Computer aided translation of radiology reports to lay person- for a CT without iv contrast

Value Proposition

Radiologist reports are written in technical medical language intended for referring clinicians. However, with the advent of patient portals and empowered patients, patients are likely to be reading the radiologist report “unchaperoned” by their referring clinician or the reading radiologist. The language and terms used for example “can’t rule out malignancy” and the inclusion of comments about normal and expected findings (muscles/tendons:grossly intact; colon full of stool) can be confusing and cause anxiety for patients.  Providing radiologist reports in easy to understand language, with key findings and what they mean, next steps and actions for the patient to take will help patients engage in their care. Patients will thus provide another layer of safety for follow-up care. These easy to understand summaries will also help referring clinicians as they sometimes  find radiologist reports confusing and hard to understand. 

Narrative(s)

A 55 year old male comes in for a CT head without iv contrast after referral by a primary care physician who noted ataxia after head trauma caused by a fall in the shower.  The patient has no other history consistent with his symptoms.  He is unable to work at his construction job and is eager to get the radiologist’s report as soon as possible so the cause of his problem and possible solutions can be identified. He also indicates he would like to receive the results via the patient portal or email from the referring physician.  After the CT is completed the radiologist interprets the results and prepares a patient friendly summary for the referring physician created from his report by AI.

Workflow Description

The AI algorithm identifies the type of imaging modality, the pertinent body part, and the test objective. It then creates the patient-friendly option. The patient-friendly template is automatically populated with an illustration area of the brain and as the radiologist notes the sizes and locations of different findings, they are automatically added to the illustration of the brain. Future scaling of the approach for other body parts should be considered when developing the algorithm.  Additionally, the text is translated into patient-friendly language and automatically populates the patient-friendly template. The patient-friendly summary includes a description of the findings such as the size and location of pertinent issues, an estimate of the probability of each of them being related to the patient’s symptoms, an illustration showing their relative size and location, and a description of the options for next steps for the patient. Examples of the next steps could include talking to your primary care physician about the need for a neurological consult and possible treatment recommendations.  The full radiology report, images, and the patient-friendly radiology report could be provided to the patient via the patient portal, or via HIPAA secure patient preference. 

Are there different types of reports that should be considered when training the algorithm? 

radiologist reports written for head CT

What procedures might prompt this algorithm?

Head CT without contrast 

What should be included in the training set?

• Identify most common terminology terms used in head CT reports and provide data dictionary of layperson language

• identify examples of images 

Inputs

Radiologist Report

Primary Outputs

Structured patient friendly report

RADIOLOGIST REPORT

HEAD CT WITHOUT IV CONTRAST

CLINICAL INDICATION: Head trauma

TECHNIQUE: Axial CT images from skull base to vertex without IV contrast.

COMPARISON: CT brain January 11, 2013

FINDINGS:

Areas of encephalomalacia are seen in the left temporal and frontal lobes with

associated volume loss and exvacuo dilatation of the left lateral ventricle.

Evidence of prior left hemispheric cranioplasty and duraplasty. No acute

intracranial hemorrhage.

The density of the larger dural venous sinuses is normal.

The ventricles are normal in size, shape and position.

The included paranasal sinuses and mastoid air cells are predominantly clear.

IMPRESSION:

Multifocal left hemispheric encephalomalacia and associated volume loss.

Evidence of prior left cranioplasty and duraplasty. No intracranial hemorrhage.

LAYPERSON VERSION OF REPORT

HEAD CT WITHOUT IV CONTRAST

CLINICAL INDICATION: Head trauma

TECHNIQUE: Axial CT images from skull base to vertex without IV contrast.

COMPARISON: CT brain January 11, 2013

FINDINGS:

There are areas of brain tissue loss due to bleeding or inflammation seen on the left side of the brain in the temple lobe and in the front lobes of the brain. This is causing the brain to lose volume in that area and the cavity (ventricle) on the left side of the brain to expand to fill the void left by the loss of volume. Evidence of a previous brain surgery is seen on the CT scan. The CT scan does not show any acute bleeding in the brain.

The channels the veins run through in the brain are normal.

The brain cavities are normal.

The sinuses around the nasal cavity are normal

The air filled cavities around the temple bone behind the ear are normal

IMPRESSION:

Softening of brain matter in the left hemisphere of the brain resulting in loss of brain volume. The images show there was a prior surgery to the brain. There is no acute bleeding