Dale-Chall Readability Formula Research Articles

ChatGPT: is it good for our glaucoma patients?

Our study investigates ChatGPT and its ability to communicate with glaucoma patients. We inputted eight glaucoma-related questions/topics found on the American Academy of Ophthalmology (AAO)'s website into ChatGPT. We used the Flesch-Kincaid test, Gunning Fog Index, SMOG Index, and Dale-Chall readability formula to evaluate the comprehensibility of its responses for patients. ChatGPT's answers were compared with those found on the AAO's website. ChatGPT's responses required reading comprehension of a higher grade level (average = grade 12.5 ± 1.6) than that of the text on the AAO's website (average = 9.4 grade ± 3.5), (0.0384). For the eight responses, the key ophthalmic terms appeared 34 out of 86 times in the ChatGPT responses vs. 86 out of 86 times in the text on the AAO's website. The term "eye doctor" appeared once in the ChatGPT text, but the formal term "ophthalmologist" did not appear. The term "ophthalmologist" appears 26 times on the AAO's website. The word counts of the answers produced by ChatGPT and those on the AAO's website were similar (p = 0.571), with phrases of a homogenous length. ChatGPT trains on the texts, phrases, and algorithms inputted by software engineers. As ophthalmologists, through our websites and journals, we should consider encoding the phrase "see an ophthalmologist". Our medical assistants should sit with patients during their appointments to ensure that the text is accurate and that they fully comprehend its meaning. ChatGPT is effective for providing general information such as definitions or potential treatment options for glaucoma. However, ChatGPT has a tendency toward repetitive answers and, due to their elevated readability scores, these could be too difficult for a patient to read.

SAT119 Artificial Intelligence Mediated Assistants: Will They Educate The Public About Health Disparities In Diabetes?

Abstract Disclosure: W. Zhao: None. G. Wu: None. E. Cheng: None. J. Lee: None. A. Wong: None. Background: In 2022, 37 million US adults had diabetes and 96 million had pre-diabetes. Diabetes and prediabetes affect 49.3% population in America. In the diabetic population, 12.1% are non-Hispanic blacks, 11.8% of Hispanics, and 9.5% of Asian Americans. 54% of Americans read at or below the sixth-grade level. ChatGPTTM, launched 11/30/22, has the newest Artificial Intelligence (AI) software versus Google AssistantTM, launched 05/2016. Purpose: Can ChatGPT use its natural language software to educate the lay public about diabetes and health disparities? Methods: Evaluate the readability of responses after five questions were posed to ChatGPTTM and Google AssistantTMQuestions: 1. Do African Americans have a higher risk of complications with Type 2 Diabetes? 2. Do Hispanic Americans have a higher risk of complications with Type 2 diabetes? 3. Do Asian Americans have a higher risk of complications with Type 2 diabetes? 4. Do women get Type 2 diabetes more than men? 5. What is pre-diabetes vs diabetes? Word count and Dale-Chall score assessed the readability level of both ChatGPT and Google Assistant responses. The Dale-Chall readability formula is calculated based on the percentage of difficult words and average sentence length in words. The U.S. Department of Education used the Dale-Chall formula to adjust the text to grade-level readability. Result: Word count: CHAT:Q1=104; Q2=135; Q3=136; Q4=133; Q5=232 vs GOOGLE: Q1=38, Q2=49, Q3=16; Q4=50; Q5=42. CHAT Word Count Avg=148, SD=48.81; GOOGLE Word Count Avg=39, SD=13.7; P-value=0.003908 Dale-Chall: CHAT: Q1=8.4; Q2=8.6; Q3=9.8, Q4=8.6, Q5=8.7 vs. GOOGLE: Q1=6.7, Q2=9, Q3=9.4, Q4=6.3, Q5=9.1. CHAT Dale-Chall Score Avg=8.82, SD=0.56; GOOGLE Dale-Chall Score Avg=8.1, SD=1.47; P-value=0.1306. ChatGPT has nearly the same grade level of comprehension as Google Assistant, including statistics about health disparities. However, ChatGPT was trained using information and transforming it into paragraphs, and google assistant extracts the data from websites and the variability is higher with a higher standard deviation than ChatGPT. Conclusion: ChatGPT with its artificial intelligence software is able to provide answers to our patients. While the answers may require a high school reading level and beyond, this is an excellent beginning for health education. Presentation: Saturday, June 17, 2023

Quality Assessment of Online Resources for Thoracic Outlet Syndrome Patients

The internet has become a leading resource for patients, to research information about their medical conditions. Access to inaccurate information can lead to miscommunication, poor patient satisfaction and effect shared decision-making with the provider. This study seeks to evaluate the quality and readability of patient resources that appear in the top search results for Thoracic Outlet Syndrome (TOS). Searches were performed for "TOS" and "Thoracic Outlet Syndrome" on the search engines Google ©, Yahoo ©, and Bing©, and on the meta-search platforms Yippy© and Dogpile©. Websites were screened for exclusion and evaluated by 2 reviewers for accountability, interactivity, structure/organization, and content. Exclusion criteria included duplications, no original content on TOS, resources not intended for patients, foreign language, and inaccessible websites. Reviewers came to a consensus on scoring discrepancies. Four indices were used to evaluate readability. Statistical analysis was performed using the Rstudio with ANOVA. In total, 44 websites met inclusion criteria. There were 25 hospital/healthcare organization websites (57%), 11 open access (25%), 5 government agency (11%), 2 professional medical society (5%), and 1 industry sponsored (2%). Median scores were 5.00 out of 16.00 for Accountability (interquartile range IQR: 1.50-8.75), 1.50 out of 5.00 for Interactivity (IQR:1.50-1.50), 3.00 out of 4.00 for Structure/Organization (IQR: 2.00-3.13), 10.00 out of 25.00 for Content (IQR: 7.90-12.63) and 20.25 out of 50.00 for Total Score (IQR: 16.73-27.75). Websites performed well-describing TOS with 98% of websites providing a definition, 90% providing an etiology, 93% providing description or images of the anatomy, 98% providing symptoms of neurogenic TOS, 93% providing symptoms of venous TOS, and 93% providing symptoms of arterial TOS. Physical therapy was the most discussed treatment option (91%) followed by decompression surgery (86%), thrombolysis (41%), vascular repair (39%), interscalene injections (18%), and embolectomy (11%). There was no significant difference across website types for any category other than accountability where Open Access scored the highest (Table II). Readability was difficult with median Flesch Reading Ease formula score correlating to a college level (IQR: 10th-12th grade-college), median Flesch-Kincaid Grade Level of 10 (IQR: 9th-12th grade), median Standardized Measure of Gobbledygook (SMOG) grade of 10 (IQR: 9th-11th grade), and median Dale-Chall Readability Formula Score correlating to 11th-12th grade (IQR: 11th to 12th-college grade level). There was no significant difference between website types for readability. The top web results for TOS have varying degrees of quality with a clear gap in certain areas of information. While websites performed well-explaining the disease, they lacked discussion of the full scope of treatment that may be offered. In addition, readability was poor across all website types which will not help patients' understanding of their condition. Providers should take into account the variability in websites when entering into shared decision-making discussions with patients.

Critical analysis of the quality of internet resources for patients with varicose veins

ObjectivePatients increasingly seek information on their medical conditions from the internet. The present study evaluated the quality and readability of readily available online patient resources for varicose veins. MethodsAn internet search for “varicose veins” was conducted using the meta-search engines Yippy and Dogpile and the general search engines Google, Yahoo, and Bing with a cleared-cache web browser in July 2019. Two trained raters scored the websites separately on the dimensions of accessibility, accountability, interactivity, structure, and content. Any discrepancies were discussed, and a consensus was reached. Readability was calculated using four readability metric systems. Rater consistency was evaluated using kappa, weighted kappa, and interrater correlation coefficient, as indicated. ResultsA total of 189 websites met the inclusion criteria. The total median quality score was 15.6 (interquartile range [IQR], 13.1-20.5; range, 7.4-31.3) of 38. The websites scored a median of 4 (IQR, 1-8) of 15 for accountability, 2 (IQR, 2-2) of 5 for interactivity, 4 (IQR, 2-4) of 4 for organization, and 6.4 (IQR, 3.9-7.9) of 14 for weighted content. Most websites (81.5%) were accessible. However, the overall readability was poor. The median Flesch-Kincaid reading ease score was 55.1 (IQR, 49.4-6.7), indicating that the text was fairly difficult to read. The median grade level was 10th grade using both the Flesch-Kincaid grade level and simple measure of the Gobbledygook index and 11th to 12th grade using the new Dale-Chall readability formula. Government websites were the most accountable, featured the best content, and were the most readable. The website traffic had a positive, nonlinear correlation with the total score and a negative, nonlinear correlation with the website rank (or position on the search result page). Website rank correlated negatively with the total score, although the correlation was weak. ConclusionsThe quality of the online patient resources on varicose veins varies greatly, and the readability for most sites is poor. Government-sponsored websites had the highest quality and were the most readable. Physicians are advised to consider providing a list of appropriate websites to their patients to better inform them, avoid confusion, and ensure appropriate delivery of accurate and readable information.

Assessment of the Readability of Online Patient Education Material from Major Geriatric Associations.

An increasing number of patients are using the internet to supplement information provided by medical professionals. Online geriatric patient education materials (PEMs) should be written at or below a 6th grade reading level (GRL) that takes into account barriers unique to the geriatric population. The objectives of the study are to assess PEMs of geriatric associations' websites and determine whether they are above the GRL recommended by the Centers for Disease Control and National Institutes of Health. Descriptive and correlational methodology. PEMs from 10 major geriatric associations were assessed for their GRL using 10 scales. Eight of the scales provide a numerical GRL while two of the scales provide a visual representation of the GRLs. Analysis was conducted using Readability Studio 2019.3. Analysis was conducted February 2020. Identified 10 geriatric associations and 884 PEMs. GRLs were measured by 10 validated readability indices: the Degrees of Reading Power and Grade Equivalent test, Flesch-Kincaid grade level, Simple Measure of Gobbledygook test, Coleman-Liau Index, Gunning Fog Index, New Fog Count, New Dale-Chall readability formula, Ford, Caylor, Sticht scale, Raygor readability estimate graph, and Fry readability graph. The mean of all PEMs using the numerical scales was 11.1 ± 2.4. Ninety-nine percent of PEMs are above the 6th GRL. PEMs ranged from a grade 3.0 to 19.0 reading level. Analysis of variance demonstrated a significant difference between associations (P < .0001), and multiple comparison analysis identified the National Institute on Aging as the content easiest to read (9.5 ± 1.6). PEMs from geriatric association websites are written above the recommended 6th GRL. As patients increasingly look toward online supplementary health information during COVID-19, there is an opportunity for improving PEMs to enable greater comprehension by the target population.

Work effort, readability and quality of pharmacy transcription of patient directions from electronic prescriptions: a retrospective observational cohort analysis

BackgroundFree-text directions generated by prescribers in electronic prescriptions can be difficult for patients to understand due to their variability, complexity and ambiguity. Pharmacy staff are responsible for transcribing these directions...

Assessing readability and comprehension of informed consent materials for medical device research: A survey of informed consents from FDA's Center for Devices and Radiological Health

Legally effective informed consent has been a long-standing requirement for FDA-regulated clinical studies. However, informed consent forms (ICFs) are often thought to be too long, too complex, and too difficult for participants to understand. In this article, investigators from the FDAs Center for Devices and Radiological Health (CDRH) surveyed 399 ICFs from approved investigational device exemption (IDE) applications for fiscal years 2015 and 2016 to evaluate the readability of ICFs.The investigators collected data from the ICFs, using variables related to structure, readability, and comprehension.The investigators found that the mean grade-reading levels of the ICFs ranged from 10th grade to college level (Table 2), higher than the recommended 6th to 8th grade level, when measured by major readability evaluation tools (the SMOG readability grade level formula, the Flesch-Kincaid Index Grade Level Readability Formula, the Flesch Reading Ease test, and the Dale-Chall readability formula).Overall, the ICFs and informed consent (IC) processes, as described in the IDE application, lacked components that enhanced participants' comprehension, such as short sentences (e.g., no more than 8 to 10 to words) and the use of pictures, tables, and diagrams.CDRH investigators believe that information about ICFs' readability, comprehension, and structure will help support current and future efforts to improve the IC process. The intent of the article is to demonstrate that improvements are needed in the IC process and to encourage clinical trial stakeholders to consider implementing those approaches that optimize patient comprehension in the development of their IC processes.

Poor Readability of AOSSM Patient Education Resources and Opportunities for Improvement.

Background:Appropriate education on the disease processes associated with orthopaedic pathology can affect patient expectations and functional outcome.Hypothesis:Patient education resources from the American Orthopaedic Society for Sports Medicine (AOSSM) are too complex for comprehension by the average orthopaedic patient.Study Design:Cross-sectional study.Methods:Patient education resources provided by the AOSSM were analyzed with software that provided 10 readability scores as well as opportunities for improving readability. The readability scores were compared with the recommended eighth-grade reading level.Results:A total of 39 patient education resources were identified and evaluated. The mean ± SD reading grade-level scores were as follows: Coleman-Liau Index, 12.5 ± 1.11; New Dale-Chall Readability Formula, 10.9 ± 1.37; Flesch-Kincaid Grade Level, 9.9 ± 1.06; FORCAST Readability Formula, 11.4 ± 0.51; Fry Readability Formula, 12.8 ± 2.79; Gunning Fog Index, 11.9 ± 1.37; Raygor Readability Index, 13.1 ± 2.37; Simple Measure of Gobbledygook, 12.3 ± 0.90; Automated Readability Index, 11.2 ± 1.18; and New Automated Readability Index, 10.6 ± 1.27. After averaging the reading grade-level scores, only 1 patient education resource was found to be written at an 8th- to 9th-grade level, and 14 (36%) were written above a 12th-grade level. All scores were significantly different from the eighth-grade level (P < .0065). The percentage of complex words and long words were 19.6% ± 2.67% and 41.4% ± 3.18%, respectively.Conclusion:Patient education resources provided by the AOSSM are at a significantly higher reading level than recommended. Simple changes can drastically improve these scores to increase health literacy and possibly outcome.

How Readable Is BPH Treatment Information on the Internet? Assessing Barriers to Literacy in Prostate Health.

Information about benign prostatic hyperplasia (BPH) has become increasingly accessible on the Internet. Though the ability to find such material is encouraging, its readability and impact on informing patient decision making are not known. To evaluate the readability of Internet-based information about BPH in the context of website ownership and Health on the Net certification, three search engines were queried daily for 1 month with BPH-related keywords. Website ownership data and Health on the Net certification status were verified. Three readability analyses were performed: SMOG test, Dale–Chall readability formula, and Fry readability graph. An adjusted SMOG calculation was performed to reduce overestimation from medical jargon. After a total of 270 searches, 52 websites met inclusion criteria. Mean SMOG grade was 10.6 (SD = 1.4) and 10.2 after adjustment. Mean Dale–Chall score was 9.1 (SD = 0.6), or Grades 13 to 15. Mean Fry graph coordinates (173 syllables, 5.1 sentences) corresponded to Grade 15. Seven sites (13%) were at or below the average adult reading level based on SMOG; none of the sites qualified based on the other tests. Readability was significantly poorer for academic versus commercial sites and for Health on the Net-certified versus noncertified sites. In conclusion, online information about BPH treatment markedly exceeds the reading comprehension of most U.S. adults. Websites maintained by academic institutions and certified by the Health on the Net standard have more difficult readability. Efforts to improve literacy with respect to urological health should target content readability independent of reliability.

Readability analysis of online health information about overactive bladder.

Despite the prevalence of overactive bladder (OAB) and the widespread accessibility of patient education information on the Internet, the readability of this information and its potential impact on patient decision-making are not known. This study evaluates the readability of OAB material online in the context of website ownership and the Health on the Net standard for information reliability. Three Internet search platforms were queried daily with OAB-related keywords for 30 days. Readability analysis was performed using the SMOG test, Dale-Chall readability formula, and Fry readability graph. Websites were stratified by ownership type and Health on the Net certification to compare readability metrics. After 270 total searches, 57 websites were analyzed. Mean SMOG reading grade was 10.7 (SD = 1.6) and 10.1 in an adjusted calculation to reduce overestimation from medical jargon. Mean Dale-Chall score was 9.2 (SD = 0.9), or grade 13-15. Mean Fry graph coordinates (177 syllables, 5.9 sentences) corresponded to grade 15. Only seven sites (12%) were predicted to be readable by the average adult with an eighth-grade reading level. Mean reading grades were not significantly different between academic versus commercial sites and Health on the Net-certified versus non-certified sites. A large majority of online information about OAB treatment exceeds the reading ability of most adults. Neither websites sponsored by academic institutions nor those certified by the Health on the Net standard have easier readability. The readability of health information online may be distinct from reliability in the context of urological literacy.

Readability of Online Patient Educational Resources Found on NCI-Designated Cancer Center Web Sites.

The NIH and Department of Health & Human Services recommend online patient information (OPI) be written at a sixth grade level. We used a panel of readability analyses to assess OPI from NCI-Designated Cancer Center (NCIDCC) Web sites. Cancer.gov was used to identify 68 NCIDCC Web sites from which we collected both general OPI and OPI specific to breast, prostate, lung, and colon cancers. This text was analyzed by 10 commonly used readability tests: the New Dale-Chall Readability Formula, Flesch Reading Ease scale, Flesch-Kinaid Grade Level, FORCAST scale, Fry Readability Graph, Simple Measure of Gobbledygook test, Gunning Frequency of Gobbledygook index, New Fog Count, Raygor Readability Estimate Graph, and Coleman-Liau Index. We tested the hypothesis that the readability of NCIDCC OPI was written at the sixth grade level. Secondary analyses were performed to compare readability of OPI between comprehensive and noncomprehensive centers, by region, and to OPI produced by the American Cancer Society (ACS). A mean of 30,507 words from 40 comprehensive and 18 noncomprehensive NCIDCCs was analyzed (7 nonclinical and 3 without appropriate OPI were excluded). Using a composite grade level score, the mean readability score of 12.46 (ie, college level: 95% CI, 12.13-12.79) was significantly greater than the target grade level of 6 (middle-school: P<.001). No difference between comprehensive and noncomprehensive centers was identified. Regional differences were identified in 4 of the 10 readability metrics (P<.05). ACS OPI provides easier language, at the seventh to ninth grade level, across all tests (P<.01). OPI from NCIDCC Web sites is more complex than recommended for the average patient.

Assessment of online patient education materials from major ophthalmologic associations.

Patients are increasingly using the Internet to supplement finding medical information, which can be complex and requires a high level of reading comprehension. Online ophthalmologic materials from major ophthalmologic associations should be written at an appropriate reading level. To assess ophthalmologic online patient education materials (PEMs) on ophthalmologic association websites and to determine whether they are above the reading level recommended by the American Medical Association and National Institutes of Health. Descriptive and correlational design. Patient education materials from major ophthalmology websites were downloaded from June 1, 2014, through June 30, 2014, and assessed for level of readability using 10 scales. The Flesch Reading Ease test, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook test, Coleman-Liau Index, Gunning Fog Index, New Fog Count, New Dale-Chall Readability Formula, FORCAST scale, Raygor Readability Estimate Graph, and Fry Readability Graph were used. Text from each article was pasted into Microsoft Word and analyzed using the software Readability Studio professional edition version 2012.1 for Windows. Flesch Reading Ease score, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook grade, Coleman-Liau Index score, Gunning Fog Index score, New Fog Count, New Dale-Chall Readability Formula score, FORCAST score, Raygor Readability Estimate Graph score, and Fry Readability Graph score. Three hundred thirty-nine online PEMs were assessed. The mean Flesch Reading Ease score was 40.7 (range, 17.0-51.0), which correlates with a difficult level of reading. The mean readability grade levels ranged as follows: 10.4 to 12.6 for the Flesch-Kincaid Grade Level; 12.9 to 17.7 for the Simple Measure of Gobbledygook test; 11.4 to 15.8 for the Coleman-Liau Index; 12.4 to 18.7 for the Gunning Fog Index; 8.2 to 16.0 for the New Fog Count; 11.2 to 16.0 for the New Dale-Chall Readability Formula; 10.9 to 12.5 for the FORCAST scale; 11.0 to 17.0 for the Raygor Readability Estimate Graph; and 12.0 to 17.0 for the Fry Readability Graph. Analysis of variance demonstrated a significant difference (P < .001) between the websites for each reading scale. Online PEMs on major ophthalmologic association websites are written well above the recommended reading level. Consideration should be given to revision of these materials to allow greater comprehension among a wider audience.

MP76-15 CAN PATIENTS COMPREHEND ONLINE INFORMATION ABOUT OAB TREATMENT? A READABILITY ANALYSIS

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-neurogenic Voiding Dysfunction1 Apr 2014MP76-15 CAN PATIENTS COMPREHEND ONLINE INFORMATION ABOUT OAB TREATMENT? A READABILITY ANALYSIS Kevin Koo and Ronald Yap Kevin KooKevin Koo More articles by this author and Ronald YapRonald Yap More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2408AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Overactive bladder (OAB) affects millions of people, who look on the Internet for information about this common condition. Although online resources about OAB are widely available, the comprehensibility of such material to an average adult with an 8th grade reading level is not well understood. This study systematically evaluates information about OAB treatment on the Internet to assess its readability. METHODS Three search engines representing 96% of Internet search traffic (Google, Bing, and Yahoo!) were queried for the keywords, "overactive bladder," "overactive bladder syndrome," and "OAB." The top 100 results were recorded daily for one month, to account for variability among individual searches. Duplicated, non-English, and non-OAB-specific websites were excluded. For each website, the domain, owner, and Health on the Net "HONcode" certification status were recorded. Text discussing OAB treatment was subjected to three readability tests: SMOG index, a standard metric for evaluating consumer health material; Dale-Chall Readability Formula, which assesses sentence length and vocabulary difficulty; and the Fry graph, which plots the mean number of sentences against the mean number of syllables, per 100 words. Statistical analysis was performed using Stata. RESULTS Of 342 links returned in the queries, 57 websites met inclusion criteria (Table). Mean SMOG index was 10.7 (SD=1.6), equal to a grade 11 reading level. Mean Dale-Chall score overall was 9.2 (SD=0.9), equal to a grade 13-15 or college reading level. On the Fry readability graph, the mean coordinates (177 syllables, 5.9 sentences) represent a grade 15 or college reading level. Based on SMOG indices, only 7 sites (12%) were written at or below the average U.S. adult's grade 8 reading level; none of the sites was at this level using the Dale-Chall or Fry tests. There was no statistical difference in the SMOG indices for commercial vs. academic sites (11.0 vs. 10.8, p=0.37), or for HONcode-certified vs. non-certified sites (10.6 vs. 10.8, p=0.23). CONCLUSIONS Based on 3 standard readability tests, information on the Internet about OAB treatment is written at a grade level exceeding most adults' reading ability. Websites that target easier readability may facilitate greater patient literacy about OAB. Table. Readability Characteristics of Websites about OAB Treatment n = 57 % SMOG Mean Dale-Chall Mean Dale-Chall Grade Ownership Commercial 20 35.1 11.0 9.2 13-15 Academic 11 19.3 10.8 9.2 13-15 Private Practice 11 19.3 10.6 9.4 13-15 Non-Government Organization 7 12.3 11.0 9.5 13-15 Government 3 5.3 10.1 8.8 11-12 Other 5 8.8 10.8 9.0 13-15 Health on the Net (HONcode) Certification Certified 17 29.8 10.6 9.1 13-15 Non-Certified 40 70.2 10.8 9.2 13-15 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e887-e888 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Kevin Koo More articles by this author Ronald Yap More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

MP15-19 CAN PATIENTS UNDERSTAND INFORMATION ABOUT BPH ON THE INTERNET? A READABILITY ANALYSIS

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2014MP15-19 CAN PATIENTS UNDERSTAND INFORMATION ABOUT BPH ON THE INTERNET? A READABILITY ANALYSIS Kevin Koo and Ronald Yap Kevin KooKevin Koo More articles by this author and Ronald YapRonald Yap More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.572AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Benign prostatic hyperplasia (BPH) is a highly prevalent condition in older men, with millions of affected individuals seeking health information online. Information about BPH is widely available on the Internet, but little is known about whether the average adult with a grade 8 reading level can comprehend it. This study systematically examines information about BPH treatment on the Internet to evaluate its readability. METHODS Three search engines representing 96% of Internet search traffic (Google, Bing, and Yahoo!) were queried for the keywords, "benign prostatic hyperplasia," "prostate enlargement," and "BPH." To account for variability in results among searches, the top 100 results were recorded daily for one month. Websites that were duplicates, non-English, or not primarily about BPH were excluded. For each website, the domain, owner, and Health on the Net "HONcode" certification status were recorded. Text addressing BPH treatment was subjected to 3 readability analyses: SMOG index, a standard metric for evaluating consumer health material; Dale-Chall Readability Formula, which assesses sentence length and vocabulary difficulty; and the Fry graph, which plots the mean number of sentences against the mean number of syllables, per 100 words. Statistical analysis was performed using Stata. RESULTS Of 373 links returned in the queries, 52 websites met inclusion criteria (Table). Mean SMOG index was 10.6 (SD=1.4), equal to a grade 11 reading level. Mean Dale-Chall score overall was 9.1 (SD=0.6), equal to a grade 13-15 or college reading level. On the Fry readability graph, the mean coordinates (173 syllables, 5.1 sentences) represent a grade 15 or college reading level. Based on SMOG indices, only 7 sites (13%) were written at or below the average U.S. adult's grade 8 reading level; none of the sites was at this level using the Dale-Chall or Fry tests. SMOG indices were significantly lower for commercial vs. academic sites (10.2 vs. 11.0, p=0.030) and for HONcode-certified vs. non-certified sites (10.0 vs. 10.8, p=0.049). CONCLUSIONS Based on 3 readability analyses, online information about BPH treatment is written at a grade level exceeding the reading ability of most adult Americans. To improve patients' understanding about BPH, websites should target easier readability that facilitates greater comprehension. Table. Readability Characteristics of Websites Presenting Information on BPH n = 52 % SMOG Mean Dale-Chall Mean Dale-Chall Grade Ownership Commercial 18 34.6 10.2 9.0 13-15 Academic 15 28.8 11.0 9.3 13-15 Private Practice 7 13.5 10.4 9.0 13-15 Non-Government Organization 6 11.5 10.6 9.3 13-15 Government 2 3.8 11.0 8.9 11-12 Other 4 7.7 10.9 9.3 13-15 Health on the Net (HONcode) Certification Certified 14 26.9 10.8 9.2 13-15 Non-Certified 38 73.1 10.0 9.0 13-15 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e152 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Kevin Koo More articles by this author Ronald Yap More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Readability assessment of the American Rhinologic Society patient education materials

The extensive amount of medical literature available on the Internet is frequently accessed by patients. To effectively contribute to healthcare decision-making, these online resources should be worded at a level that is readable by any patient seeking information. The American Medical Association and National Institutes of Health recommend the readability of patient information material should be between a 4th to 6th grade level. In this study, we evaluate the readability of online patient education information available from the American Rhinologic Society (ARS) website using 9 different assessment tools that analyze the materials for reading ease and grade level of the target audience. Online patient education material from the ARS was downloaded in February 2012 and assessed for level of readability using the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook (SMOG) Grading, Coleman-Liau Index, Gunning-Fog Index, FORCAST formula, Raygor Readability Estimate, the Fry Graph, and the New Dale-Chall Readability Formula. Each article was pasted as plain text into a Microsoft® Word® document and each subsection was analyzed using the software package Readability Studio Professional Edition Version 2012.1. All healthcare education materials assessed were written between a 9th grade and graduate reading level and were considered "difficult" to read by the assessment scales. Online patient education materials on the ARS website are written above the recommended 6th grade level and may require revision to make them easily understood by a broader audience.

Readability analysis of healthcare‐oriented education resources from the american academy of facial plastic and reconstructive surgery

Deficient health literacy remains a widespread public issue. As such, the National Institutes of Health (NIH) recommends that all patient resources should be written around a sixth-grade level. The authors evaluate healthcare-oriented resources specified for patient use on the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) Web site in order to identify potential areas of improvement and highlight those sections that may serve as paradigms for future revisions. Descriptive and correlational design. Seventeen healthcare-oriented resources specifically for patients were downloaded in February 2012 from the American Academy of Facial Plastic and Reconstructive Surgery Web site. Readability assessments of each article were performed using Readability Studio Professional Edition Version 2012.1. These tests included the Flesch Reading Ease, Flesch-Kincaid Grade Level, SMOG Grading, Coleman-Liau Index, Gunning-Fog Index, the New Fog Count, the New Dale-Chall Readability Formula, FORCAST formula, Raygor Readability Estimate, and the Fry Graph. Patient health education material found on the AAFPRS Web site has been found to be written at an average grade level of 12th grade using 10 different readability scales. Modifications of the patient education section of the AAFPRS Web site can increase the readability of the literature, and allow greater comprehension among a wider audience.

Readability Assessment of Patient Education Materials on Major Otolaryngology Association Websites

Various otolaryngology associations provide Internet-based patient education material (IPEM) to the general public. However, this information may be written above the fourth- to sixth-grade reading level recommended by the American Medical Association (AMA) and National Institutes of Health (NIH). The purpose of this study was to assess the readability of otolaryngology-related IPEMs on various otolaryngology association websites and to determine whether they are above the recommended reading level for patient education materials. Analysis of patient education materials from 9 major otolaryngology association websites. The readability of 262 otolaryngology-related IPEMs was assessed with 8 numerical and 2 graphical readability tools. Averages were evaluated against national recommendations and between each source using analysis of variance (ANOVA) with post hoc Tukey's honestly significant difference (HSD) analysis. Mean readability scores for each otolaryngology association website were compared. Mean website readability scores using Flesch Reading Ease test, Flesch-Kincaid Grade Level, Coleman-Liau Index, SMOG grading, Gunning Fog Index, New Dale-Chall Readability Formula, FORCAST Formula, New Fog Count Test, Raygor Readability Estimate, and the Fry Readability Graph ranged from 20.0 to 57.8, 9.7 to 17.1, 10.7 to 15.9, 11.6 to 18.2, 10.9 to 15.0, 8.6 to 16.0, 10.4 to 12.1, 8.5 to 11.8, 10.5 to 17.0, and 10.0 to 17.0, respectively. ANOVA results indicate a significant difference (P < .05) between the websites for each individual assessment. The IPEMs found on all otolaryngology association websites exceed the recommended fourth- to sixth-grade reading level.

Reliability and Readability of Questionnaire: Peak Performance and Peak Experience

The Questionnaire: Peak Performance and Peak Experience is based on both research and theoretical content found through a comparative analysis of literature germane to peak performance, peak experience, and flow. The Dale-Chall Readability Formula indicated that readability of the questionnaire is at the upper limits of the 9th and 10th grades. A Pearson product-moment correlation, based on 33 paired trials, was used to estimate over-all reliability (.70) and reliability of 42 individual test items. Scores were from 21 women and 12 men, aged 20 to 49 yr.

Readability, comprehension and judgement

The experiments reported here concern the relationship between pupils’ expected abilities to ‘comprehend’ four written texts, as predicted by the Dale-Chall readability formula, Cloze procedure and Britton's model of language functions, and their observed abilities to make reasoned judgments about these texts. The two readability measures and the Britton model gave the same predicted order of difficulty for four stylistically different prose passages on the theme Road Accidents. Despite these differences, there were no significant differences between the four passages in the levels of judgment achieved by sixteen-year-old and twelve-year-old pupils in response to questions based on the texts. It seems, therefore, that the linguistic difficulty of a text, as assessed by standard measures of readability, was not an important factor in determining the quality of judgments displayed by the pupils. This suggests that the readability tests are concerned simply with linguistic features of a text and that these may be of no special relevance to the interaction of reader and text involved in the process of judgment

Sample Frequency in Application of Dale-Chall Readability Formula

Using 48 college texts, comparisons were made of Dale-Chall Readability Formula results based on samples taken from various page intervals. Results indicate that for the 48 textbooks examined, samples taken at 20, 30, 40, and 50-page intervals are as reliable as samples taken from 10 page intervals.