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Elhakim T, Brea AR, Fidelis W, Paravastu SS, Malavia M, Omer M, Mort A, Ramasamy SK, Tripathi S, Dezube M, Smolinski-Zhao S, Daye D. PRO-READ IR: Enhanced PROcedural Information READability for Patient-Centered Care in Interventional Radiology With Large Language Models. J Am Coll Radiol 2024:S1546-1440(24)00702-6. [PMID: 39216782 DOI: 10.1016/j.jacr.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 08/15/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE To evaluate the extent to which Generative Pre-trained Transformer 4 (GPT-4) can educate patients by generating easily understandable information about the most common interventional radiology (IR) procedures. MATERIALS AND METHODS We reviewed 10 IR procedures and prepared prompts for GPT-4 to provide patient educational instructions about each procedure in layman's terms. The instructions were then evaluated by four clinical physicians and nine nonclinical assessors to determine their clinical appropriateness, understandability, and clarity using a survey. A grade-level readability assessment was performed using validated metrics to evaluate accessibility to a wide patient population. The same procedures were also evaluated from the patient instructions available at radiologyinfo.org and compared with GPT-generated instructions utilizing a paired t test. RESULTS Evaluation by four clinical physicians shows that nine GPT-generated instructions were fully appropriate, whereas arterial embolization instructions was somewhat appropriate. Evaluation by nine nonclinical assessors shows that paracentesis, dialysis catheter placement, thrombectomy, ultrasound-guided biopsy, and nephrostomy-tube instructions were rated excellent by 57% and good by 43%. The arterial embolization and biliary-drain instructions were rated excellent by 28.6% and good by 71.4%. In contrast, thoracentesis, port placement, and CT-guided biopsy instructions received 43% excellent, 43% good, and 14% fair. The readability assessment across all procedural instructions showed a better Flesch-Kincaid mean grade of GPT-4 instructions compared with radiologyinfo.org (7.8 ± 0.87 versus 9.6 ± 0.83; P = .007) indicating excellent readability at 7th- to 8th-grade level compared with 9th to 10th grade. Additionally there was a lower Gunning Fog mean index (10.4 ± 1.2 versus 12.7 ± 0.93; P = .006), and higher Flesch Reading Ease mean score (69.4 ± 4.8 versus 51.3±3.9; P = .0001) indicating better readability. CONCLUSION IR procedural instructions generated by GPT-4 can aid in improving health literacy and patient-centered care in IR by generating easily understandable explanations.
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Affiliation(s)
- Tarig Elhakim
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Massachusetts General Hospital, Boston, Massachusetts.
| | - Allison R Brea
- Tufts university school of medicine, Boston, Massachusetts
| | - Wilton Fidelis
- Georgetown university school of medicine, Washington, DC
| | - Sriram S Paravastu
- University of Missouri- Kansas City School of Medicine, Kansas City, Missouri
| | - Mira Malavia
- University of Missouri- Kansas City School of Medicine, Kansas City, Missouri
| | - Mustafa Omer
- The James Cook University Hospital, Middlesbrough, United Kingdom
| | - Ana Mort
- Saint Louis University School of Medicine, St Louis, Missouri
| | | | - Satvik Tripathi
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Sara Smolinski-Zhao
- Associate Program Director of the Interventional Radiology Residency, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Dania Daye
- Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Boston, Massachusetts; IR Division Quality Director and Co-Director of IR Research and also Director of Precision Interventional and Medical Imaging Lab at the Division of Vascular and Interventional Radiology, Massachusetts General Hospital
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2
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O'Brien E, Ludwigson A, Vemuru S, Higgins M, Hampanda K, Adams M, Wolverton D, Sams S, Taft N, Miles R, Lin CT, Cumbler E, Tevis S. Interpretation of immediately released health information: Informing patient medical education in breast oncology. Am J Surg 2024:115853. [PMID: 39095250 DOI: 10.1016/j.amjsurg.2024.115853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 06/18/2024] [Accepted: 07/17/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND The Cures Act mandated immediately released health information. In this study, we investigated patient comprehension of mammography reports and the utility of online resources to aid report interpretation. METHODS Patients who received a normal mammogram from February to April 2022 were invited to complete semi-structured interviews paired with health literacy questionnaires to assess patient's report comprehension before and after internet search. RESULTS Thirteen selected patients via purposeful sampling completed interviews. Most patients described their initial understanding of the mammography report as "good" and improved to between "good" and "very good" after an internet search. Patients suggested "a little column on the side" for medical terminology, "an extra prompt" for making an appointment, or a recommendation for "good sites" to improve mammography reports. CONCLUSION Patients varied in their ability to independently interpret medical reports and seek additional resources. While online resources marginally improved patient understanding, actionable and clear resources are needed.
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Affiliation(s)
- Elizabeth O'Brien
- University of Colorado School of Medicine, Department of Surgery, 12631 East 17th Ave. 6th Floor, Aurora, CO, 80045, USA.
| | - Abigail Ludwigson
- University of Colorado School of Medicine, Department of Surgery, 12631 East 17th Ave. 6th Floor, Aurora, CO, 80045, USA
| | - Sudheer Vemuru
- University of Colorado School of Medicine, Department of Surgery, 12631 East 17th Ave. 6th Floor, Aurora, CO, 80045, USA
| | - Madeline Higgins
- University of Colorado School of Medicine, Department of Surgery, 12631 East 17th Ave. 6th Floor, Aurora, CO, 80045, USA
| | - Karen Hampanda
- University of Colorado School of Medicine, Department of Obstetrics and Gynecology, 12631 East 17th Avenue. 4th Floor, Aurora, CO, 80045, USA
| | - Monica Adams
- University of Colorado School of Medicine, Department of Surgery, 12631 East 17th Ave. 6th Floor, Aurora, CO, 80045, USA
| | - Dulcy Wolverton
- University of Colorado School of Medicine, Department of Radiology, 12401 East 17th Ave, Aurora, CO, 80045, USA
| | - Sharon Sams
- University of Colorado School of Medicine, Department of Pathology, 12631 East 17th Ave. 2nd Floor, Aurora, CO, 80045, USA
| | - Nancy Taft
- University of Colorado School of Medicine, Department of Surgery, 12631 East 17th Ave. 6th Floor, Aurora, CO, 80045, USA
| | - Randy Miles
- University of Colorado School of Medicine, Department of Radiology, 12401 East 17th Ave, Aurora, CO, 80045, USA
| | - Chen-Tan Lin
- University of Colorado School of Medicine, Department of Medicine, 12631 East 17th Ave. 8th Floor, Aurora, CO, 80045, USA
| | - Ethan Cumbler
- University of Colorado School of Medicine, Department of Medicine, 12631 East 17th Ave. 8th Floor, Aurora, CO, 80045, USA
| | - Sarah Tevis
- University of Colorado School of Medicine, Department of Surgery, 12631 East 17th Ave. 6th Floor, Aurora, CO, 80045, USA
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Bozer J, Peng K, Magyer M, Niedermeier M, Makary MS. Interventional radiology education: Patient experience with an educational website. Clin Imaging 2024; 105:110026. [PMID: 37992626 DOI: 10.1016/j.clinimag.2023.110026] [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: 04/16/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to examine the impact of an educational website on patient understanding of Interventional Radiology (IR). MATERIAL AND METHODS An informational website with descriptions and images of 12 common IR procedures was developed with the aim of educating patients. One hundred patients referred to a large, academic institution were randomly selected to participate. Anonymous 11-question, 5-point Likert-scale assessments were administered before and after engaging with the educational website. The survey evaluated patients' understanding of IR procedures and satisfaction with the website as an educational tool. RESULTS One hundred patients completed the pre-/post-implementation evaluations. Among matched questions, there was an increase in patient understanding of IR with mean score improvement from 2.10 to 4.57 (p < 0.001), their knowledge of common procedures from 1.74 to 4.66 (p < 0.001), and their consideration for their next procedure to be with IR from 2.24 to 4.62 (p < 0.001). Additionally, patients had an overall positive impression of the website (mean 4.80). Over 75% of patients found the descriptions and images "very helpful". CONCLUSION This study demonstrated that website use for patient education has the potential to be effective in increasing overall patient understanding of IR and familiarity with common interventional procedures.
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Affiliation(s)
- Jordan Bozer
- College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| | - Kevin Peng
- College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| | - Melissa Magyer
- College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| | - Marilyn Niedermeier
- College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| | - Mina S Makary
- Department of Radiology, The Ohio State Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210, USA.
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Rahmani G, O'Sullivan GJ. Revisiting the Readability of Online Patient Information in Interventional Radiology. Cardiovasc Intervent Radiol 2023:10.1007/s00270-023-03423-z. [PMID: 36977903 DOI: 10.1007/s00270-023-03423-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023]
Affiliation(s)
- George Rahmani
- Department of Interventional Radiology, Galway University Hospitals, Newcastle Road, Galway, H91 YR71, Ireland.
| | - Gerard J O'Sullivan
- Department of Interventional Radiology, Galway University Hospitals, Newcastle Road, Galway, H91 YR71, Ireland
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Alarifi M, Jabour AM, Wu M, Aldosary A, Almanaa M, Luo J. Proposed Questions to Assess the Extent of Knowledge in Understanding the Radiology Report Language. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11808. [PMID: 36142078 PMCID: PMC9517641 DOI: 10.3390/ijerph191811808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Radiotherapy and diagnostic imaging play a significant role in medical care. The amount of patient participation and communication can be increased by helping patients understand radiology reports. There is insufficient information on how to measure a patient's knowledge of a written radiology report. The goal of this study is to design a tool that will measure patient literacy of radiology reports. A radiological literacy tool was created and evaluated as part of the project. There were two groups of patients: control and intervention. A sample radiological report was provided to each group for reading. After reading the report, the groups were quizzed to see how well they understood the report. The participants answered the questions and the correlation between the understanding of the radiology report and the radiology report literacy questions was calculated. The correlations between radiology report literacy questions and radiology report understanding for the intervention and control groups were 0.522, p < 0.001, and 0.536, p < 0.001, respectively. Our radiology literacy tool demonstrated a good ability to measure the awareness of radiology report understanding (area under the receiver operator curve in control group (95% CI: 0.77 (0.71-0.81)) and intervention group (95% CI: 0.79 (0.74-0.84))). We successfully designed a tool that can measure the radiology literacy of patients. This tool is one of the first to measure the level of patient knowledge in the field of radiology understanding.
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Affiliation(s)
- Mohammad Alarifi
- Health Informatics & Administration Department, College of Health Sciences, University of Wisconsin, Milwaukee, WI 53211, USA
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Abdulrahman M. Jabour
- Health Informatics Department, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Min Wu
- Health Informatics & Administration Department, College of Health Sciences, University of Wisconsin, Milwaukee, WI 53211, USA
| | - Abdullah Aldosary
- Body Imaging Department, Medical Imaging Administration, King Fahad Medical City, Riyadh 12231, Saudi Arabia
| | - Mansour Almanaa
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Jake Luo
- Health Informatics & Administration Department, College of Health Sciences, University of Wisconsin, Milwaukee, WI 53211, USA
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Gad B, Shanmugasundaram S, Kumar A, Shukla P. Quality and Reliability of YouTube Videos on Uterine Fibroid Embolization. J Am Coll Radiol 2022; 19:905-912. [PMID: 35487248 DOI: 10.1016/j.jacr.2022.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the quality of information available in YouTube videos on the treatment of uterine fibroids. MATERIALS AND METHODS The DISCERN Scale Criterion was used to quantify the quality of YouTube videos on uterine fibroid embolization. The Video Power Index was used to quantify the popularity of videos on uterine fibroid embolization. RESULTS Among the 31 videos identified in the study, the average total DISCERN score was 48.82 ± 14.48, indicative of average to poor quality. There was no correlation between a video's popularity and its quality. Popularity, as measured by Video Power Index, was not significantly different between videos containing a board-certified physician and those that did not. Videos with a board-certified interventional radiologist had a significantly lower Video Power Index than those without a board-certified physician. CONCLUSION YouTube is not currently a high-quality source of information for uterine fibroid treatment options. Physicians should be aware of highly viewed material on YouTube to have informed discussions with patients about their treatment options and address misperceptions.
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Affiliation(s)
- Bishoy Gad
- Medical Student, Department of Radiology, Division of Vascular and Interventional Radiology, Rutgers-New Jersey Medical School, Newark, New Jersey
| | - Srinidhi Shanmugasundaram
- Medical Student, Department of Radiology, Division of Vascular and Interventional Radiology, Rutgers-New Jersey Medical School, Newark, New Jersey; ACR Scholarship Committee Chair
| | - Abhishek Kumar
- Associate Professor, Division Chief of Vascular and Interventional Radiology, Rutgers-New Jersey Medical School, Newark, New Jersey
| | - Pratik Shukla
- Assistant Professor, Department of Radiology, Division of Vascular and Interventional Radiology, Rutgers-New Jersey Medical School, Newark, New Jersey; Radiology Site Director; and Director of IR Quality Assurance.
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7
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Talutis SD, Watson J, Goldsborough E, Masciale E, Woo K. Working group Stakeholder perspectives on education in aortic dissection. Semin Vasc Surg 2022; 35:69-77. [DOI: 10.1053/j.semvascsurg.2022.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 11/11/2022]
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Lim STJM, Kelly M, Selvarajah L, Murray M, Scanlon T. Transjugular intrahepatic portosystemic shunt (TIPS) procedure: an assessment of the quality and readability of online information. BMC Med Inform Decis Mak 2021; 21:149. [PMID: 33952225 PMCID: PMC8101024 DOI: 10.1186/s12911-021-01513-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose Transjugular intrahepatic portosystemic shunt (TIPS) procedure is an established procedure carried out by interventional radiologists to achieve portal decompression and to manage the complications of portal hypertension. The aim of this study was to evaluate the quality and readability of information available online for TIPS procedure. Methods Websites were identified using the search terms “TIPS procedure”, “TIPSS procedure”, “transjugular intrahepatic portosystemic shunt procedure”, with the first 25 pages from the three most popular search engines (Google, Bing and Yahoo) being selected for evaluation with a total of 225. Each Website was grouped by authorship into one of five categories: (1) Physician, (2) Academic, (3) For-profit, (4) Non-profit (including government and public health), or (5) Other (discussion/social media). Readability of each Website was assessed using the Flesch-Reading Ease score, Flesch–Kincaid grade level, Gunning-Fog Index, Coleman–Liau and SMOG index. Quality was calculated using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria and the presence of Health on the Net (HON) code certification. Results After disregarding duplicate and non-accessible Websites a total of 81 were included. The mean DISCERN score assessing the quality of information provided by Websites was “good” (59.3 ± 10.2) with adherence to the JAMA Benchmark being 54.3%. Websites with HON-code certification were statistically significantly higher in terms of DISCERN (p = 0.034) and JAMA scores (p = 0.003) compared to HON-code negative sites. The readability scores of Websites ranged from 10 to 12th grade across calculators. Thirty-two out of the 81 Websites were targeted towards patients (39.5%), 46 towards medical professionals (56.8%) and 3 were aimed at neither (3.7%). The medical professional aimed Websites were statistically significantly more difficulty to read across all readability formulas (all p < 0.001). Conclusion While quality of online information available to patients is “good”, the average readability for information on the internet for TIPS is set far above the recommended 7th-grade level. Academic Websites were of the highest quality, yet most challenging for the general public to read. These findings call for the production of high-quality and comprehensible content around TIPS procedure, where physicians can reliably direct their patients for information.
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Affiliation(s)
- Sean-Tee J M Lim
- Department of Surgery, Limerick University Hospital, St Nessan's Rd, Dooradoyle, Co. Limerick, V94 F858, Ireland.
| | - Martin Kelly
- Department of Surgery, Limerick University Hospital, St Nessan's Rd, Dooradoyle, Co. Limerick, V94 F858, Ireland
| | - Logeswaran Selvarajah
- Department of Radiology, Limerick University Hospital, St Nessan's Rd, Dooradoyle, Co. Limerick, V94 F858, Ireland
| | - Michael Murray
- Department of Radiology, Limerick University Hospital, St Nessan's Rd, Dooradoyle, Co. Limerick, V94 F858, Ireland
| | - Timothy Scanlon
- Department of Radiology, Limerick University Hospital, St Nessan's Rd, Dooradoyle, Co. Limerick, V94 F858, Ireland
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Para A, Thelmo F, Rynecki ND, Zelman B, Gupta R, Coban D, Ayyaswami V, Prabhu AV, Ippolito JA, Agarwal N, Moore JM, Beebe KS. Evaluating the Readability of Online Patient Education Materials Related to Orthopedic Oncology. Orthopedics 2021; 44:38-42. [PMID: 33141234 DOI: 10.3928/01477447-20201012-04] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/20/2020] [Indexed: 02/03/2023]
Abstract
The internet is increasingly used to access patient education materials. The average American reading level has been found to be that of a 7th- to 8th-grade student, prompting the National Institutes of Health (NIH) and the American Medical Association (AMA) to advise that patient education materials be written between the 4th- to 6th-grade reading level. The purpose of this study was to evaluate the reading level of current patient education materials for the most common musculoskeletal oncological tumors. A Google search was performed with all location filters off to account for geographic variability for patient education materials related to 28 orthopedic primary or secondary tumors. All patient education articles from the first 10 website hits for each tumor type were analyzed. Patient education materials from these websites were evaluated using 8 validated readability scales. Patient resources were found to be written at an average grade level nearly double the NIH and AMA recommendation. Patient education materials for soft tissue chondromas were written at the highest level (14.8±1.9), whereas education materials for chordomas (10.1±1.0) most closely approached national recommendations, despite still being written at a readability level nearly 4 grade levels higher than has been recommended. The Flesch Reading Ease assessment provided a mean score of 46.5±7.7, corresponding with a "difficult to read" result. Current patient education materials regarding oncological musculoskeletal-related patient education materials are written significantly above the recommended reading level. Further modification of these resources is warranted to ensure adequate comprehension and informed decision making in the clinical setting. [Orthopedics. 2021;44(1):38-42.].
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Ayyaswami V, Padmanabhan D, Patel M, Prabhu AV, Hansberry DR, Agarwal N, Magnani JW. A Readability Analysis of Online Cardiovascular Disease-Related Health Education Materials. Health Lit Res Pract 2019; 3:e74-e80. [PMID: 31049489 PMCID: PMC6489118 DOI: 10.3928/24748307-20190306-03] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Online cardiovascular health materials are easily accessible with an Internet connection, but the readability of its content may limit practical use by patients. Objective: The goal of our study was to assess the readability of the most commonly searched Internet health education materials for cardiovascular diseases accessed via Google. Methods: We selected 20 commonly searched cardiovascular disease terms: aneurysm, angina, atherosclerosis, cardiomyopathy, congenital heart disease, coronary artery disease, deep vein thrombosis, heart attack, heart failure, high blood pressure, pericardial disease, peripheral arterial disease, rheumatic heart disease, stroke, sudden death, valvular heart disease, mini-stroke, lower extremity edema, pulmonary embolism, and exertional dyspnea. Terms were selected on Google and selected up to 10 results in order of presentation in the search results by reviewing a maximum of 15 pages of Google search results specifically providing education toward patients to yield 196 total patient education articles. Key Results: All readability measures assessing grade level measures found the 196 articles were written at a mean 10.9 (SD = 1.8) grade reading level. Moreover, 99.5% of the articles were written beyond the 5th- to 6th-grade level recommended by the American Medical Association. Conclusions: Given the prominent use of online patient education material, we consider readability as a quality metric that should be evaluated prior to online publication of any health education materials. Further study of how to improve the readability of online materials may enhance patient education, engagement, and health outcomes. [HLRP: Health Literacy Research and Practice. 2019;3(2):e74–e80.] Plain Language Summary: Patients often use Google as a tool for understanding their medical conditions. This study examined the readability of articles accessed via Google for commonly searched cardiovascular diseases and found all articles were written above reading grade levels appropriate for patients. We hope this study will promote the importance of ensuring that online patient education articles are written at appropriate reading levels.
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Affiliation(s)
| | | | | | | | | | | | - Jared W Magnani
- University of Pittsburgh Medical Center Heart and Vascular Institute
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12
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Ma Y, Zeiger J, McKee S, Yang A, Schaberg M, Del-Signore A, Govindaraj S, Iloreta A. Double-blinded randomized controlled trial to evaluate a multimedia surgical care tour in improving patient satisfaction and knowledge after functional endoscopic sinus surgery. Int Forum Allergy Rhinol 2018; 9:286-291. [PMID: 30548928 DOI: 10.1002/alr.22233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 09/27/2018] [Accepted: 10/05/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Current delivery of patient education is done during the clinic visit, where physicians or clinic staff have limited time for each patient. One potential solution is to provide a multimedia surgical care tour delivered to patients throughout the perioperative period. The purpose of the study is to evaluate the effectiveness of this surgical care tour in enhancing patient knowledge and satisfaction after functional endoscopic sinus surgery (FESS). METHODS A total of 121 patients were enrolled and a double-blinded randomized controlled trial was initiated. Patients in the experimental group received 4 educational videos and automated reminders to take medications. The control group received a sham platform. Patients were randomized by MEDUMO software, and physicians, clinic staff, and patients were blinded. Patient satisfaction was measured by Consumer Assessment of Healthcare Providers and Systems (CAHPS) Surgical Care Survey Version 2.0. Patient knowledge was graded by the blinded surgeon and clinic staff. Fischer's exact test and 2-tailed independent samples Student t test were used to compare the satisfaction and patient knowledge outcomes, respectively. RESULTS Patients in the experimental group were more likely to answer "Yes, definitely" to "Did these pictures drawings models or videos help you better understand your condition and its treatment?" (95.7% vs 74.1%, p = 0.011). The mean ± standard deviation clinic staff assessment of patient knowledge was 3.04 ± 1.05 in the control group and 3.68 ± 1.41 in the experimental group (p = 0.043). CONCLUSION A multimedia surgical care tour was developed and has promising effects on patient satisfaction and knowledge after FESS.
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Affiliation(s)
- Yue Ma
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Josh Zeiger
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Sean McKee
- State University of New York (SUNY) Downstate Medical Center, Brooklyn, NY
| | - Anthony Yang
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Madeleine Schaberg
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Anthony Del-Signore
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Satish Govindaraj
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Alfred Iloreta
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
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Lung Cancer Screening Guidelines: How Readable Are Internet-Based Patient Education Resources? AJR Am J Roentgenol 2018; 211:W42-W46. [DOI: 10.2214/ajr.17.19042] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Hansberry DR, Shah K, Agarwal N, Kim SM, Intenzo CM. Nuclear Medicine and Resources for Patients: How Complex Are Online Patient Educational Materials? J Nucl Med Technol 2018; 46:144-146. [PMID: 29438010 DOI: 10.2967/jnmt.117.203380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 12/06/2017] [Indexed: 11/16/2022] Open
Abstract
The Internet is a major source of health care information for patients. The American Medical Association and the National Institutes of Health recommend that consumer health care websites be written at a third- to seventh-grade level. The purpose of this study was to evaluate the level of readability of patient education websites pertaining to nuclear medicine. Methods: We searched for 10 terms on Google, collected the top 10 links for each term, and analyzed their level of readability using 10 well-established readability scales. Results: Collectively, the 99 articles were written at a grade level of 11.8 (SD, 3.4). Only 5 of the 99 articles were written at the third- to seventh-grade level recommended by the National Institutes of Health and the American Medical Association. Conclusion: There is a clear discordance between the readability level of nuclear medicine-related imaging terms and the National Institutes of Health and American Medical Association guidelines. This discordance may have a negative impact on patient understanding, contributing to poor health outcomes.
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Affiliation(s)
- David R Hansberry
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Kush Shah
- Department of Medicine, Rowan School of Osteopathic Medicine, Stratford, New Jersey; and
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sung M Kim
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Charles M Intenzo
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Hansberry DR, D'Angelo M, White MD, Prabhu AV, Cox M, Agarwal N, Deshmukh S. Quantitative analysis of the level of readability of online emergency radiology-based patient education resources. Emerg Radiol 2017; 25:147-152. [PMID: 29143222 DOI: 10.1007/s10140-017-1566-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 11/06/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE The vast amount of information found on the internet, combined with its accessibility, makes it a widely utilized resource for Americans to find information pertaining to medical information. The field of radiology is no exception. In this paper, we assess the readability level of websites pertaining specifically to emergency radiology. METHODS Using Google, 23 terms were searched, and the top 10 results were recorded. Each link was evaluated for its readability level using a set of ten reputable readability scales. The search terms included the following: abdominal ultrasound, abdominal aortic aneurysm, aortic dissection, appendicitis, cord compression, CT abdomen, cholecystitis, CT chest, diverticulitis, ectopic pregnancy, epidural hematoma, dural venous thrombosis, head CT, MRI brain, MR angiography, MRI spine, ovarian torsion, pancreatitis, pelvic ultrasound, pneumoperitoneum, pulmonary embolism, subarachnoid hemorrhage, and subdural hematoma. Any content that was not written for patients was excluded. RESULTS The 230 articles that were assessed were written, on average, at a 12.1 grade level. Only 2 of the 230 articles (1%) were written at the third to seventh grade recommended reading level set forth by the National Institutes of Health (NIH) and American Medical Association (AMA). Fifty-two percent of the 230 articles were written so as to require a minimum of a high school education (at least a 12th grade level). Additionally, 17 of the 230 articles (7.3%) were written at a level that exceeded an undergraduate education (at least a 16th grade level). CONCLUSIONS The majority of websites with emergency radiology-related patient education materials are not adhering to the NIH and AMA's recommended reading levels, and it is likely that the average reader is not benefiting fully from these information outlets. With the link between health literacy and poor health outcomes, it is important to address the online content in this area of radiology, allowing for patient to more fully benefit from their online searches.
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Affiliation(s)
- David R Hansberry
- Department of Radiology, Thomas Jefferson University Hospitals, 132 South 10th Street, Philadelphia, PA, 19107, USA.
| | - Michael D'Angelo
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Michael D White
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Arpan V Prabhu
- Department of Radiation Oncology, University of Pittsburgh Hillman Cancer Institute, Pittsburgh, PA, 15213, USA
| | - Mougnyan Cox
- Department of Radiology, Thomas Jefferson University Hospitals, 132 South 10th Street, Philadelphia, PA, 19107, USA
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Sandeep Deshmukh
- Department of Radiology, Thomas Jefferson University Hospitals, 132 South 10th Street, Philadelphia, PA, 19107, USA
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Hansberry DR, Agarwal N, John ES, John AM, Agarwal P, Reynolds JC, Baker SR. Evaluation of internet-based patient education materials from internal medicine subspecialty organizations: will patients understand them? Intern Emerg Med 2017; 12:535-543. [PMID: 28138915 DOI: 10.1007/s11739-017-1611-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 01/18/2017] [Indexed: 11/26/2022]
Abstract
The majority of Americans use the Internet daily, if not more often, and many search online for health information to better understand a diagnosis they have been given or to research treatment options. The average American reads at an eighth-grade level. The purpose of this study is to evaluate the readability of online patient education materials on the websites of 14 professional organizations representing the major internal medicine subspecialties. We used ten well-established quantitative readability scales to assess written text from patient education materials published on the websites of the major professional organizations representing the following subspecialty groups: allergy and immunology, cardiology, endocrinology, gastroenterology, geriatrics, hematology, hospice and palliative care, infectious disease, nephrology, oncology, pulmonology and critical care, rheumatology, sleep medicine, and sports medicine. Collectively the 540 articles analyzed were written at an 11th-grade level (SD 1.4 grade levels). The sleep medicine and nephrology websites had the most readable materials, written at an academic grade level of 8.5 ± 1.5 and 9.0 ± 0.2, respectively. Material at the infectious disease site was written at the most difficult level, with average readability corresponding to grades 13.9 ± 0.3. None of the patient education materials we reviewed conformed to the American Medical Association (AMA) and the National Institutes of Health (NIH) guidelines requiring that patient education articles be written at a third- to seventh-grade reading level. If these online resources were rewritten, it is likely that more patients would derive benefit from reading them.
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Affiliation(s)
- David R Hansberry
- Department of Radiology, Thomas Jefferson University Hospitals, 132 South 10th Street, Philadelphia, PA, 19107, USA.
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Elizabeth S John
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Ann M John
- Department of Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Prateek Agarwal
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - James C Reynolds
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephen R Baker
- Department of Radiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
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Kim H, Xie B. Health literacy in the eHealth era: A systematic review of the literature. PATIENT EDUCATION AND COUNSELING 2017; 100:1073-1082. [PMID: 28174067 DOI: 10.1016/j.pec.2017.01.015] [Citation(s) in RCA: 182] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/29/2016] [Accepted: 01/24/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVES This study aimed to identify studies on online health service use by people with limited health literacy, as the findings could provide insights into how health literacy has been, and should be, addressed in the eHealth era. METHODS To identify the relevant literature published since 2010, we performed four rounds of selection-database selection, keyword search, screening of the titles and abstracts, and screening of full texts. This process produced a final of 74 publications. RESULTS The themes addressed in the 74 publications fell into five categories: evaluation of health-related content, development and evaluation of eHealth services, development and evaluation of health literacy measurement tools, interventions to improve health literacy, and online health information seeking behavior. CONCLUSION Barriers to access to and use of online health information can result from the readability of content and poor usability of eHealth services. We need new health literacy screening tools to identify skills for adequate use of eHealth services. Mobile apps hold great potential for eHealth and mHealth services tailored to people with low health literacy. PRACTICE IMPLICATIONS Efforts should be made to make eHealth services easily accessible to low-literacy individuals and to enhance individual health literacy through educational programs.
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Affiliation(s)
- Henna Kim
- School of Information, The University of Texas at Austin, 1616 Guadalupe Suite #5.518, Austin, TX, 78701, USA.
| | - Bo Xie
- School of Nursing & School of Information, The University of Texas at Austin, Austin, USA.
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Hansberry DR, Donovan AL, Prabhu AV, Agarwal N, Cox M, Flanders AE. Enhancing the Radiologist-Patient Relationship through Improved Communication: A Quantitative Readability Analysis in Spine Radiology. AJNR Am J Neuroradiol 2017; 38:1252-1256. [PMID: 28385883 PMCID: PMC7960072 DOI: 10.3174/ajnr.a5151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/25/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE More than 75 million Americans have less than adequate health literacy skills according to the National Center for Education Statistics. Readability scores are used as a measure of how well populations read and understand patient education materials. The purpose of this study was to assess the readability of Web sites dedicated to patient education for radiologic spine imaging and interventions. MATERIALS AND METHODS Eleven search terms relevant to radiologic spine imaging were searched on the public Internet, and the top 10 links for each term were collected and analyzed to determine readability scores by using 10 well-validated quantitative readability assessments from patient-centered education Web sites. The search terms included the following: x-ray spine, CT spine, MR imaging spine, lumbar puncture, kyphoplasty, vertebroplasty, discogram, myelogram, cervical spine, thoracic spine, and lumbar spine. RESULTS Collectively, the 110 articles were written at an 11.3 grade level (grade range, 7.1-16.9). None of the articles were written at the American Medical Association and National Institutes of Health recommended 3rd-to-7th grade reading levels. The vertebroplasty articles were written at a statistically significant (P < .05) more advanced level than the articles for x-ray spine, CT spine, and MR imaging spine. CONCLUSIONS Increasing use of the Internet to obtain health information has made it imperative that on-line patient education be written for easy comprehension by the average American. However, given the discordance between readability scores of the articles and the American Medical Association and National Institutes of Health recommended guidelines, it is likely that many patients do not fully benefit from these resources.
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Affiliation(s)
- D R Hansberry
- From the Department of Radiology (D.R.H., M.C., A.E.F.), Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - A L Donovan
- Department of Radiation Oncology (A.L.D., A.V.P.), University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - A V Prabhu
- Department of Radiation Oncology (A.L.D., A.V.P.), University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - N Agarwal
- Department of Neurological Surgery (N.A.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - M Cox
- From the Department of Radiology (D.R.H., M.C., A.E.F.), Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - A E Flanders
- From the Department of Radiology (D.R.H., M.C., A.E.F.), Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Prabhu AV, Donovan AL, Crihalmeanu T, Hansberry DR, Agarwal N, Beriwal S, Kale H, Heller M. Radiology Online Patient Education Materials Provided by Major University Hospitals: Do They Conform to NIH and AMA Guidelines? Curr Probl Diagn Radiol 2017; 47:75-79. [PMID: 28669431 DOI: 10.1067/j.cpradiol.2017.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/16/2017] [Indexed: 11/22/2022]
Abstract
AIMS The internet creates opportunities for Americans to access medical information about imaging tests and modalities to guide them in their medical decision-making. Owing to health literacy variations in the general population, the American Medical Association and National Institutes of Health recommend patient education resources to be written between the third and seventh grade levels. Our purpose is to quantitatively assess the readability levels of online radiology educational materials, written for the public, in 20 major university hospitals. MATERIALS AND METHODS In September and October 2016, we identified 20 major university hospitals with radiology residency-affiliated hospital systems. On each hospital׳s website, we downloaded all radiology-related articles written for patient use. A total of 375 articles were analyzed for readability level using 9 quantitative readability scales that are well validated in the medical literature. RESULTS The 375 articles from 20 hospital systems were collectively written at an 11.4 ± 3.0 grade level (range: 8.4-17.1). Only 11 (2.9%) articles were written at the recommended third to seventh grade levels. Overall, 126 (33.6%) were written above a full high-school reading level. University of Washington Medical Center׳s articles were the most readable with a reading level corresponding to 7.9 ± 0.9. CONCLUSIONS The vast majority of websites at major academic hospitals with radiology residencies designed to provide patients with information about imaging were written above the nationally recommended health literacy guidelines to meet the needs of the average American. This may limit the benefit that patients can derive from these educational materials.
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Affiliation(s)
- Arpan V Prabhu
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA; Department of Radiation Oncology, University of Pittsburgh Hillman Cancer Institute, Pittsburgh, PA.
| | - Ashley L Donovan
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - David R Hansberry
- Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, PA
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Sushil Beriwal
- Department of Radiation Oncology, University of Pittsburgh Hillman Cancer Institute, Pittsburgh, PA
| | - Hrishikesh Kale
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Matthew Heller
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA
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Hansberry DR, Ayyaswami V, Sood A, Prabhu AV, Agarwal N, Deshmukh SP. Abdominal imaging and patient education resources: enhancing the radiologist-patient relationship through improved communication. Abdom Radiol (NY) 2017; 42:1276-1280. [PMID: 27838772 DOI: 10.1007/s00261-016-0977-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The relative ease of Internet access and its seemingly endless amount of information creates opportunities for Americans to research medical diseases, diagnoses, and treatment plans. Our objective is quantitative evaluation of the readability level of patient education websites, written for the lay public, pertaining to common radiologic diagnostic test, and radiologic diagnoses specific to abdominal imaging. METHODS In October 2015, 10 search terms were entered in the Google search engine, and the top 10 links for each term were collected and independently examined for their readability level using 10 well-validated quantitative readability scales. Search terms included CT abdomen, MRI abdomen, MRI enterography, ultrasound abdomen, X-ray abdomen, cholecystitis, diverticulitis, hepatitis, inflammatory bowel disease, and pancreatitis. Websites not written exclusively for patients were excluded from the analysis. RESULTS As a group, the 100 articles were assessed at an 11.7 grade level. Only 2% (2/100) were written at the National Institutes of Health (NIH), and American Medical Association (AMA) suggested 3rd to 7th grade level to meet the 8th grade average reading level in the United States. In fact, 49% were written at a level that required a high school education or higher (greater than 12th grade). CONCLUSIONS With websites like radiologyinfo.org, generating over a million visitors a month, it is that clear there is a public interest in learning about radiology. However, given the discordance between the level of readability of the majority of the Internet articles and the NIH and AMA guidelines noted in this study on abdominal imaging readability, it is likely that many readers do not fully benefit from these resources on abdominal imaging.
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Affiliation(s)
- David R Hansberry
- Department of Radiology, Thomas Jefferson University Hospital, 132 South 10th Street, Philadelphia, PA, 19107, USA.
| | - Varun Ayyaswami
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anshum Sood
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Arpan V Prabhu
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sandeep P Deshmukh
- Department of Radiology, Thomas Jefferson University Hospital, 132 South 10th Street, Philadelphia, PA, 19107, USA
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Agarwal N, Kommana SS, Hansberry DR, Kashkoush AI, Friedlander RM, Lunsford LD. Accessibility, reliability, and usability of neurosurgical resources. J Neurosurg 2017; 126:1263-1268. [DOI: 10.3171/2015.12.jns151102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Closing the knowledge gap that exists between patients and health care providers is essential and is facilitated by easy access to patient education materials. Although such information has the potential to be an effective resource, it must be written in a user-friendly and understandable manner, especially when such material pertains to specialized and highly technical fields such as neurological surgery. The authors evaluated the accessibility, usability, and reliability of current educational resources provided by the American Association of Neurological Surgeons (AANS), Healthwise, and the National Institute for Neurological Disorders and Stroke (NINDS).
METHODS
Online neurosurgical patient education information provided by AANS, Healthwise, and NINDS was evaluated using the LIDA scale, a website quality assessment tool, by medical professionals and nonmedical professionals. A high achieving score is regarded as 90% or greater using the LIDA scale.
RESULTS
Accessibility scores were 76.7% (AANS), 83.3% (Healthwise), and 75.0% (NINDS). Average usability scores for the AANS, Healthwise, and NINDS were 73.3%, 82.6%, and 82.9%, respectively, when evaluated by medical professionals and 78.5%, 80.7%, and 75.9%, respectively, for nonmedical professionals, respectively. Average reliability scores were 58.5%, 53.3%, 72.6%, respectively, for medical professionals and 70.4%, 66.7%, and 78.5%, respectively, for nonmedical professionals when evaluating the AANS, Healthwise, and NINDS websites.
CONCLUSIONS
Although organizations like AANS, Healthwise, and NINDS should be commended for their ongoing commitment to provide health care–oriented materials, modification of this material is suggested to improve the patient education value.
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Affiliation(s)
- Nitin Agarwal
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - David R. Hansberry
- 3Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Ahmed I. Kashkoush
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Robert M. Friedlander
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - L. Dade Lunsford
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Colorectal cancer screening patient education materials-how effective is online health information? Int J Colorectal Dis 2016; 31:1817-1824. [PMID: 27649702 DOI: 10.1007/s00384-016-2652-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 02/04/2023]
Abstract
PURPOSE Patients screened for colorectal cancer (CRC) frequently turn to the Internet to improve their understanding of tests used for detection, including colonoscopy, flexible sigmoidoscopy, fecal occult blood test (FOBT), and CT colonography. It was of interest to determine the quality and readability levels of online health information. METHODS The screening tools were googled, and the top 20 results of each test were analyzed for readability, accessibility, usability, and reliability. The 80 articles excluded scientific literature and blogs. We used ten validated readability scales to measure grade levels, and one-way ANOVA and Tukey's honestly statistical different (HSD) post hoc analyses to determine any statistically significant differences among the four diagnostic tests. The LIDA tool assessed overall quality by measuring accessibility, usability, and reliability. RESULTS The 80 articles were written at an 11.7 grade level, with CT colonography articles written at significantly higher levels than FOBT articles, F(3, 75) = 3.07, p = 0.033. LIDA showed moderate percentages in accessibility (83.9 %), usability (73.0 %), and reliability (75.9 %). CONCLUSIONS Online health information about CRC screening tools are written at higher levels than the National Institute of Health (NIH) and American Medical Association (AMA) recommended third to seventh grade levels. More patients could benefit from this modality of information if it were written at a level and quality that would better facilitate understanding.
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Mammography Patient Information at Hospital Websites: Most Neither Comprehensible Nor Guideline Supported. AJR Am J Roentgenol 2016; 207:947-951. [DOI: 10.2214/ajr.16.16436] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Health Literacy and Patient Preparation in Radiology. J Med Imaging Radiat Sci 2016; 47:283-286. [DOI: 10.1016/j.jmir.2016.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/07/2016] [Accepted: 06/03/2016] [Indexed: 11/18/2022]
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Prabhu AV, Hansberry DR, Agarwal N, Clump DA, Heron DE. Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations. Int J Radiat Oncol Biol Phys 2016; 96:521-8. [PMID: 27681748 DOI: 10.1016/j.ijrobp.2016.06.2449] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE Physicians encourage patients to be informed about their health care options, but much of the online health care-related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). METHODS Radiation oncology-related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, RadiologyInfo.org, and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. RESULTS When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. CONCLUSION Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment options, making each physician-patient interaction more productive and efficient.
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Affiliation(s)
- Arpan V Prabhu
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - David R Hansberry
- Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - David A Clump
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Dwight E Heron
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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Understanding of Health Information by Patients. AJR Am J Roentgenol 2015. [DOI: 10.2214/ajr.15.14551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Sadigh G, Hawkins CM, O'Keefe JJ, Khan R, Duszak R. Can Patients Comprehend the Educational Materials that Hospitals Provide about Common IR Procedures? J Vasc Interv Radiol 2015; 26:1156-61. [PMID: 26074029 DOI: 10.1016/j.jvir.2015.04.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 04/25/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To assess the readability of online education materials offered by hospitals describing commonly performed interventional radiology (IR) procedures. MATERIALS AND METHODS Online patient education materials from 402 hospitals selected from the Medicare Hospital Compare database were assessed. The presence of an IR service was determined by representation in the Society of Interventional Radiology physician finder directory. Patient online education materials about (i) uterine artery embolization for fibroid tumors, (ii) liver cancer embolization, (iii) varicose vein treatment, (iv) central venous access, (v) inferior vena cava (IVC) filter placement, (vi) nephrostomy tube insertion, (vii) gastrostomy tube placement, and (viii) vertebral augmentation were targeted and assessed by using six validated readability scoring systems. RESULTS Of 402 hospitals sampled, 156 (39%) were presumed to offer IR services. Of these, 119 (76%) offered online patient education material for one or more of the eight service lines. The average readability scores corresponding to grade varied between the ninth- and 12th-grade levels. All were higher than the recommended seventh-grade level (P < .05) except for nephrostomy and gastrostomy tube placement. Average Flesch-Kincaid Reading Ease scores ranged from 42 to 69, corresponding with fairly difficult to difficult readability for all service lines except IVC filter and gastrostomy tube placement, which corresponded with standard readability. CONCLUSIONS A majority of hospitals offering IR services provide at least some online patient education material. Most, however, are written significantly above the reading comprehension level of most Americans. More attention to health literacy by hospitals and IR physicians is warranted.
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Affiliation(s)
- Gelareh Sadigh
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd., Room 125 D, Atlanta, GA 30322..
| | - C Matthew Hawkins
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd., Room 125 D, Atlanta, GA 30322
| | - John J O'Keefe
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd., Room 125 D, Atlanta, GA 30322
| | - Ramsha Khan
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd., Room 125 D, Atlanta, GA 30322
| | - Richard Duszak
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd., Room 125 D, Atlanta, GA 30322
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McEnteggart GE, Naeem M, Skierkowski D, Baird GL, Ahn SH, Soares G. Readability of Online Patient Education Materials Related to IR. J Vasc Interv Radiol 2015; 26:1164-8. [PMID: 25935147 DOI: 10.1016/j.jvir.2015.03.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/14/2015] [Accepted: 03/20/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To assess the readability of online patient education materials (OPEM) related to common diseases treated by and procedures performed by interventional radiology (IR). MATERIALS AND METHODS The following websites were chosen based on their average Google search return for each IR OPEM content area examined in this study: Society of Interventional Radiology (SIR), Cardiovascular and Interventional Radiological Society of Europe (CIRSE), National Library of Medicine, RadiologyInfo, Mayo Clinic, WebMD, and Wikipedia. IR OPEM content area was assessed for the following: peripheral arterial disease, central venous catheter, varicocele, uterine artery embolization, vertebroplasty, transjugular intrahepatic portosystemic shunt, and deep vein thrombosis. The following algorithms were used to estimate and compare readability levels: Flesch-Kincaid Grade Formula, Flesch Reading Ease Score, Gunning Frequency of Gobbledygook, Simple Measure of Gobbledygook, and Coleman-Liau Index. Data were analyzed using general mixed modeling. RESULTS On average, online sources that required beyond high school grade-level readability were Wikipedia (15.0), SIR (14.2), and RadiologyInfo (12.4); sources that required high school grade-level readability were CIRSE (11.3), Mayo Clinic (11.0), WebMD (10.6), and National Library of Medicine (9.0). On average, OPEM on uterine artery embolization, vertebroplasty, varicocele, and peripheral arterial disease required the highest level of readability (12.5, 12.3, 12.3, and 12.2, respectively). CONCLUSIONS The IR OPEM assessed in this study were written above the recommended sixth-grade reading level and the health literacy level of the average American adult. Many patients in the general public may not have the ability to read and understand health information in IR OPEM.
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Affiliation(s)
- Gregory E McEnteggart
- Vascular Disease Research Center, Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903
| | - Muhammad Naeem
- Vascular Disease Research Center, Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903.
| | - Dorothy Skierkowski
- Biostatistics Core, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903
| | - Grayson L Baird
- Biostatistics Core, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903
| | - Sun H Ahn
- Vascular Disease Research Center, Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903
| | - Gregory Soares
- Vascular Disease Research Center, Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903
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Health literacy and online educational resources: an opportunity to educate patients. AJR Am J Roentgenol 2015; 204:111-6. [PMID: 25539245 DOI: 10.2214/ajr.14.13086] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Given the increasing accessibility of material on the Internet and the use of these materials by patients as a source of health care information, the purpose of this study was to quantitatively evaluate the level of readability of resources made available on the European Society of Radiology website to determine whether these materials meet the health literacy needs of the general public as set forth by guidelines of the U.S. National Institutes of Health (NIH) and the American Medical Association (AMA). MATERIALS AND METHODS All 41 patient education articles created by the European Society of Radiology (ESR) were downloaded and analyzed with the following 10 quantitative readability scales: the Coleman-Liau Index, Flesch-Kincaid Grade Level, Flesch Reading Ease, FORCAST Formula, Fry Graph, Gunning Fog Index, New Dale-Chall, New Fog Count, Raygor Reading Estimate, and the Simple Measure of Gobbledygook. RESULTS The 41 articles were written collectively at a mean grade level of 13.0 ± 1.6 with a range from 10.8 to 17.2. For full understanding of the material, 73.2% of the articles required the reading comprehension level of, at minimum, a high school graduate (12th grade). CONCLUSION The patient education resources on the ESR website are written at a comprehension level well above that of the average Internet viewer. The resources fail to meet the NIH and AMA guidelines that patient education material be written between the third and seventh grade levels. Recasting these resources in a simpler format would probably lead to greater comprehension by ESR website viewers.
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Barnes JA, Davies L. Reading grade level and completeness of freely available materials on thyroid nodules: there is work to be done. Thyroid 2015; 25:147-56. [PMID: 25384093 PMCID: PMC4321770 DOI: 10.1089/thy.2014.0352] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Patient education is one of the key components required for patients to participate in decision making for their care. Sources of information should be complete and understandable. The objective of this study was to assess the quality and reading grade level of freely available materials pertaining to the evaluation and treatment of thyroid nodules. METHODS All available materials were gathered through a comprehensive Internet search or direct contact with each identified organization associated with thyroid care. Materials meeting inclusion criteria were assessed for completeness of content and reading grade level using the SMOG readability formula. Then, the DISCERN instrument was utilized to assess the quality of the five materials which had the best (lowest) and the five materials that had the worst (highest) SMOG reading grade levels. RESULTS A total of 63 materials on thyroid nodule evaluation and management were identified. A minority of materials presented readers with a complete picture of the topic, describing both benefits and cautions of thyroid nodule evaluation, benefits and cautions of fine-needle thyroid nodule biopsy, or risks, benefits, and long-term effects of thyroidectomy. The SMOG reading grade level assessment was well above recommended levels. The range was eighth grade to college level; the mean and median reading grade level were 13. Lastly, the DISCERN instrument revealed that most of the materials with both the best and the worst reading grade levels assessed had "extensive or serious shortcomings" that would impede their usefulness as high-quality sources of information regarding management options. CONCLUSIONS Existing thyroid nodule evaluation and management materials have serious shortcomings. Future work should focus on the development of patient materials that are both grade level appropriate and meet the DISCERN criteria for topic completeness and accuracy.
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Affiliation(s)
- J. Aaron Barnes
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Louise Davies
- The VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, Vermont
- Section of Otolaryngology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
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Hansberry DR, Agarwal N, Gonzales SF, Baker SR. Are we effectively informing patients? A quantitative analysis of on-line patient education resources from the American Society of Neuroradiology. AJNR Am J Neuroradiol 2014; 35:1270-5. [PMID: 24763420 DOI: 10.3174/ajnr.a3854] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The ubiquitous use of the Internet by the public in an attempt to better understand their health care requires the on-line resources written at an appropriate level to maximize comprehension for the average user. The National Institutes of Health and the American Medical Association recommend on-line patient education resources written at a third-to-seventh grade level. We evaluated the readability of the patient education resources provided on the Web site of the American Society of Neuroradiology (http://www.asnr.org/patientinfo/). MATERIALS AND METHODS All patient education material from the ASNR Web site and the Society of Neurointerventional Surgery Web site were downloaded and evaluated with the computer software, Readability Studio Professional Edition, by using 10 quantitative readability scales: the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Coleman-Liau Index, Gunning Fog Index, New Dale-Chall, FORCAST Formula, Fry Graph, Raygor Reading Estimate, and New Fog Count. An unpaired t test was used to compare the readability level of resources available on the American Society of Neuroradiology and the Society of Neurointerventional Surgery Web sites. RESULTS The 20 individual patient education articles were written at a 13.9 ± 1.4 grade level with only 5% written at <11th grade level. There was no statistical difference between the level of readability of the resources on the American Society of Neuroradiology and Society of Neurointerventional Surgery Web sites. CONCLUSIONS The patient education resources on these Web sites fail to meet the guidelines of the National Institutes of Health and American Medical Association. Members of the public may fail to fully understand these resources and would benefit from revisions that result in more comprehensible information cast in simpler language.
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Affiliation(s)
- D R Hansberry
- From the Departments of Radiology (D.R.H., S.F.G., S.R.B.)
| | - N Agarwal
- Neurological Surgery (N.A.), New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
| | - S F Gonzales
- From the Departments of Radiology (D.R.H., S.F.G., S.R.B.)
| | - S R Baker
- From the Departments of Radiology (D.R.H., S.F.G., S.R.B.)
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