Is the Message Clear? Evaluation of Readability Levels for Cleft Lip, Cleft Palate, and Craniofacial Websites

Abstract

Web-based health information is the leading source of medical knowledge for patients and families. The American Medical Association (AMA) and US Department of Health and Human Services recommend reading material be at or below a sixth-grade reading level. This study aimed to evaluate and compare the readability of the most popularly searched cleft lip and/or palate (CL/P) and other craniofacial syndrome (CFS) websites. Google searches for “cleft lip,” “cleft palate,” and “craniofacial syndromes” were performed to identify the top 40 websites in an incognito window with the location set to the United States. Flesch Reading Ease Score (FRES) was used to determine ease of reading from 0 (most difficult) to 100 (greatest ease of reading) and Flesch-Kincaid Reading Grade (FKGL) for website content and compared between websites using an FRES of 80 to 90 and FKGL of 6.0 to 6.9 for a sixth-grade reading level. Readability was low for all sites with 6 CL/P websites and no CFS websites at or below a sixth-grade reading level. CL/P websites had FRES readability scores of 58.5 ± 12.3 and were at a 9.4 ± 2.3 grade level. CFS websites had readability scores on the FRES of 39.8 ± 13.1 and were at a 10.8 ± 1.8 grade level. Web-based information related to CL/P and CFS is on average several grade levels above the recommended sixth-grade reading level. Online information for CL/P and CFS may need to be revised to improve understanding for the public and families.

The Quality and Readability of Online Patient Information on Positional Head Shape Conditions

“…Evaluation of readability using both FRES, which determines the ease of reading based on the average length of words and sentences, and FKGL, which determines the United States grade level of text based on average sentence length and syllables per word, indicates that less than 40% of all websites reviewed had a standard reading level, and only 5.3% were written at the recommended level of 6th grade. 5 These results align with previous studies on pediatric and adult facial plastic surgery procedures that found inconsistencies between patient information and the recommended 6th grade reading level 21,22,24,25,29–33 . In 2022, a scoping review of 36 previously published studies examined the readability of online patient information for plastic surgery procedures, which represents the largest analysis of educational material for the plastic surgery patient to date (n = 1539).…”