Lumbar spine MRI reports too complex for patients to understand

Lumbar spine MRI reports are too confusing for an average patient to read and understand, according to new findings published in the American Journal of Roentgenology.

“The potential complexity of the findings and terminology of lumbar spine MRI may result in reports that are difficult for patients to read, which could lead to poor patient comprehension and unnecessary anxiety or confusion,” wrote Paul Hyunsoo Yi, MD, of Johns Hopkins University School of Medicine in Baltimore, and colleagues. “Moreover, the unique and well-documented relationship between low back pain and emotional distress and other psychologic factors makes accurate and effective communication of lumbar spine MRI results particularly important.”

The authors reviewed 110 lumbar spine MRI reports by 11 radiologists from a single academic medical center. Five different tests were used to assess the readability of each report. The average reading ability of adults in the United States is an eighth-grade reading level, and the National Institutes of Health and American Medical Association recommend patient education materials be written at a sixth-grade level, so the researchers focused specifically on those two reading levels.

Overall, the reports had a mean readability grade level that was greater than 12th grade according to all of the applied tests. A single report was written at or below an eighth-grade reading level, and none were written at or below a sixth-grade reading level.

“Patients directly accessing and reading their radiology reports raises concerns about their ability to comprehend these complex documents, which are often difficult for even nonradiologist physicians to comprehend,” the authors wrote. “Not surprisingly, patients often find radiology reports difficult to understand because of the technical nature of words used in reports as well as the overall length of reports. Poor patient comprehension of radiology reports that contain complex language and findings, such as lumbar spine MRIs, could lead to unnecessary anxiety or confusion.”

The researchers noted that MRI reports often include complex words with a high number of syllables, something that leads to a higher readability level.

“One potential solution to this problem is replacing complex medical terminology with simpler words (e.g., ‘swelling’ instead of ‘edema’), which has been shown to decrease readability levels of patient educational materials,” Yi et al. wrote.

Using a more conversational style is another way the authors recommended radiologists change their writing approach to help patients.