{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:59:11Z","timestamp":1789462751637,"version":"build-2803163510"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":37,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["1R21MD019870-01A1"],"award-info":[{"award-number":["1R21MD019870-01A1"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BioData Mining"],"DOI":"10.1186\/s13040-026-00528-2","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T01:35:34Z","timestamp":1773106534000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A multi-metric evaluation of readability in psychiatric discharge summaries"],"prefix":"10.1186","volume":"19","author":[{"given":"Fuchen","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey Overby","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayah","family":"Zirikly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"528_CR1","unstructured":"Office of the National Coordinator for Health Information Technology (ONC). 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program. 2020. Available from: https:\/\/www.healthit.gov\/curesrule"},{"issue":"1","key":"528_CR2","doi-asserted-by":"publisher","first-page":"e17","DOI":"10.2196\/medinform.8611","volume":"6","author":"J Zheng","year":"2018","unstructured":"Zheng J, Yu H. Assessing the readability of medical documents: A ranking approach. JMIR Med Inf. 2018;6(1):e17.","journal-title":"JMIR Med Inf"},{"issue":"7","key":"528_CR3","doi-asserted-by":"publisher","first-page":"461","DOI":"10.7326\/0003-4819-157-7-201210020-00002","volume":"157","author":"T Delbanco","year":"2012","unstructured":"Delbanco T, Walker J, Bell SK, et al. Inviting patients to read their doctors\u2019 notes: a quasi-experimental study and a look ahead. Ann Intern Med. 2012;157(7):461\u201370.","journal-title":"Ann Intern Med"},{"issue":"e1","key":"528_CR4","doi-asserted-by":"publisher","first-page":"e166","DOI":"10.1093\/jamia\/ocw108","volume":"24","author":"JL Wolff","year":"2017","unstructured":"Wolff JL, Darer JD, Berger A, et al. Inviting patients and care partners to read doctors\u2019 notes: opennotes and shared access to electronic medical records. J Am Med Inf Assoc. 2017;24(e1):e166\u201372. https:\/\/doi.org\/10.1093\/jamia\/ocw108.","journal-title":"J Am Med Inf Assoc"},{"key":"528_CR5","doi-asserted-by":"publisher","first-page":"e72667","DOI":"10.2196\/72667","volume":"27","author":"E Meier-Diedrich","year":"2025","unstructured":"Meier-Diedrich E, Blease C, Heinze M, W\u00f6rdemann J, Schwarz J. Changes in Documentation after implementing open notes in mental health care: Pre-Post mixed methods study. J Med Internet Res. 2025;27:e72667.","journal-title":"J Med Internet Res"},{"issue":"4","key":"528_CR6","doi-asserted-by":"publisher","first-page":"e27397","DOI":"10.2196\/27397","volume":"8","author":"C Blease","year":"2021","unstructured":"Blease C, Torous J, Kharko A, DesRoches CM, Harcourt K, O\u2019Neill S, Salmi L, Wachenheim D, H\u00e4gglund M. Preparing patients and clinicians for open notes in mental health: qualitative inquiry of international experts. JMIR Ment Health. 2021;8(4):e27397. https:\/\/doi.org\/10.2196\/27397.","journal-title":"JMIR Ment Health"},{"key":"528_CR7","doi-asserted-by":"publisher","unstructured":"Maryam Rahimian JL, Warner L, Salmi S, Trent Rosenbloom, Roger B, Davis, Robin M, Joyce. Open notes sounds great, but will a provider\u2019s documentation change? An exploratory study of the effect of open notes on oncology documentation. JAMIA Open. July 2021;4(3):ooab051. https:\/\/doi.org\/10.1093\/jamiaopen\/ooab051.","DOI":"10.1093\/jamiaopen\/ooab051"},{"issue":"6","key":"528_CR8","doi-asserted-by":"publisher","first-page":"1316","DOI":"10.2214\/AJR.19.22202","volume":"214","author":"K Joshua","year":"2020","unstructured":"Joshua K, Cho HM, Zafar, Cook TS. Use of an online crowdsourcing platform to assess patient comprehension of radiology reports and colloquialisms. Am J Roentgenol. 2020;214(6):1316\u201320.","journal-title":"Am J Roentgenol"},{"issue":"6","key":"528_CR9","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1016\/j.jbi.2012.07.012","volume":"45","author":"Alla Keselman and Catherine Arnott Smith","year":"2012","unstructured":"Alla Keselman and Catherine Arnott Smith. A classification of errors in Lay comprehension of medical documents. J Biomed Inform. 2012;45(6):1151\u201363.","journal-title":"J Biomed Inform"},{"key":"528_CR10","doi-asserted-by":"crossref","unstructured":"Lee J et al. 2022. Prevalence of sensitive terms in clinical notes using natural language processing techniques: observational study. JMIR Med inform. 2022;10(6): e38482.","DOI":"10.2196\/38482"},{"key":"528_CR11","doi-asserted-by":"crossref","unstructured":"Schwarz J et al. 2021. Sharing clinical notes and electronic health records with people affected by mental health conditions: scoping review. JMIR Ment Health 2021;8(12): e34170.","DOI":"10.2196\/34170"},{"key":"528_CR12","doi-asserted-by":"crossref","unstructured":"Blease C et al. 2021. Preparing patients and clinicians for open notes in mental health: qualitative inquiry of international experts. JMIR Ment Health. 2021;8(4): e27397.","DOI":"10.2196\/27397"},{"key":"528_CR13","doi-asserted-by":"crossref","unstructured":"O\u2019Neill S et al. 2019. Embracing the new age of transparency: mental health patients reading their psychotherapy notes online. Journal of Mental Health. 2019;28(5): 527\u2013535.","DOI":"10.1080\/09638237.2019.1644490"},{"issue":"3","key":"528_CR14","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1177\/1742271X221140024","volume":"31","author":"S Charlie Rogers","year":"2023","unstructured":"Charlie Rogers S, Willis S, Gillard, Chudleigh J. Patient experience of imaging reports: A systematic literature review. Ultrasound. 2023;31(3):164\u201375.","journal-title":"Ultrasound"},{"issue":"5","key":"528_CR15","doi-asserted-by":"publisher","first-page":"2817","DOI":"10.1007\/s00330-023-10213-1","volume":"34","author":"B Katharina Jeblick","year":"2024","unstructured":"Katharina Jeblick B, Schachtner J, Dexl A, Mittermeier AT, St\u00fcbner J, Topalis T, Weber P, Wesp B, Sabel J, Ricke, Michael Ingrisch. ChatGPT makes medicine easy to swallow: an exploratory case study on simplified radiology reports. Eur Radiol. 2024;34(5):2817\u201325.","journal-title":"Eur Radiol"},{"key":"528_CR16","doi-asserted-by":"crossref","unstructured":"Qing Lyu J, Tan ME, Zapadka J, Ponnatapura C, Niu KJ, Myers G, Wang, Whitlow CT. Translating radiology reports into plain language using ChatGPT and GPT-4 with prompt learning: results limitations, and potential. Vis Comput Ind Biomed Art. 2023;6(1), 9.","DOI":"10.1186\/s42492-023-00136-5"},{"key":"528_CR17","unstructured":"Francesco Moramarco D, Juric A, Savkov J, Flann M, Lehl K, Boda T, Grafen V, Zhelezniak S, Gohil. Alex Papadopoulos Korfiatis, and Nils Hammerla. Towards more patient friendly clinical notes through language models and ontologies. In: AMIA Annu Symp ProcIn , American Medical Informatics Association, 2021;881\u2013890."},{"key":"528_CR18","unstructured":"Imperial J, Marvin, and Harish Tayyar Madabushi. Flesch or fumble? Evaluating readability standard alignment of instruction-tuned language models. ArXiv Preprint. 2023;arXiv:2309.05454."},{"key":"528_CR19","doi-asserted-by":"publisher","first-page":"e030140","DOI":"10.1161\/JAHA.123.030140","volume":"13","author":"C Bhatt","year":"2024","unstructured":"Bhatt C, et al. Evaluating readability, understandability, and actionability of online printable patient education materials for cholesterol management: a systematic review. J Am Heart Association. 2024;13:e030140.","journal-title":"J Am Heart Association"},{"issue":"2","key":"528_CR20","doi-asserted-by":"publisher","first-page":"26","DOI":"10.3390\/clinpract15020026","volume":"15","author":"Garc\u00eda-\u00c1lvarez","year":"2025","unstructured":"Garc\u00eda-\u00c1lvarez. Jos\u00e9 Manuel, and Alfonso Garc\u00eda-S\u00e1nchez. Readability of informed consent forms for medical and surgical clinical procedures: A systematic review. Clin Pract. 2025;15(2):26.","journal-title":"Clin Pract"},{"key":"528_CR21","unstructured":"Scholz K. and Markus Wenzel. Evaluating readability metrics for German medical text simplification. Proceedings of the 31st International Conference on Computational Linguistics. 2025."},{"key":"528_CR22","unstructured":"Alsentzer E et al. Publicly available clinical bert embeddings. arxiv preprint. 2019;arxiv:1904.03323."},{"key":"528_CR23","doi-asserted-by":"crossref","unstructured":"Chao Jiang and Wei Xu. 2024. MedReadMe: A systematic study for fine-grained sentence readability in medical domain. In Proceedings of the 2024 Conference on Empirical Methods in Natural Language Processing, Miami, Florida, USA. Association for Computational Linguistics. pages 17293\u201317319,","DOI":"10.18653\/v1\/2024.emnlp-main.958"},{"key":"528_CR24","doi-asserted-by":"publisher","DOI":"10.13026\/kpb9-mt58","author":"A Johnson","year":"2024","unstructured":"Johnson A, Bulgarelli L, Pollard T, Gow B, Moody B, Horng S, Celi LA, Mark R. MIMIC-IV (version 3.1). PhysioNet. 2024. https:\/\/doi.org\/10.13026\/kpb9-mt58. RRID:SCR_007345.","journal-title":"PhysioNet"},{"key":"528_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41597-022-01899-x","volume":"10","author":"AEW Johnson","year":"2023","unstructured":"Johnson AEW, Bulgarelli L, Shen L, et al. MIMIC-IV, a freely accessible electronic health record dataset. Sci Data. 2023;10:1. https:\/\/doi.org\/10.1038\/s41597-022-01899-x.","journal-title":"Sci Data"},{"issue":"23","key":"528_CR26","first-page":"e215","volume":"101","author":"A Goldberger","year":"2000","unstructured":"Goldberger A, Amaral L, Glass, et al. PhysioBank, PhysioToolkit, and physionet: components of a new research resource for complex physiologic signals. Circulation [Online]. 2000;101(23):e215\u201320. RRID:SCR_007345.","journal-title":"Circulation [Online]"},{"key":"528_CR27","doi-asserted-by":"publisher","DOI":"10.13026\/1n74-ne17","author":"A Johnson","year":"2023","unstructured":"Johnson A, Pollard T, Horng S, Celi LA, Mark R. MIMIC-IV-Note: deidentified free-text clinical notes (version 2.2). PhysioNet. 2023. https:\/\/doi.org\/10.13026\/1n74-ne17. RRID:SCR_007345.","journal-title":"PhysioNet"},{"key":"528_CR28","unstructured":"Honnibal M, Montani I, Van Landeghem S, Boyd A. spaCy: industrial-strength natural language processing in Python. 2020. Available from: https:\/\/spacy.io"},{"issue":"3","key":"528_CR29","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1002\/j.1538-7305.1948.tb01338.x","volume":"27","author":"CE Shannon","year":"1948","unstructured":"Shannon CE. A mathematical theory of communication. Bell Syst Tech J. 1948;27(3):379\u2013423.","journal-title":"Bell Syst Tech J"},{"key":"528_CR30","doi-asserted-by":"crossref","unstructured":"Kincaid, Peter J, et al. Derivation of new readability formulas (automated readability index, fog count and Flesch reading ease formula) for navy enlisted personnel. 1975.","DOI":"10.21236\/ADA006655"},{"key":"528_CR31","first-page":"639","volume":"12","author":"G Mc Laughlin","year":"1969","unstructured":"Mc Laughlin G, Harry. SMOG grading-a new readability formula. J Read. 1969;12:639\u201346.","journal-title":"J Read"},{"key":"528_CR32","unstructured":"Gunning R. The technique of clear writing. McGraw-Hill; 1952."},{"key":"528_CR33","doi-asserted-by":"crossref","unstructured":"Gondy Leroy JE, Endicott D, Kauchak O, Mouradi, and Melissa Just. User evaluation of the effects of a text simplification algorithm using term familiarity on perception, understanding, learning, and information retention. J Med Internet Res. 2013;15(7), e2569.","DOI":"10.2196\/jmir.2569"},{"key":"528_CR34","doi-asserted-by":"crossref","unstructured":"Estop\u00e0 R, Amor M. Montan\u00e9. 2020. Terminology in medical reports: textual parameters and their lexical indicators that hinder patient understanding. Terminology. 2020;26(2):213\u2013236.","DOI":"10.1075\/term.00051.est"},{"key":"528_CR35","doi-asserted-by":"crossref","unstructured":"Michalopoulos G et al. Umlsbert: Clinical domain knowledge augmentation of contextual embeddings using the Unified Medical Language System Metathesaurus. arXiv preprint. 2020; arXiv:2010.10391.","DOI":"10.18653\/v1\/2021.naacl-main.139"},{"key":"528_CR36","doi-asserted-by":"publisher","first-page":"D267","DOI":"10.1093\/nar\/gkh061","volume":"32","author":"O Bodenreider","year":"2004","unstructured":"Bodenreider O. The unified medical Language system (UMLS): integrating biomedical terminology. Nucleic Acids Res. 2004;32:D267\u201370.","journal-title":"Nucleic Acids Res"},{"key":"528_CR37","unstructured":"McCray AT, Burgun A, Bodenreider O. Aggregating UMLS semantic types for reducing conceptual complexity. MEDINFO 2001. IOS Press, 2001."},{"issue":"6","key":"528_CR38","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/j.jbi.2003.11.002","volume":"36","author":"O Bodenreider","year":"2003","unstructured":"Bodenreider O, Alexa T. McCray. Exploring semantic groups through visual approaches. J Biomed Inform. 2003;36(6):414\u201332.","journal-title":"J Biomed Inform"},{"key":"528_CR39","unstructured":"Soldaini L, Goharian N. Quickumls: a fast, unsupervised approach for medical concept extraction. MedIR workshop, sigir. 2016."},{"key":"528_CR40","unstructured":"Menta A, Garcia-Serrano A. Controllable sentence simplification using transfer learning. Proceedings of the Working Notes of CLEF. 2022."}],"container-title":["BioData Mining"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13040-026-00528-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13040-026-00528-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13040-026-00528-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T09:37:49Z","timestamp":1776332269000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13040-026-00528-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["528"],"URL":"https:\/\/doi.org\/10.1186\/s13040-026-00528-2","relation":{},"ISSN":["1756-0381"],"issn-type":[{"value":"1756-0381","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]},"assertion":[{"value":"16 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"27"}}