Readability of Trauma-related Patient Education Materials From the American Academy of Orthopaedic Surgeons and Orthopaedic Trauma Association Websites.

Abstract

Web-based resources serve as a fundamental educational platform for orthopaedic trauma patients; however, they are frequently written above the recommended sixth-grade reading level, and previous studies have demonstrated this for the American Academy of Orthopaedic Surgeons (AAOS) web-based articles. In this study, we perform an updated assessment of the readability of AAOS trauma-related educational articles as compared with injury-matched education materials developed by the Orthopaedic Trauma Association (OTA). All 46 AAOS trauma-related web-based (https://www.orthoinfo.org/) patient education articles were analyzed for readability. Two independent reviewers used (1) the Flesch-Kincaid Grade Level (FKGL) and (2) the Flesch Reading Ease (FRE) algorithms to calculate the readability level. Mean readability scores were compared across body part categories. A one-sample t-test was done to compare mean FKGL with the recommended sixth-grade readability level and the average American adult reading level. A two-sample t-test was used to compare the readability scores of the AAOS trauma-related articles with those of the OTA. The average (SD) FKGL and FRE for the AAOS articles were 8.9 (0.74) and 57.2 (5.8), respectively. All articles were written above the sixth-grade reading level. The average readability of the AAOS articles was significantly greater than the recommended sixth-grade reading level (P < 0.001). The average FKGL and FRE for all AAOS articles were significantly higher compared with those of the OTA articles (8.9 ± 0.74 versus 8.1 ± 1.14, P < 0.001 and 57.2 ± 5.8 versus 65.6 ± 6.6, P < 0.001, respectively). Excellent agreement was observed between raters for the FKGL 0.956 (95% confidence interval, 0.922 to 0.975) and FRE 0.993 (95% confidence interval, 0.987 to 0.996). Our findings suggest that after almost a decade, the readability of the AAOS trauma-related articles remains unchanged. The AAOS and OTA trauma patient education materials have high readability levels and may be too difficult for patient comprehension. A need remains to improve the readability of these commonly used trauma education materials.