Readability of radiology reports: implications for patient-centered care

Radiology reports, although written primarily for healthcare providers, are read increasingly by patients and their family. This study sought to assess the readability of radiology reports.

From 108,228 consecutive radiology reports from a large US health system, we excluded duplicate reports, reports of research exams, and reports with missing data. For each report, we measured the numbers of words and sentences, and computed a "reading grade level" (RGL) as the mean of three readability indices: Flesch-Kincaid Grade Level, Gunning Fog index, and Simple Measure of Gobbledygook. Analysis of variance (ANOVA) evaluated the effects of modality, patient setting, examination urgency, and combinations thereof on RGL.

The 97,052 reports in the study cohort had a mean (±standard deviation) of 17.6 ± 12.8 sentences and 203 ± 161 words. Patient setting, modality, and examination urgency all had significant independent effects on RGL (all with p < 0.001). There were 4094 reports (4.2%) at a reading grade level of 8 or lower.

Radiology reports often contain complex concepts and polysyllabic terms unfamiliar to lay readers. Only 4% of all radiology reports in our sample were readable at the 8th grade level, which is the reading level of the average US adult. Although radiology reports are written for physicians and other healthcare providers, radiologists might explore using simpler, more structured language to address the goals of patient-centered care.