Most patient education materials on shoulder conditions from the American Academy of Orthopaedic Surgeons exceed recommended readability levels

Sudah, Suleiman Y.; Faccone, Robert D.; Manzi, Joseph E.; Kirchner, Gregory J.; Constantinescu, David S.; Nicholson, Allen D.; Menendez, Mariano E.

doi:10.1016/j.jseint.2022.09.004

Cited by 9 publications

(4 citation statements)

References 17 publications

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“…All pictures, videos, advertisements, copyright notices, references, and other text not directly related to ankle fractures were removed. ReadablePro ( https://app.readable.com/text/ ), 25 an online calculator, was then used to evaluate the readability of each reformatted document as described in Sudah et al 31 The calculator was used to generate a score for the following validated instruments: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease (FRE), and Gunning Fog Index (GFI). Both FRE and FKGL calculate readability based on the average sentence length and the average word length.…”

Section: Methodsmentioning

confidence: 99%

Analysis of the Most Popular Online Ankle Fracture–Related Patient Education Materials

Arif,

LeBrun,

Moore

et al. 2024

Foot & Ankle Orthopaedics

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Background: Given the increasing accessibility of Internet access, it is critical to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures. Methods: After conducting a Google search using 6 terms related to ankle fractures, we collected the first 20 nonsponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using custom created Ankle Fracture Index (AFI). Results: A total of 46 of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an “acceptable” quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth-grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations. Conclusion: We found that online patient-facing materials on ankle fractures demonstrated an eighth-grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery while ensuring that readability levels remain below at least the eighth-grade level.

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Section: Methodsmentioning

confidence: 99%

Analysis of the Most Popular Online Ankle Fracture–Related Patient Education Materials

Arif,

LeBrun,

Moore

et al. 2024

Foot & Ankle Orthopaedics

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“…To address this issue, organisations such as the AMA and NIH recommend that all PEMs should have readability at or below the sixth-grade reading level. However, PEMs within the field of orthopaedics have consistently been shown to rarely meet these recommendations, potentially having a negative impact on patient health literacy and outcomes (Abdullah et al, 2022;Baumann et al, 2023;Ghanem et al, 2023;Hanish et al, 2023;Stelzer et al, 2022;Sudah et al, 2023).…”

Section: F I G U R Ementioning

confidence: 99%

“…It is recommended that PEM readability should be at or below the 6th‐grade level. However, studies consistently show that these recommendations are rarely met in PEMs related to orthopaedic diseases, conditions, treatments, and recovery (Abdullah et al., 2022; Baumann et al., 2023; Ghanem et al., 2023; Hanish et al., 2023; Stelzer et al., 2022; Sudah et al., 2023). Similar findings have consistently been shown in PEMs related to THA and TKA, which is particularly problematic as these surgeries are extremely common (Doinn et al., 2020; Karimi et al., 2023; Murphy et al., 2022; Shnaekel et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

A standardised method for improving the readability of patient education materials for total hip & knee arthroplasty patients

Baumann,

Marshall,

O’Malley

et al. 2024

Musculoskeletal Care

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PurposeOrthopaedic Patient Education Materials (PEMs) related to total hip and total knee arthroplasty (TKA) have repeatedly been shown to not meet American Medical Association and National Institutes of Health recommendations for readability. PEMs that are written with too much complexity limit the ability of some readers to comprehend the material. These complex PEMs also limit the health literacy of patients, a key determinant of health status and outcomes. The purpose of this study was to improve the readability of total hip and TKA‐related PEMs by limiting the use of sentences with ≥15 words and limiting the use of words with ≥ three syllables.MethodsThe readability of all 26 PEMs in this study was assessed before and after editing. Editing of articles included limiting the use of sentences with ≥15 words and limiting the use of words with ≥three syllables while preserving PEM content.ResultsA total of 26 PEMs were available for use in this study after the application of inclusion and exclusion criteria. The percentage of original PEMs at or below the recommended sixth‐grade reading level was 0% (0 out of 26), while the percentage of edited PEMs at or below the sixth‐grade reading level was 50% (13 out of 26).ConclusionsUsing this standardised method for reducing sentence length to <15 words and limiting the use of words with >2 syllables, while preserving key content, significantly improved the readability of PEMs related to total hip and TKA.

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“…However, studies on the readability of texts in a medical context have shown that the effects are obvious and an accurate understanding of the (medical) texts is crucial, especially after the COVID-19 pandemic when most patients turn to websites for medical information [13]. There is now a disconnect between the wealth of medical and health information available on the internet and patient literacy [14], and sourcing this information from the Internet means there is less advice from medical experts. To avoid unwanted risks, continuous evaluations of the readability of medical texts are carried out.…”

Section: Introductionmentioning

confidence: 99%

Text readability: its impact on reading comprehension and reading time

Zainurrahman,

Yusuf,

Sukyadi

2024

EduLearn

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Recently, the readability of texts has become the focus of reading research because it is believed to have implications for reading comprehension, which is of utmost importance in the field of English as a foreign language (EFL), particularly in the teaching, learning and assessment of reading comprehension. Unfortunately, the influence of text readability on reading comprehension (and reading time) has not been well studied in the EFL context. Most text readability studies are conducted in medical contexts, but these studies are often limited in predicting readability scores for sample texts. To address this gap, the current study aimed to evaluate the influence of text readability levels (based on the Flesch-Kincaid grade level (FKGL)) on students’ reading comprehension and reading time. Data were collected through reading test and analyzed using SPSS version 22. The Friedman test revealed that the distribution of students' reading comprehension score (X2=197.532, p=0.000) and reading time (X2=215.323, p=0.000) are different in each text, suggesting that the readability of texts has a significant influence on both. This study contributed to the practices of reading instruction and assessment. Limitations and suggestions for further research are briefly discussed.

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Most patient education materials on shoulder conditions from the American Academy of Orthopaedic Surgeons exceed recommended readability levels

Cited by 9 publications

References 17 publications

Analysis of the Most Popular Online Ankle Fracture–Related Patient Education Materials

Analysis of the Most Popular Online Ankle Fracture–Related Patient Education Materials

A standardised method for improving the readability of patient education materials for total hip & knee arthroplasty patients

Text readability: its impact on reading comprehension and reading time

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