Few would dispute that the proliferation of patient portals, along with the success of the OpenNotes initiative, have represented anything but positive steps along U.S. healthcare’s march toward patient-centric transparency. However, many patients have considerable trouble understanding radiology reports—and sometimes too much information can be more vexing than not enough.

The authors of a study published online April 12 in the American Journal of Roentgenology suggest as much, presenting their findings on patient comprehension as a pilot project to assess the feasibility of collecting structured feedback from patients on actual radiology reports.

Lead author Andrew Gunn, MD, of the University of Alabama and colleagues randomly selected eight radiology reports (two for x-rays, two for ultrasound images, two for CT scans, and two for MR images) for review by 104 patients using a feedback form.

The researchers asked the patients to rate their level of report comprehension and identify any particular problems. The patients were also invited to use a free-text section to ask questions.

In total, the patients completed 832 report evaluations.

Using a 1-to-5 scale, the patients returned a median score of 2.5 for overall report comprehension. The most common confounders were “unclear or technical language” (mentioned in 59.6 percent of evaluations) and the report being “too long” (10.2 percent).

Additionally, the researchers found an inverse relationship between report length and patient comprehension (p < 0.001).

In the free-text section, the most common request was for an explanation of the report in lay terms (20.1 percent).

Interestingly, there was no correlation between the educational status and report comprehension of the patients. However, patients who had prior experience with their own radiology reports had greater comprehension than patients with no prior experience (p = 0.003).

In their discussion, Gunn et al. acknowledge among the study’s limitations its small, single-institution sample and nonrandom volunteer participants.

“Regardless, we think that the present study yields useful information for the radiologist in that radiology reports are not well understood by patients, who identified the technical language and long length of the reports as the most common problems affecting patient comprehension,” they write. “Moreover, longer reports tended to be less well understood.”

The authors further suggest their pilot study demonstrates the viability of a patient-centered method for improving reporting practices. They state that a similar mechanism could be implemented via online patient portals “to provide the radiologist regular feedback from patients as part of a quality improvement program of a radiology practice.”

“As the field of radiology continues shifting to embrace the perspective of patient primacy, it will be important to weigh the effect of radiology reporting practices on patient care,” the authors conclude. “At the very least, radiologists should be aware of, and should maintain sensitivity toward, patient preferences when formulating their reports.”