Readability of Online Patient Material Provided by Reflux Centers in the United States

2021 ◽  
pp. 000313482110508
Author(s):  
Elisabeth Ekkel ◽  
Kevin Seeras
Keyword(s):  
United States ◽  
Patient Education ◽  
Web Sites ◽  
Sixth Grade ◽  
The United States ◽  
Reading Level ◽  
General Description ◽  
Average Patient ◽  
Grade Reading Level ◽  
Google Search

The American Medical Association (AMA) and the National Institutes of Health (NIH) suggest patient education materials should not exceed the sixth-grade reading level. Several studies have shown that patient information has been written well above this reading level across multiple specialties. A search was conducted utilizing the Google Chrome browser and the Google search engine. The key words “Reflux Center” and “GERD Center” were used to identify links to programs within the United States. The web site’s general description of reflux or gastroesophageal reflux disease was copied and pasted into the Readable.io service, and the readability tests were conducted via the program. Of 52 web sites, none had fulfilled the recommended reading level. Our results reveal that readability related to reflux pathology on center web sites is too difficult for the average patient. In order to improve patient education regarding reflux pathology and treatment, reading materials should be improved.

Readability of Online Health Information: A Meta-Narrative Systematic Review

2018 ◽  
Vol 33 (5) ◽  
pp. 487-492 ◽  
Author(s):  
Lubna Daraz ◽  
Allison S. Morrow ◽  
Oscar J. Ponce ◽  
Wigdan Farah ◽  
Abdulrahman Katabi ◽  
...  
Keyword(s):  
United States ◽  
Systematic Review ◽  
Health Information ◽  
Grade Level ◽  
General Public ◽  
Sixth Grade ◽  
The United States ◽  
Reading Level ◽  
Online Health Information ◽  
Cross Sectional

Online health information should meet the reading level for the general public (set at sixth-grade level). Readability is a key requirement for information to be helpful and improve quality of care. The authors conducted a systematic review to evaluate the readability of online health information in the United States and Canada. Out of 3743 references, the authors included 157 cross-sectional studies evaluating 7891 websites using 13 readability scales. The mean readability grade level across websites ranged from grade 10 to 15 based on the different scales. Stratification by specialty, health condition, and type of organization producing information revealed the same findings. In conclusion, online health information in the United States and Canada has a readability level that is inappropriate for general public use. Poor readability can lead to misinformation and may have a detrimental effect on health. Efforts are needed to improve readability and the content of online health information.

Readability Assessment of Patient Education Materials on Major Otolaryngology Association Websites

2012 ◽  
Vol 147 (5) ◽  
pp. 848-854 ◽  
Author(s):  
Jean Anderson Eloy ◽  
Shawn Li ◽  
Khushabu Kasabwala ◽  
Nitin Agarwal ◽  
David R. Hansberry ◽  
...  
Keyword(s):  
Patient Education ◽  
Sixth Grade ◽  
Reading Level ◽  
Flesch Reading Ease ◽  
Education Material ◽  
Individual Assessment ◽  
Honestly Significant Difference ◽  
Significant Difference ◽  
Grade Reading Level ◽  
Post Hoc

Objective Various otolaryngology associations provide Internet-based patient education material (IPEM) to the general public. However, this information may be written above the fourth- to sixth-grade reading level recommended by the American Medical Association (AMA) and National Institutes of Health (NIH). The purpose of this study was to assess the readability of otolaryngology-related IPEMs on various otolaryngology association websites and to determine whether they are above the recommended reading level for patient education materials. Study Design and Setting Analysis of patient education materials from 9 major otolaryngology association websites. Methods The readability of 262 otolaryngology-related IPEMs was assessed with 8 numerical and 2 graphical readability tools. Averages were evaluated against national recommendations and between each source using analysis of variance (ANOVA) with post hoc Tukey’s honestly significant difference (HSD) analysis. Mean readability scores for each otolaryngology association website were compared. Results Mean website readability scores using Flesch Reading Ease test, Flesch-Kincaid Grade Level, Coleman-Liau Index, SMOG grading, Gunning Fog Index, New Dale-Chall Readability Formula, FORCAST Formula, New Fog Count Test, Raygor Readability Estimate, and the Fry Readability Graph ranged from 20.0 to 57.8, 9.7 to 17.1, 10.7 to 15.9, 11.6 to 18.2, 10.9 to 15.0, 8.6 to 16.0, 10.4 to 12.1, 8.5 to 11.8, 10.5 to 17.0, and 10.0 to 17.0, respectively. ANOVA results indicate a significant difference ( P < .05) between the websites for each individual assessment. Conclusion The IPEMs found on all otolaryngology association websites exceed the recommended fourth- to sixth-grade reading level.

scholarly journals Achilles Tendon Repair: Can Patients Read, Understand, and Act on Online Educational Resources?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0022
Author(s):  
Burke Gao ◽  
Alan G. Shamrock ◽  
Trevor Gulbrandsen ◽  
John E. Femino ◽  
Cesar de Cesar Netto ◽  
...  
Keyword(s):  
Patient Education ◽  
Achilles Tendon ◽  
Grade Level ◽  
Elective Surgery ◽  
Tendon Repair ◽  
Reading Level ◽  
Achilles Tendon Repair ◽  
Grade Reading Level ◽  
Google Search ◽  
Online Patient Education

Category: Sports; Trauma Introduction/Purpose: Patients often access online resources to learn about orthopedic procedures prior to undergoing elective surgery. In order to be fully understood by the average English-speaking adult, online health information must be written at an elementary school reading level. To be helpful to patients, educational resources should also be generally understandable and have actionable direction that positively affects healthcare interactions. There are several previously validated indices for accessing the reading level of written materials. The Patient Education Materials Assessment Tool (PEMAT) provides a reliable and validated method to measure the understandability and actionability of education materials. The purpose of this study was to utilize PEMAT and readability algorithms to quantify readability, understandability and actionability of online patient education materials related to Achilles tendon repair. Methods: Online patient education materials were identified using two independently conducted Google engine searches with the term ‘Achilles tendon repair’. Using the top 50 search results, articles were included if they specifically served to educate patients regarding TAA. Exclusion criteria included news articles, non-text materials (video), research manuscripts, industry websites, and articles not related to Achilles tendon repair. The readability of included articles was quantified using the validated Flesch-Kincaid Grade Level index. The PEMAT form for printed materials was used to assess understandability and actionability using a 0-100 scale for both measures of interest. Spearman’s correlation coefficient was utilized to examine the relationship between a website’s average rank on Google (from first to last) and its readability, understandability, and actionability. P-values of less than 0.05 were considered significant. Results: Thirty-one websites met inclusion criteria. The mean Flesch Kincaid reading grade level was 10.8+-2.9, with only one website written below the 6th grade reading level. Higher Flesch-Kincaid grade was associated with later Google seach rank (rho: 0.488, p=0.010). Mean understandability and actionability scores were 67.1+-16.4% and 38.3+-28.4%, respectively. Among understandability criteria, only 12.9% (n=4) of articles included summaries and just 38.7% (n=12) included visual aids. Among actionability categories, 74% (n=23) of websites identified at least one action for readers, while only 60.8% (n=14) of these studies broke down actions into explicit, easy to understand steps. Actionability scores were not correlated with Google search rank (rho: -0.02, p=0.888), while higher understandability scores were associated with later Google search rank (rho: 0.45, p=0.017). Conclusion: Only one website describing Achilles tendon repair was written at or below the nationally recommended 6th grade reading level. Overall, Achilles tendon repair online educational materials scored poorly with respect to readability, understandability, and actionability. Articles that appeared earlier in the Google search had lower readability and understandability scores. In the era of shared decision making, it is vital that patients understand procedures, as well as the risks and benefits prior to undergoing elective surgery. These results suggest that current publicly available resources for Achilles tendon repair remain inadequate for patient education.

Quality of Patient Education Materials on Safe Opioid Management in the Acute Perioperative Period: What Do Patients Find Online?

Pain Medicine ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 171-175 ◽  
Author(s):  
Gunjan Kumar ◽  
Kellie M Jaremko ◽  
Alex Kou ◽  
Steven K Howard ◽  
T Kyle Harrison ◽  
...  
Keyword(s):  
Patient Education ◽  
Grade Level ◽  
Perioperative Period ◽  
Postoperative Pain Management ◽  
Sixth Grade ◽  
Reading Level ◽  
Specific Content ◽  
Caregiver Education ◽  
Institutional Review ◽  
Grade Reading Level

Abstract Objective Guidelines on postoperative pain management recommend inclusion of patient and caregiver education on opioid safety. Patient education materials (PEMs) should be written at or below a sixth grade reading level. We designed this study to compare the readability of online PEMs related to postoperative opioid management produced by institutions with and without a regional anesthesiology and acute pain medicine (RAAPM) fellowship. Methods With institutional review board exemption, we constructed our cohort of PEMs by searching RAAPM fellowship websites from North American academic medical centers and identified additional websites using structured Internet searches. Readability metrics were calculated from PEMs using the TextStat 0.4.1 textual analysis package for Python 2.7. The primary outcome was the Flesch-Kincaid Grade Level (FKGL), a score based on words per sentence and syllables per word. We also compared fellowship-based and nonfellowship PEMs on the presence or absence of specific content-related items. Results PEMs from 15 fellowship and 23 nonfellowship institutions were included. The mean (SD) FKGL for PEMs was grade 7.84 (1.98) compared with the recommended sixth grade level (P &lt; 0.001) and was not different between groups. Less than half of online PEMs contained explicit discussion of opioid tapering or cessation. Disposal and overdose risk were addressed more often by nonfellowship PEMs. Conclusions Available online PEMs related to opioid management are beyond the recommended reading level, but readability metrics for online PEMs do not differ between fellowship and nonfellowship groups. More than two-thirds of RAAPM fellowship programs in North America are lacking readable online PEMs on safe postoperative opioid management.

scholarly journals Readability of the Most Commonly Accessed Online Patient Education Materials Pertaining to Pathology of the Hand

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 705-714 ◽  
Author(s):  
Sheriff D. Akinleye ◽  
Garret Garofolo-Gonzalez ◽  
Michael Montuori ◽  
Maya Deza Culbertson ◽  
Jennifer Hashem ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Patient Education ◽  
Carpal Tunnel ◽  
Tendon Injuries ◽  
Reading Level ◽  
Average Grade ◽  
Hand Fractures ◽  
Tunnel Syndrome ◽  
Grade Reading Level ◽  
Google Search

Background: The American Medical Association (AMA) and National Institutes of Health (NIH) recommend that patient education materials be written at no higher than a sixth-grade reading level. Methods: We examined 100 online educational materials for the 10 hand conditions most commonly treated by hand surgeons, as reported by the American Society for Surgery of the Hand. The listed conditions were carpal tunnel syndrome, basal joint arthritis of the thumb, de Quervain syndrome, Dupuytren’s contracture, ganglion cysts, hand fractures, trigger finger, extensor tendon injuries, flexor tendon injuries, and mallet finger. Following a Google search for each condition, we analyzed the 10 most visited websites for each disorder utilizing the Flesch-Kincaid formula. Results: The average grade reading level of the 100 websites studied was 9.49 with a reading ease of 53.03 (“fairly difficult high school”). Only 29% of the websites were at or below the national average of an eighth-grade reading level. Carpal tunnel syndrome had the highest average grade reading level at 10.32 (standard deviation: 1.52), whereas hand fractures had the lowest at 8.14 (2.03). Every hand condition in this study had an average readability at or above the ninth-grade reading level. Conclusions: The most frequently accessed materials for common maladies of the hand exceed both the readability limits recommended by the AMA and NIH, and the average reading ability of most US adults. Therefore, the most commonly accessed websites pertaining to hand pathology may not be comprehended by the audience for which it is intended.

The Digital Divide in Internet-Based Patient Education Materials

2012 ◽  
Vol 147 (5) ◽  
pp. 855-857 ◽  
Author(s):  
Gordon H. Sun
Keyword(s):  
Patient Education ◽  
Health Care Providers ◽  
Sixth Grade ◽  
Neck Surgery ◽  
Reading Level ◽  
The Internet ◽  
Care Providers ◽  
Related Information ◽  
Health Related ◽  
Grade Reading Level

The ubiquity of the Internet has led to the widespread availability of health-related information to the public, and the subsequent empowerment of patients has fundamentally altered the patient-physician relationship. Among several concerns of physicians is the possibility that patients may be misinformed by information obtained from the Internet. One opportunity for health care providers to address this problem exists within Internet-based patient education materials (IPEMs). According to recent research in Otolaryngology–Head and Neck Surgery, IPEMs found within professional otolaryngology websites are written at the 8th- to 18th-grade reading comprehension level, essentially unchanged over the past 3 years. This greatly exceeds the fourth- to sixth-grade reading level recommended by the National Institutes of Health. Benefits, strategies, and challenges to improving the readability of IPEMs are discussed.

scholarly journals Hand Surgery Resources Exceed American Health Literacy

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 547-551 ◽  
Author(s):  
Julia A. Cook ◽  
Sarah E. Sasor ◽  
Sunil S. Tholpady ◽  
Arash Momeni ◽  
Michael W. Chu
Keyword(s):  
Patient Education ◽  
Orthopedic Surgery ◽  
Grade Level ◽  
Training Programs ◽  
Hand Surgery ◽  
Sixth Grade ◽  
Educational Material ◽  
Reading Level ◽  
Surgery Training ◽  
Grade Reading Level

Background: The National Institutes of Health, American Medical Association, and US National Library of Medicine recommend that educational material for patients be written at a sixth-grade reading level. The purpose of this study is to assess the complexity of hand surgery information on academic plastic and orthopedic surgery websites. Methods: An online search was performed for all hand surgery patient education materials provided by institutions with plastic and orthopedic surgery training programs. Readability analyses were conducted using the Flesch-Kincaid Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook Index, Gunning Fog Score, Automated Readability Index, and Coleman-Liau Index. A 2-tailed z test was used to compare means. Results: Seventy-six institutions with both plastic and orthopedic surgery training programs were identified; 42 had educational material available online. The average readability for all hand-related information was at the 11.92 grade reading level. Information regarding de Quervain tenosynovitis had the highest grade level for all plastic surgery procedures (13.45). Hand arthritis had the highest grade level for all orthopedic surgery procedures (12.82). Ganglion cysts had the lowest grade level for both plastic and orthopedic surgery (10.15 and 11.01, respectively; P = .12). Carpal tunnel release was the most commonly described procedure overall. There were no differences in text complexity among geographic regions. Conclusions: Online patient resources for common hand ailments are too complex for the average patient to understand. Efforts should be made to provide materials at the recommended sixth-grade reading level to improve patient education and improve the physician-patient relationship.

scholarly journals Readability of Patient Education Materials From High-Impact Medical Journals: A 20-Year Analysis

2021 ◽  
Vol 8 ◽  
pp. 237437352199884
Author(s):  
Michael K Rooney ◽  
Gaia Santiago ◽  
Subha Perni ◽  
David P Horowitz ◽  
Anne R McCall ◽  
...  
Keyword(s):  
Patient Education ◽  
Grade Level ◽  
Treatment Options ◽  
Sixth Grade ◽  
High Impact ◽  
Reading Level ◽  
Eighth Grade ◽  
Medical Journals ◽  
Grade Levels ◽  
Grade Reading Level

Comprehensive patient education is necessary for shared decision-making. While patient–provider conversations primarily drive patient education, patients also use published materials to enhance their understanding. In this investigation, we evaluated the readability of 2585 patient education materials published in high-impact medical journals from 1998 to 2018 and compared our findings to readability recommendations from national groups. For all materials, mean readability grade levels ranged from 11.2 to 13.8 by various metrics. Fifty-four (2.1%) materials met the American Medical Association recommendation of sixth grade reading level, and 215 (8.2%) met the National Institutes of Health recommendation of eighth grade level. When stratified by journal and material type, general medical education materials from Annals of Internal Medicine were the most readable ( P < .001), with 79.8% meeting the eighth grade level. Readability did not differ significantly over time. Efforts to standardize publication practice with the incorporation of readability evaluation during the review process may improve patients’ understanding of their disease processes and treatment options.

Hearing Aid Patient Education Materials: Is There Room for Improvement?

2016 ◽  
Vol 27 (04) ◽  
pp. 354-359 ◽  
Author(s):  
John Joseph ◽  
Peter F. Svider ◽  
Kevin Shaigany ◽  
Jean Anderson Eloy ◽  
Paulette G. McDonald ◽  
...  
Keyword(s):  
Patient Education ◽  
Hearing Aids ◽  
Web Sites ◽  
Grade Level ◽  
Hearing Aid ◽  
Reading Level ◽  
Reading Levels ◽  
Flesch Reading Ease ◽  
Average Grade ◽  
Grade Reading Level

Purpose: The purpose of this study was to analyze and compare the readability of patient education materials (PEMs) from leading manufacturers of behind-the-ear style hearing aids and popular hearing aid information Web sites to determine if they meet guidelines recommended by public health agencies. Research Design: Analysis of hearing aid PEMs. Methods: Printed user guides from six of the leading manufacturers of BTE hearing aids and 15 of the most popular hearing aid–information Web sites were accessed online and analyzed for readability using the Gunning-Fog Index, New Fog Count, Raygor Estimate Graph, Simple Measure of Gobbledygook, and Flesch Reading Ease score. Results: Overall average grade–level readability for all six printed manufacturer user manuals was calculated to be written at a 10th grade reading level. Overall average grade-level readabilities for all 15 popular online hearing aid–information Web sites representing professional organizations, suppliers, and health information services were calculated to be written at 10th, 10th, and 11th grade reading levels, respectively. Average Flesch Reading Ease scores for all printed guides and online patient information Web sites were calculated to fall within the fairly difficult category for readability. Conclusions: PEMs provided by top hearing aid manufactures and popular hearing aid Web sites are written well above the reading level recommended by the National Institutes of Health. Consideration should be given toward simplifying these materials in order to enhance user experience and increase compliance among behind-the-ear hearing aid users.

Assessment of American Cleft Palate-Craniofacial Association-Approved Teams’ Websites for Patient-Oriented Content and Readability

2019 ◽  
Vol 56 (9) ◽  
pp. 1213-1219 ◽  
Author(s):  
Allyson R. Alfonso ◽  
Evellyn M. DeMitchell-Rodriguez ◽  
Elie P. Ramly ◽  
Daphney Y. Noel ◽  
Dina Levy-Lambert ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Sixth Grade ◽  
The United States ◽  
Reading Level ◽  
Reading Grade Level ◽  
Grade Reading Level ◽  
Available Information ◽  
Website Content ◽  
The Relationship

Objective: Informed decision-making relies on available information, including online resources. We evaluated the content and readability of websites published by American Cleft Palate-Craniofacial Association (ACPA)-approved cleft lip and/or palate (CLP) teams in the United States. Design: Team websites were reviewed, and teams with no accessible website or <30 sentences of content were excluded. Website content was scored by presence/absence of 20 variables derived from ACPA approval standards. Readability was evaluated with 8 scales. Readability was then compared to American Medical Association (AMA) recommendations. The relationship between website content and readability was assessed. Main Outcome Measure(s): Content and readability of team websites. Results: From 167 reviewed teams, 47 (28.1%) had nonfunctional links, 17 (10.2%) had no accessible website, and 39 (23.4%) had <30 sentences. The average content score for all 111 team websites included was 14.5 (2.6) of 20. The combined average reading level across all scales (10.7 [1.9]) exceeded the AMA-recommended sixth-grade reading level; this finding held true for each individual website. Children’s Hospital-affiliated teams (n = 86) had a significantly higher content score (14.8 vs 13.5; P = .03) and better readability as evidenced by lower reading grade level (10.5 vs 11.4; P = .04). On linear regression, a higher content score significantly predicted better readability (β = −0.226; P < .001). Conclusions: Websites published by ACPA-approved CLP teams vary in accessibility and content and exceed the recommended reading level. These findings could inform future efforts to improve patient-oriented resources.

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