Readability of online sources of information regarding epilepsy surgery and its impact on decision-making processes

O'Callaghan, Caitlin; Rogan, P. G.; Brigo, Francesco; Rahilly, Joan; Kinney, Michael

doi:10.1016/j.yebeh.2021.108033

Cited by 2 publications

(6 citation statements)

References 13 publications

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“…Our study revealed that online health information about epilepsy surgery has overall poor readability, with the median readability level higher than that of a high school senior and several grade levels above the US and UK averages. This was consistent with the previous readability study performed in the UK 5 . The purpose of online health information is to increase health literacy for the general public and people living with specific conditions, and in their current state, epilepsy surgery‐related materials are not meeting this goal.…”

Section: Discussionsupporting

confidence: 90%

“…However, data from other sources, such as Medicaid enrollees, suggests that the mean reading level in some important health consumers is at or below the sixth‐grade level 4 . In the United Kingdom (UK), the average adult has a reading age equivalent to that of a 9‐year‐old (estimated at US equivalent 4th‐grade level) 5 …”

Section: Introductionmentioning

confidence: 99%

“…A prior UK study analyzed the readability of websites pertaining to epilepsy surgery and showed reading levels well above the adult average reading aptitude 5 . However, their study did not evaluate how website characteristics and origins affected the readability.…”

Section: Introductionmentioning

confidence: 99%

“…4 In the United Kingdom (UK), the average adult has a reading age equivalent to that of a 9-yearold (estimated at US equivalent 4th-grade level). 5 The US Department of Health and Human Services and the American Medical Association recommend a reading level below a sixth-grade level for health information. 6 Similarly, Health Education England suggestions are differentiated by the complexity of content, with simple health information recommended at a 9-year-old level while complex health information materials should be understood by at least an 11-year-old (estimated at US equivalent 6th-grade level).…”

Section: Introductionmentioning

confidence: 99%

“…A prior UK study analyzed the readability of websites pertaining to epilepsy surgery and showed reading levels well above the adult average reading aptitude. 5 However, their study did not evaluate how website characteristics and origins affected the readability. The paper briefly discussed the inclusion of important content and suggested content analysis as important in future studies.…”

Section: Introductionmentioning

confidence: 99%

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Readability and content gaps in online epilepsy surgery materials as potential health literacy and shared‐decision‐making barriers

Seneviratne,

Ho,

Boro

et al. 2023

Epilepsia Open

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ObjectiveEpilepsy surgery is an effective albeit underused treatment for refractory epilepsy, and online materials are vital to patient understanding of the complex process. Our goal is to analyze readability and content inclusion of online patient health education materials designed for epilepsy surgery.MethodsA private browser setting was used on Google and Bing to identify the top 100 search results for the terms “epilepsy+surgery”. Scientific papers, insurance pages, pay‐wall access sites, and non‐text content were excluded. The website text was re‐formatted to exclude graphics, contact information, links, and headers. Readability metrics were calculated using an online tool. Text content was analyzed for inclusion of important concepts (pre‐surgical evaluation, complications, risks of continued seizures, types of surgery, complimentary diagrams/audiovisual material). Comparison of readability and content inclusion were performed as a function of organization types (epilepsy center, community health organization, pediatric‐specific) and location (region, country).ResultsBrowser search yielded 82 distinct websites with information regarding epilepsy surgery, with 98.7% of websites exceeding the recommended 6th‐grade reading level for health information. Epilepsy centers had significantly worse readability (Flesch‐Kincaid Grade Level (FKGL) p<0.01 and Flesch Reading Ease (FRE) p<0.05). Content analysis showed that only 37% of websites discuss surgical side effects and only 23% mention the risks of continued seizures. Epilepsy centers were less likely to report information on surgical side effects (p<0.001). UK‐based websites had better readability (FKGL p<0.01 and FRE p<0.01) and were more likely to discuss side effects (p=0.01) compared to US‐based websites.SignificanceThe majority of online health content is overly complex and relatively incomplete in multiple key areas important to health literacy and understanding of surgical candidacy. Our findings suggest academic organizations, including level 4 epilepsy centers, need to simplify and broaden online education resources. More comprehensive, publicly accessible, and readable information may lead to better shared decision‐making.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Readability and content gaps in online epilepsy surgery materials as potential health literacy and shared‐decision‐making barriers

Seneviratne,

Ho,

Boro

et al. 2023

Epilepsia Open

View full text Add to dashboard Cite

show abstract

Large language models and bariatric surgery patient education: a comparative readability analysis of GPT-3.5, GPT-4, Bard, and online institutional resources

Srinivasan,

Samaan,

Rajeev

et al. 2024

Surg Endosc

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Background The readability of online bariatric surgery patient education materials (PEMs) often surpasses the recommended 6th grade level. Large language models (LLMs), like ChatGPT and Bard, have the potential to revolutionize PEM delivery. We aimed to evaluate the readability of PEMs produced by U.S. medical institutions compared to LLMs, as well as the ability of LLMs to simplify their responses. Methods Responses to frequently asked questions (FAQs) related to bariatric surgery were gathered from top-ranked health institutions. FAQ responses were also generated from GPT-3.5, GPT-4, and Bard. LLMs were then prompted to improve the readability of their initial responses. The readability of institutional responses, initial LLM responses, and simplified LLM responses were graded using validated readability formulas. Accuracy and comprehensiveness of initial and simplified LLM responses were also compared. Results Responses to 66 FAQs were included. All institutional and initial LLM responses had poor readability, with average reading levels ranging from 9th grade to college graduate. Simplified responses from LLMs had significantly improved readability, with reading levels ranging from 6th grade to college freshman. When comparing simplified LLM responses, GPT-4 responses demonstrated the highest readability, with reading levels ranging from 6th to 9th grade. Accuracy was similar between initial and simplified responses from all LLMs. Comprehensiveness was similar between initial and simplified responses from GPT-3.5 and GPT-4. However, 34.8% of Bard's simplified responses were graded as less comprehensive compared to initial. Conclusion Our study highlights the efficacy of LLMs in enhancing the readability of bariatric surgery PEMs. GPT-4 outperformed other models, generating simplified PEMs from 6th to 9th grade reading levels. Unlike GPT-3.5 and GPT-4, Bard’s simplified responses were graded as less comprehensive. We advocate for future studies examining the potential role of LLMs as dynamic and personalized sources of PEMs for diverse patient populations of all literacy levels.

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Readability of online sources of information regarding epilepsy surgery and its impact on decision-making processes

Cited by 2 publications

References 13 publications

Readability and content gaps in online epilepsy surgery materials as potential health literacy and shared‐decision‐making barriers

Readability and content gaps in online epilepsy surgery materials as potential health literacy and shared‐decision‐making barriers

Large language models and bariatric surgery patient education: a comparative readability analysis of GPT-3.5, GPT-4, Bard, and online institutional resources

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