Good Readability Research Articles

Tingkat Keterbacaan dan Keefektifan Kalimat pada Teks Narasi sebagai Bahan Ajar Membaca Pemahaman di Buku Narasi Literasi Bahasa Indonesia Kelas IX Terbitan Direktorat Pendidikan

Reading comprehension skills are a major focus in Indonesian language learning, especially in grade IX, as narrative comprehension helps students relate information in a broader context. The purpose of this study is to provide comprehensive guidelines for the development of more effective Indonesian learning materials and to strengthen the reading comprehension skills of grade IX students. This study evaluates the readability using Fry's Graph Formula and the effectiveness of sentences in narrative texts as teaching materials for reading comprehension in grade IX Indonesian literacy narrative books. By using the Fry's Graph Formula analysis method, this research helps to adapt the text to the intended grade level. Of the six narrative texts analyzed, there are three that have good readability, two that have poor readability, and one that has poor readability. In addition, this study analyzed sentence ineffectiveness. Sentence ineffectiveness can be caused by various reasons, such as word inefficiency, inaccurate use of conjunctions, inaccuracy in word usage, inaccurate use of punctuation, and meaninglessness. The results of the study provide insight into the quality of grade IX Indonesian literacy narrative teaching materials and contribute to improving students' reading comprehension and ability. The readability and effectiveness of the sentences in the grade IX Indonesian literacy narrative book are very important to ensure that the material presented can be well understood by students, thus having a positive impact on the learning process and the achievement of learning objectives.

Age Estimation in Sepia officinalis Using Beaks and Statoliths.

Establishing the age of cephalopods is crucial for understanding their life history, which can then be used for assessment and management. This is particularly true for the common cuttlefish Sepia officinalis (Linnaeus, 1758), one of the most important resources for coastal fisheries. For this reason, an age analysis of S. officinalis was performed for the first time in the Mediterranean, using beaks and statoliths from 158 wild specimens (55-222 mm mantle length; 23-1382 g total weight) at different maturity stages (immature to mature). Growth increments were counted in the lateral wall of the upper beaks and the lateral dome of statoliths. In both cases, a good relationship was found between the counts and the sizes of the animals. The low values of coefficients of variation between the readings obtained for beaks (3.96 ± 1.87%) and statoliths (4.00 ± 1.89%) showed a high level of precision and accuracy in the readings. However, the analysis was simpler for beaks, which were all successfully analyzed, while it was more complex for statoliths, with 69% being lost due to rejection or overgrinding. Based on daily increments previously validated in statoliths, the beaks were cross-verified by comparing their counts with those from statoliths extracted from the same 83 specimens, obtaining a statistically significant relationship between the two counts, confirmed by the ANOVA test. Absolute growth rates that were assessed using both beaks and statoliths indicated that the two sexes had a higher growth rate at 122 and 182 days, which subsequently declined in older specimens. Due to the relative simplicity of its processing method, the beak was finally proposed as a suitable hard structure to study the age of S. officinalis. We also confirmed the good readability of increments in the lateral wall of the beak, which could be considered a valid alternative to the rostrum surface.

The Accuracy of PUMA Questionnaire in Combination With Peak Expiratory Flow Rate to Identify At-risk, Undiagnosed COPD Patients

IntroductionThe English PUMA questionnaire emerges as an effective COPD case-finding tool. We aimed to use the PUMA questionnaire in combination with peak expiratory flow rate (PEFR) to improve case-finding efficacy in Chinese population. MethodsThis cross-sectional, observational study included two stages: translating English to Chinese PUMA (C-PUMA) questionnaire with linguistic validation and psychometric evaluation, followed by clinical validation. Eligible participants (with age ≥40 years, respiratory symptoms, smoking history ≥10 pack-years) were enrolled and subjected to three questionnaires (C-PUMA, COPD assessment test [CAT], and generic health survey [SF-12V2]), PEFR measurement, and confirmatory spirometry. The C-PUMA score and PEFR were incorporated into a PUMA-PEFR prediction model applying binary logistic regression coefficients to estimate the probability of COPD (PCOPD). ResultsC-PUMA was finalized through standard forward–backward translation processes and confirmation of good readability, comprehensibility, and reliability. In clinical validation, 240 participants completed the study. 78/240 (32.5%) were diagnosed with COPD. C-PUMA exhibited significant validity (correlated with CAT or physical component scores of SF-12V2, both P<0.05, respectively). PUMA-PEFR model had higher diagnostic accuracy than C-PUMA alone (area under ROC curve, 0.893 vs. 0.749, P<0.05). The best cutoff values of C-PUMA and PUMA-PEFR model (PCOPD) were ≥6 and ≥0.39, accounting for a sensitivity/specificity/numbers needed to screen of 77%/64%/3 and 79%/88%/2, respectively. C-PUMA ≥5 detected more underdiagnosed patients, up to 11.5% (vs. C-PUMA ≥6). ConclusionC-PUMA is well-validated. The PUMA-PEFR model provides more accurate and cost-effective case-finding efficacy than C-PUMA alone in at-risk, undiagnosed COPD patients. These tools can be useful to detect COPD early.

Development of test instruments to measure problem-solving and science literacy of grade XI students on ion equilibrium material in salt hydrolysis

Low science literacy in students will have an impact on students' ability to solve problems. To improve it, it is necessary to develop an assessment instrument in the form of a science literacy instrument. This study aims to develop valid, reliable problem solving and science literacy assessment instruments for students. The material chosen is ion equilibrium in salt solution. The research was conducted in high, medium and low ability schools namely SMA Negeri 1 Pekanbaru, SMA Negeri 12 Pekanbaru and SMA Negeri 15 Pekanbaru. There are 16 questions out of 20 questions that are constructively valid with a correlation value&gt; 0.36. The questions developed have met the reliability requirements with a Cronbach alpha coefficient value greater than 0.6, reaching a value of 0.874. The level of difficulty of questions between 0.3 -0.7 is in the good enough category and differentiating power ≥ 0.3. Based on two trials, namely one-on-one trials and limited trials, the same results were obtained that the assessment instruments developed for students had very good readability aspects (85%), good adequacy aspects (64%) and assessment instruments developed for teachers had very good feasibility aspects (91%). There is a significant difference in the ability of students in high schools with medium and low ability schools.

Analisis Keterbacaan dan Efisiensi Pada Logo HUT 76 Lombok Tengah

The quality of the 76-year-old Central Lombok logo is considered to lack good readability and efficiency. This can affect the quality of the audience’s readability in understanding the visuals. Moreover, Central Lombok is a mirror reflection of Indonesia at international scale MotoGP events and is required to develop regional branding. The aim of this research is to analyze the level of readability and efficiency through analyzing the use of color and the application of typography in the logo. The method used in this research uses quantitative methods with research stages including the data collection process through digital observation on the diskominfoloteng Instagram. In the research results, the error in choosing colors in the 76 Central Lombok logo by using red and white in the logo, where the two colors have very different color intensities and different levels of legibility, readability and visibility, gives rise to poor readability. Due to the addition of a script font to the 76 Years of Central Lombok logo design. The results show that the choice of color intensity can influence the application of media to dark or light backgrounds. The author provides a solution in the form of using one color in one logo structure and the author also recommends that designers do not use script fonts in a logo so that typographic principles can be maximally applied in all media applications.

Quality and Readability Assessment of Web-based Arabic Health Information on Early Childhood Caries.

Patients are increasingly using the internet for searching health-related information. However, the quality and readability of the information available on the internet need to be assessed. To date, no study has assessed the quality and readability of web-based Arabic health information on early childhood caries. To evaluate the quality and readability of patient-oriented online Arabic health information regarding early childhood caries. For this infodemiological study, the Google and Yahoo search engines were searched using specific Arabic terms for early childhood caries, and the top 100 searches from both search engines were considered. Eligible websites were categorized in terms of affiliation as commercial, health portal, dental practice, professional, and journalism. The quality of the websites was assessed using the QUality Evaluation Scoring Tool (QUEST), and readability using the Gunning Fog index (GFI). A total of 140 websites were included after applying the exclusion criteria, of which 50.7% websites were of journalism. The majority of the websites (70%) had an overall low-quality level, with a QUEST score <10. The quality of websites retrieved from Google searches was of significantly higher quality than those from Yahoo (P < 0.0001). More than half (51.4%) of the websites had good readability, with a GFI score ≤8. Journalism websites had a significantly higher proportion of websites with poor readability level (62%) compared with other affiliations (P = 0.0072). The web-based Arabic information regarding early childhood caries is currently of low quality and moderate readability level, thereby indicating a need for improving such patient-facing content.

Validity and reliability of the English version of the Diabetic Foot Self-Care Questionnaire: a cross-cultural adaptation.

The objective of this study was to carry out the cross-cultural adaptation and validation of the Diabetic Foot Self-Care Questionnaire into the English language, broadening the applicability of this patient-reported outcome measure and improving the monitoring of patients with diabetic foot disease. The validation study into English was conducted in two phases: cross-cultural adaptation and psychometric validation study. Short Form-12 Version 2, EuroQoL-5D and Foot Function Index were used to analyze the criterion validity. Item response, internal consistency, standard error of measurement, minimal detectable change and construct validity were calculated in the validation phase. An English version of the questionnaire (DFSQ-UMA-En) was successfully obtained. A total of n = 193 participants were tested to confirm the validity and reliability of the questionnaire. Internal consistency values ranged from very good to excellent (Cronbach's α =0.889-0.981), and reliability was excellent (ICC = 0.854-0.959). Standard error measurement value was =2.543. Criterion validity ranged from r = 0.429 to r = 0.844. For construct validity, Kaiser-Meyer-Olkin test was =0.752. DFSQ-UMA-En is a valid and reliable tool with good readability and comprehension features. This questionnaire addresses foot self-care behaviors in patients with diabetic foot disease, standing out as essential for early diagnosis and prevention strategies in clinical and research settings.

Supporting health and social care professionals in serious illness conversations: Development, validation, and preliminary evaluation of an educational booklet.

Serious illness conversations aim to align the care process with the goals and preferences of adult patients suffering from any advanced disease. They represent a challenge for healthcare professionals and require specific skills. Conversation guides consistent with task-centered instructional strategies may be particularly helpful to improve the quality of communication. This study aims to develop, validate, and preliminarily evaluate an educational booklet to support Italian social and healthcare professionals in serious illness conversations. A three-step approach, including development, validation, and evaluation, was followed. A co-creation process with meaningful stakeholders led to the development of the booklet, validated by 15 experts on clarity, completeness, coherence, and relevance. It underwent testing on readability (Gulpease index, 0 = lowest-100 = maximum) and design (Baker Able Leaflet Design criteria, 0 = worst to 32 = best). Twenty-two professionals with different scope of practice and care settings evaluated acceptability (acceptable if score ≥30), usefulness, feasibility to use (1 = not at all to 10 = extremely), and perceived acquired knowledge (1 = not at all to 5 = extremely). After four rounds of adjustments, the booklet scored 97% for relevance, 60 for readability, and 25/32 for design. In all, 18 (81.8%), 19 (86.4%) and 17 (77.3%) professionals deemed the booklet acceptable, moderate to highly useful, and feasible to use, respectively; 18/22 perceived gain in knowledge and all would recommend it to colleagues. The booklet has good readability, excellent design, high content validity, and a high degree of perceived usefulness and acquired knowledge. The booklet is tailored to users' priorities, mirrors their most frequent daily practice challenges, and offers 1-minute, 2-minute and 5-minute solutions for each scenario. The co-creation process ensured the development of an educational resource that could be useful regardless of the scope of practice and the care setting to support professionals in serious illness conversations.

Interpretable hierarchical belief rule base expert system for complex system modeling

Belief rule base (BRB) expert system has been widely used in complex system modeling. Readability and consistency are the primary characteristics and advantages of BRB. However, these two characteristics may be lost in BRB establishment and optimization. Aiming at this problem, a novel hierarchical BRB (H-BRB) expert system is proposed. To quantify the interpretability of BRB, the definition of interpretability of BRB is proposed from the readability and the consistency. Two strategies are proposed to construct the H-BRB expert system with good readability. A new optimization method is proposed to guarantee the consistency of H-BRB, including a new optimization mechanism, a new objective function with interpretability constraints, and a modified optimization algorithm. With all the above, an H-BRB expert system with good readability and consistency can be established. A case study of the health state assessment of the aerospace relay is implemented to verify the effectiveness of the proposed method.

E-Module Gerak Lurus: Peluang Pengembangan Keterampilan Proses Sains dan Keterampilan Bernalar

This research aims to develop an e-module based on Predict-Observe-Explain (POE) equipped with questions that refer to the Minimum Competency Assessment (AKM) for high school students on the topic of linear motion that is valid, readable, and practical. This research uses a Research and Development (R&amp;D) research design with a 4D model, namely Define, Design, Develop, and Disseminate. This research produces an e-module for the topic of linear motion in the form of an application that can be used on Android-based devices. E-module has material presented with POE stages in each learning activity, which has the opportunity to improve students' science process skills. Moreover, the e-module is also equipped with AKM questions on the same topic, linear motion, which is expected to improve students' reasoning skills. The results of this research show that the e-module developed is classified as very valid with a percentage of 95.6%. In addition, the e-module also has very good readability and practicality, with a percentage of 94.8%. Thus, the e-module can be used in learning the physics topic, linear motion, for high school students.

The Development of an E-Module Based on Discovery Learning on Coordination System Material to Improve 4C Skills of High School Students

The results of interviews with biology teachers in class XI MIPA at SMA Negeri 1 Slawi show that the 4C skills of students in class XI MIPA are low due to the absence of a variety of teaching materials and that the role of the teacher as a teacher has not been implemented properly. Therefore, a discovery-learning-based e-module was developed on coordination material to improve students' 4C skills. The purpose of this study was to analyse the feasibility, readability, and practicality of using e-modules and the improvement of students' 4C skills on coordination system material. This type of research is research and development, and the research design used is the development research design, according to Thiagarajan et al. (1974). The instruments used in this study were the product validation questionnaire, teacher response questionnaire, readability questionnaire, student response questionnaire, pre-test and post-test questions, observation sheet, and peer assessment. The results of the study showed that the e-module was feasible to use, obtaining an average score of 92.97%. Students' readability of the e-module obtained a score of 96.48% with very good criteria. Students' responses to the practicality of using e-modules amounted to 89.82%, with very practical criteria. The discovery learning-based e-module developed on coordination system material has an effect on students in the form of increasing their 4C skills. The conclusion of this research is that e-modules based on discovery learning on coordination system material are feasible and practical to use in learning coordination systems, have very good readability, and are effective in improving the 4C skills of SMA Negeri 1 Slawi students.

The capabilities of the adjoint of GEOS-Chem model to support HEMCO emission inventories and MERRA-2 meteorological data

Abstract. The adjoint of the GEOS-Chem (Goddard Earth Observing System with Chemistry) model has been widely used to constrain the sources of atmospheric compositions. Here, we designed a new framework to facilitate emission inventory updates in the adjoint of the GEOS-Chem model. The major advantage of this new framework is good readability and extensibility, which allows us to support Harmonized Emissions Component (HEMCO) emission inventories conveniently and to easily add more emission inventories following future updates in GEOS-Chem forward simulations. Furthermore, we developed new modules to support MERRA-2 (Modern-Era Retrospective Analysis for Research and Applications, version 2) meteorological data, which allows us to perform long-term analyses with consistent meteorological data for the period 1979–present. The performances of the developed capabilities were evaluated with the following steps: (1) diagnostic outputs of carbon monoxide (CO) sources and sinks to ensure the correct reading and use of emission inventories, (2) forward simulations to compare the modeled surface and column CO concentrations among various model versions, (3) backward simulations to compare adjoint gradients of global CO concentrations to CO emissions with finite-difference gradients, and (4) observing system simulation experiments (OSSEs) to evaluate the model performance in 4D variational (4D-Var) assimilations. Finally, an example application of 4D-Var assimilation was presented to constrain anthropogenic CO emissions in 2015 by assimilating Measurement of Pollution in the Troposphere (MOPITT) CO observations. The capabilities developed in this work are important for better applications of the adjoint of the GEOS-Chem model in the future. These capabilities will be submitted to the standard GEOS-Chem adjoint code base for better development of the community of the adjoint of the GEOS-Chem model.

Pengembangan bahan ajar teks fabel bermuatan nilai peduli dengan pendekatan saintifik pada MTS Miftahul Khair

The purpose of this research is to identify the development process, measure effectiveness, and evaluate the appeal of instructional materials in the form of value-based fable texts using a scientific approach for students in the seventh grade of Madrasah Tsanawiyah Miftahul Khair Loa Janan, Kutai Kartanegara Regency. This research employs the research and development (R&amp;D) method. The research resulted in a module of value-based fable texts with a scientific approach for seventh-grade students, which is overall excellent and aligned with the 2013 curriculum. Expert assessments from subject matter experts, instructional design experts, students, and subject teachers indicate that the module has a clear content presentation, an attractive layout, good readability, and significant benefits in enhancing students' competence. The development of this instructional material has proven to be effective, as evidenced by improved student learning outcomes after using the module. Although some students initially did not reach the minimum passing grade, the post-test results showed significant improvement, influenced by both teacher and student factors. In conclusion, this module has successfully created effective instructional materials to enhance students' competence in writing value-based fable texts using a scientific approach.

Development of Project Based Ethno-STEM Online Learning Module to Increase Interpersonal Literacy and Learning Out-come

Interpersonal skills are ability to understand sociocultural phenomena which include aspects of communication, appreciation, tolerance, caring, empathy, and being able to work with others and be able to adapt well in the surrounding environment. This is a very important provision that must be owned by every student. Purpose of this research is to develop learning media for brave science that examines local wisdom content to study the topic of food ingredients. This research was conducted at An-Nur Ungaran Middle School and several traditional food industry places around the student's residences. The research method used is R&amp;D with the ADDIE model. This media was validated and declared appropriate by media experts and material experts, then applied in science learning. The data obtained from the readability test, and the N-Gain test from students. The results of the study show that 1) Ethno-STEM learning module can be developed using the ADDIE model and is declared feasible to be applied in learning; 2) Ethno-STEM learning module can be developed to have good readability results, namely at a score of 61.4%; 3) Using of this Ethno-STEM module can improve interpersonal literacy and learning outcomes with N-gain values of 0.31 and 0.33, respectively.

Improving health literacy of antifungal use-Comparison of the readability of antifungal medicines information from Australia, EU, UK, and US of 16 antifungal agents across 5 classes (allylamines, azoles, echinocandins, polyenes, and others).

Adherence to antifungals is poor in high endemic regions where antifungal resistance is high. Poor readability of prescription/over-the-counter (OTC) antifungals may contribute to poor adherence, due to the patient not fully understanding the purpose, importance, and dosage of their antifungal medicine. As there are no reports on the readability of antifungals, this study examined the readability of patient-facing antifungal information. Antifungals (n=16; five classes [allylamines, azoles, echinocandins, polyenes, and others-flucytosine and griseofulvin]) were selected. Readability of four sources of information, (i) summary of product characteristics, (ii) patient information leaflets (PILs), (iii) OTC patient information, and (iv) patient web-based information, was calculated using Readable software, to obtain readability scores [(i) Flesch Reading Ease [FRE], (ii) Flesch-Kinkaid Grade Level [FKGL], (iii) Gunning Fog Index, and (iv) Simple Measure of Gobbledygook (SMOG) Index) and text metrics [word count, sentence count, words/sentence, and syllables/word]. PILs, web-based resources, and OTC patient information had good readability (FRE mean±sd=52.8±6.7, 58.6±6.9, and 57.3±7.4, respectively), just falling short of the≥ 60 target. For FKGL (target≤8.0), PILs, web-based resources, and OTC patient information also had good readability (mean±sd=8.5±1.0, 7.2±0.86, and 7.8±0.1, respectively). Improved readability scores observed correlate with reduced words, words/sentence and syllables/word. Improving readability may lead to improved patient health literacy. Healthcare professionals, academics, and publishers preparing written materials regarding antifungals for the lay/patient community are encouraged to employ readability calculators to check the readability of their work, so that the final material is within recommended readability reference parameters, to support the health literacy of their patients/readers.

Negative Effect of Local Politics on Multifactor Leadership of Junior High School Principals: Empirical Facts from Indonesia

This research focuses on investigating and examining the influence of local politics on the multifactor leadership of junior high school principals. The method used is a quantitative survey, with the unit of analysis being principals and teachers as respondents from 15 districts (regencies and cities) in Lampung Province. The data collection instrument used was the standardized multifactor leadership questionnaire in the Indonesian version resulting from the translation from English by an expert in the subject and was then discussed in the Forum Group Discussion to get good readability items. The questionnaire was completed by 393 teachers as respondents in 15 districts. The collected data were examined using the SEM Amos Version 22. The results show that the score of local political influence on multifactor leadership is -0,333, transformational is -1,877, transactional is -2,061, and laissez-faire is -,333. The authors conclude that local politics negatively affects all latent variables and all dimensions of multifactor leadership. This research contributes to human resource management and leadership in maintaining and developing and mainstreaming effective management and leadership practices which in this case is multifactor leadership by reducing a disturbing factor: anxiety.

Feature-aware conditional GAN for category text generation

Category text generation receives considerable attentions since it is beneficial for various natural language processing tasks. Recently, the generative adversarial network (GAN) has attained promising performance in text generation, attributed to its adversarial training process. However, there are several issues in text GANs, including discreteness, training instability, mode collapse, lack of diversity and controllability etc. To address these issues, this paper proposes a novel GAN framework, the feature-aware conditional GAN (FA-GAN), for controllable category text generation. In FA-GAN, the generator has a sequence-to-sequence structure for improving sentence diversity, which consists of three encoders including a special feature-aware encoder and a category-aware encoder, and one relational-memory-core-based decoder with the Gumbel SoftMax activation function. The discriminator has an additional category classification head. To generate sentences with specified categories, the multi-class classification loss is supplemented in the adversarial training. Comprehensive experiments have been conducted, and the results show that FA-GAN consistently outperforms 10 state-of-the-art text generation approaches on 6 text classification datasets. The case study demonstrates that the synthetic sentences generated by FA-GAN can match the required categories and are aware of the features of conditioned sentences, with good readability, fluency, and text authenticity.

NeatSankey: Sankey diagrams with improved readability based on node positioning and edge bundling

Sankey diagrams are widely used to visualize event sequence data. However, when the data volume is large, its readability is affected by dense edge crossings, excessive swing amplitude, and small crossover angles, while it is computationally intensive to obtain an optimal layout. In this paper, we propose NeatSankey, a balanced method that generates Sankey diagrams smoothly. It can be laid out quickly with good readability when Sankey diagrams are very complex. At the same time, to comprehensively evaluate the readability of Sankey diagrams, we use three evaluation metrics: crossing number, swing amplitude, and layout coverage. Firstly, we use a heuristic layout algorithm and a force-directed algorithm to adjust the node layout to minimize the edge crossings and swing amplitude with edge widths considered. Secondly, to better reduce the dense confusion caused by edge crossings, we introduce a edge bundling algorithm based on attribute similarity. We present three evaluations: a comprehensive comparison of our results with state-of-the-art techniques, user studies with thirty volunteers, and a case study of two datasets. Our evaluations demonstrate the effectiveness and practicability of the NeatSankey.

Psychometric Properties of the BAASIS: A Meta-analysis of Individual Participant Data.

Nonadherence to immunosuppressives, a risk factor for poor posttransplant outcomes, can be assessed by self-report using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS). Available in written and interview versions, and previously validated on content, the BAASIS is widely used in research and clinical practice. The aim of this study was to investigate its psychometric properties. Using a literature search and our BAASIS database, this meta-analysis identified completed studies in adult transplant recipients whose data were usable to examine the BAASIS' reliability and 3 validity aspects: (1) relationships with other variables (electronic monitoring, other self-report scales, tacrolimus blood-level variability, collateral report, depressive symptoms, psycho-behavioral constructs, and interventions); (2) response processes; and (3) internal structure. Testing used random-effects logistic regressions. Our sample included 12 109 graft recipients from 26 studies. Of these 26, a total of 20 provided individual participant data. Evidence of the BAASIS' stability over time supports its reliability. Validity testing of relationships with other variables showed that BAASIS-assessed nonadherence was significantly associated with the selected variables: electronically monitored nonadherence ( P < 0.03), other self- and collaterally-reported nonadherence ( P < 0.001), higher variability in tacrolimus concentrations ( P = 0.02), higher barriers ( P < 0.001), lower self-efficacy ( P < 0.001), lower intention ( P < 0.001), and higher worries ( P = 0.02). Nonadherence also decreased after regimen change interventions ( P = 0.03). Response process evaluation indicated good readability and slightly higher nonadherence with the written version. Structurally, items on taking and timing shared variability. The BAASIS shows good validity and reliability as a self-report instrument to assess medication nonadherence in transplantation.

Readability of Persian Oxford Elbow Score Using Health Literacy Questionnaire

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