If a report states that X was not found, it does not mean X did not exist, it means it was not found.
What may be lost on the layperson is the nuance and understanding of how thorough or not a particular scan is and how much weight to give the findings and thus the odds that the report is correct.
Yah you can argue that the tool is not ideal for that diagnostic, yadda yadda. I get it, and in the end I agree with the subtle difference you highlight, because it is something that makes sense to a certain kind of people. You know how many medics would read the report exactly like the author did? Too many.
How do I know? Im not in a wheelchair after being constantly misdiagnosed by using the wrong imagiology technique by (mostly) chance, and a good help from friends, including a surgeon. This seems to be a case where AI would be a valuable doctor tool for differential diagnosis; instead we have know-it-alls that can't bother to verify, and AI that often gets details wrong. That is the problem.
That might be true, but it is definitely not the world we live in.
And I think we can easily have examples where we can reasonably trust this, and a spectrum of such.
E.g. there is a math solution and the report says "there is no errors in this solution", you would imagine that to be quite reliable, no?
Even then, the context that "ultrasound isn't a great way to assess for calcification" is important when reading either statement. Laypeople don't necessarily have that context.
I’m fairly sure that there are no lions in my house. Lions are quite large and I’m capable of detecting lion sized objects with my eyes.
To demonstrate that something is not present you first define the object, then come up with a test that will reliably detect the object. If the test comes back negative then the object is not there.
In a strict philosophical sense I cannot prove that there are no lions in my house, the external world might not exist! A hypothesis that no one has thought of might be correct and that hypothesis could show that there are invisible lions in my house!
However I intend to act with the certainty that there are no lions in my house. Because I have no evidence of lions in my house.
Absence of evidence is evidence of absence.
My internal model is/was “if the scan wasn’t set up / can’t detect the thing, why would the statement be present at all?”.
That implicit assumption is really subtle.
I don’t think that’s true. Avoiding this mistake requires knowing that an ultrasound may not detect calcification. For a patient reading their own report, I don’t think that’s intuitive. I would expect most people to read “no calcifications” and assume that their joint has no calcifications.