# ChatGPT Makes Medicine Easy to Swallow:
An Exploratory Case Study on Simplified
Radiology Reports

Katharina Jeblick1,2 Balthasar Schachtner1 Jakob Dexl1,3 Andreas Mittermeier1
Anna Theresa Stüber1,4 Johanna Topalis1 Tobias Weber1,3,4 Philipp Wesp1
Bastian Sabel1 Jens Ricke1 Michael Ingrisch1,3
1Department of Radiology, University Hospital, LMU Munich
2Comprehensive Pneumology Center (CPC-M), Member of the
German Center for Lung Research (DZL), Munich
3Munich Center for Machine Learning (MCML)
4Department of Statistics, LMU Munich
{katharina.jeblick<EMAIL_ADDRESS>
###### Abstract

The release of ChatGPT, a language model capable of generating text that
appears human-like and authentic, has gained significant attention beyond the
research community. We expect that the convincing performance of ChatGPT
incentivizes users to apply it to a variety of downstream tasks, including
prompting the model to simplify their own medical reports. To investigate this
phenomenon, we conducted an exploratory case study. In a questionnaire, we
asked 15 radiologists to assess the quality of radiology reports simplified by
ChatGPT. Most radiologists agreed that the simplified reports were factually
correct, complete, and not potentially harmful to the patient. Nevertheless,
instances of incorrect statements, missed key medical findings, and
potentially harmful passages were reported. While further studies are needed,
the initial insights of this study indicate a great potential in using large
language models like ChatGPT to improve patient-centered care in radiology and
other medical domains. ††All authors contributed equally. †† ††The title was
generated with ChatGPT.

##  1 Introduction

"ChatGPT, am I dying? What does this medical report mean? Can you explain it
to me like I’m five?" With the latest release of OpenAI’s Large Language Model
(LLM) ChatGPT [1], algorithmic language modeling has reached a new milestone
in generating human-like responses to user text inputs. Just five days after
its release, ChatGPT had already attracted over a million users and gained a
significant amount of media attention [2, 3, 4, 5]. Given the level of
popularity and widespread access to the public, the question as to how people
will use such models arises and which opportunities and challenges are
associated with them. In our experience, the text output of ChatGPT was
astonishingly convincing for a variety of tasks, such that we expect
disruptive change across numerous domains and industries in a very short time.

Among a myriad of potential downstream applications, LLMs are able to simplify
complex text [6] and subsequently make it more accessible to a broader
audience. There is a huge need for simplification in domains where expert
knowledge is necessary to put text into context and interpret it. For example,
legal or medical documents are written by trained experts in highly
specialized language, but often have immediate consequences for clients or
patients, respectively, who are usually non-experts. Simplifying these
documents promises to enable individuals to actively and autonomously oversee
them. One domain where text simplification might be particularly useful is
radiology. Radiological findings are typically communicated in a free-text
report in specialized medical jargon, targeting a clinician or doctor as the
recipient. For readers without a medical background, these reports are often
inaccessible and potentially misleading. For example, a study [7] showed, that
only 4% of all analyzed radiology reports were readable by the average US
adult. They concluded to use simpler and more structured language to improve
patient-centered care.

Ideally, radiological findings are communicated in a timely, personalized
conversation between doctor and patient. However, in resource-constrained
health systems, this conversation is often delayed. Therefore, patients might
try to make their radiology reports accessible upfront. For instance, patients
might research isolated medical terms on the internet without being able to
place them in the correct medical context, potentially leading to
misinterpretations and confusion. In this context, [8] developed an online
system that augments radiology reports with lay-language definitions.
Alternatively, patients might use free simplification
services111https://washabich.de (visited on 12/28/2022), which often lack
popularity, accessibility, or scalability. We expect, that in the very near
future, publicly accessible LLMs such as ChatGPT will increasingly be applied
by interested patients to simplify their own medical reports filling the gap.

However, ChatGPT was not explicitly trained for medical text simplification
and is not intended to be used for this critical task. While it can generate
plausible-sounding text, the content does not need to be true, as shown in
Figure 1. This raises the question of whether LLMs such as ChatGPT are able to
simplify radiology reports such that the output is factually correct,
complete, and not potentially harmful to the patient. Patients, i.e.,
potential LLM users, are not able to answer this question. The quality of
these simplified reports needs to be thoroughly assessed by expert
radiologists.

In this work, we conducted an exploratory case study to investigate the
phenomenon that emerging LLMs such as ChatGPT may be used or misused by
patients to simplify their radiology reports. This unintended use may raise
chances and challenges for patient-centered care. Therefore, we asked 15
radiologists to rate the quality of three radiology reports simplified by
ChatGPT regarding their factual correctness, completeness, and potential harm
using a questionnaire. Descriptive statistics and inductive categories were
used to evaluate the questionnaire. Based on our findings, we elaborated
opportunities and challenges of using ChatGPT-like LLMs for simplifying
radiology reports.

ChatGPT Explain this medical report to a child using simple language: $[...]$
No metastatic thoracic lymph nodes.  Thyroid struma. No pleural effusions.
$[...]$ PromptGenerated Response $[...]$ They also saw that the person had an
extra thyroid gland, but there was no infection in the chest. $[...]$ $[...]$
The thyroid gland (a small butterfly-shaped gland in the neck) looks a little
bigger than usual. $[...]$ ✓✗

Figure 1: Prompting ChatGPT to simplify a radiology report of an oncological
CT. While producing plausible-sounding responses, the content does not need to
be true.

##  2 Background

In this section, we introduce LLMs, as well as the technical specifics of
ChatGPT. We shortly discuss techniques for summarization and simplification of
radiology reports and mention known limitations of LMMs. This will serve as a
basis for discussing chances and potential challenges for a scenario where
these models are used to simplify radiology reports by patients.

###  2.1 Large Language Models in Natural Language Processing

Since introducing the concept of attention in deep learning models [9], the
transformer is an established architecture with dominance in nearly all
natural language processing (NLP) benchmarks, including question answering,
translation, and text classification [10]. While the base-model architecture
remained relatively unchanged throughout the years, significant progress was
made by scaling the number of layers and internal dimensions resulting in so-
called Large Language Models (LLMs) with billions of parameters, which lead to
increased model capacity and abilities. Popular architectures grew in
parameter size starting, e.g., from BERT (345M; [11]) over MegatronLM (8.3B;
[12]) and T-5 (11B; [13]) up to BLOOM (176B; [14]) and PaLM (540B; [10]). A
significant success factor for fitting LLMs is an enormous training dataset,
e.g., the Pile [15], which contains documents from Arxiv, PubMed, Stack
Exchange, Wikipedia, as well as a subset of Common
Crawl222http://commoncrawl.org/, and GitHub, among others. For these kinds of
LLMs, [16] introduced the terminology of foundation models, which defines
training on a very large data basis and the ability to adapt to a variety of
downstream tasks.

###  2.2 ChatGPT

ChatGPT is an LLM developed by OpenAI that was first released on November
30th, 2022. The user can directly prompt the model via an API in a
conversational way, e.g., allowing for follow-up questions or admission of
mistakes [1]. The backbone of ChatGPT is based on the generative pre-trained
transformer series (GPT; [17, 18, 19]). Despite the success and capacity of
the third GPT iteration (GPT-3) [19] with 175B parameters, the challenge of
engineering text prompts for achieving the desired generative output remained.
This is due to the autoregressive training procedure, which tasks the model to
predict a token based on the previous text and thus is optimized for text
completion and not dialogues. To improve the dialogue capabilities of the
model as well as to reduce bias and general toxicity, [20] developed
InstructGPT, a fine-tuned GPT-3, that leverages a novel training procedure in
order to follow user instructions more persistently. The basic idea for
InstructGPT is reinforcement learning from human feedback (RLHF, [21]), which
is composed of three phases: First, human labelers manually create responses
for randomly sampled prompts from a prompt database. This handcrafted data
served to fine-tune GPT-3 in a supervised fashion (SFT model), i.e., through
training on the manually created output for the respective prompt. In the
second step, SFT is tasked to create multiple outputs for a given prompt,
which are subsequently ranked by a human labeler from best to worst. This new
ranking dataset serves to train a reward model, which assigns a scalar reward
as a measure of quality for the given SFT outputs. In the final step, concepts
from reinforcement learning and proximal policy optimization [22] were applied
to fine-tune SFT using a previously trained reward model as an approximate
reward function. This allows evaluation of the quality of the online-generated
outputs using the reward model.

The setups of training InstructGPT and ChatGPT are nearly identical with minor
differences concerning the data collection [1]. The major difference lies in
the backbone itself. InstructGPT is based on GPT-3. ChatGPT uses GPT-3.5, a
newer, iterated version of the original GPT-3. Additionally, OpenAI embedded
various non-disclosed safety mechanisms into ChatGPT to promote a secure and
non-toxic environment.

###  2.3 Simplification and Summarization of Radiology Reports

Despite being closely related, simplification and summarization express two
different concepts. Text summarization describes the task of creating a short
version of a text including all important aspects. A supervised recurrent
model for this domain was proposed by [23] with increased performance in
comparison to previous non-neural approaches. [24] noted a lack of medical
terminology in BERT and therefore proposed fine-tuning the model on chest
x-ray reports before summarizing impression sections. A domain adaption was
done by [25] for a German version of BERT with the goal of summarizing German
chest x-ray reports. Further approaches for abstractive summarization
employed, e.g., a pointer-generator network [26] or a reinforcement-learning
inspired procedure [27] to solve this task. For extractive summarization of
medical data, BioBERT was fine-tuned by [28] and a sentence-ranking framework
with random forests in the backbone was proposed by [29]. Overall, [30] argued
that the continuously growing availability of biomedical text data has led to
increased attention to the research field of text summarization, where
meanwhile the majority of methods focus on machine learning.

In contrast to summarization, simplifying a text does not necessarily imply
shortening, but describes a transformation to make it more readable and
understandable [31, 32]. For instance, [33] identified a considerate
proportion of recurring standard phrases in their radiology report dataset and
argued that these could be easily and consistently replaced with simpler
terminology, while more varied descriptions of unique pathological findings
were less easy to simplify automatically. A similar procedure was applied in
[34], where human evaluators report a simplification of the medical reports
after the substitution. The replacement method was also adapted and extended
by a semantic network in [35]. The open-access consumer health vocabulary
(CHV) was used by [36] for simplifying text. They came to the conclusion that
even some CHV terms may not be appropriate for laypersons.

In addition to this technical work on how to generate simplified reports,
studies were conducted to investigate how well patients can understand
conventional radiology reports, and if they prefer simplified reports. Using
readability tests, [37] showed that the required reading level for their set
of lumbar spine reports exceeded 12th grade. They argued that the patients’
understanding of complex texts should be considered since patients
increasingly read reports themselves. As mentioned in the introduction, [7]
concluded that only 4% of more than 100,000 consecutive radiology reports were
at a reading level below the reading level of an average US adult. This
finding was further investigated in a randomized controlled trial [38], where
the majority of patients showed a preference for patient-friendly radiology
reports over traditional radiology reports.

There is a clear need for patients to be able to better understand radiology
reports [7]. While machine learning has made significant progress in the area
of radiology report summarization, to the best of our knowledge, automated
report simplification has not yet received adequate attention within the NLP
community. ChatGPT and other foundation models present promising opportunities
for simplifying radiology reports, but it is important to consider their
limitations, particularly when used in the medical field.

###  2.4 Known Limitations of LLMs

The GPT-3 publication [19] discussed the potential for misuse since the
generated outputs become close to indistinguishable from human language.
Furthermore, they highlighted model-inherent issues with biases and fairness.
Access to GPT is only granted over an API and not to the original model. With
an effort to democratize artificial intelligence, EleutherAI published GPT-J
as an open-source alternative for GPT-3 [39]. [16] also elaborated on
intrinsic biases, which are inherent to foundation models. In addition, they
brought up the concept of extrinsic harms that occur by adaption to a
downstream task. Moreover, the aspect of centralization of power was mentioned
as a problem, where only a specific part of society is able to access tools
like an LLM. [40] critically discussed the aspect of training data being one
source of harmful and biased behavior of LLMs and depicted the financial as
well as environmental impacts of large model training. Additionally, [41] were
able to extract potentially sensitive training data from LLMs, indicating that
larger models tend to be more vulnerable to these attacks due to increased
memorization. Another important issue is that LLMs can produce a text which
sounds plausible to the reader but is incorrect or nonsensical. In a benchmark
to measure truthful answers, larger models tended to score lower than their
smaller versions with fewer parameters [42]. Recently, Meta launched the
Galactica LLM [43] to support scientific writing. However, the API was taken
offline three days after its release due to a backlash: The model produced
seemingly correct-sounding but factually incorrect articles.

When using ChatGPT to simplify radiology reports, we expect the output to
sound plausible, while its factual correctness and completeness are not
guaranteed. In the next chapter, we present our approach for assessing the
quality of ChatGPT-generated simplified reports.

##  3 Methods

To investigate the capabilities of ChatGPT for simplification of radiology
reports, we conducted an exploratory case study (Figure 2) based on the
research question: What is the radiologists’ opinion on the quality of
simplified radiology reports generated with ChatGPT? We designed a
questionnaire that included three fictitious original radiology reports
written by an experienced radiologist and a unique simplified version of each
generated by ChatGPT. We asked 15 radiologists to rate the simplified reports
and analyzed the results of the questionnaire.

Figure 2: Summary of our evaluation pipeline. ChatGPT is prompted to generate
multiple simplified reports. Radiologists are then tasked to assess their
quality in a questionnaire. Lastly, the obtained data is evaluated.

###  3.1 Original Radiology Reports

A radiologist with 10 years of experience wrote three artificial radiology
reports. The artificial reports did not contain any sensitive personalized
information. Each report contains multiple findings, which are associated with
one another, e.g. tumor with edema, meniscus lesion with cruciate ligament
lesion, and systemic metastasis. All three reports are of moderate complexity,
based on a definition, where a report is of low complexity in case it contains
no pathological or at most one explicit pathological finding, and of high
complexity in case of many and especially unclear findings. The fictitious
reports mimic real cases in clinical routine, i.e., the reports include
previous medical information, describe the findings on the image, and contain
a conclusion.

The first report Knee MRI (A.1.0) describes a case in musculoskeletal
radiology. The case of a neuroradiological MRI of the brain is the subject of
the second report Head MRI (A.2.0). It describes a follow-up examination and
mentions comparisons to the previous examinations. The third report (A.3.0),
referred to as Oncol. CT, describes a fictitious oncological imaging event,
reporting a follow-up whole-body CT scan. To give an impression of the complex
wordings in radiology reports, some excerpts of the original reports are shown
in Figure 3.

$[...]$ Medial compartment: Minor cartilage damage at dorsal femoral condyle grade 2. Minor edema subchondrally, medially at medial femoral condyle DD postcontusion $[...]$ |  $[...]$ significantly size-progressive contrast-enhancing space- occupying lesion right parietooccipital with significantly increasing perifocal edema, DD distant GBM manifestation. $[...]$ |  $[...]$ Abdomen: Homogeneous contrast of liver parenchyma with no metastatic lesions. Portal vein and hepatic veins open. Gallbladder non-irritant with small calculus. $[...]$
---|---|---
Figure 3: Excerpts from the original radiology reports: Knee MRI (left), Brain
MRI (middle), and Oncol. CT (right). The full original reports are included in
the Appendix.

###  3.2 Simplifying Reports using ChatGPT

The original radiology reports were simplified by prompting the ChatGPT
(version December 15th, 2022) online interface with the request "Explain this
medical report to a child using simple language:" followed by the original
radiology report in text format.

This prompt was derived in a heuristic fashion using a separate fictitious
radiology report that was different from the original reports described in
Section 3.1. First, we tested different prompt versions of different lengths
and compositions, including "Simplify", "Explain like I’m five", "Explain this
medical report like I’m five", "Explain to a child using simple language",
"Explain this medical report using simple language", and "Explain this medical
report to a child using simple language". Based on several trials, we gained
the impression that the latter prompt produced the best and most stable
results and we perceived the language of the generated reports to be
significantly simpler compared to the original report. We assume that this
might be traced back to its detailed and explicit form, containing a concise
call to action ("Explain"), specifying a narrow domain ("medical report"), and
asking for a specific level of language complexity ("to a child using simple
language"). During our tests, including phrases like "to a child" or "like I’m
five" in the prompt on top of "simplify" or "using simple language" appeared
to be beneficial for language simplification. While our final prompt choice
"Explain this medical report to a child using simple language" worked well for
our radiology report examples in this study, we do not claim that this version
is necessarily the best option for the task of simplifying radiology report
with ChatGPT.

The output of ChatGPT is not deterministic by default. In principle, the model
outputs probabilities for the next token in the autoregressive generation
procedure. However, the current settings of the ChatGPT interface do not allow
tuning the temperature parameter responsible for handling the predicted token
probabilities. To account for the variability in the text output of ChatGPT
and to achieve good coverage of its generative capability, we prompted the
model 15 times for each of the three original reports, respectively, i.e., we
generated 15 different simplified reports per original report. Before each
repeat of the prompt, we restarted the chat session to ensure that no tokens
in the cache could distort the generated response. All 45 ChatGPT-generated
simplified reports can be found in Appendix A.

###  3.3 Questionnaire

We designed a questionnaire to query radiologists on the quality of the
simplified reports generated with ChatGPT. We defined the quality of radiology
reports as the combination of (i) factual correctness, (ii) completeness, and
(iii) harmfulness. Factual correctness was not further specified. By our
definition, a complete report includes all key medical information, relevant
to the patient. We specify harm as the potential that a subject could draw
wrong conclusions from a simplification, which might result in any physical or
psychological harm or lead to unwanted change in therapy or compliance.

The anonymized questionnaire "Questionnaire - Quality of Simplified
Radiological Reports" (Appendix B.1) consisted of the three original radiology
reports (section 3.1) and three unique simplified reports created with
ChatGPT, respectively (section 3.2). On the front page, the participating
radiologists were explicitly informed that the simplified radiology reports
were generated with "the machine learning language model ChatGPT" and received
a description of the setup of the questionnaire and an instruction on how to
answer. Further, we asked for consent to participate and the years of
experience, starting from the first year of residency.

Each questionnaire contained three blocks: (i) the original report, (ii) a
single, randomly selected, unique simplified version of the original report,
referred to as a "simplified report", and (iii) a series of questions to
access the quality of the simplified reports. We asked the participants to
rate their level of agreement with each criterion on a five-point Likert scale
(formulated as a statement, respectively). Additionally, each question was
accompanied by a follow-up question in which we asked the radiologists to
provide text evidence for their assessment.

  * •

Factual Correctness: "The simplified radiological report is factually
correct."
Follow-up: "Highlight all incorrect text passages (if applicable) of the
simplified report with a text marker".

  * •

Completeness: "Relevant medical information for the patient is included in the
simplified radiological report."
Follow-up: "List all relevant medical information, which is missing in the
simplified report (if applicable)."

  * •

Potential Harm: "The simplified report leads patients to draw wrong
conclusions, which might result in physical and/or psychological harm."
Follow-up: "List all potentially harmful conclusions, which might be drawn
from the simplified report (if applicable)."

15 radiologists with varying levels of experience from our clinic (Department
of Radiology, University Hospital, LMU Munich) were asked to answer our
questionnaire independently. Each radiologist received the same three original
reports and different, unique simplified reports.

###  3.4 Evaluation

The questionnaires were collected and checked for consent and completeness.
For each participant, the years of experience were recorded, respectively. The
radiologists’ ratings on the Likert Scales for factual correctness,
completeness, and potential harm were evaluated for each of the three cases
(Knee MRI, Brain MRI, Oncol. CT). Statistical parameters for the ordinal
scales were calculated: median, 25%-quantile ($Q_{1}$), 75%-quantile
($Q_{3}$), interquartile range (IQR), minimum, maximum, mean, and standard
deviation (SD). The word count for the original reports and each simplified
report was noted. For each report, all passages of the highlighted text, as
well as answers in the free-text fields were transcribed manually to a
spreadsheet (Table LABEL:app:tab:questionnaire_answers). Additionally, the
percentage of free-text questions and text highlights where text evidence was
provided by the participants was calculated. Finally, the free-text answers
were inductively categorized by content.

##  4 Results

In this section, we present our evaluation of the questionnaires, which were
answered by 15 radiologists with a median (IQR) experience of 5 (9) years. We
analyzed their ratings on the Likert Scale, followed by the free-text analysis
and the word count of the reports.

###  4.1 Likert Scale Analysis

We first evaluated the radiologists’ ratings for all 45 simplified reports
(see Table 1 and Figure 4(a)). The participants generally agreed (median = 2)
with the statements that the simplified reports are factually correct and
complete, respectively. For both quality criteria, 75% of all ratings were
given for "Agree" or "Fully agree" ($Q_{3}=2$), while "Fully disagree" was not
selected at all. In the case of completeness, we found a slight tendency
towards more positive ratings compared to factual correctness. 25% of all
completeness ratings were "Fully agree" ($Q_{1}=1$), more than for factual
correctness. Further, "Neutral" and "Disagree" were only selected four times,
but were selected ten times for factual correctness. Accordingly, the mean is
slightly lower (closer to 1 = Fully agree) for completeness (mean = 1.8)
compared to factual correctness (mean = 2.2). In line with these findings, the
participants disagreed (median = 4) on the potential of wrong conclusions
drawn from the simplified reports resulting in physical and/or psychological
harm.

(a) Results over all reports.

(b) Results grouped by original report.

Figure 4: Frequency of radiologists’ ratings for all 45 simplified reports
grouped by statement.

Compared to factual correctness (SD = 0.9) and completeness (SD = 0.7), the
radiologists’ ratings of potential harm are more broadly distributed (SD =
1.0) with a considerable proportion of ratings for "Neutral" and "Agree".
"Strongly Disagree" was not chosen at all.

In the second step, we also evaluated the radiologists’ ratings for each of
the three cases (Knee MRI, Brain MRI, and Oncol. CT) individually. The results
of the three reports are illustrated in Figure 4(b) and summarized in Table 2.
The median of the ratings showed no relevant differences in factual
correctness, completeness, and potential harm. However, there is a tendency
that the Head MRI and the Oncol. CT reports are judged to have a higher risk
of patients drawing wrong conclusions with potentially harmful consequences.

Question | Median | $Q_{1}$ | $Q_{3}$ | IQR | Min | Max | Mean | SD
---|---|---|---|---|---|---|---|---
Factual correctness | 2 | 2 | 2 | 0 | 1 | 4 | 2.2 | 0.9
Completeness | 2 | 1 | 2 | 1 | 1 | 4 | 1.8 | 0.7
Potential harm | 4 | 3 | 4 | 1 | 2 | 5 | 3.5 | 1.0
Table 1: Summary statistics for factual correctness, completeness, and potential harm over all 45 simplified reports. 1 = Strongly agree, 2 = Agree, 3 = Neutral, 4 = Disagree, 5 = Strongly disagree. Question | Report | Median | $Q_{1}$ | $Q_{3}$ | IQR | Min | Max | Mean | SD
---|---|---|---|---|---|---|---|---|---
Factual correctness | Knee MRI | 2 | 2 | 2 | 0 | 1 | 3 | 1.9 | 0.5
Head MRI | 2 | 2 | 2 | 0 | 1 | 4 | 2.1 | 0.9
Oncol. CT | 2 | 2 | 3.5 | 1.5 | 1 | 4 | 2.5 | 1.1
Completeness | Knee MRI | 2 | 1 | 2 | 1 | 1 | 2 | 1.6 | 0.5
Head MRI | 2 | 2 | 2 | 0 | 1 | 4 | 2.1 | 0.8
Oncol. CT | 2 | 1 | 2 | 1 | 1 | 4 | 1.8 | 0.8
Potential harm | Knee MRI | 4 | 4 | 4 | 0 | 3 | 5 | 4 | 0.5
Head MRI | 3 | 2.5 | 3.5 | 1 | 2 | 5 | 3.1 | 1
Oncol. CT | 4 | 2 | 4 | 2 | 2 | 5 | 3.3 | 1.1
Table 2: Summary statistics for factual correctness, completeness, and
potential harm grouped by original report. 1 = Strongly agree, 2 = Agree, 3 =
Neutral, 4 = Disagree, 5 = Strongly disagree.

###  4.2 Free-text Analysis

In the following, we summarize the results of the follow-up questions. For
each follow-up question, we applied inductive categorization of the free-text
data by content. We present the identified categories along with a few
selected examples for each. 51% of the participants highlighted incorrect
passages, while only 22% and 36% of the radiologists listed missing relevant
information and potentially harmful conclusions, respectively (Table 3).

| Answered (%)
---|---
Highlight incorrect passages | 51
List missing relevant information | 22
List harmful conclusions | 36
Table 3: Percentage of free-text questions and text highlights where text
evidence was provided by the participants.

####  4.2.1 Highlights of Incorrect Text Passages

We asked the participants to mark incorrect passages in the text (see
highlighted passages in the simplified texts in Appendix A), which unveiled a
variety of weak points in the simplified reports of ChatGPT.

##### Misinterpretation of medical terms

We observed that in the simplified text generated by ChatGPT medical
terminology was misinterpreted in several cases. The abbreviation "DD"
(differential diagnosis) was often mistaken as a final diagnosis (A.2.6,
A.2.8), e.g., the simplified report contains "The conclusion of the report is
that the mass on the right side of the head is a type of cancer called a
glioblastoma $[...]$" for the original statement "$[...]$ DD distant GBM
manifestation". Furthermore, "thyroid struma" was described by ChatGPT in one
instance as "infection in their thyroid gland" (A.3.13) and in another as
"extra thyroid gland" (A.3.7). The finding "No pneumothorax" was described as
"no holes in the walls between the lungs and chest" (A.3.3). The lateral
compartment of the knee was described as being on the "part of your body
that’s on the outside" (A.1.15). The term "retroperitoneal" (referring to
lymph nodes in need of further control) was wrongly interpreted as "in the
person’s back" (A.3.9). Lastly, a growing mass of "currently max. 22 mm" was
incorrectly simplified as a "small, abnormal growth $[...]$ that has gotten
bigger" (A.2.3).

##### Imprecise language

In some cases we observed that the automated simplification led to passages of
imprecise language: The medial compartment of the knee was described as the
"middle part of your leg" (A.1.5), the brain as the "head" (A.2.7), the
abdomen as the "stomach" (A.3.7) and thyroid struma as "thyroid problems"
(A.3.12). Partial regression was described as "gotten smaller and is not
spreading as much as before" (A.3.12), intercondylar area as "the area between
the two bones that make up the lower part of the leg" (A.1.4) and cartilage
was described as "hard, smooth substance" (A.1.9). Metastases were imprecisely
simplified as "spots" (A.3.5). A case of ambiguous simplification of the
original text is found where the simple report ended with "$[...]$ is no
evidence of the cancer spreading to other parts of the body." (A.3.13). In the
original report pulmonary metastases were described.

##### Hallucination

Some findings were not contained in the original report, i.e. they were made
up in the simplified reports, for instance, "no signs of cancer $[...]$ in the
thyroid gland" (A.3.3) or "brain does not seem to be damaged" (A.2.9).

##### Odd language

We observed odd and unsuited language in several simplified reports. The idiom
"wear and tear" (A.1.4) was used to describe the degeneration of tendons and a
radiological examination was circumscribed as "to see how the cancer is doing"
(A.3.8). In report A.2.6 contrast media was paraphrased with the word "dye"
and tumor as a "group of abnormal cells".

##### Grammatical errors

Grammatical errors such as "CT scan" instead of "CT scanner" (A.3.7) were the
exception.

####  4.2.2 Missing Key Medical Information

Furthermore, the simplified reports often missed key medical findings
mentioned in the original report.

##### Missed findings

For Knee MRI (A.1.0), a participant noted that the information on cartilage
damage on the inner side of the knee was missing in the simplified report
(A.1.5). In the Head MRI report (A.2.0) the information on "no intermediate or
recent ischemia" (A.2.2) was missing in one instance. Another missed finding
was the growth of the lesion on the parietooccipital side in the conclusion of
the simplified report (A.2.4). For Oncol. CT (A.3.0) one participant reported
that mentioning "spots" in contrast to metastases removes medical information.
Furthermore the fact, that the solid portions of the pulmonary metastases are
decreasing (A.3.5) - consistent with therapy response - is not included in the
simplified report. In another simplified report (A.3.13), where the thyroid
struma is misinterpreted as infection, the description of the enlargement is
missing.

##### Unspecific location

We observed missing or unspecific location information in the simplified
reports. In the simplified report A.1.15 the location of the described finding
(knee) was not mentioned. A participant mentioned that "the back" (A.3.14) is
not precise enough to describe the affected retroperitoneum. Non-specific
descriptions of the location resulted in problems with the identification of
the present tumor and the excised tumor (A.2.11).

####  4.2.3 Potentially Harmful

Finally, we asked the participants to list all potentially harmful
conclusions, which might be drawn from the simplified report. The given
answers corresponded mostly to already highlighted passages of incorrect text
or missing key medical information and corroborated the detected weaknesses.
Odd language and grammatical errors were not considered potentially harmful.

##### Misinterpretation of medical terms

Participants listed the misinterpretation of differential diagnosis ("DD") for
final diagnosis as potentially harmful for the patient, e.g., "GBM is one
(likely) DD which implies that other DDs exist (e.g. radionecrosis)" (A.2.7).
Lymph nodes were presented in the simplified report like "they might have
cancer"(A.3.9). This was considered harmful since the original report stated
that there was "no evidence of recurrence or new lymph node metastases".
Furthermore, the wording "small growth" (A.2.3) was deemed a harmful
conclusion, as the original report Head MRI (A.2.0) states a progression in
size, which "almost doubled".

##### Hallucination

Participants assessed the hallucination "brain does not seem to be damaged"
(A.2.9) as potentially harmful to the patient, as the original report
describes a growing mass.

##### Imprecise language

We observed that imprecise language highlighted as incorrect was sometimes
also graded as potentially harmful to the patient. One participant noted that
"there is no (new) spread of cancer" in the simplified oncological report
(A.3.13). Additionally, participants listed these potentially harmful
conclusions: "not clear that spots are pulmonal metastasis" (A.3.5), "changes
happened recently (how recently?)", and "some extra fluid $\neq$ sign. incr.
edema" (A.2.13).

##### Missed findings

We found that potentially harmful conclusions can originate from missing
information in the simplified report. The sentence "the parts that are staying
the same size are changing" (A.3.5) was found to be an unclear statement
missing interpretation. One participant stated that "information $[...]$ about
the lesion showing growth" is missing from the conclusion of the simplified
report (A.2.4).

##### Unspecific location

Cases, where ChatGPT misses the correct information about a location of a
disease, can lead to potentially harmful conclusions. Examples were:
"misunderstanding which lesion is stable and which one is in progress can lead
the patient to some wrong expectations" (A.2.11) and "patient might be misled
to look at cancer spots on their back" (A.3.14).

###  4.3 Word Count

The median word count for the simplified Head MRI and Oncol. CT reports were
comparable to their respective original reports (Table 4). The simplified Knee
MRI report with a median (IQR) word count of 414 (60) is generally longer
compared to the original report (word count = 222).

Report | Original | Simplified
---|---|---
|  | Median | Min | Max | IQR
Knee MRI | 222 | 414 | 249 | 538 | 60
Head MRI | 117 | 150 | 91 | 241 | 79
Oncol. CT | 241 | 249 | 111 | 386 | 94
Table 4: Word count of the original radiology reports and the ChatGPT-
generated simplified reports.

##  5 Discussion

In this exploratory study, we evaluated the opinion of radiologists on the
quality of radiology reports which were simplified by ChatGPT. Participating
radiologists rated the simplified radiology reports according to (i) factual
correctness, (ii) completeness, and (iii) potential harmfulness. In the
following, we discuss the implication of our results presented in Section 4.

###  5.1 Quality of Simplified Reports Generated with ChatGPT

We prompted ChatGPT to generate 45 simplified radiology reports for this
study. According to the authors of ChatGPT, the model is in principle able to
state to not know the answer [1]. However, in no instance, the model refused
to give an answer or indicated that the response could be incorrect while
generating consistent plausible-sounding outputs.

####  5.1.1 Factual Correctness

Although ChatGPT was not explicitly trained for the purpose of simplifying
radiology reports, most radiologists agreed that the generated simplified
reports are factually correct (median = 2, Section 4). However, some
radiologists also identified statements that were not considered factually
correct (Figure 4). In particular, we identified the following error
categories: misinterpretation of medical terms, imprecise language,
hallucination, odd language, and grammatical errors.

On the one hand, we speculate that the problem of misinterpretation of medical
terms, imprecise language, odd language, and grammatical errors may be solved
by the adoption of a ChatGPT-like model for the medical domain, as well as by
optimizing the prompt. On the other hand, we also observed hallucination,
which is a type of behavior where the model adds statements to the simplified
report that cannot be derived from the original report (Section 4.2.1). This
is an intrinsic problem in generative models like LLMs [44].

####  5.1.2 Completeness

Prompting ChatGPT for simplification is likely to cause responses, where
content is removed or rephrased in oversimplified terms. Therefore, we tasked
radiologists to verify the completeness of the simplified reports. Overall,
the radiologists agreed that the simplified reports contained the medical
information relevant for the patients (median = 2, Section 4.1). This
indicates that ChatGPT is able to identify the most important aspects of the
complex medical content of radiology reports. Nevertheless, the participants
also detected missing key medical information, which we summarized in the two
categories missed findings and unspecific location (Section 4). These findings
suggest that paraphrasing and explaining complex medical terminology in more
simple terms can have the side effect of losing medical context and
professional preciseness.

It is an open question if the problem of missing key medical information could
be solved by adapting the prompt or if this is an unreachable goal for the
current version of ChatGPT.

####  5.1.3 Potential Harm

Non-maleficence, i.e., to not harm individual patients, is a major principle
of medical ethics, also in the context of AI applications [45, 46]. Thus, we
asked the radiologists if they think that "The simplified report leads
patients to draw wrong conclusions, which might result in physical and/or
psychological harm.”

Overall, radiologists disagreed that potentially harmful conclusions will be
drawn from the ChatGPT-generated reports (median = 4, Table 1). This finding
may encourage patients to use ChatGPT or similar LLMs as a tool to simplify
radiology reports. However, as shown in Section 4.2.1 and 4.2.2, simplified
reports can contain errors and key medical findings might be missed. About
half of the radiologists found critical statements in the simplified reports
with a high potential of leading patients to wrong conclusions, which bears
the great risk of causing physical or psychological harm (Section 4.2.3). For
example, the medical finding that certain lymph nodes "might have cancer" is
an overstatement in the simplified report A.3.9. The original report clearly
states that there is "No evidence of recurrence or new lymph node metastases"
and only suggests to "further control" the "Unchanged prominent
retroperitoneal lymph nodes". This might cause psychological harm since the
patient could conclude that the CT shows hints of new lymph node metastases.
Another example can be found in the simplified report A.2.3. Here, only a
"small growth" of the contrast-enhancing mass is described, whereas the
original report (A.2.0) states a progression in size, which "almost doubled".
This is a clear understatement, which could lead the patient to underestimate
the progression of the disease.

While, overall, radiologists do not see a high risk for potential harm, they
still point out that single errors occur which might be potentially harmful.
Users of ChatGPT should be aware of this problem.

###  5.2 Opportunities and Challenges

With openly available LLMs like ChatGPT, patients might use these tools to
simplify their radiology reports in the near future. This scenario raises a
number of opportunities and challenges.

##### Patient-centered care

Improved accessibility of personal medical information may be beneficial to
the patient in multiple ways. Simplified reports give patients the chance to
better comprehend their health situation instead of making them feel
overwhelmed by the medical terminology found in the original report and might
help patients to better prepare themselves for future doctor-patient
interactions. For instance, the simplified report might raise questions
patients could then ask the medical practitioner. This might lead to an
improved understanding of their own health condition which, in turn, empowers
the patients, strengthens their position throughout the medical treatment, and
facilitates informed patient decisions. Simplified radiology reports are
particularly valuable for patients who do not speak the native language of the
country in which they are treated. Even though ChatGPT works best for English,
other languages are supported with varying quality. In the case of poorly
supported languages, reports could be translated into English using
established tools prior to simplification. Overall, easily accessible
simplified radiology reports may help to increase patient autonomy and allow
them to take on a more active role throughout their medical treatment process
facilitating patient-centered care.

However, when patients simplify their reports in advance of a medical
consultation, patients will not be assisted by an expert while reading and
attempting to interpret them. Without medical advice, patients could
misinterpret certain findings or even learn about a life-threatening diagnosis
from their simplified report, but the information might not be accompanied by
additional context, e.g., therapy options. This could put the patient in a
state of mental stress. Additionally, there might be an increased risk of
patients making their own clinical decisions, such as delaying or even
omitting further doctor appointments or terminating a therapy without
professional medical consultation. Even though the language conveying the
information might be simplified, the content of radiology reports and the
process of clinical decision-making remains complex.

##### Zero-shot simplification of radiology reports

In this study, we found that ChatGPT already performs surprisingly well at
simplifying radiology reports out of the box. It produces fairly accurate and
complete simplified reports. If this technology continues to become even more
easily accessible for laypersons, it has the potential to be applied by a wide
range of users in the near future. To fully leverage this tool as a radiology
report simplifier with maximum benefit for patients, several technical hurdles
need to be overcome.

Among others, we see the following challenges: ChatGPT was not developed for
the specific task of simplifying radiology reports. A domain adaption of
ChatGPT to the medical field could further improve the quality of generated
simplified radiology reports, e.g., leading to a more correct interpretation
of medical terms. The task of simplification could be enforced by using a
reward model trained to estimate the quality of simplified radiology reports
in the RLHF training procedure of ChatGPT. Like other LLMs, ChatGPT might have
intrinsic biases due to imbalanced training data [16, 19]. We hypothesize that
for the task of simplifying radiology reports, rare pathologies might be
handled less accurately than more common ones. Furthermore, medicine is an
active and dynamic field of science, which is subject to progress and change.
However, ChatGPT - like most LLMs - is trained on data with a certain
timestamp [40]. New research findings in medicine are thus not reflected in
the model’s output. Another problematic property of ChatGPT is the non-
deterministic output. ChatGPT generates text by predicting tokens on a
probabilistic basis, which does not guarantee the most likely response. While
this fosters dynamic dialogue, it could also lead to high variance with
respect to output reliability. As of now, there is no way for users to control
ChatGPT, e.g., with a temperature parameter or seed. This makes it difficult,
if not almost impossible, to reproduce a certain output, even when applying
the same input multiple times. Finally, there are privacy concerns when
sensitive data is uploaded to a proprietary service.

##### Potential future clinical application

Simplified radiology reports have the potential to increase patient autonomy
during the treatment process. With the release of ChatGPT, patients now have
unprecedented possibilities to automatically generate such simplified reports
themselves. However, there is an unavoidable risk for patients to draw
potentially harmful conclusions from those reports, when no medical oversight
is provided.

We envision a future integration of ChatGPT-like LLMs directly in the clinic
or radiology centers. In this scenario, a simplified radiology report would
always be automatically generated with an LLM alongside the original report,
proofread by a radiologist, and corrected where necessary. Both reports would
then be issued to the patient. We imagine the application of an appropriate
LLM that is adapted to the medical domain, properly certified, and hosted in a
privacy-preserving way, e.g., on-premise. In our opinion, this would be a
cost-efficient way to leverage state-of-the-art technology for improving
patient-centered care.

###  5.3 Limitations of the Study

The number of original radiology reports (n = 3) and experts (n = 15) for
assessing the quality of the simplified reports is small. Further, we used
fictitious radiology reports written by an experienced radiologist instead of
original reports of patients to protect patient privacy. The radiologist who
generated the simplified reports is German, i.e., not a native English
speaker. A German abbreviation ("Z.n." for "Zustand nach", which can be
paraphrased as "following"), which does not exist in English, was found in the
original reports. The original reports used in this study are at a medium
complexity level. It is unclear how the quality of less or more complex
reports would be rated. Also, the language simplicity of ChatGPT-generated
radiology reports was analyzed only qualitatively during the design process of
the input prompt ("Explain this medical report to a child using simple
language"). We did not further investigate the ability of ChatGPT to simplify
language with respect to established guidelines for simple language. We do not
claim that our prompt for triggering a simplification of radiology reports
through ChatGPT, is optimal for this task. Our prompt is the result of a
heuristic evaluation of experimenting with different inputs. Finally, the
quality of the simplified reports generated with ChatGPT was only evaluated
from a radiologist’s point of view. The patients’ perspective on the
readability, accessibility, and added value of those simplified reports was
not part of this study.

##  6 Conclusion

In this case study, we asked radiologists to assess the quality of simplified
radiology reports generated with ChatGPT. We found that most radiologists
agree that the simplified reports are factually correct, complete, and not
potentially harmful to patients. This positive vote illustrates the great
potential that LLMs could have for medical text simplification. In particular,
we argue that simplified reports generated with LLMs like ChatGPT would
strengthen patients’ autonomy. However, the radiologists also identified
factual incorrect statements, missing key medical information, and text
passages, which might lead patients to draw potentially harmful conclusions
from the simplified reports, if physicians are not kept in the loop. We
hypothesize that LLMs like ChatGPT may be used by patients to simplify
radiology reports that contain critical medical information, even though the
models were not developed for this specific medical use case. Thus, we see a
need for technical improvements and fine-tuning of ChatGPT or similar LLMs to
the specific task of simplifying radiology reports.

Our exploratory case study can only give first insights into the field of
automated simplification of radiology reports with ChatGPT, especially due to
the limited number of participants and radiology report cases. Given the great
potential of LLMs for simplifying radiology reports, there is a demand for
future research to validate the findings of our case study and to further
explore the many possibilities of this new technology in the medical domain.
This requires quantitative studies on the quality of simplified radiology
reports generated with ChatGPT and similar LLMs. Also, the opinion of patients
regarding the accessibility of those simplified reports and their overall
added value within the treatment process should be investigated. We propose to
include the automatic generation of simplified radiology reports in the
clinical process based on a domain-adapted model. These should be approved by
experts and issued to patients alongside their original report. Overall, we
see great potential in using LLMs like ChatGPT to improve patient-centered
care in radiology and other medical domains.

## Acknowledgments

We thank all radiologists who participated in this study. This work has been
partially funded by the Deutsche Forschungsgemeinschaft (DFG, German Research
Foundation) as part of BERD@NFDI - grant number 460037581.

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##  Appendix A Appendix

In Appendix A, we summarize the original reports and the simplified reports
generated by ChatGPT. The incorrect text passages (question 1a) identified by
participants were highlighted in the simplified reports.

###  A.1 Report #1: Knee MRI

####  A.1.0 Original Report

Radiography is used for correlation. Extended MRI in different sequencing
techniques and slice planes, application of additional, special sequencing
techniques, including spectral and/or inversion-based fat suppression. Medial
compartment: Minor cartilage damage at dorsal femoral condyle grade 2. Minor
edema subchondrally, medially at medial femoral condyle DD postcontusion.
Meniscus intact. Higher grade partial rupture of superficial medial ligament
portions. Specifically meniscofemoral somewhat frayed deep medial ligament
portions. Decent distal muscle fiber tear of the semimembranosus muscle.
Lateral compartment: Extensive bone marrow edema at the lateral tibial
plateau. No definite cartilage damage. Oblique tear at the posterior horn
outer meniscus, tibial femoral side (3/8). Suspected damage to adjacent
meniscopopliteal fascicles. Continuous lateral collateral ligament. If signal
elevation is present, rupture of ALL suspected. Tractus iliotibialis
continuous. Popliteus muscle intact. Patellofemoral joint/extensor: Minor
tendinopathy of quadriceps tendon, tendinopathy of patellar tendon at tibial
tuberosity. Patella centered. M PFL thinned out. Intercondylar: Anterior
cruciate ligament cannot be continuously delineated, most likely complete
rupture. Posterior cruciate ligament intact. Conclusion: - Complete rupture of
the anterior cruciate ligament. - Higher grade rupture of the medial ligament,
predominantly of the superficial portions. - Infraction at the lateral tibial
plateau without step formation. - Tear formation at the outer meniscus
posterior horn. Ruptured anterolateral ligament. - Muscle fiber tear of
semimembranosus muscle. Minimal cartilage damage to the medial femoral
condyle.

####  A.1.1 Simplified Report Sample #1

Radiography is a way to take pictures of the inside of your body using special
machines. An MRI is a special kind of picture that shows more detail inside
your body. It can be taken in different ways to get different types of
pictures. The medial compartment is the inside part of your leg. There is some
damage to the cartilage, which is a hard, smooth material that helps your
joints move easily. There is also some swelling and bruising on the inside of
your knee. The meniscus, which is a c-shaped piece of cartilage in your knee,
is not damaged. However, there is some damage to the ligaments, which are
strong bands of tissue that help hold your bones together. There is also a
small tear in a muscle called the semimembranosus muscle. The lateral
compartment is the outside part of your leg. There is a lot of swelling in the
bone in the top part of your shin bone. There is no damage to the cartilage in
this area. There is a tear in the meniscus, which is a c-shaped piece of
cartilage in your knee, on the outside of your knee. There may also be some
damage to the ligaments and muscles around your knee. The patellofemoral joint
is the joint between your knee cap (patella) and your thigh bone (femur).
There is some wear and tear on the tendons that attach your thigh muscles to
your knee cap and shin bone. Your knee cap is in the right position. There is
some thinning of a ligament called the M PFL. The intercondylar joint is the
joint between the two rounded parts (condyles) on the top of your shin bone.
The anterior cruciate ligament, which helps keep your shin bone in place, is
most likely completely torn. The posterior cruciate ligament, which is on the
back of your shin bone, is not damaged. In conclusion, you have a complete
tear of the anterior cruciate ligament, a higher grade tear of the medial
ligament, a tear in the meniscus, and a muscle fiber tear in the
semimembranosus muscle. There is also some swelling in the bone on the outside
of your shin and some wear and tear on the tendons around your knee cap. There
is only minor damage to the cartilage on the inside of your thigh bone.

####  A.1.2 Simplified Report Sample #2

Radiography is a way of taking pictures of the inside of your body using
special machines that use x-rays. An MRI is a way of taking pictures of the
inside of your body using magnets and computers. It can be used to look at
different parts of your body in different ways. Sometimes, it can be used to
make the pictures clearer or to highlight certain parts of your body. The
medial compartment is the inside part of your leg. There is some damage to the
cartilage on the top of your shinbone and some swelling on the inside of your
knee. The meniscus, which is a pad of cartilage in your knee, is okay. There
is some damage to the ligaments on the inside of your knee, but they are not
completely torn. There is also a small tear in one of the muscles in the back
of your leg. The lateral compartment is the outside part of your leg. There is
some swelling in the bone in the top of your shinbone on the outside of your
knee. There is no damage to the cartilage. There is a small tear in one of the
pads of cartilage in your knee. There might be some damage to the ligaments
and muscles around your knee, but it is not certain. The ligaments on the
outside of your knee are okay. The muscle on the back of your leg is okay. The
patellofemoral joint is the joint between your knee cap and your thigh bone.
There is some wear and tear on the tendons that attach your leg muscles to
your bones. There is also some wear and tear on the tendon that attaches your
knee cap to your shinbone. Your knee cap is in the right place. The ligament
that holds your knee cap in place is a little thin. The intercondylar joint is
the joint between the two parts of your thigh bone. The ligament that holds
your knee together in the front is most likely completely torn. The ligament
that holds your knee together in the back is okay. Overall, there is a
complete tear in the ligament in the front of your knee and some tears in the
ligaments and muscles on the inside and outside of your knee. There is also
some damage to the bone and cartilage in your leg.

####  A.1.3 Simplified Report Sample #3

Radiography is a way to take pictures of the inside of your body using special
machines. The doctor used a special kind of MRI machine to take many pictures
of your leg from different angles. They also used some extra techniques to
make the pictures clearer. In the middle part of your leg, there is a little
bit of damage to the cartilage (a tough, rubbery substance that helps your
joints move smoothly) at the top of your shin bone. There is also some
swelling and bruising around the joint at the top of your shin bone. The
cartilage in the middle of your knee is not damaged. The meniscus (a cushion
in your knee) is not damaged either. However, some of the ligaments (tough,
fibrous bands of tissue that hold your joints together) on the inside of your
knee are slightly torn or frayed. There is also a small tear in a muscle
called the semimembranosus muscle. On the outside of your leg, there is a lot
of swelling in the bone around the joint at the top of your shin bone. The
cartilage in this area is not damaged. There is a tear in the meniscus (a
cushion in your knee) on the outside of your knee. It is possible that some
other tissues around the meniscus are also damaged. The ligament on the
outside of your knee (called the lateral collateral ligament) is not torn.
However, there may be a tear in another ligament called the anterolateral
ligament. The muscle called the popliteus is not damaged. In the front of your
knee, the tendons (tough, fibrous cords that connect muscles to bones) that
help straighten your leg are a little bit sore. The patella (your kneecap) is
in the right place. There is some thinning of a ligament called the M PFL. In
the back of your knee, the ligament that helps keep your shin bone in place
(called the anterior cruciate ligament) is most likely completely torn. The
ligament that helps keep your thigh bone in place (called the posterior
cruciate ligament) is not damaged. Overall, it looks like you have a complete
tear in the anterior cruciate ligament and higher grade tears in the medial
ligaments in your knee. There is also a tear in the meniscus on the outside of
your knee and a possible tear in the anterolateral ligament. There is a small
tear in the semimembranosus muscle and minimal cartilage damage in the medial
femoral condyle.

####  A.1.4 Simplified Report Sample #4

Radiography is a type of medical test that uses special machines to take
pictures of the inside of your body. An MRI is another type of medical test
that uses strong magnets and radio waves to take detailed pictures of the
inside of your body. Sometimes, doctors will use different techniques or
change the way the MRI machine takes pictures to get a better look at certain
areas. They might also use special techniques to help them see certain tissues
more clearly. The medical report is talking about a person’s knee. The knee
has two compartments, the medial compartment (the inner part) and the lateral
compartment (the outer part). In the medial compartment, there is some minor
damage to the cartilage (a smooth, rubbery material that covers the bones and
helps them move smoothly against each other). There is also some swelling and
minor damage to the bone in this area. The meniscus (a c-shaped piece of
cartilage that acts like a shock absorber) is okay, but there is some damage
to the ligaments (tough bands of tissue that hold the bones together). There
is also a small tear in the semimembranosus muscle (a muscle in the leg). In
the lateral compartment, there is some swelling in the bone and no definite
cartilage damage. There is also a tear in the meniscus and possible damage to
other tissues. The lateral collateral ligament (another ligament in the knee)
is okay. There is a possibility of damage to the anterolateral ligament
(another ligament in the knee), and the popliteus muscle (another muscle in
the leg) is okay. In the patellofemoral joint (the joint between the patella,
or kneecap, and the femur, or thigh bone) and the quadriceps tendon (a tendon
that connects the quadriceps muscle to the patella), there is some minor wear
and tear. The patella (kneecap) is in the correct position. The medial
patellofemoral ligament (a ligament in the knee) is thinned out. In the
intercondylar area (the area between the two bones that make up the lower part
of the leg), the anterior cruciate ligament (a ligament in the knee) is most
likely completely ruptured (broken). The posterior cruciate ligament (another
ligament in the knee) is okay. The conclusion of the medical report is that
the person has a complete rupture of the anterior cruciate ligament, higher
grade rupture of the medial ligament (mostly the superficial portions), a
small fracture in the lateral tibial plateau without a step formation, a tear
in the outer meniscus posterior horn, and a muscle fiber tear of the
semimembranosus muscle. There is also minimal cartilage damage to the medial
femoral condyle.

####  A.1.5 Simplified Report Sample #5

Radiography is a way doctors can take pictures of the inside of your body
using special machines. The doctors used a special machine called an MRI to
take detailed pictures of your legs. They looked at different parts of your
legs and used different techniques to get the best pictures. In the middle
part of your leg (called the medial compartment), there was a small amount of
damage to some cartilage on your knee and a small amount of swelling. The
meniscus, which is a small, crescent-shaped piece of cartilage in your knee,
was not damaged. However, some of the ligaments that help hold your knee
together were partially torn. There was also a small tear in a muscle called
the semimembranosus muscle. In the outer part of your leg (called the lateral
compartment), there was a lot of swelling in the bone in your lower leg and no
damage to the cartilage. There was a tear in the meniscus in your knee on the
outer side. There might also be some damage to some other ligaments and
tissues near the meniscus. The lateral collateral ligament was not damaged,
but there might be a problem with the anterolateral ligament. The muscle
called the popliteus was not damaged. In the front of your knee (called the
patellofemoral joint), there was a small amount of wear and tear on the
tendons that connect your thigh muscle to your knee and shin bone. The
patella, or kneecap, was in the right place. There was also some thinning of
the ligament called the M PFL. In the area between the bones of your knee
(called the intercondylar area), the anterior cruciate ligament was most
likely completely torn. The posterior cruciate ligament was not damaged.
Overall, the main problems were a complete tear in the anterior cruciate
ligament, a higher grade tear in the medial ligament, a tear in the meniscus
in the outer part of the knee, a small tear in a muscle in the middle part of
the leg, and some swelling in the bone in the outer part of the leg. There was
only a small amount of damage to the cartilage in the middle part of the leg.

####  A.1.6 Simplified Report Sample #6

Radiography is a test that uses X-rays to take pictures of the inside of the
body. The doctors used this test to get more information about the patient’s
injuries. The MRI is a test that uses strong magnets and radio waves to take
detailed pictures of the inside of the body. The doctors used different
techniques and took pictures from different angles to get a better look at the
patient’s injuries. The patient had some injuries to their knee. There was
some damage to the cartilage (a hard, smooth surface that covers the ends of
bones) on the top part of the shinbone. There was also some swelling and
injury to the cartilage on the inside of the knee. The meniscus (a cushion in
the knee) was not damaged. However, some of the ligaments (tough bands of
tissue that hold bones together) on the inside of the knee were partly torn.
The patient also had a small tear in a muscle called the semimembranosus
muscle. On the outside of the knee, there was swelling in the bone and some
damage to the meniscus. There might also be damage to other tissues in the
knee. The ligaments on the outside of the knee were not torn. The popliteus
muscle (a muscle in the back of the knee) was not damaged. The patient also
had some injuries to the tendons (tough cords of tissue that connect muscles
to bones) in their knee. The quadriceps tendon (a tendon in the front of the
thigh) and the patellar tendon (a tendon in the front of the shinbone) were
slightly damaged. The patella (kneecap) was in the correct position. The
ligament that helps hold the patella in place was slightly damaged. In the
middle part of the knee, the anterior cruciate ligament (a ligament that helps
keep the knee stable) was completely torn. The posterior cruciate ligament
(another ligament that helps keep the knee stable) was not damaged. In
summary, the patient had a complete tear of the anterior cruciate ligament and
partial tears of the ligaments on the inside of the knee. There was also some
damage to the cartilage on the inside of the knee, swelling in the bone on the
outside of the knee, and a tear in the meniscus on the outside of the knee.
The patient also had some slight damage to the tendons in the front of the leg
and the patella.

####  A.1.7 Simplified Report Sample #7

Okay, let’s break this down into simpler language. Radiography is a type of
medical test that uses special machines to take pictures of the inside of your
body. This can help doctors understand what might be wrong and how to help
you. An MRI is another type of medical test that also takes pictures of the
inside of your body. It uses magnets and radio waves instead of x-rays to get
these pictures. Sometimes, doctors need to do a special type of MRI where they
take even more detailed pictures from different angles, or they use extra
techniques to get a clearer image. Your knee has different parts, or
compartments, that can be injured. The medial compartment is the inside part
of your knee, and the lateral compartment is the outside part. In the medial
compartment, there is some minor damage to the cartilage on the top of your
thigh bone. Cartilage is a tough, slippery material that helps your bones move
smoothly against each other. There is also some swelling and a little bit of
injury to the cartilage on the inside part of your knee. The meniscus, which
is a C-shaped piece of cartilage in your knee, is not damaged. However, there
is some damage to the ligaments, which are strong bands of tissue that hold
your bones together and help your knee move. There is also a small tear in one
of the muscles in your thigh. In the lateral compartment, there is a lot of
swelling and injury in the bone inside your lower leg bone. There is no damage
to the cartilage in this area. There is a tear in the meniscus, which is the
C-shaped piece of cartilage in your knee, on the outside part of your knee.
There might also be some damage to other tissues in this area. The ligament on
the outside of your knee is not damaged. There is also no damage to the muscle
in the back of your knee. In the patellofemoral joint, which is the joint
where your kneecap (patella) and thigh bone (femur) meet, there is some minor
damage to the tendons, which are strong cords of tissue that attach muscles to
bones. The kneecap is in the right place. There is also some thinning of the
ligament that helps hold the kneecap in place. In the intercondylar area,
which is the area between the two bumpy parts (condyles) at the top of your
thigh bone, the anterior cruciate ligament (ACL) is completely torn. The ACL
is a very important ligament that helps keep your knee stable. The posterior
cruciate ligament (PCL), which is another important ligament in your knee, is
not damaged. Overall, this report is saying that you have a complete tear of
the ACL and some other injuries to the ligaments, bones, and cartilage in your
knee. You also have a small tear in a muscle in your thigh and some minor
damage to the tendons around your kneecap. There is minimal damage to the
cartilage on the inside part of your knee.

####  A.1.8 Simplified Report Sample #8

Radiography is a way to take pictures of the inside of your body using special
equipment. MRI stands for magnetic resonance imaging. It’s a way to get even
more detailed pictures of the inside of your body by using magnets and radio
waves. Different techniques and slice planes are just different ways to take
the pictures. The medial compartment is the inner part of your knee. There is
some damage to the cartilage, which is the smooth layer on top of the bone
that helps your knee move smoothly. There is also some swelling and bruising
on the inner part of the bone. The meniscus, which is a cushion in your knee,
is okay. But there is some damage to the ligaments, which are strong bands of
tissue that hold your knee together. There is also a small tear in one of the
muscles that helps you bend your leg. The lateral compartment is the outer
part of your knee. There is a lot of swelling in the bone and some damage to
the meniscus, which is the cushion in your knee. There is also possible damage
to other tissues in your knee. The lateral collateral ligament, which is
another strong band of tissue that helps keep your knee stable, is okay. The
iliotibial band and the popliteus muscle, which are other tissues that help
your leg move, are also okay. The patellofemoral joint is the joint where your
kneecap (patella) moves against your thigh bone (femur). There is some minor
irritation of the tendons, which are strong cords of tissue that connect your
muscles to your bones. The kneecap is in the right position. The medial
patellofemoral ligament, which is a strong band of tissue that helps keep your
kneecap in place, is thinned out. The intercondylar area is the space between
the bones (condyles) in your knee. The anterior cruciate ligament, which helps
keep your knee stable when you move, is most likely completely torn. The
posterior cruciate ligament, which is another ligament that helps keep your
knee stable, is okay. Overall, there is a complete tear of the anterior
cruciate ligament and some other damage to the ligaments and muscles in your
knee. There is also some swelling in the bone and minor damage to the
cartilage.

####  A.1.9 Simplified Report Sample #9

Radiography is a medical test that takes pictures of the inside of your body.
It helps doctors understand what is happening inside your body. An MRI is
another medical test that takes pictures of the inside of your body. It uses
strong magnets and radio waves to create detailed pictures of your bones and
tissues. The MRI in this report used different ways of taking pictures and
looked at different parts of the body. The report mentions several parts of
the body that were examined, including the medial compartment, which is the
inside part of the knee, and the lateral compartment, which is the outside
part of the knee. The report also mentions the patellofemoral joint, which is
the joint between the kneecap and the thigh bone, and the intercondylar, which
is the area between the two bones that make up the lower part of the leg. The
report says that there is some damage to the cartilage, which is a hard,
smooth substance that helps protect the bones, in the medial compartment.
There is also swelling and some damage to the ligaments, which are strong
bands of tissue that hold the bones together, in the medial compartment. The
meniscus, which is a crescent-shaped piece of cartilage in the knee, is not
damaged. However, there is a tear in the muscle called the semimembranosus
muscle. In the lateral compartment, there is swelling in the bone and a tear
in the meniscus. There may also be damage to the ligaments and muscle called
the iliotibialis. The popliteus muscle is not damaged. In the patellofemoral
joint and extensor, there is some wear and tear on the tendons, which are
strong cords of tissue that connect muscles to bones, and the patella, which
is the kneecap, is in the correct position. In the intercondylar, the anterior
cruciate ligament, which is a ligament in the knee, is most likely completely
torn. The posterior cruciate ligament, which is another ligament in the knee,
is not damaged. Overall, the report says that there is a complete tear in the
anterior cruciate ligament and some damage to other ligaments and muscles in
the knee. There is also some swelling in the bone and a tear in the meniscus.
However, there is minimal damage to the cartilage in the medial compartment.

####  A.1.10 Simplified Report Sample #10

Radiography is a special kind of test that uses x-rays to create pictures of
the inside of your body. The doctors used this test to help them understand
what is happening in your body. The MRI is another special test that uses
magnets and computers to create detailed pictures of the inside of your body.
The doctors used different techniques and planes to get a good look at
different parts of your body. In the medial compartment (the inside part) of
your leg, there is some minor damage to the cartilage (the smooth, white
material that covers the ends of bones) on the top part of your thigh bone.
There is also some swelling and minor damage to the cartilage on the inside
part of the bone at the bottom of your thigh. The meniscus (the c-shaped piece
of cartilage in your knee) is okay. However, there is some damage to the
ligaments (the strong, elastic bands of tissue that hold bones together) on
the inside of your leg. There is also some damage to the muscle (the tissues
in your body that help you move) on the back part of your thigh. In the
lateral compartment (the outside part) of your leg, there is some swelling in
the bone marrow (the spongy tissue inside your bones that helps make blood
cells) on the outer part of your shin bone. There is no damage to the
cartilage in this area. However, there is a small tear in the meniscus (the
c-shaped piece of cartilage in your knee) on the outer part of your leg. There
might also be some damage to the tissues around the meniscus. The ligament
(the strong, elastic bands of tissue that hold bones together) on the outside
of your leg is okay. The muscle (the tissues in your body that help you move)
on the back of your leg is also okay. In the patellofemoral joint (the joint
where your knee cap meets your thigh bone) and the extensor muscles (the
muscles that help you straighten your leg), there is some minor damage to the
tendons (the tough, white cords that connect your muscles to your bones) in
your quadriceps (the group of muscles at the front of your thigh) and your
knee cap. Your knee cap is in the right position. The ligament (the strong,
elastic bands of tissue that hold bones together) on the inside of your leg is
thinned out. In the intercondylar (the space between the two parts of your
thigh bone) area, the anterior cruciate ligament (ACL, one of the main
ligaments in your knee) is probably completely torn. The posterior cruciate
ligament (PCL, another main ligament in your knee) is okay. In conclusion, you
have a complete tear of the ACL ligament and some higher grade tears of the
ligaments on the inside of your leg. There is also some damage to the bone on
the outer part of your shin and a tear in the meniscus on the outer part of
your leg. You have a small tear in the muscle on the back of your thigh and
some minor damage to the cartilage on the inside part of the bone at the
bottom of your thigh.

####  A.1.11 Simplified Report Sample #11

This medical report is talking about a person’s knee. The knee is made up of
different parts, including the thigh bone, shin bone, and kneecap. The report
says that there are some problems with the knee. One problem is that there is
a tear in the ligament, which is a strong band of tissue that connects bones.
The ligament on the inside of the knee has a higher grade tear, which means it
is more serious. There is also a tear in a muscle called the semimembranosus
muscle. Another problem is that the knee has some swelling, which is called
edema. There is also some damage to the cartilage, which is a smooth, white
tissue that covers the ends of the bones and helps them move smoothly. There
is also a problem with the knee joint on the side of the knee. There is
swelling in the bone and a tear in the meniscus, which is a C-shaped piece of
cartilage that helps cushion the joint. There may also be a problem with the
ligament on the side of the knee. Finally, the report says that there may be a
problem with the ligaments that connect the thigh bone to the shin bone. One
of these ligaments, called the anterior cruciate ligament, may be completely
torn. However, the other ligament, called the posterior cruciate ligament, is
still okay. Overall, this medical report is saying that the person has some
injuries to their knee that will need to be treated.

####  A.1.12 Simplified Report Sample #12

Radiography is a type of medical test that helps doctors see inside your body
using special machines. They use it to help them understand what might be
causing a problem or injury. An MRI is another type of medical test that uses
powerful magnets and radio waves to take pictures of the inside of your body.
There are different ways the doctors can use the MRI machine to get different
types of pictures. They might also use other special techniques to get even
clearer pictures. The medial compartment is the inside part of your leg. There
is some damage to a small piece of cartilage on the top part of the bone in
your leg. There is also some swelling and a little bit of injury to the bone
under the cartilage. The meniscus, which is a small, C-shaped piece of
cartilage in your knee, is not injured. But some of the ligaments that help
hold your knee together are a little bit damaged or frayed. There is also a
small tear in one of the muscles in your leg. The lateral compartment is the
outside part of your leg. There is some swelling in the bone in the top part
of your leg. There is no damage to the cartilage in your knee. There is a
small tear in a part of the meniscus that is on the outside of your leg. There
might also be some damage to other small ligaments near the meniscus. The
ligament that helps hold your leg and knee together is not damaged. The muscle
that helps you bend your leg is also not damaged. The patellofemoral joint is
the joint between your kneecap and your leg bone. There is some minor injury
to the tendons in your leg that help you straighten your leg. There is also
some injury to the tendon that goes from your kneecap to your leg bone. Your
kneecap is in the right position. There is some thinning of a ligament that
helps hold your kneecap in place. The intercondylar is the area between the
two bones in your leg. The ligament that helps hold your leg bones together in
the front is most likely completely torn. The ligament that helps hold your
leg bones together in the back is not damaged. The conclusion is that you have
a complete tear in the front ligament in your knee, a higher grade tear in
some of the ligaments on the inside of your leg, some swelling in the bone on
the outside of your leg without any step formation, a tear in the meniscus on
the outside of your leg, and a small tear in one of the muscles in your leg.
There is only minimal damage to the cartilage on the inside of your leg bone.

####  A.1.13 Simplified Report Sample #13

Radiography is a way to take pictures inside the body using special machines.
The pictures help doctors see what is going on inside the body. MRI is another
way to take pictures inside the body. It uses strong magnets and radio waves
to make the pictures. Sometimes, doctors need to use different techniques or
planes to get the best pictures. The medial compartment is the part of the
knee on the inside. In this case, there is some damage to the cartilage, which
is the smooth white material that helps the bones move smoothly. There is also
some swelling and bruising on the bone under the cartilage. The meniscus,
which is a c-shaped piece of cartilage in the knee, is okay. But some of the
ligaments, which are strong bands of tissue that help hold the bones together,
are a little bit damaged. There is also a small tear in a muscle called the
semimembranosus muscle. The lateral compartment is the part of the knee on the
outside. In this case, there is a lot of swelling in the bone under the
cartilage on the outside of the tibia, which is one of the bones in the leg.
There is no damage to the cartilage, but there is a tear in the meniscus,
which is a c-shaped piece of cartilage in the knee. There might also be damage
to some of the ligaments and muscle fibers in this area. The ligaments on the
outside of the knee, called the lateral collateral ligament, and the muscle
called the popliteus muscle, are both okay. The patellofemoral joint is the
joint where the kneecap (patella) and thighbone (femur) meet. In this case,
there is some minor damage to the tendons that attach the quadriceps muscles
(which straighten the leg) and the patellar tendon (which extends the leg) to
the bones. The kneecap is in the right position. The medial patellofemoral
ligament (which helps hold the kneecap in place) is a little bit thin. The
intercondylar joint is the joint between the two bones (tibia and femur) in
the lower leg. In this case, the anterior cruciate ligament (which helps hold
the bones together and keeps the knee stable) is most likely completely torn.
The posterior cruciate ligament (which also helps hold the bones together and
keeps the knee stable) is still intact. In conclusion, there is a complete
tear of the anterior cruciate ligament and a higher grade tear of the medial
ligament in the knee. There is also a tear in the meniscus and some damage to
the lateral collateral ligament on the outside of the knee. There is a small
tear in the semimembranosus muscle and minimal damage to the cartilage on the
inside of the knee.

####  A.1.14 Simplified Report Sample #14

Radiography is a way to take pictures of the inside of your body using special
machines. MRI stands for magnetic resonance imaging and is another way to take
pictures of the inside of your body using magnets and radio waves. Different
slices and techniques can be used to get different kinds of pictures. The
medial compartment is the part of your leg that is closest to the middle of
your body. There is some minor damage to the cartilage on the top of your
thigh bone, and there is some swelling near the cartilage on the top of the
bone in your lower leg. The meniscus, which is a piece of cartilage in your
knee, is okay. There is also some damage to some of the ligaments on the
inside of your knee. The ligaments are like strong ropes that help hold your
bones together. There is also a small tear in a muscle called the
semimembranosus muscle. The lateral compartment is the part of your leg that
is farther from the middle of your body. There is some swelling in the bone in
the top of your lower leg, but no damage to the cartilage. There is a tear in
a piece of cartilage called the meniscus on the outside of your knee. There
might also be some damage to some other ligaments and muscles near your knee.
The ligaments and muscles on the outside of your knee are okay. The
patellofemoral joint is the joint between your kneecap (patella) and your
thigh bone (femur). There is some minor damage to the tendons, which are like
strong cords that connect your muscles to your bones, in your knee. Your
kneecap is in the right place. There is also some thinning of a ligament
called the M PFL. The intercondylar area is the space between the two parts of
your thigh bone that stick out at the top of your knee. The anterior cruciate
ligament (ACL), which is a ligament that helps hold your thigh bone and lower
leg bone together, is probably completely torn. The posterior cruciate
ligament (PCL), which is another ligament that helps hold your thigh bone and
lower leg bone together, is okay. In conclusion, you have a complete tear of
the ACL and a higher grade tear of the medial ligament in your knee. There is
also a tear in the meniscus and possibly some damage to other ligaments and
muscles on the outside of your knee. There is a small tear in the
semimembranosus muscle and minimal cartilage damage on the inside of your
knee.

####  A.1.15 Simplified Report Sample #15

Sure, I can explain this medical report to a child using simple language.
Radiography is a way to take pictures of the inside of your body, usually
using x-rays. An MRI is a special machine that uses powerful magnets and radio
waves to take detailed pictures of the inside of your body. It can show
different parts of your body in different ways by using different techniques,
like special slicing planes and special techniques to highlight or suppress
certain types of tissue. The medial compartment is the part of your body
that’s on the inside, closer to the center. There’s some minor damage to the
cartilage (a special kind of tissue that helps protect bones) on the top of
your leg bone, and some swelling on the inside of your leg bone near the top.
The meniscus (a special kind of tissue that helps protect your knee joint) is
okay. There’s also some damage to the ligaments (tissues that hold bones
together) on the inside of your knee, and a small tear in the muscle (tissue
that helps you move) on the back of your thigh. The lateral compartment is the
part of your body that’s on the outside, farther from the center. There’s some
swelling in the bone tissue on the outside of your lower leg bone, but no
damage to the cartilage. There’s also a tear in the meniscus on the outside of
your knee, and possibly some damage to nearby tissues. The ligament on the
outside of your knee is okay, but there might be a tear in the ligament on the
front of your thigh. The muscle on the back of your calf is okay. The
patellofemoral joint is the joint where your kneecap (patella) and your thigh
bone (femur) meet. There’s some minor damage to the tendons (tissues that
connect muscles to bones) on the front of your thigh and your kneecap, but the
kneecap is in the right place. The ligament on the inside of your knee is a
little thin. The intercondylar joint is the joint between the two parts of
your thigh bone (femur). The anterior cruciate ligament (ACL) is probably
completely torn. The posterior cruciate ligament (PCL) is okay. So, the main
problems are: a complete tear of the ACL, a higher grade tear of the medial
ligament, a tear in the meniscus on the outside of the knee, a small tear in
the muscle on the back of the thigh, and some minor damage to the cartilage on
the inside of the leg bone.

###  A.2 Report #2: Head MRI

####  A.2.0 Original Report

Several previous examinations are available for comparison. The contrast-
enhancing mass on the right parietooccipital side shows a progression in size
in the short-term follow-up (currently max. 22 mm, in the previous examination
max. 12 mm), with significantly increasing perifocal edema. The resection area
on the right frontal side remains essentially unchanged, and there is still no
definite evidence of a new contrast-enhancing mass. Otherwise, no evidence of
recent or intermediate ischemia. No evidence of intracranial hemorrhage. No
signs of cerebrospinal fluid circulation disturbance. Conclusion: \- In the
short-term follow-up, significantly size-progressive contrast-enhancing space-
occupying lesion right parietooccipital with significantly increasing
perifocal edema, DD distant GBM manifestation. No evidence of a contrast-
enhancing mass in the right frontal resection area.

####  A.2.1 Simplified Report Sample #1

This medical report is talking about a person’s brain. There have been some
previous exams that doctors can compare to the current one. There is a mass in
the right side of the brain that has gotten bigger since the last exam. It is
also causing swelling around it. There is no new mass in the right side of the
brain, but there is no evidence of any problems with the blood vessels or
bleeding in the brain. There are also no problems with the fluid that
surrounds the brain. The doctors think that the mass in the right side of the
brain is likely a type of brain cancer called glioblastoma.

####  A.2.2 Simplified Report Sample #2

This medical report is talking about a person’s brain. There have been
previous times when doctors have looked at the brain and taken pictures of it.
The report says that there is a mass (a lump) on the right side of the back of
the head that has grown bigger in size recently. It also says that there is
swelling (edema) around the mass. The report also mentions that there was an
area on the right side of the front of the head that the doctors removed
something from before, and there is no new mass there now. The report also
says that there is no evidence of bleeding in the brain or any problems with
the fluid that surrounds the brain. The conclusion of the report says that the
mass on the right side of the back of the head is likely a type of brain
cancer called glioblastoma.

####  A.2.3 Simplified Report Sample #3

Okay, let’s break down this medical report into simpler language. This report
is about a person who has had some medical tests done before and has had more
tests done recently. The tests show that there is a small, abnormal growth in
the person’s brain that has gotten bigger in the short-term follow-up (recent
tests). This growth is called a "mass" and it is causing swelling around it.
There was no change in another area of the brain that had been treated before,
and there is no new growth in that area. The tests also showed that there is
no bleeding in the brain and no problems with the fluid that surrounds the
brain. The conclusion of the report is that the person has a small, abnormal
growth in their brain that has gotten bigger recently and is causing swelling.
This growth is called a "space-occupying lesion" and it is likely a type of
brain cancer called glioblastoma (GBM). There is no evidence of a similar
growth in the other area of the brain that was treated before.

####  A.2.4 Simplified Report Sample #4

This medical report is talking about a person’s brain. The report says that
there is a mass or growth in a certain area of the brain that has gotten
bigger since the last time it was checked. There is also swelling around the
mass. The report also says that there is no evidence of any other growths in a
different area of the brain that was previously treated. The report also
mentions that there is no evidence of any problems with the brain’s blood flow
or with the fluid that surrounds the brain. The report concludes that the mass
is likely a type of brain cancer called a glioblastoma.

####  A.2.5 Simplified Report Sample #5

This medical report is talking about a person’s brain. There are some pictures
of the brain from different times, and the doctors are comparing them to see
how the brain has changed. There is a problem in the right side of the back of
the brain. It is called a "mass," and it is bigger now than it was before. It
is also causing some swelling around it. On the right side of the front of the
brain, there is a place where the doctors took out some tissue before, and it
has not changed. There is no new problem in that area. Overall, the brain does
not have any signs of not getting enough blood or oxygen, or bleeding. The
fluid that surrounds the brain and spine is also normal. The doctors think
that the problem in the right side of the back of the brain might be a type of
tumor called a "glioblastoma." This is a serious type of tumor that can spread
to other parts of the brain. The report concludes by saying that the problem
in the right side of the back of the brain has gotten bigger and is causing
swelling, and it might be a glioblastoma. There is no new problem in the right
side of the front of the brain.

####  A.2.6 Simplified Report Sample #6

This medical report is about someone who has had a few medical exams in the
past, and the doctors are comparing the results from these exams to see if
anything has changed. The report says that there is a mass (a group of
abnormal cells) on the right side of the back of the head that has gotten
bigger since the last exam. The mass is called a "contrast-enhancing mass"
because it shows up better on certain types of medical images when a special
dye is used. The mass has grown from 12 millimeters (mm) to 22 mm, which is a
big change in a short amount of time. There is also swelling (edema) around
the mass. On the other side of the head, in the right frontal area, there was
a surgery to remove a mass. The report says that this area looks the same as
it did before and there is no evidence of a new mass forming. The report also
mentions that there is no evidence of bleeding in the brain or any problems
with the fluid that surrounds the brain and spine. The conclusion of the
report is that the mass on the right side of the head is a type of cancer
called a glioblastoma, and it has gotten bigger and caused more swelling in a
short amount of time. There is no evidence of a new mass in the area where the
surgery was done.

####  A.2.7 Simplified Report Sample #7

This medical report is talking about a person’s brain. They have had some
tests done before and are comparing them to a new test. There is a problem in
the right side of the back of the head. It is a mass (a lump) that is growing.
It is also causing swelling around it. There is no new problem in the right
side of the front of the head, and there are no problems with the blood
vessels or bleeding in the brain. There are also no problems with the fluid
that surrounds the brain. The doctors think that the mass on the right side of
the back of the head is a type of brain cancer called a GBM.

####  A.2.8 Simplified Report Sample #8

This medical report is talking about a mass (a lump) that was found in the
brain. This mass is growing bigger and bigger, and it is causing swelling
around it. The doctors have been watching it over time, and they can see that
it has gotten bigger in the short term (recently). The mass is located on the
right side of the back of the head. There is no other mass in the right side
of the front part of the head. The doctors do not see any problems with blood
flow or bleeding in the brain, and they do not see any problems with the fluid
that surrounds the brain. The doctors think that this mass might be a type of
brain tumor called a glioblastoma (GBM). It is called a "space-occupying
lesion" because it takes up space in the brain and can cause problems. The
doctors will continue to watch the mass and see if it gets bigger or if there
are any other changes.

####  A.2.9 Simplified Report Sample #9

This medical report is about a person who has had some medical tests done on
their brain. The report shows that there is a mass (a lump) on the right side
of the brain that has gotten bigger since the last time it was checked. The
mass is causing some swelling around it. There is no new mass on the right
side of the head, and the person’s brain does not seem to be damaged or
bleeding. There is also no problem with the fluid that surrounds the brain.
The doctors think that the mass might be a type of cancer called a
glioblastoma.

####  A.2.10 Simplified Report Sample #10

This medical report is talking about a person who has had some medical tests
done recently, and they also had some tests done before. The doctors are
comparing the results of the new tests to the old ones to see if anything has
changed. The report says that there is a mass (a lump) on the right side of
the back of the head that has gotten bigger since the last time they were
checked. The mass is called a "contrast-enhancing mass" because it shows up
better on the medical tests when a special dye is used. The mass is also
causing some swelling around it. The report also says that there is no new
mass on the right side of the front of the head, and that there are no signs
of any problems with blood flow to the brain or with bleeding in the brain.
There are also no signs of any problems with the fluid that surrounds the
brain. The doctors have concluded that the mass on the back of the head is
likely a type of brain tumor called a glioblastoma, and it is getting bigger.
There is no new mass on the front of the head.

####  A.2.11 Simplified Report Sample #11

A medical report is a document that describes the results of a medical
examination or test. It can be written in medical language, which is a special
way of talking about the body and its functions. This medical report is
talking about a person’s brain. The brain is the part of the body that
controls everything we do and think. The report says that there is a problem
in the right side of the brain. It’s a mass, which means it’s a lump or bump.
This mass is growing bigger and causing swelling around it. This is called
edema. The report also mentions that there was a surgery done on the right
side of the brain before. The report says that there is no new problem in that
area. The report also says that there is no bleeding in the brain, and that
the brain is getting enough blood and oxygen. It also says that the brain is
not having any trouble sending messages through the body. The conclusion of
the report is that there is a growing mass on the right side of the brain that
is causing swelling, and it might be a type of cancer called a GBM. But there
is no new problem in the area where the surgery was done.

####  A.2.12 Simplified Report Sample #12

Okay, let’s break this down into simpler language: There are some past medical
exams that we can compare to the current one. The current exam shows that
there is a mass (a lump) on the right side of the back of the head that has
grown bigger since the last exam (it’s 22mm now, but it was 12mm before).
There is also some swelling around the mass. There is no new mass on the right
side of the front of the head, and there are no problems with blood flow or
bleeding in the brain. There are also no problems with the fluid that
surrounds the brain. Overall, it looks like the mass on the right side of the
back of the head has grown quickly and is causing some swelling. We think it
might be a type of cancer called glioblastoma. There is no new mass on the
right side of the front of the head.

####  A.2.13 Simplified Report Sample #13

This medical report is talking about a person’s brain and some changes that
have happened recently. There was a mass or growth on the right side of the
brain that has gotten bigger in a short amount of time. There is also some
extra fluid around this mass. On the other side of the brain, there doesn’t
seem to be any changes. There are no signs of problems with the blood or fluid
in the brain. The doctors think that this mass might be a type of brain cancer
called glioblastoma.

####  A.2.14 Simplified Report Sample #14

This medical report is about a person who has had some medical exams done in
the past and has a new exam done recently. In the new exam, there is a mass (a
lump or growth) in the back of their head that has gotten bigger since the
last exam. The area around the mass is also swollen. There was no evidence of
a mass in the front of the head where the person had surgery before. The
report also mentions that there is no evidence of bleeding in the brain or
problems with the fluid that surrounds the brain. The doctors think that the
mass in the back of the head is probably a type of brain cancer called a
glioblastoma.

####  A.2.15 Simplified Report Sample #15

This medical report is talking about a person’s brain and some changes that
have happened since their last medical examination. It mentions that there is
a mass or growth on the right side of the brain that has gotten bigger since
the last examination. There is also some swelling around this mass. The report
also mentions that there is no evidence of any other masses or growths in the
brain or any problems with the blood or fluid in the brain. The conclusion of
the report says that the mass and swelling on the right side of the brain are
likely caused by a type of cancer called glioblastoma.

###  A.3 Report #3: Oncology CT

####  A.3.0 Original Report

Findings: Multiple CT scans available for comparison. Thorax: Port system
right prepectoral. Heart normal in size. No pericardial effusion. No
metastatic thoracic lymph nodes. Thyroid struma. No pleural effusions. No
pneumonia. No pneumothorax. Marked pleural calcifications unchanged. Pulmonary
metastases show response to therapy, e.g., size regrowth of left apical
metastasis at 1.9 x 1.5 cm (previously 2.2 x 2.1 cm) and decreasing solid
portions with new cavitation in left subpleural metastasis in lower lobe at
1.8 cm (previously 1.9 cm). No new pulmonary metastases detected. Abdomen:
Homogeneous contrast of liver parenchyma with no metastatic lesions. Portal
vein and hepatic veins open. Gallbladder non-irritant with small calculus. No
cholestasis. Spleen, pancreas and adrenal glands unremarkable. Lateral
contrast of the kidneys. No urinary retention. No ascites. No free abdominal
air. Z. n. resection of lymph node metastases in the mesentery, no evidence of
recurrence there. No newly metastatic abdominal lymph nodes. Unchanged
prominent retroperitoneal lymph nodes, these in need of further control.
Skeleton: No suspicious osseous lesions. No evidence of acute fractures.
Conclusion: In metastatic colorectal carcinoma, significant response to
therapy in comparison to the previous examination: 1. pulmonary metastases
present partly in regression and partly constant, but in the latter case with
decreased solid parts in the sense of a therapy response. 2. no evidence of
recurrence or new lymph node metastases after resection of the mesenteric
lymph node metastasis. 3. no evidence of new hematogenous distant metastases
in the examination area.

####  A.3.1 Simplified Report Sample #1

This medical report is talking about a person who has a type of cancer called
colorectal carcinoma, which means cancer that starts in the colon or rectum.
The report has information about different parts of the body and how the
cancer is affecting them. The thorax is the area in the body that includes the
chest and the organs inside it, like the heart and lungs. The report says that
the heart is normal in size and there is no extra fluid around it. It also
says that there are no infections in the lungs and no air leaking from the
lungs. The report says that there are some spots on the lungs where the cancer
has spread, but they are getting smaller and changing in a way that shows that
the person is responding to treatment. The abdomen is the area in the body
that includes the belly and the organs inside it, like the liver, stomach, and
intestines. The report says that the liver looks normal and doesn’t have any
cancer spreading to it. It also says that the gallbladder and spleen look
normal, and there is no extra fluid in the belly. The report says that there
was surgery to remove some cancer from the lymph nodes in the mesentery, which
is a sheet of tissue that holds the intestines in place. The report says that
there is no cancer in the lymph nodes now, but there are some other lymph
nodes in the belly that need to be checked again. The skeleton is the body’s
framework of bones. The report says that there are no bones with cancer and no
broken bones. The conclusion of the report is that the person’s cancer is
responding to treatment. It is getting smaller in some places and changing in
a way that shows the treatment is working. There is no new cancer in the lymph
nodes or other parts of the body, and the surgery to remove cancer from the
lymph nodes was successful.

####  A.3.2 Simplified Report Sample #2

This medical report is about a person who has cancer that has spread from
their colon to other parts of their body. The report describes the results of
some tests that were done to see how the cancer is doing. The tests show that
there are some cancer cells in the person’s lungs, but they are getting
smaller. There is also no evidence that the cancer has spread to other parts
of the body, like the liver or bones. There were also some cancer cells
removed from the person’s belly, but they are not growing back. Overall, it
looks like the person is responding well to treatment, which means that the
cancer is getting smaller or not spreading as much. It is important to
continue to monitor the cancer and see how it responds to treatment.

####  A.3.3 Simplified Report Sample #3

This medical report is about a person who has cancer that has spread to other
parts of their body. The report is talking about different parts of the body
and whether there are any signs of cancer in those areas. In the thorax, or
chest, the report says that the person’s heart is normal and there is no extra
fluid around it. There are no signs of cancer in the lymph nodes in the chest
or in the thyroid gland. There is no infection in the lungs and no holes in
the walls between the lungs and chest. The report also mentions some spots on
the person’s lungs that are caused by the cancer. These spots are getting
smaller, which is a good sign and means that the person is responding to
treatment. In the abdomen, or belly, the report says that the liver looks
normal and there are no signs of cancer. The gallbladder and bile ducts are
also normal. The spleen, pancreas, and adrenal glands are all normal. The
kidneys are also normal and there is no extra fluid in the belly. The report
mentions some cancer in the lymph nodes in the belly that has been removed,
but there are no signs that the cancer has come back or spread to other lymph
nodes. In the skeleton, or bones, the report says that there are no signs of
cancer or any recent fractures. Overall, the report says that the person’s
cancer is responding to treatment. The cancer in the lungs is getting smaller
and there are no new signs of cancer in the other parts of the body that were
checked.

####  A.3.4 Simplified Report Sample #4

A medical report is a document that explains the results of different tests
that were done on a person. The report has information about the person’s
chest (called the thorax), stomach (called the abdomen), and bones (called the
skeleton). The chest looks normal, and the heart is the right size. There is
no extra fluid around the heart or in the lungs, and the person does not have
an infection in the lungs. The thyroid gland is swollen, but there are no
other problems in the chest. There are some spots on the lungs that are
smaller than they were before and are getting better with treatment. There are
no new spots on the lungs. The stomach looks good, with no abnormal growths.
The liver and gallbladder are normal, and there is no blockage in the bile
ducts. The spleen, pancreas, and adrenal glands are normal. The kidneys are
working well and there is no extra fluid in the stomach. There are no new
abnormal growths in the lymph nodes in the stomach, and the lymph nodes in the
back of the stomach will need to be checked again later. The bones are normal
and there are no broken bones. Overall, the person’s cancer is responding well
to treatment. The abnormal growths in the lungs are getting smaller and there
are no new abnormal growths in the lymph nodes or other parts of the body.

####  A.3.5 Simplified Report Sample #5

A CT scan is a special kind of X-ray that takes pictures of the inside of your
body. The doctor looked at multiple CT scans from different times to see how
your body has changed. The doctor saw that your heart is normal in size and
there is no extra fluid around it. The doctor also saw that your thyroid gland
is bigger than normal. The thyroid is a small gland in your neck that helps
control your body’s functions. The doctor did not see any infection in your
lungs or any air in the space between your lungs and chest wall. There were
some spots on your lungs that have gotten smaller because of the medicine you
are taking. There were also some spots on your lungs that have changed, but
they are not getting bigger. The doctor did not see any new spots on your
lungs. The doctor saw that your liver looks normal and there are no new spots
on it. The veins that carry blood to and from your liver are open and working
properly. Your gallbladder and the tube that carries bile (a substance that
helps you digest food) from your liver to your intestine are normal. The
spleen, pancreas, and adrenal glands (organs that help with digestion and
other body functions) are normal. The doctor saw that your kidneys (organs
that help filter waste from your blood) are normal and there is no urine (pee)
building up in your bladder. There is no extra fluid in your belly and no
extra air in your belly. The doctor saw that the lymph nodes (small organs
that help fight infection) near your intestine were removed before and there
are no new ones. There are some lymph nodes near your belly that the doctor
will keep an eye on. The doctor did not see any new or suspicious spots on
your bones and there are no broken bones. Overall, the doctor saw that the
cancer in your body is responding to the medicine you are taking. The cancer
in your lungs is partly getting smaller and partly staying the same size, but
the parts that are staying the same size are changing. There is no cancer in
the lymph nodes near your intestine and no new cancer in other parts of your
body.

####  A.3.6 Simplified Report Sample #6

This medical report is about a person who has a type of cancer called
colorectal carcinoma, which means the cancer started in the colon or rectum.
The doctor used some special machines called CT scans to take pictures of the
inside of the person’s body to see how the cancer is doing. The pictures
showed that the person’s heart is normal and there is no extra fluid around
it. The thyroid gland (a small butterfly-shaped gland in the neck) looks a
little bigger than usual, but there are no other problems in the chest. There
are some spots on the person’s lungs where the cancer has spread, but they are
getting smaller and changing in a way that shows the person is responding to
treatment. There are no new spots on the lungs. The pictures also showed that
the person’s liver looks normal and there are no cancer spots on it. The
gallbladder (a small organ that stores bile) has a small stone, but it’s not
causing any problems. The rest of the organs in the stomach area look normal
too. There was some cancer in the lymph nodes (small, bean-shaped organs that
help fight infections) near the stomach, but it has been removed and there is
no sign that it has come back. There are some bigger lymph nodes in the back
of the stomach that the doctor will keep an eye on. The pictures didn’t show
any problems with the person’s bones, and there are no broken bones. Overall,
the doctor thinks that the person’s cancer is responding well to treatment and
there is no new cancer in the body.

####  A.3.7 Simplified Report Sample #7

Here is a summary of the medical report in simple language: The doctor did
some special pictures of the inside of the person’s body using a machine
called a CT scan. They looked at the person’s chest and saw that the heart was
a normal size and there was no fluid around it. They also saw that the person
had an extra thyroid gland, but there was no infection in the chest and no air
was leaking out of the lungs. The doctor saw that the cancer in the person’s
lungs was getting smaller after treatment and there were no new areas of
cancer. The doctor also looked at the person’s stomach and saw that the liver
was healthy and there were no cancer cells there. The gallbladder was also
healthy, with just a small stone inside. The other organs in the stomach, like
the spleen and pancreas, were normal. The kidneys looked good and there was no
extra fluid in the stomach. The doctor saw that the cancer in the person’s
abdomen had been removed and there was no evidence that it had come back.
There were also no new areas of cancer in the abdomen. The doctor also looked
at the person’s bones and saw that they were normal and not broken. Overall,
the doctor saw that the treatment for the person’s cancer was working and the
cancer was getting smaller. There were no new areas of cancer and no evidence
that the cancer had come back.

####  A.3.8 Simplified Report Sample #8

The medical report is about a person who has cancer that has spread to other
parts of their body. The doctors did some special pictures of the inside of
the person’s body to see how the cancer is doing. The cancer in the person’s
lungs is getting smaller in some parts and there is less solid cancer in other
parts, which is good because it means the medicine the person is taking is
working. The cancer has not spread to any new parts of the body and the cancer
that was removed from the person’s intestine is not coming back. The bones are
all healthy and there are no broken bones.

####  A.3.9 Simplified Report Sample #9

This medical report is talking about a person who has cancer in their colon
(part of the large intestine) that has spread to other parts of their body.
The doctors used a special machine called a CT scan to take pictures of the
inside of the person’s body to see how the cancer is doing. The CT scan showed
that the cancer in the person’s lungs is getting smaller in some parts and not
growing as much in other parts, which is a good sign that the treatment is
working. The CT scan also showed that there is no cancer in the person’s
liver, gallbladder, spleen, pancreas, adrenal glands, or kidneys, and that
there is no cancer in the person’s bones. There is also no cancer in the
person’s abdomen (belly) after the doctors removed some lymph nodes that had
cancer in them. However, there are some lymph nodes in the person’s back that
the doctors need to keep an eye on because they might have cancer. Overall,
the treatment seems to be helping the person’s cancer get better.

####  A.3.10 Simplified Report Sample #10

This medical report is about a person who has cancer that has spread from the
colon to other parts of the body. The report is talking about a series of
tests that were done to see how the cancer is doing. The tests show that the
person’s heart is a normal size and is not causing any problems. The thyroid
gland is swollen, but there is no fluid or infection around the lungs. The
lungs have some cancer in them, but the cancer is getting smaller and there is