Impression Preferences & Guidelines
Teach the AI your personal reporting style so it generates impressions the way you would write them.
Your administrator must enable this feature under Integration Settings → Enable Impression Preferences. This feature is currently in BETA.
What Are Impression Preferences?
Instead of getting generic, one-size-fits-all impressions, you can customize how the AI writes impressions to match your style. Think of it as training the AI to write impressions the way you would.
What you control:
Should the AI suggest diagnoses or just describe findings?
How should incidental findings be handled?
Which degenerative changes make it into the impression?
What order should findings be listed?
These settings apply to your account only - your colleagues can have different preferences.
Where to Find It
User Profile → Preferences → Impression Preferences
Your Preference Options
Diagnostic Mode
What it does: Controls whether AI suggests diagnoses or sticks to descriptive findings.
Your options:
Disabled (default)
Descriptive impressions only "Right lower lobe consolidation"
Most radiologists who prefer to provide their own diagnoses
Enabled
Diagnosis suggestions included "Right lower lobe consolidation, likely pneumonia"
When you want AI assistance with differential diagnoses
Example difference:
When enabled, always review AI diagnosis suggestions carefully. The AI provides possibilities, not definitive diagnoses.
Incidental Findings Format
What it does: Determines how non-acute or incidental findings appear in your impression.
Your options:
Threshold Based (default) ⭐ Recommended
Only includes incidental findings if they're clinically significant.
What gets included:
✅ "6 mm pulmonary nodule, recommend CT follow-up in 6 months"
✅ "Moderate hepatosplenomegaly"
What gets excluded:
✗ "Trace free fluid"
✗ "Mild hepatic steatosis"
Best for: Most radiologists - gives a balanced impression without clutter
Summary Statement
Groups all minor findings into a single summary line.
Example impression:
Best for: High-volume practices, streamlined reporting, or when referring providers prefer concise impressions
List All
Every finding gets its own numbered impression point, regardless of significance.
Example impression:
Best for: Completeness-focused reporting or specific institutional requirements
Omit Non-Acute
Excludes all incidental and non-acute findings from the impression entirely.
Example impression:
(No mention of chronic or incidental findings)
Best for: Emergency radiology where only acute findings matter
Degenerative Changes Reporting
What it does: Controls which age-related changes (arthritis, disc disease, etc.) appear in impressions.
Your options:
Severe Only (default)
Only "severe", "advanced", or "extensive" degenerative changes
✅ "Severe multilevel lumbar spondylosis" ✗ "Mild disc space narrowing at L4-L5"
All Changes
Every degenerative change, regardless of severity
✅ "Mild degenerative changes at L4-L5" ✅ "Moderate facet arthropathy"
Never Include
No degenerative changes in impression at all
✗ No degenerative findings listed
When to use each:
Severe Only: Standard for most practices - avoids cluttering impressions with expected age-related changes
All Changes: Orthopedics, rheumatology, or pain management referrals where all changes matter
Never Include: Emergency radiology where acute pathology is the only concern
Chronic Findings Inclusion
What it does: Determines which stable/chronic conditions make it into the impression.
Your options:
Relevant Only (default)
Includes chronic findings only if they relate to the clinical question
History: "Chest pain" ✅ "Stable moderate COPD" (could cause CP) ✗ "Stable nephrolithiasis" (unrelated)
Severe Only
Includes only if described as "severe", "advanced", or "extensive"
✅ "Severe cirrhosis" ✗ "Moderate COPD"
All Chronic
Includes all chronic findings regardless of relevance
✅ Everything gets listed
Never Include
Excludes all chronic findings
✗ No chronic findings in impression
Practical example:
Finding Priority Order
What it does: Controls the order in which findings are listed in your impression.
Your options:
Significance (default) ⭐
AI orders findings by clinical importance.
Best for: General radiology - lets AI determine what's most important
Clinical Relevance
Findings related to the clinical history come first.
Best for: When you focus heavily on answering the clinical question
Acuity Based
Most acute/life-threatening findings first, regardless of clinical history.
Best for: Emergency radiology where acuity determines priority
Anatomical
Findings organized by location or organ system.
Best for: Complex multi-organ studies (trauma, staging scans)
Impression Guidelines
In addition to your personal preferences, your organization may have Impression Guidelines that you can enable or disable.
What Are Guidelines?
Guidelines are organization-created rules that provide the AI with domain-specific instructions.
Examples:
"Lung nodules: Include Fleischner classification and follow-up recommendations"
"Fractures: Always mention alignment and displacement"
"Cardiac imaging: Comment on chamber sizes and ejection fraction if measurable"
How to Enable/Disable Guidelines
Navigate to: User Profile → Preferences → Impression Guidelines
See the list of guidelines your organization has created
Check the guidelines you want active for your reports
Uncheck guidelines you don't want applied
Changes save automatically
How It All Works
AI Processing Flow
AI reads your findings section — understands what you dictated
Applies your preferences — follows your personal settings
Considers active guidelines — applies organization rules you've enabled
Checks clinical history — uses context to determine relevance
Generates impression — creates text matching your style
You review and edit — final control before signing
Getting Started
Step 2: Make One Change at a Time
After the trial period, adjust one preference and use it for a few days.
Why? If you change everything at once, you won't know which setting caused which change.
Example progression:
Week 1–3: Use defaults, take notes
Week 4: Change "Incidental Findings" to Summary Statement
Week 5: If you like it, adjust "Finding Priority Order"
Week 6: Fine-tune "Degenerative Changes Reporting"
Tips for Success
Make Preferences Work for You
✅ Do:
Start conservative, adjust gradually
Note patterns in your edits to guide preference changes
Test new settings on routine cases first
Share successful configurations with colleagues
❌ Don't:
Change everything at once
Expect perfection immediately
Forget to re-test after changing settings
Ignore feedback from referring providers
Common Preference Combinations
"I want concise impressions"
"I want comprehensive impressions"
"I want emergency-focused impressions"
"I want AI diagnostic assistance"
Voice Your Feedback
Your administrator needs to hear:
Which preferences work well
Which need more options
Ideas for new organization guidelines
Technical issues you encounter
This helps improve the system for everyone.
Frequently Asked Questions
Will changing preferences affect reports I've already signed?
No. Preferences only affect new impression generation. Signed reports remain unchanged.
Can I have different preferences for different exam types?
Not currently. Preferences apply to all your reports. However, you can:
Manually edit impressions as needed
Use organization guidelines that activate based on study type
Change preferences between cases (though not ideal for workflow)
Do my preferences affect my colleagues' reports?
No. Each user has their own preference settings. Your choices don't impact anyone else.
How do I know if a guideline is mandatory?
Mandatory guidelines have a lock icon 🔒 and appear greyed out (cannot be unchecked).
Can I see what impression preferences my colleague uses?
Not directly through the interface. However, you can:
Ask them to share screenshots
Discuss preferences as a team
Have your admin create organization guidelines based on team consensus
Last updated