Flesch Reading Ease Score Score Research Articles

A quality assessment of Internet information regarding accelerated orthodontics

Abstract Objective The aim of the present study was to evaluate the quality of information uploaded onto the Internet regarding accelerated orthodontics. Materials and methods The selected search terms ‘accelerated orthodontics’, ‘rapid orthodontics’, ‘speed orthodontics’, ‘rapid braces’, and ‘speed braces’ were searched by three commonly used search engines (Google, Yahoo, and Bing), and the URLs of the top 50 websites were recorded. The websites were evaluated using DISCERN, HONcode, and the Journal of the American Medical Association (JAMA) benchmark instruments. The readability of the websites was evaluated by the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Grade Level (FKGL). Results The total mean DISCERN score (section 1 + section 2) for all websites was 29.50/75 (range: 15–68). The average FRES of all websites was 52.99 ± 31.91. Also, the average FKGL score of all websites was 10.73 ± 2.03. Professional health organisation websites had significantly higher DISCERN scores than other websites (p < 0.001). Only three websites had the HONcode seal. Professional organisation and private dental practice websites showed better compliance with JAMA benchmarks. There was no statistically significant difference related to FRES and FKGL scores between groups (p > 0.05). Conclusions Information regarding accelerated orthodontics found on the Internet is insufficient. It is recommended that orthodontic societies and orthodontists increase the quality of the websites which describe accelerated orthodontics.

Readability of Online Materials Related to Vocal Cord Leukoplakia.

ObjectivesTo assess readability and understandability of online materials for vocal cord leukoplakia.Study DesignReview of online materials.SettingAcademic medical center.MethodsA 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.ResultsTwenty-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.ConclusionOnline 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.

Glioblastoma: assessment of the readability and reliability of online information

Introduction Glioblastoma Multiforme (GBM) represents one of the most common and most aggressive forms of brain tumours with a poor prognosis. There is often uncertainty around diagnosis and prognosis amongst patients diagnosed with cancer. Most patients rely on internet to access health-related information. The aim of this study was to assess the readability and reliability of online information on GBM. Methods The terms ‘Glioblastoma’ and ‘GBM’ were used to search Google and the first 50 websites identified were screened. For each website, the quality of each website was assessed using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria and the Health on the Net Foundation code certification (HON-code). The readability was assessed using the Flesch Reading Ease Score (FRE), the Flesch-Kincaid grade level (FKGL) and the Gunning Fog Index (GFI). The relevant patient information by 4 International patient information websites were also assessed. Results Following screening, 31 websites met the inclusion criteria with only four websites displaying the HON-code (12.9%). The median DISCERN score was 43 (range: 17–70) corresponding to ‘fair’ quality, and the median JAMA benchmark criteria score was 1. Display of the HON-code certificate or the publication date was associated with higher quality websites. The median FRE score corresponded to ‘difficult’ to read (34.4). The median GFI score (15.9) and FKGL score (13.3) corresponded to a ‘college’ level of education reading ability. The Cancer Australia online information was the most readable website while Cancer Research UK had the highest quality information. Conclusion The readability and reliability of online information relating to GBM is inadequate. Health professionals need to provide or guide patients to information that is both readable and reliable.

Quality of online information for the general public on COVID-19

ObjectivesTo analyse the quality of information included in websites aimed at the public on COVID-19. MethodsYahoo!, Google and Bing search engines were browsed using selected keywords on COVID-19. The first 100 websites from each search engine for each keyword were evaluated. Validated tools were used to assess readability [Flesch Reading Ease Score (FRES)], usability and reliability (LIDA tool) and quality (DISCERN instrument). Non-parametric tests were used for statistical analyses. ResultsEighty-four eligible sites were analysed. The median FRES score was 54.2 (range: 23.2−73.5). The median LIDA usability and reliability scores were 46 (range: 18−54) and 37(range:14−51), respectively. A low (<50 %) overall LIDA score was recorded for 30.9 % (n = 26) of the websites. The median DISCERN score was 49.5 (range: 21–77). The DISCERN score of ≤50 % was found in 45 (53.6 %) websites. The DISCERN score was significantly associated with LIDA usability and reliability scores (p < 0.001) and the FRES score (p = 0.024). ConclusionThe majority of websites on COVID-19 for the public had moderate to low scores with regards to readability, usability, reliability and quality. Practice ImplicationsPrompt strategies should be implemented to standardize online health information on COVID-19 during this pandemic to ensure the general public has access to good quality reliable information.

Arteriovenous Fistula for dialysis – Let's Google it. Readability and quality of online information

BackgroundThis study evaluated the readability and quality of information regarding arteriovenous (AV) fistula for dialysis on the Internet in the English language. Study designUsing Google© search, the keywords “AV Fistula for dialysis” were searched. The top 75 ranking sites were analyzed. One website was excluded due to repetition. Each landing page was assessed independently by two authors (RB, LR) for readability using the Flesch Reading Ease Score (FRES) and Gunning Fog Index (GFI). Web site quality was assessed using the DISCERN instrument. The individual position of the top 15 websites in the search engine ranking order list was noted. The country of origin, organization type and issuance of Health on the Net (HoN) Certification was recorded. Statistical analyses were performed using unpaired t-tests and ANOVA variance. ResultsThe mean GFI score was 9.2 and the mean FRES score was 50.6, indicating poor readability. The mean DISCERN score was 48.4, indicating weak quality of websites. Website quality was influenced by the academic/healthcare organization type (p = 0.012). Organization type was not found to impact GFI and FRES scores. Presence of a HoN Certification was not found to impact the quality of information. The majority of sites originated from the United States (61%). ConclusionOur study demonstrates that internet information pertaining to AV fistula for dialysis is of poor quality necessitating improvements to readability and overall website quality to improve the patient experience. Further research into how to improve healthcare web information is needed.

Quality of the patient-oriented information on thyroid cancer in the internet

ObjectivesThis study was conducted to analyse the readability and quality of patient education websites about thyroid cancer. MethodsYahoo!, Google and Bing were searched with their default settings using the keywords thyroid cancer, thyroid tumour, thyroid tumor, and thyroid malignancy for relevant websites. The first 50 websites obtained for each keyword and search engine were evaluated using validated Flesch Reading Ease Score (FRES), LIDA and DISCERN scores to assess readability, usability and reliability, and quality of information. Statistical analysis were done using non-parametric tests. ResultsThe analysis included 49 eligible websites selected out of 600 websites obtained from the search engines. Twenty-two (44.9%) web sites had obtained Health on the net foundation code of conduct (HON-code) certification. The included websites had a median FRES score of 55.3(range 25.3–85.3) and the LIDA reliability and usability scores were 22.0(range 14–30) and 39.0(range 28–50), respectively. The median DISCERN score was 48.0(range 33–63). A total DISCERN score of 50% or less (low score) was found in 28.5%(n = 14) of the websites. A significant association was found between LIDA usability and, reliability scores and DISCERN score (p<0.001, p=0.001, respectively). ConclusionThe quality of the websites, readability and usability scores were moderate or low based on the criteria used. Access to quality information may help with better informed decisions on treatment, follow up and prognosis. As the internet use by the public is ever increasing, implementing measures to ensure the quality information without a bias should be considered a priority.

Abstract No. 640 Readability assessment of internet-based patient education materials related to treatment options for benign prostatic hyperplasia

To assess the current readability levels for online Internet-based patient education materials (IPEMs) related to treatment options for benign prostatic hyperplasia (BPH), including transurethral resection of prostate (TURP) and prostate artery embolization (PAE). Using the Google search engine only we identified 40 IPEM’s pertaining to TURP and PAE that fit HON-code criteria. Readability comprehension analysis was performed using the following algorithms: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Formula (FKGL), Simple Measure of Gobbledygook (SMOG), and the Gunning Frequency of Gobbledygook (Gunning FOG). Only 7.5% (3/40) websites met the United States Department of Health and Human Services (USDHHS) recommendation of a 6th grade or lower comprehension levels, with FRES scores in the “fairly easy.” Comparison of TURP to PAE groups showed that TURP readability scores with respect FRES and FKGL were significantly easier to read. According to SMOG and GFOG analysis there was no difference between the two groups by grade level, which demonstrated an average at the 12th grade reading level. Subgroup analysis of IPEM type, categorized as Health Networks (12), University Hospitals (14), Clinical Practices (6), and Miscellaneous (8), found no difference in reading level across all scoring systems. Currently available IPEM’s pertaining to BPH treatment options are written at a level that is too difficult for the average American to understand. Physicians and health networks should take USDHHS recommendations into consideration when designing IPEMs to optimize accessibility of health information to improve patient compliance and outcomes.TableAverage FRES, FKGL, SMOG & GFOG of all IPEMsReadability ScaleTotal Average Score (95% Cl)TURP Average Score (95% CI)PAE Average Score (95% CI)P valueFRES52.9 (48.7−57.0)57.7 (54.5−61.4)47.7 (43.9−51.6)0.01FKGL9.7 (8.9−10.4)8.8 (7.1−10.5)10.6 (9.1−12.1)0.02SMOG12.9 (12.2−13.6)12.5 (11.4−13.7)13.3 (11.9−14.6)0.29GFOG12.9 (11.9−13.8)11.9 (10.1−13.8)13.8 (12.0−15.5)0.06 Open table in a new tab

Readability Assessment of Internet-based Patient Education Materials Related to Treatment Options for Benign Prostatic Hyperplasia

To assess the current readability levels for online Internet-Based Patient Education Materials (IPEMs) related to treatment options for benign prostatic hyperplasia, including transurethral resection of prostate (TURP) and prostate artery embolization (PAE). Using the Google search engine we identified 40 IPEMs pertaining to TURP and PAE. Readability analysis was performed using the following algorithms: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Formula (FKGL), Simple Measure of Gobbledygook (SMOG), and the Gunning Frequency of Gobbledygook (GFOG). Scores are categorized by difficulty (FRES) and grade level (FKGL, SMOG, GFOG). Only 7.5% (3/40) websites met the United States Department of Health and Human Services recommendation of a sixth grade or lower comprehension levels, with FRES scores in the "fairly easy" category. Comparison of TURP to PAE groups showed that TURP readability scores with respect FRES and FKGL were significantly easier to read. According to SMOG and GFOG analysis there was no difference between the two groups by grade level, which demonstrated an average at the 12th grade reading level. Subgroup analysis of IPEM type, categorized as Health Networks (12), University Hospitals (14), Clinical Practices (6), and Miscellaneous (8), found no difference in reading level across all scoring systems. Currently available IPEMs pertaining to benign prostatic hyperplasia treatment options are written at a level that is too difficult for the average American to understand. Physicians and health networks should take United States Department of Health and Human Services recommendations into consideration when designing IPEMs to optimize accessibility of health information to improve patient compliance and outcomes.

Quality and scientific accuracy of patient-oriented information on the internet on minimally invasive surgery for colorectal cancer

ObjectivesAppropriate information on minimally invasive surgery for colorectal cancer would help the patients and their caretakers to understand the treatment process. We aimed to assess the readability, quality and scientific content of patient-oriented information on minimally invasive surgery for colorectal cancer on the internet. MethodsInternet search on “minimally invasive surgery for colorectal cancer”, “laparoscopic surgery for colorectal cancer” and “robotic surgery for colorectal cancer” was performed on search engines (Google, Yahoo! and Bing). Quality and readability were assessed by DISCERN instrument and validated Flesch Reading Ease Score (FRES) respectively. ResultsFifty-five websites were analysed. The median DISCERN score was 41(range:24–66) and the median FRES score was 33.9(range:10.4–59.8) indicating low readability. Twenty-seven sites (49.1%) were affiliated with hospitals or clinics. Benefits of surgery and the surgical procedure were mentioned in 76.4% and 81.8% respectively. However, pre-op preparation, surgical complications, and quality of life were not mentioned in 49(82.1%), 42(76.4%) and 44(80%) sites respectively. Overall on DISCERN, 7(12.73%) were identified as “Excellent”, 25(45.45%) as “Good” or “Moderate” and 23(41.82%) as “Poor”. ConclusionAnalysis of the quality and scientific content of patient information on MIS for CRC revealed a considerable deficiency in the information provided and sub-standard readability. Several aspects such as pre-op preparation, surgical complications and post-operative quality of life which are of concern to the patient were not discussed in a considerable proportion of articles. As the internet is expanding as a readily available source of information, steps should be taken to ensure the highest quality information.

Quality and Readability of Online Information on In-Office Vocal Fold Injections.

Vocal fold injection augmentations are increasingly being performed in the office setting on awake patients, as opposed to the operating room. These procedures thus require patient cooperation and education. As the Internet is a widely-used resource for patients, our aim was to assess the quality and readability of online resources on in-office awake vocal fold injections. An online Google search using the terms "office vocal fold injection medialization" and "awake vocal fold injection" was conducted. The first 50 English-language websites were categorized into professional- and patient-targeted, and major and minor sources. They were analyzed using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL) test, and DISCERN quality score. Fifty websites were evaluated, and the overall DISCERN score was 2.60 ± 1.01, the mean FRES was 32.16 ± 19.10, and the mean FKGL was 13.76 ± 4.12. Between the 25 professional-targeted and 25 patient-targeted websites, professional-targeted sites had significantly higher DISCERN (P < .05) and FKGL (P < .05) scores, and lower FRES (P < .05) scores. Between the 30 major and 20 minor websites, major websites had significantly lower FRES (P < .05) and higher FKGL (P < .05) scores, and there was a trend toward significance for higher DISCERN scores (P = .052). Our study shows that half of the top Google results for our topic were not written for patient education, but rather for health care professionals. The reading level of this information exceeds the recommended grade level for patient education materials, and may be less comprehensible than intended. While patient-targeted materials are easier to read than professional-targeted sites, they are of lower quality. The quality of the available online information on this topic is suboptimal for both patients and health care providers. This research highlights the need for more appropriate patient education materials given low health literacy rates.

EHealth tool for patients with abdominal aortic aneurysm: development and initial evaluation.

Abdominal aortic aneurysm (AAA) is a prevalent condition among elderly men and may require surgical repair. Recent technical advances offer new opportunities to provide patients and next of kin with tailored and individualised information. eHealth tools have proven useful in other patient cohorts, but there are currently no validated educational eHealth tools for patients with AAA. Our aim was to develop and evaluate an eHealth tool for patients with abdominal aortic aneurysm using a participatory design process. Patients, healthcare professionals and a technical team were involved in the development of the eHealth tool. The tool was assessed for content and usability through questionnaires, validated instruments and focus group interviews. Readability was assessed using Flesch Reading Ease Score (FRE) and Flesch-Kincaid Grade Level (FKGL). Interview data were analysed using thematic content analysis. Factual content and illustrations were accurate and in line with current information routine. Readability assessments produced a mean FRE score of 42.2 (±3,7) and mean FKGL of 10 (±1), implying that the eHealth tool may be difficult to comprehend for certain users. However, participants in the focus group interviews found the tool to be understandable, relevant and easy to use. The developed eHealth tool is acceptable, understandable and usable for the potential end-users. Further evaluation of the usability of the tool and effect on outcome in clinical care is warranted. This is the first educational eHealth tool for patients with AAA and has potential to contribute to improved communication and quality of care for AAA patients.

Assessment of the quality of patient-oriented information over internet on testicular cancer

BackgroundThis study aimed to assess the quality and readability of patient education information available on the internet on testicular cancer.MethodsInternet searches were performed using the keywords ‘testicular cancer’, ‘testicular tumour’, ‘testicular tumor’, ‘testicular malignancy’, ‘germ cell tumour’ and ‘germ cell tumor’ using Google, Yahoo! And Bing search engines with default settings. The first 50 web links appeared in each search engine were evaluated for their readability by using the validated Flesch Reading Ease Score (FRES) while accessibility, usability and reliability were assessed using the LIDA tool. The quality was assessed using DISCERN instrument. Non-parametric tests were used for statistical analysis.ResultsOverall, 900 websites were assessed and 62 websites were included in the analysis. Twenty two (22) websites (35.5%) were certified by Health on the Net Foundation code of conduct (HON code). The majority (n = 57, 91.9%) were non-governmental websites. The median FRES score was 51.6 (range: 28.1–74.1), the overall median LIDA score was 115 (range: 81–147); accessibility 55 (range: 46–61), reliability 22 (range: 8–45) and usability 38.5 (range: 21–50), while the median DISCERN score was 43.5 (range: 16–69). The DISCERN score was significantly associated with the overall LIDA score and usability and reliability components of the LIDA score (p < 0.001). However, no significant associations were observed between readability and accessibility. A significant correlation was noted between usability and reliability components of the LIDA score (Spearman’s rho: 0.789, p < 0.001).ConclusionIn this study, the readability, reliability and quality scores of most websites were found to be suboptimal and hence, there is potential for improvement. As the internet is expanding rapidly as a readily available source of information to the public, it is essential to implement steps to ensure that highest quality information is provided without any commercial motivation or bias.

So Difficult to Understand : Readability Index Analysis of Online Patient Information on Lymphoma from NCI- Designated Cancer Center.

Objectives - In current era of information technology, there is abundance of medical information for the patients and families. It is recommended that the online patient information (OPI) should be written no greater than sixth grade as per The National Institute of Health (NIH), American Medical Association, Department of Health & Human Services. We aim is to assess whether OPI on lymphoma from NCI-Designated Cancer Center (NCIDCC) and various cancer associations websites meet the current recommendations on a panel of readability indexes.Methods - OPI from patient only section of NCIDCC and cancer associations websites were collected. This text was analyzed by 7 commonly used readability tests - Flesch Reading Ease score(FRE), Gunning Fog(GF), Flesch-Kincaid Grade Level(FKGL), The Coleman-Liau Index(CLI), The Simple Measure of Gobbledygook (SMOG) Index, Automated Readability Index(ARI) and Linsear Write Formula(LWF). Text from each article was pasted into Microsoft Word and analyzed using the online software Readability formulas.Results - The mean FRE score is 55.4 (range 37.4-67.9) which corresponded to difficult level grade. The mean GF score is 12.9 (range 10.8-15.2) that comes between difficult and hard. The FKGL score is 9.9 (range 7.2-11.9) that corresponds to above the level of ninth grader.The mean CLI score is 11.09 (range 9-12) which represented text of twelfth grade. The mean SMOG index is 9.6 (range 8.1-11.1) which corresponded to greater than seventh grade level. While the mean ARI score was 10.5 (range 7.7-12.5) which represents readability suitable for people more than tenth grade. The mean LWF was 11.29 (range 7.8-14.4) that corresponds to tenth grade level of text.Conclusion - The currently available OPI on lymphoma did not met the set national recommendations level on seven different validated readability indexes. Currently, available literature is difficult to understand and comprehend for average patient and their kins. There is a dire need to revise the currently available material for easy comprehension and understanding by the general patient population. DisclosuresNo relevant conflicts of interest to declare.

Adult orthodontics: a quality assessment of Internet information.

This study evaluated the quality, reliability and readability of information on the Internet on adult orthodontics. A quality assessment of adult orthodontic websites. Postgraduate Orthodontic Unit, Cork University Dental School and Hospital, Cork, Ireland. An Internet search using three search engines (Google, Yahoo and Bing) was conducted using the terms ('adult orthodontics' and 'adult braces'). The first 50 websites from each engine and under each search term were screened and exclusion criteria applied. Included websites were then assessed for quality using four methods: the HON seal, JAMA benchmarks, the DISCERN instrument and the LIDA tool. Readability of included websites was assessed using the Flesch Reading Ease Score (FRES). Only 13 websites met the inclusion criteria. Most were of US origin (n = 8; 61%). The authors of the websites were dentists (n = 5; 39%), professional organizations (n = 2; 15%), past patients (n = 2; 15%) and unspecified (n = 4; 31%). Only 1 website displayed the HON seal and three websites contained all JAMA benchmarks. The mean overall score for DISCERN was 3.9/5 and the mean total LIDA score was 115/144. The average FRES score was 63.1/100. The number of informative websites on adult orthodontics is low and these are of moderate quality. More accurate, high-quality Internet resources are required on adult orthodontics. Recommendations are made as to how this may be achieved.

An analysis of the readability of patient information materials for common urological conditions.

Health literacy has been shown to be an important determinant of outcomes in numerous disease states. In an effort to improve health literacy, the Canadian Urological Association (CUA) publishes freely accessible patient information materials (PIMs) on common urological conditions. We sought to evaluate the readability of the CUA's PIMs. All PIMs were accessed through the CUA website. The Flesch Reading Ease Score (FRES), the Flesch-Kincaid Grade Level (FKGL), and the number of educational graphics were determined for each PIM. Low FRES scores and high FKGL scores are associated with more difficult-to-read text. Average readability values were calculated for each PIM category based on the CUA-defined subject categorizes. The five pamphlets with the highest FKGL scores were revised using word substitutions for complex multisyllabic words and reanalyzed. The Kruskal-Wallis test was used to identify readability differences between PIM categories and paired t-tests were used to test differences between FKGL scores before and after revisions. Across all PIMs, FRES values were low (mean 47.5, standard deviation [SD] 7.47). This corresponded to an average FKGL of 10.5 (range 8.1-12.0). Among PIM categories, the infertility and sexual function PIMs exhibited the highest average FKGL (mean 11.6), however, differences in scores between categories were not statistically significant (p=0.38). The average number of words per sentence was also highest in the infertility and sexual function PIMs and significantly higher than other categories (mean 17.2; p=0.01). On average, there were 1.4 graphics displayed per PIM (range 0-4), which did not vary significantly by disease state (p=0.928). Simple words substitutions improved the readability of the five most difficult-to-read PIMs by an average of 3.1 grade points (p<0.01). Current patient information materials published by the CUA compare favourably to those produced by other organizations, but may be difficult to read for low-literacy patients. Readability levels must be balanced against the required informational needs of patients, which may be intrinsically complex.

Readability Assessment of Online Tracheostomy Care Resources

Objectives: (1) Assess the readability of online tracheostomy care resources. (2) Compare the readability of major versus minor websites and patient- versus professional-oriented resources. Methods: A Google search was performed for “Tracheostomy care” in January 2014. The top fifty results were categorized into major versus minor websites, and patient- versus professional-oriented resources. These websites were evaluated with the following readability tools: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (GFOG). Results: Readability scores for the 50 websites were FRES 57.21 ± 16.71 (possible range = 0 to 100), FKGL 8.33 ± 2.84 (possible range = 3 to 12), SMOG 11.25 ± 2.49 (possible range = 3 to 19), and GFOG 11.43 ± 4.07 (possible range = 3 to 19). There was no significant difference in all 4 readability scores between major (n = 41) and minor (n = 9) websites. Professional-oriented websites (n = 19) had the following readability scores: FRES 40.77 ± 11.69, FKGL 10.93 ± 2.48, SMOG 13.29 ± 2.32, and GFOG 14.91 ± 3.98. Patient-oriented websites (n = 31) had the following readability scores: FRES 67.29 ± 9.91, FKGL 6.73 ± 1.61, SMOG 10.01 ± 1.64, and GFOG scores 9.30 ± 2.27. Professional-oriented websites had more difficult readability scores than patient-oriented websites for FRES ( P &lt; .00), FKGL ( P &lt; .00), SMOG ( P &lt; .00), and GFOG scores ( P &lt; .00). Conclusions: Online tracheostomy care resources were written at a level more difficult than the recommended fourth- to sixth-grade level for written health information. There was no significant difference in readability between major and minor websites. Professional-oriented websites were more difficult to read than patient-oriented websites.

Assessing the quality of online information for patients with carotid disease

IntroductionControversy exists relating to carotid endarterectomy (CEA) versus carotid artery stenting (CAS). We aimed to assess the quality of online patient information relating to both. MethodsThe Google search engine was searched for “carotid endarterectomy” and “carotid stenting”. The first 50 webpages returned were assessed. The Gunning Fog Index (GFI) and Flesch Reading Ease Score (FRES) were calculated to assess readability. The LIDA tool (Minervation Ltd., Oxford, U.K.) was used to assess accessibility, usability and reliability. Results20% (n = 10) of the webpages returned for CEA were from peer reviewed sources with 34% (n = 17) posted by hospitals or health services. Comparatively, for CAS, 40% (n = 20) were peer reviewed with 16% (n = 8) posted by hospitals or health services. GFI and FRES scores indicated webpages for both CEA and CAS had poor general readability. Webpages for CEA were easier to read than those for CAS (mean FRES difference of 6.7 (95% CI 0.51 to 12.93, p = 0.03). Median LIDA scores demonstrated acceptable reliability, accessibility and usability of information for both CEA and CAS webpages. The more readable webpages were not associated with higher LIDA scores for either CEA or CAS webpages. ConclusionWebpages providing information on carotid disease management must be made more readable. Online information currently available to patients regarding CAS is more difficult to read and comprehend than CEA.

Evaluating the Quality and Readability of Thyroplasty Information on the Internet

To assess the quality and readability of thyroplasty information available on the Internet. Cross-sectional study. We conducted a Google search for "thyroplasty treatment" and analyzed the first 50 Web sites using the DISCERN instrument, the Flesch Reading Ease Score (FRES), and the Flesch-Kincaid Grade Level (FKGL) score. DISCERN is a 16-item validated questionnaire used to assess the quality of written health information for patients. FRES and FKGL are commonly used instruments to assess readability of written information. We also further analyzed major versus minor and patient-targeted versus professional Web sites. Overall DISCERN score was 2.20±0.60. Overall FRES score was 29.68±16.64. Overall FKGL score was 13.07±3.95. We found significant differences between patient-targeted and professional Web sites on FRES (43.80±2.78 and 18.58±9.04, respectively) and FKGL (11.46±3.36 and 14.33±4.30, respectively) (P<0.00 and P=0.01, respectively). We also found significant differences between major and minor Web sites on DISCERN (2.35±2.35 and 1.95±0.61, respectively), FRES (24.75±14.61 and 37.71±16.97, respectively), and FKGL (14.19±3.68 and 11.24±3.77, respectively) (P=0.03, 0.01, and 0.01, respectively). Thyroplasty information available online is of suboptimal quality and written at a level too difficult for the average American adult to read comfortably. Major Web sites have higher quality information but are more difficult to read. Professional Web sites are also more difficult to read than patient-targeted Web sites.

Readability assessment of online thyroid surgery patient education materials

Published guidelines recommend written health information be written at or below the sixth-grade level. We evaluate the readability of online materials related to thyroid surgery. Thyroid surgery materials were evaluated using Flesch Reading Ease Score (FRES), Flesch Kincaid Grade Level (FKGL), Gunning Frequency of Gobbledygook (GFOG), and Simple Measure of Gobbledygook (SMOG). Thirty-one documents were evaluated. FRES scores ranged from 29.3 to 67.8 (possible range = 0 to 100), and averaged 50.5. FKGL ranged from 6.9 to 14.9 (possible range = 3 to 12), and averaged 10.4. SMOG scores ranged from 11.8 to 14.5 (possible range = 3 to 19), and averaged 13.0. GFOG scores ranged from 10.6 to 18.0 (possible range = 3 to 19), and averaged 13.5. Readability scores for online thyroid surgery materials are higher (i.e., more difficult) than the recommended levels. However, readability is only one aspect of comprehension. Written information should be designed with that fact in mind.

Readability of printed patient information for epileptic patients.

Written information can be a valuable tool in patient education. Studies evaluating written information for various disease states have frequently demonstrated that the majority of literature is written at a readability level that exceeds that of the average patient, and it has been recommended that written communications for adult patients should be provided at a fifth-grade level or lower. To assess the readability of printed patient information available to patients with epilepsy. Samples of written patient information (n = 101) were obtained from various sources. The information was classified based on source, content, and intended audience, and readability was assessed using the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL) score. The mean FRES and FKGL score for all samples were 50.2 and 9.4, respectively. Significant differences were observed in both the FRES and FKGL score of material obtained from different sources; however, no differences were observed when material was analyzed according to content. The mean FRES and FKGL score for materials intended for adults were 49.6 and 9.5, respectively. In comparison, mean FRES and FKGL scores for materials intended for children/adolescents were 78.9 and 5.3, respectively. The majority of information tested was written at a level that exceeds the reading ability of many patients. The information intended for children is actually written at the appropriate level for an adult. Efforts should be taken to develop written teaching tools that target low-level readers, especially for a disease state that affects many children.