Improving the Readability of Online Foot and Ankle Patient Education Materials

Sheppard, Evan; Hyde, Zane; Florence, Mason N.; McGwin, Gerald; Kirchner, John S.; Ponce, Brent A.

doi:10.1177/1071100714550650

Cited by 62 publications

(65 citation statements)

References 15 publications

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“…The guidelines advise simple interventions to improve readability including limiting sentences to 10 words, replacing complex medical terminology with the definition, and limiting the use of medical jargon 37 . Previous literature has demonstrated that the application of these interventions can both improve readability and patient knowledge without sacrificing medical content 38 . For example, POPDI‐6 uses the phrase “lower abdominal pressure”; this is a vague term that can be communicated more clearly by providing a medical analogy or simplifying terminology.…”

Section: Discussionmentioning

confidence: 99%

Readability of pelvic floor dysfunction questionnaires

Gaines

Malik

2020

Neurourology and Urodynamics

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Background: The National Institutes of Health and Center for Disease Control recommend the readability of self-administered patient questionnaires to be written at or below a sixth to eight grade reading level. The aim of this study is to evaluate the readability of commonly used urinary incontinence (UI), pelvic organ prolapse (POP), overactive bladder (OAB), and benign prostate hyperplasia (BPH) questionnaires.Methods: Eighteen validated urologic questionnaires were analyzed using four readability assessment tools. A mean grade-level needed to comprehend each questionnaire was calculated.Results: For UI questionnaires, three out of five questionnaires required a reading level of 10th grade or higher, two grade levels above recommendations.Only one POP questionnaire met recommendations with a mean readability score of 5.9, whereas the other questionnaires required a ninth-grade reading level or higher. For the OAB questionnaires, three out of five questionnaires met reading recommendations. Readability scores for BPH questionnaires ranged from 6.4 to 11.2, with only the International Prostate Symptom Score questionnaire in compliance with recommendations. Conclusions: The majority of currently available pelvic floor dysfunction questionnaires do not comply with recommended reading levels, suggesting that these questionnaires are written at a level too advanced for a large proportion of the population. This limits their effectiveness in accurately assessing symptom severity and impact on quality of life. K E Y W O R D Soveractive bladder, pelvic floor dysfunction, pelvic organ prolapse, questionnaires, readability, urinary incontinence

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Section: Discussionmentioning

confidence: 99%

Readability of pelvic floor dysfunction questionnaires

Gaines

Malik

2020

Neurourology and Urodynamics

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“…It has been shown that despite complex medical content, the readability of PEMs can be significantly improved by using simpler sentences and shorter words. Dalziel et al [12] reported on an average grade level improvement of 3.1 in PEM comprehension by simple substitution of multisyllabic words, with a further reduction by simplification of sentence structure [25,26]. These simple measures are easily applicable to German PEMs and might help to improve their readability significantly.…”

Section: Discussionmentioning

confidence: 99%

Readability Assessment of Patient Education Material Published by German-Speaking Associations of Urology

Betschart

Zumstein²,

Ali³

et al. 2017

Urol Int

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Objective: To assess the readability and comprehensibility of web-based German-language patient education material (PEM) issued by urological associations. Materials and Methods: German PEM available in June 2017 was obtained from the European Association of Urology (EAU), German (DGU), Swiss (SGU) and Austrian (ÖGU) Association of Urology websites. Each educational text was analyzed separately using 4 well-established readability assessment tools: the Amstad Test (AT), G-SMOG (SMOG), Wiener Sachtextformel (WS) and the Lesbarkeitsindex (LIX). Results: The EAU has issued PEM on 8 topics, the DGU 22 and the SGU 5. The ÖGU refers to the PEMs published by the DGU. Calculation of grade levels (SMOG, WS, LIX) showed readability scores of the 7th-14th grades. The easiest readability was found for materials on Nocturia and Urinary Incontinence issued by the EAU. Kidney Cancer and Infertility, issued by the DGU had the hardest readability. The EAU achieved the best median AT score, followed by the SGU, and the DGU. Conclusion: Remarkable differences between readability were found for the PEMs issued by EAU, DGU and SGU. Materials published by the EAU were the easiest to read. Improving the readability of certain PEMs is of crucial importance to meet patient needs and act in the interests of a growing, self-informing German-speaking patient community.

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“…We hypothesize that additional reductions in grade level readability would be possible by further alterations to sentence structure and this is supported by the existing literature. 15,16 Horner et al developed a framework for revision of PIMs based on targeting specific obstructions to comprehension. 15 Their framework provided a four-step process to improve upon existing PIMs.…”

Section: Readability Of Patient Information Materialsmentioning

confidence: 99%

An analysis of the readability of patient information materials for common urological conditions

Dalziel¹,

Leveridge²,

Steele³

et al. 2016

CUAJ

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Introduction: Health literacy has been shown to be an important determinant of outcomes in numerous disease states. In an effort to improve health literacy, the Canadian Urological Association (CUA) publishes freely accessible patient information materials (PIMs) on common urological conditions. We sought to evaluate the readability of the CUA's PIMs. Methods: All PIMs were accessed through the CUA website. The Flesch Reading Ease Score (FRES), the Flesch-Kincaid Grade Level (FKGL), and the number of educational graphics were determined for each PIM. Low FRES scores and high FKGL scores are associated with more difficult-to-read text. Average readability values were calculated for each PIM category based on the CUA-defined subject categorizes. The five pamphlets with the highest FKGL scores were revised using word substitutions for complex multisyllabic words and reanalyzed. The Kruskal-Wallis test was used to identify readability differences between PIM categories and paired t-tests were used to test differences between FKGL scores before and after revisions. Results: Across all PIMs, FRES values were low (mean 47.5, standard deviation [SD] 7.47). This corresponded to an average FKGL of 10.5 (range 8.1-12.0). Among PIM categories, the infertility and sexual function PIMs exhibited the highest average FKGL (mean 11.6), however, differences in scores between categories were not statistically significant (p=0.38). The average number of words per sentence was also highest in the infertility and sexual function PIMs and significantly higher than other categories (mean 17.2; p=0.01). On average, there were 1.4 graphics displayed per PIM (range 0-4), which did not vary significantly by disease state (p=0.928). Simple words substitutions improved the readability of the five most difficult-to-read PIMs by an average of 3.1 grade points (p<0.01). Conclusions: Current patient information materials published by the CUA compare favourably to those produced by other organizations, but may be difficult to read for low-literacy patients. Readability levels must be balanced against the required informational needs of patients, which may be intrinsically complex.

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Improving the Readability of Online Foot and Ankle Patient Education Materials

Cited by 62 publications

References 15 publications

Readability of pelvic floor dysfunction questionnaires

Readability of pelvic floor dysfunction questionnaires

Readability Assessment of Patient Education Material Published by German-Speaking Associations of Urology

An analysis of the readability of patient information materials for common urological conditions

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