Are Patients Able To Understand Their Abdominal MRI Reports? A Readability Analysis

From the 2018 HVPAA National Conference

Paul Yi (Johns Hopkins Department of Radiology), Sean Golden (University of Wisconsin School of Medicine and Public Health), John Harringa (University of Wisconsin School of Medicine and Public Health), Mark Kliewer (University of Wisconsin School of Medicine and Public Health)


Although  traditionally written for referring clinical providers, radiology reports are increasingly being read by patients via online patient health record “portals.” This trend has raised concerns about patients’ ability to comprehend these complex medical documents.


The purpose of this study was thus to assess the readability of abdominal MRI reports.


We reviewed 90 consecutive abdominal MRI reports from a single academic center (10 reports dictated by 10 fellowship-trained abdominal imaging radiologists). We assessed each article for readability using 5 quantitative readability scales: the Flesch-Kincaid (FK) grade level, Flesch Reading Ease, Gunning-Fog Index, Coleman-Liau Index, and the Simple Measure of Gobbledygook (SMOG). The number of reports with readability ≤ the 8th grade level (average reading ability of US adults) and the 6th grade level (NIH-recommended level for patient education materials) were determined.


The mean readability grade level of the MRI reports was greater than the 11th grade reading level for all readability scales. No reports were written ≤ 8th or 6th grade levels.


Abdominal MRI reports are written at a level too high for the average patient to adequately understand. Although radiology reports traditionally written for referring clinical providers, consideration should be made to the patients who may likely read these reports during the current practice of accessing online health record portals.

Implications for the Patient

Radiology reports are written at readability levels too high for the average patient, which may lead to poor health literacy levels. As poor health literacy is linked to worse clinical outcomes and increased healthcare expenditures, this represents an area to improve patient communication and increase value of radiology reports.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog