Readability of Online Materials Related to Vocal Cord Leukoplakia

Abstract

Objectives To assess readability and understandability of online materials for vocal cord leukoplakia. Study Design Review of online materials. Setting Academic medical center. Methods A Google search of “vocal cord leukoplakia” was performed, and the first 50 websites were considered for analysis. Readability was measured by the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). Understandability and actionability were assessed by 2 independent reviewers with the PEMAT-P (Patient Education Materials Assessment Tool for Printable Materials). Unpaired t tests compared scores between sites aimed at physicians and those at patients, and a Cohen’s kappa was calculated to measure interrater reliability. Results Twenty-two websites (17 patient oriented, 5 physician oriented) met inclusion criteria. For the entire cohort, FRES, FKGL, and SMOG scores (mean ± SD) were 36.90 ± 20.65, 12.96 ± 3.28, and 15.65 ± 3.57, respectively, indicating that materials were difficult to read at a >12th-grade level. PEMAT-P understandability and actionability scores were 73.65% ± 7.05% and 13.63% ± 22.47%. Statistically, patient-oriented sites were more easily read than physician-oriented sites ( P < .02 for each of the FRES, FKGL, and SMOG comparisons); there were no differences in understandability or actionability scores between these categories of sites. Conclusion Online materials for vocal cord leukoplakia are written at a level more advanced than what is recommended for patient education materials. Awareness of the current ways that these online materials are failing our patients may lead to improved education materials in the future.

Readability Analysis and Accessibility of Online Materials About Transgender Voice Care

“…This score is at the lower end of the range of scores for other topics within otolaryngology that report scores between 66% and 74%. [4][5][6] Moreover, the actionability score in this study, 40.55% 6 23.86%, was poor and similar to scores reported in some studies, 35 although several studies in otolaryngology have reported lower actionability scores between 10% and 20%. 5,36 This difference might be due in part to the relatively large patient population SLPs and laryngologists care for, ranging from professional singers, patients with cancer, patients with Parkinson's disease, and TGD patients.…”

“…[4][5][6] Moreover, the actionability score in this study, 40.55% 6 23.86%, was poor and similar to scores reported in some studies, 35 although several studies in otolaryngology have reported lower actionability scores between 10% and 20%. 5,36 This difference might be due in part to the relatively large patient population SLPs and laryngologists care for, ranging from professional singers, patients with cancer, patients with Parkinson's disease, and TGD patients. These myriad indications for voice care, often listed all together on provider websites, require clear organization and actionable items to differentiate types of care, leading to inherently higher actionability scores.…”

“…PEMAT‐P scores similarly reflected poor understandability of the websites focused on TGD voice care, with an average understandability score across analyzed sites of 64.95% ± 15.78%. This score is at the lower end of the range of scores for other topics within otolaryngology that report scores between 66% and 74% 4‐6 . Moreover, the actionability score in this study, 40.55% ± 23.86%, was poor and similar to scores reported in some studies, 35 although several studies in otolaryngology have reported lower actionability scores between 10% and 20% 5,36 .…”

“…The American Medical Association (AMA) and the National Institutes of Health (NIH) recommend that patient education resources be written at a sixth-grade level to maximize patient comprehension. 1 Consequently, several publications in diverse medical specialties ranging from rheumatology, 2 plastic surgery, 3 and otolaryngology 4-6 have evaluated the readability and quality of online education website materials.…”

Are Mobile Applications in Laryngology Designed for All Patients?

“…Even when health apps contain evidence‐based and comprehensive health information, they remain ineffective when they do not provide accessible and inclusive content. The medical informatics literature has an increasing number of publications on the importance of making digital material accessible and usable by diverse users 15,16,29–37 . Inclusivity considerations also include image representation of diverse populations, content availability in languages other than English, and accommodations for those with disabilities, such as hearing or voice impairments.…”