Discharge summaries provided to owners of pets newly diagnosed with cancer exceed recommended readability levels

Abstract

OBJECTIVE To analyze the readability of discharge summaries distributed to owners of pets newly diagnosed with cancer. SAMPLE 118 discharge summaries provided to pet owners following initial consultation. PROCEDURES A database search identified records of new patients that had been presented to the North Carolina State Veterinary Hospital medical oncology service between June 2017 and January 2019. Owner-directed portions of the summaries provided at the time of discharge were copied and pasted into a document and stripped of all identifying information. Readability of summaries was assessed with the use of 2 previously established readability calculators: the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) tests. RESULTS Mean ± SD FKGL was 11.9 ± 1.1 (median, 11.9; range, 8.6 to 15.5; target ≤ 6), and the mean ± SD FRE score was 43 ± 5.9 (median, 42.7; range, 25.5 to 58.1; target ≥ 60). There were no significant differences in FKGL or FRE scores among discharge summaries for patients with the 4 most common tumor types diagnosed or the described treatment options. Ninety-three percent (110/118) of summaries were scored as difficult or very difficult to read. CLINICAL RELEVANCE Owner-directed written information regarding a diagnosis of cancer at a single teaching hospital exceeded readability levels recommended by the American Medical Association and NIH and was above the average reading level of most US adults. Efforts to improve readability are an important component of promoting relationship-centered care and may improve owner compliance and patient outcomes.

Readability of postoperative discharge instructions is associated with complication rate in companion animals undergoing sterilisation

“…One previous study, assessing readability within the NCSU CVM medical oncology service, reported a mean readability score of 11.9 (FKGL). 16 In that study, discharge instructions were written by attending clinicians and there were no factors assessed pertaining to individual clinician experience or understanding of readability. 16 In the present study, every discharge summary was written by a pair of third-year students from an AVMA-accredited veterinary school.…”

“…16 In that study, discharge instructions were written by attending clinicians and there were no factors assessed pertaining to individual clinician experience or understanding of readability. 16 In the present study, every discharge summary was written by a pair of third-year students from an AVMA-accredited veterinary school. The difference in FKGL readability scores between the present study and the study by Medland et al 16 could be due to discrepancies between the writing styles of students and clinicians.…”

“…16 In the present study, every discharge summary was written by a pair of third-year students from an AVMA-accredited veterinary school. The difference in FKGL readability scores between the present study and the study by Medland et al 16 could be due to discrepancies between the writing styles of students and clinicians. Students are more likely to write in a nonprofessional writing style, whereas attending clinicians may be inclined to write using more advanced medical terminology.…”

“…These studies proved that written correspondence designed to educate clients about medical information relevant to their pets does not comply with the guidelines set forth by the AMA and NIH. [13][14][15][16] In the study by Chen et al, data were accumulated from websites providing education for clients regarding pet obesity. It was found that the mean estimated reading grade level of the 68 websites examined was 9.07, which is over three grade levels higher than the NIH-recommended readability grade level for patient education materials.…”

“…Medland et al analysed 118 discharge summaries from the oncology service at North Carolina State University College of Veterinary Medicine (NCSU CVM), and they determined that 93% scored as difficult or very difficult to read. 16 Writing discharge summaries is a task that many veterinarians perform daily. Therefore, veterinary educational institutions should be teaching students to produce discharge summaries that are easy to read.…”