Designing a Consumer-Friendly Radiology Report using a Patient-Centered Approach

PRECISE framework: Enhanced radiology reporting with GPT for improved readability, reliability, and patient-centered care

BACKGROUND

The PRECISE framework, defined as Patient-Focused Radiology Reports with Enhanced Clarity and Informative Summaries for Effective Communication, leverages GPT-4 to create patient-friendly summaries of radiology reports at a sixth-grade reading level.

PURPOSE

The purpose of the study was to evaluate the effectiveness of the PRECISE framework in improving the readability, reliability, and understandability of radiology reports. We hypothesized that the PRECISE framework improves the readability and patient understanding of radiology reports compared to the original versions.

MATERIALS AND METHODS

The PRECISE framework was assessed using 500 chest X-ray reports. Readability was evaluated using the Flesch Reading Ease, Gunning Fog Index, and Automated Readability Index. Reliability was gauged by clinical volunteers, while understandability was assessed by non-medical volunteers. Statistical analyses including t-tests, regression analyses, and Mann-Whitney U tests were conducted to determine the significance of the differences in readability scores between the original and PRECISE-generated reports.

RESULTS

Readability scores significantly improved, with the mean Flesch Reading Ease score increasing from 38.28 to 80.82 (p-value < 0.001), the Gunning Fog Index decreasing from 13.04 to 6.99 (p-value < 0.001), and the ARI score improving from 13.33 to 5.86 (p-value < 0.001). Clinical volunteer assessments found 95 % of the summaries reliable, and non-medical volunteers rated 97 % of the PRECISE-generated summaries as fully understandable.

CONCLUSION

The application of the PRECISE approach demonstrates promise in enhancing patient understanding and communication without adding significant burden to radiologists. With improved reliability and patient-friendly summaries, this approach holds promise for fostering patient engagement and understanding in healthcare decision-making. The PRECISE framework represents a pivotal step towards more inclusive and patient-centric care delivery.

The impact of different radiology report formats on patient information processing: a systematic review

BACKGROUND

Since radiology reports are primarily written for health professionals, patients may experience difficulties understanding jargon and terminology used, leading to anxiety and confusion.

OBJECTIVES

This review evaluates the impact of different radiology report formats on outcomes related to patient information processing, including perception, decision (behavioral intention), action (actual health behavior), and memory (recall of information).

METHODS

PubMed, Web of Science, EMBASE, and PsycInfo were searched for relevant qualitative and quantitative articles describing or comparing ways of presenting diagnostic radiology reports to patients. Two reviewers independently screened for relevant articles and extracted data from those included. The quality of articles was assessed using the Mixed Methods Appraisal Tool.

RESULTS

Eighteen studies, two qualitative and sixteen quantitative, were included. Sixteen studies compared multiple presentation formats, most frequently traditional unmodified reports (n = 15), or reports with anatomic illustrations (n = 8), lay summaries (n = 6) or glossaries (n = 6). Glossaries, illustrations, lay summaries, lay reports or lay conclusions all significantly improved participants' cognitive perception and perception of communication of radiology reports, compared to traditional reports. Furthermore, these formats increased affective perception (e.g., reduced anxiety and worry), although only significant for lay reports and conclusions.

CONCLUSION

Modifying traditional radiology reports with glossaries, illustrations or lay language enhances patient information processing.

KEY POINTS

Question Identifying the impact of different radiology report formats on outcomes related to patient information processing to enhance patient engagement through online access to radiology reports. Findings Lay language summaries, glossaries with patient-oriented definitions, and anatomic illustrations increase patients' satisfaction with and understanding of their radiology reports. Clinical relevance To increase patients' satisfaction, perceived usefulness and understanding with radiology reports, the use of lay language summaries, glossaries with patient-oriented definitions, and anatomic illustrations is recommended. These modifications decrease patients' unnecessary insecurity, confusion, anxiety and physician consultations after viewing reports.

Appropriateness of Thyroid Nodule Cancer Risk Assessment and Management Recommendations Provided by Large Language Models

The study evaluates the appropriateness and reliability of thyroid nodule cancer risk assessment recommendations provided by large language models (LLMs) ChatGPT, Gemini, and Claude in alignment with clinical guidelines from the American Thyroid Association (ATA) and the National Comprehensive Cancer Network (NCCN). A team comprising a medical imaging informatics specialist and two radiologists developed 24 clinically relevant questions based on ATA and NCCN guidelines. The readability of AI-generated responses was evaluated using the Readability Scoring System. A total of 322 radiologists in training or practice from the United States, recruited via Amazon Mechanical Turk, assessed the AI responses. Quantitative analysis using SPSS measured the appropriateness of recommendations, while qualitative feedback was analyzed through Dedoose. The study compared the performance of three AI models ChatGPT, Gemini, and Claude in providing appropriate recommendations. Paired samples t-tests showed no statistically significant differences in overall performance among the models. Claude achieved the highest mean score (21.84), followed closely by ChatGPT (21.83) and Gemini (21.47). Inappropriate response rates did not differ significantly, though Gemini showed a trend toward higher rates. However, ChatGPT achieved the highest accuracy (92.5%) in providing appropriate responses, followed by Claude (92.1%) and Gemini (90.4%). Qualitative feedback highlighted ChatGPT's clarity and structure, Gemini's accessibility but shallowness, and Claude's organization with occasional divergence from focus. LLMs like ChatGPT, Gemini, and Claude show potential in supporting thyroid nodule cancer risk assessment but require clinical oversight to ensure alignment with guidelines. Claude and ChatGPT performed nearly identically overall, with Claude having the highest mean score, though the difference was marginal. Further development is necessary to enhance their reliability for clinical use.

Patterns of Access to Radiology Reports and Images Through a Patient Portal

Access to radiology reports and images through a patient portal offers several advantages. The purpose of this study was to characterize patient's interactions with their radiology results. This was a retrospective study that evaluated radiography, ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography, exams performed between July 2020 and June 2021 for patients aged 12 and older. Exam information, access logs of radiology reports and images, and patient demographics were obtained from the electronic health record and image viewing software. Descriptive statistics were computed. The study included 1,685,239 exams. A total of 54.1% of reports were viewed. MRI and PET reports were viewed with the greatest frequency (70.2% and 67.6%, respectively); 25.5% of exam images were viewed, with the greatest frequency for MRI (40.1%). Exams were shared a total of 17,095 times and downloaded 8409 times; 64% of reports were viewed for patients aged 18-39 and 34% for patients aged 80 and greater. The rate of reports viewed was greater for patients with English as their preferred language (57.1%) compared to other languages (33.3%). Among those viewed, 56.5% of reports and 48.2% of images were viewed multiple times; 72.8% of images were viewed on smartphones, 25.8% on desktop computers, and 1.4% on tablets. Patients utilize a portal to view reports and view and share images. Continued efforts are warranted to promote the use of portals and create patient-friendly imaging results to help empower patients.

[Patient-centered radiology : What patients want from radiologists]

BACKGROUND

In the transition from volume-based to value-based radiology, patient communication plays a crucial role in terms of patient-centeredness in radiology. This overview article aims to describe various patient contact situations in a radiology setting and discuss them based on current literature, including any recommendations for action if applicable.

OBJECTIVES

What do patients wish for from radiologists?

MATERIALS AND METHODS

Digital literature research with a narrative summary of important publications on patient-centeredness in the context of communication in the radiology-patient relationship.

RESULTS

There is limited literature available in most areas regarding communication between radiology and patients. The most common type of literature found is surveys that assess patients' opinions, which sometimes yield divergent results regarding preferences for direct communication with radiologists after the examination. However, it has been shown that direct patient conversations and an empathetic physician-patient relationship allow for a positive evaluation of radiology and foster a sense of appreciation.

CONCLUSION

As we transition from volume-based to value-based radiology, it will be crucial for radiology to optimize the physician-patient relationship through improved communication, both verbally and by utilizing new media.

[Patient-centered vs. employee-centered radiology : Does this pose a conflict?]

BACKGROUND

Patient-centered radiology and employee-centered radiology are being increasingly discussed as an extension of the established structure- and process-oriented management perspective. Concerning potential conflicts, it is unclear if and how these approaches should best be implemented in a radiology department.

OBJECTIVE

The aim of this narrative review is to identify and critically correlate underlying characteristics of patient-centered and employee-centered approaches including their similarities, conflicts, and synergies as applicable to the radiological work environment.

MATERIALS AND METHODS

Based on a literature search using PubMed, Scopus, Web of Science, and Google Scholar, the current body of knowledge regarding patient- and employee-centered radiology is presented.

RESULTS

Patient- and employee-centered radiology focus on the individual needs of patients and employees, respectively, and promise to improve patient satisfaction, healthcare outcomes, and organizational performance. Conflicts result from an increased organizational complexity and the concurrent utilization of limited resources, such as time, money, and staff. Overall, however, synergies outweigh the potential conflicts.

CONCLUSIONS

Successful implementation of patient- and employee-centered approaches in radiology requires a human-centered leadership approach and an overarching strategy with the execution of specific interventions in the processes. We provide specific recommendations to this effect.

Proposed Questions to Assess the Extent of Knowledge in Understanding the Radiology Report Language

Radiotherapy and diagnostic imaging play a significant role in medical care. The amount of patient participation and communication can be increased by helping patients understand radiology reports. There is insufficient information on how to measure a patient's knowledge of a written radiology report. The goal of this study is to design a tool that will measure patient literacy of radiology reports. A radiological literacy tool was created and evaluated as part of the project. There were two groups of patients: control and intervention. A sample radiological report was provided to each group for reading. After reading the report, the groups were quizzed to see how well they understood the report. The participants answered the questions and the correlation between the understanding of the radiology report and the radiology report literacy questions was calculated. The correlations between radiology report literacy questions and radiology report understanding for the intervention and control groups were 0.522, p < 0.001, and 0.536, p < 0.001, respectively. Our radiology literacy tool demonstrated a good ability to measure the awareness of radiology report understanding (area under the receiver operator curve in control group (95% CI: 0.77 (0.71-0.81)) and intervention group (95% CI: 0.79 (0.74-0.84))). We successfully designed a tool that can measure the radiology literacy of patients. This tool is one of the first to measure the level of patient knowledge in the field of radiology understanding.

Communicating with patients in the age of online portals-challenges and opportunities on the horizon for radiologists

The deployment of electronic patient portals increasingly allows patients throughout Europe to consult and share their radiology reports and images securely and timely online. Technical solutions and rules for releasing reports and images on patient portals may differ among institutions, regions and countries, and radiologists should therefore be familiar with the criteria by which reports and images are made available to their patients. Radiologists may also be solicited by patients who wish to discuss complex or critical imaging findings directly with the imaging expert who is responsible for the diagnosis. This emphasises the importance of radiologists’ communication skills as well as appropriate and efficient communication pathways and methods including electronic tools. Radiologists may also have to think about adapting reports as their final product in order to enable both referrers and patients to understand imaging findings. Actionable reports for a medical audience require structured, organ-specific terms and quantitative information, whereas patient-friendly summaries should preferably be based on consumer health language and include explanatory multimedia support or hyperlinks. Owing to the cultural and linguistic diversity in Europe dedicated solutions will require close collaboration between radiologists, patient representatives and software developers; software tools using artificial intelligence and natural language processing could potentially be useful in this context. By engaging actively in the challenges that are associated with increased communication with their patients, radiologists will not only have the opportunity to contribute to patient-centred care, but also to enhance the clinical relevance and the visibility of their profession.