Quality improvement project: Patient-centered breast imaging letters.

Area of Science:

• Radiology and Medical Imaging
• Patient Communication
• Health Literacy

Background:

• Mammography recall letters are crucial for patient follow-up.
• Existing letters may lack clarity and patient-centered design.
• Improving communication enhances patient understanding and adherence.

Purpose of the Study:

• To assess patient-centered revisions of screening mammography recall letters.
• To evaluate letters for Breast Imaging Reporting and Data System (BIRADS) 0 and BIRADS 0-dense breast categories.
• To employ validated readability and usability instruments for assessment.

Main Methods:

• Cross-sectional analysis of revised mammography recall letters (BIRADS 0 and BIRADS 0-DB).
• Utilized AI (ChatGPT v3.5) and Flesch-Kincaid Grade Level (FKGL) during editorial revision.
• Assessed understandability and actionability using PEMAT by subject-matter experts.
• Evaluated comprehensibility, utility, and design with patients via CIRF.

Main Results:

• Revised letters showed reduced FKGL from 11.9/10.7 to 6.7/5.8.
• Understandability for BIRADS 0 improved from 41% to 90%; actionability from 50% to 88%.
• BIRADS 0-DB understandability rose from 46% to 85%; actionability from 44% to 73%; added images were highly valued.

Conclusions:

• Validated tools confirmed improvements in readability, understandability, actionability, utility, and design of new breast imaging letters.
• The revision process establishes a model for future patient communication document updates.
• Patient-centered communication enhancements are vital in radiology reporting.