Readability of Persian Oxford Elbow Score Using Health Literacy Questionnaire

Abstract

Objectives Readability and understanding of the questions by patients are determining factors in choosing a patient-rated outcome measure. This can be done using Flesh Reading Ease Score (FRES) in English. In place of this software in other languages, we aimed to assess the readability of the Persian-Oxford elbow score (OES) using the validated health literacy questionnaire. Over 110 million speakers widely speak this language from more than six Middle Eastern countries. Methods We enrolled 60 patients with elbow and 60 with non-elbow conditions as the control group. Patients rated each of the 12 items of the EOS on a 3-point Likert scale as very little, moderate, and very good in response to “How understandable was the question to you?”. The rating was compared with the health literacy score, which was categorized as insufficient, not enough, sufficient, and excellent health literacy. Results Testing readability of individual items of the OES showed that the median readability of each item was 3 out of 3 (very good) for all 12 items. There was no significant difference between an elbow and non-elbow involvement (P=0.17), which was suggestive of very good readability of the EOS by the general population, even if the patients have not experienced the symptoms. Moreover, there was no significant difference among different levels of health literacy which is suggestive of very good readability of OES even when the health literacy was insufficient. Conclusion OES readability is very good and high enough to be understandable by different levels of health literacy, education levels, and different age groups. Persian-EOS can be used confidently for initial and follow-up assessments of elbow conditions.