Patient-centered care may require radiologists embrace structured, easy-to-read reporting

Healthcare is becoming increasingly consumer-focused and patients are demanding a larger role in their care, including access to imaging results. And researchers of a new study set out discover exactly what patients prefer when it comes to viewing chest radiograph reports online.

To do this, a trio of doctors from Emory University School of Medicine asked paid volunteers to complete a survey indicating whether they understood freestyle or structured chest x-ray reports better, and which they preferred. As the authors hypothesized, respondents favored a structured format when looking over negative chest radiographs.

Specifically, volunteers said structured reports were easier to comprehend, and acknowledged that they would be less likely to seek follow-up when exams were described as negative. The findings build upon past studies showing similar results, and should guide stakeholders, including radiologists, as the field continues to build its online infrastructure.

“As policymakers increasingly prioritize patient satisfaction and appropriate imaging follow-up, these findings all have important implications for radiology practices as patient portal access increases,” first author Alexander Dabrowiecki, MD, with Emory’s Department of Radiology and Imaging Sciences, and colleagues wrote May 12 in the Journal of the American College of Radiology.

The investigators gathered more than 5,100 responses over a 15-day period, a majority from those who received prior imaging (93.8%), with 68.9% claiming to have had undergone chest radiography. Notably, Dabrowiecki et al. reported that more than 75% of the latter had reviewed their radiology reports in the past.

Per the 18-question survey, participants were offered the same two radiology reports—one freestyle and one structured—and presented with four commonly used impression statements, such as “unremarkable examination” or “negative chest.”

There was no difference in volunteers’ confidence in radiologists between structured and unstructured reports, but when the former was accompanied with “unremarkable examination” confidence fell. That sentiment rose, however, when the report read “no acute disease.”

Aside from style comprehension and preference, the authors pointed out that radiologists’ language clearly matters. And if rads want to embrace the move toward value-based care, they should begin thinking about their reporting habits.

“As emerging value-based metrics increasingly prioritize patient satisfaction, radiologists’ future payments could potentially be influenced by the readability of their reports,” Dabrowiecki and colleagues added.