Hedging their mets: the use of uncertainty terms in clinical documents and its potential implications when sharing the documents with patients.

In this study, we quantified the use of uncertainty expressions, referred to as 'hedge' phrases, among a corpus of 100,000 clinical documents retrieved from our institution's electronic health record system. The frequency of each hedge phrase appearing in the corpus was characterized across document types and clinical departments. We also used a natural language processing tool to identify clinical concepts that were spatially, and potentially semantically, associated with the hedge phrases identified. The objective was to delineate the prevalence of hedge phrase usage in clinical documentation which may have a profound impact on patient care and provider-patient communication, and may become a source of unintended consequences when such documents are made directly accessible to patients via patient portals.