Factors influencing patient understanding of information on radiology examinations

PURPOSE: To determine which factors influence patient understanding of information documents on radiology examinations. MATERIALS AND METHODS: This is a randomized prospective study with 361 consecutive patients. Documents with information on 9 radiology exams were obtained (www.radiologyinfo.org). Three versions of each of these were written at low (below 7th grade), middle (8–12th grade), and high (college) reading grades. Before their scheduled radiology exam, patients were randomized to read one document. Their subjective and objective understanding of the information was assessed. Statistics including logistic regression used to assess relationships between demographic factors and document grade level and understanding. RESULTS: Twenty-eight percent (100/361) of patients completed the study. More females vs. males (85% vs. 66%) read their entire document (p = 0.042). Document grade level was not associated with understanding (p > 0.05). Correlation between college degrees and subjective understanding was positive (r = 0.234, p = 0.019). More females (74% vs. 54%, p = 0.047) and patients with college degrees (72% vs. 48%, p = 0.034) had higher objective understanding. Controlling for document grade level and demographics, patients with college degrees were more likely to have subjective understanding of at least half of the document (OR 7.97, 95% CI [1.24, 51.34], p = 0.029) and females were more likely to have higher objective understanding (OR 2.65, 95% CI [1.06, 6.62], p = 0.037). CONCLUSION: Patients with college degrees understood more on information documents. Females read more of the documents than males and had a higher objective understanding. Reading grade level did not affect understanding. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00256-023-04301-y.