Orthodontic treatment consent forms: A readability analysis

Abstract

Objective: To evaluate the readability of orthodontic treatment informed consent forms (ICFs). Design: A cross-sectional observational investigation. Methods: An online search strategy was adopted to identify ICFs for orthodontic treatment. The text of each form that satisfied inclusion criteria was modified to a standardised protocol. The readability was evaluated using three validated instruments. GraphPad Software (GraphPad Software Inc., La Jolla, CA, USA) was used for statistical analyses. Results: A total of 59 ICFs were evaluated. The majority were available on the websites of orthodontists (66.1%) and general dentists (27.1%). The scores recorded from the three instruments indicated that the content of 93.2%–98.3% of ICFs was difficult to read. A strong correlation was observed between the Simple Measure of Gobbledegook (SMOG) and the Flesch Kincaid Grade level (FKGL) instruments (r = 0.9782; P < 0.0001). The mean SMOG score for all assessed forms was 11.19 (95% confidence interval [CI] 10.85−11.54). The ICFs authored by the manufacturers of orthodontic appliances provided by clinicians recorded a mean Flesch Reading (FRE) score of 40.14 (95% CI 33.91−46.37) out of a maximum 100. An analysis of the SMOG scores indicated that the content of ICFs authored by national orthodontic societies was more difficult to read than those written by all other authors ( P=0.01; 95% CI −1.6 to −0.2) Conclusion: The readability of the ICFs was too difficult for a significant number of the population. Many patients will be unable to validly consent to treatment based solely on reading of the content of the evaluated ICFs. A greater effort is required to improve the readability of ICFs to help ensure patient autonomy regarding orthodontic treatment decision-making and management.

Ectopic and impacted maxillary canines: A quality evaluation of online information

“…However, high-quality content is of little value if it cannot be read easily (Meade and Dreyer, 2022). The SMOG tool is considered the ‘gold standard’ for assessing the readability of health information and an accurate determinant of the level for complete understanding of the text (Fitzsimmons et al, 2010).…”

“…Readability pertains to the ease by which an extract of text can be read and understood (Meade and Dreyer, 2022). The average reading age in the UK and many countries with English as a first language is approximately nine years (Moser, 1999; National Centre for Education Statistics, 2006).…”

Alveolar osteitis: A qualitative and readability assessment of patient information on the Internet

“…Corresponding with the search strategy applied in similar investigations, 26,33,37 the three most commonly used search engines in the world (‘Google™’, ‘Bing™’ and ‘Yahoo™’) were used to identify a wide sample of information pertaining to AO 38 . Only 20 websites from each search were assessed which was similar to the number evaluated in two previous quality surveys which assessed dental information 39,40 .…”

“…The readability of the websites was assessed by two validated and reliable tools (Table 1). Both tools have been validated against the McCall Crabbs Standard Test Lessons in Reading 25,26 . The relevant text within the websites was entered into an online readability calculator (http://www.readabilityformulas.com) subsequent to text modification to remove bullet points and additional ‘non‐text’ and typographical errors that may hinder accurate readability analysis 27,28 …”

“…Both tools have been validated against the McCall Crabbs Standard Test Lessons in Reading. 25,26 The relevant text within the websites was entered into an online readability calculator (www.reada bilit yform ulas.com) subsequent to text modification to remove bullet points and additional 'non-text' and typographical errors that may hinder accurate readability analysis. 27,28 The Simple Measure of Gobbledygook (SMOG) formula computes a score that equates to the readability of the average student within a certain United States (U.S.) grade level.…”