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Morse E, Odigie E, Gillespie H, Rameau A. The Readability of Patient-Facing Social Media Posts on Common Otolaryngologic Diagnoses. Otolaryngol Head Neck Surg 2024; 170:1051-1058. [PMID: 38018504 DOI: 10.1002/ohn.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/09/2023] [Accepted: 10/28/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To assess the readability of patient-facing educational information about the most common otolaryngology diagnoses on popular social media platforms. STUDY DESIGN Cross-sectional study. SETTING Social media platforms. METHODS The top 5 otolaryngologic diagnoses were identified from the National Ambulatory Medical Care Survey Database. Facebook, Twitter, TikTok, and Instagram were searched using these terms, and the top 25 patient-facing posts from unique accounts for each search term and poster type (otolaryngologist, other medical professional, layperson) were identified. Captions, text, and audio from images and video, and linked articles were extracted. The readability of each post element was calculated with multiple readability formulae. Readability was summarized and was compared between poster types, platforms, and search terms via Kruskal-Wallis testing. RESULTS Median readability, by grade level, by grade level, was greater than 10 for captions, 5 for image-associated text, and 9 for linked articles. Captions and images in posts by laypeople were significantly more readable than captions by otolaryngologists or other medical professionals, but there was no difference for linked articles. All post components were more readable in posts about cerumen than those about other search terms. CONCLUSIONS When examining the readability of posts on social media regarding the most common otolaryngology diagnoses, we found that many posts are less readable than recommended for patients, and found that posts by laypeople were significantly more readable than those by medical professionals. Medical professionals should work to make educational social media posts more readable to facilitate patient comprehension.
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Affiliation(s)
- Elliot Morse
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Eseosa Odigie
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
- Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, USA
| | - Helen Gillespie
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
- Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, USA
| | - Anaïs Rameau
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
- Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, USA
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Hutchings HA, Cochrane M, Battle C. Study to evaluate the readability and visual appearance of online resources for blunt chest trauma: an evaluation of online resources using mixed methods. BMJ Open 2024; 14:e078552. [PMID: 38320839 PMCID: PMC10860042 DOI: 10.1136/bmjopen-2023-078552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES Blunt chest trauma (BCT) is characterised by forceful and non-penetrative impact to the chest region. Increased access to the internet has led to online healthcare resources becoming used by the public to educate themselves about medical conditions. This study aimed to determine whether online resources for BCT are at an appropriate readability level and visual appearance for the public. DESIGN We undertook a (1) a narrative overview assessment of the website; (2) a visual assessment of the identified website material content using an adapted framework of predetermined key criteria based on the Centers for Medicare and Medicaid Services toolkit and (3) a readability assessment using five readability scores and the Flesch reading ease score using Readable software. DATA SOURCES Using a range of key search terms, we searched Google, Bing and Yahoo websites on 9 October 2023 for online resources about BCT. RESULTS We identified and assessed 85 websites. The median visual assessment score for the identified websites was 22, with a range of -14 to 37. The median readability score generated was 9 (14-15 years), with a range of 4.9-15.8. There was a significant association between the visual assessment and readability scores with a tendency for websites with lower readability scores having higher scores for the visual assessment (Spearman's r=-0.485; p<0.01). The median score for Flesch reading ease was 63.9 (plain English) with a range of 21.1-85.3. CONCLUSIONS Although the readability levels and visual appearance were acceptable for the public for many websites, many of the resources had much higher readability scores than the recommended level (8-10) and visually were poor.Better use of images would improve the appearance of websites further. Less medical terminology and shorter word and sentence length would also allow the public to comprehend the contained information more easily.
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Affiliation(s)
| | - Max Cochrane
- School of Medicine, Swansea University, Swansea, UK
| | - Ceri Battle
- School of Medicine, Swansea University, Swansea, UK
- Physiotherapy Department, Swansea Bay University Health Board, Swansea, UK
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Ahmadzadeh K, Bahrami M, Zare-Farashbandi F, Adibi P, Boroumand MA, Rahimi A. Patient education information material assessment criteria: A scoping review. Health Info Libr J 2023; 40:3-28. [PMID: 36637218 DOI: 10.1111/hir.12467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 10/13/2022] [Accepted: 11/03/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Patient education information material (PEIM) is an essential component of patient education programs in increasing patients' ability to cope with their diseases. Therefore, it is essential to consider the criteria that will be used to prepare and evaluate these resources. OBJECTIVE This paper aims to identify these criteria and recognize the tools or methods used to evaluate them. METHODS National and international databases and indexing banks, including PubMed, Scopus, Web of Science, ProQuest, the Cochrane Library, Magiran, SID and ISC, were searched for this review. Original or review articles, theses, short surveys, and conference papers published between January 1990 and June 2022 were included. RESULTS Overall, 4688 documents were retrieved, of which 298 documents met the inclusion criteria. The criteria were grouped into 24 overarching criteria. The most frequently used criteria were readability, quality, suitability, comprehensibility and understandability. CONCLUSION This review has provided empirical evidence to identify criteria, tools, techniques or methods for developing or evaluating a PEIM. The authors suggest that developing a comprehensive tool based on these findings is critical for evaluating the overall efficiency of PEIM using effective criteria.
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Affiliation(s)
- Khadijeh Ahmadzadeh
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Commitee, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Masoud Bahrami
- Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Boroumand
- Department of Medical Library and Information Sciences, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rahimi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Health Literacy in Plastic Surgery: A Scoping Review. Plast Reconstr Surg Glob Open 2022; 10:e4247. [PMID: 35433155 PMCID: PMC9007188 DOI: 10.1097/gox.0000000000004247] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
Abstract
Health literacy of plastic surgery patients may affect surgical decision-making and perioperative outcomes. In addition to consulting a plastic surgeon, patients often refer to online-based resources to learn about surgical options. The aim of this scoping review was to identify evidence detailing the state of health literacy of plastic surgery patients and available resources to highlight areas of improvement for clinical practice and future research.
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Chang IA, Wells MW, Zheng DX, Mulligan KM, Wong C, Scott JF, Zins JE. A Multimetric Readability Analysis of Online Patient Educational Materials for Submental Fat Reduction. Aesthetic Plast Surg 2022; 46:712-718. [PMID: 35037081 PMCID: PMC8761512 DOI: 10.1007/s00266-021-02675-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 11/07/2021] [Indexed: 11/24/2022]
Abstract
Background Patients often utilize the Internet to seek information related to their care. This study assesses the readability of online patient educational materials for submental fat reduction. Methods Patient educational materials from the 12 most popular websites related to submental fat reduction were downloaded and assessed for readability grade level using 10 unique scales. Results Analysis of the 12 most popular websites (and corresponding 47 articles) revealed that patient educational materials were written, on average, at an 11th grade reading level. The Flesch Reading Ease score was 48.9 (range 39.8–59.2), representing a “difficult” level of reading. Mean readability grade levels (range 9–13th grade for individual websites) were as follows: Coleman-Liau, 11.1; Flesch-Kincaid, 10.8; FORCAST, 10.8; Fry Graph, 10.1; Gunning Fog, 12.7; New Dale-Chall, 10.1; New Fog Count, 11.8; Simple Measure of Gobbledygook, 11.7; Raygor, 6.7. No website was at the 6th grade reading level for patient educational materials recommended by the American Medical Association and National Institutes of Health. Conclusions Online patient educational materials for submental fat reduction are written well above the recommended reading level. Recognition of disparities in health literacy is necessary to enable patients to make informed decisions and become active participants in their own care. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266
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Nnamani Silva ON, Ammanuel SG, Segobiano BM, Edwards CS, Hoffman WY. Assessing the Readability of Online Patient Education Resources Related to Gynecomastia. Ann Plast Surg 2021; 87:123-125. [PMID: 33346559 DOI: 10.1097/sap.0000000000002620] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Internet has a plethora of online patient education resources for many symptoms and diseases. National medical governing bodies recommend that patient education materials are written at or below the eighth-grade level, and the literature suggests that health literacy has been linked to increased adherence to treatment regimens and improved outcomes. The primary aim of the study is to assess the readability of online patient materials relating to gynecomastia and ascertain the availability of patient materials in non-English languages. METHODS The readability of patient education materials relating to gynecomastia for academic-based websites and nonacademic websites was assessed using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). The prevalence of non-English patient education materials was assessed for both academic-based and nonacademic websites. RESULTS Fifty-eight documents were collected across academic websites. Overall median values were 10.7 for the FKGL, 47.0 for the FRE, and 11.4 for the SMOG. For the 10 nonacademic institutions, the overall median values were 10.6 for the FKGL, 45.2 for the FRE, and 10.8 for the SMOG. No appreciable differences were observed for readability when stratified by region or source. The prevalence of non-English patient materials was 19.1% across institutions. None of the noninstitutional materials had information in non-English languages. CONCLUSIONS The readability of patient education materials related to gynecomastia is at higher levels than recommended by national organizations. There are limited non-English patient education materials. Future efforts should focus on improving the readability and accessibility of patient materials.
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Affiliation(s)
| | - Simon G Ammanuel
- From the University of California, San Francisco School of Medicine, San Francisco, CA
| | - Brett M Segobiano
- College of Arts and Letters, University of Notre Dame, South Bend, IN
| | - Caleb S Edwards
- From the University of California, San Francisco School of Medicine, San Francisco, CA
| | - William Y Hoffman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
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Wasserburg JR, Sayegh F, Sanati-Mehrizy P, Graziano FD, Taub PJ. Cleft Care Readability: Can Patients Access Helpful Online Resources? Cleft Palate Craniofac J 2020; 58:1287-1293. [PMID: 33325255 DOI: 10.1177/1055665620980244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The present study identifies and analyzes online patient resources for cleft lip with or without cleft palate to survey the online educational landscape relative to the recommended difficulty set by the National Institutes of Health (NIH) and American Medical Association (AMA). METHODS An internet search of "cleft palate," "cleft lip," and 12 similar inputs were entered into a search engine. The first 50 links for each search term were identified, collected, and reviewed individually for relevance and accessibility. The content of the websites was analyzed with Readability Studio Version 2019.1. The following readability metrics were utilized in this study: (1) Coleman-Liau (grade levels), (2) New Dale-Chall, (3) Flesch-Kincaid, (4) Flesch Reading Ease, (5) FORCAST, (6) Fry, (7) Gunning Fog, (8) New Fog Count, (9) Raygor Readability Estimate, and (10) Simple Measure of Gobbledygook. RESULTS In no combination of search terms did any collection of links provide information within the mid-seventh grade levels recommended by the NIH. The analysis of 143 unique websites in the "Cleft Palate" group showed a readability level appropriate to high school students. The analysis of 144 unique websites in the "Cleft Lip" group showed a readability level appropriate for eighth grade students with 6 months of class complete. CONCLUSIONS The information presented to patients on cleft care is too complex and well above the recommended 7th-grade reading level target set forth by the NIH and AMA, which hinders functional health literacy.
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Affiliation(s)
- J Roscoe Wasserburg
- Division of Plastic and Reconstructive Surgery, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Farah Sayegh
- Division of Plastic and Reconstructive Surgery, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paymon Sanati-Mehrizy
- Division of Plastic and Reconstructive Surgery, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francis D Graziano
- Division of Plastic and Reconstructive Surgery, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter J Taub
- Division of Plastic and Reconstructive Surgery, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Comprehensive Assessment of Vascularized Composite Allotransplantation Patient-Oriented Online Resources. Ann Plast Surg 2020; 83:217-223. [PMID: 31232818 DOI: 10.1097/sap.0000000000001931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Online resources have become a major source of medical information for the general public. To date, there has not been an assessment of patient-oriented online resources for face and upper extremity transplantation candidates and patients. The goal of this study is to perform a comprehensive assessment of these resources. METHODS Our analysis relied on 2 dimensions: comprehensiveness and readability. Comprehensiveness was evaluated using 14 predetermined variables. Readability was evaluated using 8 different readability scales through the Readability Studio Professional Edition Software (Oleander Software, Ltd, Vandalia, Ohio). Data were also collected from solid organ transplantation (SOT), specifically kidney and liver, programs for comparison. RESULTS Face and upper extremity transplantation programs were significantly more likely to list exclusion criteria (73.9% vs 41.2%; P = 0.02), the need for life-long immunosuppression (87.0% vs 58.8%; P = 0.02), and benefits of transplantation (91.3% vs 61.8%; P = 0.01) compared with SOT programs. The average readability level of online resources by all face and upper extremity transplantation programs exceeded the sixth grade reading level recommended by the National Institutes of Health and the American Medical Association. The average reading grade level of online resources by these programs was also significantly higher than those of SOT with both exceeding the recommended reading level (13.95 ± 1.55 vs 12.60 ± 1.65; P = 0.003). CONCLUSIONS Future efforts in face and upper extremity transplantation should be directed toward developing standardized, comprehensive, and intelligible resources with high-quality content and simple language.
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Marsh JM, Dobbs TD, Hutchings HA. The readability of online health resources for phenylketonuria. J Community Genet 2020; 11:451-459. [PMID: 32221843 PMCID: PMC7475157 DOI: 10.1007/s12687-020-00461-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/16/2020] [Indexed: 01/24/2023] Open
Abstract
Phenylketonuria (PKU) is a condition that results in the build-up of phenylalanine in the blood. This can cause severe brain damage and neurological issues if left untreated. Management can be complex and many individuals may turn to the internet to access further information. It is important that resources are understood as misinterpretation could result in harm to health. The aim of this study was to assess the readability of online resources for PKU and to assess their visual appearance using a communication sciences assessment framework. We searched the top five websites through Google using the search term “phenylketonuria/PKU”. We then analysed the text content of the identified websites using five readability formulae to determine the USA and UK reading grade. The median readability level across the five websites was US grade/UK grade 10.6/11.6, with individual grades ranging from 10/11 to 13.3/14.3. We found wide differences in the focus, layout and general appearance of the websites. The readability of resources was much higher than the recommended US 6th grade level. Online resources for PKU need to be simplified to ensure they can be easily understood.
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Affiliation(s)
- Jessie M Marsh
- Patient and Population Health and Informatics Research, Swansea University Medical School, Singleton Park, Swansea, SA2 8PP, UK
| | - Thomas D Dobbs
- Reconstructive Surgery and Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Swansea, SA2 8PP, UK
| | - Hayley A Hutchings
- Patient and Population Health and Informatics Research, Swansea University Medical School, Singleton Park, Swansea, SA2 8PP, UK.
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Santos PJF, Daar DA, Badeau A, Leis A. Readability of online materials for Dupuytren's contracture. J Hand Ther 2019; 31:472-479. [PMID: 28843342 DOI: 10.1016/j.jht.2017.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Descriptive. BACKGROUND Dupuytren's contracture is a common disorder involving fibrosis of the palmar fascia. As patients are increasingly using online materials to gather health care information, it is imperative to assess the readability and appropriateness of this content. The recommended grade level for patient educational materials is seventh to eighth grade according to the National Institutes of Health. This study aims to assess the readability and content of online patient resources for Dupuytren's contracture. PURPOSE OF THE STUDY Evaluate readability of online patient education materials for Dupuytren's contracture. METHODS The largest public search engine, Google, was queried using the term "Dupuytren's contracture surgery" on February 26, 2016. Location filters were disabled, and sponsored results were excluded to avoid any inadvertent search bias. The 10 most popular Web sites were identified, and all relevant patient-directed information within 1 click from the original site was downloaded and saved as plain text. Readability was analyzed using 6 established analyses (Readable.io, Added Bytes, Ltd, UK). RESULTS Analysis of 10 Web sites demonstrates an average grade level of at least 11th grade (Flesch-Kincaid grade level, 10.2; Gunning-Fog grade level, 13.1; Coleman-Liau grade level, 14.4; Simple Measure of Gobbledygook grade level, 10.0; automated readability grade level, 9.7; and average grade level, 11.5). Overall Flesch-Kincaid reading ease index was 46.4, which is difficult. No single article was at the recommended reading level. CONCLUSIONS Online materials available for treatment of Dupuytren's contracture are above recommended reading levels and do not include a comprehensive explanation of treatment options, which may negatively impact decision making in patients seeking treatment for this condition. Surgeons and hand therapists alike should be cognizant of available online patient materials and make efforts to develop and provide more appropriate materials. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Pauline Joy F Santos
- Department of Plastic Surgery, University of California Irvine, Orange, CA, USA.
| | - David A Daar
- Department of Plastic Surgery, University of California Irvine, Orange, CA, USA
| | - Austin Badeau
- Department of Plastic Surgery, University of California Irvine, Orange, CA, USA
| | - Amber Leis
- Department of Plastic Surgery, University of California Irvine, Orange, CA, USA
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Tran BNN, Ruan QZ, Epstein S, Ricci JA, Rudd RE, Lee BT. Literacy analysis of National Comprehensive Cancer Network patient guidelines for the most common malignancies in the United States. Cancer 2017; 124:769-774. [DOI: 10.1002/cncr.31113] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/01/2017] [Accepted: 10/11/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Bao Ngoc N. Tran
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center; Harvard Medical School; Boston Massachusetts
| | - Qing Z. Ruan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center; Harvard Medical School; Boston Massachusetts
| | - Sherise Epstein
- Department of Social and Behavioral Sciences; Harvard T. H. Chan School of Public Health; Boston Massachusetts
| | - Joseph A. Ricci
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center; Harvard Medical School; Boston Massachusetts
| | - Rima E. Rudd
- Department of Social and Behavioral Sciences; Harvard T. H. Chan School of Public Health; Boston Massachusetts
| | - Bernard T. Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center; Harvard Medical School; Boston Massachusetts
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Readability, complexity, and suitability of online resources for mastectomy and lumpectomy. J Surg Res 2017; 212:214-221. [DOI: 10.1016/j.jss.2017.01.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/29/2016] [Accepted: 01/18/2017] [Indexed: 11/21/2022]
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Tran BNN, Singh M, Lee BT, Rudd R, Singhal D. Readability, complexity, and suitability analysis of online lymphedema resources. J Surg Res 2017; 213:251-260. [PMID: 28601323 DOI: 10.1016/j.jss.2017.02.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 02/14/2017] [Accepted: 02/24/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Over 72% of Americans use online health information to assist in health care decision-making. Previous studies of lymphedema literature have focused only on reading level of patient-oriented materials online. Findings indicate they are too advanced for most patients to comprehend. This, more comprehensive study, expands the previous analysis to include critical elements of health materials beyond readability using assessment tools to report on the complexity and density of data as well as text design, vocabulary, and organization. METHODS The top 10 highest ranked websites on lymphedema were identified using the most popular search engine (Google). Website content was analyzed for readability, complexity, and suitability using Simple Measure of Gobbledygook, PMOSE/iKIRSCH, and Suitability Assessment of Materials (SAM), respectively. PMOSE/iKIRSCH and SAM were performed by two independent raters. Fleiss' kappa score was calculated to ensure inter-rater reliability. RESULTS Online lymphedema literature had a reading grade level of 14.0 (SMOG). Overall complexity score was 6.7 (PMOSE/iKIRSCH) corresponding to "low" complexity and requiring a 8th-12th grade education. Fleiss' kappa score was 80% (P = 0.04, "substantial" agreement). Overall suitability score was 45% (SAM) correlating to the lowest level of "adequate" suitability. Fleiss' kappa score was 76% (P = 0.06, "substantial" agreement). CONCLUSIONS Online resources for lymphedema are above the recommended levels for readability and complexity. The suitability level is barely adequate for the intended audience. Overall, these materials are too sophisticated for the average American adult, whose literacy skills are well documented. Further efforts to revise these materials are needed to improve patient comprehension and understanding.
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Affiliation(s)
- Bao Ngoc N Tran
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Mansher Singh
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Bernard T Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
| | - Rima Rudd
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dhruv Singhal
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Abstract
BACKGROUND As patients strive to become informed about health care, inadequate functional health literacy is a significant barrier. Nearly half of American adults have poor or marginal health literacy skills and the National Institutes of Health and American Medical Association have recommended that patient information should be written at a sixth grade level. The aim of this study is to identify the most commonly used online patient information about liposuction and to evaluate its readability relative to average American literacy. METHODS An internet search of "liposuction" was performed and the 10 most popular websites identified. User and location data were disabled and sponsored results excluded. All relevant, patient-directed articles were downloaded and formatted into plain text. Articles were then analyzed using 10 established readability tests. A comparison group was constructed to identify the most popular online consumer information about tattooing. Mean readability scores and specific article characteristics were compared. RESULTS A total of 80 articles were collected from websites about liposuction. Readability analysis revealed an overall 13.6 grade reading level (range, 10-16 grade); all articles exceeded the target sixth grade level. Consumer websites about tattooing were significantly easier to read, with a mean 7.8 grade level. These sites contained significantly fewer characters per word and words per sentence, as well as a smaller proportion of complex, long, and unfamiliar words. CONCLUSIONS Online patient resources about liposuction are potentially too difficult for a large number of Americans to understand. Liposuction websites are significantly harder to read than consumer websites about tattooing. Aesthetic surgeons are advised to discuss with patients resources they use and guide patients to appropriate information for their skill level.
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Ibrahim AM, Vargas CR, Koolen PG, Chuang DJ, Lin SJ, Lee BT. Readability of online patient resources for melanoma. Melanoma Res 2016; 26:58-65. [DOI: 10.1097/cmr.0000000000000210] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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