by resolving edema.  Pulmonary vascular congestion has not improved.  No other relevant changes.","['Change location', 'Add contradiction', 'False negation']"
a9415ba1-3d12f1ec-964b6738-a9e76fa5-30aca88b,51939978,17945610,"Findings: An ET tube is present, tip approximately 3.3 cm above the carina.  Left IJ central line is present --___ tip partially obscured, but likely overlying the mid SVC.  No pneumothorax is detected.  There is extensive somewhat patchy opacification of the right lung, with air bronchograms.  There is a vascular plethora in the left lung.There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation.  Probable small right-greater-than-left effusions.    Biapical pleural scarring is present.  A left-sided dual lead pacemaker is present, with lead tips over the right atrium and right ventricle.  There is cardiomegaly.  Aortic calcification is present.  Osteopenia and scoliosis of the spine are noted, not fully evaluated. Impression: 1. ET tube approximately 3.3 cm above the carina.  Left IJ central line tip over mid SVC.  No pneumothorax detected. 2. Extensive opacification of the right lung, with air bronchograms.  The differential diagnosis includes pulmonary edema, as CHF is also seen the left lung, and infection or, in the appropriate clinical setting , ARDS. 3. Left lower lobe collapse and/or consolidation. 4. Bilateral right-greater-than-left effusions.","Findings: An ET tube is present, tip approximately 4.1 cm above the carina.  Left IJ central line is present --___ tip partially obscured, but likely overlying the mid SVC.  No pneumothorax is detected.  There is extensive somewhat patchy opacification of the right lung, with air bronchograms.  There is no vascular plethora in the left lung. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation.  Probable small right-greater-than-left effusions.    Biapical pleural scarring is present.  A left-sided dual lead pacemaker is present, with lead tips over the right atrium and right ventricle.  There is cardiomegaly.  Aortic calcification is present.  Osteopenia and scoliosis of the spine are noted, not fully evaluated. An additional NG tube is noted in the upper esophagus. Impression: 1. ET tube approximately 3.3 cm above the carina.  Left IJ central line tip over mid SVC.  No pneumothorax detected. 2. Extensive opacification of the right lung, with air bronchograms.  The differential diagnosis includes pulmonary edema, as CHF is also seen in the left lung, and infection or, in the appropriate clinical setting , ARDS. 3. Left lower lobe collapse and/or consolidation. 4. Bilateral right-greater-than-left effusions.","['Change measurement', 'Add contradiction', 'Add medical device']"
889de77f-1402d0bf-fd2d2420-a6980f4b-09ae6ed7,52122560,17945610,"Findings: The ETT is in standard position.  The right pigtail catheter also appears intact and unchanged in position projecting over the right aspect of the mediastinum in the lower hemithorax.  The enteric tube crosses the midline and the is tip is not seen. The stomach is nondistended.  Bilateral pulmonary edema has markedly improved since ___ and minimally improved since ___, now mild in severity.  Persistent focal right upper lobe opacity could represent concurrent pneumonia.  Hazy opacification blunting of the left costophrenic angle is overall similar and suggest persistent small left pleural effusion.  No definite right pleural effusion.  Mild to moderate cardiomegaly persists and is unchanged.  The mediastinum is not widened.  No pneumothorax.  Aortic knob calcifications are re- demonstrated.  Dextroconvex scoliosis of the thoracic spine is unchanged. Impression: Improving, now mild, pulmonary edema with persistent right upper lobe opacity which could represent concurrent pneumonia.","Findings: The ETT is positioned closer to the carina.  The right pigtail catheter also appears intact and unchanged in position projecting over the lower aspect of the mediastinum in the lower hemithorax.  The enteric tube crosses the midline and the is tip is not seen. The stomach is nondistended.  Bilateral pulmonary edema has markedly improved since ___ and minimally improved since ____, but remains unchanged in severity.  Persistent focal right upper lobe opacity could represent concurrent pneumonia.  No opacification blunting of the left costophrenic angle is overall similar and suggest persistent small left pleural effusion.  No definite right pleural effusion.  Mild to moderate cardiomegaly persists and is unchanged.  The mediastinum is not widened.  No pneumothorax.  Aortic knob calcifications are re-demonstrated.  Dextroconvex scoliosis of the thoracic spine is unchanged. Impression: Improving, now mild, pulmonary edema with persistent right upper lobe opacity which could represent concurrent pneumonia.","['Change position of device', 'Add contradiction', 'False negation']"
ba6dbc8f-1a49e9ff-024c2020-64ad895a-bca8cb55,53456512,17945610,"Impression: With the chin down, tip of the new endotracheal tube less than a cm from the carina is 2.5 cm below appropriate positioning.  Esophageal drainage tube passes into the stomach and out of view.  New left internal jugular line ends in the low SVC.  Transvenous right atrial right ventricular pacer leads continuous from the left pectoral generator.  Previous mild pulmonary edema has improved or cleared, but there is still very severe bilateral pulmonary consolidation, worst throughout the right lung but in the left lower lobe as well.  This is pneumonia and/or pulmonary hemorrhage.  Moderate bilateral pleural effusion, right greater than left, has increased since ___, probablya reflection of previous transient heart failure.","Impression: With the chin down, tip of the new endotracheal tube less than a cm from the carina is now 1 cm below appropriate positioning.  Esophageal drainage tube terminates just above the stomach.  New left internal jugular line ends just above the right atrium.  Transvenous right atrial right ventricular pacer leads terminate in the right ventricle from the left pectoral generator.  Previous mild pulmonary edema has improved or cleared, but there is still no bilateral pulmonary consolidation.  This is pneumonia and/or pulmonary hemorrhage.  Moderate bilateral pleural effusion, right greater than left, has decreased since ___, probably a reflection of previous transient heart failure. ","['Change position of device', 'Add contradiction', 'False negation']"
"9302ed70-b3b573ff-41f32027-d4a641c9-04b09ba9, ab618eee-2a493884-a478b561-100f5f42-562e5657",54490035,17945610,"Findings: Obscuration of the right heart border with wedge opacity projecting over the right middle lobe is noted.  Lungs are otherwise notable for increased interstitial markings, overall improved since priors.  There is no effusion.  Mild cardiomegaly is again seen.  Left chest wall dual lead pacing device is again noted.  IVC filter visualized within the abdomen. Impression: Right middle lobe opacity compatible with atelectasis and posssible infection.","Findings: No obscuration of the right heart border with wedge opacity projecting over the right middle lobe is noted.  Lungs are otherwise notable for increased interstitial markings, overall improved since priors.  There is no effusion.  Moderate cardiomegaly is again seen.  Left chest wall duel lead pacing device is again noted.  IVC filter visualized within the abdomen. Impression: No right middle lobe opacity.","['Change severity', 'Change to homophone', 'False negation']"
35b9c6fa-00c88823-d2b016e7-860235a2-35e10b1b,54832536,17945610,"Findings: Compared with ___ at 16:27, the ET tube, NG tube and left IJ central line have been removed.  The right pigtail has also been removed.  Minimal blunting of the right costophrenic angle is very slightly greater.  No pneumothorax or other evidence of right-sided effusion is identified.  Allowing for technical differences, there is otherwise minimal interval change.  Again seen is focal sclerosis in the right proximal humerus.  Is there history of old healed fracture.  No lucent fracture line is identified. Impression: As above..","Findings: Compared with ___ at 16:27, the ET tube, NG tube, and left IJ central line have been removed.  The right pigtail has also been removed.  Moderate blunting of the right costophrenic angle is very slightly greater.  No pneumothorax or other evidence of right-sided effusion is identified.  Allowing for technical differences, there is otherwise minimal interval change.  Again seen is focal sclerosis in the right proximal humerus.  Is there history of old healed fracture.  Lucent fracture lines are identified. Impression: Prominent right-sided effusion. ","['Change name of device', 'Add contradiction', 'False prediction']"
"03c75931-b2196163-ee0a3e6e-0decfe16-830818ae, 6bce6e3d-c0808929-7010788f-068f1c13-2b766a1a",55278676,17945610,"Impression: As compared to the previous radiograph, there is a slight increase of the moderate right pleural effusion.  Moderate cardiomegaly persists.  The pacemaker wires are in unchanged position.  Normal appearance of the left lung.","Impression: As compared to the previous radiograph, there is a slight increase of the moderate right pleural effusion. Moderate cardiomegaly persists. The AICD wires are in unchanged position. Normal appearance of the left lung. The AICD wires are in unchanged position. A left-sided port-a-cath is visualized.","['Change name of device', 'Add repetitions', 'Add medical device']"
7faad21d-d5e10065-97ed8c34-1de6fab7-d7a77f09,56803911,17945610,Impression: Left-sided pacemaker with leads are unchanged in position.  There is unchanged cardiomegaly.  There is mild improved aeration.  There remains prominence of the pulmonary interstitial markings. There is an opacity at the right medial heart border.  This may represent pneumonia or aspiration.  No pneumothoraces are seen.,Impression: Left-sided vascular stent with leads are unchanged in position.  There is unchanged cardiomegaly.  There is mild improved aeration.  There remains prominence of the pulmonary interstitial markings. There is an opacity at the right medial heart border.  This may represent pneumonia or aspiration.  No pneumothorax are seen.,"['Change name of device', 'Change to homophone', 'False prediction']"
ccdf59cc-7eee47c2-02d0bc2e-3a7bcf33-0a35c23e,58920910,17945610,"Impression: ET tube has been repositioned, in standard placement.  Slight increase in the extent of opacification in the right lung is probably due to a decrease in moderate bilateral pleural effusion, right still greater than left, rather than much change in severe bilateral pulmonary consolidation due to pneumonia and/or pulmonary hemorrhage.  Mild cardiomegaly is stable.  Other lines and tubes in stable, standard positions.  No pneumothorax.","Impression: ET tube has been repositioned, in standard placemat.  Slight increase in the extent of opacification in the left lung is probably due to a decrease in moderate bilateral pleural effusion, right still greater than left, rather than much change in severe bilateral pulmonary consolidation due to pneumonia and/or pulmonary hemorrhage.  Mild cardiomegaly is stable.  Other lines and tubes in stable, standard positions.  No pneumothorax.  A pacemaker is also present.","['Change position of device', 'Change to homophone', 'Add medical device']"
d1049806-4b17d015-4e13b1d0-05247bd2-7b72efcb,59139883,17945610,"Impression: As compared to the previous image, the patient has received a pigtail catheter inserted into the right pleural space.  The catheter has drained parts of the pre-existing right pleural effusion.  No evidence of pneumothorax.  On the left, after an attempt of tube placement, there is no evidence for the presence of a pneumothorax.  The nasogastric tube and the endotracheal tube are unchanged.  Unchanged appearance of the cardiac silhouette.","Impression: As compared to the previous image, the patient has received a pigtail catheter inserted into the left pleural space.  The catheter has drained parts of the pre-existing right pleural effusion.  No evidence of pneumothorax.  On the left, after an attempt of tube placement, there is no evidence for the presence of a pneumothorax.  The nasogastric tube and the endotracheal tube are unchanged.  No thoracic surgery indications noted.  The nasogastric tube and the endotracheal tube are unchanged.  Unchanged appearance of the cardiac silhouette.","['Change position of device', 'Add repetitions', 'Add medical device']"
"1df7311e-0604deb0-5cf21129-d9d6af6a-dac5004d, 6660e8d2-6381a94a-843d96da-11713488-59a660eb",51622821,17971994,"Impression: No previous images.  There is a left chest tube following a VATS wedge resection with probably a tiny apical pneumothorax.  The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.","Impression: Nurse previous images.  There is a left chest tube following a VATS wedge resection with probably a tiny apical pneumonia.  The cardiac silhouette is mildly enlarged and there is no vascular congestion, pleural effusion, or acute focal pneumonia.","['Change position of device', 'Add typo', 'False prediction']"
"1164d62f-9e4a6099-a99a9a12-017229ad-7b6f71b5, 7aebfaa7-d5a1f4ed-24dfd06b-e5e86c5c-5850e00f",51958471,17971994,Findings: The lungs are hyperinflated.  There is no pneumothorax.  Bilateral effusions are small.  Retrocardiac opacity correlates with postoperative changes seen on concurrent CTA chest.  The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process. Faint nodules throughout the lungs are better seen on concurrent CTA chest.,Findings: The lungs are hyperinflated.  There is blatant pneumothorax.  Bilateral effusions are large.  Retrocardiac opacity correlates with postoperative changes seen on concurrent CTA chest.  The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process. Faint nodules throughout the lungs are better seen on concurrent CTA chest. A large mass is noted in the right upper lobe.,"['Change severity', 'Add contradiction', 'False prediction']"
9eaa5798-a1f9ce99-1756bdf0-83b81c43-45840f0f,58301819,17971994,Findings: The left-sided chest tube is been removed.  There is a small left pleural effusion and volume loss in the left lower lobe better new compared to prior.  There is no pneumothorax.  There is a small right effusion as well Impression: Worsened appearance to the left lung.,Findings: The left-sided chest tuube is been removed. There is large right pleural effusion and volume loss in the left lower lobe better new compared to prior. There is no pneumothorax. No right effusion seen. Impression: Severe worsened appearance to the left lung.,"['Change severity', 'Add typo', 'False negation']"
"10012b3a-50cadc6b-2c7edc30-cd4462d7-94cc5a75, 9b8e858a-9dcf3d99-30cd9e93-a545b503-a374c56f",52381069,17978047,"Findings: Mild cardiomegaly and a calcified aorta are again seen.  The lungs remain hyperinflated, and central pulmonary arteries remain prominent.  Thin linear opacities at the lateral left base on the PA view are similar to prior, compatible with atelectasis or scarring.  There is no evidence for pulmonary consolidation, pulmonary edema, pleural effusion, or pneumothorax.  There are degenerative changes and dextroconvex scoliosis in the thoracic spine. Impression: Stable appearance of the chest without evidence for acute abnormalities.","Findings: Severe cardiomegaly and a calcified aorta are again seen.  The lungs remain hyperinflated, and central pulmonary arteries remain prominent.  Thin linear opacities at the lateral left base on the PA view are similar to prior, compatible with atelectasis or scarring.  There is no evidence for pulmonary consolidation, pulmonary edema, or pleural effusion, but there is mild pneumothorax.  There are no degenerative changes in the thoracic spine. Impression: Mild cardiomegaly without evidence for acute abnormalities.","['Change severity', 'Add contradiction', 'False negation']"
"7ecdb716-e49a94e2-ad048b9b-135f180b-c96aa97b, ba03cd17-84ef8c6e-04903ede-41a75c34-165e5c44",54309228,18001816,"Findings: Chest, PA and lateral.  Lung volumes are low.  The hilar and cardiomediastinal contours are within normal limits. No chf, focal infiltrate, effusion or pneumothorax is detected. Impression: No acute pulmonary process identified.","Findings: Chest, PA and lateral. Lung volumes are low. The hilar and cardiomediastinal contours are within normal limits. No chf, focal infiltrate, effusion or pneumothorax is detected. Impression: There is evidence of an acute pulmonary process.","['Change location', 'Add contradiction', 'False negation']"
3eeeb2ac-9bca9174-549fbb9e-0dad8292-81377269,50340409,18007398,"Impression: The patient is intubated, the tip of the endotracheal tube projects 4 cm above the carina.  To right and 1 left-sided chest tube are in place.  Nasogastric tube shows a normal course.  Left retrocardiac atelectasis.  Minimal right pleural effusion.  No visible pneumothorax.  Non displaced rib fractures described on the CT examination from ___, 19:33, are not visualized on the radiograph.","Impression: The patient is intubated, the tip of the endotracheal tube projects 4.9 cm above the carina.  To rigth and 1 left-sided chest tube are in place.  Nasogastric tube shows a normal course.  Left retrocardiac atelectasis.  Minimal right pleural effusion.  No visible pneumothorax.  Non displaced rib fractures described on the CT examination from ___, 19:33, are not visualized on the radiograph.  Pacemaker is present in the upper left chest.","['Change measurement', 'Add typo', 'Add medical device']"
"a6d4bff1-d42c2ba8-4e17dc8b-1cd7a3a8-46d67185, c8c44515-6c17950e-f2e98985-ecc89cbf-7e860f4e",54285117,18014772,"Findings: No focal consolidation, pleural effusion, or pneumothorax is seen.  Heart and mediastinal contours are within normal limits.  Two nodular opacities project over the right anterior second rib. Impression: 1. No radiographic evidence for acute cardiopulmonary process. 2. Possible right upper lobe nodules.  Shallow oblique views are recommended for further evaluation.   These findings and recommendations were discussed with Dr. ___ by Dr. ___ by telephone at 10:50 a.m. on ___.","Findings: No focal consolidation, pleural effusion, or pneumothorax was seen. Heart and mediastinal cnotours are within normal limits. Two nodular opacities project over the left anterior second rib. There is evidence of mild interstitial edema. Impression: 1. No radiographic evidence for acute cardiopulmonary process. 2. Possible left upper lobe nodules. Shallow oblique views are recommended for further evaluation. These findings and recommendations were discussed with Dr. ___ by Dr. ___ by telephone at 10:50 a.m. on ___.","['Change location', 'Add typo', 'False prediction']"
"1bfdb2fd-6ff900ec-a426db98-a566d026-6f1d6677, 61370059-4f1745cc-d3636639-4b9629ce-bb9b8467",56399172,18016444,"Findings: Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. Impression: Normal chest radiographs.","Findings: Hart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. Impression: Normal chest radiographs. There is a right IJ central venous catheter in the SVC. Mild pleural effusion is noted.","['Add contradiction', 'Change to homophone', 'Add medical device']"
c3429ad6-8e5e462a-4c90cdef-f2d92103-a0820652,54358320,18043502,Impression: Hardware is seen within the lower cervical spine.  Cardiomediastinal silhouette is within normal limits.  There has been improved aeration since the prior study.  There remains atelectasis at the lung bases and likely a small left-sided pleural effusion. There are no pneumothoraces.  Severe scoliosis of the thoracolumbar spine is again seen.,Impression: Hardware is seen within the lower cervcal spine.  Cardiomediastinal silhouette is within normal limits.  There has been imroved aeration since the prior study.  There remains atelectasis at the lung bases with a cavitary lung lesion also present. There are no pneumothoraces.  Mild scoliosis of the thoracolumbar spine is again seen.,"['Change severity', 'Add typo', 'False prediction']"
"cfed9cac-3eed3cf9-1641a7bc-780ed24d-5337833e, f720a50a-3a52b680-e44f6730-6f239683-55ab1ac3",57430048,18043502,Impression: The study is somewhat limited due to the patient's thoracolumbar scoliosis as well as the chin projecting over the lung apices.  Cardiomediastinal silhouette is within normal limits.  There is a left-sided pleural effusion and a left retrocardiac opacity.  There are no signs for overt pulmonary edema or pneumothoraces.,Impression: The study is somewhat limited due to the patient's thoracolumbar scoliosis as well as the chin projecting over the lung apices. Cardiomediastinal silhouette is within normal limits. There is a right-sided pleural effusion and a left retrocardiac opacity. There is a left-sided pleural effusion and a left retrocardiac opacity. There are no signs for overt pulmonary edema or a small left apical pneumothorax.,"['Change location', 'Add repetitions', 'False prediction']"
"5ddde0e8-36797a7f-860a133e-21c372bc-632c20b9, e4a62f0a-718060e7-49ef0069-e95d38ff-96fac7fd",50285888,18057037,"Impression: Interval development of left greater than right bibasilar opacities, possibly atelectasis, but aspiration or pneumonia cannot be excluded. Mild pulmonary vascular congestion and probable trace bilateral pleural effusions.","Impression: Interval resolution of left greater than right bibasilar opacities, possibly atelectasis, but aspiration or pneumonia cannot be excluded. Mild pulmonary vascular congestion and probable trace bilateral pleural effusions.","['Change severity', 'Add contradiction', 'False prediction']"
ab80b235-0f6e4319-62504f7b-e293fad3-0ad33347,50572963,18057037,Findings: Volume loss in both lower lungs  has increased compared to the prior day. the heart size is mildly enlarged and there is mild pulmonary vascular redistribution.  An underlying infectious infiltrate cannot be excluded. ,Findings: Volume loss in both lower lungs has increased compared to the prior day. the heart size is mildly enlarged and there is mild pulmonary vascular redistribution. An underlying infectious infiltrate cannot be excluded. An endotracheal tube is seen with the tip at the level of the carina. Impression: No pulmonary vascular redistribution and the heart size is severely enlarged. ,"['Change severity', 'Add contradiction', 'Add medical device']"
"1b963d3e-0bf48d72-cbaf1a14-ed74724c-b8534d5a, 5139b8e5-f1349775-39057827-046ed642-60133e35",50572999,18057037,Findings: PA and lateral chest radiographs were obtained.   Lung volumes remain low with right basilar atelctasis as well as enlargement of main pulmonary artery and cardiac silhouette.  There are small bilateral pleural effusions.  No pneumothorax is identified.  Surgical clips are again noted in the left upper quadrant. Impression: Exam unchanged with bilateral small pleural effusions and right basilar atelectasis and stable cardiomegaly.,Findings: PA and lateral chest radiographs were obtained.  Lung volumes remain low with right basilar atelectasis and no enlargement of the main pulmonary artery and cardiac silhouette.  No small bilateral pleural effusions.  No pneumothorax is identified.  Surgical staples are again noted in the left upper quadrant.  Impression: Exam unchanged with no pleural effusions and right basilar atelectasis and stable cardiomegaly.,"['Change name of device', 'Change to homophone', 'False negation']"
"57ae3cb1-97ee6261-ad57fd24-2fdfb967-9f57b03e, d7e76bf7-a2164a84-93ac8bab-30112b43-10fce823",51935226,18057037,"Findings: AP and lateral chest radiographs.  Lung volumes remain low with right basilar atelectasis, similar to recent radiographs.  The main pulmonary artery remains markedly enlarged.  Small bilateral pleural effusions are similar to CTA chest of ___.  There is no pneumothorax.  Moderate cardiomegaly is stable.  Surgical clips are noted in the upper abdomen. ","Findings: AP and lateral chest radiographs.  Lung volumes remain low with right basilar atelectasis, similar to recent radiographs.  The main pulmonary vein remains markedly enlarged.  Small bilateral pleural effusions are similar to CTA chest of ___.  There is no pneumothorax.  Moderate cardiomegaly is stable.  Surgical clips are projected over the lower lung.  There is a suspicious nodule in the left lung apex.","['Change position of device', 'Change to homophone', 'False prediction']"
7aba81f6-645a2f48-7aa04bfb-489d2880-2f72270c,51940572,18057037,Impression: 1.  New CHF with interstitial and probable early alveolar edema.  2.  Bibasilar collapse and/or consolidation and small left effusion similar to the ___ radiograph.,Impression: 1. No CHF with interstitial and probable early alveolar edema.  2.  Bibasilar collapse and/or consolidation and small left effusion similar to the ___ radiograph.,"['Change severity', 'Change to homophone', 'False negation']"
"57949fd6-88aba5c8-27f26572-80587301-346f13c9, 9d33ba30-3b746ce7-bf969585-85fde961-8967f38c",52244987,18057037,"Findings: Frontal and lateral views of the chest.  The cardiac and mediastinal silhouettes are stable.  Prominence of the interstitial markings as well as bilateral patchy airspace opacities consistent with pulmonary edema which is new since ___.  Moderate, left greater than right, pleural effusions are unchanged.  No pneumothorax is identified.  There are surgical clips in the left upper abdomen.  There is eventration of the right hemidiaphragm. Impression: New mild pulmonary edema and unchanged small bilateral pleural effusions, since ___.","Findings: Frontal and lateral views of the chest.  The cardiac and mediastinal silhouettes are stable.  Prominence of the interstitial markings as well as no airspace opacities are present.  Moderate, left greater than right, pleural effusions are unchanged.  No pneumothorax is identified.  There are surgical clips in the left upper abdomen.  There is elevation of the right hemidiaphragm. Impression: New mild pulmonary edema and unchanged small bilateral plural effusions, since ___.","['Change name of device', 'Change to homophone', 'False negation']"
ed9cb7d3-e541763d-995f4deb-46c21698-b3f3f780,53058109,18057037,"Findings: In comparison with study of ___, there is continued enlargement of the cardiac silhouette without evidence of pulmonary edema.  Small left effusion is seen.  Again, there is substantial elevation of the right hemidiaphragmatic contour, as clearly demonstrated on the CT of ___. ","Findings: In comparison with study of ___, there is continued enlargement of the cardiac silhouette without evidence of pulmonary edema.  No effusion is seen.  Again, there is substantial elevation of the left hemidiaphragmatic contour, as clearly demonstrated on the CT of ___.  Small rite effusion is seen.","['Change location', 'Change to homophone', 'False negation']"
d37198a2-d588ccee-08feb12c-5d4942b3-98453d12,53273352,18057037,"Findings: Comparison is made to the prior radiographs from ___.  Heart size is enlarged but stable.  There is atelectasis at the lung bases.  There are again seen bilateral pleural effusions, left worse than right and there is prominence of the pulmonary interstitial markings which is slightly improved.  There are no pneumothoraces. ","Findings: Comparison is made to the prior radiographs from ___.  Heart size is enlarged but stable.  There is atelectasis at the left lung apex.  There are again seen bilateral pleural effusions, left worse than right and there is prominence of the pulmonary interstitial markings which is slightly improved. No significant pulmonary interstitial markings are noted.  There are no pneumothoraces. An ET tube is present.","['Change location', 'Add contradiction', 'Add medical device']"
e7159328-08569709-798aa964-ee7f2027-c51daa27,53912941,18057037,"Findings: The cardiac, mediastinal, and hilar contours appear stable including enlargement of the heart and main pulmonary artery contour.  The lung volumes are low.  There are somewhat increased patchy densities at both lung bases which are not specific but which can probably be explained by atelectasis; particularly on the left, also perhaps coinciding small pleural effusion.  There is similar mild interstitial abnormality, although vasculature appears more distinct, suggesting improvement. ","Findings: The cardiac, mediastinal, and hilar contours appear stable including enlargement of the hart and main pulmonary artery contour.  The lung volumes are hi.  There are somewhat increased patchy densities at both lung bases which are not specific but which can probably be explained by atelectasis; particularly on the left, also perhaps coinciding no pleural effusion.  There is similar moderate interstitial abnormality, although vasculature appears more distinct, suggesting improvement.","['Change severity', 'Change to homophone', 'False negation']"
af3f9a0c-07676bf2-1d617e8f-3296d7ff-7c04924a,54064052,18057037,"Findings: There is new pulmonary vascular cephalization and mild interstitial pulmonary edema, compared to the prior radiograph from ___.  Atelectasis in the right middle lobe is substantial  No pneumothorax or large pleural effusion is seen. Mild cardiomegaly is chronic.  The mediastinal contours are otherwise normal.  Multiple surgical clips project over the left mid-to-upper abdomen.  There is levoscoliosis of the thoracolumbar spine. Impression: 1.  New mild interstitial pulmonary edema. Chronic mild cardiomegaly.  2.  New right middle lobe atelectasis.","Findings: There is new pulmonary vascular cephalization and moderate interstitial pulmonary edema, compared to the prior radiograph from ___.  Atelectasis in the right middle lobe is substantial  No pneumothorax or large pleural effusion is seen. Mild cardiomegaly is chronic.  The mediastinal contours are otherwise normal.  Multiple surgical clips project over the left mid-to-upper abdomen.  There is levoscoliosis of the thoracolumbar spine. An ET tube is seen in the mid-trachea. The mediastinal contours are otherwise normal. ","['Change severity', 'Add repetitions', 'Add medical device']"
d41856c5-443e32f5-5cb1c4d7-e56e908c-563ca827,54565799,18057037,"Impression: AP chest compared to ___:  Atelectasis or consolidation in the right middle lobe is increased since ___, and lateral view showed small bilateral pleural effusions, probably unchanged.  Mild cardiomegaly and mediastinal vascular engorgement stable.  Upper lungs grossly clear.  No pneumothorax.","Impression: AP chest compared to ___: Atelectasis or consolidation in the right middle lobe is increased since ___, and lateral view showed small left pleural effusions, probably unchanged. Mild cardiomegaly and mediastinal vascular engorgement stabel. Upper lungs grossly clear. No pneumothorax.","['Change location', 'Add typo', 'False negation']"
dee24a5d-8e44ec45-f88ab6f6-4846c054-3da6b73d,55093079,18057037,"Findings: In comparison with study of ___, there are continued relatively low lung volumes with bilateral pleural effusions, more prominent on the right, with compressive atelectasis at the bases.  Some elevation of pulmonary vascularity is seen.  The left lung is essentially clear.  Given the low lung volumes and effusion on the right, it would be difficult to exclude supervening pneumonia in the appropriate clinical scenario.  Of incidental note is an apparent curvilinear opacification just above the right humeral head, worrisome for calcific tendinosis in the rotator cuff or calcific deposits in the deltoid bursa. ","Findings: In comparison with study of ___, there are continued relatively low lung volumes with bilateral pleural effusions, more prominent on the left, with compressive atelectasis at the bases. Some elevation of pulmonary vascularity is scene. There is a right lung mass. Given the low lung volumes and effusion on the right, it would be difficult to exclude supervening pneumonia in the appropriate clinical scenario. Of incidental note is an apparent curvilinear opacification just above the right humeral head, worrisome for calcific tendinosis in the rotator cuff or calcific deposits in the deltoid bursa. ","['Change location', 'Change to homophone', 'False prediction']"
"b5c48946-bd1838f7-c09076f9-1427ea90-d701bf5d, ba46fee9-9f0df347-3c94ff1d-8e80ed2c-aeea650b",56203584,18057037,Findings: PA and lateral views of the chest.  There is mild bibasilar atelectasis.  Persistent slight elevation of the right hemidiaphragm.  There is no focal parenchymal opacities concerning for pneumonia.  There is no pleural effusion or pneumothorax.  The cardiac and mediastinal silhouettes are stable.  Multiple surgical clips in the left upper quadrant. Impression: 1.  No evidence of pneumonia.  2.  Mild bibasilar atelectasis.,Findings: PA and lateral views of the chest.  There is mild bibasilar atelectasis.  Persistent slight elevation of the right hemidiaphragm.  There is no focal parenchymal opacities concerning for pneumonia.  An ET tube is noted with the tip at the carina.  There is no pleural effusion or pneumothorax.  The cardiac and mediastinal silhouettes are stable.  Multiple surgical clips in the left upper quadrant. Persistent slight elevation of the right hemidiaphragm. Impression: 1.  No evidence of pneumonia.  2.  Mild bibasilar atelectasis.,"['Change name of device', 'Add repetitions', 'Add medical device']"
"3ada78bb-a6dcb49e-ac2a09e8-3671d4fe-e3b5aa68, 96783e57-b5dd59af-319563e6-f8f155cf-ffa2de57",56972774,18057037,"Findings: Lung volumes are low.  Assessment of the apices is somewhat obscured by the patient's chin and soft tissues of the neck projecting over and obscuring this region.  The heart size appears unchanged, which is within normal limits.  There does appear to be a left ventricular predominance.  The mediastinal and hilar contours are unchanged.  There is crowding of the bronchovascular structures as a result of low lung volumes.  Streaky opacities in the lung bases likely reflect atelectasis, and appear improved compared to the previous radiograph.  No pleural effusion or focal consolidation is seen.  There is no pneumothorax.  Numerous clips are demonstrated in the left upper quadrant of the abdomen.  Diffuse demineralization of the osseous structures is redemonstrated. Impression: Low lung volumes with improving bibasilar atelectasis.","Findings: Lung volumes are low.  Assessment of the apices is somewhat obscured by the patient's chin and soft tissues of the chest projecting over and obscuring this region.  The heart size appears unchanged, which is within normal limits.  There does appear to be a right ventricular predominance.  The mediastinal and hilar contours are unchanged.  There is crowding of the bronchovascular structures as a result of low lung volumes.  Streaky opacities in the lung bases likely reflect atelectasis, and appear improved compared to the previous radiograph.  No pleural effusion or focal consolidation is seen.  There is a right apical pneumothorax.  Numerous clips are demonstrated in the left upper quadrant of the abdomen.  Diffuse demineralization of the osseous structures is redemonstrated. Impression: Low lung volumes with improving bibasilar atelectasis.  ","['Change location', 'Change to homophone', 'False prediction']"
3455b174-7955b50f-69214401-26f4d34d-3672b50a,57649308,18057037,Impression: No acute cardiopulmonary process,Impression: No acute cardiopulmonary process. A central venous line is noted in the right subclavian vein. Impression: No acute cardiopulmonary process.,"['Change to homophone', 'Add repetitions', 'Add medical device']"
"54cefdc7-0441ba41-15e39589-9ca6ea57-40e19af5, 87d13784-35495ec2-cffeda97-23cf108b-c05e835b",57717537,18057037,"Findings: Frontal and lateral views of the chest.  The lung volumes are very low, which is only slightly worsened since ___.  This accentuates the cardiac silhouette which appears stably enlarged.  There is mild vascular congestion, but no overt pulmonary edema.  The mediastinal contour is stable; the pulmonary artery is enlarged.  Patchy bilateral lower lobe opacities likely represent atelectasis.  There is a small left pleural effusion.  No pneumothorax is seen.  There are clips in the left upper quadrant of the abdomen. Impression: Very low lung volumes have slightly decreased since ___.  Patchy bilateral lower lobe opacities most likely represent atelectasis.  A small left pleural effusion is unchanged since ___.  Mild pulmonary vascular congestion is unchanged since ___.","Findings: Frontal and lateral views of the chest.  The lung volumes are very low, which is only slightly worsened since ___.  This accentuates the cardiac silhouette which appears stably enlarged.  There is mild vascular congestion, but no overt pulmonary edema.  The mediastinal contour is stable; the pulmonary artery is enlarged.  Patchy bilateral lower lobe opacities likely represent atelectasis.  There is a small right pleural effusion.  No pneumothorax is seen.  There are clips in the left upper quadrant of the abdomen. Impression: Very low lung volumes have slightly decreased since ___.  Patchy bilateral lower lobe opacities most likely represent atelectasis.  A small left pleural effusion is unchanged since ___.  Mild pulmonary vascular congestion is unchanged since something similar from before. ","['Change name of device', 'Add repetitions', 'False prediction']"
"59d4fab4-679af5b7-5d8299ee-5de4e775-51372e47, a56559c6-1aa73e1f-2d284a2c-337f7055-1780d9e6",57929210,18057037,"Findings: Lung volumes are low.  Interstitial markings are increased bilaterally.  The lung apices are partially obscured by the patient's chin and incompletely evaluated.  The heart size is moderately enlarged.  Basilar atelectasis is mild.  Bilateral pleural effusions are small.  Surgical clips project over the left upper quadrant.  The thoracic aorta is unfolded with atherosclerotic calcifications. Impression: Moderately cardiomegaly is worse with small bilateral pleural effusions, and moderate interstitial pulmonary edema in the setting of CHF exacerbation.","Findings: Lung volumes are low.  Interstitial markings are increased bilaterally.  An NG tube is noted to be in the distal esophagus.  The heart size is moderately enlarged.  Basilar atelectasis is mild.  Bilateral pleural effusions are small.  Surgical clips project over the left upper quadrant.  The thoracic aorta is unfolded with atherosclerotic calcifications. Impression: Lung volumes are normal with small bilateral pleural effusions, and moderate interstitial pulmonary edema in the setting of CHF exacerbation.","['Change position of device', 'Add contradiction', 'Add medical device']"
031e1a10-9b03a629-29234928-e2dbc65d-7ac75537,58078706,18057037,"Findings: In comparison with the study of ___, there is substantial improvement in the pulmonary edema.  Indeed, the vascularity is now essentially within normal limits.  Some atelectatic changes are seen at the right base, silhouetting the hemidiaphragm.  In the appropriate clinical setting, supervening pneumonia would have to be considered.    Low lung volumes accentuate the transverse diameter of the heart. ","Findings: In comparison with the study of ___, there is substantial improvement in the pulmonary edema.  Indeed, the vascularity is now essentially within normal limits.  Some atelectatic changes are seen at the left base, silhouetting the hemidiaphragm.  Some atelectatic changes are seen at the left base, silhouetting the hemidiaphragm.  In the appropriate clinical setting, a central venous line is noted.  Low lung volumes accentuate the transverse diameter of the heart.  ","['Change location', 'Add repetitions', 'Add medical device']"
"9e0e4686-1372bf57-292f7d25-12a3bc81-945870b4, a185bea9-f95f19a1-32f0ea92-8d192ae9-1f3a5a07",58548470,18057037,"Findings: Lung volumes are reduced.  This accentuates the size of the cardiac silhouette which is mildly enlarged.  Crowding of the bronchovascular structures is also demonstrated, without overt pulmonary edema noted.  The mediastinal contour is unremarkable.  Bibasilar patchy opacities may reflect atelectasis though infection is not excluded.  There appears to be a trace left pleural effusion, and a small right pleural effusion cannot be excluded.  No pneumothorax is seen.  There are multiple clips demonstrated within the left upper quadrant of the abdomen. Impression: Low lung volumes.  Bibasilar patchy opacities may reflect atelectasis but infection is not excluded.  Small left pleural effusion and possible trace right pleural effusion.  No overt pulmonary edema.","Findings: Lung volumes are reduced. This makes the cardiac silhouette appear normal. Crowding of the bronchovascular structures is also demonstrated, with signs of mild pulmonary edema noted. The mediastinal contour is remarkable. Bibasilar patchy opacities may reflect atelectasis though infection is not excluded. There appears to be a moderate left pleural effusion, and a small right pleural effusion cannot be excluded. No pneumothorax is seen. There are multiple clips demonstrated within the right upper quadrant of the abdomen. Impression: Low lung volumes. Bibasilar patchy opacities may reflect atelectasis but infection is not excluded. Small left pleural effusion and possible trace right pleural effusion. Pulmonary edema.","['Change position of device', 'Add contradiction', 'False prediction']"
11362097-a0bac3fa-316e02be-b753a0b5-16e69386,58608862,18057037,"Findings: Single AP upright portable chest radiograph was provided.  There is increase of interstitial markings bilaterally although worse in the right lung, which may be due to asymmetric pulmonary edema.  There is bibasilar atelectasis.  Obscuration of the right hemidiaphragm may be due to atelectasis; however, infection cannot be excluded.  Cardiomediastinal silhouette is unchanged.  The bones are intact. Impression: Pulmonary edema, worse in the right lung with bibasilar atelectasis. Pneumonia in the right lower lobe may be possible in the correct clinical setting.","Findings: Single AP upright portable chest radiograph was provided.  There is increase of interstitial markings bilaterally although worse in the left lung, which may be due to asymmetric pulmonary edema.  There is bibasilar atelectasis.  Obscuration of the right hemidiaphragm may be due to atelectasis; however, infection cannot be excluded.  Cardiomediastinal silhouette is unchanged.  There is a right pleural effusion. Impression: Pulmonary edema, worse in the left lung with bibasilar atelectasis. Pneumonia in the right lower lobe may be possible in the correct clinical setting. No significant pleural effusion noted.","['Change location', 'Add contradiction', 'False prediction']"
a250f743-48863d40-60cab50b-3c50f654-52796233,59332345,18057037,"Findings: Diffuse interstitial prominence with moderate cardiomegaly is consistent with moderate pulmonary edema.  More linear area of focal consolidation within the right lower lobe is unchanged and is thought to reflect scarring/atelectasis.  There is chronic elevation of the right hemidiaphragm.  There is no pleural effusion or pneumothorax.  While the patient has known mediastinal lymphadenopathy, this and mediastinal lipomatosis, are better appreciated on the prior CT.  Clips within the left upper abdomen are unchanged. Impression: Moderate pulmonary edema.","Findings: Diffuse interstitial prominence with moderate cardiomegaly is consistent with moderate pulmonary edema.  More linear area of focal consolidation within the right lower lobe is unchanged and is thought to reflect scarring/atelectasis.  There is chronic elevation of the right hemidiaphragm.  There is no pleural effusion or pneumothorax.  While the patient has known mediastinal lymphadenopathy, this and mediastinal lipomatosis, are better appreciated on the prior CT. Clips extend over the left lower abdomen.  There is a mass in the left upper lung. Impression: Moderate pulmonary edema.  Diffuse interstitial prominence with moderate cardiomegaly is consistent with moderate pulmonary edema.","['Change position of device', 'Add repetitions', 'False prediction']"
"033e88a7-b72e1f61-9e9c608c-95650c3f-87cd1f6a, db21cdac-6b505ece-719ff0fc-4c4291ad-e52017ab",53067857,18088902,"Findings: There is persistent elevation of the right hemidiaphragm, unchanged.  Otherwise, the lungs are well expanded and clear.  No pulmonary edema.  Stable appearance of the cardiomediastinal silhouette.  No pleural effusion.  No pneumothorax. Impression: No evidence of pneumonia.  Stable elevation of the right hemidiaphragm.","Findings: There is persistent elevation of the left hemidiaphragm, unchanged.  Otherwise, the lungs are well expanded and clear.  There is mild pulmonary edema.  Stable appearance of the cardiomediastinal silhouette.  No pleural effusion.  No pneumothorax. Impression: No evidence of pneumonia.  There is significant pulmonary edema.  Stable elevation of the right hemidiaphragm.","['Change location', 'Add contradiction', 'False prediction']"
"2b1a2dcd-992835fd-c9e705f3-e74f11b1-05d75de9, 68ad0229-fbf719ec-6407d47e-398368ac-1c4ffe02",56895618,18088902,Findings: Lungs:  The lungs are well inflated.  There is no consolidation.  Pleura:  Her hemidiaphragm is elevated as it was in the past.  This is likely due to hepatic enlargement or diaphragmatic paresis.  Heart:  The heart is not enlarged.  Mediastinum and hila:  There is no mediastinal mass.  Osseous structures: The osseous structures are normal for age.  Other findings: None Impression: Lungs clear.  Elevated right hemidiaphragm,Findings: Lungs:  The lungs are well inflated.  There is no consolidation.  Pleura:  His hemidiaphragm is elevated as it was in the past.  This is likely due to hepatic enlargement or diaphragmatic paresis.  Heart:  The heart is enlarged. Mediastinum and hila:  There is no mediastinal mass.  Osseous structures: The osseous structures are normal for age.  Other findings: A pacemaker is present. Impression: Lungs clear.  Hemidiaphragms at normal levels.,"['Change location', 'Add contradiction', 'Add medical device']"
"355e43d2-bc7162e3-9c3436fc-e74a4192-f7389712, 4d0125e1-1cc299af-9d2fccd0-d04efd8a-8f0d7220",51635143,18088903,"Findings: The inspiratory lung volumes remain low in comparison to the prior study.  There is no focal consolidation concerning for pneumonia.  No pleural effusion or pneumothorax is present.  The pulmonary vasculature is not engorged.  The cardiac silhouette is normal in size.  The mediastinal and hilar contours are within normal limits.  The osseous structures are grossly unremarkable, although evaluation is limited secondary to body habitus. Impression: No acute cardiopulmonary process.",Findings: The inspiratory lung volumes remain low in comparison to the prior study. There is no focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax is present. The pulmonary vasculature is not engorged. The cardiac silhhouette is normal in size. The mediastinal and hilar contours are within normal limits. No notable osseous abnormalities. Impression: No acute cardiopulmonary process. There is an endotracheal (ET) tube in the trachea. ,"['Add medical device', 'Add typo', 'False negation']"
"31cbe120-34a6c3e2-c1b2549f-22f5ce48-a57db40d, a06a5b51-aebbc955-b0030bd6-02f1d289-201a4233",55137528,18088903,"Findings: Lungs are clear without focal consolidation, effusion or vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. Impression: No acute cardiopulmonary process.","Findings: Lungs are clear without focal consolidation, effusion or vascualr congestion. The cardiomediastinal silhouette is within normal limits. A left IJ central venous catheter is in place. No acute osseous abnormalities identified. Impression: No acute cardiopulmonary process. Mild bilateral pleural effusions are present.","['Add contradiction', 'Add typo', 'Add medical device']"
"4fc9abbd-f405ecdb-ca896442-413d67c8-928fe3c4, ee8009d0-8d39c5ea-7834a7a0-14647847-d9dd7ef1",58140208,18095293,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is noraml. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: No acute cardiopulmonary abnormality. Central venous line is noted.,"['False negation', 'Add typo', 'Add medical device']"
c7e010a6-159db893-31dac930-c5bc900b-9feb9c89,54922575,18113771,Findings: Single portable view of the chest.  Left greater than right basilar opacities suggestive of atelectasis.  The lungs are otherwise clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormality is identified.  No free intraperitoneal air identified. Impression: No definite acute cardiopulmonary process.,Findings: Single portable view of the chest.  Right greater than left basilar opacities suggestive of atelectasis.  The lungs are otherwise clear.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormality is identified.  No free intraperitoneal air identified. Impression: No definite acute cardiopulmonary process.  The lungs are otherwise clear.,"['Change location', 'Add repetitions', 'False negation']"
17f90d58-ab2032f6-2a154aae-fe200888-93cc7dcb,53975230,18137951,"Findings: In comparison with the study of ___, there are lower lung volumes. No vascular congestion or pleural effusion.  There is a faint suggestion of some increased opacification at the right base medially.  This most likely represents merely atelectasis or crowding of pulmonary vessels.  In the appropriate clinical setting, this could conceivably represent the early stages of aspiration. ","Findings: In comparison with the study of ___, there are upper lung volumes. No vascular congestion or pleural effusion.  There is a faint suggestion of some increased opaccification at the right base medially.  No opacification is noted.  In the appropriate clinical setting, this could conceivably represent the early stages of aspiratoin.  ","['Change location', 'Add typo', 'False negation']"
1a102f04-c4935ccf-9ee44ac4-ab62d6f6-49575979,58460896,18137951,"Findings: AP single view of the chest has been obtained with patient in upright position.  Available for comparison is the next preceding chest examination of ___.  Relatively high positioned diaphragms obscure major portion of the heart shadow.  The heart size may be at the upper limit of normal variation, but no typical configurational abnormalities identified.  Unremarkable and unchanged appearance of thoracic aorta.  The pulmonary vasculature is not congested.  No signs of acute or chronic parenchymal infiltrates are present and the lateral pleural sinuses are free.  No evidence of pneumothorax in the apical area.  Skeletal structures of the thorax grossly unremarkable.  On previous examination of ___, small left-sided pleural effusion was diagnosed.  This cannot be confirmed as a lateral view was not obtained at this time. Impression: Mostly unremarkable chest findings on single view examination.","Findings: AP single view of the chest has been obtained with patient in upright position. Available for comparison is the next preceding chest examination of ___. Relatively high positioned diaphragms obscure major portion of the hart shadow. The heart size may be at the upper limit of normal variation, but no typical configurational abnormalities identified. Unremarkable and unchanged appearance of thoracic aorta. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral pleural sinuses are free. No evidence of pneumothorax in the apical area. Skeletal structures of the thorax grossly unremarkable. On previous examination of ___, no pleural effusion was diagnosed. This cannot be confirmed as a lateral view was not obtained at this time. Impression: Mostly unremarkable chest findings on single view examination.","['Change severity', 'Change to homophone', 'False negation']"
"82c84432-ff11fe52-0064b58c-b7bc2f43-ef86e88b, f67f5909-0dc953ec-e5e01fdb-e6c98f3b-b855ab75",58918762,18137951,"Findings: PA and lateral views of the chest. Low lung volumes.   There is a small left pleural effusion.  Heart size is normal.  There are no focal opacities concerning for pneumonia.  The mediastinal and hilar contours are normal.  No pneumothorax. Impression: Small left pleural effusion.  Otherwise, unremarkable examination of the chest.","Findings: PA and lateral views of the chest. Low lung volumes.  There is a large left pleural effusion.  Heart size is normal.  There are no focal opacities concerning for pneumonia.  The mediastinal and hilar contours are normal.  No pneumothorax. Impression: Small left pleural effusion.  Otherwise, unremarkable examination of the chest. Mild left pleural effusion noted.","['Change severity', 'Add contradiction', 'False prediction']"
"28899768-1ec862b2-b7624c9a-91e7b8f8-da17effb, b7b91050-b97763e5-97f0ce69-b8864ea3-c7daf556",50091256,18156346,"Findings: Lungs are well-expanded and clear.  Cardiomediastinal and hilar contours are unremarkable.  There is no pneumothorax, pleural effusion, or consolidation. Impression: No acute cardiopulmonary process.",Findings: Lungs are well-expanded and clear.  Cardiomediastinal and hilar contours are unremarkable.  There is a small pneumothorax visualized on the left. Impression: No acute cardiopulmonary process. A nasogastric tube is in place with the tip appearing to be in the stomach.,"['Add medical device', 'Add contradiction', 'False negation']"
"5d5a7606-5db82e01-30ed2d70-68cf2b3e-01014d34, f0e6ae67-f29f6b22-401dbf2c-393e1029-2691d372",51908330,18162895,"Findings: PA and lateral views of the chest.  The lungs are clear without focal consolidation, effusion or pulmonary vascular congestion.  Calcified granuloma again seen at the right lung base.  There is no pneumothorax.  The cardiomediastinal silhouette is within normal limits.  Pneumomediastinum identified on prior chest CT is not definitively identified by this chest x-ray.  There is no subcutaneous gas identified in the neck.  There is no free intraperitoneal air.  Osseous structures are unremarkable. Impression: Known pneumomediastinum identified on chest CT from one day prior is not clearly identified by this plain film.","Findings: PA and lateral views of the chest.  The lungs are clear without focal consolidation, effusion or pulmonary vascular congestion.  Calcified granuloma again seen at the left lung base.  There are mild streaky opacities in lower lobes.  The cardiomediastinal silhouette is within normal limits.  Pneumomediastinum identified on prior chest CT is not definitively identified by this chest x-ray.  A small pleural effusion is noted.  There is no free intraperitoneal air.  Osseous structures are unremarkable. Impression: Known pneumomediastinum identified on chest CT from one day before is not clearly identified by this plain film.","['Change location', 'Change to homophone', 'False prediction']"
"1785b82d-5e3ac09e-800e0e20-792c6780-24b63d89, af3990fd-dd3e3ef2-b30e6f3b-3e3db1fa-025c0d4f",53273716,18162895,Findings: Heart size is normal.  Mediastinal and hilar contours are within normal limits.  Lungs are clear.  Pulmonary vascularity is normal.  No pleural effusion or pneumothorax is present.  No acute osseous abnormalities are present.  Oral contrast material is seen within the left colon. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  Mediastinal and hilar contours are within normal limits.  Lungs show bilateral infiltrates.  Pulmonary vascularity is normal.  No pleural effusion or pneumothorax is present.  No acute osseous abnormalities are present.  Oral contrast material is seen within the ascending colon.  An ET tube is correctly positioned above the carina. Impression: No acute cardiopulmonary abnormality is identified. Findings: Extensive opacities are noted in both lungs.,"['Change location', 'Add contradiction', 'Add medical device']"
32f085e4-a986fed6-56bf1ebe-f3cd4874-fd51818f,57889329,18162895,"Findings: Portable upright radiograph of the chest demonstrates well expanded and clear lungs.  The cardiomediastinal and hilar contours are unremarkable.  There is no pneumothorax, pleural effusion, or opacity.  Pneumomediastinum is not apparent on this radiograph. Impression: Normal chest x-ray examination.  No evidence of pneumomediastinum.","Findings: Portable upright radiograph of the chest demonstrates well expanded and clear loans. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or opacity. There is no pneumothorax, pleural effusion, or opacity. Pneumomediastinum is not apparent on this radiograph. Impression: Normal chest x-ray examination. Small right pleural effusion noted.","['Change to homophone', 'Add repetitions', 'False prediction']"
"7173d21e-1df4d0c0-2f84a218-b57e994b-3c112aaf, 74148346-3344cf5f-1ce06a31-e433d994-9e1fabd5",57478248,18166102,Findings: The lungs are hyperexpanded with increased opacification of the right upper and middle lobes with silhouetting of the right cardiac border and retrocardiac opacification on lateral view suggests pneumonia.  The mediastinal silhouette and bilateral hemidiaphragms stable.  The left lung is clear.  No pneumothorax or pleural effusion is present. Impression: Retrocardiac opacification concerning for pneumonia.  Repeat radiograph 6 weeks after completion of treatment is recommended to ensure resolution.  RECOMMENDATION(S):  Repeat chest radiograph 6 weeks after completion of treatment is recommended to ensure resolution.,Findings: The lungs are hyperexpanded with increased opacification of the right upper and middle lobes with silhouetting of the right cardiac border and retrocardiac opacification on lateral view suggests pneumonia.  The mediastinal silhouette and bilateral hemidiaphragms stable.  The left lung is clear.  No pneumothorax or pleural effusion is present.  A pacemaker is present in the right chest wall. Impression: Retrocardiac opacification concerning for pneumonia.  Right lower lobe shows no signs of pneumonia.  Repeat radiograph 6 weeks after completion of treatment is recommended to ensure resolution.  RECOMMENDATION(S):  Repeat chest radiograph 6 weeks after completion of treatment is recommended to ensure resolution.,"['Change location', 'Add contradiction', 'Add medical device']"
54a0a07c-a256fe2b-d0e96074-68ce7def-af588be7,57599964,18166102,"Impression: Heart size is normal.  Mediastinum is normal.  Lungs are well inflated.  There is left basal opacity, new as compared to ___, concerning for all interval aspiration or infection.  There is also slight interval progression of interstitial opacities that might be consistent with mild degree of interstitial edema.  No appreciable pleural effusion or pneumothorax is seen.","Impression: Heart size is normal.  Mediastinum is normal.  Lungs are well inflated.  There is left basal opacity, new as compared to ___, concerning for all interval aspiration or infection.  There is also slight interval progression of interstitial opacities that might be consistent with moderate degree of interstitial edema.  No appreciable pleural effusion or pneumothorax is seen.  A pacemaker is present in the chest. Lungs are well inflated.","['Change severity', 'Add repetitions', 'Add medical device']"
396e5b3c-00057105-b7061e7b-156f2268-0e379e3b,58826153,18166102,"Findings: There is no focal consolidation, effusion, or pneumothorax.  There is mild pulmonary vascular congestion.  There is mild peribronchial thickening.  The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen.  Endotracheal tube tip is approximately 2 cm above the carina.  Side port of the NG tube is near the GE junction. Impression: 1. Endotracheal tube tip is approximately 2 cm above the carina. 2. Side port of the NG tube is near the GE junction.  Advancement by approximately 5 cm may be considered. 3. Mild interstitial edema.","Findings: There is no focal consolidation, effusion, or pneumothorax.  There is mild pulmonary vascular congestion.  There is mild peribronchial thickening.  The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen.  Endotracheal tube tip is approximately 1 mm above the carina.  Side port of the NG tube is near the GE junction.  Impression: 1. Endotracheal tube tip is approximately 2 cm above the carina. 2. Side port of the NG tube is near the GE junction.  Advancement by approximately 5 cm may be considered. 3. Mild interstitial edema.  A central venous line is present.","['Change measurement', 'Add repetitions', 'Add medical device']"
"3e7af712-008df97e-4476ff9a-66300e98-bd0ce2be, f8080681-868cdc36-e7ccdf1d-570e4c42-ef04d221",53300045,18167484,"Findings: Heart is normal size and mediastinal contours are within normal limits.  Calcifications are noted in the aortic arch.  Lungs are symmetrically expanded and clear.  There is no pleural effusion.  No pneumothorax.  Bones are grossly unremarkable. Impression: 1.  No acute intrathoracic abnormality.  2.  Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted,  the location of any referrable focal findings  should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning.","Findings: Heart is moderately enlarged and mediastinal contours are within normal limits.  Calcifications are noted in the aortic arch.  Lungs are symmetrically expanded and clear.  There is a small pleural effusion.  No pneumothorax is present.  Bones are grossly unremarkable other than multiple old, healed rib fractures. Impression: 1.  No acute intrathoracic abnormality.  2.  Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted,  the location of any referrable focal findings  should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning. ","['Change severity', 'Add contradiction', 'False prediction']"
"2616dd8d-82775207-5edd6d79-cb2caae5-77859f51, 5495cf03-882d6e53-523d1ccc-3ac2643f-f294b347",57657192,18172293,Findings: PA and lateral views of the chest provided.   Lung volumes are low which limits assessment.  There is mild left basal/retrocardiac opacity which could represent atelectasis versus an early pneumonia.  The right lung appears clear.  No large effusion is seen.  No pneumothorax.  No signs of congestion or edema.  The heart appears mildly enlarged.  Mediastinal contour appears normal.  Imaged bony structures are intact.  No free air below the right hemidiaphragm. Impression: As above.,Findings: PA and lateral views of the chest provided. Lung volumes are low witch limits assessment. There is moderate left basal/retrocardiac opacity which could represent atelectasis versus an early pneumonia. The right lung appears to have a small nodule. No large effusion is seen. No pneumothorax. No signs of moderate congestion or edema. The heart appears moderately enlarged. Mediastinal contour appears normal. Imaged bony structures are intact. Moderate free air below the right hemidiaphragm. Impression: As above.,"['Change severity', 'Change to homophone', 'False prediction']"
"b83da8c3-f89f1640-af7d7c50-231b3560-b1313ec6, c26d509f-4ab96801-8ee15b4c-2f8b99b8-80e43f8c",58393728,18194501,"Findings: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal.  No foreign bodies identified. Impression: No foreign body identified. No evidence of trauma.","Findings: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. No pulmonary nodules. Impression: No foreign body identified. No evidence of trauma. Presence of central venous line.","['False negation', 'Add contradiction', 'Add medical device']"
"707a7540-cb3bf051-5a339e77-d0bf7c09-1031feb5, 93c4c79c-b00b5507-3b1a9853-af840f9b-b413930a",55748803,18232123,"Findings: The cardiomediastinal and hilar contours are within normal limits.  The lungs are well expanded and clear.  There is no focal consolidation, pleural effusion or pneumothorax.  There are mild degenerative changes within the shoulders, right greater than left.  Note is made of inferior spurring of the glenohumeral joint on the right. Impression: No radiographic evidence of an acute cardiopulmonary process.","Findings: The cardiomediastinal and hilar contours are within normal limits. The lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. The shoulders appear normal. Note is made of inferior spurring of the glenohumeral joint on the right. Impression: No radiographic evidence of an acute cardiopulmonary process. Severe degenerative changes are noted within the shoulders, right greater than left.","['Change severity', 'Add contradiction', 'False negation']"
254eb3cc-aa57e502-283895be-388e5661-ad37acfe,57032495,18260067,"Impression: Comparison to ___.  The PICC line on the right has been pulled back.  The tip of the line now projects over the mid SVC.  No evidence of complications, notably no pneumothorax.  No pleural effusions.  Normal size of the heart.","Impression: Comparison to ___.  The PICC line on the right has been pulled back.  The tip of the line now projects over the right atrium.  No evidence of complications, notably no pneumothorax.  Mild bilateral pleural effusions.  Normal size of the heart.  There is mild cardiomegaly.","['Change position of device', 'Add contradiction', 'False prediction']"
"0207a7bb-11610206-8ac040e0-8e2749f5-afc70954, d5cb4f6b-7ce099e6-0bcd162e-b5ed316b-981ddbeb",58083874,18267367,"Findings: Lung volumes are low.  Heart size is normal accounting for the low lung volumes.  Mediastinal and hilar contours are unremarkable.  There is no pulmonary edema.  Streaky opacities in the lung bases likely reflect atelectasis.  No focal consolidation, pleural effusion or pneumothorax is seen.  There are no acute osseous abnormalities. Impression: Low lung volumes with mild bibasilar atelectasis.","Findings: Lung volumes are low.  Heart size is increased accounting for the low lung volumes.  Mediastinal and hilar contours are unremarkable.  There is no obvious congestive heart failure.  Streaky opacities in the lung bases likely reflect atelectasis.  No focal consolidation, pleural effusion or pneumothorax is seen, but there is evidence of mild pleural thickening.  There are no acute osseous abnormalities. Impression: Low lung volumes with mild bibasilar atelectasis and pleural thickening.","['Change severity', 'Add contradiction', 'False prediction']"
45e83449-8e77917b-9b15cf9a-2ae245a7-7114989c,58927022,18351086,"Impression: In comparison with the study of ___, there is little overall change.  Some widening of the mediastinum, which in the appropriate clinical setting could reflect some bleeding with in the mediastinum.  Cardiac silhouette is mildly enlarged and indistinctness of pulmonary vessels suggests some elevated pulmonary venous pressure. Multiple rib fractures are again seen, though there is no evidence of pneumothorax.","Impression: In comparison with the study of ___, there is little overall change. No widening of the mediastinum. Cardiac silhouette is mildly enlarged and indistinctness of pulmonary vessels suggests some elevated pulmonary venous pressure. The pulmonary vessels are clear and distinct. Multiple rib fractures are again seen, though there is no evidence of pneumothorax. Multiple rib fractures are again seen, though there is no evidence of pneumothorax.","['False negation', 'Add repetitions', 'False prediction']"
26d91d75-cf5c6002-96b0a11b-d3f93367-d109b784,52364831,18373333,"Impression: As compared to ___, there has been further worsening of a bilateral interstitial pattern, now with a mid and lower lung predominance.  It is uncertain whether this represents interstitial edema or a progressive atypical pneumonia.","Impression: As compared to ___, there has been further worsening of a bilateral interstitial pattern, now with a mid and upper lung predominance. It is uncertain whether this represents interstitial edema or a progressive a typical pneumonia. A central venous line is noted in place. ","['Change location', 'Change to homophone', 'Add medical device']"
f476d858-db17c76e-3282dfa8-d9202f8a-764adcbd,52931972,18373333,Impression: Heart size is within normal limits. There is prominence of the pulmonary interstitial markings without overt pulmonary edema or focal areas of consolidation. There is subsegmental atelectasis at the left base. There are no pneumothoraces.,Impression: Heart size is within normal limits. There is prominence of the pulmonary interstitial markings without overt pulmonary edema or focal areas of consolidation. There is subsegmental atelectasis at the right base. There are not pneumothoraces. There are metallic densities in the right hemithorax.,"['Change location', 'Add typo', 'False prediction']"
2c4551ac-f33843fc-07abff12-2c11868b-b5674eea,56279753,18373333,"Impression: As compared to the previous radiograph, the signs of interstitial lung edema have decreased in extent and severity but continue to be clearly visible.  Mild cardiomegaly persists.  No pleural effusions.  No new focal parenchymal opacities.","Impression: As compared to the previous radiograph, the signs of interstitial lung edema have decreased in extent and severity but continue to be cleralyy visible.  Moderate cardiomegaly persists.  No pleural effusions.  No new focal parenchymal opacities.  A central venous line is present.  ","['Change severity', 'Add typo', 'Add medical device']"
"1df86c6a-c5308f87-4dae24bf-5acfe642-c5e79dd4, 479e390c-9327b20e-4def5215-87e07920-281e62ea",53660780,18380327,"Findings: Frontal and lateral radiographs of the chest demonstrate low lung volumes.  The heart is top normal in size, which is exaggerated by the low lung volumes.  There is no evidence of tuberculosis.  Aeration of the right lung base is suboptimal as compared to the left, and some crowding versus atelectasis is seen in this region. There is no pleural effusion or pneumothorax. Impression: 1.  No evidence of tuberculosis.    2.  Low lung volumes, with possible crowding versus atelectasis at the right lung base.  Consider repeat chest x-ray examination with increased inspiratory volumes for additional evaluation.","Findings: Frontal and lateral radiographs of the chest demonstrate low lung volumes.  There is an opacity in the right upper lung zone, which is exaggerated by the low lung volumes.  There is no evidence of tuberculosis.  Aeration of the left lung base is suboptimal as compared to the left, and some crowding versus atelectasis is seen in this region. Aeration of the left lung base is suboptimal as compared to the left, and some crowding versus atelectasis is seen in this region. There is no pleural effusion or pneumothorax. Impression: 1.  No evidence of tuberculosis.    2.  Low lung volumes, with possible crowding versus atelectasis at the right lung base.  Consider repeat chest x-ray examination with increased inspiratory volumes for additional evaluation. There is a mild hyperinflation seen in both lungs.","['Change location', 'Add repetitions', 'False prediction']"
11ba7b99-79869f9b-4e54a718-f74bd86f-50205054,51327502,18383430,Findings: No focal consolidation is seen.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.,Findings: No focal consolidation is scene.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pleural effusion or pneumothorax is seen. Impression: the cardiac and mediastinal silhouettes are unremarkable.,"['Change to homophone', 'Add repetitions', 'False negation']"
"c9da4948-05264240-eb4ff71e-f2c88106-f3c8cf60, d56ec13f-3fe3f117-6b11abb3-4cb39cf6-67273b67",57343186,18408427,Findings: PA and lateral chest views were obtained with patient in upright position.  Analysis is performed in direct comparison with the next preceding similar chest examination ___ ___.  Heart size remains within normal limits.  No typical configurational abnormality is identified.  Thoracic aorta is unchanged and unremarkable.  Pulmonary vasculature is not congested and there is no evidence of pneumothorax on the frontal view in the apical area.  The patient is rather heavyset and able to elevate the arms on the lateral view (allegedly related to shoulder discomfort).  The pulmonary vasculature is not congested.  The lateral and posterior pleural sinuses are free from any fluid accumulation.  No acute pulmonary parenchymal infiltrates can be identified.  Mild degree of degenerative changes are noted in the thoracic spine but appear unchanged in comparison with the previous study of ___. Impression: No evidence of acute infiltrates or CHF.  Stable chest findings since ___.,Findings: PA and lateral chest views were obtained with patient in upright posiiton.  Analysis is performed in direct comparison with the next preceding similar chest examination ___ ___.  Heart size remains within noemal limits.  No typical configurational abnormality is identified.  Thoracic aorta is unchanged and unremarkable.  Pulmonary vasculature is not congested and there is no evidence of pneumothorax on the frontal view in the blasal area.  The patient is rather heavyset and able to elevate the arms on the lateral view (allegedly related to shoulder discomfort).  A pacemaker is present.  The pulmonary vasculature is not congested.  The lateral and posterior pleural sinuses are free from any fluid accumulation.  No acute pulmonary parenchymal infiltrates can be identified.  Mild degree of degenerative changes are noted in the lumbar spine but appear unchanged in comparison with the previous study of ___. Impression: No evidence of acute infiltrates or CHF.  Stable chest findings since ___.,"['Change location', 'Add typo', 'Add medical device']"
"64cc948a-2c477474-c2629ba4-d9cc0822-1ec6d0f7, fb08df17-1af8c15c-daeb4b46-18fc42dc-91643df8",50317024,18411490,"Impression: In comparison with the study ___ ___, the patient has taken a much better inspiration.  Cardiac silhouette remains mildly enlarged an there is an appearance of the left hemidiaphragm and costophrenic angle the could reflect pleural fluid or chronic thickening.  No evidence of acute focal pneumonia.","Impression: In comparison with the study ___ ___, the patient has taken a much better inspiration. Cardiac silhouette remains mildly enlarged and there is an appearance of the right hemidiaphragm and costophrenic angle that could reflect pleural fluid or chronic thickening. Right lower lobe consolidation is seen. No evidence of acute focal pneumonia.","['Change location', 'Change to homophone', 'False prediction']"
"4bd8decb-25920510-72d388b1-8a496755-56136b26, d58d0e27-e1c60eac-ce1656c7-d7b99a45-484b6ea5",50523107,18411490,Findings: PA and lateral views of the chest provided.    Lung volumes are low.  Mild cardiomegaly is noted.  There is subtle blunting of the left CP angle suggesting a tiny effusion or pleural thickening.  The lungs appear clear without focal consolidation or edema.  No pneumothorax.  Mediastinal contour is normal.  Bony structures are intact.  Partially imaged spinal hardware is again noted in the lumbar spine. Impression: Cardiomegaly with tiny left pleural effusion versus pleural thickening.  No findings to account for acute chest pain.,Findings: AP and lateral views of the chest provided.  Lung volumes are low.  Mild cardiomegaly is noted.  There is subtle blunting of the right CP angle suggesting a tiny effusion or pleural thickening.  The lungs appear clear with focal consolidation and edema.  No pneumothorax.  Mediastinal contour is normal.  Bony structures are intact.  Partially imaged spinal hardware is again noted in the lumbar spine.  There is a central venous line terminating in the SVC.  Impression: Cardiomegaly with tiny left pleural effusion versus pleural thickening.  Findings consistent with significant acute chest pain.,"['Change location', 'Add contradiction', 'Add medical device']"
"5dd8247e-7b3b9aae-2d55445e-f24c799b-0e14112f, 7142481e-5cdb79dd-d3fb4159-d280d895-b663f1ab",50698281,18429449,"Impression: In comparison with the study of ___, there are interstitial markings in the region of the previous opacification overlying the fifth lateral posterior rib on the left.  This could reflect interval consolidation with fibrous healing. The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal consolidation.  Right IJ Port-A-Cath extends to the mid to lower portion of the SVC.","Impression: In comparison with the study of ___, there are interstitial markings in the region of the previous opacification overlying the fifth lateral posterior rib on the left.  This could reflect interval consolidation with fibrous healing. The cardiac silhouette is within normal limits and there is no vascular congestion, pneumothorax, or acute focal consolidation.  Right IJ Port-A-Cath extends to the proximal portion of the SVC.","['Change position of device', 'Add typo', 'False prediction']"
"3063fefa-19c17307-b873e001-4512111f-8a620446, 34d23bc3-2fc08ad2-36eb96f0-2fa778fb-138343b1",58984392,18429449,"Findings: Frontal and lateral chest radiographs demonstrate an ill-defined opacity projecting over the ___ lateral posterior left rib, not seen on lateral views. For this, additional imaging with chest CT is recommended.  The lungs are otherwise well expanded and clear without focal consolidation, pleural effusion, or pneumothorax.  The cardiomediastinal and hilar contours are unremarkable. Impression: 1. Ill defined opacity projecting over the ___ lateral posterior left rib not seen on lateral views for which additional imaging with CT is recommended.   2. No findings to suggest lymphadenopathy.    These findings were communicated to the ordering physician via ___ critical findings website at the time findings were reviewed.","Findings: Frontal and lateral chest radiographs demonstrate an ill-defined opacity projecting over the ___ posterior right rib, not seen on lateral views. For this, additional imaging with chest CT is recommended.  The lungs are otherwise well expanded and clear without focal consolidation, pleural effusion, or pneumothorax.  The cardiomediastinal and hilar contours are unremarkable. The lungs show mild interstitial prominence near the bases. Impression: 1. Ill defined opacity projecting over the ___ lateral posterior left rib not seen on lateral views for which additional imaging with CT is recommended.   2. Ill-defined opacity projecting over the ___ lateral posterior left rib not seen on lateral views for which additional imaging with CT is recommended.   3. No findings to suggest lymphadenopathy.    These findings were communicated to the ordering physician via ___ critical findings website at the time findings were reviewed. ","['Change location', 'Add repetitions', 'False prediction']"
255028bc-0d427abe-7648f577-5c5161c9-7bd1a3e9,56589490,18437840,Impression: The lung volumes are low.  Moderate cardiomegaly. Small bilateral pleural effusions with areas of subsequent atelectasis. Mild to moderate pulmonary edema.  No pneumothorax.  No pneumonia.,Impression: The lung volumes are loe.  Severe cardiomegaly. No pleural effusions. Severe to moderate pulmonary edema.  No pneumothorax.  No pneumonia.,"['Change severity', 'Add typo', 'False negation']"
f6c5958a-7b37c4fa-304dac93-268f2d4f-0dacd28a,57704953,18457691,Impression: Lung volumes are low compared to the prior study.  The heart is moderately enlarged. There is pulmonary vascular redistribution.  There increased lung markings right greater than left. There small bilateral effusions. The overall impression is that of mild CHF,Impression: Lung volumes are low compared to the prior study.  The heart is severely enlarged. There is pulmonary vascular redistribution.  There increased lung markings right greater than left. No effusions. The overall impression is that of moderate CHF,"['Change severity', 'Change to homophone', 'False negation']"
"66d13817-333439e1-2134a531-fed0a9cb-579956fd, b67cd139-11d3def4-dd27dd95-352e5abf-1593d5ae",51903210,18465343,"Findings: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema.  Blunting of the left costophrenic angle on the lateral view suggests chronic pleural thickening rather than small effusion.  The cardiomediastinal silhouette is within normal limits. Impression: No evidence of acute cardiopulmonary process.","Findings: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or moderate pulmonary edema.  Blunting of the left costophrenic angle on the lateral view suggests chronic pleural thickening rather than mild effusion.  The cardiomediastinal silhouette is mildly enlarged.  Left-sided central venous catheter is present. Impression: No evidence of acute cardiopulmonary process. Mild left pleural effusion noted.","['Change severity', 'Add contradiction', 'Add medical device']"
"98938972-36f72211-d3e34220-54a0a0bc-18bc8bb8, a567b6d8-c57e0444-3e56f41a-a87709c3-ca1cf01e",59362958,18465343,"Findings: Cardiac, mediastinal and hilar contours are normal.  Lungs are clear and the pulmonary vascularity is normal.  No pneumothorax or pleural effusion is seen. There are multilevel degenerative changes in the thoracic spine. Impression: No acute cardiopulmonary process.","Findings: Cardiac, mediastinal and hilar contours are normal.  Lungs are clear and the pulmonary vascularity is normal.  No pneumothorax or pleural effusion is seen. There are no degenerative changes. There are no degenerative changes. Impression: No acute cardiopulmonary process. A pacemaker is present.","['False negation', 'Add repetitions', 'Add medical device']"
"9c1262ca-2e73d948-e988de44-6da23bff-79ef4e19, c7493a34-fa6245e8-4f50a1db-54eb6ba2-c461f0ea",50216176,18480741,"Findings: No definite focal opacity to suggest pneumonia is seen.  No pleural effusion, pulmonary edema or pneumothorax is present.  The cardiomediastinal silhouette and pleural surface contours are normal. ","Findings: No definite focal opacity to suggest pneumonia is seen.  A nasogastric tube tip is visualized in the stomach.  No pleural effusion, pulmonary edema or pneumothorax is present.  The cardiomediastinal silhouette and pleural surface contours are normal.  Mild pleural effusion and cardiomegaly are noted.","['Add medical device', 'Add contradiction', 'False prediction']"
"418573f9-e9d1de26-ef5715f9-5d7c0434-177c5b61, 6c233358-c9769f69-bf08e314-edf080d7-c9951a7c",54584844,18480741,"Findings: Frontal and lateral views of the chest were obtained.  The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax.  Heart size is normal.  Mediastinal silhouette and hilar contours are normal. Impression: Normal chest radiographs.  Dr. ___ was paged at 11:40 a.m. ___ per request.","Findings: Frontal and lateral views of the chest were obtained. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. A small left pleural effusion is noted. Heart size is normal. Mediastinal silhouette and hilar contours are not normal. Impression: Normal chest radiographs. Dr. ___ was paged at 11:40 a.m. ___ per request.","['Change location', 'Change to homophone', 'False prediction']"
"1e0fedfe-9bcbb335-3fe84f33-734baf67-40b747ef, b4adc8a7-02440962-bb00288a-9076327f-ba931356",55144227,18482407,Findings: PA and lateral views of the chest are obtained.  Lungs are clear and well expanded.  A nodular hyperdensity in the right upper lung is unchanged and likely reflects a calcified granuloma.  No large effusion or pneumothorax is seen.  The heart and mediastinal contours are normal.  The bony structures are intact.  No free air below the right hemidiaphragm. Impression: No acute intrathoracic process.,Findings: PA and lateral views of the chest are obtained.  Lungs are clear and well expanded.  A nodular hyperdensity in the left upper lung is unchanged and likely reflects a calcified granuloma.  No large effusion or pneumothorax is seen.  The heart and mediastinal contours are normal.  The bony structures are intact.  No free air below the right hemidiaphragm.  There is a central venous line in place. Impression: No acute intrathoracic process.  There is mild pulmonary edema.,"['Change location', 'Add contradiction', 'Add medical device']"
"abc4a049-302a6e06-7b883fd5-3ba7cf2b-2417c4bc, ec4a1322-8a9bf09f-33fbd390-0a0943c8-11b3c889",59225584,18482407,Impression: No acute cardiopulmonary abnormality.,Impression: No acute cardiopulmonary abnormaliy.  ,"['Add typo', 'Change to homophone', 'False prediction']"
85d0b656-71639eb3-56a3068f-a6adcea9-b539fb4b,57630819,18520122,"Findings: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is top-normal.  No pulmonary edema.  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 provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is enlarged. No pulmonary edema. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. The left lung shows patchy opacities suggestive of infection. Impression: No acute intrathoracic process.","['Change location', 'Add repetitions', 'False prediction']"
"832bc387-3c9cf25c-7fb73452-7a6ee080-80be4aa8, 8564d276-76a6899e-b7cedb7e-1cfee69f-ddaeb8e9",51037397,18528269,Findings: The lungs are hyperinflated consistent with the given history of asthma.  There is no evidence of focal consolidation worrisome for pneumonia.  No pleural effusion or pneumothorax.  The cardiac size is normal.  The hilar contours are unremarkable.  There is slight loss of height anteriorly of a mid thoracic vertebral body seen on the lateral views. Impression: 1.  No evidence of pneumonia. 2.  Hyperinflation consistent with asthma. 3.  Slight height loss anteriorly (~___%) of a mid thoracic vertebral body of unknown chronicity.,Findings: The lungs are hyperinflated consistent with the given history of asthma.  Their is no evidence of focal consolidation worrisome for pneumonia.  No pleural effusion or pneumothorax.  The cardiac size is normal.  The hilar contours are unremarkable.  There are no noted vertebral body changes. Impression: 1.  No evidence of pneumonia. 2.  Hyperinflation consistent with asthma. 3.  No noted height loss of vertebral body.,"['Change location', 'Change to homophone', 'False negation']"
"a7b11686-430bd527-08172ee1-1bd780f3-551fb77a, c7350b13-4a95608f-6f277ab2-575e6d61-37cee493",54998180,18528269,Findings: PA and lateral views of the chest were provided.  The lungs are hyperinflated and clear.  No effusion or pneumothorax is seen.  The heart and mediastinal contours are normal.  Bony structures are intact.  No free air below the right hemidiaphragm. Impression: No acute intrathoracic process.,Findings: PA and lateral views of the chest were provided.  The lungs are hyperinflated and deer.  No effusion or pneumothorax is seen.  The heart and mediastinal contours are cervical.  Bony structures are intact.  No free air below the right hemidiaphragm. A central venous line is present. Impression: No acute intrathoracic process.,"['Change location', 'Change to homophone', 'Add medical device']"
ceb961ba-2ced940d-471b2b09-087e5b3f-b9118db0,53931664,18536624,"Impression: As compared to the previous examination, the miniscule left pneumothorax has completely resolved.  The pre-existing right pneumothorax is smaller but still clearly visualized.  There is no evidence of tension.  Improved transparent see of the lung parenchyma reflect improved ventilation.  The size of the cardiac silhouette has decreased.  Increased density at the lateral aspect of the seventh right rib is unchanged.","Impression: As compared to the previous examination, the miniscule left pneumothorax has completely resolved.  No pneumothorax.  There is no evidence of tension.  Improved transparent see of the lung parenchyma reflect improved ventilation.  The size of the cardiac silhouette has decreased.  Increased density at the lateral aspect of the seventh left rib is unchanged.  Improved transparent see of the lung parenchyma reflect improved ventilation.","['Change location', 'Add repetitions', 'False negation']"
f3de0579-711a8c1f-7d79200b-cadc13ed-61edf359,54882674,18536624,"Findings: Bibasilar opacities are again seen silhouetting the hemidiaphragm, suggestive of pleural effusions.  Indistinct pulmonary vascular markings seen superiorly. There is more focal opacity in the right infrahilar region.  There is likely cardiomegaly although given silhouetting, assessment is limited.  No acute osseous abnormalities. Impression: Moderate bilateral pleural effusions with adjacent atelectasis and mild pulmonary edema.  Superimposed infection cannot be excluded.  More focal opacity in the infrahilar region on the right which should be followed for resolution on subsequent exams.","Findings: Bibasilar opacities are again seen silhouetting the hemidiaphragm, suggestive of pleural effusions. Indistinct pulmonary vascular markings scene superiorly. There is more focal opacity in the right infrahilar region. There is severe cardiomegaly although given silhouetting, assessment is limited. No acute osseous abnormalities present in the ribs and spine. Impression: Moderate bilateral pleural effusions with adjacent atelectasis and moderate pulmonary edema. Superimposed infection cannot be excluded. More focal opacity in the infrahilar region on the right which should be followed for resolution on subsequent exams. ","['Change severity', 'Change to homophone', 'False prediction']"
74cb0482-4e08c24c-84bc00b1-327a2c16-342697fb,55739485,18536624,"Impression: Cardiomegaly is substantial with interval increase in size of the cardiac silhouette, highly concerning for pericardial effusion, correlation with echocardiography is recommended.  Replaced mitral valve is in expected position.  Mild vascular enlargement is present.  Small left apical pneumothorax is noted.","Impression: Cardiomegaly is substantial with interval decrease in size of the cardiac silhouette, highly concerning for pericardial effusion, correlation with echocardiography is recommended.  Replaced mitral valve is in unexpected position.  Mild vascular enlargement is present.  Small left apical pneumothorax is noted. A pacemaker is present in the right atrium.","['Change position of device', 'Add contradiction', 'Add medical device']"
48069ad7-2198507a-3a1a76f6-2f451959-3323f7de,58825648,18536624,"Findings: Since the chest radiograph obtained 1 day prior, there has been interval removal of the right-sided pleural drainage catheter.  Small left apical pneumothorax is unchanged.  Approximately 1.5 cm right apical pneumothorax is new.  Cardiomegaly is unchanged since 1 day prior, but new since 4 days prior. Increased left lower lobe atelectasis and probably a new, small left pleural effusion.  A small rounded opacity in the lateral right lung is likely a focus of atelectasis or hematoma in the prior location of the pleural drainage catheter.  Lungs are otherwise fully expanded and clear. Impression: New right apical pneumothorax as described above.  Unchanged, small, left apical pneumothorax.  Cardiomegaly unchanged since 1 day prior, but new since 4 days prior.  Correlation with echocardiogram recommended.","Findings: Since the chest radiograph obtained 1 day prior, there has been interval removal of the right-sided pleural drainage catheter.  No left apical pneumothorax is seen.  Approximately 2 cm right apical pneumothorax is new.  Cardiomegaly is unchanged since 1 day prior, but new since 4 days prior. Increased left lower lobe atelectasis and probably a new, small left pleural effusion.  A small rounded opacity in the lateral right lung is likely a focus of atelectasis or hematoma in a new location away from the prior pleural drainage catheter.  Lungs are otherwise fully expanded and clear. Increased left lower lobe atelectasis and probably a new, small left pleural effusion. Impression: New right apical pneumothorax as described above.  Unchanged, small, left apical pneumothorax.  Cardiomegaly unchanged since 1 day prior, but new since 4 days prior.  Correlation with echocardiogram recommended.","['Change position of device', 'Add repetitions', 'False negation']"
"1d01bd22-422dfa0a-8b8364e0-68924d73-beb6f4dc, d54665db-507b626e-61a70dc4-41fd219f-cb59c1f4",58872394,18536624,Findings: Patient is status post median sternotomy and cardiac valve replacement.  Lungs remain hyperinflated suggesting chronic obstructive pulmonary disease.  No focal consolidation is seen.  There is no pleural effusion or pneumothorax.  The cardiac and mediastinal silhouettes are stable. No displaced fracture is identified. Impression: No acute cardiopulmonary process.,Findings: Patient is status post median sternotomy and cardiac valve replacement.  Lungs remain hyperinflated suggesting chronic obstructive pulmonary dicease.  No focal consolidation is seen.  There is a small right pleural effusion.  The cardiac and mediastinal silhouettes are slightly enlarged. No displaced fracture is identified. Impression: Possible early pneumonia in the left lower lobe.,"['Change position of device', 'Change to homophone', 'False prediction']"
"7a7f9061-9eef6733-e94cb29b-c4088494-9177b82f, fee15199-0d437dad-0c55b167-3a23044f-96fc8d9e",52534188,18548611,"Findings: The lungs are clear without focal consolidation, pleural effusion or pneumothorax.  There is no pulmonary edema.  Minimal atelectasis is noted in the lung bases.  The heart is normal in size, and the mediastinal contours are normal. Impression: No acute cardiopulmonary process.","Findings: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary atelectasis. Minimal atelectasis is noted in the lung bases, and a large mass is seen in the right upper lobe. The heart is normal in size, and the mediastinal counters are normal. Impression: Mild acute cardiopulmonary process.","['Change severity', 'Change to homophone', 'False prediction']"
5e4621d6-249803ba-afaa008b-2751e009-8daaa308,54082213,18548611,Findings: Cardiomediastinal contours are normal.  Lungs are well expanded and grossly clear. ,Findings: Cardiomediastinal contours are normal.  Lungs are well expanded and grossly deer.  Surgical clips are noted.,"['False negation', 'Change to homophone', 'Add medical device']"
3b09934f-106f393a-5f3d7fda-81d7cd07-48d3b226,53452152,18552428,Findings: Bullet fragments project over the left humeral head.  Heart size is normal.  An opacity in the left lung may represent atelectasis and mild pulmonary vascular congestion.  There is no osseous abnormality.  There is no pneumothorax or pleural effusion. Impression: Mild pulmonary vascular congestion.  Bullet fragments are re- demonstrated.,Findings: Bullet fragments project over the left humeral head. Heart sighs is normal. An opacity in the right lung may represent atelectasis and mild pulmonary vascular congestion. There is no osseous abnormality. A central venous line is present. There is no pneumothorax or pleural effusion. Impression: Mild pulmonary vascular congestion. Bullet fragments are re-demonstrated.,"['Change location', 'Change to homophone', 'Add medical device']"
41d2924f-85f8e580-6d8773b6-5ede09de-b23811f6,50660145,18573829,"Impression: On ___ patient had large right and moderate left pleural effusion. Today the moderate left pleural effusion is smaller, but the right hemi thorax is now fully opacified.  Since the mediastinum is not shifted to the left, there is an equivalent loss of volume a due to atelectasis compared to the residual right pleural effusion, often an indication that the pleural effusion accumulated slowly. In addition there is an abrupt termination to the air column in the right main bronchus the strongly suggesting retained impacted secretions.  Feeding tube ends in the upper stomach.  No endotracheal tube is seen.  Heterogeneous opacification at the apex of the left lung is new from ___. Although interpreted prospectively it might have been diagnosed as pneumonia, the subsequent chest radiograph performed at 21:30 available the time of this review showed clearing. Therefore this is either edema or aspiration.","Impression: On ___ patient had large right and moderate left pleural effusion. Today the moderate left pleural effusion is smaller, but the right hemi thorax is now fully opacified.  Since the mediastinum is not shifted to the left, there is an equivalent loss of volume a due to atelectasis compared to the residual right pleural effusion, often an indication that the pleural effusion accumulated slowly. In addition there is an abrupt termination to the air column in the right main bronchus the strongly suggesting retained impacted secretions.  Feeding tube ends in the lower esophagus.  No endotracheal tube is seen.  Heterogeneous opacification at the apex of the left lung is knew from ___. Although interpreted prospectively it might have been diagnosed as pneumonia, the subsequent chest radiograph performed at 21:30 available the time of this review showed clearing. Therefore this is either edema or aspiration, and scattered nodules are also noted throughout the lung fields.","['Change position of device', 'Change to homophone', 'False prediction']"
51cd61fb-702bc603-25a5fc14-7ed07e7e-4628c152,52255209,18573829,"Impression: As compared to the previous radiograph, the right pleural effusion has decreased. The effusion is now limited to the right costophrenic sinus. There is no evidence of pneumothorax. No pneumonia, no pulmonary edema. Unchanged alignment of the sternal wires. No cardiomegaly. Mild tortuosity of the thoracic aorta.","Impression: As compared to the previous radiograph, the left pleural effusion has decreased. Both right and left pleural effusions are observed. The effusion is now limited to the right costophrenic sinus. There is no evidence of pneumothorax. Diaphragmatic hernia appreciated. No pneumonia, no pulmonary edema. Unchanged alignment of the sternal wires. No cardiomegaly. Marked tortuosity of the thoracic aorta.","['Change location', 'Add contradiction', 'False prediction']"
"a063e32e-12a44bd1-9ba6e452-1adda21f-511a1751, f1148b37-70b8bdb2-2bf622b4-d2c92d4d-23d892a6",56404519,18573829,"Impression: Large bilateral pleural effusions right greater than left associated with atelectasis are unchanged. Of note the images were taken with the patient very rotated, these limits the evaluation of the study. There is no evident pneumothorax. Cardiomediastinal silhouette is grossly unchanged. Left PICC tip is in the upper SVC  There are no new lung abnormalities","Impression: Large bilateral pleural effusions right greater then left associated with atelectasis are unchanged. Of note the images were taken with the patient very rotated, these limits the evaluation of the study. There is no evident pneumothorax. Cardiomediastinal silhouette is grossly unchanged. Left ureteral stent tip is in the upper SVC  There are no new lung abnormalities. New ET tube in place.","['Change name of device', 'Change to homophone', 'Add medical device']"
dc77150b-061bf4d5-09e23a26-52d9ada0-45856897,57045282,18573829,"Findings: Left subclavian central venous catheter is stable.  Lung volumes are reduced, and the cardiomediastinal contours are unchanged.  Basilar lung haziness is likely fluid or atelectasis.  No evidence of pneumonia or pulmonary edema. Impression: No evidence of pneumonia or pulmonary edema.","Findings: Left subclavian central venous catheter terminates in the right atrium.  Lung volumes are reduced, and the cardiomediastinal contours are unchanged.  Basilar lung haziness is likely due to fibrosis.  No evidence of pneumonia. Impression: No evidence of pneumonia or pulmonary edema with signs of mild pulmonary edema.","['Change position of device', 'Add contradiction', 'False prediction']"
"078eec80-ef37c7df-f352dd0a-ad6da42a-370e6a41, 13979aad-0fbe709d-a58598fb-e0033945-fa62f790",57755274,18573829,"Findings: PA and lateral views of the chest were provided.  Midline sternotomy wires are again seen along with mediastinal clips.  There is a tiny right pleural effusion.  Otherwise, the lungs are clear.  No signs of edema or pneumonia.  The cardiomediastinal silhouette is normal.  Bony structures are intact.  No free air below the right hemidiaphragm. Impression: Small right pleural effusion.  Otherwise, normal.","Findings: PA and lateral views of the chest were ppovided.  Midline sternotomy wires are again seen along with mediastinal clips.  There is a tiny right pleural effusion.  Otherwise, the lungs are clear.  No signs of edema or pneumonnia.  The cardiomediastinal silhouette is normal.  Bony structures are intact.  No free air below the right hemidiaphragm. A left-sided AICD is also noted. Impression: Small right pleural effusion.  Otherwise, nowmal.","['Change name of device', 'Add typo', 'Add medical device']"
7bb64264-3a27db3b-774da98c-671a380d-9805e329,58940888,18573829,"Findings: Slightly rotated positioning.  The left IJ central line tip overlies the upper right atrium.  No pneumothorax is detected.    Sternotomy wires are present and there is probable cardiomegaly.  There is upper zone re-distribution and diffuse vascular blurring, consistent with CHF. Hazy opacity at the lung bases suggests layering effusions, likely with underlying collapse and/or consolidation. The CHF and pleural parenchymal findings are new compared with the ___ CXR.     Note is made of slight change in caliber in the trachea at the level of the lower neck, which is similar to the ___ film. ","Findings: Slightly rotated positinong. The left IJ central line tip overlies the upper left atrium. No pneumothorax is detected. Sternotomy wires are present and there is probable cardiomegaly. There is lower zone re-distribution and diffuse vascular blurring, consistent with CHF. Hazy opacity at the lung base suggests layering effusions, likely with underlying collapse and/or consolidation. The CHF and pleural parenchymal findings are new compared with the ___ CXR. Note is made of slight change in caliber in the trachea at the level of the lower neck, which is similar to the ___ film. Visualized partially is the placement of a pacemaker.","['Change location', 'Add typo', 'Add medical device']"
"20c64870-d997ca68-0c568c8b-eaa9f10c-809cbc76, 99dbd90a-b66a0c18-466175fd-f5fe089e-8c92b47e",59567651,18573829,"Findings: The left-sided PICC line is confirmed to end at the level of the mid SVC in the lateral view. Otherwise there is no significant change compared with radiograph performed 3 hr earlier, with bilateral pleural effusions, right worse than left with probable associated atelectasis. No focal parenchymal opacities are seen in the aerated portions of the lungs. There is no pneumothorax.  A left-sided IJ line ends in the upper atrium. Sternotomy wires are intact. Impression: Left-sided PICC line is confirmed to end at the level of the mid SVC in the lateral view. Otherwise unchanged appearance of the thorax compared with radiograph performed 3 hr earlier.","Findings: The lfeft-sided PICC line is confirmed to end at the level of the mid SVC in the lateral view. Otherwise there is no significant change compared with radiograph performed 3 hr earlier, with bilateral pleural effusions, right worse than left with probable associated atelectasis. No focal parenchymal opacities are seidn in the aerated portions of the lungs. There is a pneumothorax.  A right-sided IJ line ends in the upper atrium. Sternotomy wires are intact. A pacemaker is also present. Impression: Left-sided PICC line is confirmed to end at the level of the mid SVC in the lateral view. Otherwise unchanged appearance of the thorax compared with radiograph performed 3 he earlier.","['Change location', 'Add typo', 'Add medical device']"
135f0d17-a5c68038-e9f9097a-b89be36b-245e82fe,59688115,18573829,Impression: New left central venous line ends in the mid superior vena cava.,Impression: New right central venous line ends in the mid superior vena cava.,"['Change location', 'Add contradiction', 'Add medical device']"
"08fd4c57-e13761d9-96132981-e2878469-e4018317, f0e340f0-d387cf51-931c26a5-2c512b2f-92ba4aba",56782686,18577540,"Findings: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. 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 abdomen provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. There is a central venous line in place. Impression: No acute intrathoracic process. There is no focal consolidation, effusion, or pneumothorax. ","['Change location', 'Add repetitions', 'Add medical device']"
"04dd2d3b-b0cf87a9-bb364724-243aefcf-5facd320, 65863386-93ba861b-edce159d-5d6bc336-734e0cc1",58531102,18577540,"Findings: The cardiac, mediastinal and hilar contours appear stable.  There is no pleural effusion or pneumothorax.  The lungs appear clear.  Bony structures are unremarkable.  There has been no significant change. Impression: No evidence of acute cardiopulmonary disease.","Findings: The cardiac, mediastinal and hilar contours appear stable.  There is no pleural effusion or pneumothorax.  The lungs appear clear.  Bony structures are unremarkable.  There has been no significant change. Impression: Mild cardiomegaly.","['Change severity', 'Add contradiction', 'False negation']"
d9dbe791-88e5c7a0-dc34613c-5913966a-50de825a,51202750,18580594,"Findings: Cardiomediastinal silhouette and hilar contours are normal.  Again appreciated are innumerable bilateral nodular densities, better appreciated and evaluated on recent chest CTA.  There is no evidence of vascular congestion and interstitial edema.  There is no large pleural effusion or pneumothorax. Impression: Innumerable bilateral nodular opacities, better evaluated on recent CT, without evidence of edema or large area of consolidation worrisome for pneumonia.","Findings: Cardiomediastinal silhouette and hilar contours are normal. Again appreciated are moderate innumerable bilateral nodular densities, better appreciated and evaluated on recent chest CTA. There is no evidence of vascular congestion and interstitial edema. Cardiomediastinal silhouette and hilar contours are normal. There is no large pleural effusion or pneumothorax. There is a central venous line in place.","['Change severity', 'Add repetitions', 'Add medical device']"
79d26270-6ac0b789-8f537c71-f31636b6-652a10b8,52783924,18580594,"Findings: As compared to the previous radiograph, there is no relevant change.  The extent and severity of the known bilateral diffuse metastatic lung disease is unchanged.  No new areas of focal consolidations or opacities. Unchanged size of the cardiac silhouette.  No pleural effusions.  No pneumothorax.  Unchanged course and position of the right PICC line. ","Findings: As compared to the previous radiograph, there is no relevant change.  The extent and severity of the known bilateral diffuse metastatic lung disease is unchanged. No new areas of focal consolidations or opacities. The cardiac silhouette appears normal.  No pleural effusions.  No pneumothorax.  Unchanged course and position of the right IJ line.  The extent and severity of the known bilateral diffuse metastatic lung disease is unchanged. ","['Change position of device', 'Add repetitions', 'False negation']"
c5c3a5a3-5e5063e6-7ebc4940-55888e2a-27a9bf62,54419841,18580594,"Findings: As compared to the prior examination, lung volumes are decreased.  There is crowding of previously seen bilateral nodular opacities due to decreased lung volumes, however there is likely superimposed fluid overload.  There may be minimal increase in cardiac size however the majority of the apparent increase is due to differences in technique. ","Findings: As compared to the prior examination, lung volumes are decreased.  There is crowding of previously seen bilateral nodular opacities due to decreased lung volumes, however there is likely superimposed fluid overload.  Lung volumes are decreased.  There may be mild increase in cardiac size however the majority of the apparent increase is due to differences in technique.  A central venous line is noted in the right subclavian vein.","['Change severity', 'Add repetitions', 'Add medical device']"
e9fd9d5d-4686d244-07a3bcbf-1f4fe6d7-c8a17d5d,55411644,18580594,"Findings: As compared to the previous radiograph, there is no relevant change.  Known diffuse metastatic lung disease, but no evidence of new parenchymal opacities.  A slightly denser area next to the left chest wall is unchanged in extent and severity.  Unchanged appearance of the cardiac silhouette.  Unchanged left PICC line. ","Findings: As compared to the previous radiograph, there is no relevant change. Known diffuse metastatic lung disease, but no evidence of knew parenchymal opacities. A slightly denser area next to the right chest wall is unchanged in extent and severity. Unchanged appearance of the cardiac silhouette. Unchanged left PICC line. A pacemaker is present.","['Change location', 'Change to homophone', 'Add medical device']"
"6abe4ea4-169e4ba1-a84d3279-9d50d94c-f5eea071, b298a1e4-63c03117-5b7448ea-6d2e5afd-c1c39bd7",56562091,18580594,"Findings: AP and lateral views of the chest.  The innumerable bilateral nodular densities, better appreciated on recent chest CTA from ___, appear slightly worse compared to study done on ___ but this may be exaggerated by difference in technique and superimposed edema.  The cardiomediastinal and hilar contours are normal.  There is no pleural effusion or pneumothorax. Impression: Innumerable bilateral nodular opacities, better seen on recent chest CT from ___, appear slightly worse compared to study done on ___ but this may be exaggerated by difference in technique and possibly superimposed edema.","Findings: AP and lateral views of the left chest. The innumerable bilateral nodular densities, better appreciated on recent chest CTA from ___, appear slightly worse compared to study done on ___ but this may be exaggerated by difference in technique and superimposed edema.  The cardiomediastinal and hilar contours are normal.  There is no pleural effusion.  The right atrium appears enlarged. Impression: Innumerable bilateral nodular opacities, better seen on recent chest CT from ___, appear slightly worse compared to study done on ___ but this may be exaggerated by difference in technique and possibly superimposed edema. ","['Change location', 'Change to homophone', 'False prediction']"
184bb758-6458694f-18e228fd-256ef804-8bfa0dba,56772300,18580594,"Findings: In comparison with study of ___, there is little overall change in the diffuse bilateral pulmonary nodules, consistent with widespread metastases from renal cell carcinoma.  The patient has taken a slightly better inspiration.  There may be some mild elevation of pulmonary venous pressure. ","Findings: In comparison with study of ___, there is moderate overall change in the diffuse bilateral pulmonary nodules, consistent with widespread metastases from renal cell carcinoma.  The patient has taken a slightly better inspiration.  There may be some severe elevation of pulmonary venous pressure.  ","['Change severity', 'Add contradiction', 'False negation']"
c2bd3ed1-3fb9aa51-ff427719-79f840dd-3d5cefd4,58794154,18580594,"Findings: Cardiac silhouette is upper limits of normal in size.  Mediastinal and hilar contours are stable.  Widespread pulmonary metastases are again demonstrated, with a dominant 3.3-cm diameter peripheral mass in the lingula.  On the lateral view, increasing confluent opacity is seen overlying the lower thoracic spine as compared to the lateral chest radiograph of ___, with associated partial obscuration of the right hemidiaphragm.  Small right pleural effusion is present, similar to ___ radiograph. Impression: 1.  Widespread pulmonary metastases. 2.  Dependent consolidation overlying the lower thoracic spine on lateral chest x-ray, which could be due to an infectious pneumonia in the appropriate clinical setting. 3.  Small pleural effusions.","Findings: Cardiac silhouette is upper limits of normal in size.  Mediastinal and hilar contours are stabel.  No pulmonary metastases are demonstrated.  On the lateral view, increasing confluent opacity is seen overlying the lower thoracic spine as compared to the lateral chest radiograph of ___, with associated partial obscuration of the right hemidiaphragm.  Small right pleural effusion is present, similar to ___ radiograph. Impression: 1.  No pulmonary metastases. 2.  Dependent consolidation overlying the lower thoracic spine on lateral chest x-ray, which could be due to an infectious pneumonia in the appropriate clinical setting. 3.  Small pleural effuusions.","['Change measurement', 'Add typo', 'False negation']"
"05ff4e34-05d8cfb5-a89bc7fa-e2f28c07-5b9f190f, 1b398554-24b876ce-53da141f-517699d4-08516f6c",55703291,18581076,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The cardiac and mediastinal silhouettes are unremarkable. A central venous line is noted. Impression: No a cute cardiopulmonary process.,"['Add repetitions', 'Change to homophone', 'Add medical device']"
"5ebc8d35-a5ece81f-8e1833b8-9605b2d7-688ef3e9, c502fad6-5a1460c0-33a61be8-895f2500-fe404a52",50605041,18619672,"Findings: PA and lateral chest radiographs were obtained.  The lungs are well expanded and clear.  There is no focal consolidation, effusion, pneumothorax.  Cardiac and mediastinal contours are normal. Impression: No acute cardiopulmonary process.","Findings: PA and lateral chest radiographs were obtained.  The left lungs are well expanded and clear.  There is no focal consolidation, effusion, pneumothorax.  Cardiac and mediastinal contours are normal.  Cardiac and mediastinal contours are normal. There is an ICD in place. Impression: No acute cardiopulmonary process.","['Change location', 'Add repetitions', 'Add medical device']"
"1843348c-a8b55a25-08721baf-8e014c14-6ce86d05, 696a7413-9343a3f1-4d2a119b-8b6bbf79-599b2c4c",55152029,18619672,Findings: Heart size is normal.  Mediastinal and hilar contours are within normal limits.  Lungs are clear.  Pulmonary vascularity is normal.  No pleural effusion or pneumothorax is present.  No acute osseous abnormalities are present. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  Mediastinal and hilar contours are within normal limits.  Lungs are clear.  Pulmonary vascularity is increased.  No pleural effusion or pneumothorax is present.  There is no pneumonia seen in the lungs. No acute osseous abnormalities are present. Impression: No acute cardiopulmonary abnormality. The cardiomediastinal silhouette is enlarged.,"['Add repetitions', 'Add contradiction', 'False prediction']"
"27db5636-5ac48338-c162ea71-78b0c5c2-eabd85fb, 7deb3ae1-86efe564-c5517815-59b4395a-2cb08397",56692775,18627107,Findings: The cardiomediastinal silhouette and pulmonary vasculature are normal.  No focal consolidation is seen.  There is no pleural effusion or pneumothorax. Impression: No acute intrathoracic abnormality.,Findings: The cardiomediastinal silhouette and pulmonary vasculature are nomral.  No focal consolidation is seen.  There is no pleural effusion or pneumothorax. There is no pleural effusion or pneumothorax. There are basilar opacities suggestive of atelectasis. Impression: No acute intrathoracic abnormality.,"['Add typo', 'Add repetitions', 'False prediction']"
93318c78-1b671842-1af554f7-52f54a25-91a64acf,57833703,18648021,"Findings: In comparison with the study of ___, there is little change and no evidence of acute focal pneumonia.  Right apical pleural and parenchymal abnormalities again seen, most likely related to previous infection and scarring.  Continued hyperinflation of the lungs consistent with chronic pulmonary disease.  No vascular congestion or acute focal pneumonia. ","Findings: In comparison with the study of ___, there is litle change and no evidence of acute focal pneumonia. Left apical pleural and parenchymal abnormalities again seen, most likely related to previous infection and scarring. Continued hyperinflation of the lungs consistent with chronic pulmonary disease. Presence of an ET tube.  No vascular congestion or acute focal pneumonia.  ","['Change location', 'Add typo', 'Add medical device']"
"6a1dcdef-77f285f3-0dc88baa-e1241adf-0eba3f6b, fd887488-95c00556-1dbb3798-7a3c05a2-0c60eacc",50263751,18711952,"Findings: PA and lateral views of the chest provided.   Chronic scarring in the left lower lobe accounts for retrocardiac opacity. No new consolidation is seen. No evidence of edema, large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm Impression: No acute findings. Stable retrocardiac opacity compatible with scarring in the left lower lobe.","Findings: PA and lateral views of the chest provided. Chronic scarring in the left lower lobe accounts for a severe retrocardiac opacity. No new consolidation is seen. No evidence of edema, large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm. Impression: No acute findings. Stable retrocardiac opacity compatible with scarring in the left lower lobe. Mild retrocardiac opacity observed, not consistent with scarring in the left lower lobe.","['Change severity', 'Add contradiction', 'False prediction']"
"089ab3b5-4b7f0a82-24c89f6a-d876a8f0-34b46929, 98460d00-834dcec0-77ec3b51-61149fa4-dfdbde10",51452692,18711952,"Findings: The cardiac silhouette is enlarged with mild interstitial edema.  Pulmonary artery is enlarged.   Lung volumes are low, and there is a left retrocardiac opacity.  A left axillary vascular stent is again noted. Impression: Cardiomegaly with mild interstitial edema. Suspected pulmonary hypertension.","Findings: The cardiac silhouette is severely enlarged with mild interstitial edema.  Pulmonary artery is severely enlarged.   Lung volumes are low, and there is a left retrocardiac opacity.  A left axillary vascular stent is again noted.  There is no evidence of vascular stents. Impression: Cardiomegaly with severe interstitial edema. Suspected pulmonary hypertension. ","['Change severity', 'Add contradiction', 'Add medical device']"
cf6a4352-a09fe502-cedb583d-cf8a12af-f09a5c62,51736713,18711952,"Impression: PA and lateral chest compared to ___.  Previous small-to-moderate left pleural effusion is smaller, although there is residual pleural thickening.  Lateral view shows a region of peripheral atelectasis, where previously there was a posteriorly collected pleural effusion.  There may be a tiny right pleural effusion in the posterior sulcus.  Heart is mildly enlarged, larger today than in ___, but the pulmonary vasculature is unremarkable and there is no edema.  A supraclavicular dual-channel central venous catheter ends in the upper right atrium.","Impression: PA and lateral chest compared to ___.  No left pleural effusion is present, although there is residual pleural thickening.  Lateral view shows a region of peripheral atelectasis, where previously there was a posteriorly collected pleural effusion.  There is a large right pleural effusion in the posterior sulcus.  Heart is mildly enlarged, smaller today than in ___, but the pulmonary vasculature is unremarkable and there is no edema.  A supraclavicular dual-channel central venous catheter ends in the mid SVC.","['Change position of device', 'Add contradiction', 'False negation']"
a6eaf07c-7d11c9e6-cbf92b96-72eb5709-8e9f4163,52019235,18711952,"Impression: In comparison with the study of ___, the the elevated pulmonary venous pressure is no longer appreciated. There is continued small left effusion with basilar atelectatic changes.  No definite acute focal pneumonia.","Impression: In comparison with the study of ___, the the elevated pulmonary venous pleasure is no longer appreciated. There is continued small left pleural effusion with basilar alectatic changes. There is mild cardiomegaly with no definite acute focal pneumonia.","['Change location', 'Add typo', 'False prediction']"
"7f7bf68e-6d6ce67a-f6531a2b-edaf79cd-8825f540, cdc9c3fc-2c1de092-1ff45e6d-12accd18-918c173c",52152687,18711952,Findings: Frontal and lateral radiographs of the chest.  The moderate right pleural effusion is unchanged with associated atelectasis.  There is interval improvement in pulmonary edema.  Stable mildly enlarged cardiac silhouette.  No right pleural effusion.  No pneumothorax. Impression: Persistent moderate right pleural effusion with associated atelectasis and resolving pneumonia.  Improved pulmonary edema.,Findings: Frontal and lateral radiographs of the chest.  The small right pleural effusion is unchanged with associated atelectasis.  There is interval improvement in pulmonary edema.  Stable mildly enlarged cardiac silhouette.  No right pleural effusion.  No right pleural effusion.  No pneumothorax.  Presence of a central venous line. Impression: Persistent moderate right pleural effusion with associated atelectasis and resolving pneumonia.  Improved pulmonary edema.,"['Change severity', 'Add repetitions', 'Add medical device']"
"901bb0dd-fdfda3ed-2d96b0f4-d803b7bb-9e4b3bd8, d9d7f6db-ecc8ba46-a7b9f746-8fffb884-c4ea3c67",52575467,18711952,"Impression: Since ___ there been substantial changes: Moderate enlargement of the cardiac silhouette is new, borderline interstitial edema has developed, small left pleural effusion is larger, and new heterogeneous opacification at the right base could be dependent atelectasis and edema.  Overall findings indicate cardiac decompensation.  Possibility of acute pulmonary embolism should be considered from a clinical standpoint, particular given.","Impression: Since ___ there been substantial changes: Moderate enlargement of the cardiac silhouette is new, borderline interstitial edema has developed, small right pleural effusion is larger, and new heterogeneous opacification at the right base could be dependent atelectasis and edema. Small pleural effusions are stable, with no change in their size.  Overall findings indicate cardiac stabilization.  Possibility of acute pulmonary embolism should be considered from a clinical standpoint, particular given the absence of any clinical indicators of such an event.","['Change location', 'Add contradiction', 'False prediction']"
ac1c8deb-4d1a48db-00b1f8e6-74207e6d-aca12386,54064544,18711952,"Impression: PA and lateral chest compared to ___ through ___:  Small left pleural effusion, slightly smaller today than on ___.  At least two left juxtahilar lung nodules are still visible.  A right supraclavicular dual-channel hemodialysis catheter ends in the right atrium.  Mild cardiomegaly stable.  No pulmonary edema.","Impression: PA and lateral chest compared to ___ through ___: Small left pleural effusion, slightly smaller today than on ___. Bilateral lung fields are clear. A right supraclavicular dual-chamber pacemaker is seen with leads ending in the right atrium. Mild cardiomegaly stable. Prominent pulmonary edema.","['Change name of device', 'Add contradiction', 'False prediction']"
"694a7591-50712b48-fbfaf08a-6b31c47d-5bce159e, ee82f2ad-31d58c5b-8760e53b-07c17cf2-7ebebc97",55724407,18711952,Findings: Frontal and lateral views of the chest.  There is a large left pleural effusion.  The right lung is clear of consolidation.  Trace blunting of the posterior costophrenic angles suggest trace effusion.  There is mild pulmonary vascular congestion.  Cardiomediastinal silhouette cannot be assessed given silhouetting the left heart border.  No acute osseous abnormalities. Impression: Large left pleural effusion with probable underlying atelectasis noting infection cannot be excluded.  Pulmonary vascular congestion.,Findings: Frontal and lateral views of the chest.  No pleural effusion.  The left lung is clear of consolidation.  Trace blunting of the left costophrenic angles suggest trace effusion.  There is mild pulmonary vascular congestion.  Cardiomediastinal silhouette cannot be assessed given silhouetting the left heart border.  No acute osseous abnormalities. Impressions: Large left pleural effusion with probable underlying atelectasis noting infection cannot be excluded.  No pleural effusion.  Pulmonary vascular congestion.,"['Change location', 'Add repetitions', 'False negation']"
8918e0bb-74e205be-380e930e-9217a419-27d4eab0,55943354,18711952,"Impression: 1.  Persistent left-sided pleural effusion which may have slightly increased in size with some associated patchy opacity most likely reflecting patchy atelectasis, although pneumonia could also have this appearance.  There is increasing prominence to the interstitium suggesting a component of superimposed interstitial edema.  A smaller right effusion is likely.  Overall cardiac and mediastinal contours are unchanged.  No pneumothorax.","Impression: 1.  Persistent right-sided pleural effusion which may have slightly increased in size with some associated patchy opacity most likely reflecting patchy atelectasis, although pneumonia could also have this appearance.  There is increasing prominence to the interstitium suggesting a component of superimposed interstitial edema.  A smaller right effusion is likely.  Overall cardiac and mediastinal contours are unchanged.  No pneumothorax.  Persistent right-sided pleural effusion which may have slightly increased in size with some associated patchy opacity most likely reflecting patchy atelectasis, although pneumonia could also have this appearance.  A mass in the left upper lobe could be seen.  No pneumothorax.","['Change location', 'Add repetitions', 'False prediction']"
45efdb5c-2180d248-108c9392-5955178b-868c7a3c,56213448,18711952,"Findings: As compared to the previous radiograph, the patient has undergone left thoracocentesis.  There is no visualization of an apical or basal pneumothorax.  The effusion has moderately decreased in extent.  Borderline size of the cardiac silhouette.  Double-lumen dialysis catheter.  The left heart border is delineated in a sharper manner than on the previous radiograph, likely caused by slight patient rotation to the left. ","Findings: As compared to the previous radiograph, the patient has undergone left thoracocentesis.  There is no visualization of an apical or basal pneumothorax.  The effusion has moderately decreased in extent.  Size of the cardiac silhouette is enlarged.  Double-lumen dialysis catheter.  The left heart border is delineated in a sharper manner than on the previous radiograph, likely caused by slight patient rotation to the left.  A right-sided Port-A-Cath is also present.","['Change position of device', 'Add contradiction', 'Add medical device']"
"330a14e1-0c40a813-603d2660-12ea9afb-4349743e, 44fbc6d0-0c39e6ef-e9181984-728748c3-7d42ff10",57803827,18711952,"Findings: There has been interval placement of a left axillary stent.  Lung volumes are low, and the cardiac silhouette is enlarged.  There is mild central vascular congestion, and small pleural effusions are noted.  No focal consolidation or pneumothorax is seen. Impression: Cardiomegaly with mild central vascular congestion.  Small bilateral pleural effusions.","Findings: There has been interval placement of a left axillary stent. Lung volumes are low, and the cardiac silhouette is enlarged. There is mild central vascular congestion, and small pleural effusions are noted. No focal consolidation or pneumothorax is seen. Bilateral patchy opacities are present. Impression: Cardiomegaly with mild central vascular congestion. Small bilateral pleural effusions. No pleural effusions noted. ","['Change position of device', 'Add contradiction', 'False prediction']"
"9a0a7c9d-1d812343-2d53c9b4-bc13998e-a629c3e5, f73732eb-00de1875-6b069814-599043c8-9c65ba0a",57885425,18711952,"Findings: A moderate-sized left pleural effusion has partially reaccumulated following recent thoracentesis procedure.  Cardiac silhouette is upper limits of normal in size and accompanied by pulmonary vascular congestion and peribronchial cuffing.  Additionally, a widespread reticular and nodular pattern has developed diffusely as well as more confluent opacities in the left mid and lower lung regions. Impression: 1.  Partial reaccumulation of left pleural effusion, now moderate in size. 2.  Diffuse reticulonodular opacities, possibly due to pulmonary edema, but atypical or opportunistic infection is an additional consideration given the nodular appearance.  If persistent after diuresis, consider a CT scan for further characterization to exclude a miliary nodular infection. 3.  Patchy and linear opacities in left mid and lower lung may be due to atelectasis or infectious consolidation.","Findings: A mild-sized left pleural effusion has partially reaccumulated following recent thoracentesis procedure. No cardiac silhouette is noted and accompanied by pulmonary vascular congestion and peribronchial cuffing. No reticular and nodular pattern noted. Impression: 1. Partial reaccumulation of left pleural effusion, now large in size. 2. Diffuse reticulonodular opacities, possibly due to pulmonary edema, but atypical or opportunistic infection is an additional consideration given the nodular appearance.  If persistent after diuresis, consider a CT scan for further characterization to exclude a miliary nodular infection. 3. No opacities noted.","['Change severity', 'Add contradiction', 'False negation']"
"16e01908-f73fd063-90006332-eb5aeba7-50b4fe00, b1cd1859-8c39d24b-4a7eabaf-0c5ecbe3-983c532b",50314735,18713335,Findings: Cardiac silhouette size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. Clips are seen in the right upper quadrant of the abdomen. There are no acute osseous abnormalities identified. Impression: No acute cardiopulmonary abnormality.,Findings: Cardiac silhouette size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. Clips are seen in the left lower quadrant of the abdomen. There are no acute osseous abnormalities identified. Impression: Small left pleural effusion.,"['Change position of device', 'Add contradiction', 'False negation']"
"20f781f3-8af7bfae-44ed8008-540a4975-ce41f5b7, 25d32771-00781a5a-8920ea8f-ae2f4879-373b3c21",56629662,18713335,"Findings: As compared to the previous radiograph, the lung volumes have slightly increased, however, not returned to normal.  There is decrease of the pre-existing pulmonary edema bilaterally, however there is still mild-to-moderate pulmonary edema bilaterally.  The cardiomediastinal silhouette is slightly smaller than the prior radiograph. ","Findings: As compared to the previous radiograph, the lung volumes have slightly increased, however, knot returned to normal. There is decrease of the pre-existing pulmonary edema bilaterally, however there is still moderate pulmonary edema bilaterally. The cardiomediastinal silhouette is slightly smaller than the prior radiograph. An endotracheal tube is present.  ","['Change severity', 'Change to homophone', 'Add medical device']"
"29e8cd30-6d1c3bf6-20b37ebf-0129c596-941196da, 52dba646-d5793a41-017a31e5-359f85e9-fdc22168",58318194,18713335,"Findings: As compared to the previous radiograph, the size of the cardiac silhouette is moderately increased.  Given lower lung volumes, there is more crowding of the vascular and bronchial structures, notably at the lung bases, but no pulmonary edema is present.  No pneumonia.  No pleural effusions.  No lung nodules or masses. ","Findings: As compared to the previous radiograph, the size of the cardiac silhouette is moderately increased.  Given lower lung volumes, there is more crowding of the vascular and bronchial structures, notably at the right lung bases, but now pulmonary edema is present.  No pneumonia.  No pleural effusions.  No lung nodules or masses.  ","['Change location', 'Add typo', 'False negation']"
b29d0852-2f33563f-2443c212-e00db2ff-74a4c5d7,58417790,18713335,"Findings: As compared to the previous radiograph, the lung volumes have decreased.  There is now moderate cardiomegaly with signs of predominantly centralized moderate pulmonary edema.  Increased areas of atelectasis are seen at both lung bases.  The asymmetry of the changes does not clearly support the suspicion for pneumonia.  At the time of dictation and observation, 8:47 a.m., on the ___, the referring physician, ___. ___ was paged for notification. ","Findings: As compared to the previous radiograph, the lung volumes have decreased.  There is now moderate cardiomegaly with signs of predominantly mild pulmonary edema.  Increased areas of atelectasis are seen at both lung bases.  The asymmetry of the changes does not clearly support the suspicion for pneumonia.  A pacemaker is present over the left chest.  At the time of dictation and observation, 8:47 a.m., on the ___, the referring physician, ___. ___ was paged for notification.  There is now moderate cardiomegaly with signs of predominantly centralized moderate pulmonary edema.","['Change severity', 'Add repetitions', 'Add medical device']"
"1c009226-64474f8f-8f47e3e0-01640769-ae6bc0ae, f06dc57e-95386549-8727f7a4-4e899b36-07f250d0",56089705,18776448,"Findings: The lungs are well expanded.  There is no focal consolidation, pleural effusion or pneumothorax.  Cardiomediastinal silhouette is normal.  The imaged upper abdomen is unremarkable. Impression: No acute cardiopulmonary process.",Findings: The lungs are well expanded. There is a left-sided pleural effusion present. Cardiomediastinal silhouette is normal. There is no significant abnormality in osseous structures. Impression: No acute cardiopulmonary process.,"['Change location', 'Change to homophone', 'False prediction']"
"024cc0c3-67fb5ac5-621d954e-656314f7-e8ceed76, 2bce0faf-d8f186be-2b15d6e3-a0339a41-170ec289",53467295,18783450,"Findings: PA and lateral chest views were obtained with patient in upright position.  The heart is mildly enlarged.  The configuration demonstrates a prominence of the left ventricular contour to the left and posteriorly but no evidence of marked left atrial enlargement.  Thoracic aorta is mildly widened but does not show any local contour abnormalities.  A right-sided internal jugular vein approach Port-A-Cath system is noted and the line terminates in mid-to-lower SVC.  No pneumothorax is present.  The pulmonary vasculature is not congested.  There is no evidence of new acute parenchymal infiltrates.  There is mild blunting of the lateral and posterior pleural sinuses, but in the absence of acute pulmonary congestion, these findings are most likely related to patient's past medical history, which includes a liver transplant, probably represent pleural scar formations.  There is no evidence of pneumothorax on either side.  Skeletal structures of the thorax grossly unremarkable. Impression: Mild cardiac enlargement with left ventricular prominence, but absence of acute pulmonary congestion or left atrial enlargement.  No acute infiltrates.  Bilateral pleural scar formations, probably related to past history.  Thus, presently no evidence of acute pulmonary infiltrates or significant CHF.","Findings: PA and lateral chest views were obtained with patient in upright position. The heart is severely enlarged. The configuration demonstrates a prominence of the left ventricular contour to the left and posteriorly but no evidence of marked left atrial enlargement. Thoracic aorta is mildly widened but does not show any local contour abnormalities. A right-sided internal jugular vein approach Port-A-Cath system is noted and the line terminates in mid-to-lower SVC. No pneumothorax is present. The pulmonary vasculature is knot congested. There is evidence of new acute parenchymal infiltrates at the lung bases. There is mild blunting of the lateral and posterior pleural sinuses, but in the absence of acute pulmonary congestion, these findings are most likely related to patient's past medical history, which includes a liver transplant, probably represent pleural scar formations. There is no evidence of pneumothorax on either side. Skeletal structures of the thorax grossly unremarkable. Impression: Severe cardiac enlargement with left ventricular prominence, but absence of acute pulmonary congestion or left atrial enlargement. No acute infiltrates. Bilateral pleural scar formations, probably related to past history. Evidence of CHF-related pleural effusions. Presently no evidence of significant CHF.","['Change severity', 'Change to homophone', 'False prediction']"
08f2e527-aed6e0fd-7613e553-eebf480b-65419307,54421674,18783450,"Impression: AP chest compared to preoperative chest radiograph ___:  In addition to new interstitial abnormality, there is uniform opacification in the right lower hemithorax due in part to moderate pleural effusion but potentially concealing pneumonia.  Careful followup with conventional chest radiographs if possible should be obtained.  There is no pneumothorax.  Right central venous infusion line ends low in the SVC.  Findings were discussed by telephone with the staff physician covering this patient at 11am.","Impression: AP chest compared to preoperative chest radiograph ___:  In addition to new interstitial abnormality, there is uniform opacification in the left lower hemithorax due in part to moderate pleural effusion but potentially concealing pneumonia.  Careful followup with conventional chest radiographs if possible should bee obtained.  There is no pneumothorax.  Right central venous infusion line ends low in the SVC.  Findings were discussed by telephone with the staff physician covering this patient at 11am.  Endotracheal tube is present, with its tip at the level of the carina.","['Change location', 'Change to homophone', 'Add medical device']"
1f400fee-753579b0-b459be3b-04c5dbab-120f6074,58473980,18783450,Findings: Comparison is made to the previous study from ___.  There is improved aeration at the right base.  There remains some atelectasis at the bases bilaterally.  There is an unchanged right-sided Port-A-Cath with distal lead tip at the distal SVC.  Heart size is normal.  There are no pneumothoraces. ,Findings: Comparison is made to the previous study from ___.  No aeration improvement at the right base.  There remains some atelectasis at the bases bilaterally.  There is an unchanged right-sided Port-A-Cath with distal lead tip at the mid SVC.  Heart size is normal.  There are no pneumothoraces.  There remains some atelectasis at the bases bilaterally.,"['Change position of device', 'Add repetitions', 'False negation']"
"0d51daed-be7d1717-a01acc11-037992a6-8340357b, 43a98704-16eea15d-90d9ddae-e5ce78e7-7321540c",54610506,18788733,"Findings: There are streaky bibasilar opacities likely due to atelectasis in the setting of low lung volumes.  There is no other region of consolidation, effusion, or edema.  The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.  Surgical clips in the right upper quadrant suggest prior cholecystectomy. Impression: Bibasilar opacities which are most likely atelectasis.  Lungs are otherwise clear without acute cardiopulmonary process.","Findings: There are streaky bibasilar opacities likely due to atelectasis in the setting of low lung volumes.  There is no other region of consolidation, effusion, or edema.  The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.  No surgical clips identified. Impression: No bibasilar opacities.  Lungs are otherwise clear without acute cardiopulmonary process.","['Change position of device', 'Change to homophone', 'False negation']"
f1f1e890-138d12a5-79b715a3-cba88b1a-39949fcf,51515861,18795271,"Findings: Nasogastric tube now terminates in the stomach, sideport at the esophagus.  Lung volumes are low.  There is persistent elevation of the right hemidiaphragm.  The left hemidiaphragm is obscured by retrocardiac opacity.  The left costophrenic angle is not fully imaged.  There is no right pleural effusion.  No pneumothorax.  Hilar and mediastinal silhouettes are unchanged.  Heart size is top normal.  No pulmonary edema. Impression: 1.  Nasogastric tube terminates in the stomach, side port likely at the esophagus.  2.  Retrocardiac opacities may represent atelectasis, aspiration or infection in the correct clinical setting.","Findings: Nasogastric tube now terminates in the stomach, sideport at the esophagus.  Lung volumes are low.  There is persistent elevation of the left hemidiaphragm.  The left hemidiaphragm is obscured by retrocardiac opacity.  The left costophrenic angle is not fully imaged.  There is no right pleural effusion.  No pneumothorax.  Hilar and mediastinal silhouettes are unchanged.  Heart size is top normal.  No pulmonary edema. Impression: 1.  Nasogastric tube terminates in the stomach, side port likely at the esophagus.  2.  Retrocardiac opacities may represent atelectasis, aspiration or infection in the correct clinical setting. 3.  Bilateral basilar opacities consistent with mild pulmonary edema.","['Change location', 'Add contradiction', 'Add medical device']"
416015bf-a5b87cdb-e0e532be-9c61feb1-ef52aed5,55361629,18795271,"Findings: Single AP upright portable view of the chest was obtained.  There is persistent elevation of the right hemidiaphragm with overlying right base atelectasis.  An enteric tube is seen, distal aspect terminating in the region of the gastroesophageal junction.  Recommend advancement by several centimeters so that it is well within the stomach.  There is no large pleural effusion or pneumothorax.  The aortic knob is calcified.  The cardiac silhouette is unremarkable. Impression: 1.  Elevation of the right hemidiaphragm which is increased as compared to the prior study with overlying basilar atelectasis. 2.  Enteric tube terminates in the region of the gastroesophageal junction, recommend advancement so that it is well within the stomach.","Findings: Single AP upright portable view of the chest was optained.  There is persistent elevation of the right hemidiaphragm with overlying right base atelectasis.  An enteric stent is seen, distal aspect terminating in the region of the gastroesophageal junction.  Recommend advancement by several centimeters so that it is well within the stomach.  There is no large pleural effusion or pneumothorax.  The aortic knob is calcified.  The cardiac silhouette is unremarkable, but a right lower lobe opacity is noted. Impression: 1.  Elevation of the right hemidiaphragm which is increased as compared to the prior study with overlying basilar atelectasis. 2.  Enteric tube terminates in the region of the gastroesophageal junction, recommend advancement so that it is well within the stomach.","['Change name of device', 'Add typo', 'False prediction']"
"28de63ad-f4c09f50-2feebf2a-0a625b1e-bbb2d5ab, ea824a78-8cbd68db-cdc27d64-6ecd71ac-4000879e",56093039,18824826,"Findings: There is a subtle opacity in the left lung base adjacent to the left heart border on the frontal projection.  There is no other focal consolidation, pleural effusion, pulmonary edema, or pneumothorax seen.  The heart and mediastinal contours are normal. Impression: Subtle opacity within the left lower lung suggestive of pneumonia.","Findings: There is a subtle opacity in the right lung base adjacent to the left heart border on the frontal projection.  There is no other focal consolidation, pleural effusion, pulmonary edema, or pneumothorax seen.  The heart and mediastinal contours are normal. There is no subtle opacity.  Impression: Subtle opacity within the left lower lung suggestive of pneumonia.  ","['Change location', 'Add repetitions', 'False negation']"
"67f234c1-478fd442-029776c8-c5f0b2d1-d6e0b994, ca4ee096-74120228-b98bdda3-8a6b881a-616b1793",54191170,18827738,"Findings: A portable frontal chest radiograph initially demonstrate a Dobbhoff tube looped back upon itself projecting over the mid chest.  Subsequent images demonstrate interval removal of the Dobbhoff tube. A nasoenteric tube is looped within a hiatal hernia.  The tip of the endotracheal tube is approximately 3 cm above the carina.  The cardiomediastinal silhouette is unchanged and the lungs are without focal consolidation.  There is no pleural effusion or pneumothorax. Impression: 1.  Unchanged chest radiograph.  2.  The tip of the endotracheal tube is 3 cm above the carina.  These findings were communicated to the covering team at approximately ___ on ___, at which time the patient had already been extubated.","Findings: A portable frontal chest radiograph initially demonstrate a Dobbhoff tube looped back upon itself projecting over the mid chest.  Subsequent images demonstrate interval removal of the Dobbhoff tube. A nasoenteric tube is looped within a hiatal hernia.  The tip of the endotracheal tube is approximately 4 cm above the carina.  The cardiomediastinal silhouette enlarges and the lungs are without focal consolidation.  There is a minimal pleural effusion or pneumothorax. A nasoenteric tube is looped within a hiatal hernia. Impression: 1.  Unchanged chest radiograph.  2.  The tip of the endotracheal tube is 4 cm above the carina.  These findings were communicated to the covering team at approximately ___ on ___, at which time the patient had already been extubated.","['Change measurement', 'Add repetitions', 'False prediction']"
f487266f-6dea1fff-43365092-396868ad-c98b60cb,55331592,18827738,"Findings: Portable semi-upright view of the chest was provided.  The endotracheal tube is seen with its tip located 4.6 cm above the carina.  The lungs are clear bilaterally.  No effusion or pneumothorax is seen, though the right CP angle is partially excluded.  Cardiomediastinal silhouette appears grossly unremarkable.  No acute bony abnormalities are seen.  However, a defect within the right humeral head is compatible with a reverse Hill-___ deformity likely reflecting chronic posterior shoulder dislocations. Impression: Appropriately positioned endotracheal tube without acute intrathoracic process.","Findings: Portable semi-upright view of the chest was provided. The endotracheal tube is seen with its tip located 5.5 cm above the carina. The lungs are hyperinflated bilaterally. No effusion or pneumothorax is seen, though the right CP angle is partially excluded. Cardiomediastinal silhouette appears grossly unremarkable. No acute bony abnormalities are seen. However, a defect within the right humeral head is compatible with a reverse Hill-___ deformity likely reflecting chronic posterior shoulder dislocations. Impression: Appropriately positioned endotracheal tube without acute intrathoracic process. Additionally, there is mild pleural effusion on the left side.","['Change measurement', 'Add contradiction', 'False prediction']"
"4753a502-c0764b72-9dfef68a-2024bf26-7d348cb1, af380c20-a7857620-9cbd8440-6b0b451b-3af932a9",57151471,18827738,Findings: The Dobbhoff tube tip is coiled in the hiatal hernia with the tip pointed upward the appearance of the lungs are unchanged. ,Findings: The nasogastric tube tip is coiled in the hiatal hernia with the tip pointed upward the appearance of the lungs are unchanged. ,"['Change name of device', 'Add repetitions', 'False prediction']"
"db391cbe-733e6800-d302fc4f-9088941c-5412983d, f158d781-2937f072-b4cabcce-b2330204-b4b8eda0",58586249,18827738,"Findings: The feeding tube has a tortuous course with the tip coiled in a hiatal hernia, pointed upward in the chest.  The cardiac and mediastinal silhouettes are unchanged. ","Findings: The endotracheal tube has a tortuous course with the tip coiled in a hiatal hernia, pointed upward in the chest.  The cardiac and mediastinal silhouettes are unchanged. There is evidence of minimal pleural effusion on the left side.","['Change name of device', 'Change to homophone', 'False prediction']"
"29847a97-543ba118-400dc446-20bb735a-56fc0b38, 52ac6adf-201696d0-8d539eec-992db677-0c6526da",59572474,18827738,"Impression: AP chest compared to ___, 1:07 p.m.:  New upper enteric drainage tube loops below the diaphragm and returns to end either in the distal esophagus or more likely hiatus hernia.  ET tube is in standard placement.  Lungs are clear and the heart is normal size.","Impression: AP chest compared to ___, 1:07 p.m.: New upper enteric drainage tube loops within the thorax and returns to end either in the distal esophagus or more likely hiatus hernia. ET tube terminates 2 cm above the carina. Lungs are clear and the heart is normal size. ET tube terminates 2 cm above the carina. ","['Change position of device', 'Add repetitions', 'False negation']"
"4dbf3ee6-55d63b13-8a456a59-195d85d2-ad0e7faf, c599ea98-5ed5ec57-e623db3a-2326ff93-5aeb931f",53115506,18837251,Impression: No previous images. No evidence of acute cardiopulmonary disease or old tuberculous disease. There is a pectus deformity.,Impression: No previous images. No evidence of cute cardiopulmonary disease or old tuberculous disease. There is no pectus deformity. There is a mild pectus deformity.,"['Add contradiction', 'Change to homophone', 'False negation']"
9ed7d647-e4937ff7-83b5ba6d-6e6b0565-04722acd,57480718,18914641,"Impression: The lung volumes are normal. The patient shows bilateral small pleural effusions seen on both the frontal and the lateral radiograph. There are signs of mild pulmonary edema. In addition, both in the retrocardiac lung region and at the bases of the right lung, subtle ill-defined parenchymal opacities are seen that could reflect pneumonia.  No abnormal hilar contours.","Impression: The lung volumes are normal. The patient shows bilateral small pleural effusions seen on both the frontal and the lateral radiograph. The patient shows bilateral small pleural effusions seen on both the frontal and the lateral radiograph. There are signs of moderate pulmonary edema. In addition, both in the retrocardiac lung region and at the bases of the right lung, subtle ill-defined parenchymal opacities are seen that could reflect pneumonia. No abnormal hilar contours. No parenchymal opacities are seen.","['Change severity', 'Add repetitions', 'False negation']"
"1de067b7-f6abe6fa-821f73e9-23feadb6-1a2bda49, fbe115e8-ec164702-1ef97452-fd82e502-5ea6806a",56495618,18920143,"Findings: The heart is normal in size.  The mediastinal and hilar contours appear within normal limits.  There is retrocardiac opacity, probably referring to opacity in the left lower lobe, although best seen on the PA view, suggesting pneumonia.  The lungs appear otherwise clear.  There is no pleural effusion or pneumothorax. Impression: Findings suggest pneumonia in the left lower lobe.","Findings: The heart is noraml in size.  The mediastinal and hilar contours appear within normal limits.  There is retrocardiac opacity, probably referring to opacity in the right lower lobe, although best seen on the PA view, suggesting pneumonia.  The lings appear otherwise clear.  There is no pleural effusion or pneumothorax.  A pacemaker is present in the thoracic area.","['Change location', 'Add typo', 'Add medical device']"
"af474c68-0fb2d552-26f4cb34-74f1c5d1-8ade5ca4, c5e42130-348838fa-de1e5517-65edefb9-a57952c4",53494114,18926499,Findings: Left lower lung opacity is re- demonstrated. Known small hemothorax blunts the left costophrenic sulcus. Heart size is normal. Known small left pneumothorax is not well seen. Non-displaced rib fractures are better seen on concurrent CT of the chest. Impression: Known small left pneumothorax seen on CT is not appreciated on the radiograph. Left lower lobe contusions are also better seen on CT.,Findings: Left lower lung opacity is re-demonstrated. Known small hemothorax blunts the left costophrenic sulcus. Heart size is normal. The central venous line is properly placed. Non-displaced rib fractures are better seen on concurrent CT of the chest. Non-displaced rib fractures are better seen on concurrent CT of the chest. Impression: Known small right pneumothorax seen on CT is not appreciated on the radiograph. Left lower lobe contusions are also better seen on CT.,"['Change location', 'Add repetitions', 'Add medical device']"
"2699223e-a2cb7790-18bf0c76-76c3652e-4e0989c7, 2b07a6ee-51d37168-a67a3218-d5454eee-2a3dbae5",52558395,18969267,"Findings: There are low lung volumes which accentuate the bronchovascular markings.  Given this, there is central pulmonary vascular engorgement and mild vascular congestion without overt pulmonary edema.No definite focal consolidation is seen.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable given differences in technique and inspiration.. Impression: Low lung volumes which accentuate the bronchovascular markings.  Given this, there may be central vascular engorgement, mild vascular congestion without overt pulmonary edema.  No lobar consolidation.","Findings: There are low lung volumes which accentuate the bronchovascular markings.  Given this, there is central pulmonary vascular engorgement and moderate vascular congestion without overt pulmonary edema.No definite focal consolidation is seen.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable given differences in technique and inspiration. A right-sided NG tube is partially visualized.. Impression: Low lung volumes which accentuate the bronchovascular markings.  Given this, there may be central vascular engorgement, mild vascular congestion without overt pulmonary edema.  No acute cardiopulmonary process.  No lobar consolidation.","['Change severity', 'Add contradiction', 'Add medical device']"
"59b5b5e5-634c07ed-17d92c27-463e06df-2f15f98a, 6f8c8386-c00f970e-7ffd5cbb-1c5c050c-802c2c88",52583675,18969267,"Findings: PA and lateral views of the chest provided.   Extensive consolidation in the left lower lobe is compatible with pneumonia.  There is mild opacity at the right lung base which in the correct clinical setting may represent additional site of pneumonia.  Cardiomediastinal silhouette appears grossly unchanged.  No large pneumothorax or effusion.  Bony structures are intact. Impression: Left lower lobe pneumonia, possible additional focus of pneumonia at the right lung base.","Findings: PA and lateral views of the chest provided. Extensive consolidation in the left lower lobe is compatible with pneumonia.  There is mild opacity at the right lung base which in the correct clinical setting may represent additional site of pneumonia. Cardiomediastinal silhouette appears grossly unchanged.  No large pneumothorax or effusion. There is a small left pleural effusion. Bony structures are intact. Impression: Left lower lobe pneumonia, possible additional focus of pneumonia at the right lung base.","['Change severity', 'Add repetitions', 'False prediction']"
"d0656529-d4148e4d-645f1099-b131dec9-41324e42, eed7debf-292679cb-a89b7580-25336d55-4e0d77ef",53255510,18969267,"Findings: Lungs are well-expanded and clear.  Thickening of the tracheal wall is better seen on recent CT of the neck.  The heart appears mildly enlarged with mild prominence of the bilateral hila consistent with mild congestive heart failure.  No pneumothorax, pleural effusion, or consolidation. Impression: Findings consistent with mild congestive heart failure.  No acute cardiopulmonary process seen.","Findings: Lungs are well-expanded and clear.  No thickening of the tracheal wall.  The heart appears severely enlarged with mild prominence of the bilateral hila consistent with mild congestive heart failure.  No pneumothorax, pleural effusion, or consolidation. Impression: Findings consistent with mild congestive heart failure.  Acute cardiopulmonary process seen.","['Change severity', 'Add contradiction', 'False negation']"
"f0fefa76-d34f1995-4d6ab311-59a4186b-11142bb7, f51f8fb4-e8a08675-4ebd7d90-deaa4b73-bfbd51e5",57377879,18969267,"Findings: The heart remains mildly enlarged but unchanged.  The aorta is tortuous.  The mediastinal and hilar contours are within normal limits.  Pulmonary vascularity is not engorged.  No focal consolidation, pleural effusion or pneumothorax is identified.  No acute osseous abnormalities detected. Impression: No acute cardiopulmonary process.","Findings: The heart remains mildly enlarged but unchanged.  The aorta is tortuous.  The mediastinal and hilar contours are within normal limits.  Pulmonary vascularity is not engorged.  No focal consolidation, no pleural effusion or pneumothorax is identified.  Chronic interstitial markings observed.  No acute osseous abnormalities detected.  The aorta is tortuous. Impression: No acute cardiopulmonary process.","['False prediction', 'Add repetitions', 'False negation']"
"dcda9207-1934e86d-ee932544-116c6360-2c689e4d, f9336862-6f5ba32d-3b88ebe0-2e1469ca-0e802f47",51076696,18971051,"Findings: The lungs remain hyperinflated. The cardiac and mediastinal silhouettes are stable with the aorta calcified and tortuous the cardiac silhouette mildly enlarged. There is aortic valve calcification. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Impression: No acute cardiopulmonary process.  No significant interval change.","Findings: The lungs remain hyperinflated. The cardiac and mediastinal silhouettes are stable with the aorta calcified and tortuous the cardiac silhouette severely enlarged. There is aortic valve calcifiction. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Impression: No acute cardiopulmonary process. No significant interval change.","['Change severity', 'Add typo', 'False negation']"
"0c088f46-a898f4d0-f2c3ebaf-d0ebdf2f-26b6a95e, 5370ba78-40e007c3-900db6e0-8e30a136-c8d87452",52465162,18971051,"Findings: AP upright and lateral views of the chest provided.  The lungs appear clear. No focal consolidation, large effusion or pneumothorax is seen. The heart appears mildly enlarged with aortic atherosclerosis noted. No bony abnormalities. No free air below the right hemidiaphragm. Impression: No acute findings.","Findings: AP upright and PA views of the chest provided.  The lungs appear clear. No focal consolidation, large effusion or pneumothorax is seen. No heart enlargement with aortic atherosclerosis noted. No bony abnormalities. No free air below the right hemidiaphragm. Impression: No focal consolidation, large effusion or pneumothorax is seen. ","['Change location', 'Add repetitions', 'False negation']"
"0469019a-6cd3631d-c792015d-a2891105-1e527c1a, f1b9387f-6abbc55f-e58e81c6-62aebe62-f030ef73",57901910,18971051,"Findings: Lungs are hyperinflated and diaphragms are flattened, consistent with COPD.  The heart is moderately enlarged.  Coronary artery calcification noted. Aortic calcification and mediastinal contours are similar to prior.  Bibasilar streaky opacities are consistent with atelectasis. No focal consolidation, pleural effusion, or pneumothorax. Impression: COPD.  Moderate cardiomegaly .Bibasilar atelectasis.  No CHF or focal consolidation identified.","Findings: Lungs are hyperinflated and diaphragms are flattened, consistent with COPD.  The heart is mildly enlarged.  Coronary artery calcification nooted. Aortic calcification and mediastinal contours are similar to prior.  Bibasilar streaky opacities are consistent with atelectasis. No focal consolidation, pleural effusion, or pneumothorax. Bibasilar consolidation is also evident. Impression: COPD.  Mild cardiomegaly .Bibasilar atelectasis.  No CHF or focal consolidation identified.","['Change severity', 'Add typo', 'False prediction']"
1d61f7d6-031720b7-8d226ade-2f1b8262-31b028fa,58408306,18971051,"Impression: As compared to the previous radiograph, no relevant change is seen. Low lung volumes. Substantial calcifications of the elongated descending aorta. Moderate cardiomegaly.  Contrast is seen in the esophagus.","Impression: As compared to the previous radiograph, no relevant change is seen. Low lung volumes. Substantial calcifications of the elongated descending aorta. Severe cardiomegaly.  Contrast is seen in the esophagus. There is evidence of mild left basal atelectasis.","['Change severity', 'Add repetitions', 'False prediction']"
"5d6c57bc-d3142da8-3564fd8f-d31a2032-4720945c, 87596a09-0a0d5ff2-883ad32d-b20af4df-b2e35d87",56011616,19001503,Findings: Frontal and lateral views of the chest were obtained.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable.  No overt pulmonary edema is seen. Impression: No acute cardiopulmonary process.,Findings: Frontal and lateral views of the chest were obtained.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  Cardiac and mediastinal silhouettes are unremarkable.  There is mild bilateral pleural effusion.  Impression: No acute cardiopulmonary process.,"['Change location', 'Add contradiction', 'False prediction']"
"7add735d-68204a28-3c833b2f-90d5f57f-3055ca58, c89ccc41-96dc86b4-1bc72c5c-42c36213-914fde11",50830008,19001598,"Findings: PA and lateral views of the chest provided.   Midline sternotomy wires and left chest wall pacer device appear unchanged.  The pacer leads extending to the region of the right atrium and right ventricle.  The lungs are clear.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is unchanged. 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 provided. Midline sternotomy wires and left chest wall vascular stent appear unchanged. The pacer leads extending to the region of the right atrium and right ventricle. The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is unchanged. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. The cardiomediastinal silhouette is unchanged. Impression: No acute intrathoracic process. The cardiomediastinal silhouette is unchanged.","['Change name of device', 'Add repetitions', 'False prediction']"
"06ca01c5-996b76a3-a56826bd-06fecf32-4a6279f9, 2c8f15e6-d3fed417-e5c8efc5-20074fce-ef925ffa",54038226,19001598,Findings: The patient is status post median sternotomy and CABG.  Left-sided dual-chamber pacemaker device is seen with leads terminating in the right atrium and right ventricle.  The heart is normal in size.  Mediastinal and hilar contours are unremarkable.  The pulmonary vascularity is normal.  Lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen.  There are no acute osseous abnormalities.  Multiple spiral radiopaque densities within the upper anterior abdominal wall are compatible with prior ventral hernia repair.  No free air is seen under the diaphragms. Impression: No acute cardiopulmonary abnormality.  No free air under the diaphragms.,Findings: The patient is status post median sternotomy and CABG. Left-sided central venous catheter is seen with leads terminating in the right atrium and right ventricle. The heart is normal in size. Mediatsinal and hilar contours are unremarkable. The pulmonary vascularity is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. No radiopaque densities are seen. No free air is seen under the diaphragms.,"['Change name of device', 'Add typo', 'False negation']"
cb6c796c-9671f70e-c1a3ebb2-cc1a326b-ed83cfa1,56307251,19001598,"Findings: Rotated positioning.  A left-sided pacemaker present, with lead tips over right atrium right ventricle.  An NG tube is present, tip extending beneath diaphragm, off film.  Surgical ___ are noted over the upper abdomen in the midline.  Linear density overlying the left lung could represent an epidural catheter, best correlated clinically.  The patient is status post sternotomy.  Note is made that the lower most sternotomy wire is fractured.  There is probable mild cardiomegaly.  There is increased retrocardiac density with a probable small left effusion and partial obscuration the left hemidiaphragm.  There is minimal atelectasis in the right cardiophrenic region.  No pneumothorax is detected.  There is pleural parenchymal thickening/scarring at the left lung apex.  The right first rib may be truncated, but is unchanged.  Aside from right base atelectasis, the right lung is grossly clear.  No gross right effusion, though minimal pleural fluid could be present on the right.  Suspect background hyperinflation/COPD.  Note made of old rib fractures seen in lower right chest, similar to ___.  Compared to ___ the heart size is larger.  Left effusion and left lower lobe collapse and/or consolidation is new and right cardiophrenic atelectasis is more pronounced. Impression: 1. Small to moderate left effusion with underlying collapse and/or consolidation of the left base. 2. Atelectasis in the right cardiophrenic region. 3. Cardiac silhouette larger compared with ___. 4. Clinical correlation is required for full assessment. 5. Fractured inferior sternotomy wire, unchanged compared with ___.","Findings: Rotated positioning.  A left-sided pacemaker present, with lead tips over right atrium right ventricle.  An NG tube is present, tip extending beneath diaphragm, off film.  Surgical ___ are noted over the upper abdomen in the midline.  Linear density overlying the left lung could represent an epidural catheter, best correlated clinically.  The patient is status post sternotomy.  Note is made that the lower most sternotomy wire is fractured.  There is probable moderate cardiomegaly.  There is increased retrocardiac density with a probable small left effusion and partial obscuration the left hemidiaphragm.  There is minimal atelectasis in the right cardiophrenic region.  No pneumothorax is detected.  There is pleural parenchymal thickening/scarring at the left lung apex.  The right first rib may be truncated, but is unchanged.  Aside from right base atelectasis, the right lung is grossly clear.  No gross right effusion, though minimal pleural fluid could be present on the right.  Suspect background hyperinflation/COPD.  Note made of old rib fractures seen in lower right chest, similar to ___.  Compared to ___ the heart size is larger.  There is probable mild cardiomegaly. Left effusion and left lower lobe collapse and/or consolidation is new and right cardiophrenic atelectasis is more pronounced.  There is minimal right lower lobe consolidation. Impression: 1. Small to moderate left effusion with underlying collapse and/or consolidation of the left base. 2. Atelectasis in the right cardiophrenic region. 3. Cardiac silhouette larger compared with ___. 4. Clinical correlation is required for full assessment. 5. Fractured inferior sternotomy wire, unchanged compared with ___.","['Change severity', 'Add repetitions', 'False prediction']"
01ac23e4-2e8ff6db-5c62d77f-fd15e7d9-9850b8c5,58253643,19001598,"Findings: Compared with the prior study, the cardiomediastinal silhouette is probably unchanged.  There is upper zone redistribution, without overt CHF.  Fractured inferior sternotomy wire again noted.  The left hemidiaphragm and left costophrenic sulcus are now better defined, suggesting interval improvement in the the left effusion and left lower lobe collapse/consolidation.  Some residual left lower lobe atelectasis persists.  On the right, there has been slight improvement in the right cardiophrenic opacity.  The small right effusion is again seen, similar to prior.  Left-greater-than-right apical pleural thickening again noted.  Fractures of the  mid/lower posterior right ribs again noted, presumably old.  No pneumothorax detected.  NG tube, pacemaker, and presumed epidural catheter again noted. Impression: Partial interval improvement in collapse/consolidation at the left base and in the right cardiophrenic opacity.  Marked improvement in left pleural effusion.  NG tube extends beneath the diaphragm off the film.  The sideport is not well delineated, but appears to lie immediately beyond the GE junction.","Findings: Compared with the prior study, the cardiomediastinal silhouette is probably unchanged.  There is upper zone redistribution, without over CHF.  Fractured inferior sternotomy wire again noted.  The left hemidiaphragm and left costophrenic sulcus are now better defined, suggesting interval improvement in the the left effusion and left lower lobe collapse/consolidation.  Some residual left lower lobe atelectasis persists.  On the right, there has been slight improvement in the right cardiophrenic opacity.  The small right effusion is again not seen.  Left-greater-than-right apical pleural thickening again noted.  Fractures of the mid/lower posterior right ribs again noted, presumably old.  No pneumothorax detected.  NG tube, pacemaker, and presumed epidural catheter again placed. Impression: Partial interval improvement in collapse/consolidation at the left base and in the right cardiophrenic opacity.  Marked improvement in left pleural effusion.  NG tube extends beneath the diaphragm off the film.  The side port is not well delineated, but appears to lie immediately beyond the GE junction.","['Change position of device', 'Change to homophone', 'False negation']"
"28a5d454-4f6e8afe-c96281bb-c685dc86-984117dc, 72335c83-f8df103c-90862052-8739001b-b46dd5c7",54985891,19017542,"Findings: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. Impression: Normal chest radiographs.","Findings: There is no focal consolidation, pleural effusion, or pulmonary edema. Hyperinflation of the lungs is noted. The cardiomediastinal contour is normal. Surgical clips are noted in the left hemithorax. Impression: Nowmal chest radiographs.","['Add medical device', 'Add typo', 'False prediction']"
"42d1d942-0aefbde6-c54835e3-15294715-8113041e, 7fc62039-7d07c76e-bed2b1d5-5c06a0b3-c6684d07",52704228,19045192,Impression: Mild volume overload.,Impression: Moderate volume overload.,"['Change severity', 'Change to homophone', 'False negation']"
"3694d980-dfbab221-6c09fb9f-436a7848-8fc1c1f9, 51ccd2f2-81bd59a9-10d57832-76910dd4-9757fbf3",54353558,19045192,Findings: Low lung volumes accentuate the cardiomediastinal contours and result in crowding of bronchovascular structures.  There are no focal areas of consolidation to suggest the presence of pneumonia.  .  Cardiomediastinal silhouette is stable.   No pleural effusion or pneumothorax is seen. Impression: No acute cardiopulmonary process.,Findings: Lowe lung volumes accentuate the cardiomediastinal contours and result in crowding of bronchovascular structures.  There are know focal areas of consolidation to suggest the presence of pneumonia.  .  Cardiomediastinal silhouette is stable.   No pleural effusion or pneumothorax is scene.  A centrally placed pacemaker is noted.,"['Change to homophone', 'Add typo', 'Add medical device']"
ca35468b-f8c1177c-cb354cc1-79281df8-b354b74d,52498426,19079797,"Findings: Portable supine chest film of ___ at 04:14 is submitted. Impression: Patient is status post median sternotomy with postoperative cardiac and mediastinal contours. The aorta is somewhat unfolded and tortuous. Lung volumes are low with faint opacities at both bases most likely representing patchy atelectasis in this setting of low lung volumes.  No evidence of pulmonary edema, pleural effusions or pneumothorax.","Findings: Portable supine chest film of ___ at 04:14 is summbtted. Impression: Patient is status post median sternotomy with postoperative cardiac and mediatinal contours. The aorta is somewatt unfolded and tortuous. Lung volumes are low with feint opacities at both bases most likely representing patchy atelectasis in this setting of loo lung volumes.  No evidence of pulmonary edema, pleural effusions or pneumothorax. A left-sided central venous line is present.","['Add typo', 'Change to homophone', 'Add medical device']"
ae4d45fc-815b6cd8-d29c078f-ad849410-cbb8cf47,51197801,19109135,Findings: The cardiomediastinal silhouette is normal.  There is bronchovascular crowding in the left lower lobe consistent with atelectasis.  Otherwise the lungs are clear.  No pleural abnormalities.  No pneumothorax. The visualized bones and soft tissues are normal.  The new right port tip is in the right atrium. Impression: 1. No pneumonia.  2.  Atelectasis in the left lower lobe.,Findings: The cardiomediastinal silhouette is normal.  There is bronchovascular crowding in the lower right lobe consistent with atelectasis.  Otherwise the loans are clear.  No pleural abnormalities.  No pneumothorax. The visualized bones and soft tissues are normal.  No port tip is seen. Impression: 1. No pneumonia.  2.  No atelectasis.,"['Change location', 'Change to homophone', 'False negation']"
"83dd9edd-80c04183-0af2e87e-2ce059ea-1fe0f5e8, d991387d-c47df4dc-71e59cb0-adf1a788-5c14659b",57563883,19109135,"Findings: The lungs are clear.  There is no consolidation, effusion or edema. Cardiac silhouette is within normal limits.  There is somewhat increased density of the aortic arch which may be technical however repeat with PA technique is suggested to further evaluate.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.  Apparent increased density projecting over the aortic arch, potentially technical however further clarification with PA film is suggested to confirm.","Findings: The lungs are clear. No increased density of the aortic arch. Cardiac silhouette is within normal limits. There is somewhat increased density of the aortic arch which may be technical however repeat with PA technique is suggested to further evaluate. No acute osseous abnormalities. Impression: No acute cardiopulmonary process. Apparent increased density projecting over the aortic arch, potentially technical however further clarification with PA film is suggested to confirm infiltration.","['False negation', 'Add contradiction', 'False prediction']"
e3bf86d4-2c188caf-80a8b447-d21fd5c8-83251226,50417837,19112585,"Findings: Portable semi-erect chest radiograph ___ at 17:45 is submitted. Impression: The right internal jugular Swan-Ganz catheter and nasogastric tube are unchanged in position.  Endotracheal tube has its tip approximately 5 cm above the carina.  The heart remains stably enlarged.  Overall, there is improving aeration in both lungs suggestive of resolving moderate pulmonary edema.  Retrocardiac consolidation persists likely reflecting lobar collapse in the setting of a pleural effusion.  Pneumonia in the retrocardiac area cannot be excluded.  The and right pleural effusion.  Patient is status post median sternotomy for CABG.  No pneumothorax.","Findings: Portable semi-erect chest radiograph ___ at 17:45 is submitted. Impression: The right internal jugular Swan-Ganz catheter and nasogastric tube are unchanged in position.  Endotracheal tube has its tip approximately 6 mm above the carina.  The heart remains stably enlarged.  Overall, there is improving aeration in both lungs suggestive of resolving moderate pulmonary edema.  Retrocardiac consolidation persists likely reflecting lobar collapse in the setting of a pleural effusion.  Pneumonia in the retrocardiac area cannot be excluded.  There is no right pleural effusion.  Pacemaker is noted in the left upper chest.  Patient is status post median sternotomy for CABG.  No pneumothorax.","['Change measurement', 'Add contradiction', 'Add medical device']"
98e92146-cf132a6d-d90a4651-242ac169-fea4e9f8,50907555,19112585,"Impression: There is a Swan-Ganz catheter with the distal lead tip in the main pulmonary artery.  Endotracheal tube tip is 4.8 cm above the carina, appropriately sited.  Mediastinal drains and chest tubes are seen. There is an intra-aortic balloon pump whose tip is low and could be advanced 3 cm for more optimal placement.  There is a left retrocardiac opacity.  There are no pneumothoraces.  There is atelectasis at the lung bases.  There is mild prominence of the pulmonary vascular markings.","Impression: There is a Swan-Ganz catheter with the distal lead tip in the main pulmonary artery. Endotracheal tube tip is 5.7 cm above the carina, appropriately sited. Mediastinal drains and chest tubes are seen. There is an intra-aortic balloon pump whose tip is low and could be advanced 30 mm for more optimal placement. There is a left retrocardiac opacity. There are no pneumothoraces. There is a left retrocardiac opacity. There is atelectasis at the lung bases. There is mild prominence of the pulmonary vascular markings with interstitial edema.","['Change measurement', 'Add repetitions', 'False prediction']"
2eb2c117-a495b0ea-466306d2-d1850d33-09918dc6,51263600,19112585,"Impression: In comparison with the study of ___, there is little change in the monitoring and support devices, which appear to be in good position.  Continued enlargement of the cardiac silhouette with layering bilateral effusions, more prominent on the right, and bibasilar compressive atelectasis.","Impression: In comparison with the study of ___, there is little change in the monitoring and support devices, which appear to be in good position.  There is a central venous line in place. Continued enlargement of the cardiac silhouette with layering bilateral effusions, more prominent on the left, and bibasilar compressive atelectasis. In comparison with the study of ___, there is little change in the monitoring and support devices, which appear to be in good position.","['Change location', 'Add repetitions', 'Add medical device']"
ed33263a-e35f6636-9c2018a1-259dfa81-3022c5b4,51825039,19112585,"Findings: Portable semi-erect chest radiograph ___ at 12:19 is submitted. Impression: Interval intubation with the endotracheal tube having its tip approximately 3.5 cm above the carina.  The feeding tube courses below the diaphragm with the tip not identified.  The right internal jugular Swan-___ catheter continues to have its tip in the right pulmonary outflow tract.  There are layering effusions, right greater than left, with associated bibasilar opacities suggestive of atelectasis.  Increasing retrocardiac consolidation likely reflects left lower lobe collapse.  There is stable bilateral diffuse airspace process suggestive of moderate pulmonary edema. No pneumothorax.  Status post median sternotomy with stable cardiac enlargement.","Findings: Portable semi-erect chest radiograph ___ at 12:19 is submitted. Impression: Interval intubation with the endotracheal tube having its tip approximately 3 mm above the carina.  The feeding tube courses below the diaphragm with the tip clearly identified.  The right internal jugular pacemaker continues to have its tip in the right pulmonary outflow tract.  There are no layering effusions, right greater than left, with associated bibasilar opacities suggestive of atelectasis.  Increasing retrocardiac consolidation likely reflects left lower lobe collapse.  There is stable bilateral diffuse airspace process suggestive of moderate pulmonary edema. No pneumothorax.  Status post median sternotomy with stable cardiac enlargement.","['Change measurement', 'Add contradiction', 'Add medical device']"
5cc68f09-82923919-b78e0dc5-7b2ffc0a-64b53314,51995292,19112585,Impression: Comparison to ___.  The aortic balloon pump was removed.  Newly placed.  Feeding tube shows a normal course.  The tip is not visualized on the image.  No relevant change in appearance of the cardiac silhouette and the lung parenchyma.,Impression: Comparison to ___.  The aortic catheter was removed.  Newly placed.  Feeding tube shows a normal coarse.  The tip is not visualized on the image.  No relevant change in appearance of the cardiac silhouette and the lung parenchyma.  A recently inserted pacemaker is in place.,"['Change position of device', 'Change to homophone', 'Add medical device']"
bcdccbea-2977c6e2-95eeb72a-3a7b6a89-ce41591a,52350751,19112585,"Findings: Portable semi-erect chest radiograph ___ at 07:33 is submitted. Impression: Right internal jugular Swan-Ganz catheter, endotracheal tube and nasogastric tube are unchanged in position.  Status post median sternotomy with stable postoperative cardiac and mediastinal enlargement.  Layering bilateral effusions with bibasilar patchy opacities likely representing lower lobe atelectasis.  Prominent perihilar vasculature likely reflects combination of low lung volumes and residual perihilar edema.  No pneumothorax.","Findings: Portable semi-erect chest radiograph ___ at 07:33 is submitted. Impression: Right internal jugular central venous catheter, endotracheal tube and nasogastric tube are unchanged in position.  Status post median sternotomy with unstable postoperative cardiac and mediastinal enlargement.  Layering bilateral effusions with bibasilar patchy opacities likely representing lower lobe atelectasis.  Prominent perihilar vasculature likely reflects pulmonary hypertension.  No pneumothorax. Additionally, a left-sided AICD device is present.","['Change name of device', 'Add contradiction', 'Add medical device']"
d6b8c37f-5e300c14-2ef5df39-9a6aaed8-96b5e681,54898602,19112585,Findings: There are bibasilar opacities which are most likely due to atelectasis in the setting of relatively low lung volumes.  The lungs are otherwise clear.  There is no pneumothorax.  The cardiomediastinal silhouette is within normal limits. No visualized acute osseous abnormality. Impression: No acute cardiopulmonary process.,Findings: There are bibasilar opacities which are most likely due to atelectasis in the setting of relatively low lung volumes.  The lungs are otherwise clear.  There is no pneumothorax.  The cardiomediastinal silhouette is within normal limits.  A pacemaker is noted in the left chest. No visualized acute osseous abnormality. Impression: Mild cardiomegaly with pulmonary edema and no acute cardiopulmonary process.  There is no pneumothorax.,"['Add contradiction', 'Add repetitions', 'Add medical device']"
a5ccbb4c-fe240b55-19cfa1a7-48bc782d-22e7841a,55060173,19112585,"Findings: Portable semi-erect chest film ___ at 05:49 Impression: Feeding tube courses below the diaphragm with tip not identified. Right internal jugular Swan-Ganz catheter has its tip in the right pulmonary outflow tract.  Status post median sternotomy with expected stable postoperative cardiac and mediastinal contours.  Interval worsening of moderate pulmonary edema; an infectious process would be less likely.  Probable layering effusions, left greater than right.  No pneumothorax.","Findings: Portable semi-erect chest film ___ at 05:49 Impression: Feeding tube courses below the diaphragm with tip not identified. Right internal jugular PICC line has its tip in the right pulmonary outflow tract. Status post median sternotomy with expected stable postoperative cardiac and mediastinal contours. Interval worsening of moderate pulmonary edema; an infectious process wood be less likely. Probable layering effusions, left greater than right. No pneumothorax. A left-sided ICD device is present with leads terminating in the right ventricle.","['Change name of device', 'Change to homophone', 'Add medical device']"
6e0c3a9d-b6a3aad7-a1167a4c-7aa2cbf2-f2410dc0,55332191,19112585,"Impression: Previous postoperative widening of the cardiomediastinal silhouette has improved, pulmonary edema has resolved.  Combination of moderate right pleural effusion and atelectasis and severe left lower lobe atelectasis are unchanged. Intra-aortic balloon pump is in standard position, as are endotracheal tube, esophageal drain, Swan-Ganz catheter in the right pulmonary artery, midline and left pleural drains.  No pneumothorax.","Impression: Previous postoperative widening of the cardiomediastinal silhouette has improved, moderate pulmonary edema persists. Combination of moderate right pleural effusion and atelectasis and severe left lower lobe atelectasis are unchanged. Intra-aortic balloon pump is in standard position, as are endotracheal tube, chest drainage tube, Swan-Ganz catheter in the right pulmonary artery, midline and left pleural drains. No pneumothorax. Mild hyperinflation of the lungs is observed.","['Change name of device', 'Add contradiction', 'False prediction']"
"2245b56c-bef29181-03fb974d-088f889f-31d7c6e7, 3e8150f5-16ec8826-edb42d0e-18f9504b-dc42097f",55747398,19112585,"Impression: Mild pulmonary edema and moderate postoperative widening of the upper mediastinum are unchanged since ___ at 04:05.  The intra-aortic balloon pump has been partially withdrawn, now in standard placement midway between the upper margin of the left main bronchus and the aortic apex.  Moderately severe left lower lobe atelectasis and small right pleural effusion have increased.  Left pleural drain and mediastinal drains are still in place. ET tube, esophageal drainage tube, right internal jugular line, Swan-Ganz catheter are all in standard placements unchanged.  No pneumothorax.","Impression: Mild pulmonary edema and moderate postoperative widening of the upper mediastinum are unchanged since ___ at 04:05.  The intra-aortic balloon pump has been partially withdrawn, now in standard placement almost touching the aortic arch.  Moderately severe left lower lobe atelectasis and small right pleural effusion have increased.  Left pleural drain and mediastinal drains are stilll in place. ET tube, esophageal drainage tube, right internal jugular line, Swan-Ganz catheter are all in standard placements unchanged.  No evidence of pneumonia.","['Change position of device', 'Add typo', 'False prediction']"
2d9ed611-bc3073f4-d4e08942-1248dbfd-bacafcb5,55937978,19112585,"Impression: As compared to the previous radiograph, the chest tubes and mediastinal drains have been removed.  There is no evidence for the presence of a pneumothorax.  The other monitoring and support devices, including the intra-aortic balloon pump are in unchanged correct position.  Mild right-sided pleural effusion.  Mild fluid overload but no overt pulmonary edema.  Unchanged bilateral areas of atelectasis.  No pneumothorax.","Impression: As compared to the previous radiograph, the chets tubes and mediastinal drains have been removed. There is no evidence for the presence of a pneumothorax. The other monitoring and support devices, including the intra-aortic balloon pump are in unchanged correct position. Moderate right-sided pleural effusion. Mild fluid overload but no overt pulmonary edema. New bilateral areas of atelectasis. No pneumothorax.","['Change severity', 'Add typo', 'False prediction']"
"8a5ed9d8-5074c4ff-013c2e7c-54c8d59c-8dc24871, d3dee386-e9b6900f-6ef74044-1b87f5dc-768f423a",56896133,19112585,"Impression: In comparison with the study of ___, the monitoring and support devices are unchanged, with the nasogastric and Dobhoff tubes extending at least to the distal stomach.  The Dobhoff tube appears to take a downward course, suggesting that extends into the duodenum. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive basilar atelectasis, more prominent on the right.","Impression: In comparison with the study of ___, the monitoring and support devices are unchanged, with the nasogastric and Dobhoff tubes extending at least to the distal stomach. The Dobhoff tube terminates in the gastric antrum. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive basilar atelectasis, more prominent on the right. The Dobhoff tube terminates in the gastric antrum. ET tube is seen in the trachea.","['Change position of device', 'Add repetitions', 'Add medical device']"
9f997d60-cf0331fe-18c6ed7f-d56768f9-1fac8323,58052191,19112585,"Findings: Portable semi-erect chest radiograph ___ at 14:12 is submitted. Impression: There has been interval removal of the right internal jugular Swan-Ganz catheter with the introducer sheath remaining in place.  Interval placement of a left internal jugular Swan-Ganz catheter which has its tip in the right pulmonary artery.  A nasogastric tube is seen coursing below the diaphragm with the tip not identified.  No pneumothorax is seen.  There continues to be perihilar fullness and pulmonary vascular indistinctness consistent with mild pulmonary edema.  Overall, aeration has improved at the right base but the left basilar opacity is unchanged and likely reflects lower lobe atelectasis in the setting of a layering effusion.  Status post median sternotomy with stable postoperative cardiac and mediastinal contours.","Findings: Portable semi-erect chest radiograph ___ at 14:12 is submitted. Impression: There has been interval removal of the right internal jugular PICC line with the introducer sheath remaining in place.  Interval placement of a left internal jugular Swan-Ganz catheter which has its tip in the right pulmonary artery.  A nasogastric tube is seen coursing below the diaphragm with the tip not identified.  No pneumothorax is seen.  There continues to be perihilar fullness and pulmonary vascular indistinctness consistent with mild pulmonary edema.  Overall, aeration has improved at the right base but the left basilar opacity is unchanged and likely reflects lower lobe atelectasis in the setting of a layering effusion.  Status post median sternotomy with stable postoperative cardiac and mediastinal contours.  A central venous line is present along the right chest.","['Change name of device', 'Add repetitions', 'Add medical device']"
f1f2b384-1ed8cf77-dbdb7e4c-c5c50a77-ffb579d3,58996566,19112585,Impression: Mild to moderate pulmonary edema has improved.  Cardiomegaly is stable.  Swan-Ganz catheter tip is in the proximal right pulmonary artery.  Sternal wires are aligned.  Enteric tube tip is out of view below the diaphragm.  There is no evident pneumothorax.  If any there is a small right effusion.,Impression: Mild to moderate pulmonary edema has improved.  Cardiomegaly is worse.  Swan-Ganz catheter tip is in the proximal write pulmonary artery.  Sternal wires are aligned.  Enteric tube tip is out of view below the diaphragm.  There is no evident pneumothorax.  If any there is a small right effusion.  Central venous line is present.,"['Change severity', 'Change to homophone', 'Add medical device']"
"a09b466b-9724e5f0-d2ac9a43-4acb44c4-dac93e07, bccf39d1-b1198fdc-c79b3778-9ae6e91c-8804d3ac",59975773,19112585,Impression: Moderate cardiomegaly is stable.  Widening mediastinum is grossly unchanged.  Moderate to severe pulmonary edema has worsened.  Small to moderate bilateral effusions have increased with increasing adjacent atelectasis.  ET tube is in standard position.  Swan-Ganz catheter tip is in the main pulmonary artery.  Enteric tube tip is out of view below the diaphragm.  Sternal wires are aligned,Impression: Moderate cardiomegaly is stable.  Widening mediastinum is grossly unchanged.  Small bilateral effusions have increased with increasing adjacent atelectasis.  ET tube is in appropriate position. Right-sided dual lumen Port-A-Cath terminates in the right atrium.  Swan-Ganz catheter tip is in the right pulmonary artery.  Enteric tube tip is slightly visible below the diaphragm.  Sternal wires are aligned,"['Change position of device', 'Add contradiction', 'Add medical device']"
49fbba93-49346260-5c3cc7e9-ad087106-f84c1739,59202016,19128767,"Findings: Multifocal areas of consolidation are present, mostly in the right lower lobe, with a lesser degree of involvement in the right middle lobe and posterior segment left lower lobe.  Heart size, mediastinal and hilar contours are normal.  There are questionable small pleural effusions on the lateral view. Impression: Multifocal pneumonia.  Recommend followup chest x-ray 4 weeks after completion of antibiotic therapy.  Findings entered in radiology communications dashboard on date of study.","Findings: Multifocal areas of consolidation are present, mostly in the right lower lobe, with a lesser degree of involvement in the right middle lobe and posterior segment left lower lobe.  Heart size, mediastinal and hilar contours are normal.  Their are questionable small pleural effusions on the lateral view. Impression: No pneumonia.  Recommend followup chest x-ray 4 weeks after completion of antibiotic therapy.  Findings entered in radiology communications dashboard on date of study.","['Change severity', 'Change to homophone', 'False negation']"
eee03001-19c73647-bfb514b6-dd1597b1-3379cbc6,58485003,19144092,"Findings: There are right lower lobe and left lower lobe consolidations as well as bilateral mild pleural effusions, suggestive of an infectious process. The heart size is normal.  The mediastinal and hilar contours are unremarkable.  There is no evidence of pneumothorax.  The osseous structures are unremarkable. Impression: Right lower lobe and left lower lobe pneumonia.","Findings: There are left lower lobe and left lower lobe consolidations as well as bilateral mild pleural effusions, suggestive of an infectious process. The heart size is normal. The mediastinal and hilar counters are unremarkable. There is no evidence of pneumothorax. The osseous structures are unremarkable. Impression: No pneumonia.","['Change location', 'Change to homophone', 'False negation']"
"6045dc58-d2828d46-c4119b31-d6945588-c87489d8, bf6eb378-707fd26c-5cd1b5e6-c5ded073-83c8bd46",50127791,19175595,"Findings: In comparison with study of ___, there is little change in the degree of left pneumothorax.  Persistent atelectatic changes are seen at the left base.  On the lateral view, there is an air-fluid level posteriorly, consistent with some degree of hydropneumothorax, possibly loculated.  Dilatation of gas-filled loops of bowel is consistent with adynamic ileus. ","Findings: In comparison with study of ___, there is little change in the degree of right pneumothorax. Persistent atelectatic changes are seen at the left base. On the lateral view, there is an air-fluid level posteriorly, consistent with some degree of hydropneumothorax, possibly located. There is a large pulmonary nodule in the right lung.","['Change location', 'Change to homophone', 'False prediction']"
"1a69741a-aa169990-9b05cf75-eb6c6d2e-46fef0ae, 6136ff46-3dfea390-1639cd6f-50dc91c7-f1069f7b",52014921,19175595,"Findings: The heart size is normal.  Mediastinal and hilar contours are normal.  The pulmonary vascularity is normal.  There is minimal streaky opacity within the left lower lobe, likely reflective of atelectasis.  Blunting of the left costophrenic angle on the lateral view posteriorly suggests a small left pleural effusion.  No right-sided pleural effusion or pneumothorax is definitively seen.  There are mildly displaced fractures of the left lateral ___ and likely 9th ribs. Impression: Mildly displaced fractures of the left ___ and likely ___ lateral ribs.  Mild left lower lobe atelectasis and probable trace left pleural effusion.","Findings: The heart size is normal.  Mediastinal and hilar contours are normal.  The pulmonary vascularity is normal.  There is minimal streaky opacity within the left lower lobe, likely reflective of atelectasis.  No blunting of the left costophrenic angle is seen on the lateral view posteriorly.  No right-sided pleural effusion or pneumothorax is definitively seen.  There are mildly displaced fractures of the left lateral ___ and likely 9th ribs. Impression: Mildly displaced fractures of the left ___ and likely ___ lateral ribs.  Mild left lower lobe atelectasis, and no pleural effusion.","['Change severity', 'Add contradiction', 'False negation']"
"468a1675-344a56da-7cf12651-0344086a-8454a87a, c4f34ece-6df384b0-73e1b938-fa6f5e5a-3c19569e",52445151,19175595,"Impression: AP chest compared to ___:  Consolidation at the base of the left lung which worsened from ___ through ___ at 12:08 a.m. is unchanged.  This could be atelectasis alone or aspiration.  A small amount of fluid has accumulated in the left hemithorax with persistence of the moderate left pneumothorax, unchanged in volume since it was first detectable radiographically on ___.  Heart size is top normal.  The fractures of the right middle ribs laterally are probably chronic.","Impression: AP chest compared to ___:  Consolidation at the base of the right lung which worsened from ___ through ___ at 12:08 a.m. is unchanged. This could be atelectasis alone or aspiration. A small amount of fluid has accumulated in the right hemithorax with persistence of the moderate left pneumothorax, unchanged in volume since it was first detectable radiographically on ___. Heart size is top normal. A small amount of fluid has accumulated in the right hemithorax with persistence of the moderate left pneumothorax, unchanged in volume since it was first detectable radiographically on ___. The fractures of the right middle ribs laterally are probably chronic. There is a central venous line in appropriate position.  ","['Change location', 'Add repetitions', 'Add medical device']"
"6f50e12e-0dcd33c3-ae2d6fa8-24696640-f1e54f40, 756771db-5805a998-08667cd8-f505ae42-22e2414b",52873579,19175595,"Findings: There is no longer an apical component to the previously described left pneumothorax.  A small-to-moderate left pleural effusion persists on the left with few areas of streaky associated atelectasis.  An air-fluid level best seen on the lateral view indicated some degree of hydropneumothorax.  There is no evidence of diaphragmatic flattening or mediastinal shift.  Right mid rib fractures are nondisplaced, not well appreciated on the current exam. Impression: Resolution of apical portion of left pneumothorax with lower left hydropneumothorax; no evidence of tension.",Findings: There is a large apical component to the previously described left pneumothorax. A large left pleural effusion persists on the left with few areas of streaky associated atelectasis. An air-fluid level best seen on the lateral view indicated some degree of hydropneumothorax. There is evidence of diaphragmatic flattening or mediastinal shift. Right mid rib fractures are nondisplaced. Impression: Worsening apical portion of left pneumothorax with lower left hydropneumothorax; no evidence of tension.,"['Change severity', 'Add contradiction', 'False prediction']"
"deb37379-032473c6-622ef262-94526850-6baecd52, f9e9f170-19e813d2-a7c0fbe9-2610a969-b3913c3c",54079675,19175595,"Findings: In comparison to earlier study of this date, there are lower lung volumes with little change in the degree of small-to-moderate left pneumothorax.  Opacification in the retrocardiac region is consistent with atelectasis.  Right lung is clear and there is no evidence of vascular congestion. ","Findings: In comparison to earlier study of this date, there are lower lung volumes with little change in the degree of small-to-severe left pneumothorax. Opacification in the retrocardiac region is consistent with atelectasis. Right lung is clear and a small pleural effusion is noted. Right lung is clear and a small pleural effusion is noted.","['Change severity', 'Add repetitions', 'False prediction']"
"6c981cc4-bd356c27-7aefca93-0d0cbb87-f8d25f29, 9113059a-7f7d2278-1cf93415-c8add273-78e36ba7",54164846,19245983,"Findings: The cardiomediastinal and hilar contours are normal.  There is no focal consolidation, pleural effusion or pneumothorax. Impression: No acute cardiopulmonary process.",Findings: The cardiomediastinal and hilar contours are normal. There are no focal consolidation or pleural effusion noted. The lungs show evidence of right lower lobe pneumonia. Impression: No acute cardiopulmonary process.,"['False negation', 'Change to homophone', 'False prediction']"
"98c8ef8a-af44f96c-04eb8005-a3977408-9c9fd5f2, daad30b9-976a0ab4-d4b667cf-38d005b1-ec3a483a",56562756,19245983,"Findings: The lungs are clear.  There is no consolidation, effusion, or edema.  The cardiomediastinal silhouette is within normal limits.  No acute osseous abnormalities. Impression: No acute cardiopulmonary process.","Findings: The lings are clear.  There is no consolidation, affusion, or edema.  The cardiomediastinal silhouette is with in normal limits.  Right-sided subsegmental atelectasis is present. Impression: Now acute cardiopulmonary process.","['Add typo', 'Change to homophone', 'False prediction']"
48003dc6-c6038610-25596c4c-016c4acd-3d08f408,51170210,19254322,"Impression: Pneumothorax unchanged, dense atelectasis left base.","Impression: Pneumothorax unchanged, dense atelectasis right base. A pacemaker is present.","['Change location', 'Add repetitions', 'Add medical device']"
89f3149c-f6f200a1-5dbedfd8-3206d746-7401ee75,54219769,19254322,"Impression: Postoperative subcutaneous emphysema in the left anterior and lateral chest wall extends up the axilla to the neck.  I do not believe there is appreciable pneumothorax, left apical pleural tube crosses the left chest obliquely.  A uniform opacity also marginated obliquely in the left upper hemithorax is probably loculated pleural fluid or blood.  Left lower lobe is mildly atelectatic.  Right lung is low in volume but well aerated.  Heart size is normal.  Dr. ___ was paged at 2:15, 1 minute after the findings were recognized, and again at 2:25pm and 4:45pm.","Impression: Postoperative subcutaneous emphysema in the left anterior and lateral chest wall extends up the axilla to the nec. I do not believe there is appreciable pneumothorax, left apical pleural tube crosses the right chest obliquely. No uniform opacity is marginated obliquely in the left upper hemithorax. Left lower lobe is mildly atelectatic. Right lung is low in volume but well aeraated. Heart size is normal. Dr. ___ was paged at 2:15, 1 minut after the findings were recognized, and again at 2:25pm and 4:45pm.","['Change position of device', 'Add typo', 'False negation']"
6552c73b-641178aa-c4ebf4fa-a12d5896-b0902876,54752436,19254322,"Impression: AP chest compared to ___.  No pneumothorax, pleural effusion, or mediastinal widening.  Aside from left basal lung nodule, lungs are clear.  Heart size normal.  Ascending thoracic aorta is tortuous but not appreciably dilated, as seen on chest CT ___, which also showed extensive pleural calcification, not evident on the conventional radiographs.","Impression: AP chest compared to ___. No pneumothorax, pleural effusion, or mediastinal widening. Aside from left basal lung nodule, lungs are clear. Heart size normal. Ascending thoracic aorta is tortuous but severely dilated, as seen on chest CT ___, which also showed extensive pleural calcification, not evident on the conventional radiographs. No pneumothorax, pleural effusion, or mediastinal widening. There is a small right-sided pleural effusion.","['Change severity', 'Add repetitions', 'False prediction']"
"06b75236-ced07b2e-79c9e581-f467c788-1f9b791f, b44db4cf-00ed4571-ed3e3788-243f9191-7dbe505b",57036456,19254322,"Findings: The cardiomediastinal silhouette is difficult to assess given posttreatment changes in left lung.  Mediastinal surgical clips are noted.  There is opacity in the left lower lung with elevation of the left hemidiaphragm and blunting of left lateral CP angle with left lateral pleural thickening.  This correlates to findings on a CT chest from ___, likely relating to post treatment changes in the left lung.  The left upper lung is grossly clear.  The right lung is mildly hypoinflated but clear.  There is no pneumothorax.  There is no right pleural effusion.  There is no pulmonary edema. Impression: Post-treatment changes in the left lung correlate to findings from prior CT chest from ___, not appreciably changed.  No evidence of superimposed acute cardiopulmonary process.","Findings: The cardiomediastinal silhouette is difficult to assess given posttreatment changes in left lunga.  Mediastinal surgical drains are noted.  No opacity seen.  This correlates to findings on a CT chest from ___, likely relating to post treatment changes in the left lung.  The left upper lung is grosly clear.  The right lung is mildly hypoinflated but cleer.  There is no pneumothorax.  There is no right pleural effusion.  There is no pulmonary edema. Impression: Post-treatment changes in the left lung correlate to findings from prior CT chest from ___, not appreciably changed.  No evidence of superimposed acute cardiopulmonary process.","['Change name of device', 'Add typo', 'False negation']"
07433a77-6618a230-fa1a2487-25bdc989-873a79da,57699153,19254322,"Impression: AP chest compared to ___:  Small-to-moderate left pleural effusion has redistributed, slightly larger.  There is no appreciable left pleural effusion and atelectasis is restricted to the base of the postoperative left lung.  Right lung is clear.  Bulge in the mediastinum in the region of the ascending aorta is unexplained.  I had repeated chest radiograph later this afternoon to make sure that there is no mediastinal fluid accumulation.  Moderate-to-severe gaseous distention of the stomach, with air and fluid, present with no visible nasogastric tube.  Subcutaneous emphysema in the left chest wall is relatively stable.  Dr. ___ was paged at 11:20 a.m. as soon as the findings were recognized.","Impression: AP chest compared to __:  Small-to-moderate left pleural effusion has redistributd, slightly larger.  Ther is no appreciable left pleural effusion and atelectasis is restricted to the base of the postoperative left lung.  Right lung is clear.  Bulge in the mediastinum in the region of the ascending aorta is unexplained.  I had repeated chest radiograph later this afternoon to make sure that there is no mediastinal fluid accumulation. Moderate-to-severe gaseous distention of the stomach, with air and fluid, present with no visible nasogastric tube.  Since this morning a central venous line was inserted and confirmed to be in the correct position.  Subcutaneous emphysema in the left chest wall is relatively stable.  Dr. ___ was paged at 11:20 a.m. as son as the findings were recognized.","['Change position of device', 'Add typo', 'Add medical device']"
"01751cc7-4bb8333e-14073a53-1c074d9c-32d10cd5, 59f5f47e-bd8f07fb-0a0cd227-04f336ca-695f4502",52617198,19303480,"Findings: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. There are mild multilevel degenerative changes in the thoracic spine. Impression: No acute cardiopulmonary abnormality.","Findings: Cardiac, mediastinal and hilar contours are normal. Lungs are clera. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. There are moderate multilevel degenerative changes in the thoracic spine. Impression: No acute cardiopulmonary abnormality.","['Change severity', 'Add typo', 'False negation']"
f97a3cfc-72288627-14f2608a-5806db3f-293a557c,50338064,19358609,"Impression: There has been interval increase in right lower lobe consolidations /pneumonia.  Right apical subpleural consolidation is more conspicuous than before, part of it is chronic scarring.  There appears to be also vascular congestion.  Right pleural effusion has increased.  Multifocal opacities in the left lung are grossly unchanged.  There is evidence of loss of volume in the left lung, distortion of the lung architecture and shifting of the cardiomediastinal structures to the left.  ET tube is in standard position.  Right PICC tip is in the lower SVC.  NG tube tip is in the stomach","Impression: There has been interval increase in right lower lobe consolidations /pneumonia.  Right apical subpleural consolidation is more conspicuous than before, part of it is chronic scarring.  There appears to be also vascular congestion.  Right pleural effusion has increased.  Multifocal opacities in the left lung are grossly unchanged.  There is evidence of loss of volume in the left lung, distortion of the lung architecture and shifting of the cardiomediastinal structures to the left.  Chest drainage tube is in standard position.  Right PICC tip is in the lower SVC.  NG tube tip is in the stomach.  ET tube is in standard position.","['Change name of device', 'Add repetitions', 'Add medical device']"
83e5f26d-15cf2429-72ba60ba-801c754d-2a8d1fbc,50510466,19358609,"Findings: As compared to the previous radiograph, the post-surgical left lung is unchanged.  In the right lung, there is an increase in interstitial markings, notably at the lung bases and in the right lower lung.  In addition, there is blunting of the right costophrenic sinus, suggesting the presence of a small right pleural effusion.  The size of the cardiac silhouette is unchanged.  The findings in the right lung might represent a combination of pulmonary edema and pneumonia.  At the time of observation and dictation, 1:14 p.m., on ___, the referring physician, ___. ___, was paged for notification and the findings were subsequently discussed over the telephone. ","Findings: As compared to the previous radiograph, the post-surgical left lung is mildly worse.  In the right lung, there is an increase in interstitial markings, notably at the lung bases and in the right lower lung.  In addition, there is blunting of the right costophrenic sinus, suggesting the presence of a small right pleural effusion.  The size of the cardiac silhouette is mildly enlarged.  The findings in the right lung might represent a combination of pulmonary edema and pneumonia.  A mass is noted in the upper left lung.  At the time of observation and dictation, 1:14 p.m., on ___, the referring physician, ___. ___, was paged for notification and the findings were subsequently discussed over the telephone.  ","['Change severity', 'Add contradiction', 'False prediction']"
19acab4d-9db0ca67-2cd73a86-53c399fe-f5fabe3e,50546404,19358609,"Impression: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends to the mid body of the stomach with the side port distal to the esophagogastric junction.  Otherwise little change.","Impression: In comparison with the earlier study of this date, there has been placement of a feeding tube that extends to the mid body of the stomach with the side port distal to the esophagogastric junction.  Otherwise little change. A small pleural effusion on the right side is evident.","['Change name of device', 'Change to homophone', 'False prediction']"
6c51a20d-ad614c00-74639c29-a955b0c2-daf48f6e,50588678,19358609,"Impression: In comparison with the study ___ ___, the monitoring and support devices are unchanged.  The opacification in the left mid and upper zone has decreased.  Basilar opacification on this side is consistent with postsurgical changes.","Impression: In comparison with the study ___ ___, the manitoring and support devices are unchanged.  No opacification seen.  Basilar opacification on the rigth side is consistent with postsurgical changes.","['Change location', 'Add typo', 'False negation']"
"96f87f7a-986127ad-254bbe00-6092f98c-b455bf5e, cd719187-aac4497a-487e9373-f862d5a4-63a1c6b1",50685017,19358609,Findings: Frontal and lateral radiographs demonstrate stable extensive post-surgical changes of the left hemithorax with associated loss of volume. Stable scarring noted in the right lung apex.  On a background of chronic lung disease and chronic bibasilar opacifications there is new prominence of the interstitium as well as Kerley B lines consistent with pulmonary edeam.  Heart size is top normal and stable.  No pleural effusion or pneumothorax identified. Impression: Stable background chronic lung changes.  Stable top normal heart size with evidence of volume overload consistent with provided diagnosis of right ventricular regurgitation.,Findings: Frontal and lateral radiographs demonstrate stable extensive post-surgical changes of the left hemithorax without associated loss of volume. Stable scarring noeid in the right lung apex. On a background of chronic lung disease and chronic bibasilar opacificiations there is new prominence of the interstitium as well as Kerley B lines consistent with pulmonary edema. Heart size is top normal and enlarged. No pleural effusion or pneumothorax identified.,"['Change severity', 'Add typo', 'False negation']"
d6578a26-c6384eff-9c8f4ab6-bfb13557-27002f4f,51015335,19358609,Findings: Portable frontal radiograph of the chest demonstrates a consolidation in the left lower lobe which is slightly increased compared to the recent CT. Parenchymal opacification in the right lower lobe likely reflects aspiration.  Diffusely abnormal background parenchymal changes are again seen.  The bilateral pleural effusions have decreased in size.  There is an unchanged rounded structure in the right costophrenic sinus which was masked by the pleural effusion on the prior CT exam.  There is stable deformity of the left thoracic cage.  No pneumothorax. ,Findings: Portable frontal radiograph of the chest demonstrates a consolidation in the right lower lobe which is slightly increased compared to the recent CT. Parenchymal opacification in the right lower lobe likely reflects aspiration.  No parenchymal opacification is noted.  The bilateral pleural effusions have decreased in size.  There is an unchanged rounded structure in the left costophrenic sinus which was masked by the pleural effusion on the prior CT exam.  There is stable deformity of the left thoracic cage.  No pneumothorax. ,"['Change location', 'Add repetitions', 'False negation']"
d13ad04b-c27e53cc-ff9b10b6-436d461b-1193ec8b,51677032,19358609,"Findings: Superimposed on chronic volume loss, parenchymal scarring, and pleural thickening in the left hemithorax, there is a persistent superimposed opacification in the left lung, which has worsened somewhat between over two days including increased volume loss. Findings in the right lung appear more chronic. Impression: Worsening volume loss and opacification of the left lung suggesting pneumonia superimposed on chronic findings.","Findings: Superimposed on chronic volume loss, parenchymal scarring, and pleural thickening in the right hemithorax, there is a persistent superimposed opacification in the left lung, which has worsened somewhat between over two days including increased volume loss. Findings in the right lung appear more chronic. Findings in the right lung appear more chronic. Impression: Worsening volume loss and opacification of the left lung suggesting pneumonia superimposed on chronic findings. An ET tube is also present.","['Change location', 'Add repetitions', 'Add medical device']"
"d25bbe23-d111ed9c-d5ff0630-42378992-62fb128c, eca38af0-486cb1f9-a049b2a7-9013ebc3-46eb8b84",51748246,19358609,Findings: PA and lateral views of the chest show interval clearing in bilateral airspace consolidation with no increased size in spiculated common nodular pleural thickening at the right lung apex compared to ___. Marker of on Ill volume loss in the left hemithorax related to the patient's surgery for Pancoast tumor is a chronic finding and occludes upper rib resections. Bones are demineralized. Impression: Interval clearing of bibasilar consolidation compared to ___,Findings: PA and lateral views of the chest show interval clearing in unilateral airspace consolidation with no increased size in spiculated common nodular pleural thickening at the right lung apex compared to ___. No airspace consolidation noted. Marker of on Ill volume loss in the right hemithorax related to the patient's surgery for Pancoast tumor is a chronic finding and occludes upper rib resections. Bones are demineralized. Impression: Interval clearing of bibasilar consolidation compared to ___. Interval clearing of bibasilar consolidation compared to ___,"['Change location', 'Add repetitions', 'False negation']"
64a79d58-bf2c5aca-fb7bf4f7-833548bf-24fa5543,52687447,19358609,"Findings: As compared to the previous radiograph, there is no relevant change.  Extensive post-surgical left lung changes with reduction in volume of the left hemithorax, extensive probably post-tuberculous changes in the right apex, known moderate parenchymal changes at the left lung bases.  No new focal parenchymal opacity.  Normal size of the cardiac silhouette. ","Findings: As compared to the previous radiograph, there is no relevant change.  Extensive post-surgical left lung changes with reduction in volume of the left hemithorax, extensive probably post-tuberculous changes in the right apex, known mild parenchymal changes at the left lung bases.  No new focal parenchymal opacity.  Normal size of the cardiac silhouette.  Extensive post-surgical left lung changes with reduction in volume of the left hemithorax. ","['Change severity', 'Add repetitions', 'False negation']"
"5a0fbb50-16fcbb3c-b43ab7db-64bdd2fa-0d3ba8ae, c3ab7330-992f2893-ebd35a90-84ee8f64-3922a960",53320690,19358609,"Findings: The multifocal bilateral opacities have essentially completely resolved since ___.  Left pleural effusion has also completely resolved.  Residual background emphysematous changes most prominent in the right upper lung with scarring and pleural thickening as well as background post-left upper lobectomy changes with elevation of the left hemidiaphragm are unchanged compared to ___.   Blunting of the left costophrenic angle reflects thickening/scarring.  A calcified perihilar node is unchanged.  The heart is normal in size.  The descending thoracic aorta is slightly tortuous, unchanged.  Dextroconvex scoliosis of thoracic spine is overall similar with similar distortion of thoracic cage.  Prominent degenerative changes in the thoracic spine are also overall unchanged. Impression: Interval resolution of pneumonia.","Findings: The multifocal unilateral opacities have essentially completely resolved since ___. Right pleural effusion has also completely resolved. Residual background emphysematous changes most prominent in the left upper lung with scarring and pleural thickening as well as background post-right upper lobectomy changes with elevation of the right hemidiaphragm are unchanged compared to ___. ET tube is seen in the trachea. Blunting of the right costophrenic angle reflects thickening/scarring. A calcified perihilar node is unchanged. The heart is normal in size. The descending thoracic aorta is slightly tortuous, unchanged. Dextroconvex scoliosis of thoracic spine is overall similar with similar distortion of thoracic cage. Prominent degenerative changes in the thoracic spine are overall unchanged. Impression: Mild pneumonia remains in the left lower lobe.","['Change location', 'Add contradiction', 'Add medical device']"
960a353d-a835332d-fb31336b-b05f1fbf-749acc88,53579425,19358609,"Impression: In comparison with the study ___ ___, there is little change in the appearance of the heart and lungs and monitoring and support devices.","Impression: Inn comparison with the study ___ ___, there is little change in the appearance of the heart and lungs and monitoring and support devices. In comparison with the study ___ ___, there is little change in the appearance of the heart and lungs and monitoring and support devices. Confluent opacities are noted in the left lung base, concerning for pneumonia.","['Change to homophone', 'Add repetitions', 'False prediction']"
2b50b42f-50c05b8c-99e75eff-0b02afd4-9ceb9ef7,53839366,19358609,"Impression: In comparison with the earlier study of this date, the nasogastric tube extends to the mid to upper stomach.  Other monitoring and support devices are unchanged. The degree of pulmonary vascular congestion appears to have improved.  Extensive opacification is again seen involving much of the left hemithorax.","Impression: In comparison with the earlier study of this date, the nasogastric tube extends to the mid to upper stomach. Other monitoring and support devices are unchanged. The degree of pulmonary vascular congestion does not appear to have improved. No extensive opacification is seen.","['Change severity', 'Change to homophone', 'False negation']"
5a9c035a-33267a29-76c4b71b-04e91d63-e786f0ab,53857831,19358609,"Findings: Portable AP upright view of the chest was provided.  There is again noted to be post-surgical change of the left lung apex with volume loss and leftward retraction of the mediastinal structures.  There is also evidence of prior left upper rib cage resection with chest wall deformity evident.  The right lung is hyperinflated with upper lobe lucency, likely reflecting underlying emphysema.  Coarsened interstitial markings with micronodular opacity in the right lower lung likely reflect scarring and appears stable from prior exam.  The left CP angle is excluded thus limiting evaluation.  No definite new consolidation in the left lung to suggest the presence of pneumonia.  The heart size appears stable. Impression: Post-surgical changes in the left upper chest, with no definite signs of pneumonia.","Findings: Portable AP upright view of the chest was provided.  There is again noted to be post-surgical change of the right lung apex with volume loss and leftward retraction of the mediastinal structures.  There is also evidence of prior left upper rib cage resection with chest wall deformity evident.  The right lung is hyperinflated with upper lobe lucency, likely reflecting underlying emphysema.  Coarsened interstitial markings with micronodular opacity in the right lower lung likely reflect scarring and appears stable from prior exam.  The left CP angle is excluded thus limiting evaluation.  No definite new consolidation in the left lung to suggest the presence of pneumonia.  The heart size appears stable.  There is a nasogastric tube in the stomach. Impression: Post-surgical changes in the left upper chest, with no definite signs of pneumonia.  There is evidence of pneumonia in the left lung.","['Change location', 'Add contradiction', 'Add medical device']"
"30cd4597-152ce976-4d8610c8-3ef5b4e6-5ba36ff8, a1f65d5b-9e03494b-9a28f79a-cd20821a-d860e1d6",53962747,19358609,"Impression: Substantial distortion of the chest in particular left hemi thorax with chronic changes in the right apex and in the left upper lung are noted. On the other hand there is new right basal and to lesser extent left basal opacity, findings concerning for pneumonia. No definitive evidence of pulmonary edema is present. No pleural effusion demonstrated.  Nodular opacity as part of the scarring is demonstrated in the right apex, slightly more conspicuous on current examination and should be reassessed with chest CT to exclude the possibility of growing malignancy","Impression: Substantial distortion of the chest in particular rigth hemi thorax with chronic changes in the right apex and in the right upper lung are noted. On the other hand there is new right basal and to lesser extent left basal opacity, findings concerning for pneumonia. No definitive evidence of pulmonary edema is present. No pleural effusion demonstrated. Nodular opacity as part of the scarring is demonstrated in the right lower lung, slightly more conspicuous on current examination and should be reassessed with chest CT to exclude the possibility of growing malignancy. An NG tube is also noted.","['Change location', 'Add typo', 'Add medical device']"
90dc8a36-b65c30b0-f61c7c30-0cb97d36-9c2108dc,54721865,19358609,"Impression: Comparison to ___.  The patient is of the change of the endotracheal tube.  The tip of the tube is within 2 cm of the carina.  If possible, the tube should be pulled back by approximately 1 cm.  No complications.  Stable position of the feeding tube and of the right PICC line.  Extensive parenchymal and pleural abnormalities are stable.","Impression: Comparison to ___.  The patient is of the change of the endotracheal tube.  The tip of the tube is within 3 cm of the carina.  If possible, the tube should be pulled back by approximately 1 mm.  No complications.  Stable position of the feeding tube and of the right PICC line.  Extensive parenchymal and pleural abnormalities are stable.  Stable position of the feeding tube and of the right PICC line.  No abnormalities seen in the placement of the cardiac pacemaker.","['Change measurement', 'Add repetitions', 'Add medical device']"
7d8e75db-5a64240f-63dbb72d-72d03f5c-1bd59e3b,54944374,19358609,"Impression: In comparison with the study of ___, the endotracheal tube and nasogastric tubes have been removed.  Little overall change in the appearance of the heart and lungs.","Impression: In comparison with the study of ___, the endotracheal tube and nasogastric tubes are now in place. Little overall change in the appearance of the hart and lungs. A central venous line is noted.","['Change position of device', 'Change to homophone', 'Add medical device']"
3b855f21-6bd34ead-a839a055-cfb4b29a-2a914e01,55623177,19358609,Findings: One portable AP view of the chest.  Patient is post left left upper lobe resection with thoracoplasty.  Top normal heart size is stable.  Mediastinal and hilar contours are stable.  Bibasilar opacities are unchanged. Mild pulmonary vascular congestion is also unchanged.  Severe emphysematous changes are again seen.  Biapical scarring is unchanged.  No pleural effusion or pneumothorax. Impression: No significant change in bibasilar opacities and pulmonary vascular congestion compared to study done yesterday.,Findings: One portable AP view of the chest.  Patient is post right upper lobe resection with thoracoplasty.  Top normal heart size is stable.  Mediastinal and hilar contours are stable.  Bibasilar opacities are unchanged. Mild pulmonary vascular congestion is absent.  Severe emphysematous changes are again seen.  Biapical scarring is unchanged.  No pleural effusion or pneumothorax. Impression: No significant change in bibasilar opacities and pulmonary vascular congestion compared to study done yesterday. Mild pulmonary vascular congestion noted.,"['Change location', 'Add contradiction', 'False negation']"
"e4532f81-d73cf78d-6747f5f7-f662d37a-93adfab2, e795300e-988f4a20-2e6a36c2-86804f01-da329264",55682079,19358609,Findings: Scarring of the lung parenchyma and a left chest wall deformity are stable. Hyperinflated lungs with lucency reflect known emphysema. The previously seen left retrocardiac opacity has cle resolved ared.  No focal opacity.  Prominent interstitial markings may indicate mild edema.  There is no pleural effusion or pneumothorax. The heart size is top normal. The aortic knob is calcified in the aorta is ectatic. There is no free air beneath the right hemidiaphragm. Impression: Mild interstitial edema superimposed on a background of severe emphysema. No signs of pneumonia or pneumothorax.,"Findings: Scarring of the lung parenchyma and a left chest wall deformity are stable. Hyperinflated lungs with lucency reflect known emphysema. The previously seen left retrocardiac opacity has cle resolved. No focal opacity. Prominent interstitial markings may indicate moderate edema.  There is no pleural effusion or pneumothorax. The heart size is top normal. The aortic knob is calcified, no evidence of ectasia. There is no free air beneath the right hemidiaphragm. Impression: Moderate interstitial edema superimposed on a background of severe emphysema. No signs of pneumonia or pneumothorax.","['Change severity', 'Add typo', 'False negation']"
2fed9c2c-64914c97-cb9d127e-7724fdc3-079b6dc1,56325235,19358609,Impression: ET tube tip points toward the left main bronchus and should be pulled back at least 3 cm.  Heart size and mediastinum are stable.  Bilateral pleural effusions and bibasal consolidations are extensive but unchanged as compared to the previous study.,Impression: NG tube tip points toward the left main bronchus and should be pulled back at least 3 cm.  Heart size and mediastinum are stable.  Bilateral pleural effusions and bibasal consolidations are extensive but unchanged as compared to the previous study.  ET tube is correctly positioned.  Heart size and mediastinum are stable.,"['Change name of device', 'Add repetitions', 'Add medical device']"
2eded953-12e403aa-4515137d-deea45f7-2743ebe9,56345686,19358609,"Impression: Compared to chest radiographs ___ through ___.  Greater opacification in the right lower hemi thorax is due to increasing moderate right pleural effusion and probable substantial consolidation or atelectasis in the right lower lobe, both persistent, recurrent problems.  Left pleural effusion is small.  No pneumothorax.  Scarring following left upper thoracoplasty unchanged.  Heart size indeterminate.  ET tube in standard placement.  Nasogastric drainage tube ends in the upper stomach.  Right central venous line ends in the low SVC.","Impression: Compared to chest radiographs ___ through ___.  Greater opacification in the right lower hemi thorax is due to increasing mild right pleural effusion and probable substantial consolidation or atelectasis in the right lower lobe, both persistent, recurrent problems.  Left pleural effusion is large.  No pneumothorax.  Scarring following left upper thoracoplasty unchanged.  Heart size indeterminate.  ET tube is not visualized.  Nasogastric drainage tube ends in the upper stomach.  Right central venous line ends in the mid SVC.","['Change severity', 'Add contradiction', 'Add medical device']"
"17563248-b5619d12-71d589df-57facf81-8d6a38bc, 731ab0b4-e2d74d1d-aa17c85c-e9b48928-13109378",56360897,19358609,"Findings: AP upright and lateral views of the chest were provided.  The lungs are hyperinflated with chronic deformity of the left upper hemithorax and rib cage.  There are opacities in the lower lungs which raise concern for pneumonia.  Underlying scarring is better assessed on the prior CT.  The heart size is difficult to assess, though appears grossly stable.  The mediastinal contour also is grossly unchanged.  Small right pleural effusion is present. Impression: Findings concerning for pneumonia within the lower lungs.","Findings: AP upright and lateral views of the chest were provided.  The lungs are hyperinflated with chronic deformity of the left upper hemithorax and rib cage.  There are opacities in the lower lungs which raise concern for pneumonia.  The lungs are hyperinflated with chronic deformity of the left upper hemithorax and rib cage.  Underlying scarring is better assessed on the prior CT.  The heart size is difficult to assess, though appears grossly stable.  The mediastinal contour also is grossly unchanged.  Moderate right pleural effusion is present.  Central venous line is in place. Impression: Findings concerning for pneumonia within the lower lungs.","['Change severity', 'Add repetitions', 'Add medical device']"
190c77fc-21f447bf-1bcfcedc-289f119d-bf901d30,57135581,19358609,"Impression: AP chest compared to ___ and ___, and ___ ___:  Patient has had left upper thoracoplasty, usually for tuberculosis or lung cancer.  Heterogeneous opacification in the right lung has worsened since ___, probably pulmonary edema, accompanied by increasing small right pleural effusion.  Predominant abnormality in the axillary region of the right upper lobe could be concurrent pneumonia, but I am not surprised by asymmetric distribution of edema in this patient with moderate-to-severe emphysema and scarring at the right lung apex.  Heart size is normal, in the leftward shifted mediastinum.  No pneumothorax.","Impression: AP chest compared to ___ and ___, and ___ ___:  Patient has had left upper thoracoplasty, usually for tuberculosis or lung cancer.  Heterogeneous opacification in the right lung has worsened since ___, probably mild pulmonary edema, accompanied by increasing small right pleural effusion.  Predominant abnormality in the axillary region of the right upper lobe could be concurrent pneumonia, but I am not surprised by asymmetric distribution of edema in this patient with moderate-to-severe emphysema and scarring at the right lung apex.  Heart size is normal, in the lefftward shifted mediastinum.  No pneumothorax.","['Change severity', 'Add typo', 'False negation']"
19b27bf0-71c9fedb-001e6ba5-2e5dda70-8c6ed8b4,57935686,19358609,"Impression: In comparison with the earlier study of this date, there is increased opacification at the left base with poor definition of the hemidiaphragm. This is consistent with developing pneumonia, possibly associated with some volume loss in the left lower lobe and pleural effusion. Increased opacification at the right base could reflect either atelectatic changes or a multifocal infiltrate.","Impression: In comparison with the earlier study of this date, there is increased opacification at the left base with poor definition of the hemidiaphragm. This is consistent with developing pneumonia, possibly associated with some volume loss in the left lower lobe and pleural effusion. No pneumonia. Increased opacification at the left base could reflect either atelectatic changes or a multifocal infiltrate. In comparison with the earlier study of this date, there is increased opacification at the left base with poor definition of the hemidiaphragm.","['Change location', 'Add repetitions', 'False negation']"
feaef4bc-9543453e-5299332e-ba1069aa-f1907e03,57984800,19358609,Findings: Increased opacity at the left upper and lower lung concerning for multi focal pneumonia.  Left basilar atelectasis and pleural effusion is present.  Small right pleural effusion is also noted.  Right apical scarring is unchanged.  There is no pneumothorax.  The cardiac and mediastinal silhouettes are unchanged. An endotracheal tube is in standard position.  Enteric tube terminates in the stomach.  A linear tube extending to the level of the endotracheal tube it may represent esophageal probe.  The right PICC terminates in the distal SVC. Impression: 1. The endotracheal tube is in standard position. 2. Multi focal pneumonia affecting the left upper lower lungs. 3. Moderate left pleural effusion and small right pleural effusion.,Findings: Increased opacity at the right upper and lower lung concerning for multi focal pneumonia.  Left basilar atelectasis and pleural effusion is present.  Small write pleural effusion is also noted.  Right apical scarring is unchanged.  There is no pneumothorax.  The cardiac and mediastinal silhouettes are unchanged. An endotracheal tube is in standard position.  Enteric tube terminates in the stomach.  A linear tube extending to the level of the endotracheal tube; it may represent esophageal probe.  The write PICC terminates in the distal SVC.  A pacemaker device is seen in the right anterior chest wall. Impression: 1. The endotracheal tube is in standard position. 2. Multi focal pneumonia affecting the left upper lower lungs. 3. Moderate left pleural effusion and small right pleural effusion.,"['Change location', 'Change to homophone', 'Add medical device']"
23b893a4-1cc40a42-3da788ed-83286c42-25495fd6,58119690,19358609,Impression: Bibasal opacities and the entire chronic deformity of the chest appears to be similar to the previous study concerning for bibasal multifocal pneumonia,Impression: Bilateral fibrous shadows and the entire chronic deformity of the chest appears to be similar to the previous study concerning for bibasal multifocal pneumonia. The patient has an NG tube in place.,"['Add medical device', 'Add typo', 'False prediction']"
a910b094-06011b04-d15075aa-21b8d267-25f63219,58676813,19358609,"Findings: The patient's neck is flexed to the right.  The ET tube tip appears to be 0.6 cm above the carina.  Right PICC tip is in the lower SVC.  Side port of the NG tube is likely below the GE junction, with the tip out of view.  There is moderate pulmonary edema.  Moderate right and small to moderate left effusions appear similar to prior, allowing for differences in patient positioning.  Retrocardiac opacity and silhouetting of the left hemidiaphragm are similar to prior.  Left upper lung distortion is similar to prior. There is no pneumothorax. The cardiomediastinal silhouette is normal.  Aortic calcification projecting over the heart is similar to prior.  No free air below the right hemidiaphragm is seen. Impression: 1. Evaluation of ET tube location is suboptimal due to patient positioning, but appears low. 2. Right PICC and NG tube are similar to prior. 3. Moderate right and small to moderate left effusions appear similar to prior, allowing for differences in patient positioning. 4. Other findings are similar to ___.","Findings: The patient's neck is flexed to the right.  The ET tube tip appears to be 2.5 cm above the carina.  Right PICC tip is in the right atrium.  Side port of the NG tube is likely below the GE junction, with the tip out of view.  The ET tube tip appears to be 0.6 cm above the carina.  There is moderate pulmonary edema with evidence of a large left pleural effusion.  Moderate right and small to moderate left effusions appear similar to prior, allowing for differences in patient positioning.  Retrocardiac opacity and silhouetting of the left hemidiaphragm are similar to prior.  Left upper lung distortion is similar to prior. There is no pneumothorax. The cardiomediastinal silhouette is normal.  Aortic calcification projecting over the heart is similar to prior.  No free air below the right hemidiaphragm is seen. Impression: 1. Evaluation of ET tube location is suboptimal due to patient positioning, but appears low. 2. Right PICC and NG tube are similar to prior. 3. Moderate right and small to moderate left effusions appear similar to prior, allowing for differences in patient positioning. 4. Other findings are similar to ___.","['Change position of device', 'Add repetitions', 'False prediction']"
916c8cda-4a5b71e7-48853bfe-64498756-5f944dfe,58804781,19358609,Impression: There has been some interval partial clearing of the right-sided infiltrate.  However given the extensive distortion of the thoracic anatomy it is difficult to assess for resolution of the acute on chronic changes. The ET tube is unchanged,Impression: Their has been some interval partial clearing of the right-sided infiltrate. However given the extensive distortion of the thoracic anatomy it is difficult to assess for resolution of the acute on chronic changes. The PleurX catheter is unchanged. A left-sided central venous line is seen.,"['Change name of device', 'Change to homophone', 'Add medical device']"
"619e7a1b-911eac64-eb4b724e-a0b08550-9ed1342b, 76d88971-1492bc74-4a00303b-111fa19f-a617a23b",59002259,19358609,"Findings: Frontal and lateral views of the chest demonstrate a stable postoperative appearance of the left hemithorax status post thoracoplasty.  Right apical scarring persists.  Right lung base opacity partially obscuring right hemidiaphragm is new since prior exam.  Ill-defined left lung base opacity is also noted.  No pleural effusion is seen.  There is no pulmonary edema.  Emphysema predominantly involving upper lung zones is unchanged.  Hilar and mediastinal silhouettes are stable.  Heart size is normal.  Partially imaged upper abdomen is unremarkable. Impression: Bibasilar opacities are new since ___ exam, possibly atelectasis, aspiration, or infection in appropriate clinical setting.",Findings: Frontal and lateral views of the chest demonstrate a stable postoperative appearance of the left hemithorax status post thoracoplasty. Right apical scarring is not seen. Left lung base opacity partially obscuring left hemidiaphragm is new since prior exam. Ill-defined left lung base opacity is also noted. No pleural effusion is seen. There is no pulmonary edema. No emphysema is seen. Hilar and mediastinal silhouettes are stable. Heart size is normal. Partially imaged upper abdomen is unremarkable. Impression: No bibasilar opacities.,"['Change location', 'Change to homophone', 'False negation']"
3ae34505-09ffb124-9c5fe036-82b07f1e-8705cb06,59338434,19358609,Findings: Compared to the prior study there is no significant interval change. Impression: No change.,Findings: Compared to the prior study there is no significatn interval change. Impression: No change.,"['Change severity', 'Add typo', 'False negation']"
ae4f09dd-f871aed3-8165305a-661a70af-14375e0d,59343870,19358609,"Impression: In comparison with the study ___ ___, there is little change in the appearance of the heart and lungs and the monitoring and support devices","Impression: In comparison with the study ___ ___, there is little change in the appearance of the hart and lungs and the monitoring and support devices. There is a small left-sided pleural effusion noted.","['Change to homophone', 'Add repetitions', 'False prediction']"
2d432182-9bf3ffc9-5168db43-277efaa2-9a16f74a,59658365,19358609,"Impression: Compared to chest radiographs ___ through ___.  Combination of moderate right pleural effusion and right lower lobe atelectasis has decreased slightly.  Severe volume loss in the left lower lobe and somewhat smaller left pleural effusion are stable.  Multifocal left upper lobe consolidation is unchanged.  Heart size is indeterminate.  Right PIC line, ET tube, nasogastric drainage tube are all in standard placements.","Impression: Compared to chest radiographs ___ trhoough ___.  Cmobination of moderate right pleural effusion and right lower lobe atelectasis has decreased slightly.  Severe volume loss in the left lower lobe and somewhat smaller left pleural effusion are stable.  Multifocal left upper lobe consolidation is unchanged.  Heart size is indeterminate.  Right PICC line, ET tube, nasogastric drainage tube are all in standard placements.  A	left-sided AICD device is seen.","['Change name of device', 'Add typo', 'Add medical device']"
6f58b90c-095967a1-12f62c81-70614815-9208a903,59926281,19358609,"Findings: In comparison with the study of ___, there is little overall change in the post-surgical appearance of the left upper chest.  Chronic changes are seen bilaterally, but no evidence of acute focal pneumonia. ","Findings: In comparison with the study of ___, there is little overall change in the post-surgical appearance of the right upper chest. Chronic changes are seen bilaterally, but no evidence of acute focal pneumonia.  An NG tube is in place within the stomach.","['Change location', 'Add contradiction', 'Add medical device']"
37230aa4-c435f397-efca09f0-e71f6a7f-ccd59a4a,59969313,19358609,Findings: Compared to the prior study there is no significant interval change. Impression: No change.,Findings: Compared to the prior study there is no significant interval change. A small left-sided pleural effusion is noted. Impression: No change.,"['Change severity', 'Add contradiction', 'Add medical device']"
"7d40d26a-1bbef5c3-f92a45c2-470022da-0cd16459, cf12c942-00f9c4e0-d2a23250-9d3bb177-19775339",52111228,19365784,"Impression: The lung volumes are increased.  There is increased sagittal diameter of the thorax as well as an increase of the retrosternal space. Together with flattening of the diaphragm these findings are highly suggestive of severe functional obstruction, for example caused by COPD.  No evidence of pneumonia or pulmonary edema.  Normal size of the cardiac silhouette. Moderate elongation of the descending aorta.  Minimal right apical thickening.","Impression: The lung volumes are decreased.  There is increased sagittal diameter of the thorax as well as an increase of the retrosternal space. Together with flattening of the diaphragm these findings are highly suggestive of severe functional obstruction, for example caused by COPD.  No evidence of pneumonia or pulmonary edema.  Normal size of the cardiac silhouette. No elongation of the aorta.  Minimal right apical thickening. Minimal right apical thickening.","['Change location', 'Add repetitions', 'False negation']"
da94e05c-941be1ba-f5996c0b-75dd288f-278d8503,50411452,19366448,Impression: There are low lung volumes.  Cardiac size is top-normal accentuated by the projection of the low lung volumes.  Lines and tubes are in unchanged standard position.  There is mild vascular congestion.  Increasing bibasilar opacities are likely atelectasis.  Atelectasis in the perihilar regions bilaterally are unchanged,Impression: There are low lung volumes.  Cardiac size is top-normal accentuated by the projection of the low lung volumes.  Lines and tubes are in unchanged standard position.  There is moderate vascular congestion.  Increasing bibasilar opacities are likely atelectasis.  No atelectasis.,"['Change severity', 'Add contradiction', 'False negation']"
da330caa-eaa7ebe9-4d1535ac-17f87653-e729c518,51571135,19366448,Findings: There is interval worsening of pulmonary vascular congestion.  There is mild pulmonary edema. The heart and mediastinal structures are unchanged. An endotracheal tube nasogastric tube and left internal jugular catheter remain in place. There are no concerning bone findings. Impression: Interval worsening of vascular congestion.  There is mild pulmonary edema.,Findings: There is interval worsening of pulmonary vescular congestion. No pulmonary edema. The heart and mediastinal structures are unchanged. An endotracheal tube nasogastric tube and left-sided subclavian catheter remain in place. There are no concerning bone findings. Impression: Interval worsening of vascular congestion. There is no pulmonary edema.,"['Change name of device', 'Add typo', 'False negation']"
7edb8547-95df07ca-f8f9e9d2-6c7ffe4e-34a97b30,51687346,19366448,"Impression: In comparison with the earlier study of this date, the monitoring and support devices are essentially unchanged.  Relatively low lung volumes with the cardiac silhouette at the upper limits of normal or mildly enlarged.  Continued mild to moderate pulmonary vascular congestion with bibasilar atelectatic changes. In the appropriate clinical setting, it would be difficult to unequivocally exclude superimposed pneumonia, especially in the absence of a lateral view.","Impression: In comparison with the earlier study of this dat, the monitoring and support devices are essentially unchanged. Relatively low lung volumes with the cardiac silhouette at the upper limits of normal or moderately enlarged. Continued mild pulmonary vascular congestion with bibasilar atelectatic changes. In the appropriate clinical setting, it would be difficult to unequivocally exclude superimposed pneumonia, especially in the absence of a lateral view.  There is a small right-sided pleural effusion.","['Change severity', 'Add typo', 'False prediction']"
861e6fd8-db9763b1-684e5bf9-a814a02e-e28cca70,55970267,19366448,"Findings: Lung volumes remain persistently low.  Left internal jugular central venous catheter tip terminates at the confluence of the brachiocephalic veins.  No pneumothorax.  Endotracheal tube is in standard position terminating approximately 4 cm from the carina.  Enteric tube courses below the left hemidiaphragm, into the stomach and off the inferior borders of the film.  Heart size is normal.  Mediastinal and hilar contours are unchanged.  Mild pulmonary vascular congestion is slightly improved in the interval.  Patchy atelectasis is noted in the lung bases.  No large pleural effusion is noted however the extreme left costophrenic angle is excluded from the field of view.  No acute osseous abnormalities are detected. Impression: 1. Left internal jugular central venous catheter tip at the confluence of the brachiocephalic veins.  No pneumothorax. 2. Standard positioning of the endotracheal and enteric tubes. 3. Improving mild pulmonary vascular congestion.","Findings: Lung volumes remain persistently low.  Left internal jugular central venous catheter tip terminates at the confluence of the brachiocephallic veins.  No pneumothorax.  Endotracheal tube is in standard position terminating approximately 3 mm from the carina.  Enteric tube courses below the left hemidiaphragm, into the stomach and off the inferior borders of the film.  Heart size is normal.  Mediastinal and hilar contours are unchanged.  Mild pulmonary vascular congestion is slightly improved in the interval.  Patchy atelectasis is noted in the lung bases.  No large pleural effusion is noted however the extreme left costophrenic angle is excluded from the field of view.  No acute osseous abnormalities are detected.   External device, likely a pacemaker, is present in the right upper chest. Impression: 1. Left internal jugular central venous catheter tip at the confluence of the brachiocephalic veins.  No pneumothorax. 2. Standard positioning of the endotracheal and enteric tubes. 3. Improving mild pulmonary vascular congestion.","['Change measurement', 'Add typo', 'Add medical device']"
4c21d27a-14b093bd-9c833943-ccdfb838-1b72eec0,56614916,19366448,"Findings: Lung volumes remain low.  There is continued evidence of mild pulmonary edema mediastinal structures are unchanged. An endotracheal tube, nasogastric tube and left internal jugular catheter remain in place. There is no significant change. Impression: No significant change.","Findings: Lung volumes remain low. There is continued evidence of mild pulmonary ededma mediastinal structures are unchanged. An endotracheal tube, nasogastric tube and left internal jugular catheter end in the right atrium. Mild bilateral pleural effusions are noted. There is no significant change. Impression: Right hilar enlargement found.","['Change position of device', 'Add typo', 'False prediction']"
c5c9ba27-4ce72de1-06e2852c-338a1906-49904456,57258316,19366448,"Impression: In comparison with the study of ___, the monitoring and support devices are essentially unchanged.  Scatter radiation related to the size of the patient somewhat obscures detail.  Cardiac silhouette remains at the upper limits of normal in size with mild elevation of pulmonary venous pressure in bilateral pleural effusions with compressive basilar atelectasis, with the volume loss most prominent in the left lower lobe.","Impression: In comparison with the study of ___, the monitoring and support devices are essentially unchanged.  Scatter radiation related to the size of the patient somewhat obscures detail.  The cardiac silhouette remains at the upper limits of normal in size with mild elevation of pulmonary venous pressure in bilateral pleural effusions with compressive basilar atelectasis, with the volume loss most prominent in the right lower lobe.","['Change location', 'Add repetitions', 'False prediction']"
865486e4-6d43765f-e1cebccc-d80670c5-b9aeea25,57729179,19366448,Impression: Comparison to ___.  No relevant change is noted.  Low lung volumes. Mild fluid overload but no overt pulmonary edema.  Borderline size of the cardiac silhouette.  Mild bilateral pleural effusions.  Stable left lower lobe atelectasis.,"Impression: Comparison too ___.  The right lung is clear, with no relevant change is noted.  Low lung volumes. Severe fluid overload but no overt pulmonary edema.  Borderline size of the cardiac silhouette.  Large bilateral pleural effusions.  Stable left upper lobe atelectasis.","['Change severity', 'Change to homophone', 'False prediction']"
"4ac43164-3a114bed-4f423e11-4ccf1fe2-6d812258, 641c0bab-e8835ec0-a9953bda-359a9381-a8bc717a",50829350,19423061,"Findings: PA and lateral views of the chest provided.  Port-A-Cath over the right chest wall is again seen with catheter extending into the region of the mid SVC. In this patient with known pulmonary nodules better seen on the a recent CT exam, nodules are poorly visualized on radiograph. There is a small right pleural effusion which appears unchanged from the recent CT exam. No evidence of superimposed pneumonia or edema. Cardiomediastinal silhouette is stable. The imaged bony structures are intact. Impression: 1. No acute findings. 2. Small right pleural effusion stable from recent PET-CT. 3. Pulmonary nodules better assessed on recent PET-CT.","Findings: PA and lateral views of the chest provided. Port-A-Cath over the left chest wall is again seen with catheter extending into the region of the mid SVC. In this patient with known pulmonary nodules better seen on the a recent CT exam, nodules are poorly visualized on radiograph. There is a small right pleural effusion which appears unchanged from the recent PET exam. No evidence of superimposed pneumonia or edema. There is a left lower lobe infiltrate not seen on previous exams. Cardiomediastinal silhouette is stable. The imaged bony structures are in tact. Impression: 1. No acute findings. 2. Small right pleural effusion stable from recent PET-CT. 3. Pulmonary nodules better assessed on recent PET-CT.","['Change location', 'Change to homophone', 'False prediction']"
"4a8a8e66-03b9b039-c4231b00-c940972e-629116b0, 4f168bc8-3e6328a5-313a3636-4e952ac6-a0ae095f",59322832,19423061,"Findings: A Port-A-Cath is in place, with tip over distal SVC.  There is background hyperinflation, consistent with COPD. The cardiomediastinal silhouette is not enlarged. Mild aortic calcification noted.  There is slight blunting of the right cardiophrenic angle, consistent with a small amount of pleural fluid or thickening. On the lateral view, there is suggestion of focal nodular density in the lower lobe posteriorly on 1 side. Additional patchy density projects over the cardiac silhouette. Indistinct opacities are seen laterally in both right and left lower zones. These small opacities likely correspond to opacities seen on the ___ chest CT.  No CHF or large consolidation is identified. Oral contrast is noted within the bowel. Impression: 1. Port-A-Cath tip over distal SVC. 2. Bibasilar focal opacities, likely corresponding to opacity seen on an outside the ___ chest CT. Correlation with clinical history is requested for further assessment. 3. Small right effusion.","Findings: A Port-A-Cath is in place, with tip over mid SVC. There is background hyperinflation, consistant with COPD. The cardiomediastinal silhouette is not enlarged. Mild aortic calcification noted. There is slight blunting of the right cardiophrenic angle, consistent with a small amount of pleural fluid or thickening. On the lateral view, there is suggestion of focal nodular density in the lower lobe posteriorly on 1 side as well as a right middle lobe consolidation. Additional patchy density projects over the cardiac silhouette. Indistinct opacities are seen laterally in both right and left lower zones. These small opacities likley correspond to opacities seen on the ___ chest CT. Fluid collection is noted in the pericardial space. No CHF or large consolidation is identified. Oral contrast is noted within the bowell. Impression: 1. Port-A-Cath tip over distal SVC. 2. Bibasilar focal opacities, likely corresponding to opacity seen on an outside the ___ chest CT. Correlation with clinical history is requested for further assessment. 3. Small left pleural effusion.","['Change position of device', 'Add typo', 'False prediction']"
"1b308ded-6c895775-949f5d75-5be20754-a244cd15, a229d223-937a556a-7a395dbc-951be366-22d9e940",55802076,19442226,"Findings: PA and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette.  There is no focal consolidation, pleural effusion, or pneumothorax.  A convex, linear opacity in the right lung base is stable from ___ and may represent an area of scarring.  The pulmonary vasculature is normal. Impression: No cardiopulmonary process.","Findings: PA and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette.  There is no focal consolidation, bilateral pleural effusion, or pneumothorax.  A convex, linear opacity in the right lung apex is stable from ___ and may represent an area of scarring.  The pulmonary vasculature is normal. There is evidence of mild interstitial fibrosis. Impression: No acute cardiopulmonary process.","['Change location', 'Change to homophone', 'False prediction']"
"013d509d-3aabeff2-5f8a03ca-0fa9071b-9475198d, fdafa989-14d5d94d-091f7100-328c5f82-033331a3",59457175,19468400,"Findings: The patient is rotated, limiting assessment. The mediastinum is normal in size and contour. The cardiac silhouette is normal in size. The hila are unremarkable. There is no pneumothorax lungs are expanded and clear without focal consolidation. Gaseous distention of multiple bowel loops is noted in the upper abdomen. Impression: No acute cardiopulmonary process.","Findings: The patient is rotated, limiting assessment. The mediastinum is normal in size and contour. The cardiac silhouette is normal in sighs. The hila are unremarkable. There is no pneumothorax lungs are expanded and clear without focal consolidation. Gaseous distention of multiple bowel loops is noted in the lower abdomen. An NG tube is placed with its tip in the stomach. Impression: No acute cardiopulmonary process.","['Change location', 'Change to homophone', 'Add medical device']"
a38ab00a-694908eb-0e3cac94-ff0635c9-41d52d82,51851862,19486351,"Findings: As compared to the previous radiograph, there is no relevant change.  Loss in volume of the left hemithorax, associated with juxtaphrenic peak at the left lung bases.  No pleural effusion.  No masses or consolidations.  Unremarkable right lung. ","Findings: As compared to the previous radiograph, there is no relevant change. Loss in volume of the right hemithorax, associated with juxtaphrenic peak at the left lung bases. No pleural effusion. No masses or consolations. Unremarkable right lung. Presence of a central venous line.","['Change location', 'Change to homophone', 'Add medical device']"
98b0f854-2f8c7b87-0750ac8e-5001cfd3-4449e97b,54810204,19486351,Findings: No consolidation.  Left hilar and mediastinal regions have normal postoperative appearance unchanged from prior.  No pleural effusion or pneumothorax.  The cardiomediastinal silhouette is normal. Impression: No pneumonia.,Findings: No consolidation.  Left hilar and mediastinal regions have normal postgraduate appearance unchanged from prior.  No pleural effusion or pneumothorax.  The cardiomediastinal silhouette is normal. Impression: No pneumonia. An ET tube is present.,"['Change location', 'Add typo', 'Add medical device']"
"3f2efd86-6d2f7dd3-13733c06-96512585-461537e4, a0bbefae-b9205d65-6b6f009e-7a4bda2b-72871e9b",55981228,19486351,Findings: The right lung is clear.  Post-surgical changes are noted in the left lung with elevation of the left hemidiaphragm and rightward deviation of normally midline structures as expected after completion left upper lobectomy. Tiny left pleural effusion may be present.  Cardiac silhouette is unremarkable. Impression: Tiny left pleural effusion with expected post-surgical appearance to the left lung.,Findings: The right lung is clear. Post-surgical changes are noted in the left lung with elovation of the left hemidiaphragm and rightward deviation of normally midline structures as expected after completion left upper lobectomy. No left pleural effusion may be present. Cardiac silhouette is unremarkable. Impression: Tiny left pleural effusion with expected post-surgical appearance to the left lung.,"['Change severity', 'Add typo', 'False negation']"
8a4e1705-f30d7e1d-dd1ef999-a8521d7e-e64ad0c9,57905310,19486351,"Impression: AP chest compared to ___:  New heterogeneous opacification in the right mid lung, particularly projecting over the anterior right second and third ribs could be edema or early pneumonia.  Careful followup advised.  Left lower lobe atelectasis is new, along the descending thoracic aorta.  Small left pleural effusion is present.  No appreciable pneumothorax, left apical pleural tube in place.  Heart size normal.  Dr. ___ was paged to report these findings.","Impression: AP chest compared to ___:  New heterogeneous opacification in the right mid lung, particularly projecting over the anterior right second and third ribs could be edema or early pneumonia.  Careful followup advised.  Left lower lobe atelectasis is new, along the descending thoracic aorta.  Small left pleural effusion is present.  No appreciable pneumothorax, left apical pleural tube is pneumonvisible.  Heaart size normal.  There is a right-sided pleural effusion.  Dr. ___ was paged to report these findings.","['Change position of device', 'Add typo', 'False prediction']"
278ef848-f481280c-dc9c5c10-bbaaf9d2-37100e82,58557335,19486351,"Findings: Patient is status post left upper lobectomy.  Left chest tube is seen terminating at the left upper lung.   Lung volumes are low. Mild haziness of the left lung, volume loss and mild mediastinal shift to the left attributed to left upper lobectomy.  There is no pneumothorax or pleural effusion. ","Findings: Patient is status post left upper lobectomy.  Left chest tube is seen terminating in the lower left hemithorax.   Lung volumes are low. Mild haziness of the left lung, volume loss and mild mediastinal shift to the left attributed to left upper lobectomy.  There is no pneumothorax or pleural effusion.  The film demonstrates a right-sided central venous line in appropriate position. ","['Change position of device', 'Add repetitions', 'Add medical device']"
"48dab47e-3cb83d67-35673a0a-37fba33f-80d39c82, cfad9518-e9155e36-b7ddfe25-0756fe5d-a11405f1",54655842,19519113,"Findings: PA and lateral chest radiographs demonstrate clear lungs.  There is no pleural effusion, pneumothorax, or pulmonary vascular congestion.  The cardiomediastinal silhouette is normal. Impression: No acute cardiopulmonary process.","Findings: PA and lateral chest radiographs demonstrate clear tongues.  There is no pleural effusion, pneumothorax, or pulmonary vascular congestion.  The cardiomediastinal silhouette is abnormal. Impression: No acute cardiopulmonary process.  A central venous line is in place.","['Change location', 'Change to homophone', 'Add medical device']"
"0e19c90a-56616e62-58e69f3d-49b1cc24-9969f3c9, 1abba9e2-b59f090a-f83d8ef2-43c94615-46bfa1cf",59627220,19521888,"Findings: The lungs are clear.  Cardiac silhouette is normal in size.  No pleural effusion, pneumothorax or pulmonary edema. Impression: No evidence of acute cardiopulmonary process.","Findings: The lungs are clear.  Cardiac silhouette is normal in size.  No pleural effusion, pneumothorax or pulmonary edema.  There is an NG tube in place.  Cardiac silhouette is normal in size. Impression: No evidence of acute cardiopulmonary process.","['Add repetitions', 'Change to homophone', 'Add medical device']"
"3525fe58-2ac660b2-9fe7511f-d9bc87f2-4e4514d4, 4a9c54a9-b2e611eb-c5682312-61c0f546-64baeb2f",51242161,19550692,Findings: Left basal platelike atelectasis.  Otherwise lungs are clear.  No signs of pneumonia or edema.  No effusion or pneumothorax.  Cardiomediastinal silhouette is stable.  Bony structures are intact.  No free air below the right hemidiaphragm. Impression: No acute intrathoracic process.,Findings: Right basal platelike atelectasis. Otherwise lungs are clear. No signs of pneumonia or edema. No effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. No hemidiaphragm air. Impression: Mild pulmonary edema.,"['Change location', 'Add contradiction', 'False negation']"
"210b09cc-67e7effb-4dfa1ad4-b1d752d3-6bbe7b9a, 368b10d5-a6b2a4df-6c666650-9ac0ca7f-d2ddd60b",52125718,19550692,"Findings: The cardiomediastinal and hilar contours are within normal limits.  Lungs are clear.  There is no focal consolidation, pleural effusion or pneumothorax. Impression: No acute cardiopulmonary process.","Findings: The cardiomediastinal and hilar contours are within normal limits. Lungs are clear. There is no substantial consolidation, pleural effusion or pneumothorax. A central venous line is noted in the right subclavian. Impression: There is mild pulmonary edema.","['False prediction', 'Change to homophone', 'Add medical device']"
"a38d0d66-d35eeff5-9125eeec-4096449c-36390916, b2cbf182-9d259151-0bab637e-69dece8f-be889649",59756917,19550692,Findings: Frontal and lateral views of the chest.  The lungs are clear.  Cardiomediastinal silhouette is within normal limits.  Mild mid thoracic dextroscoliosis is noted. Impression: No acute cardiopulmonary process.,Findings: Frontal and lateral views of the chest.  The left lung shows clear signs.  Cardiomediastinal silhouette is within normal limits.  Mild mid thoracic dextroscoliosis is noted. The lungs are clear. Impression: No acute cardiopulmonary process.  There are two small nodules in the lower left lung.,"['Change location', 'Add repetitions', 'False prediction']"
"9878db3c-76b9d4df-5665d4e6-1cfd1b57-819c2daf, cab91100-869be9c1-4ef96250-cdb5c05c-ae3b4929",51763977,19553042,"Findings: Moderate cardiomegaly, mediastinal silhouette and hilar contours are unchanged from prior exam.  There is persistent mild pulmonary edema and in this setting is difficult to discretely identify pneumonia.  Bibasilar patchy opacities are relatively unchanged compared to prior exam.  There is no pleural effusion or pneumothorax. Impression: Unchanged pulmonary edema with no change in appearance of bibasilar patchy opacities.  Infection is not excluded given the correct clinical circumstance.","Findings: Moderate cardiomegaly, mediastinal silhouette and hilar contours are unchanged from prior exam.  There is persistent mild pulmonary edema and in this setting is difficult to discretely identify pneumonia.  Bibasilar patchy opacities are relatively unchanged compared to prior exam.  No new mass or lesion is noted. There is no pleural effusion or pneumothorax. Impression: Mild pulmonary edema with no change in appearance of bibasilar patchy opacities.  Infection is not excluded given the correct clinical circumstance.","['Change severity', 'Add repetitions', 'False prediction']"
"cb99dab1-a1f4878e-3675f453-2ede08f3-11caa34b, f5ff8576-31d96895-75ed689c-6b8204ea-fb3fd185",55426590,19553042,"Findings: Frontal and lateral views of the chest were obtained.  Cardiomediastinal silhouette is stable.  Slight prominence of the right hilum is also stable.  There are relatively low lung volumes.  Given this, patchy bibasilar opacities are seen, which while could relate to underlying edema, raises a concern for multifocal infection.  There is also mid lung atelectasis.  There is prominence of interstitial markings bilaterally.  This may be due to underlying edema.  No large pleural effusion or pneumothorax is seen. Impression: Low lung volumes accentuate the bronchovascular markings.  Stable prominence of the right hilum.  Bibasilar opacities may be due to multifocal infection superimposed on mild interstitial edema depending on the clinical scenario.","Findings: Frontal and lateral views of the chest were obtdined.  Cardiomediastinal silhouette is stable.  Slight prominence of the right hilum is also stable.  There are relatively low lung volumes.  Given this, patchy bibasilar opacities are seen, which while could relate to underlying edema, raises a concern for multifocal infectioon.  There is no mid lung atelectasis.  There is prominence of interstitial markings bilaterally.  This may be due to underlying severe edema.  No large pleural effusion or pneumothorax is seen. Impression: Low lung volumes accentuate the bronchovascular markings.  Stable prominence of the rigth hilum.  Bibasilar opacities may be due to multifocal infection superimposed on mild interstitial edema depending on the clinical scenario.  ","['Change severity', 'Add typo', 'False negation']"
"7dce175c-b95f02b0-2613e6b8-bca4b708-c38779b2, 8d820a74-b9dda1a1-5dd650e4-e7836290-49aa1493",57248462,19560275,"Findings: Patient is status post median sternotomy and CABG.  There is cardiomegaly.  Prominence of the main pulmonary artery raises concern for pulmonary arterial hypertension.  Fluid is seen along the right major fissure, likely loculated.  There are small bilateral pleural effusions.  Right perihilar opacity may be due to vascular congestion and/or atelectasis, although focal consolidation is difficult to exclude.  No evidence of pneumothorax is seen. Impression: Bilateral pleural effusions with likely loculated component along the right major fissure.  Pulmonary vascular congestion.  Cardiomegaly.","Findings: Patient is status post median sternotomy and CABG.  There is no cardiomegaly.  Prominence of the mnia pulmonary artery raises concern for pulmonary arterial hypertension.  Fluid is seen along the left major fissure, likely loculated.  There are no pleural effusions.  Right perihilar opacity may be due to vascular congestion and/or atelectasis, although focal consolidation is difficult to exclude.  No evidence of pneumothorax is seen. Impression: No pleural effusions.  Pulmonary vascular congestion.  Cardiomegaly.","['Change location', 'Add typo', 'False negation']"
"31c50e15-4a244cac-11d33a37-6e57019b-63c5858f, b5ff5541-31d765d8-cd2e6649-54d1b9d4-8fffaebf",52799543,19580750,Findings: ___ CT torso Impression: Lungs are fully expanded and clear. No pleural abnormalities.  Mild cardiomegaly.  Cardiomediastinal and hilar silhouettes are normal.  A left pectoral pacemaker with right atrial and right ventricular leads is unchanged.  RECOMMENDATION(S):  No evidence of intrathoracic metastasis.,Findings: ___ CT torso Impression: Lungs are fully expanded and clear. No pleural abnormalities.  Severe cardiomegaly.  Cardiomediastinal and hilar silhouettes are nromal.  A left pectoral pacemaker with right atrial and right ventricular leads is unchanged.  RECOMMENDATION(S):  No evidence of intrathoracic metastasis.,"['Change severity', 'Add typo', 'Add medical device']"
"9f54785a-de190a20-dd1426ac-421ae5c7-cbfa9021, e58282c4-fc8a5bed-aab4317b-f3dff9c8-40e5c04c",53527021,19580750,"Findings: A left chest wall pacemaker generator and leads are unchanged. The lungs are clear.The cardiac, hilar and mediastinal contours are stable, and the heart size is top normal.No pleural abnormality is seen. Impression: Mild cardiomegaly with no evidence of pulmonary edema, or metastatic disease.","Findings: A left chest wall pacemaker generator and leads are unchanged. The lungs are clare.The cardiac, hilar and mediastinal contours are stable, and the heart size is top normal.No pleural abnormality is seen. A right-sided Port-A-Cath terminates in the mid SVC.Impression: Mild cardiomegaly with no evidence of pulmonary edema, or metastatic diesese.","['Change position of device', 'Add typo', 'Add medical device']"
"efca036a-26a1899f-b388658f-da334861-32dba3c3, f0d18413-48c2fb34-cd7b980d-88c455cc-79fcaa4e",57163769,19580750,"Impression: No relevant change.  Left pectoral pacemaker, no pulmonary edema. Mild cardiomegaly.  No pleural effusions.  No lung nodules or masses suspicious for metastatic or malignant disease.","Impression: No relevant change. Left pectoral defibrillator, no pulmonary edema. No cardiomegaly. No pleural effusions. No lung knottles or masses suspicious for metastatic or malignant disease.","['Change name of device', 'Change to homophone', 'False negation']"
"4ebe2c0c-2050b7f6-43722c9e-600d983c-63487359, ba261ef0-ec69edf5-01acf3b6-2e2adfc8-261d8e8b",53737218,19580789,Findings: Heart size is normal with mild tortuosity of the thoracic aorta.  Hilar contours are unremarkable.  The lungs are mildly hyperinflated but otherwise clear.  Pleural surfaces are clear without effusion or pneumothorax. Impression: No acute cardiopulmonary abnormality.  Mild hyperinflation.,Findings: Heart size is normal with mild tortuosity of the thoracic aorta. Hilar contours are unremarkable. The lungs are severely hyperinflated but otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. There is a small pleural effusion in the left lower lung. Impression: No acute cardiopulmonary abnormality. Mild hyperinflation.,"['Change severity', 'Change to homophone', 'False prediction']"
"3c46dc4f-b658b25f-8697ada5-6ef38005-825d9235, 5200e5f8-3431aa0b-4687f1fc-8dfbaa5d-7e230488",54896273,19580789,"Findings: Moderate cardiomegaly is re- demonstrated, unchanged.  The aorta remains tortuous.  Mediastinal and hilar contours are similar.  Pulmonary vasculature is not engorged.  No focal consolidation, pleural effusion or pneumothorax is seen.  Lungs are hyperinflated.  Mild degenerative changes are noted in the thoracic spine. Impression: No acute cardiopulmonary abnormality.","Findings: Severe cardiomegaly is re-demonstrated, unchanged. The aorta remains tortuous. Mediastinal and hilar contours are similar. Pulmonary vasculature is knot engorged. No focal consolidation, pleural effusion or pneumothorax is seen. Lungs are hyperinflated. Mild degenerative changes are noted in the thoracic spine. Blunting of the right costophrenic angle is present. Impression: No acute cardiopulmonary abnormality.","['Change severity', 'Change to homophone', 'False prediction']"
a4fb4d63-a48fc7f0-fce5fdee-044f6290-6963a261,55456794,19580789,"Findings: The cardiomediastinal and hilar contours are within normal limits.  There is mild tortuosity of the thoracic aorta.  Lung volumes are slightly decreased when compared to prior examination.  There is no focal consolidation, pleural effusion or pneumothorax. Impression: No acute cardiopulmonary process.","Findings: The cardiomediastinal and hilar contours are within normal limits. There is moderate tortuosity of the thoracic aorta. Lung volumes are slightly decreased when compared to prior examination. There is no focal consolidation, pleural infusion or pneumothorax. Impression: No acute cardiopulmonary process. An ET tube is in place.","['Change severity', 'Change to homophone', 'Add medical device']"
"02b4c25f-5d1b8bd0-38c29e2a-cd861d6f-92f7175b, 2b2045ee-2505fd4b-e315a4e9-db4d3805-1b2ec185",58022905,19580789,Findings: Heart size is normal.  The aorta is mildly tortuous.  There are mild atherosclerotic calcifications along the aorta.  The hilar contours are normal.  Pulmonary vascularity is normal.  Minimal blunting of the left costophrenic angle suggests a trace pleural effusion.  Lungs are otherwise clear.  No focal consolidation or pneumothorax is seen.  There are no acute osseous abnormalities. Impression: Tiny left pleural effusion.  Otherwise no acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The aorta is mildly tortuous.  There are mild atherosclerotic calcifications along the aorta.  The hilar contours are normal.  Pulmonary vascularity is abnormal.  Minimal blunting of the left costophrenic angle suggests a trace pleural effusion.  Lungs are otherwise clear.  No focal consolidation or pneumothorax is seen.  There are no acute osseous abnormalities. Minimal blunting of the left costophrenic angle suggests a trace pleural effusion. Impression: Tiny left pleural effusion.  Otherwise no acute cardiopulmonary abnormality. A small right apical lesion was observed.,"['Change location', 'Add repetitions', 'False prediction']"
"3b0258a9-d464c242-49cebbd6-2b55cfa3-be74740b, ad6d1465-2d48c76e-d3452db0-f0146bfd-54f5fdad",59211846,19580789,"Findings: No focal opacities concerning for infection although enlargement of the cardiac silhouette as well as the azygos vein is noted.  No large effusions.  Stable tortuous aorta.  No pneumothorax. Impression: Mild cardiomegaly, new since the prior study, and enlargement of the azygos compatible with volume overload without frank pulmonary edema.","Findings: No focal opacities concerning for infection although severe enlargement of the cardiac silhouette as well as the azygos vein is noted.  No large effusions.  Stable tortuous aura.  No pneumothorax. There is mild pleural thickening at the lung bases. Impression: Mild cardiomegaly, new since the prior study, and enlargement of the azygos compatible with volume overload without frank pulmonary edema.","['Change severity', 'Change to homophone', 'False prediction']"
"64647c0c-e9b324f5-de4e864d-0dede615-1c4d854a, bddc330b-a7c41bb2-65f9d43f-8fb16762-4baaae99",59237725,19580789,Findings: Frontal and lateral views of the chest were obtained.  Lungs are clear without focal consolidation.  No large pleural effusion or evidence of pneumothorax is seen.  The aorta is calcified and tortuous.  The cardiac silhouette is top normal.  No overt pulmonary edema is seen.  Some degenerative changes are seen along the spine. Impression: No acute cardiopulmonary process.,"Findings: Frontal and lateral views of the neck were obtained.  Lungs are clear without focal cunsolidation.  No large pleural effusion or evidence of pneumothorax is seen.  The aorta is calcified and tortuous.  The cardiac silhouette s top normal.  No overt pulmonary edema is seen.  Some degenerative changes are seen along the spine, along with left lower lobe atelectasis. Impression: No acute cardiopulmonary process.","['Change location', 'Add typo', 'False prediction']"
efb2c222-0fe78b2f-2bd67556-d10e01d8-72e87669,50637770,19586697,Impression: Normal chest.,"Impression: No evidence of devices, the chest is herd.","['False negation', 'Change to homophone', 'Add medical device']"
"48548736-8e298f5f-e35f834e-eb62c604-3202d283, ac477135-251864c0-948b84f6-f4ef7865-3c754d7f",58804043,19586697,"Findings: The lungs are moderately well inflated and clear.  No pleural effusion or pneumothorax.  Heart size, mediastinal contour, and hila are unremarkable. Impression: No acute cardiopulmonary process.  Specifically, no pulmonary edema, effusion or pneumonia.","Findings: The lungs are moderately well inflated and clare.  No pleural effusion or pneumothorax.  Heart size, mediastinal contour, and hila are unremarkable. Impression: No acute cardiopulmonary process.  Specificaly, no pulmonary edema, effusion or pneumonia.","['Change to homophone', 'Add typo', 'False negation']"
"46a6d930-2fc44fe5-967f3273-a3e6d81d-3e4f74a0, f615e0cd-8708c9de-4c3c409c-61733455-21d87814",52370369,19587538,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal.  The lungs are clear.  No pleural effusion or pneumothorax is seen. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal.  Heart size is normal.  The lungs are clrear.  No pleural effusion or pneumothorax is seen. There is a pacemaker in place. Impression: No acute cardiopulmonary abnormality.,"['Add repetitions', 'Add typo', 'Add medical device']"
"8edeaeb8-f9b613cc-f2ca6d82-b59942a8-ad118a88, af3bd66e-b12a61bb-31b04389-8bfe9264-e50eef1b",52705257,19587538,"Findings: AP upright portable view of the chest provided.  The lungs appear largely clear bilaterally aside from mild dependent basilar atelectasis.  Slightly underpenetrated technique limits the evaluation for subtle mild congestion, though there is no overt evidence for pulmonary edema.  The heart size appears normal.  The mediastinal contour is stable and within normal limits.  The bony structures appear intact.  There is no free air below the right hemidiaphragm. Impression: Bibasilar atelectasis.  No overt evidence for pneumonia or edema.","Findings: AP upright portable view of the chest provided.  The lungs appear largely clear on right side aside from mild dependent basilar atelectasis.  Slightly underpenetraeted technique limits the evaluation for subtle mild congestion, though there is no overt evidence for pulmonary edema.  The heart size appears normal.  The mediastinal contour is stable and within normal limits.  There is a partially visualized left pleural effusion.  There is no free air below the right hemidiaphragm. Impression: Bibasilar atelectasis.  No overt evidence for pneumonia or edema.","['Change location', 'Add typo', 'False prediction']"
c5157006-1a73eeaf-efe1fd1c-7c18314b-7183f206,50422579,19598137,"Findings: Exam is limited by significant rotation.  Heart size is enlarged.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Impression: Cardiomegaly, but no evidence of pulmonary edema or pneumonia.","Findings: Exam is limited by significant rotation. Heart size is enlarged. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. The mediastinal and hilar contours are normal. Impression: Cardiomegaly, but no evidence of pneumonia.","['Change severity', 'Add repetitions', 'False prediction']"
ea096f49-af1e650c-7f97b6e7-1a3d6813-f7276d49,51118033,19598137,"Impression: Comparison to ___.  No relevant change.  Moderate cardiomegaly.  No pleural effusions.  No pneumonia, no pulmonary edema.  The course of the feeding tube is stable.","Impression: Comparison to ___.  No relevant change.  Mild cardiomegaly.  No pleural effusions.  No pneumonia, no pulmonary edema.  The course of the feeding tube is stable. The course of the feeding tube is stable. A central venous line is present. ","['Change severity', 'Add repetitions', 'Add medical device']"
6f9b4419-458e6f28-c82d6907-73e32753-6c0c1e05,52070310,19598137,"Findings: There is a small amount of pneumoperitoneum below the left hemidiaphragm, which may be expected considering the recent percutaneous G-tube placement.  There is persistent mild pulmonary edema.  The small bilateral pleural effusions are unchanged in size.  There are no new focal consolidations.  The cardiomediastinal silhouette is stable.  There is no pneumothorax. Impression: 1. Small amount of pneumoperitoneum, which may be expected with the recent percutaneous G-tube placement. 2. Persistent mild pulmonary edema. 3. Small bilateral pleural effusions.","Findings: There is a moderate amount of pneumoperitoneum below the left hemidiaphragm, which may be expected considering the recent percutaneous G-tube placement. There is persistent mild pulmonary edema. There is persistent mild pulmonary edema. The small bilateral pleural effusions are unchanged in size. There is diffuse interstitial thickening. The cardiomediastinal silhouette is stable. There is no pneumothorax. Impression: 1. Small amount of pneumoperitoneum, which may be expected with the recent percutaneous G-tube placement. 2. Persistent mild pulmonary edema. 3. Small bilateral pleural effusions.","['Change severity', 'Add repetitions', 'False prediction']"
2eccb67e-a8677000-bc5af537-c58f2e49-f4234ef1,54003094,19598137,"Findings: Compared with the prior radiograph, moderate cardiomegaly is unchanged, without pleural effusions or pneumothorax.  Edema has improved.  Course of the feeding tube is unchanged.  A faint right lower lobe opacity is new. Impression: A very faint right lower lobe opacity is new, and PA and lateral radiographs may be helpful to evaluate, when the patient is able to tolerate.  Edema has improved.","Findings: Compared with the prior radiograph, moderate carddiomegaly is unchanged, without pleural effusions or pneumothorax. Edema has improved. Course of the feeding tube extends to the distal stomach. A faint right lower lobe opacity is new with possible bilateral effusions. Impression: A very faint right lower lobe opacity is newnd PA and lateral radiographs may be helpful to evaluate, when the patient is able to tolerate. Small left-sided pleural effusion identified. Edema has improved.","['Change position of device', 'Add typo', 'False prediction']"
837f34fb-f3caa2c0-91f85420-2a52db56-db213e08,57114319,19598137,"Findings: Re- demonstration of a small amount of presumed free subdiaphragmatic air below left hemidiaphragm, described previously as the likely a consequence of recent percutaneous G-tube placement.  On this semi-erect view, it is difficult to evaluate for interval change.  Persistent mild pulmonary edema, without new focal consolidation or pneumothorax.  Small bilateral effusions are unchanged.  The cardiomediastinal silhouette is also unchanged. Impression: 1.  Persistent presumed free left subdiaphragmatic air due to recent G-tube placement, as discussed with the clinician yesterday.  On this semi-erect view, it is difficult to evaluate for interval change.  2.  Persistent mild pulmonary edema.","Findings: Re- demonstration of a small amount of presumed free subdiaphragmatic air below left hemidiaphragm, described previously as the likely a consequence of recent percutaneous NG-tube placement.  On this erect view, it is difficult to evaluate for interval change.  Persistent mild pulmonary edema, without new focal consolidation or pneumothorax.  Small bilateral effusions are unchanged, but there is now new left consolidation.  The cardiomediastinal silhouette is also unchanged. Impression: 1.  Persistent presumed free left subdiaphragmatic air due to recent G-tube placement, as discussed with the clinician yesterday.  On this semi-erect view, it is difficult to evaluate for interval change.  2.  Moderate pulmonary edema.  3. Right-sided vascular stent is seen within the brachiocephalic vein.","['Change name of device', 'Add contradiction', 'Add medical device']"
8057c454-92e4f89a-2c84ed68-c2a9a717-ce21fb60,57529558,19598137,"Impression: In comparison to the previous study of 1 day earlier, a new area of right upper lobe opacification is accompanied by a elevation of the minor fissure, favoring atelectasis.  Coexisting infection or aspiration are also possible in the appropriate clinical setting.  Exam is otherwise remarkable for improved aeration at both lung bases and decreased amount of free intraperitoneal air below the diaphragm.  No other relevant changes.","Impression: In comparison to the previous study of 1 day earlier, a new area of right upper lobe opacification is accompanied by an elevation of the minor fissure, favoring atelectasis. Exam is otherwise remarkable for improved aeration at both ling bases and decreased amount of free intraperitoneal air below the diaphragm. No other relevant changes. Coexisting infection or aspiration are also possible in the appropriate clinical setting. There is also the presence of an endotracheal tube.","['Change location', 'Change to homophone', 'Add medical device']"
ea288c46-b57777bf-b5b617cc-c21e01ab-f7a752af,57551344,19598137,"Findings: There is a dobhoff coursing below the diaphragm, however the tip is not visualized.  There is increasing interstitial pulmonary edema.  There are small bilateral pleural effusions and bibasilar atelectasis, however an underlying pneumonia cannot be excluded.  The cardiomediastinal silhouette is stable.  There is no pneumothorax. Impression: 1. Appropriately positioned Dobhoff. 2. Increasing interstitial pulmonary edema with small bilateral pleural effusions, however an underlying pneumonia cannot be excluded.","Findings: There is a dobhoff coursing below the diaphragm, however the tip is not visualized. There is mild interstitial pulmonary edema. There are small bilateral pleural effusions and bibasilar atelectasis, however an underlying pneumonia cannot be excluded. The cardiomediastinal silhouette is stable. There is no pneumothorax. There is mild interstitial pulmonary edema. Impression: 1. Appropriately positioned Dobhoff.2. There is no pulmonary edema, however an underlying pneumonia cannot be excluded.","['Change severity', 'Add repetitions', 'False negation']"
"84f45a41-bb20a8f4-788c0893-ebfc60e0-d1a50ed2, 8c1f9b73-cfb72331-df480911-a6810f9a-a3fcbcb9",50421655,19636128,"Findings: The lungs are hyperinflated but clear without consolidation, effusion, or pneumothorax.  Cardiomediastinum silhouette is stable.  No displaced fractures identified.  Hypertrophic changes are noted in the spine. Impression: No acute cardiopulmonary process.","Findings: The lungs are hyperinflated but clear without consolidation, effusion, or pneumothorax.  Cardiomediastinum silhouette is stable.  No displaced fractures identified.  The lungs are hyperinflated but clear without consolidation, effusion, or pneumothorax.  Cardiomediastinum silhouette is stable.  Hypertrophic changes are noted in the spine. Impression: No acute cardiopulmonary process.  Moderate pulmonary edema noted.  Presence of a central venous line terminating in the superior vena cava.  ","['Add contradiction', 'Add repetitions', 'Add medical device']"
3d798d0a-869fac09-5939ab06-011a871f-2f43260b,53867841,19636128,Findings: The lungs are clear.  Cardiomediastinal silhouette is top-normal in size.  There is no pneumothorax or pleural effusion.  Visualized osseous structures are unremarkable.  No free air is identified diaphragm. Impression: No acute cardiopulmonary process.  No free air under the diaphragm.,Findings: The lungs show mild interstitial markings. Cardiomediastinal silhouette is top-normal in size. There is no pneumothorax or pleural effusion. Visualized osseous structures show scattered degenerative changes. No free air is identified diaphragm. Impression: No acute cardiopulmonary process. Small bilateral pleural effusions noted.,"['False prediction', 'Add contradiction', 'False negation']"
"1327d6d9-b54a5a1f-c126df8c-46566e82-77ff57e9, 1834a247-2913b335-13a0d5d6-a20329be-26d3a2bd",57207094,19636128,"Findings: The lungs are clear of focal consolidation, pleural effusion or pneumothorax.  Flattening of the diaphragms likely reflects chronic pulmonary disease.  The heart size is normal.  The mediastinal contours are normal.  There are no signs of latent or active tuberculosis. Impression: No signs of latent or active tuberculosis.","Findings: The lungs are clear of focal consolidation, pleural effusion or pneumothorax.  Flattening of the diaphragms likely reflects chronic pulmonary disease.  The heart size is normal.  The mediastinal contours are normal.  There is a centrally placed venous catheter. There are signs of latent or active tuberculosis. Impression: No signs of latent or active tuberculosis.  No signs of latent or active tuberculosis.","['Add repetitions', 'Add contradiction', 'Add medical device']"
dc232a2f-f3e99d0f-a4433b11-fcccd1c7-334c161d,57007394,19680874,Findings: There are relatively low lung volumes.  Mild pulmonary vascular congestion is seen.  There is no focal consolidation.  No large pleural effusion or pneumothorax is seen.  The cardiac silhouette is mildly enlarged.  The aorta is calcified and tortuous. Impression: Mild pulmonary vascular congestion.,Findings: There are relatively low lung volumes.  Moderate pulmonary vascular congestion is soon.  There is no focal consolidation.  No large pleural effusion or pneumothorax is sen.  The cardiac silhouette is severely enlarged.  The aorta is calcified and tortuous. Diffuse interstitial prominence is noted. Impression: Moderate pulmonary vascular congestion.,"['Change severity', 'Add typo', 'False prediction']"
2a46f86f-aa12bf29-81681d7d-afb9c9d8-23629fe0,58783883,19769430,"Findings: Compared with prior radiographs on ___, the right hemidiaphragm is not sharply seen.  There is a small right pleural effusion and atelectasis at the right lung base.  There is no new focal consolidation to suggest pneumonia.  There is no edema or pneumothorax.  Cardiomediastinal silhouette is unchanged. Impression: Small right pleural effusion and a basilar atelectasis.","Findings: Compared with prior radiographs on ___, the right hemidiaphragm is not sharply seen.  There is a large right pleural effusion and atelectasis at the right lung base.  There is no new focal consolidation to suggest pneumonia.  There is no edema or pneumothorax.  Cardiomediastinal silhouette is unchanged. Impression: No pleural effusion and a basilar atelectasis.","['Change severity', 'Change to homophone', 'False negation']"
"8c0f4b76-084be26f-d4273e90-5966adf2-f9cd14ab, b0cda8a3-ddffb15c-e8d7fdb8-00fbf9fa-a5b1a60d",57051557,19796957,Findings: PA and lateral views of the chest.  The lungs are clear.  Cardiomediastinal silhouette is normal.  Osseous and soft tissue structures are unremarkable. Impression: No acute cardiopulmonary process.,Findings: PA and lateral views of the abdomen.  The lungs are clear.  Cardiomediastinal silhouette is normal.  Osseous and soft tissue structures are unremarkable. Impression: No focal cardiopulmonary process.,"['Change location', 'Change to homophone', 'False negation']"
e8b2aa8e-420f069d-51dc7f6f-2c778b27-c505a888,52132258,19837705,"Findings: Since ___, there has been interval placement of a left pectoral pacemaker with transvenous leads seen in the right atrium, right ventricle, and a left coronary vein.  The lungs are clear.  Mild to moderate bibasilar atelectasis is noted.  No pneumothorax.  The median sternotomy wires are intact and aligned.  Patient is status post aortic valve and mitral valve repair. Impression: Left pectoral pacemaker with transvenous leads in the RA, RV, and a left coronary vein.  No pneumothorax.","Findings: Since ___, there has been interval placement of a left pectoral vascular catheter with transvenous leads seen in the right atrium, right ventricle, and a left coronary vein.  The lungs are clear.  No atelectasis.  No pneumothorax.  The median sternotomy wires are intact and aligned.  Patient is status post aortic valve and mitral valve repair. Impression: Left pectoral vascular catheter with transvenous leaves in the RA, RV, and a left coronary vein.  No pneumothorax.","['Change name of device', 'Add typo', 'False negation']"
174d1efe-f7714d0c-f1f99de2-c6e25477-48635320,52255420,19837705,"Findings: Severe cardiomegaly is stable.  Pacer leads are in standard position in the right atrium,  right ventricle and through the coronary sinus. There is no pneumothorax.  There is no pleural effusion.  Patient is status post aortic valve and mitral valve repair Impression: No pneumothorax","Findings: Mild cardiomegaly is stable.  Pacer leads are in standard position in the right atrium,  right ventricle and through the coronary sinus. There is no pneumothorax.  There is no pleural effusion.  Patient is status post aortic valve and mitral valve repair. There is a small right-sided pleural effusion. Impression: No pneumothorax. Patient is status post aortic valve and mitral valve repair","['Change severity', 'Add repetitions', 'False prediction']"
409ab484-fda170e7-cda34211-b9ba9941-eb94231c,53199615,19837705,Impression: Severe cardiomegaly is stable.  The lungs are clear.  There is no pneumothorax or enlarging pleural effusions.  The patient is status post aortic and mitral valve repair.  Sternal wires are aligned.,Impression: Severe cardiomegaly is stable.  Severe cardiomegaly is incompletely evaluated.  The lungs are clear.  There is no pneumothorax or enlarging pleural effusions.  The patient is status post aortic and mitral valve repair.  An endotracheal tube appears to be in the appropriate position.  Sternal wires are aligned.,"['Change position of device', 'Add contradiction', 'Add medical device']"
"a03600e3-6f4ea6f0-c413be5b-1dade32a-4447a53f, f20a3da2-92bbfeba-479bee91-b6741a0b-352803fa",54018390,19845866,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process.  No pneumothorax seen.,Findings: The lungs are clear without focal condensation. No pleural effusion or pneumothorax is seen. There is a suspicious nodule in the left upper lung zone. The cardiac and mediastinal silhouettes are unremarkable. The cardiac and mediastinal silhouettes are unremarkable. Impression: No acute cardiopulmonary process. No pneumothorax seen.,"['Add repetitions', 'Add typo', 'False prediction']"
59b03271-bcecfa84-7b2e92ae-e5846d6d-e977136a,51104313,19890030,"Impression: In comparison with the study of ___, the Swan-Ganz catheter has been removed. Continued enlargement of the cardiac silhouette with worsening pulmonary edema. Little change in the degree of bilateral pleural effusions, more prominent on the left.","Impression: In comparison with the study of ___, the Swan-Ganz catheter now terminates in the right atrium. Continued enlargement of the cardiac silhouette with worsening pulmonary eedema. Little change in the degree of mild bilateral pleural effusions, more prominent on the left; moderate right lower lobe consolidation is noted.","['Change position of device', 'Add typo', 'False prediction']"
f82ff9bb-9bbb3f96-d55b669c-6b737ab9-ec52275a,51116903,19890030,"Impression: In comparison with the study of ___, the monitoring and support devices have been removed with a right IJ sheath remaining in place.  No evidence of pneumothorax. The cardiac silhouette is enlarged and there is evidence of retrocardiac opacification consistent with volume loss in the left lower lobe. Mild atelectatic changes are seen on the right and there is blunting of both costophrenic angles.","Impression: In comparison with the study of ___, the monitoring and support devices have been removed with a right IJ sheath remaining in place.  No evidence of pneumothorax. The cardiac silhouette is markedly enlarged and there is evidence of retrocardiac opacification consistent with volume loss in the left lower lobe. Mild atelectatic changes are seen on the right and there is blunting of both costophrenic angles.  No evidence of pneumothorax. An endotracheal (ET) tube is noted in the trachea.","['Change severity', 'Add repetitions', 'Add medical device']"
9da44dd4-f08ae82f-ac9dd82e-966b3d51-9fec0a87,52519588,19890030,"Impression: In comparison with the earlier study of this date, there has been placement of a right PICC line that terminates in the left axilla.  Otherwise little change.","Impression: In comparison with the earlier study of this date, there has been placement of a right PICC line that terminates in the right axilla.  Otherwise little change. Otherwise little change. A new nodule is noted in the right upper lung.","['Change location', 'Add repetitions', 'False prediction']"
ed3ea821-d5846c32-5f18d81a-657f73d8-472d55eb,52916619,19890030,"Findings: In comparison with the study of ___, the monitoring and support devices are essentially unchanged.  Again, there are diffuse areas of increased opacification bilaterally, consistent with pulmonary edema with cardiomegaly and bilateral pleural effusions with compressive atelectasis at the bases.  In the appropriate clinical setting, supervening pneumonia would have to be considered. ","Findings: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Again, there are diffuse areas of increased opacification unilaterally, consistent with pulmonary edema with cardiomegaly and bilateral pleural effusions with compressive atelectasis at the bases. In the appropriate clinical setting, supervening pneumonia would have to be considered. There are no opacifications seen.","['Change location', 'Add contradiction', 'False negation']"
4ba74541-1812cc99-3b99acbf-6b40a2bd-03715cdd,54123605,19890030,"Impression: In comparison with the earlier film of this date, the Swan-Ganz catheter tip has been pulled back to the proximal portion of the right pulmonary artery.  Nasogastric tube extends into the stomach. Endotracheal tube is unchanged.  Bilateral chest tubes are in place without evidence of pneumothorax. Improved aeration in the retrocardiac region with sharp demonstration of the hemidiaphragm. Improvement in pulmonary vascular congestion.","Impression: In comparaison with the earlier film of this date, the Swan-Ganz catheter tip has been pulled back to the segmental branch of the right pulmonary artery. Nasogastric tube extend into the stomach. Endotracheal tube is unchanged. Bilateral chest tubes are in place without evidence of pneumothorax. Improved aeration in the retrocardiac region with sharp demonstration of the hemidiaphragm. Improvement in pulmonary vascular congestion. There is evidence of minimal pleural effusion.","['Change position of device', 'Add typo', 'False prediction']"
7836bdb5-cf4a3248-ef755485-efddc4f8-838caea7,55960980,19890030,"Findings: Support and monitoring devices are in standard position, and cardiomediastinal contours are stable.  Persistent pulmonary vascular congestion accompanied by improving pulmonary edema and slight decrease in size of bilateral pleural effusions. ","Findings: Support and monitoring devices are in standard position, and cardiomediastinal contours are stable.   Persistent pulmonary vascular congestion accompanied by improving pulmonary edema and slight decrease in size of left pleural effusions. A central venous line is present.","['Change location', 'Change to homophone', 'Add medical device']"
6d0fb843-3f18a296-cc24e0d5-d5196b76-d27ae8c5,56131156,19890030,"Impression: As compared to the previous radiograph, the interstitial component of the pre-existing pulmonary edema has minimally decreased and the pleural effusions have minimally increased in extent.  Signs of pulmonary edema, however, are still clearly present. The monitoring and support devices, including the Swan-Ganz catheter, are in unchanged correct position.  No new focal parenchymal opacities.  No pneumothorax.","Impression: As compared to the previous radiograph, the interstitial component of the pre-existing pulmonary edema has minimally decreased and the pleural effusions have minimally increased in extent. Signs of pulmonary edema, however, are still clearly present. The monitoring and support devices, including the endotracheal tube, are in unchanged correct position. Lung fields are clear. No pneumothorax and pleural effusion is small.","['Change name of device', 'Add contradiction', 'False negation']"
a467ed3c-e5c2d31f-310831c5-6bfd3ab4-fc6a815b,57351800,19890030,"Impression: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube was removed. The lung volumes have slightly decreased. A pleural effusion on the left is minimally increased and signs of mild to moderate pulmonary edema are present in almost unchanged manner.  No pneumothorax.  No new parenchymal opacities.","Impression: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube was removed. There is evidence of right lower lobe consolidation. The lung volumes have slightly decreased. A pleural effusion on the left is minimally increased and signs of moderate pulmonary edema are present in almost unchanged manner.  No pneumoohtorax.  No new parenchymal opacities.","['Change severity', 'Add typo', 'False prediction']"
eac34627-0d789691-739a8249-d2bf5f3c-c4240547,57378297,19890030,"Findings: An ET tube terminates 3 cm above the carina. And NG tube passes inferiorly off the image in the expected region of the stomach.  The lungs are well expanded.  Diffusely increased interstitial markings are again seen, along with engorged pulmonary vasculature and cardiomegaly and bilateral pleural effusions, consistent with moderate pulmonary edema.  Increased opacity at the left lung base compared to prior likely reflects atelectasis. No focal consolidation is seen. There is no pneumothorax. Impression: 1.  ET tube terminates 3 cm above the carina.  2.  Moderate pulmonary edema with bilateral pleural effusions.","Findings: An ET tube terminates 4 cm above the carina. And NG tube passes inferiorly off the image in the expected region of the stomach. There is no evidence of engorged pulmonary vasculature, consistent with moderate pulmonary edema. Diffusely increased interstitial markings are again seen, along with cardiomegaly and bilateral pleural effusions, consistent with moderate pulmonary edema. Increased opacity at the left lung base compared to prior likely reflects atelectasis. No focal consolidation is seen. There is no pneumothorax. Impression: 1. ET tube terminates 3 cm above the carina. 2. Moderate pulmonary edema with bilateral pleural effusions. 2. Moderate pulmonary edema with bilateral pleural effusions.","['Change measurement', 'Add repetitions', 'False negation']"
8027d184-a9e2e118-bcdce505-fcbd9f09-34dd5c61,57508468,19890030,"Findings: In comparison with study of ___, the left IJ Swan-Ganz catheter again extends well into the left pulmonary artery.  This could be withdrawn a few centimeters for standard positioning.  Otherwise, little change in the diffuse bilateral pulmonary opacifications. ","Findings: In comparison with study of ___, the left IJ Swan-Ganz catheter again extends well into the left pulmonary artery. This could be withdrawn a few centimeters for standard positioning. Otherwise, little change in the diffuse bilateral pulmonary opacifications. An NG tube is also noted in the proper position. ","['Change name of device', 'Change to homophone', 'Add medical device']"
10e73dc9-0b884e25-eafa8a2f-300f0487-def8b4d6,57519317,19890030,"Impression: In comparison with the study of 1 hour previously, there is some worsening of the pulmonary edema. Continued bilateral pleural effusions with compressive atelectasis at the bases.","Impression: In comparison with the study of yesterday, there is some worsening of the pulmonary edema. Continued bilateral pleural effusions with compressive atelectasis at the bases. There is a new left-sided pneumothorax. Continued bilateral pleural effusions with compressive atelectasis at the bases.","['Change location', 'Add repetitions', 'False prediction']"
d1ea5ea1-2de5c378-91bf68a9-68b52f49-c9f7e486,57919531,19890030,"Impression: As compared to the previous radiograph, the signs indicative of interstitial lung edema have substantially improved. There is a new retrocardiac atelectasis.  No pleural effusions. Borderline size of the cardiac silhouette persists.  Unchanged position of the monitoring and support devices.","Impression: As compared to the previous radiograh, the signs indicative of interstitial lung edema have substantially improved. There is a new retrocardiac atelectasis. No pleural effusions. No pleural effusions. Borderline size of the cardiac silhouette persists. Unchanged position of the monitoring and support devices. The chest X-ray shows a newly placed NG tube entering the stomach.","['Add typo', 'Add repetitions', 'Add medical device']"
e174e22d-517ea52f-b085dd2a-be0e9ea0-7d59e8de,57980997,19890030,Findings: The right IJ central venous catheter has been removed. There is no pneumothorax. Mild to moderate pulmonary edema has increased since the prior exam. Small bilateral pleural effusions are unchanged. The patient is status post median sternotomy with stable cardiomegaly. There is generalized osteopenia. Impression: Interval worsening of pulmonary edema with stable small bilateral pleural effusions. Stable cardiomegaly.,Findings: The right IJ central venous catheter has been removed. There is no pneumothorax. Mild to moderate pulmonary edema has increased since the prior exam. Small bilateral pleural effusions are unchanged. Atelectasis is seen in the right lower lobe. The patient is status post median sternotomy with stable cardiomegaly. There is generalized osteopenia. Impression: Interval worsening of pulmonary edema with stable small bilateral pleural effusions. Stable cardiomegaly. There is generalized osteopenia.,"['Change name of device', 'Add repetitions', 'False prediction']"
3435ed46-ac4d2fc9-701d2553-97322bab-a7090480,58510002,19890030,"Findings: A new right IJ central line terminates in the mid to low SVC. The ET tube and NG tube are unchanged from prior exam.  The lungs are well expanded. Diffusely increased interstitial markings are again noted in the lungs bilaterally, along with engorged pulmonary vasculature, cardiomegaly, and bilateral pleural effusions, consistent with moderate pulmonary edema, similar to prior exams.  Opacity at the left lung base is again noted, consistent with atelectasis. No focal consolidation is seen and there is no pneumothorax. Impression: 1. Right IJ central line terminates in the mid to low SVC.  2.  Moderate pulmonary edema with bilateral pleural effusions.","Findings: A new right IJ central line terminates in the mid to low SVC. The ET tube and NG tubee are unchanged from prior exam. The lungs are well expanded. Diffusely increased interstitial markings are again noted in the lungs bilaterally, along with engorged pulmonary vasculature, no cardiomegaly, and bilateral pleural effusions, consistent with mild pulmonary edema, similar to prior exams. Opacity at the left lung base is again noted, consistent with atelectasis. No focal consolidation is seen and there is no pneumothorax. Impression: 1. Right IJ central line terminates in the mid to low SVC. 2. Moderate pulmonary edema with no pleural effusions.","['Change severity', 'Add typo', 'False negation']"
7302c211-bcfb3845-18039b6f-551fc6f1-549ee247,59340980,19890030,"Findings: The lungs are well expanded. Diffusely increased interstitial markings, pulmonary vasculature engorgement, cardiomegaly, and small bilateral pleural effusions are seen, consistent with moderate pulmonary edema. No focal consolidation is seen. There is no pneumothorax. Impression: Moderate pulmonary edema with small bilateral pleural effusions.","Findings: The lungs are well expanded. Diffusely increased interstitial markings, pulmonary vasculature engorgement, cardiomegaly, and small bilateral pleural effusions are seen, consistent with moderate pulmonary edema. No focal consolidation is seen. There is no pneumothorax. A central venous line is in place. Impression: Mild pulmonary edema with small bilateral pleural effusions.","['Change severity', 'Add contradiction', 'Add medical device']"
fd85d68f-eb20917f-47c20d2b-ecd0f4e7-2bdee415,59921918,19890030,"Findings: In comparison with the study of ___, the monitoring and support devices are essentially unchanged.  Diffuse bilateral pulmonary opacification is consistent with pulmonary edema in a patient with cardiomegaly and bilateral pleural effusions with compressive atelectasis at the bases. ","Findings: In comparison with the study of ___, the monitoring and support devices are essentially unchanged.  Diffuse bilateral pulmonary opacification is consistent with pulmonary edema in a patient with cardiomegaly and bilateral pleural effusions with compressive atelectasis at the mediastinum.  Differential air bronchograms are noted throughout the lungs.","['Change location', 'Add typo', 'False prediction']"
9d752539-c8aeb9f8-049a169c-1605c54e-90634c71,52385709,19890966,Findings: Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present.  No acute osseous abnormalities are visualized. Impression: No acute cardiopulmonary abnormality.,Findings: Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. Impression: No acute cardiopulmonary abnormality. A pacemaker is in place.,"['Add medical device', 'Add repetitions', 'False prediction']"
"35fe6db8-9b1e2b47-acbac4cf-7c7be2b0-4e63a836, 7fbb1cce-8dd0a953-1266b08a-dbb89115-121dff79",52643889,19890966,Findings: The lungs are clear without focal consolidation.  No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Impression: No acute cardiopulmonary process.  No focal consolidation to suggest pneumonia.,Findings: The lungs are clear without focal consolidation. A left pleural effusion is seen. The cardiac and mediastinal silhouettes are stable. Impression: No acute cardiopulmonary process.  Focal consolidation to suggest pneumonia. There is a right IJ central venous line in place.,"['False negation', 'Add contradiction', 'Add medical device']"
"499b08f0-eadc74b7-e72cbb9c-48acb229-95d39e5f, fb7104eb-06978e11-1a4eaa5a-83848428-dcc8d180",55753415,19890966,"Findings: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. Impression: No acute cardiopulmonary process.","Findings: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleura abnormality is seen. Impression: The cardiac silhouette is enlarged. There is an implantable cardioverter defibrillator in place.","['Change to homophone', 'Add contradiction', 'Add medical device']"
"94d1cb3d-d73778f9-54fd1b3c-a3db8e00-ac37feda, b4ae0cda-2cd5c157-6145e13b-4f90cb33-2a458516",57024988,19890966,"Findings: PA and lateral views of the chest provided.  There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen. Impression: No acute intrathoracic process.","Findings: PA and lateral viewsof the chest provided.  There is no focal consolidation, effusion, or pnumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intaxt.  No free air below the left hemidiaphragm is seen. There is a central venous line in place. Impression: No acute intrathoracic process.","['Change location', 'Add typo', 'Add medical device']"
fc82e711-14ed01dc-ce2a326a-162251e4-aee54953,50370886,19932024,"Findings: AS COMPARED TO ___, A SWAN-GANZ CATHETER HAS BEEN REMOVED, AND A RIGHT INTERNAL JUGULAR CATHETER TERMINATES DEEP IN THE RIGHT ATRIUM.  LUNG VOLUMES ARE LOWER COMPARED TO PRIOR STUDY.  DIFFUSE ALVEOLAR PULMONARY EDEMA HAS PROBABLY SLIGHTLY WORSE IN THE INTERVAL, ALTHOUGH LOWER LUNG VOLUMES LIMIT COMPARISON. ","Findings: AS COMPARED TO ___, A CENTRAL VENOUS LINE HAS BEEN REMOVED, AND A RIGHT INTERNAL JUGULAR CATHETER TERMINATES DEEP IN THE RIGHT ATRIUM.  LUNG VOLUMES ARE LOWER COMPARED TO PRIOR STUDY.  DIFFUSE ALVEOLAR PULMONARY EDEMA HAS PROBABLY SLIGHTLY IMPROVED IN THE INTERVAL, ALTHOUGH LOWER LUNG VOLUMES LIMIT COMPARISON. A LEFT-SIDED PACEMAKER DEVICE IS NOTED WITH LEADS TERMINATING IN THE RIGHT ATRIUM AND RIGHT VENTRICLE.","['Change name of device', 'Add contradiction', 'Add medical device']"
fc325dc2-bf224206-062f3c9e-47aae515-4ef25cc0,50963033,19932024,"Impression: AS COMPARED TO THE PREVIOUS RADIOGRAPH, THE PATIENT HAS BEEN EXTUBATED AND THE NASOGASTRIC TUBE WAS REMOVED.  THE RIGHT INTERNAL JUGULAR VEIN CATHETER AND THE SWAN-GANZ CATHETER ARE IN UNCHANGED POSITION.  NEWLY APPEARED MASSIVE BILATERAL PARENCHYMAL OPACITIES, THE TIME COURSE OF THE CHANGES SUGGESTS PULMONARY EDEMA RATHER THAN PNEUMONIA, NOTABLY GIVEN THE PRESENCE ___ ___ B LINES AND OF A RETROCARDIAC ATELECTASIS.  MODERATE CARDIOMEGALY PERSISTS.  SHORT-TERM FOLLOWUP IS REQUIRED.","Impression: AS COMPARED TO THE PREVIOUS RADIOGRAPH, THE PATIENT HAS BEEN EXTUBATED AND THE NASOGASTRIC TUBE WAS REMOVED. THE RIGHT INTERNAL JUGULAR VEIN CATHETER AND THE SWAN-GANZ CATHETER ARE IN UNCHANGED POSITION. NEWLY APPEARED MASSIVE BILATERAL PARENCHYMAL OPACITIES, THE TIME COURSE OF THE CHANGES SUGGESTS PULMONARY EDEMA RATHER THAN PNEUMONIA, NOTABLY GIVEN THE PRESENCE ___ ___ B LINES AND OF A RETROCARDIAC ATELECTASIS. MODERATE CARDIOMEGALY PERSISTS. SHORT-TERM FOLLOWUP IS REQUIRED. The right internal jugular vein catheter and the Swan-Ganz catheter are in unchanged position.","['Change position of device', 'Add repetitions', 'False negation']"
"7d918df3-b51f08b1-b7c9a415-2be08ec7-a1b1bd81, a9e13b36-9f15b5ec-c6da8ece-3f40651b-6efa91f1",52421327,19932024,Findings: Heart size is normal.  The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. Impression: No acute cardiopulmonary abnormality.,Findings: Heart size is normal.  The mediastinal and hilar contours are noraml. The pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or pneumothorax is seen. Impression: No acute cardiopulmonary abnormality. There is a right-sided central venous line with tip in the SVC. Mild pulmonary edema is noted.,"['Add contradiction', 'Add typo', 'Add medical device']"
68ccd799-61e98428-3c7d8e41-6cbc342c-3426519b,54345212,19932024,"Impression: As compared to the previous image, the Swan-Ganz catheter has been pulled back.  The tip now projects over the proximal parts of the right pulmonary artery.  The other monitoring and support devices are constant.  Low lung volumes and moderate cardiomegaly persists.  Mild pulmonary edema is present on today's image.  No pneumonia.","Impression: As compared to the previous image, the Swan-Ganz catheter has bean pulled back.  The tip now projects over the proximal parts of the right pulmonary artery.  The other monitoring and support devices are constant.  Low lung volumes and mild cardiomegaly persists.  Mild pulmonary edema is present on today's image.  No pneumonia.","['Change severity', 'Change to homophone', 'False negation']"
63632dd8-b728b108-982f3619-2ca6f6b2-61729c7f,54635186,19932024,Impression: Despite the low lung volumes. The increase in the perihilar interstitial opacities and increase in the azygos vein is consistent with interstitial pulmonary edema. Small bilateral pleural effusions are most likely present.,Impression: Despite the low lung volumes. The increase in the perihilar interstitial opacities and increase in the superior vena cava is consistent with interstitial pulmonary edema. No pleural effusions are present. Small bilateral pleural effusions are most likely present.,"['Change location', 'Add repetitions', 'False negation']"
94cfab5d-c84c24dc-ebd79acf-b51bfecb-df30081b,55032644,19932024,Impression: Heart size is normal.  Mediastinum is normal.  Lungs are clear.  There is no pleural effusion or pneumothorax.,Impression: Heart sze is normal. Mediastinum is normal. Lungs are clear. There is bilateral pleural effusion. No pneumothorax is present.,"['Add typo', 'Add contradiction', 'False prediction']"
e83af64a-ef08e235-e0e92758-c6fe1b4d-09380b28,56211786,19932024,"Impression: As compared to the previous radiograph, the extensive bilateral parenchymal opacities, diffusely distributed in both lungs, are not substantially changed. The lung volumes remain low.  Moderate cardiomegaly.  No pleural effusions.","Impression: As compared to the previous radiograph, the extensive bilateral parenchymal opacities, diffusely distributed in both lungs, are not substantially changed. The lung volumes remain low. Sever cardiomegaly.  No pleural effusions. There is a small left-sided pneumothorax.","['Change severity', 'Add typo', 'False prediction']"
d067947d-61c60fe1-b73bc826-356d3d2c-fd22bb48,57682201,19932024,"Impression: Lung volumes are lower, but increased pulmonary vascularity is real, consistent with increase pulmonary circulation or left ventricular dysfunction.  There is no definite focal pulmonary abnormality.  Heart size top-normal.  No appreciable pleural","Impression: Lung volumes are lower, but increased pulmonary vascularity is real, consistent with increase pulmonary circulation or left ventricular dysfunction.  There is no definite focal pulmonary abnormality.  Heart size top-normal.  No appreciable plerual. Addditionaly, an NG tube is in place.  ","['Change location', 'Add typo', 'Add medical device']"
937ff0e8-71a2ffe2-83753442-7400aa5e-eceef12c,58536194,19932024,"Findings: The lung volumes are low.  There are bibasilar linear opacities, atelectasis and/ or consolidation.  Diffuse vascular prominence and cardiomegaly noted.  No pleural effusion or pneumothorax present.  EKG leads overlie the anterior chest.  Bony thorax is stable. Impression: Low lung volumes with bibasilar atelectasis and/or consolidation. Underlying mild pulmonary edema also noted.","Findings: The lung volumes are low.  There are bibasilar linear opacities, atelectasis and/ or consolidation.  Diffuse vascular prominence and cardiomegaly noted.  No pleural effusion or pneumothorax present.  EKG leads overlie the anterior chest.  Bony thorax is stable.  Diffuse vascular prominence and cardiomegaly noted. Impression: Low lung volumes with bibasilar atelectasis and/or consolidation. Underlying moderate pulmonary edema also noted.","['Change severity', 'Add repetitions', 'False negation']"
f77e46ef-2fa9d49a-1defe019-ac2c199d-7695e244,58958645,19932024,"Impression: Normal lung volumes.  Normal size of the cardiac silhouette.  Normal hilar and mediastinal contours.  No pneumothorax, no pleural effusions, no pulmonary edema.  No pneumonia.","Impression: Acute lung volumes with slight hyperinflation. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumothorax, no pleural fusion, no severe pulmonary edema. No large consolidated areas indicative of pneumonia.","['Add contradiction', 'Change to homophone', 'False prediction']"
943f96be-7c33efa1-3665b82f-60d8f305-a6ed2d9d,59300264,19932024,Findings: Moderately well inflated lungs with no change in prominence of pulmonary vasculature.  Stable cardiomegaly.  Enlarged left atrial shadow is again identified.  No pleural effusions or pneumothorax.  No change in bony thorax. Impression: No change in mild to moderate pulmonary edema and cardiomegaly.  No lobar consolidation.,Findings: Moderately well inflated lungs with no change in prominence of pulmonary vascalature.  Stable cardiomegaly.  Enlarged right atrial shadow is again identified.  No pleural effusions or pneumothorax.  No change in bony thorax.  A pacemaker is present. Impression: No change in mild to moderate pulmonary edema and cardiomegaly.  No lobar consolidation.,"['Change location', 'Add typo', 'Add medical device']"
"6895d4bc-d096ea6d-b0c6fcba-6b5fe802-4ce2705e, a8db31e4-f0fa9118-7b9e02ea-16072096-503550a0",50986956,19950864,"Findings: The cardiac, mediastinal and hilar contours appears unchanged. There is no pleural effusion or pneumothorax. Parenchymal abnormalities appear unchanged and reflect emphysema with mild accompanying interstitial disease. Subpleural scarring and a small hyperdense nodules at the right lung apex appear unchanged. Scarring and bullous changes are also stable at the base of the left chest. The chest is hyperinflated. There has been no significant change. Impression: No evidence of acute cardiopulmonary disease.","Findings: The cardiac, mediastinal and hilar contours appears unchagend. There is no pleural effusion or pneumothorax. Parenchymal abnormalities appear unchanged and reflect emphysema with no interstitial disease. Subpleural scarring and a small hyperdense nodule at the left lung apex appear unchanged. Scarring and bullous changes are also stable at the base of the left chest. The chest is normal. There has been no significant change.","['Change location', 'Add typo', 'False negation']"
"16664421-34328b5d-6c0d94e2-71285361-4233fb85, 61b2e5b3-5192e298-d28244ef-a46613e7-13ff9c2e",52815959,19950864,"Findings: There is mild interstitial edema, and the heart is normal in size.  A left basilar opacity may reflect atelectasis versus pneumonia.  There is no pleural effusion or pneumothorax. Impression: Mild interstitial edema.  Left basilar opacity may reflect atelectasis though infection can be considered in the appropriate clinical setting.","Findings: There is moderate interstitial edema, and the heart is normal in sighs.  A left basilar opacity may reflect atelectasis versus pneumonia.  There is no pleural effusion or pneumothorax.  A pacemaker is present with leads in the right atrium and ventricle. Impression: Mild interstitial edema.  Left basilar opacity may reflect atelectasis though infection can be considered in the appropriate clinical setting.","['Change severity', 'Change to homophone', 'Add medical device']"
"1fc7bf88-79d4deaf-2efe8540-6361e421-37a2c6fa, 4e9a15d6-c451210c-9add77c8-20371722-8023beef",53502057,19950864,"Findings: Parenchymal abnormality including emphysema with mild interstitial disease appears stable. There is mild pulmonary vascular congestion and interstitial edema.  Scarring at the left lung base also unchanged.  No pleural effusion or pneumothorax.  Mild cardiomegaly is noted.  The aortic knob is calcified. Impression: Emphysema with mild congestion and edema.  Bibasal atelectasis, mild cardiomegaly.","Findings: Parenchymal abnormality including emphysema with moderate interstitial disease appears stable. There is mild pulmonary vascular congestion and interstitial edema. Scarring at the left lung base also unchanged. No pleural effusion or pneumothorax. Mild cardiomegaly is noted. The aortic knob is calcified. Impression: No emphysema. Emphysema with mild congestion and edema. Bibasal atelectasis, moderate cardiomegaly.","['Change severity', 'Add repetitions', 'False negation']"
"b66f1c8b-6c12fd80-d9b69793-f7db8cd1-92ac8637, dbd9097b-81b68048-faf162d2-5ecda5ea-5d893d73",58368837,19950864,"Findings: Frontal and lateral views of the chest show no acute intrathoracic process.  Flattened diaphragms and pulmonary blebs are consistent with obstructive lung disease.  The mediastinum and pleural structures are unremarkable.  Calcifications are seen within the aortic arch.  The shoulders are not fully evaluated, however, there are no suspicious osseous lesions.  Degenerative changes are seen within the thoracic spine. Impression: No acute intrathoracic process.","Findings: Frontal and lateral views of the chest show no acute intrathoracic process. Flattened diaphragms and pulmonary blebs are consistent with obstructive lung disease. The mediastinum and pleural structures are unremarkable. Calcifications are not seen within the aortic arch. The shoulders are not fully evaluated, however, there are no suspicious osseous lesions. Degenerative changes are seen within the cervical spine. Impression: No acute intrathoracic process. Flattened diaphragms and pulmonary blebs are consistent with obstructive lung disease. ","['Change location', 'Add repetitions', 'False negation']"