Full Radiology Report through Patient Web Portal: A Literature Review

Patient-centered radiology reports with generative artificial intelligence: adding value to radiology reporting

The purposes were to assess the efficacy of AI-generated radiology reports in terms of report summary, patient-friendliness, and recommendations and to evaluate the consistent performance of report quality and accuracy, contributing to the advancement of radiology workflow. Total 685 spine MRI reports were retrieved from our hospital database. AI-generated radiology reports were generated in three formats: (1) summary reports, (2) patient-friendly reports, and (3) recommendations. The occurrence of artificial hallucinations was evaluated in the AI-generated reports. Two radiologists conducted qualitative and quantitative assessments considering the original report as a standard reference. Two non-physician raters assessed their understanding of the content of original and patient-friendly reports using a 5-point Likert scale. The scoring of the AI-generated radiology reports were overall high average scores across all three formats. The average comprehension score for the original report was 2.71 ± 0.73, while the score for the patient-friendly reports significantly increased to 4.69 ± 0.48 (p < 0.001). There were 1.12% artificial hallucinations and 7.40% potentially harmful translations. In conclusion, the potential benefits of using generative AI assistants to generate these reports include improved report quality, greater efficiency in radiology workflow for producing summaries, patient-centered reports, and recommendations, and a move toward patient-centered radiology.

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.

How to prepare for a bright future of radiology in Europe

Because artificial intelligence (AI)-powered algorithms allow automated image analysis in a growing number of diagnostic scenarios, some healthcare stakeholders have raised doubts about the future of the entire radiologic profession. Their view disregards not only the role of radiologists in the diagnostic service chain beyond reporting, but also the many multidisciplinary and patient-related consulting tasks for which radiologists are solicited. The time commitment for these non-reporting tasks is considerable but difficult to quantify and often impossible to fulfil considering the current mismatch between workload and workforce in many countries. Nonetheless, multidisciplinary, and patient-centred consulting activities could move up on radiologists' agendas as soon as AI-based tools can save time in daily routine. Although there are many reasons why AI will assist and not replace radiologists as imaging experts in the future, it is important to position the next generation of European radiologists in view of this expected trend. To ensure radiologists' personal professional recognition and fulfilment in multidisciplinary environments, the focus of training should go beyond diagnostic reporting, concentrating on clinical backgrounds, specific communication skills with referrers and patients, and integration of imaging findings with those of other disciplines. Close collaboration between the European Society of Radiology (ESR) and European national radiologic societies can help to achieve these goals. Although each adequate treatment begins with a correct diagnosis, many health politicians see radiologic procedures mainly as a cost factor. Radiologic research should, therefore, increasingly investigate the imaging impact on treatment and outcome rather than focusing mainly on technical improvements and diagnostic accuracy alone.Critical relevance statement Strategies are presented to prepare for a successful future of the radiologic profession in Europe, if AI-powered tools can alleviate the current reporting overload: engaging in multidisciplinary activities (clinical and integrative diagnostics), enhancing the value and recognition of radiologists' role through clinical expertise, focusing radiological research on the impact on diagnosis and outcome, and promoting patient-centred radiology by enhancing communication skills.Key points • AI-powered tools will not replace radiologists but hold promise to reduce the current reporting burden, enabling them to reinvest liberated time in multidisciplinary clinical and patient-related tasks.• The skills and resources for these tasks should be considered when recruiting and teaching the next generation of radiologists, when organising departments and planning staffing.• Communication skills will play an increasing role in both multidisciplinary activities and patient-centred radiology.• The value and importance of a correct and integrative diagnosis and the cost of an incorrect imaging diagnosis should be emphasised when discussing with non-medical stakeholders in healthcare.• The radiologic community in Europe should start now to prepare for a bright future of the profession for the benefit of patients and medical colleagues alike.

Patient experience of imaging reports: A systematic literature review

Introduction

Written reports are often the sole form of communication from diagnostic imaging. Reports are increasingly being accessed by patients through electronic records. Experiencing medical terminology can be confusing and lead to miscommunication, a decrease in involvement and increased anxiety for patients.

Methods

This systematic review was designed to include predefined study selection criteria and was registered prospectively on PROSPERO (CRD42020221734). MEDLINE, CINAHL, Academic Search Complete (EBSCOhost), EMBASE, Scopus and EThOS were searched to identify articles meeting the inclusion criteria. Studies were assessed against the Mixed-Methods Appraisal Tool version 2018 for quality. A segregated approach was used to synthesise data. A thematic synthesis of the qualitative data and a narrative review of the quantitative data were performed, and findings of both syntheses were then integrated.

Findings

Twelve articles reporting 13 studies were included. This review found that patients' experiences of imaging reports included positive and negative aspects. The study identified two main themes encompassing both qualitative and quantitative findings. Patients reported their experiences regarding their understanding of reports and self-management.

Discussion

Patient understanding of imaging reports is multi factorial including medical terminology, communication aids and errors. Self-management through direct access is important to patients. While receiving bad news is a concern, responsibility for accessing this is accepted.

Conclusion

A patient-centred approach to writing imaging reports may help to improve the quality of service, patient experience and wider health outcomes.

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.

The role of radiologist in the changing world of healthcare: a White Paper of the European Society of Radiology (ESR)

Radiology as a specialty has been enormously successful since its beginnings, moving over time from an adjunct to clinical decision-making to a crucial component of multidisciplinary patient care. However, this increased centrality of radiology and reliance on our services carries within it dangers, prominent among them being the danger of our being viewed as deliverers of a commodity, and the risk of our becoming overwhelmed by increasing workload, unable to interact sufficiently with patients and referrers due to pressure of work. With this White Paper, the Board of Directors of the European Society of Radiology (ESR) seeks to briefly explain the position of the radiologist in the modern healthcare environment, considering our duties and contributions as doctors, protectors, communicators, innovators, scientists and teachers. This statement is intended to serve as a summary of the breadth of our responsibilities and roles, and to assist radiologists in countering misunderstanding of who we are and what we do.

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.

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

Patient portals have helped accelerate patient engagement in treatment. Patient understanding of radiology reports has become a necessity, and we are working to design a patient-friendly radiology report that can be easily understood. We have based the design of this new radiology report on the results of a previous study that examined patient desires and needs by exploring their questions posted on online discussion forums. The current design was tested by presenting it in two groups, a control group, and an intervention group. In our evaluation, we relied on the following five concepts: understanding (quiz), cosmetics appearance, perceived ease of use, acceptance, and preference. The results showed that the new design outperformed the current design in all five concepts with an overall of (P < .00). Based on these results, we have determined that the radiology report should include both an image and notes section, and the design can be applied to all types of radiological examinations using various imaging devices. We believe this design will be an important building block in facilitating patient understanding of radiology reports.

Understanding patient needs and gaps in radiology reports through online discussion forum analysis

Our objective is to investigate patient needs and understand information gaps in radiology reports using patient questions that were posted on online discussion forums. We leveraged online question and answer platforms to collect questions posted by patients to understand current gaps and patient needs. We retrieved six hundred fifty-nine (659) questions using the following sites: Yahoo Answers, Reddit.com, Quora, and Wiki Answers. The questions retrieved were analyzed and the major themes and topics were identified. The questions retrieved were classified into eight major themes. The themes were related to the following topics: radiology report, safety, price, preparation, procedure, meaning, medical staff, and patient portal. Among the 659 questions, 35.50% were concerned with the radiology report. The most common question topics in the radiology report focused on patient understanding of the radiology report (62 of 234 [26.49%]), image visualization (53 of 234 [22.64%]), and report representation (46 of 234 [19.65%]). We also found that most patients were concerned about understanding the MRI report (32%; n = 143) compared with the other imaging modalities (n = 434). Using online discussion forums, we discussed major unmet patient needs and information gaps in radiology reports. These issues could be improved to enhance radiology design in the future.