Flesch-Kincaid Reading Ease Score Research Articles

Assessing the missions and visions of NCI-designated cancer centers and their affiliated hospitals.

e23118 Background: Mission and vision statements (MVS) help convey an institution's identity and priorities. Missions describe objectives and responsibilities, while visions describe overarching directions for the future. Effectively communicating MVS is particularly important for cancer centers and hospitals seeking to inspire and reach patients and employees. We sought to assess the composition, readability, and topics addressed for MVS provided by NCI-designated cancer centers and their affiliated hospitals. Methods: We extracted MVS data from institutional websites for 65 NCI-designated cancer centers and 59 affiliated hospitals in 2023 (6 cancer centers did not have an affiliated hospital). We determined the composition of statements using word counts and time to read. We assessed the readability of statements using Flesch-Kincaid (FK) reading ease and grade level scores. We reviewed the MVS to determine the presence of four topics: equity, quality care, training, and research. We used descriptive statistics to compare these issues in MVS for cancer center versus the hospital. Results: Among the 65 cancer centers, we found mission statements for 93.9% (61/65) and vision statements for 63.1% (41/65). All affiliated hospitals provided a mission statement and 86.4% (51/59) had a vision statement. Data for composition, readability, and topics addressed for MVS are provided in the table. Overall, readability of MVS was difficult based on FK reading ease scores, with relatively high reading grade levels. Mission statements for cancer centers had a significantly lower reading ease and higher grade level compared with hospitals. In general, mission statements were slightly longer than vision statements, more frequently addressing the topics of quality care, training, and research. Compared with hospitals, cancer centers had a significantly lower frequency of mentioning the topic "training" in their MVS. Conclusions: We found that the majority of NCI-designated cancer centers report mission statements, but fewer provide vision statements. We demonstrated difficult readability for the MVS provided, highlighting a need to consider simpler diction and structure of language. Additionally, our work provides an overview of topics addressed for these statements including equity, quality care, training, and research. These topics underscore the values and priorities of an institution, and this review of MVS provides insights into the messaging that cancer centers communicate. [Table: see text]

Readability of Neurosurgical Patient Education Resources by the American Association of Neurological Surgeons

The importance of patient education has become increasingly apparent in recent years. A prominent patient education tool in neurosurgery is the Neurosurgical Conditions and Treatments page provided by the American Association of Neurological Surgeons (AANS). This study aimed to investigate the readability of this resource page as many new articles have been incorporated in the past decade. Flesch-Kincaid Grade Level and Flesch-Kincaid Reading Ease scores were calculated for each article. One-way analysis of variance and Scheffé, Tukey-Kramer, Bonferroni, Fisher least significant difference, and Dunnett test post hoc analyses were conducted to determine differences between each category with respect to their mean grade level and reading ease scores. Overall mean (SD) Flesch-Kincaid Reading Ease score was 40.2 (12.24), and overall mean (SD) Flesch-Kincaid Grade Level score was 7.48 (1.26). Significant differences were found between mean reading ease scores between each categorization by the AANS (P= 0.014). No significant differences were found between mean grade level score for each categorization (analysis of variance, P= 0.154). As compared to a single previous investigation conducted 10 years ago, the readability of articles has changed modestly, and the reading grade level remains well above the recommendations by the American Medical Association and National Institutes of Health. The 6 new articles introduced in the past decade have demonstrated similar readability, presenting a persistent challenge in the realm of patient education in neurosurgery.

Assessment of the quality of online patient information resources for patients considering parastomal hernia treatment.

The aim was to examine the quality of online patient information resources for patients considering parastomal hernia treatment. A Google search was conducted using lay search terms for patient facing sources on parastomal hernia. The quality of the content was assessed using the validated DISCERN instrument. Readability of written content was established using the Flesch-Kincaid score. Sources were also assessed against the essential content and process standards from the National Institute for Health and Care Excellence (NICE) framework for shared decision making support tools. Content analysis was also undertaken to explore what the sources covered and to identify any commonalities across the content. Fourteen sources were identified and assessed using the identified tools. The mean Flesch-Kincaid reading ease score was 43.61, suggesting that the information was difficult to read. The overall quality of the identified sources was low based on the pooled analysis of the DISCERN and Flesch-Kincaid scores, and when assessed against the criteria in the NICE standards framework for shared decision making tools. Content analysis identified eight categories encompassing 59 codes, which highlighted considerable variation between sources. The current information available to patients considering parastomal hernia treatment is of low quality and often does not contain enough information on treatment options for patients to be able to make an informed decision about the best treatment for them. There is a need for high-quality information, ideally co-produced with patients, to provide patients with the necessary information to allow them to make informed decisions about their treatment options when faced with a symptomatic parastomal hernia.

The quality and readability of patient information provided by ChatGPT: can AI reliably explain common ENT operations?

Access to high-quality and comprehensible patient information is crucial. However, information provided by increasingly prevalent Artificial Intelligence tools has not been thoroughly investigated. This study assesses the quality and readability of information from ChatGPT regarding three index ENT operations: tonsillectomy, adenoidectomy, and grommets. We asked ChatGPT standard and simplified questions. Readability was calculated using Flesch-Kincaid Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI) and Simple Measure of Gobbledygook (SMOG) scores. We assessed quality using the DISCERN instrument and compared these with ENT UK patient leaflets. ChatGPT readability was poor, with mean FRES of 38.9 and 55.1 pre- and post-simplification, respectively. Simplified information from ChatGPT was 43.6% more readable (FRES) but scored 11.6% lower for quality. ENT UK patient information readability and quality was consistently higher. ChatGPT can simplify information at the expense of quality, resulting in shorter answers with important omissions. Limitations in knowledge and insight curb its reliability for healthcare information. Patients should use reputable sources from professional organisations alongside clear communication with their clinicians for well-informed consent and making decisions.

Quality, Reliability, and Readability of Online Information on Idiopathic Intracranial Hypertension.

To evaluate the quality & reliability, technical quality, and readability of patient-targeted online information on idiopathic intracranial hypertension. In this cross-sectional study, we searched Google and Bing search engines for the terms "idiopathic intracranial hypertension" and "pseudotumor cerebri." We evaluated the first 50 search outcomes for each search term. Peer-reviewed articles, targeted advertisements, book chapters, videos, personal blogs, websites intended for healthcare professionals, and non-English websites were excluded. Websites were classified as institutional or private. Two independent reviewers assessed each website for 1) quality and reliability using DISCERN, Health on the Net Code of Conduct (HONcode), and JAMA criteria and 2) technical quality based on 11 criteria. Readability was evaluated using 6 measures (Flesch-Kincaid Reading Ease score and grade level, Gunning Fog, Simple Measure of Gobbledygook (Smog) index, Coleman-Liau index, and automated readability index). Sixty-three websites (37 institutional) were included. The mean scores for the DISCERN, HONcode, and JAMA criteria were 3.6 ± 1 (1-4.8; 1: worse, 5: best), 10.3 ± 2.8 (2-16; 0: worse, 16: best), and 2 ± 1.3 (0-4; 0: worse, 4: best), respectively. The mean technical quality score was 0.8 ± 0.1 (0.5-1). The mean Flesch-Kincaid grade level score was 8.9 ± 1.8 (3.3-13.3). For Flesch-Kincaid grade level, 47 (74.6%) websites scored a grade level of 10 or less. For Gunning Fog Score, 35 websites (55.6%) scored from 7.3 to 10.8. For the Smog Index, 46 (73%) websites scored 5.7-8. The mean Coleman Liau Index was 16 ± 2.1 (9.6-22.2). For the automated readability index, 30 (50.7%) websites scored less than the eighth grade. No statistically significant difference was present between institutional and private websites except for JAMA, which scored higher in private websites (2.4 vs 1.7, P = 0.03). Our findings suggest that online information on idiopathic intracranial hypertension/pseudotumor cerebri for patients generally demonstrates moderate to good quality and reliability. Although most websites maintain credible technical quality, the readability exceeds recommended levels for the average American reader. This may impede understanding, emphasizing the need for future improvements.

A content analysis of medication adherence material in patient educational resources about gout.

This study aimed to investigate how medication adherence is addressed in online gout resources in six countries. We investigated how often adherence was referred to, the strategies suggested to improve patient adherence, and the types of nonadherence that were targeted. We also examined the readability of the adherence material. A content analysis was conducted on 151 online gout resources from medical and health organisations in six predominantly English-speaking countries. Two reviewers coded the content of the websites into categories (kappa 0.80). The analysis involved coding the resources for reasons for nonadherence, and adherence-promoting strategies. Flesch-Kincaid Reading Ease scores and word count were also computed. Out of 151 websites examined, 77 websites discussed medication adherence (51%), with intentional nonadherence being more prevalent than unintentional nonadherence. 67 websites targeted different types of nonadherence, including drug-specific concerns (50%), misconceptions of gout curability and the necessity of medication (16%), forgetfulness (16%), and other practical challenges (5%). Strategies to promote adherence were found in one-third of the websites, with medication education being the most prevalent strategy (17%), followed by healthcare provider engagement (13%) and memory aid strategies (6%). On average, about 11% of the words (89.27, SD = 76.35) in the entire document were focused on adherence. Difficult reading comprehension was found in one-fifth of adherence-related websites. Findings reveal limited medication adherence coverage and narrow strategies in online gout resources. Improved adherence portrayal is needed for effective gout management through comprehensive strategies and clear, understandable information.

Walking forward or on hold: Could the ChatGPT be applied for seeking health information in neurosurgical settings?

Self-management is important for patients suffering from cerebrovascular events after neurosurgical procedures. An increasing number of artificial intelligence (AI)-assisted tools have been used in postoperative health management. ChatGPT is a new trend dialog-based chatbot that could be used as a supplemental tool for seeking health information. Responses fromChatGPT version 3.5 and 4.0 toward13 questions raised by experienced neurosurgeons were evaluated in this exploratory study for their consistency and appropriatenessblindly by the other three neurosurgeons. The readability of response text was investigated quantitively by word countand the Gunning Fogand Flesch-Kincaid indices. Results showed that the chatbot could provide relatively stable output between the two versions on consistency and appropriateness (χ² = 0.348). As for readability, there was a higher demand for readers to comprehend the output text in the 4.0 version (more counts of words; lower Flesch-Kincaid reading ease score; and higher Flesch-Kincaid grade level). In general, the capacity ofChatGPT to deliver effective health information is still under debate.

ChatGPT: Is This Patient Education Tool for Urological Malignancies Readable for the General Population?

With widespread adoption of technological advancements in everyday life, patients are now increasingly able and willing to obtain information about their health conditions, treatment options, and indeed expected outcomes via the convenience of any device than can access the worldwide web. This introduces another aspect of patient care in the provision of healthcare for the modern doctor. ChatGPT is the first of an increasing number of self learning programs that have been released recently which may revolutionize and impact healthcare delivery. The aim of this study is to obtain an objective measure of the readability of information provided on ChatGPT when compared with current validated patient information sheets provided by government health institutions in Western Australia. The same structured questions were input into the program for three major urological malignancies (urothelial, renal, and prostate), with the response generated evaluated with a validated readability scoring system - Flesch-Kincaid reading ease score. The same scoring system was then applied to current patient information sheets in circulation from Cancer Council Australia and UpToDate. Findings in this study looking at ease of readability of information provided on ChatGPT as compared to other government bodies and healthcare institutions confirm that they are non-inferior and may be a useful tool or adjunct to the traditional clinic based consultations. Ease of use of the information generated from ChatGPT was increased further when the question was modified to target an audience of 16 years of age, the average level of education attained by an Australian. Future research can be done to look into incorporating the use of similar technologies to increase efficiency in the healthcare system and reduce healthcare costs.

Assessing the readability and quality of online information on benign paroxysmal positional vertigo.

Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. It can have a significant impact on quality of life, with individuals often seeking information online for reassurance and education. The aim of this study is to assess the readability and quality of online information on BPPV. The terms 'benign paroxysmal positional vertigo' and 'BPPV' were entered into Google. The first 50 websites generated for each search term were screened. Readability was assessed using the Flesch-Kincaid Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG) Index and Gunning Fog Index (GFOG). Quality was assessed using the DISCERN instrument. Spearman's correlation between quality and readability was calculated. A total of 39 websites met the inclusion criteria. The mean and 95% confidence intervals for the FRES, FKGL, SMOG, GFOG and DISCERN scores were 50.2 (46.1-54.3), 10.6 (9.87-11.4), 10.1 (9.5-10.7), 13.6 (12.7-14.4) and 36.7 (34.6-38.7), respectively. Weak correlation was noted between DISCERN and FRES (rs = -0.23, p = 0.17). Online information on BPPV is generally of poor quality and low readability. It is essential that healthcare professionals inform their patients of this limitation and advocate for improved online patient education resources that are both high quality and easy to comprehend.

AI-Generated Information for Vascular Patients: Assessing the Standard of Procedure-Specific Information Provided by the ChatGPT AI-Language Model.

Introduction Ensuring access to high-quality information is paramount to facilitating informed surgical decision-making. The use of the internet to access health-related information is increasing, along with the growing prevalence of AI language models such as ChatGPT. We aim to assess the standard of AI-generated patient-facing information through a qualitative analysis of its readability and quality. Materials and methods We performed a retrospective qualitative analysis of information regarding three common vascular procedures: endovascular aortic repair (EVAR), endovenous laser ablation (EVLA), and femoro-popliteal bypass (FPBP). The ChatGPT responses were compared to patient information leaflets provided by the vascular charity, Circulation Foundation UK. Readability was assessed using four readability scores: the Flesch-Kincaid reading ease (FKRE) score, the Flesch-Kincaid grade level (FKGL), the Gunning fog score (GFS), and the simple measure of gobbledygook (SMOG) index. Quality was assessed using the DISCERN tool by two independent assessors. Results The mean FKRE score was 33.3, compared to 59.1 for the information provided by the Circulation Foundation (SD=14.5, p=0.025) indicating poor readability of AI-generated information. The FFKGL indicated that the expected grade of students likely to read and understand ChatGPT responses was consistently higher than compared to information leaflets at 12.7 vs. 9.4 (SD=1.9, p=0.002). Two metrics measure readability in terms of the number of years of education required to understand a piece of writing: the GFS and SMOG. Both scores indicated that AI-generated answers were less accessible. The GFS for ChatGPT-provided information was 16.7 years versus 12.8 years for the leaflets (SD=2.2, p=0.002) and the SMOG index scores were 12.2 and 9.4 years for ChatGPT and the patient information leaflets, respectively (SD=1.7, p=0.001). The DISCERN scores were consistently higher in human-generated patient information leaflets compared to AI-generated information across all procedures; the mean score for the information provided by ChatGPT was 50.3 vs. 56.0 for the Circulation Foundation information leaflets (SD=3.38, p<0.001). Conclusion We concluded that AI-generated information about vascular surgical procedures is currently poor in both the readability of text and the quality of information. Patients should be directed to reputable, human-generated information sources from trusted professional bodies to supplement direct education from the clinician during the pre-procedure consultation process.

Information Quality and Readability: ChatGPT's Responses to the Most Common Questions About Spinal Cord Injury

This study aimed to assess the quality, readability, and comprehension of texts generated by ChatGPT in response to commonly asked questions about spinal cord injury (SCI). The study utilized Google Trends to identify the most frequently searched keywords related to SCI. The identified keywords were sequentially inputted into ChatGPT, and the resulting responses were assessed for quality using the Ensuring Quality Information for Patients (EQIP) tool. The readability of the texts was analyzed using the Flesch-Kincaid Grade Level and the Flesch-Kincaid Reading Ease parameters. The mean EQIP score of the texts was determined to be 43.02 ± 6.37, the Flesch-Kincaid Reading Ease score to be 26.24 ± 13.81, and the Flesch-Kincaid Grade Level was to be 14.84 ± 1.79. The analysis revealed significant concerns regarding the quality of texts generated by ChatGPT, indicating serious problems with readability and comprehension. The mean EQIP score was low, suggesting a need for improvement in the accuracy and reliability of the information provided. The Flesch-Kincaid Grade Level indicated a high linguistic complexity, requiring a level of education equivalent to approximately 14 to 15 years of formal education for comprehension. The results of this study show heightened complexity in ChatGPT-generated SCI texts, surpassing optimal health communication readability. ChatGPT currently cannot substitute comprehensive medical consultations. Enhancing text quality could be attainable through dependence on credible sources, the establishment of a scientific board, and collaboration with expert teams. Addressing these concerns could improve text accessibility, empowering patients and facilitating informed decision-making in SCI.

Evaluation High-Quality of Information from ChatGPT (Artificial Intelligence—Large Language Model) Artificial Intelligence on Shoulder Stabilization Surgery

To analyze the quality and readability of information regarding shoulder stabilization surgery available using an online AI software (ChatGPT), using standardized scoring systems, as well as to report on the given answers by the AI. An open AI model (ChatGPT) was used to answer 23 commonly asked questions from patients on shoulder stabilization surgery. These answers were evaluated for medical accuracy, quality, and readability using The JAMA Benchmark criteria, DISCERN score, Flesch-Kincaid Reading Ease Score (FRES) & Grade Level (FKGL). The JAMA Benchmark criteria score was 0, which is the lowest score, indicating no reliable resources cited. The DISCERN score was 60, which is considered a good score. The areas that open AI model did not achieve full marks were also related to the lack of available source material used to compile the answers, and finally some shortcomings with information not fully supported by the literature. The FRES was 26.2, and the FKGL was considered to be that of a college graduate. There was generally high quality in the answers given on questions relating to shoulder stabilization surgery, but there was a high reading level required to comprehend the information presented. However, it is unclear where the answers came from with no source material cited. It is important to note that the ChatGPT software repeatedly references the need to discuss these questions with an orthopaedic surgeon and the importance of shared discussion making, as well as compliance with surgeon treatment recommendations. As shoulder instability is an injury that predominantly affects younger individuals who may use the Internet for information, this study shows what information patients may be getting online.

Evaluation of readability of patient education materials on lateral epicondylitis (tennis elbow) from the top 25 orthopedic institutions

Lateral epicondylitis (LE), also known as "tennis elbow," is a common orthopedic tendinosis of the elbow that affects between 1% and 3% of the overall population. LE occurs due to overuse of the extensor mechanism or muscles of supination in the forearm. The National Institute of Health and the Center for Disease Control suggest that patient education materials (PEMs) be written at a 6th or 8th grade reading level, respectively; however, PEMs are often written far beyond these recommended reading levels. The goal of this study was to assess the readability level of PEMs published by some of the top orthopedic institutions throughout the United States. A list of the top 25 ranking orthopedic hospitals in the country was compiled using the 2022 U.S. News and World Report Best Hospitals Specialty Ranking. PEMs related to LE were cataloged from each institution's website, and readability levels for each PEM were measured using the http://www.readabilityformulas.com website. This software analyzes readability using the formulas listed in Table1. While the Flesch-Kincaid (FK) Reading Ease Score formula outputs a number from 0 to 100, in which larger numbers indicate easier reading, the remaining formulas demonstrate a text's readability through assigning a grade-appropriate reading level. A Spearman regression was used to evaluate correlation between institutional ranking and FK Reading Ease Scores. Of the 25 PEM texts analyzed during this study, none were written at or below the sixth grade reading level, as recommended by the National Institutes of Health. These results suggest that the most prestigious orthopedic hospitals provide online informational resources that are unable to be read or understood by a large portion of the institution's intended audience. Additionally, there was no correlation found between institutional ranking and FK Reading Ease Score. Internet-based health information has conveniently allowed patients to educate themselves on their health care. In accordance with National Institutes of Health and Centers for Disease Control and Prevention guidelines, orthopedic institutions should strive to publish PEMs at or below an eighth grade reading level.

Assessing the readability and quality of online information on anosmia.

Anosmia can have a significant impact on well-being and quality of life. Due to an ageing population and the coronavirus disease 2019, increasing numbers of patients are seeking online information on anosmia. This report systematically assesses the readability and quality of online information on anosmia. The terms 'anosmia' and 'loss of smell' were entered into Google. The first 50 websites generated for each search term were screened. Readability was assessed using the Flesch-Kincaid Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG) Index and Gunning Fog Index (GFI). Quality was assessed using the DISCERN instrument. Spearman's correlation between quality and readability was calculated. A total of 79 websites met the inclusion criteria. The mean and 95% confidence interval for the FRES, FKGL, SMOG, GFI and DISCERN scores were 46.31 (42.94-49.68), 12.00 (11.27-12.73), 10.70 (10.16-11.23), 14.62 (13.85-15.39) and 2.90 (2.69-3.11), respectively. Significant negative correlation was noted between the DISCERN and FRES (rs=-0.500; p<0.05). Online information on anosmia is written above the recommended reading age guidance in the UK, and has moderate deficiencies in quality. As a result, the information may be used inappropriately and could result in worse health outcomes. We recommend that patients are directed to websites produced by health providers or nonprofit organisations that develop material for patient health education. Online information on anosmia is of low readability and moderate quality. Healthcare professionals should direct patients towards high-quality resources written for the layperson.

Quality and readability of online information on hand osteoarthritis.

Objectives: This study aimed to evaluate the quality and readability of web pages providing information about hand osteoarthritis using several authorized methods.Methods: A web page exploration was performed using the Google internet search engine. The three search terms, "hand osteoarthritis," "finger osteoarthritis," and "hand OA," were used and the top 100 ranked websites were selected and divided into six categories. The Health on the Net Foundation (HON) grade scale, an instrument for judging the quality of written consumer health information on treatment choice (DISCERN instrument), and the Ensuring Quality Information for Patients (EQIP) score were used to evaluate the quality of each website. The Flesch-Kincaid reading ease (FRE) score, Flesch-Kincaid grade (FKG) level, Gunning-Fog index, and Simple Measure of Gobbledygook grade level were used to evaluate website readability.Results: Among 300 websites, 57 websites were selected following exclusion criteria. News portal websites, including the online version of newspapers and periodicals, showed the highest score in all three quality evaluation tools. Only four websites were regarded as high-quality websites based on the HON grade scale (n = 3) and the EQIP score (n = 1). Each type of website showed an average FKG level higher than 7th grade and obtained an average FRE score of less than 80 points, indicating an inappropriate level for a layperson to read.Conclusions: The online information about hand osteoarthritis is low quality and difficult to read for the general public. There is a need to enhance the quality and readability of web-based information related to hand osteoarthritis for patients to obtain credible information and receive proper treatment for the disease.

Functional endoscopic sinus surgery: assessing the readability and quality of online information.

The aim of this study was to assess the readability and quality of online information on functional endoscopic sinus surgery (FESS). The term 'functional endoscopic sinus surgery' was entered into the Google, Bing and Yahoo search engines. The first 30 websites for each search engine were screened. Readability was assessed using the Flesch-Kincaid Reading Ease Score (FRES), Flesch-Kincaid Grade (FKG), Simple Measure of Gobbledygook (SMOG) Index, and Gunning Fog Index (GFI). Quality was assessed using the DISCERN instrument. Spearman's correlation between quality and readability was calculated. Thirty-three websites met the inclusion criteria. The mean and standard deviations for the FRES, FKG, SMOG, GFI, and DISCERN scores were 49 (13.1), 10.9 (2.5), 10.2 (1.9), 13.6 (2.4), and 51.1 (12.8), respectively. A positive correlation was noted between the FRES and DISCERN (R=0.357, p=0.041). Online information on FESS is generally written above the recommended reading levels and of fair quality.

Online patient literature related to oesophageal surgery: the need for greater readability, accreditation and higher quality.

Oesophageal cancer is the sixth most common cause of death worldwide but is treatable through surgery. As part of the consenting process, surgeons may guide patients towards online information leaflets to understand more about their condition and treatment. This review aimed to systematically analyse some of the current resources that can be accessed via the internet. A stringent search criteria was used to select online patient information leaflets for oesophageal cancer surgery. Leaflets were scored based on the Flesch-Kincaid Reading Ease score, DISCERN score, Health on the Net Code of Conduct (HONcode) certification/Information Standard Certification and International Patient Decision Aid Standards (IPDAS) score. Only five sites had achieved HONcode certification. Only three sources were deemed readable using the Flesch-Kincaid scoring system and no sources reached the recommended readability using IPDAS. No source reached a maximum score with DISCERN, with the mean overall quality being 2.98. There was no significant difference between accredited and unaccredited sources. From our sample, patient information sources on oesophageal cancer surgery have a low readability. More research is required to ascertain patient behaviour with regards to accessing the literature. Patients and healthcare professionals should liaise with each other to produce more readable, high-quality patient information on oesophageal cancer surgery.

Readability, stability, and internal consistency of a new psychometric inventory on evidence-based practice in physiotherapy

Evidence-based practice (EBP) has, in the last decade, gained global prominence in health care professions because it provides the framework for lifelong and self-directed learning. These traits are crucial for the continued provision of quality health care. This study sets out to develop a culturally appropriate instrument to measure physiotherapists' knowledge, beliefs, attitudes, and behaviors relative to the use of EBP and establish the instruments' psychometric properties. A 53-item EBP inventory that consisted of seven parts sociodemographic, EBP competence and behaviors, perceived knowledge of EBP, perceived skills and resources, attitudes about EBP, and barriers related to the use of EBP was created. Theinstrument was administered to 25 physiotherapists within a two-week interval on two occasions. The Flesch-Kincaid Reading Ease and Flesch-Kincaid scores for the instrument were 49.5 and 8.3, respectively. Its Cronbach alpha range from "fair" (0.333, p&lt;.001) to "almost perfect" (0.837, p&lt;.001). The test-retest (stability) scores for the instrument parts were significantly (?2 = 4.738, p&lt;.038) different for only one (competence on EBP) of the seven factors. The overall findings revealed the instrument is relatively easy to comprehend, highly stable, and internally consistent. The availability of this instrument will promote further studies of EBP in physiotherapy.

Evaluating the quality and readability of online information on keratoconus treatment

ObjectiveThis study aims to evaluate the quality and readability of online resources on keratoconus treatment. MethodsA Google.com search was conducted on August 9, 2020; 32 web sites were selected for analysis. Popularity was assessed by Google and Alexa rank. The quality of web sites was analyzed using the quality criteria for consumer health information (DISCERN) tool, the Journal of the American Medical Association (JAMA) benchmark, and the Health On the Net Code of Conduct Certification (HONcode). The readability of the web sites was assessed using the Fleschwebr hea Reading Ease, the Automated Readability Index, and the Fleschted Readability ResultsThe JAMA benchmark scores, unlike the DISCERN scores, were correlated with the Google and Alexa rank. One web site (3.1%) met all the JAMA benchmark criteria, and 3 (9.3%) others had HONcode certification. The median DISCERN score was 33 (range, 29.6–43.1; maximum possible, 80). Rnib.org.uk scored the highest at 57 (71.0%). The mean Flesch–Kincaid Reading Ease score (52.9 ± 7.1) corresponded to uk" n DIdifficult to read.” Thirty-one web sites (96.8%) had a Flesch–Kincaid Grade higher than the American Medical Association recommendation of sixth grade level. The median Automated Readability Index score was 7 (range, 6.2–7.3). ConclusionThe majority of online information currently available on keratoconus treatment is complex and highly variable. Rnib.org.uk is the best currently available source. Clinicians should inform patients on how to assess the credibility of online information and recommend suitable information sources.

Readability of the American, Canadian, and British Otolaryngology-Head and Neck Surgery Societies' Patient Materials.

ObjectivePatient education materials across 3 national English otolaryngology–head and neck surgery (OHNS) societies: the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), the Canadian Society of Otolaryngology–Head and Neck Surgery (CSOHNS), and Ear, Nose, and Throat United Kingdom (ENT UK) were examined to determine whether they are written at a level suitable for patient comprehension.Study DesignCross-sectional study.SettingOnline patient materials presented through OHNS national societies.MethodsReadability was calculated using the Flesch-Kincaid Grade Level, Flesch-Kincaid Reading Ease Score, and Simple Measure of Gobbledygook Index. All public patient education materials available through the CSOHNS, AAO-HNS, and ENT UK websites were assessed. Patient education materials were grouped into categories by subspecialty.ResultsIn total, 128 patient materials from the 3 societies were included in the study. All 3 societies required a minimum grade 9 reading comprehension level to understand their online materials. According to Flesch-Kincaid Grade Level, the CSOHNS required a significantly higher reading grade level to comprehend the materials presented when compared to AAO-HNS (11.3 vs 9.9; 95% CI, 0.5-2.4; P < .01) and ENT UK (11.3 vs 9.4; 95% CI, 0.9-2.9; P < .01). Patient education materials related to rhinology were the least readable among all 3 societies.ConclusionThis study suggests that the reading level of the current patient materials presented through 3 national OHNS societies are written at a level that exceeds current recommendations. Promisingly, it highlights an improvement for the readability of patient materials presented through the AAO-HNS.