Readability of CT Chest Radiology Reports: Will Patients Understand?

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 radiology reports have traditionally been written for referring clinical providers, patients are increasingly reading their radiology reports through electronic health record portals, which raises concerns about whether they can adequately comprehend these reports.


The purpose of this study was to assess the readability of computed tomography (CT) chest reports.


We reviewed 60 consecutive CT chest reports at a single academic center (10 consecutive reports for each of 6 fellowship-trained thoracic imaging faculty). 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 (National Institutes of Health [NIH]-recommended level for patient education materials) were determined.


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


CT chest radiology reports are written at a level too high for the average patient to comprehend, which may result in challenges for patients who are increasingly accessing their radiology reports through online medical records. Further work is warranted to improving the communication of radiology results to patients.

Implications for the Patient

Communication of radiology results to patients may be impaired by the high readability levels of CT chest reports, which may cause stress and anxiety for patients. Interventions to improve the quality of patient communication through radiology reports should be considered as patients increasingly read their medical results online.

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