Readability assessment of online thyroid surgery patient education materials

Patel, Chirag; Cherla, Deepa V.; Sanghvi, Saurin; Baredes, Soly; Eloy, Jean Anderson

doi:10.1002/hed.23157

Cited by 59 publications

(98 citation statements)

References 21 publications

(74 reference statements)

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“…It is estimated that 34% of adults in the United States have only basic or below basic reading literacy (10) with an inverse relationship between age and reading skill level, even when adjusted for cognitive impairment or years of schooling (11). Furthermore, it has been determined that the average reading age in the United States is between a seventh-and eighth-grade level (12,13).…”

Section: Introductionmentioning

confidence: 99%

“…Information is categorized as being of ''easy'' readability if written at this level, ''average'' if assessed between seventhand ninth-grade readability, and ''difficult'' if above this (Table 1) (2). Previous studies have evaluated the readability of online patient information for a variety of medical conditions, including heart disease, cancer, stroke, chronic obstructive pulmonary disease, diabetes mellitus, thyroid surgery, craniofacial conditions, age-related macular degeneration, orthopedic conditions, dermatological problems, abdominal aortic aneurysm, epilepsy, and Parkinson's disease (Table 2) (2,4,8,9,(12)(13)(14)(15)(16)(17)(18)(19)(20). Each of these studies determined that the readability of most online patient education materials, using a variety of readability scores, is less than that recommended by USDHHS.…”

Section: Introductionmentioning

confidence: 99%

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Patient Information in Graves' Disease and Thyroid-Associated Ophthalmopathy: Readability Assessment of Online Resources

Edmunds

Denniston

Boelaert

et al. 2014

Thyroid

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient Information in Graves' Disease and Thyroid-Associated Ophthalmopathy: Readability Assessment of Online Resources

Edmunds

Denniston

Boelaert

et al. 2014

Thyroid

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“…Zheng and Yu have reported on the readability of electronic health records compared to Wikipedia pages related to diabetes and found that readability measures often do not align with user ratings of readability [22]. A common finding of these studies is that, in general, health content available on Web pages is often hard to understand by the general public; this includes content that is retrieved in topranked positions by current commercial search engines [4,5,6,7,8,9].…”

Section: Related Workmentioning

confidence: 99%

“…These measures generally rely on surface-level characteristics of text, such as characters, syllables and word counts (missing citation). While these measures have been widely used in studies investigating the understandability of health content retrieved by search engines (e.g., [4,5,6,7,8,9,18,21]), our preliminary work found that these measures are heavily affected by the methods used to extract text from the HTML source [13]. We were able to identify specific settings of an HTML preprocessing pipeline that provided consistent estimates, but due to the lack of human assessments, we were not able to investigate how well each HTML preprocessing pipeline correlated with human assessments.…”

Section: Related Workmentioning

confidence: 99%

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Consumer Health Search on the Web: Study of Web Page Understandability and Its Integration in Ranking Algorithms (Preprint)

Palotti¹,

Zuccon²,

Hanbury³

2018

Preprint

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Background: Understandability plays a key role in ensuring that people accessing health information are capable of gaining insights that can assist them with their health concerns and choices. The access to unclear or misleading information has been shown to negatively impact on the health decisions of the general public. Objective:We investigated methods to estimate the understandability of health Web pages and used these to improve the retrieval of information for people seeking health advice on the Web. Methods:Our investigation considered methods to automatically estimate the understandability of health information in Web pages, and it provided a thorough evaluation of these methods using human assessments as well as an analysis of preprocessing factors affecting understandability estimations, and associated pitfalls. Furthermore, lessons learnt for estimating Web page understandability were applied to the construction of retrieval methods with specific attention to retrieving information understandable by the general public. Results:We found that machine learning techniques were more suitable to estimate health Web page understandability than traditional readability formulae, which are often used as guidelines and benchmarking by health information providers on the Web (larger difference found for Pearson correlation of .602 using Gradient Boosting regressor compared to .438 using SMOG Index with CLEF 2015 collection). Learning to rank effectively exploited these estimates to provide the general public with more understandable search results ( H RBP ¿ reached 29.20, 22% higher than a BM25 baseline and 13% higher than the best system at CLEF 2016, both P≤ .001 ).

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Readability Assessment of Online Ophthalmic Patient Information

2013

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IMPORTANCE Patients increasingly use the Internet to access information related to their disease, but poor health literacy is known to impact negatively on medical outcomes. Multiple agencies have recommended that patient-oriented literature be written at a fourth-to sixth-grade (9-12 years of age) reading level to assist understanding. The readability of online patient-oriented materials related to ophthalmic diagnoses is not yet known. OBJECTIVE To assess the readability of online literature specifically for a range of ophthalmic conditions. DESIGN AND SETTING Body text of the top 10 patient-oriented websites for 16 different ophthalmic diagnoses, covering the full range of ophthalmic subspecialties, was analyzed for readability, source (United Kingdom vs non-United Kingdom, not for profit vs commercial), and appropriateness for sight-impaired readers. MAIN OUTCOMES AND MEASURES Four validated readability formulas were used: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index (GFOG). Data were compared with the Mann-Whitney test (for 2 groups) and Kruskal-Wallis test (for more than 2 groups) and correlation was assessed by the Spearman r. RESULTS None of the 160 webpages had readability scores within published guidelines, with 83% assessed as being of "difficult" readability. Not-for-profit webpages were of significantly greater length than commercial webpages (P = .02) and UK-based webpages had slightly superior readability scores compared with those of non-UK webpages (P = .004 to P < .001, depending on the readability formula used). Of all webpages evaluated, only 34% included facility to adjust text size to assist visually impaired readers. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study to assess readability of patient-focused webpages specifically for a range of ophthalmic diagnoses. In keeping with previous studies in other medical conditions, we determined that readability scores were inferior to those recommended, irrespective of the measure used. Although readability is only one aspect of how well a patient-oriented webpage may be comprehended, we recommend the use of readability scoring when producing such resources in the future. Minimum readability policies and inclusion of facilities within webpages to maximize viewing potential for visually impaired readers are important to ensure that online ophthalmic patient information is accessible to the broadest audience possible.

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Readability assessment of online thyroid surgery patient education materials

Abstract: Readability scores for online thyroid surgery materials are higher (i.e., more difficult) than the recommended levels. However, readability is only one aspect of comprehension. Written information should be designed with that fact in mind.

Cited by 59 publications

References 21 publications

Patient Information in Graves' Disease and Thyroid-Associated Ophthalmopathy: Readability Assessment of Online Resources

Patient Information in Graves' Disease and Thyroid-Associated Ophthalmopathy: Readability Assessment of Online Resources

Consumer Health Search on the Web: Study of Web Page Understandability and Its Integration in Ranking Algorithms (Preprint)

Readability Assessment of Online Ophthalmic Patient Information

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