Readability of Arthroscopy-Related Patient Education Materials From the American Academy of Orthopaedic Surgeons and Arthroscopy Association of North America Web Sites

Yi, Paul H.; Ganta, Abhishek; Hussein, Khalil I.; Frank, Rachel M.; Jawa, Andrew

doi:10.1016/j.arthro.2013.03.003

Cited by 44 publications

(28 citation statements)

References 32 publications

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“…Readability analysis was performed using well‐validated scales that have been commonly used to evaluate healthcare‐related materials . Readability scores were measured using the following tests: Flesch Reading Ease Formula, Flesch–Kincaid Grade Level, Fog Scale, SMOG Index, Coleman–Liau Index, Automated Readability Index, Linsear Write Formula, including the composite Text Readability Consensus Calculator ( Table ).…”

Section: Methodsmentioning

confidence: 99%

Readability of Invasive Procedure Consent Forms

Eltorai

Naqvi

Ghanian

et al. 2015

Clinical Translational Sci

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Background: Informed consent is a pillar of ethical medicine which requires patients to fully comprehend relevant issues including the risks, benefits, and alternatives of an intervention. Given the average reading skill of US adults is at the 8th grade level, the American Medical Association (AMA) and the National Institutes of Health (NIH) recommend patient information materials should not exceed a 6th grade reading level. We hypothesized that text provided in invasive procedure consent forms would exceed recommended readability guidelines for medical information. Materials and methods: To test this hypothesis, we gathered procedure consent forms from all surgical inpatient hospitals in the state of Rhode Island. For each consent form, readability analysis was measured with the following measures: Flesch Reading Ease Formula, Flesch-Kincaid Grade Level, Fog Scale, SMOG Index, Coleman-Liau Index, Automated Readability Index, and Linsear Write Formula. These readability scores were used to calculate a composite Text Readability Consensus Grade Level. Results: Invasive procedure consent forms were found to be written at an average of 15th grade level (i.e., third year of college), which is significantly higher than the average US adult reading level of 8th grade (p < 0.0001) and the AMA/NIH recommended readability guidelines for patient materials of 6th grade (p < 0.0001). Conclusion: Invasive procedure consent forms have readability levels which makes comprehension difficult or impossible for many patients. Efforts to improve the readability of procedural consent forms should improve patient understanding regarding their healthcare decisions.

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Section: Methodsmentioning

confidence: 99%

Readability of Invasive Procedure Consent Forms

Eltorai

Naqvi

Ghanian

et al. 2015

Clinical Translational Sci

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“…Our study had several limitations. Although the FKGL scoring system is well validated [2,5,13,17,44,47,54,58,63], it only factors in written text-not illustrated, video, or audio content, which may improve understanding of content. An important additional potential study limitation is the assumption that the reading skills of those reading the AAOS patient education materials are equivalent to the general US adult population.…”

Section: Discussionmentioning

confidence: 99%

“…For each document, the well-validated Flesch-Kincaid Grade Level (FKGL) formula was used to analyze written material readability in terms of academic grade levels [2,5,13,17,44,47,54,58,63]. Although there are various readability assessment tools used in the healthcare setting, the FK formula is the most widely validated method of analyzing readability [2,5,13,17,44,47,54,58,63] The FKGLs of the AAOS articles were compared with the AMA/NIH-recommended readability level (sixth grade) [18,22,36,59,60] as well as the mean US adult reading level (eighth grade) [21,43,51] with data throughout the article being presented as mean ± SD except where otherwise specified and comparisons being performed using unpaired t-tests.…”

Section: Methodsmentioning

confidence: 99%

Most American Academy of Orthopaedic Surgeons’ Online Patient Education Material Exceeds Average Patient Reading Level

Eltorai

Sharma

Wang

et al. 2015

Clinical Orthopaedics &Amp; Related Research

110

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Background Advancing health literacy has the potential to improve patient outcomes. The American Academy of Orthopaedic Surgeons' (AAOS) online patient education materials serve as a tool to improve health literacy for orthopaedic patients; however, it is unknown whether the materials currently meet the National Institutes of Health/ American Medical Association's recommended sixth grade readability guidelines for health information or the mean US adult reading level of eighth grade. Questions/purposes The purposes of this study were (1) to evaluate the mean grade level readability of online AAOS patient education materials; and (2) to determine what proportion of the online materials exceeded recommended (sixth grade) and mean US (eighth grade) reading level.Methods Reading grade levels for 99.6% (260 of 261) of the online patient education entries from the AAOS were analyzed using the Flesch-Kincaid formula built into Microsoft Word software. Results Mean grade level readability of the AAOS patient education materials was 9.2 (SD ± 1.6). Two hundred fifty-one of the 260 articles (97%) had a readability score above the sixth grade level. The readability of the AAOS articles exceeded the sixth grade level by an average of 3.2 grade levels. Of the 260 articles, 210 (81%) had a readability score above the eighth grade level, which is the average reading level of US adults. Conclusions Most of the online patient education materials from the AAOS had readability levels that are far too advanced for many patients to comprehend. Efforts to adjust the readability of online education materials to the needs of the audience may improve the health literacy of orthopaedic patients. Patient education materials can be made more comprehensible through use of simpler terms, shorter sentences, and the addition of pictures. More broadly, all health websites, not just those of the AAOS, should aspire to be comprehensible to the typical reader.

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“…only 2% of the articles were written at the or below the 8th grade level" (17). Finally, Yi et al analyzed the patient education material from the American Academy of Orthopaedic Surgeons and Arthroscopy Association of North America Web sites and found only three examples of material written at or below the 8th grade level and only one was at the 6th or lower grade level (18). Indeed, the patient education material on many of the Web sites is strikingly similar to the patient education material found on the AAOS Web site, so it is not surprising that the reading level is so high.…”

Section: Resultsmentioning

confidence: 98%