Readability of online material related to skin cancer

Online Readability Analysis: Mohs Micrographic Surgery Postsurgical Wound Care

OBJECTIVE

Although various treatment modalities exist for skin cancer care, Mohs micrographic surgery (MMS) is one of the most effective and cosmetically sensitive surgical techniques. The readability of online informational materials specifically related to MMS postsurgical wound care is extremely relevant for patients given the high rates of skin cancer in the US and the number of patients utilizing the internet for information.

METHODS

Investigators conducted Google searches to evaluate the current state of readability on MMS postsurgical wound care using the specific keywords "healing after Mohs surgery" and "wound care Mohs surgery." The readabilities of individual websites were analyzed using the WebFX online software. Health-specific click-through rate was used to select the number of samples assessed.

RESULTS

Based on the 33 unique websites evaluated, the aggregate readability of online MMS postsurgical wound care materials was 11.3, corresponding to an 11th-grade reading level by US standards.

CONCLUSIONS

Although this level of readability is an improvement in online MMS postsurgical wound care information relative to prior literature, there is still considerable work to be done by the dermatologic community in improving the readability of online patient materials regarding MMS.

Readability of online dengue materials: The need for accessible information as part of infectious disease prevention and control efforts

BACKGROUND

Dengue is the fastest spreading viral infection. A number of epidemics have occurred in subtropical and tropical regions of the United States. A future expansion and intensification of dengue has been predicted, partly due to changing environmental conditions. In the absence of treatment, prevention and control are vital to addressing this vector-borne disease. Health education and community engagement are a key part of such efforts. Given that the majority of Americans search for health information online, ensuring the readability of web-based dengue information is an important consideration for health officials. To date, there is a dearth of information on this topic.

METHODS

To address this gap, "Dengue fever" was searched using Google Chrome to generate a sample of 100 websites. Using Readable.io, the readability of these 100 sites was then determined using five different tests. The data were analyzed using SPSS.

RESULTS

The results indicate that the vast majority of online materials on dengue are written at a level far beyond what is recommended. Three of the five tests did not find any of the sampled sites to be appropriate in terms of readability. In general, the websites analyzed tended to be written at a level beyond the 10th grade.

CONCLUSION

These findings have important implications for future dengue outbreaks in the United States.

Implementation of a mobile app for trauma education: results from a multicenter study

Background

In an era of shared decision making, patient expectations for education have increased. Ideal resources would offer accurate information, digital delivery and interaction. Mobile applications have potential to fulfill these requirements. The purpose of this study was to demonstrate adoption of a patient education application (app: http://bit.ly/traumaapp) at multiple sites with disparate locations and varied populations.

Methods

A trauma patient education application was developed at one trauma center and subsequently released at three new trauma centers. The app contains information regarding treatment and recovery and was customized with provider information for each institution. Each center was provided with promotional materials, and each had strategies to inform providers and patients about the app. Data regarding utilization was collected. Patients were surveyed about usage and recommendations.

Results

Over the 16-month study period, the app was downloaded 844 times (70%) in the metropolitan regions of the study centers. The three new centers had 380, 89 and 31 downloads, while the original center had 93 downloads. 36% of sessions were greater than 2 min, while 41% were less than a few seconds. The percentage of those surveyed who used the app ranged from 14.3% to 44.0% for a weighted average of 36.8% of those having used the app. The mean patient willingness to recommend the app was 3.3 on a 5-point Likert scale. However, the distribution was bimodal: 60% of patients rated the app 4 or 5, while 32% rated it 1 or 2.

Discussion

The adoption of a trauma patient education app was successful at four centers with disparate patient populations. The majority of patients were likely to recommend the app. Variations in implementation strategies resulted in different rates of download. Integration of the app into patient education by providers is associated with more downloads.

Level of evidence

Level III care management.

Public Health Communication in Time of Crisis: Readability of On-Line COVID-19 Information

Objective:

The purpose of this study was to assess the readability of information on the Internet posted about coronavirus disease 2019 (COVID-19) to determine how closely these materials are written to the recommended reading levels.

Methods:

Using the search term “coronavirus,” information posted on the first 100 English language websites was identified. Using an online readability calculator, multiple readability tests were conducted to ensure a comprehensive representation would result.

Results:

The mean readability scores ranged between grade levels 6.2 and 17.8 (graduate school level). Four of the 5 measures (GFI, CLI, SMOG, FRE) found that readability exceeded the 10th grade reading level indicating that the text of these websites would be difficult for the average American to read. The mean reading level for nearly all noncommercial and commercial websites was at or above the 10th grade reading level.

Conclusions:

Messages about COVID-19 must be readable at an “easy” level, and must contain clear guidelines for behavior. The degree to which individuals seek information in response to risk messages is positively related to the expectation that the information will resolve uncertainty. However, if the information is too complex to interpret and it fails to lead to disambiguation, this can contribute to feelings of panic.

Readability of Cancer Clinical Trials Websites

Clinical trials are critically important for the development of new cancer treatments. According to recent estimates, however, clinical trial enrollment is only about 8%. Lack of patient understanding or awareness of clinical trials is one reason for the low rate of participation. The purpose of this observational study was to evaluate the readability of cancer clinical trial websites designed to educate the general public and patients about clinical trials. Nearly 90% of Americans use Google to search for health-related information. We conducted a Google Chrome Incognito search in 2018 using the keywords “cancer clinical trial” and “cancer clinical trials.” Content of the 100 cancer clinical trial websites was analyzed using an online readability panel consisting of Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning-Fog Index, Coleman-Liau Index, and Simple Measure of Gobbledygook scales. Reading level difficulty was assessed and compared between commercial versus non-commercial URL extensions. Content readability was found to be “difficult” (10.7 grade level). No significant difference in readability, overall, and between commercial and non-commercial URL extensions was found using 4/5 measures of readability; 90.9% of commercial versus 49.4% of non-commercial websites were written at a >10th grade (P = .013) using Gunning-Fog Index. Written cancer clinical trials content on the Internet is written at a reading level beyond the literacy capabilities of the average American reader. Improving readability to accommodate readers with basic literacy skills will provide an opportunity for greater comprehension that could potentially result in higher rates of clinical trial enrollment.

Readability of influenza information online: Implications for consumer health

BACKGROUND

Influenza (flu) is pervasive and burdensome. The purpose of this study was to determine the readability levels of online articles related to flu.

METHODS

Using the search term "influenza," the URL's of the first 100 English language Web sites were vetted for content to ascertain that the article met inclusion criteria. Five recommended readability tests were conducted using an online service to calculate readability. Overall, the analysis indicates that flu material found on the web is not being written at a level that is widely readable.

RESULTS

None of the 100 sites included in the analysis received an acceptable score on all 5 assessments. One-sample independent t tests (α = 0.05, df = 99) indicated that it is highly unlikely that flu Web sites are being written at the desirable level. Of the 100 sampled sites, 33 had a .com, 29 had a .org, and 22 had a .gov extension. Extension type did not play a role in readability level of these sites.

CONCLUSIONS

When creating content for the masses, health professionals should maximize their efforts by testing the readability as well as other factors that influence the likelihood that it will be understood.