Ultrasound Radiology Reports are “Ultra”-Unreadable

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 ordering clinical providers. However, patients are increasingly reading radiology reports through online medical record “portals,” raising concerns about their ability to comprehend these often-complex documents.


The purpose of this study was to assess the readability of abdominal ultrasound (US) reports.


We reviewed 190 consecutive abdominal US reports at 1 academic center and 1 community hospital (10 consecutive reports for each of 15 fellowship-trained body imaging academic faculty and 4 non-fellowship-trained general radiology 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. Readability levels of reports dictated by academic and community radiologists were compared using t-tests.


The mean readability grade level of the abdominal US reports was greater than the 11th grade reading level for all readability scales. No reports were written ≤ than the 8th or 6th grade levels. There was no significant difference in report readability between academic abdominal and community genera radiologists (p>0.5).


Abdominal US reports are written at a level considerably higher than the average patient can comprehend, which may impair patient understanding of their radiology reports. Further work is warranted to improving the communication of radiology results to patients in this new era of online health records.

Implications for the Patient

Abdominal US reports are “ultra”-unreadable, having a higher readability level than the average patient can comprehend, which may impair patient health literacy. As poor health literacy is linked to poor health outcomes and increased healthcare expenditures, this represents a potentially high-value area for improvement.

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