Readability of Lumbar Spine MRI Reports: Will Patients Understand?
Abstract
OBJECTIVE: Radiology reports have traditionally been written for referring clinical providers. However, as patients increasingly access their radiology reports through online medical records, concerns have been raised about their ability to comprehend these complex documents. The purpose of this study was to assess the readability of lumbar spine MRI reports. MATERIALS AND METHODS: We reviewed 110 lumbar spine MRI reports dictated by 11 fellowship-trained radiologists (eight musculoskeletal radiologists and three neuroradiologists) at a single academic medical center. We evaluated each article for readability 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. The number of reports with readability at or below eighth-grade level (average reading ability of U.S. adults) and at or below sixth-grade level (level recommended by the National Institutes of Health and the American Medical Association for patient education materials) were determined. RESULTS: The mean readability grade level of the lumbar spine MRI reports was greater than the 12th-grade reading level for all readability scales. Only one report was written at or below eighth-grade level; no reports were written at or below sixth-grade level. CONCLUSION: Lumbar spine MRI reports are written at a level too high for the average patient to comprehend. As patients increasingly read their radiology reports through online portals, consideration should be made of patients' ability to read and comprehend these complex medical documents.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
For patients without a medical background, radiology reports are often inaccessible.
“For patients without a medical background, these reports are often inaccessible [9–12].”
From ChatGPT makes medicine easy to swallow: an exploratory case study on simplified radiology reports (2023) · cites this paper as [10]
Cites
Friedman, D. B., & Hoffman‐Goetz, L. (2006) · Health Education & Behavior · doi:10.1177/1090198105277329 · Cited by 518 · see citing works
Chronic Low-Back Pain, Psychologic Distress, and Illness Behavior
Waddell, G., Main, C. J., MORRIS, E. W., PAOLA, M. D., & Gray, I. (1984) · Spine · doi:10.1097/00007632-198403000-00013 · Cited by 361 · see citing works
The radiology report — Are we getting the message across?
Wallis, A., & McCoubrie, P. (2011) · Clinical Radiology · doi:10.1016/j.crad.2011.05.013 · Cited by 187 · see citing works
Badarudeen, S., & Sabharwal, S. (2008) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.g.00347 · Cited by 184 · see citing works
Itri, J. N. (2015) · Radiographics · doi:10.1148/rg.2015150110 · Cited by 148 · see citing works
Readability and Comprehensibility of Patient Education Material in Hand-Related Web Sites
Wang, S. W., Capo, J. T., & Orillaza, N. S. (2009) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2009.04.008 · Cited by 130 · see citing works
Radiology reporting: attitudes of referring physicians.
Clinger, N. J., Hunter, T. B., & Hillman, B. (1988) · Radiology · doi:10.1148/radiology.169.3.3187005 · Cited by 129 · see citing works
A Critical Review of the Readability of Online Patient Education Resources From RadiologyInfo.Org
Hansberry, D. R., John, A. M., John, E. S., Agarwal, N., Gonzales, S. F., & Baker, S. R. (2014) · American Journal of Roentgenology · doi:10.2214/ajr.13.11223 · Cited by 86 · see citing works
Henshaw, D., Okawa, G., Ching, K., et al. (2015) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2015.01.015 · Cited by 81 · see citing works
Patient Access to Online Radiology Reports
Miles, R. C., Hippe, D. S., Elmore, J. G., Wang, C. L., Payne, T. H., & Lee, C. I. (2016) · Academic Radiology · doi:10.1016/j.acra.2016.05.005 · Cited by 78 · see citing works
Structured reporting of MRI of the shoulder – improvement of report quality?
Gassenmaier, S., Armbruster, M., Haasters, F., et al. (2017) · European Radiology · doi:10.1007/s00330-017-4778-z · Cited by 67 · see citing works
PORTER: a Prototype System for Patient-Oriented Radiology Reporting
Oh, S. C., Cook, T. S., & Kahn, C. E. (2016) · Journal of Imaging Informatics in Medicine · doi:10.1007/s10278-016-9864-2 · Cited by 65 · see citing works
Patient-centered Radiology: Where Are We, Where Do We Want to Be, and How Do We Get There?
Kemp, J. L., Mahoney, M. C., Mathews, V. P., Wintermark, M., Yee, J., & Brown, S. D. (2017) · Radiology · doi:10.1148/radiol.2017162056 · Cited by 64 · see citing works
Poor patient comprehension of abnormal mammography results
Karliner, L., Kaplan, C. P., Juarbe, T. C., et al. (2005) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2005.40281.x · Cited by 63 · see citing works
Gunn, A. J., Gilcrease-Garcia, B., Mangano, M. D., Sahani, D. V., Boland, G. W., & Choy, G. (2017) · American Journal of Roentgenology · doi:10.2214/ajr.16.17584 · Cited by 58 · see citing works
Readability of the Radiologic Report
Sierra, A., Bisesi, M. A., Rosenbaum, T. L., & Potchen, E. J. (1992) · Investigative Radiology · doi:10.1097/00004424-199203000-00012 · Cited by 55 · see citing works
Takahashi, N., Kikuchi, S., Konno, S., Morita, S., Suzukamo, Y., Green, J., & Fukuhara, S. (2006) · Spine · doi:10.1097/01.brs.0000209319.94256.89 · Cited by 52 · see citing works
Cook, T. S., Oh, S. C., & Kahn, C. E. (2017) · Academic Radiology · doi:10.1016/j.acra.2017.03.005 · Cited by 52 · see citing works
Yi, P. H., Ganta, A., Hussein, K. I., Frank, R. M., & Jawa, A. (2013) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1016/j.arthro.2013.03.003 · Cited by 48 · see citing works
Self-citationReadability of Pediatric Patient Education Materials
Klingbeil, C. G., Speece, M. W., & Schubiner, H. H. (1995) · Clinical Pediatrics · doi:10.1177/000992289503400206 · Cited by 41 · see citing works
What the Patient Wants: An Analysis of Radiology-Related Inquiries From a Web-Based Patient Portal
Mervak, B. M., Davenport, M. S., Flynt, K. A., Kazerooni, E. A., & Weadock, W. J. (2016) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2016.05.022 · Cited by 39 · see citing works
Hansberry, D. R., Kraus, C. N., Agarwal, N., et al. (2014) · CardioVascular and Interventional Radiology · doi:10.1007/s00270-013-0752-6 · Cited by 38 · see citing works
Bossen, J. K. J., Hageman, M. G. J. S., King, J. D., & Ring, D. (2013) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-013-3100-x · Cited by 37 · see citing works
Informing Patients About Risks and Benefits of Radiology Examinations: A Review Article
Cardinal, J. S., Gunderman, R. B., & Tarver, R. D. (2011) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2010.09.007 · Cited by 34 · see citing works
Wong, K., & Levi, J. R. (2016) · The Laryngoscope · doi:10.1002/lary.26359 · Cited by 34 · see citing works
Are we failing to communicate? Internet-based patient education materials and radiation safety
Hansberry, D. R., Ramchand, T., Patel, S. A., et al. (2014) · European Journal of Radiology · doi:10.1016/j.ejrad.2014.04.013 · Cited by 31 · see citing works
Full Radiology Report through Patient Web Portal: A Literature Review
Alarifi, M., Patrick, T. B., Jabour, A. M., Wu, M., & Luo, J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17103673 · Cited by 28 · see citing works
Readability of Online Patient Education Materials Related to IR
McEnteggart, G. E., Naeem, M., Skierkowski, D., et al. (2015) · Journal of Vascular and Interventional Radiology · doi:10.1016/j.jvir.2015.03.019 · Cited by 27 · see citing works
Hansberry, D. R., Agarwal, N., John, E. S., et al. (2017) · Internal and Emergency Medicine · doi:10.1007/s11739-017-1611-2 · Cited by 25 · see citing works
Sorensen, C. J., George, S. Z., Callaghan, J. P., et al. (2016) · PM&R · doi:10.1016/j.pmrj.2016.02.013 · Cited by 18 · see citing works
Is the Internet a Suitable Patient Resource for Information on Common Radiological Investigations?
Bowden, D. J., Yap, L.-C., & Sheppard, D. (2017) · Academic Radiology · doi:10.1016/j.acra.2017.01.012 · Cited by 15 · see citing works
Hansberry, D. R., Patel, S. R., Agarwal, P., et al. (2016) · International Journal of Colorectal Disease · doi:10.1007/s00384-016-2730-3 · Cited by 13 · see citing works
The Usefulness of Clinical Measures of Psychologic Factors in Patients with Spinal Pain
Murphy, D. R., & Hurwitz, E. L. (2011) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/j.jmpt.2011.09.009 · Cited by 11 · see citing works
Chen, W., Durkin, C., Huang, Y., Adler, B. H., Rust, S., & Lin, S. M. (2017) · Journal of Imaging Informatics in Medicine · doi:10.1007/s10278-017-9972-7 · Cited by 10 · see citing works
Radiology reports: a quantifiable and objective textual approach
Scott, J. A., & Palmer, E. L. (2015) · Clinical Radiology · doi:10.1016/j.crad.2015.06.080 · Cited by 9 · see citing works
Optimizing communication between the radiologist and the general practitioner
Jans, L., Bosmans, J., Verstraete, K. L., et al. (2013) · Journal of the Belgian Society of Radiology · doi:10.5334/jbr-btr.472 · Cited by 9 · see citing works
Evaluation of Audiovisual Reports to Enhance Traditional Emergency Musculoskeletal Radiology Reports
Neto, L. P., Godoy, I. R. B., Yamada, A. F., Carrete, H., Jasinowodolinski, D., & Skaf, A. Y. (2019) · Journal of Imaging Informatics in Medicine · doi:10.1007/s10278-019-00261-9 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
ChatGPT makes medicine easy to swallow: an exploratory case study on simplified radiology reports
Jeblick, K., Schachtner, B., Dexl, J., Mittermeier, A., Stüber, A. T., Topalis, J., Weber, T., Wesp, P., Sabel, B. O., Ricke, J., et al. (2023) · European Radiology · doi:10.1007/s00330-023-10213-1 · Cited by 549 · see citing works
- Authors
- Yi, P. H., Golden, S. K., Harringa, J. B., & Kliewer, M. A.
- Affiliations
- Johns Hopkins University (US)
- University of Wisconsin–Madison (US)
- Venue
- American Journal of Roentgenology
- Publisher
- American Roentgen Ray Society
- Published
- 2019-03
- Volume
- 212
- Issue
- 3
- Pages
- 602-606
- ISSN
- 0002-9580 (ISSN-L)
- 0361-803X
- 1546-3141
- OpenAlex
- W2911117234
- Cited by
- 30
- References
- 37
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 1 · 2021: 5 · 2020: 2 · 2019: 2
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Roentgenology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- patient understanding, lumbar spine MRI, online medical records, patient access to medical records, readability formulas, plain language, patient education materials
- MeSH terms
- Adult, Humans, Lumbar Vertebrae, Magnetic Resonance Imaging, Spinal Diseases, Comprehension, Health Literacy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review