Lumbar spine MRI reports are too difficult for patients to understand

As increasing numbers of patients gain online access to their radiology reports, a new study published in the April 2019 issue of the American Journal of Roentgenology (AJR) assesses how thoroughly patients understand these complex documents.

Traditionally intended to communicate findings and diagnoses to clinicians, radiology reports have become much more accessible to patients through the advent of online portals and an increasing focus among radiologists on patient-centered care. But what are these patients learning from this unprecedented access to their health records?

The study, "Readability of Lumbar Spine MRI Reports: Will Patients Understand?," reviewed 110 lumbar spine MRI reports dictated by 11 fellowship-trained radiologists at a single academic medical center. Reports were evaluated using five quantitative readability tests: the Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning Fog Index, Coleman-Liau Index, and the Simple Measure of Gobbledygook.

Unfortunately for patients looking for easily understandable health information, the authors found that all the lumbar spine MRI reports were written at a readability level significantly above the average reading ability of U.S. adults. Only one report studied was written at or below eight-grade level (the average reading ability of U.S. adults) and the mean readability grade level of all the reports was greater than a 12th-grade reading level. The authors note that in prior studies patients cited complex language, specialized terminology, and report length, as contributing factors in their difficulty understanding radiology reports.

The National Institutes of Health and the American Medical Association recommend a reading level at or below sixth-grade for patient education materials, which begs the question of how much increasing patient access to electronic health information should determine the character of the information itself. The evolving role of patient reports—from documents written exclusively for referring clinical providers to "educational" materials routinely accessed by patients—raises new considerations for how these documents might be written and presented in the future, and the role radiologists may play in helping patients to better understand them.

Paul Yi, MD, one of the authors of the study said, "It is our hope that we bring awareness to the potential difficulties patients' may have in interpreting their healthcare information, so that potential solutions can start to be developed."