Critical Quality and Readability Analysis of Online Patient Education Materials on Parotidectomy: A Cross-Sectional Study

Purpose: Complications related to parotidectomy can cause significant morbidity, and thus, the decision to pursue this surgery needs to be well-informed. Given that information available online plays a critical role in patient education, this study aimed to evaluate the readability and quality of online patient education materials (PEMs) regarding parotidectomy. Methods: A Google search was performed using the term “parotidectomy” and the first 10 pages of the search were analyzed. Quality and reliability of the online information was assessed using the DISCERN instrument. Flesch-Kincaid Grade Level (FKGL) and Flesch-Reading Ease Score (FRE) were used to evaluate readability. Results: Thirty-five PEMs met the inclusion criteria. The average FRE score was 59.3 and 16 (46%) of the online PEMs had FRE scores below 60 indicating that they were fairly difficult to very difficult to read. The average grade level of the PEMs was above the eighth grade when evaluated with the FKGL. The average DISCERN score was 41.7, which is indicative of fair quality. There were no significant differences between PEMs originating from medical institutions and PEMs originating from other sources in terms of quality or readability. Conclusion: Online PEMs on parotidectomy may not be comprehensible to the average individual. This study highlights the need for the development of more appropriate PEMs to inform patients about parotidectomy.

Writing for the Wider Public - Readability of Publicly Available Board Reports

Objective: This work aims to evaluate the readability of publicly available board reports from the Local Health Networks (LHNs) in South Australia and the National Health Service (NHS) Trusts in England. Method: Publicly available board reports from the LHNs in South Australia and NHS Trusts in England were identified, screened, and evaluated from January 2020 to August 2020. Results: The average Flesch Reading Ease score for all LHNs reviewed ranged from 34 ± 10.2 to 57 ± 0.0 (Difficult to Fairly Difficult). In comparison, the average Flesch Reading Ease score for all the NHS Foundation Trusts ranged from 46 ± 1.7 to 60 ± 3.0 (Difficult to Standard). The average Reading Ease score for metropolitan and non-metropolitan LHNs was 43 ± 8.1 and 41 ± 6.0 (Difficult to read). In contrast, the average Reading Ease score for metropolitan and non-metropolitan NHS Trust was Fairly Difficult with 53 ± 4.2 and 50 ± 3.5 respectively. Conclusion: The evaluation results suggest that there is scope for improving the quality of publicly available board reports from the boards reviewed in terms of their readability by the public.

Causality Analysis of South Africa Reserve Bank’s Monetary Policy Statements and Communication

This paper inspects whether the South Africa Reserve Bank’s (SARB) Monetary Policy Committee (MPC) statements trigger have a causality with newspaper reports from the Mail and Guardian between 2010 and 2021. The study examines whether SARB’s post MPC statements’ readability is reciprocated in the subsequent Mail and Guardian newspaper articles. Using the Flesch Reading Ease Score and Flesch-Kincaid Grade Level score as the methodology, there is a systematic unpacking of both SARB’s MPC statements and newspaper reports from the Mail and Guardian which yield a dataset which is subsequently used to create a computation. This computation is then used to examine whether SARB’s MPC statements Granger cause the subsequent Mail and Guardian newspaper articles. Resultantly, the results show that there is no Granger causality between the SARB’s MPC statements and the Mail and Guardian’s Flesch Reading Ease Score and Flesch-Kincaid Grade Level score.

Readability of patient education materials related to radiation safety: What are the implications for patient-centred radiology care?

Background Increasing numbers of patients and carers rely on online resources for healthcare information. Radiation safety can be misunderstood by patients and clinicians and lead to patient anxiety. We aimed to assess the readability of online patient educational materials (PEMs) related to radiation safety. Methods A total of 84 articles pertaining to radiation safety from 14 well-known online resources were identified. PEMs were then analysed using Readability Studio Professional Edition Version 2019. Readability was assessed using eight different instruments: the Flesch-Kincaid Reading Grade Level, Raygor Estimate, SMOG, Coleman–Liau, Fry, FORCAST, Gunning Fog, and Flesch Reading Ease Score formula. The mean reading grade level (RGL) of each article was compared to the 6th and 8th grade reading level using 1-sample t-tests. Results The cumulative mean RGL for all 84 articles was 13.3 (range = 8.6–17.4), and none were written at or below the 6th or 8th grade level. The cumulative mean RGL exceeded the 6th grade reading level by an average of 7.3 levels (95% CI, 6.8–7.8; p < 0.001) and the 8th grade level by an average of 5.3 grade levels (95% CI, 4.8–5.8; p < 0.001). The mean Flesch Reading Ease Score was 39/100 (‘difficult’). Conclusion Currently available online PEMs related to radiation safety are still written at higher than recommended reading levels. Radiation safety is a topic in which the specialist training of radiologists is crucial in providing guidance to patients. Addressing the readability of online PEMs can improve radiology-patient communication and support the shift to a patient-centred model of practice.

Kompleksitas Operasi, Manajemen Laba dan Keterbacaan Laporan Tahunan

This study aims to prove empirically the effect of operating complexity and earnings management on the readability of annual reports. The population in this study are all companies listed on the Indonesia Stock Exchange (BEI) during 2016-2017. The sample in this study was selected using purposive sampling technique with a study period of 2 years (2016-2017) in order to obtain 442 observations of data. Operational complexity is measured by the number of natural logarithms of business segments and the number of natural logarithms of geographic segments, earnings management is measured by the Modified Jones Model, readability is measured by the Flesch Reading Ease score. The data analysis technique used is multiple linear regression analysis method. The results of this study indicate that the first hypothesis, operation complexity has effect on the readability of annual reports. The second hypothesis, earnings management has no effect on the readability of annual reports.

The Effect of the Implementation of a Negotiated Syllabus on the Reading Achievement of Iranian Intermediate-level EFL Learners

The present study investigated whether or not the implementation of a selective procedural Negotiated Syllabus has any effect on the reading achievement of Iranian intermediate-level EFL learners. The hypothesis assumed in this study was that the treatment would accrue no effect. The study was conducted with the participation of 61 female intermediate-level EFL learners. The participants were grouped into four classes serving the Experimental Group (EG; n = 32) and the Control Group (CG; n = 29). The learners shared a homogenous English proficiency level and background (as well as in terms of materials and instruments). The classes were randomly assigned to EG and CG. The selected element of negotiation in this study was based on the interest areas of the EG learners. An interest areas survey (IAS) based on Likert scale (from value 1 as least interesting to value 5 as most interesting) was constructed and conducted to elicit EG learners’ areas of interest on the basis of which passages with reading ease of ±2 standard deviations (by Flesch Reading Ease score) were selected. Items scoring highest on the IAS were selected for the purpose of text selection. Interest areas were not polled in the CG and the texts given to them were arbitrarily selected. In order to observe any change in learners’ reading achievement, both groups were pretested at the outset of the experiment and post-tested at the end of the experiment with a valid reading comprehension (RC) test comprising 22 multiple-choice items. A two-way two-sample t-test was conducted to compare the means difference between the gain scores of the EG and CG over the two administrations of the RC test. The results indicated that the groups had performed equally well on the experiment and no statistically significant result was observed. This study was based on the natural-occurring pre-experimental intact groups framework of research design.

1071 SUFE and the Internet: Are Healthcare Information Websites Accessible to Parents?

Background Slipped upper femoral epiphysis(SUFE) is an adolescent hip disorder requiring rapid surgical intervention. Faced with the prospect of their child undergoing surgery, many fearful parents will turn to the internet to provide information and reassurance. Previous studies have shown the orthopaedic information can be difficult to comprehend. Objective Assess the readability of healthcare websites regarding SUFE. Method The term Slipped Upper Femoral Epiphysis was searched in Google, Bing and Yahoo and evaluated using readability software with seven specialised readability tests. A Flesich Read Ease Score (FRES) score above 65 and a Reading Grade Level (RGL) of sixth grade and under was considered acceptable. Results 21 unique websites were assessed. The average FRES was 52.5 +/- 15.4. Only 3 websites scored 65 or higher (14%). There was a statistically significant difference between website scores based on affiliation, with physician websites having the overall highest mean(P = 0.004). The average RGL was 8.67 +/- 1.8. Only two websites met the accepted RGL criteria (9.5%) while five websites were marked as extremely difficult to understand (23.8%). Only five websites offered translations (23.8%). There was no statistically significant difference in readability scores between websites which offered translation and those which did not. One-way t-tests showed that both the RGL (p &lt; 0.001; CI: 1.83-3.49) and the FRES (P &lt; 0.001, CI: -19.4 to -5.4) scores were significantly different from the accepted standard. Conclusions Most websites reviewed were deemed inaccessible. Improving readability would enhance the internet’s usability as a healthcare tool for parents.

Readability of Online Materials Related to Vocal Cord Leukoplakia

Objectives To assess readability and understandability of online materials for vocal cord leukoplakia. Study Design Review of online materials. Setting Academic medical center. Methods A Google search of “vocal cord leukoplakia” was performed, and the first 50 websites were considered for analysis. Readability was measured by the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). Understandability and actionability were assessed by 2 independent reviewers with the PEMAT-P (Patient Education Materials Assessment Tool for Printable Materials). Unpaired t tests compared scores between sites aimed at physicians and those at patients, and a Cohen’s kappa was calculated to measure interrater reliability. Results Twenty-two websites (17 patient oriented, 5 physician oriented) met inclusion criteria. For the entire cohort, FRES, FKGL, and SMOG scores (mean ± SD) were 36.90 ± 20.65, 12.96 ± 3.28, and 15.65 ± 3.57, respectively, indicating that materials were difficult to read at a >12th-grade level. PEMAT-P understandability and actionability scores were 73.65% ± 7.05% and 13.63% ± 22.47%. Statistically, patient-oriented sites were more easily read than physician-oriented sites ( P < .02 for each of the FRES, FKGL, and SMOG comparisons); there were no differences in understandability or actionability scores between these categories of sites. Conclusion Online materials for vocal cord leukoplakia are written at a level more advanced than what is recommended for patient education materials. Awareness of the current ways that these online materials are failing our patients may lead to improved education materials in the future.

An objective analysis of quality and readability of online information on COVID-19

High quality, readable health information is vital to mitigate the impact of the COVID-19 pandemic. The aim of this study was to assess the quality and readability of online COVID-19 information using 6 validated tools. This is a cross-sectional study. “COVID-19” was searched across the three most popular English language search engines. Quality was evaluated using the DISCERN score, Journal of the American Medical Association benchmark criteria and Health On the Net Foundation Code of Conduct. Readability was assessed using the Flesch Reading Ease Score, Flesch-Kincaid Grade Level and Gunning-Fog Index. 41 websites were suitable for analysis. 9.8% fulfilled all JAMA criteria. Only one website was HONCode certified. Mean DISCERN score was 47.8/80 (“fair”). This was highest in websites published by a professional society/medical journal/healthcare provider. Readability varied from an 8th to 12th grade level. The overall quality of online COVID-19 information was “fair”. Much of this information was above the recommended 5th to 6th grade level, impeding access for many.

How readable and reliable is online patient information on chronic rhinosinusitis?

Objective This study aimed to assess the quality and readability of websites on chronic rhinosinusitis. Methods A total of 180 results from 3 different search engines regarding ‘chronic rhinosinusitis’, ‘sinusitis’ and ‘sinus infections’ were analysed for readability using the Flesch–Kincaid Grade Level, Flesch Reading Ease Score and Gunning Fog Index. The Discern tool was used to approximate information quality. Results From 180 total searches, 69 unique websites were identified. These had an average Flesch–Kincaid Grade Level of 9.75 (95 per cent confidence interval = 9.12–10.4), a Flesch Reading Ease Score of 45.0 (41.0–49.0) and a Gunning Fog Index of 13.7 (12.9–14.4), which equates to the average reading level of a college or university student. Discern scores were variable but consistently showed good-quality information. Conclusion Chronic rhinosinusitis information is of a high quality but is for a reading level higher than that of the average adult. Standardising patient information should ensure adequate comprehension and improve patient compliance.