Readability of Neuroradiology CT and MRI Reports: Are They Over Patients’ Heads?

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)


Radiology reports have traditionally been written for referring clinical providers. However, patients have recently begun to access and read their radiology reports through online medical record “portals”, raising concerns about their ability to comprehend these complex documents.


The purpose of this study was to assess the readability of computed tomography (CT) head and magnetic resonance imaging (MRI) brain reports.


We reviewed 224 consecutive CT head and MRI brain reports from a single academic center. We evaluated 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 CT reports was greater than the 11th grade reading level for all readability scales. No reports were written at less than the eighth grade or below the sixth grade levels.


Neuroradiology CT and MRI reports are written at a level too high for the average patient to comprehend. As patients increasingly read their radiology reports through online medical record portals, consideration of the patient’s ability to comprehend should be taken into consideration by the radiologist generating a report.

Implications for the Patient

High readability levels of neuroradiology CT and MRI reports may contribute to poor health literacy, which is associated with worse clinical outcomes and increased healthcare expenditures. Radiologists and other physicians should be aware of the potential for impaired patient comprehension of radiology reports and consider initiatives for improvement.

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