Readability formulas: Cautions and criteria

Readability of Patient Education Materials Available at the Point of Care

“…The most readable PEMs were consistently readable at a 5 th -7 th grade level in each database. EBSCO's least readable Underestimates actual grade reading level 34 Health Literacy Advisor, 34 Meade et al 33 …”

“…33 They use mathematical formulas to assign passages of text a grade reading level based on word and sentence length (Table 1). Word length is a proxy for semantic or meaning difficulty, and sentence length is a measure of syntactic complexity.…”

“…Cannot measure readability of text in boxes or tables Health Literacy Advisor, 34 Meade et al 33 SMOG SMOG = 1.043 * SQRT(30 X Polysyllables/Sentences) + 3.1291…”

“…Does not discriminate well below a 6 th grade level 35 Health Literacy Advisor, 34 Meade et al, 33 National Cancer Institute, Center for Medicare and Medicaid Services 35 PEMs were readable at 11 th -13 th grade levels, while MedlinePlus' were readable at 14 th -17 th grade levels and Micromedex's were readable at an 11 th grade level. For each database, the percentage of PEMs above target readability, median grade reading levels, and ranges are shown in Table 2.…”

Assessing Readability of Patient Education Materials: Current Role in Orthopaedics

“…However, this failure may be related to overestimation of the patient's health literacy, resulting in inadequate education programs and thus warranting more customized solutions [38]. Another drawback of most readability formulas is that they are solely based on the length and structure of a sentence and ignore factors that influence comprehension such as illustrations, layout, and, most importantly, motivation of the reader [22,34,37]. Similar concerns have been raised against tools used to measure literacy skills and reading skills of patients.…”