CORR Insights®: Are Patient-reported Outcome Measures in Orthopaedics Easily Read by Patients?

Readability of Orthopaedic Patient-reported Outcome Measures: Is There a Fundamental Failure to Communicate?

“…The finding that more than 90% of PROMs and all areas of the PROMIS 1 are written at acceptable reading levels refutes the study by El-Daly et al [38], which led to fears regarding the widespread failure of PROMs. Based on their assessment, only 12% of PROMs had a reading grade level congruent with the average UK literacy level (reported as 11-year-old students or 6th grade), thus questioning the accuracy and reliability of data obtained through PROMs-a sentiment further endorsed in a response by Brown [20]. Inconsistencies between findings in our study and that by El-Daly et al likely center on their use of a single readability score, the Flesch Reading Ease.…”

“…In short, while the Flesch Reading Ease is a commonly used score, its aggressive grade level conversions and lack of adaptation to modern syntax may make it a poor choice on which to base sweeping PROM readability conclusions, and calls for reform. The potential alarm initiated by El-Daly et al [38] and endorsed by Brown [20] appears to be overenthusiastic and potentially misleading. However, our findings should be met with guarded optimism.…”