Difficult to read: An analysis of urology publications using readability tools

Abstract

Readers of medical literature are typically highly educated experts, but even here, increases in the non-germane work of reading may impact learning. Prior work on revising text for readability improved experts' comprehension 3 . Moderating readability makes research more accessible.Our results and previous reports indicate variability in readability across urological subspecialties. We identified higher readability in oncology papers. Contrastingly, urologic oncology patient education materials have demonstrated poor readability. 5 Replacing medical with lay terminology lowered reading levels, suggesting utility in considering the audience when writing research papers. Further, readability has a clinical impact. Following prostatectomy, patients given a more readable hospital discharge summary were less likely to contact their provider or visit the emergency department within 30 days of admission. 4 We offer the following recommendations to increase urological literature readability. First, to revise drafts to target Flesch Reading Ease Scores above 30 when writing manuscripts. Second, for editorial boards to consider readability in the editorial process. Inclusion of navigational aids using colour, font size, and graphics to simplify complex messages are design choices that may further improve reading. Attention to non-expert readers from patient, advocacy or commercial areas is increasingly important. For example, European Urology requires a succinct summary of the clinical message, in lay terms, to be provided with each submission. To date, no investigation has evaluated the effect of these interventions on patient engagement with scientific literature.Our study indicates difficult readability across the urological literature; however, our data are limited to the journals and issues analyzed. Further studies on the breadth of urological publications will be informative. Additionally, no investigation has surveyed which resources urology patients use to learn about their own care. This offers a future direction for investigation to optimize patient-targeted care resources. Finally, readability's impact on citation counts, social media footprints, or journalism uptake has yet to be investigated. Additionally, it is not clear at which point precision is sacrificed in the quest for maximally improving readability scores.Readability affects information extraction no matter the level of education. More readable papers afford medical research the usefulness the work intends, and should be a goal for authors and journals.