Readability Assessments Research Articles

An infodemiologic review of internet resources on dental hypersensitivity: A quality and readability assessment.

This study aimed to investigate the quality and readability of online English health information about dental sensitivity and how patients evaluate and utilize these web-based information. The credibility and readability of health information was obtained from three search engines. We conducted searches in "incognito" mode to reduce the possibility of biases. Quality assessment utilized JAMA benchmarks, the DISCERN tool, and HONcode. Readability was analyzed using the SMOG, FRE, and FKGL indices. Out of 600 websites, 90 were included, with 62.2% affiliated with dental or medical centers, among these websites, 80% exclusively related to dental implant treatments. Regarding JAMA benchmarks, currency was the most commonly achieved and 87.8% of websites fell into the "moderate quality" category. Word and sentence counts ranged widely with a mean of 815.7 (±435.4) and 60.2 (±33.3), respectively. FKGL averaging 8.6 (±1.6), SMOG scores averaging 7.6 (±1.1), and FRE scale showed a mean of 58.28 (±9.1), with "fair difficult" being the most common category. The overall evaluation using DISCERN indicated a moderate quality level, with a notable absence of referencing. JAMA benchmarks revealed a general non-adherence among websites, as none of the websites met all of the four criteria. Only one website was HON code certified, suggesting a lack of reliable sources for web-based health information accuracy. Readability assessments showed varying results, with the majority being "fair difficult". Although readability did not significantly differ across affiliations, a wide range of the number of words and sentences count was observed between them.

ChatGPT as a patient education tool in colorectal cancer-An in-depth assessment of efficacy, quality and readability.

Artificial intelligence (AI) chatbots such as Chat Generative Pretrained Transformer-4 (ChatGPT-4) have made significant strides in generating human-like responses. Trained on an extensive corpus of medical literature, ChatGPT-4 has the potential to augment patient education materials. These chatbots may be beneficial to populations considering a diagnosis of colorectal cancer (CRC). However, the accuracy and quality of patient education materials are crucial for informed decision-making. Given workforce demands impacting holistic care, AI chatbots can bridge gaps in CRC information, reaching wider demographics and crossing language barriers. However, rigorous evaluation is essential to ensure accuracy, quality and readability. Therefore, this study aims to evaluate the efficacy, quality and readability of answers generated by ChatGPT-4 on CRC, utilizing patient-style question prompts. To evaluate ChatGPT-4, eight CRC-related questions were derived using peer-reviewed literature and Google Trends. Eight colorectal surgeons evaluated AI responses for accuracy, safety, appropriateness, actionability and effectiveness. Quality was assessed using validated tools: the Patient Education Materials Assessment Tool (PEMAT-AI), modified DISCERN (DISCERN-AI) and Global Quality Score (GQS). A number of readability assessments were measured including Flesch Reading Ease (FRE) and the Gunning Fog Index (GFI). The responses were generally accurate (median 4.00), safe (4.25), appropriate (4.00), actionable (4.00) and effective (4.00). Quality assessments rated PEMAT-AI as 'very good' (71.43), DISCERN-AI as 'fair' (12.00) and GQS as 'high' (4.00). Readability scores indicated difficulty (FRE 47.00, GFI 12.40), suggesting a higher educational level was required. This study concludes that ChatGPT-4 is capable of providing safe but nonspecific medical information, suggesting its potential as a patient education aid. However, enhancements in readability through contextual prompting and fine-tuning techniques are required before considering implementation into clinical practice.

RCS-CSLT: a language feature-driven readability classification system for international Chinese education

The provision of reading materials that are tailored to the proficiency levels of second language (L2) learners is crucial for fostering the development of their language skills. However, there is a limited availability of reliable, and contextually relevant Chinese text readability classifiers that meet the latest demands of Chinese as a Second Language (CSL) learners. Consequently, accurately assessing the readability of uncategorized texts presents significant challenges for both students and educators. This study introduces the development of a Readability Classification System for CSL text (RCS-CSLT), which aims to grade the readability of CSL texts. The RCS-CSLT utilizes a CSL-specific BERT architecture, incorporates Chinese Proficiency Grading Standards (CPGS) for International Chinese Language Education issued by the Ministry of Education of China, and integrates Chinese language features, including lexical richness, syntactic complexity, and syntactic patterns. To evaluate its performance, a CSL text dataset was used and compared with a baseline BERT model. The results demonstrate that the RCS-CSLT model achieves excellent performance in predicting the readability levels of CSL texts, achieving an average accuracy of 89.8%, and consistently outperforms the baseline model in terms of classification performance at each level. An analysis of a wider range of Chinese text reveals that RCS-CSLT attains an accuracy exceeding 90.3% when compared to human experts’ evaluations in readability assessments. These results affirm the proficiency of RCS-CSLT in appraising the readability of Chinese texts, showcasing its efficacy within the realm of international Chinese language instruction and study. This technological advancement offers benefits to both learners and educators. For learners, RCS-CSLT functions as a grading indicator and auxiliary tool for selecting appropriate reading materials, while for educators, it provides insights into text readability levels and aids in designing instructional plans, particularly in computer-assisted language learning.

A Performance Evaluation of Large Language Models in Keratoconus: A Comparative Study of ChatGPT-3.5, ChatGPT-4.0, Gemini, Copilot, Chatsonic, and Perplexity.

Background: This study evaluates the ability of six popular chatbots; ChatGPT-3.5, ChatGPT-4.0, Gemini, Copilot, Chatsonic, and Perplexity, to provide reliable answers to questions concerning keratoconus. Methods: Chatbots responses were assessed using mDISCERN (range: 15-75) and Global Quality Score (GQS) (range: 1-5) metrics. Readability was evaluated using nine validated readability assessments. We also addressed the quality and accountability of websites from which the questions originated. Results: We analyzed 20 websites, 65% "Private practice or independent user" and 35% "Official patient education materials". The mean JAMA benchmark score was 1.40 ± 0.91 (0-4 points), indicating low accountability. Reliability, measured using mDISCERN, ranged from 42.91 ± 3.15 (ChatGPT-3.5) to 46.95 ± 3.53 (Copilot). The most frequent question was "What is keratoconus?" with 70% of websites providing relevant information. This received the highest mDISCERN score (49.30 ± 4.91) and a relatively high GQS score (3.40 ± 0.56) with an Automated Readability Level Calculator score of 13.17 ± 2.13. Moderate positive correlations were determined between the website numbers and both mDISCERN (r = 0.265, p = 0.25) and GQS (r = 0.453, p = 0.05) scores. The quality of information, assessed using the GQS, ranged from 3.02 ± 0.55 (ChatGPT-3.5) to 3.31 ± 0.64 (Gemini) (p = 0.34). The differences between the texts were statistically significant. Gemini emerged as the easiest to read, while ChatGPT-3.5 and Perplexity were the most difficult. Based on mDISCERN scores, Gemini and Copilot exhibited the highest percentage of responses in the "good" range (51-62 points). For the GQS, the Gemini model exhibited the highest percentage of responses in the "good" quality range with 40% of its responses scoring 4-5. Conclusions: While all chatbots performed well, Gemini and Copilot showed better reliability and quality. However, their readability often exceeded recommended levels. Continuous improvements are essential to match information with patients' health literacy for effective use in ophthalmology.

CULTURAL adaptation and validation of the Indonesian version of the Roland-Morris disability questionnaire: A psychometric analysis

BACKGROUND: Epidemiological evidence underscores low back pain (LBP) as a prevalent and consequential musculoskeletal disorder, posing a significant public health challenge. Patient-reported outcome measures (PROMs) play a crucial role in the diagnostic process for LBP, with the Roland-Morris Disability Questionnaire (RMDQ) being a commonly utilized tool in evaluating LBP. OBJECTIVE: This cross-sectional study aimed to cross-culturally adapt and validate the Indonesian version of the 24-item-RMDQ among nonspecific LBP (NSLBP) patients. METHODS: The RMDQ scales underwent forward-backwards translation, readability, and content validity assessments with NSLBP patients (n = 137), with a mean age of 38.6±11.8 years (59% female). Psychometric testing included assessments of internal consistency and 1-week test-retest reliability, convergent validity with pain numeric rating scale (PNRS), and the Physical Component Summary (PCS) and Mental Component Summary (MCS) of quality of life (Short Form 12). The construct validity using confirmatory factor analyses (CFA). RESULTS: The findings of this study indicated a good internal consistency (Cronbach α= 0.80) of the translated instrument. Moderate to good repeatability estimates of all RMDQ items were demonstrated with the total ICC of the total RMDQ score of 0.90 [95%CI (0.85–0.94)]. The instrument correlations with PNRS, PCS, and MCS were 0.54, 0.60, and 0.23, respectively. The goodness-of-fit test further affirmed an acceptable fit of the data, although low factor loadings were found in several RMDQ items. CONCLUSION: Although the factor structure of the RMDQ scale warrants further investigation, the overall findings support its suitability for clinical application in Indonesian NSLBP patients.

Assessment of readability, reliability, and quality of ChatGPT®, BARD®, Gemini®, Copilot®, Perplexity® responses on palliative care.

There is no study that comprehensively evaluates data on the readability and quality of "palliative care" information provided by artificial intelligence (AI) chatbots ChatGPT®, Bard®, Gemini®, Copilot®, Perplexity®. Our study is an observational and cross-sectional original research study. In our study, AI chatbots ChatGPT®, Bard®, Gemini®, Copilot®, and Perplexity® were asked to present the answers of the 100 questions most frequently asked by patients about palliative care. Responses from each 5 AI chatbots were analyzed separately. This study did not involve any human participants. Study results revealed significant differences between the readability assessments of responses from all 5 AI chatbots (P < .05). According to the results of our study, when different readability indexes were evaluated holistically, the readability of AI chatbot responses was evaluated as Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini®, from easy to difficult (P < .05). In our study, the median readability indexes of each of the 5 AI chatbots Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini® responses were compared to the "recommended" 6th grade reading level. According to the results of our study answers of all 5 AI chatbots were compared with the 6th grade reading level, statistically significant differences were observed in the all formulas (P < .001). The answers of all 5 artificial intelligence robots were determined to be at an educational level well above the 6th grade level. The modified DISCERN and Journal of American Medical Association scores was found to be the highest in Perplexity® (P < .001). Gemini® responses were found to have the highest Global Quality Scale score (P < .001). It is emphasized that patient education materials should have a readability level of 6th grade level. Of the 5 AI chatbots whose answers about palliative care were evaluated, Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini®, their current answers were found to be well above the recommended levels in terms of readability of text content. Text content quality assessment scores are also low. Both the quality and readability of texts should be brought to appropriate recommended limits.

Assessment of Online Arabic Patient-Centered Knowledge About Orthognathic Surgery: An Infodemiologic Study.

Orthognathic surgery, addressing skeletal and dental irregularities, is pivotal for patients suffering from malocclusion, facial asymmetry, and related disorders. With the internet becoming a primary source of health information, the accuracy, quality, and reliability of online Arabic-language patient-centered information on orthognathic surgery necessitate thorough evaluation. This study aimed to assess the quality, reliability, and readability of Arabic online resources about orthognathic surgery to ascertain their potential as reliable patient education tools. An infodemiological approach was employed, analyzing the top 100 websites from Google, Yahoo, and Bing based on specific Arabic search terms related to orthognathic surgery. Websites were evaluated for affiliation, content specialization, and presentation and excluded based on predetermined criteria to ensure relevance and focus. Quality assessment was conducted using the DISCERN instrument, Journal of the American Medical Association (JAMA) benchmarks, and Health On the Net code evaluation. Readability was assessed using the Flesch-Kincaid Grade Level, Simplified Measure of Gobbledygook, and Flesch Reading Ease scales. Of 600 initial websites, 96 met the inclusion criteria. Most were affiliated with universities or medical centers (53.1%), followed by commercial (28.1%), and non-profit organizations (16.7%). The majority of websites (96.9%) were only partially related to orthognathic surgery. Content analysis revealed a moderate quality of information, with a median overall DISCERN quality rating of 3 out of 5. The JAMA benchmarks showed a lack of comprehensive adherence, with currency being the most achieved criterion. Readability assessments indicated the content was generally accessible yet highlighted the need for Arabic-specific readability evaluation tools. The study reveals a critical need for enhancing Arabic online resources on orthognathic surgery. Despite the available content's moderate quality and acceptable readability, there is a substantial gap in providing comprehensive, patient-centered, and easily understandable information. Future efforts should focus on developing high-quality, reliable, and readable online resources to aid Arabic-speaking patients in making informed decisions about orthognathic surgery.

Text mining analysis of retail and consumer service leaders' sustainability narratives: Are they actually true?

This study investigates the relationship between the sustainability narratives of retail and consumer services leaders and their actual sustainability practices, with a focus on the impact of these narratives on consumer perceptions and engagement. Firm-generated content (FGC) has become a significant factor influencing consumer reactions, especially in the context of sustainability claims within the retail and consumer services sectors. Our research examines the alignment of linguistic and communicative elements in sustainability communications with the actual sustainability performance of companies employing a multifaceted analytical approach including content/theme analysis, sentiment analysis, emotion detection, and readability assessments. The findings reveal that thematic content related to sustainability, emotional engagement strategies, and the clarity of communication are shown to play vital roles in enhancing consumer trust and engagement with retail and consumer services firms. Moreover, readability and polarity are critical in shaping consumer perceptions of authenticity and reliability in sustainability narratives. The study underscores the importance of transparency and authenticity in sustainability communications, demonstrating that effective messaging can significantly influence consumer engagement with retail and consumer services firms. By bridging the gap between sustainability narratives and actual practices, the research contributes to a deeper understanding of strategic communication's role in fostering sustainable consumer behavior and trust in the retail and consumer services sector.

The Birth of the Contextual Health Education Readability Score in an Examination of Online Influenza Patient Education Materials.

Introduction Influenza is a major global health concern, with its rapid spread and mutation rate posing significant challenges in public health education and communication. Effective patient education materials (PEMs) are crucial for informed decision-making and improved health outcomes. This study evaluates the efficacy of online influenza PEMs using traditional readability tools and introduces the Contextual Health Education Readability Score (CHERS) to address the limitations of existing methods that do not capture the diverse array of visual and thematic means displayed. Materials and methods A comprehensive search was conducted to select relevant online influenza PEMs. This involved looking through Google's first two pages of results sorted by relevance, for a total of 20 results. These materials were evaluated using established readability tools (e.g., Flesch Reading Ease, Flesch-Kincaid Grade Level) and the Patient Education Materials Assessment Tool (PEMAT) for understandability and actionability. The study also involved the creation of CHERS, integrating factors such as semantic complexity, cultural relevance, and visual aid effectiveness. The development of CHERS included weighting each component based on its impact on readability and comprehension. Results The traditional readability tools demonstrated significant variability in the readability of the selected materials. The PEMAT analysis revealed general trends toward clarity in purpose and use of everyday language but indicated a need for improvement in summaries and visual aids.The CHERS formula was calculated as follows: CHERS = (0.4 × Average Sentence Length) + (0.3 × Average Syllables per Word) + (0.15 × Semantic Complexity Score) + (0.1 × Cultural Relevance Score) + (0.05 × Visual Aid Effectiveness Score), integrating multiple dimensions beyond traditional readability metrics. Discussion The study highlighted the limitations of traditional readability tools in assessing the complexity and cultural relevance of health information. The introduction of CHERS addressed these gaps by incorporating additional dimensions crucial for understanding in a healthcare context. The recommendations provided for creating effective influenza PEMs focused on language simplicity, cultural sensitivity, and actionability. This may enable further research into evaluating current PEMs and clarifying means of creating more effective content in the future. Conclusions The study underscores the need for comprehensive readability assessments in PEMs. The creation of CHERS marks a significant advancement in this field, providing a more holistic approach to evaluating health literacy materials. Its application could lead to the development of more inclusive and effective educational content, thereby improving public health outcomes and reducing the global burden of influenza. Future research should focus on further validating CHERS and exploring its applicability to other health conditions.

ChatGPT Provides Unsatisfactory Responses to Frequently Asked Questions Regarding Anterior Cruciate Ligament Reconstruction

To determine whether the free online artificial intelligence platform ChatGPT could accurately, adequately, and appropriately answer questions regarding anterior cruciate ligament (ACL) reconstruction surgery. A list of 10 questions about ACL surgery was created based on a review of frequently asked questions that appeared on websites of various orthopaedic institutions. Each question was separately entered into ChatGPT (version 3.5), and responses were recorded, scored, and graded independently by 3 authors. The reading level of the ChatGPT response was calculated using the WordCalc software package, and readability was assessed using the Flesch-Kincaid grade level, Simple Measure of Gobbledygook index, Coleman-Liau index, Gunning fog index, and automated readability index. Of the 10 frequently asked questions entered into ChatGPT, 6 were deemed as unsatisfactory and requiring substantial clarification; 1, as adequate and requiring moderate clarification; 1, as adequate and requiring minor clarification; and 2, as satisfactory and requiring minimal clarification. The mean DISCERN score was 41 (inter-rater reliability, 0.721), indicating the responses to the questions were average. According to the readability assessments, a full understanding of the ChatGPT responses required 13.4 years of education, which corresponds to the reading level of a college sophomore. Most of the ChatGPT-generated responses were outdated and failed to provide an adequate foundation for patients' understanding regarding their injury and treatment options. The reading level required to understand the responses was too advanced for some patients, leading to potential misunderstanding and misinterpretation of information. ChatGPT lacks the ability to differentiate and prioritize information that is presented to patients. Recognizing the shortcomings in artificial intelligence platforms may equip surgeons to better set expectations and provide support for patients considering and preparing for ACL reconstruction.

Development of the impact of tinnitus in children questionnaire (iTICQ)

IntroductionTinnitus is a common disorder of the auditory system. Questionnaires are essential tools for clinical assessment and research. Whilst many questionnaires are available to measure different aspects of tinnitus complaint in adults, there is currently no self-report questionnaire measure of tinnitus that has been developed for or is suitable for use with children. This study describes the development of the first self-report measure of tinnitus impact for children aged 8–16 years old.MethodsTwo phases of questionnaire development were conducted. In Phase 1 children's tinnitus-related problems were elicited from interviews with children with tinnitus (n = 11; aged 9–16 years old), parents (n = 5), and clinicians (n = 8). Interview transcripts were analyzed using qualitative content analysis. Findings were combined with problems identified by the clinical co-authors, researchers, and clinicians in a conference workshop, and those previously reported in service evaluation of UK National Health Service pediatric tinnitus services and in a scoping review. From this, a conceptual framework of tinnitus impact on health-related quality of life in children was developed. Based on the conceptual framework, a 38-item pilot questionnaire was drafted. In Phase 2, content validity of the pilot questionnaire was assessed in cognitive interviews with six children who had tinnitus (aged 8–15 years old) and an online survey with clinicians working in pediatric tinnitus services (n = 8 services and 28 clinicians). Finally, readability assessments were conducted. Feedback led to iterative revisions to the questionnaire. The final questionnaire was named the Impact of Tinnitus in Children Questionnaire (iTICQ).ResultsThe iTICQ contains three scene setting (non-scoring) items, and 33 scoring items covering six domains of tinnitus impact: Sleep and Feeling Tired, Learning, Emotional Health, Hearing and Listening, Taking Part, and Relationships.ConclusionsThe iTICQ is a new self-report measure of tinnitus impact that can be self-completed by children aged 8–16 years old. It shows good content validity and can be used to measure problem severity across the domains of core relevance to children with tinnitus. Further validation studies and translations of the iTICQ are indicated to determine its psychometric properties in different child populations and to make it widely accessible.

Development of a Vaping Cessation Text Messaging Intervention for Latino Young Adults: A Participatory Research Approach.

Describe the participatory research procedures of developing Kick Vaping, a vaping cessation text messaging intervention for Latino young adults, available in English and Spanish. Using community-based recruitment strategies, we convened a Community Advisory Board (CAB) of eight Latino young adults (ages 18-25) with different vaping experiences (never users, ex-users, and current users of e-cigarettes). Members held a series of working meetings to adapt Decídetexto, a smoking cessation text messaging intervention, for vaping cessation. Members provided iterative feedback on the text messages until reaching a consensus on content. Messages were translated from English to Spanish following a committee approach. Readability assessments were used to evaluate the legibility of the text messages. At baseline, members' mean age was 22.6years old (SD 3.1), 75% were female, and 50% used both English and Spanish equally. Three members (37.5%) were ex-users and one member (12.5%) was a current user of e-cigarettes. 18 meetings provided sufficient opportunities for iterative feedback on the text messages for developing the intervention. The Kick Vaping intervention consists of 208 text messages. Readability scores of the text messages in English were equivalent to fourth and fifth grade, and in Spanish were equivalent to easy and somewhat easy. It is feasible and practical to build participatory research among Latino young adults focused on vaping cessation. Members of the CAB added innovation and creativity to the development of the vaping cessation text messaging intervention. Future research is needed to evaluate the impact of the intervention on vaping cessation.

Assessment of Arabic Web-Based Knowledge About Clear Aligners: An Infodemiologic Study.

Orthodontic treatments aim to enhance dental aesthetics, functionality, and long-term oral health. Clear aligners have gained popularity as an aesthetic and convenient option for patients seeking orthodontic correction. However, the quality and readability of online Arabic patient-centered information regarding clear aligners has not been studied yet. The aim of our study is to investigate the quality and readability of Arabic patient-centered information about clear aligners. We conducted an extensive evaluation of Arabic web-based content pertaining to clear aligners using three prominent search engines. Eligible websites were categorized based on specialization, organizational affiliation, material type, and presentation style. We assessed website quality and reliability using the DISCERN instrument, Journal of American Medical Association (JAMA)benchmarks, and Health on the Net (HON) code. In addition, we measured readability using the Flesch Reading Ease Score (FRES), Simplified Measure of Gobbledygook (SMOG), and Flesch-Kincaid Grade Level (FKGL). Out of 600 search results, 195 websites met the inclusion criteria. None of the websites were HON-code accredited. DISCERN assessments revealed low content quality, with none of the websites achieving high-quality status. The JAMA benchmarks showed limited compliance with the four items, with currency being the most frequently achieved. Readability assessments indicated generally high readability, with FKGL scores suggesting easy comprehension for the average readers. While Arabic web-based information on clear aligners is highly readable, its credibility and quality require significant improvement. Websites should adhere to medical information standards, subject content to rigorous assessments, and seek accreditation to ensure reliability. Enhancing the accessibility and comprehensibility of health-related content will empower individuals to make informed health decisions. Addressing limitations, such as social media and video content evaluation, and conducting comparisons with English websites in future research will provide a more comprehensive understanding of the landscape of online orthodontic information.

Evaluating the readability of recruitment materials in veterinary clinical research.

Owner comprehension is vital to recruitment and study success, but limited information exists regarding the readability of public-facing veterinary clinical trial descriptions. The current study sought to evaluate the readability of public-facing online veterinary clinical trial descriptions from academic institutions and private referral practices. None. This prospective study assessed readability in a convenience sample of veterinary clinical trial study descriptions using 3 common methods: the Flesch-Kincaid Grade Level (F-K), Flesch Reading Ease Score (FRES), and online Automatic Readability Checker (ARC). Results were compared across specialties and between academic and private institutions. Grade level and readability consensus scores (RCSs) were obtained for 61 online clinical trial descriptions at universities (n = 49) and private practices (n = 12). Average grade-level RCS for study descriptions was 14.13 (range, 9-21). Using Microsoft Word, the FRES score was higher in descriptions from universities compared to private practices (P = .03), and F-K scores were lower in university compared to private practice descriptions (P = .03). FRES (P = .07), F-K (P = .12), and readability consensus (P = .17) scores obtained from ARC were not different between institution types. Forty-eight studies (79%) had RCSs over 12, equivalent to reading material at college or graduate school levels. Similar to other areas in veterinary communication, the evaluated veterinary clinical trial descriptions used for advertising and recruitment far exceeded the recommended 6th-grade reading level for medical information. Readability assessments are straightforward to conduct, and ensuring health literacy should be a customary best practice in veterinary medicine and clinical research.

Employing Source Code Quality Analytics for Enriching Code Snippets Data

The availability of code snippets in online repositories like GitHub has led to an uptick in code reuse, this way further supporting an open-source component-based development paradigm. The likelihood of code reuse rises when the code components or snippets are of high quality, especially in terms of readability, making their integration and upkeep simpler. Toward this direction, we have developed a dataset of code snippets that takes into account both the functional and the quality characteristics of the snippets. The dataset is based on the CodeSearchNet corpus and comprises additional information, including static analysis metrics, code violations, readability assessments, and source code similarity metrics. Thus, using this dataset, both software researchers and practitioners can conveniently find and employ code snippets that satisfy diverse functional needs while also demonstrating excellent readability and maintainability.

Readability Assessment of Patient Information Texts on Amblyopia on the Websites of Major Hospitals in Turkey

Especially in the last two decades, the use of internet has increased dramatically. As expected, the patient information texts on the websites of the hospitals are also read by much more people relative to the past. In this context, this paper mainly handles the readability of patient information texts on amblyopia on the websites of major hospitals in Turkey. Since the assessed texts are in Turkish, the readability assessments are carried out by Ateşman Formula which is mainly created in order to measure the readability of the texts in written in Turkish. For this purpose, the relevant information texts of the first ten hospitals that were reached as a result of typing the keyword “göz tembelliği” -which is the Turkish of “amblyopia”- on the internet search engine Google were evaluated. Average value of the Ateşman index of examined texts corresponds to the medium difficulty classification. However, the value found is quite close to the lower limit of the medium difficulty class. This reflects that the readability level of the text is relatively low. The readers of these texts consist of people from various segments of society with various levels of education. Moreover, it is highly probable that the majority of the aforementioned readership did not have a health or medical education. For all these reasons, the readability levels of these texts should be more appropriate for the readers. Various regulations can be brought by official authorities in this regard.

Quality of information and appropriateness of ChatGPT outputs for urology patients.

The proportion of health-related searches on the internet is continuously growing. ChatGPT, a natural language processing (NLP) tool created by OpenAI, has been gaining increasing user attention and can potentially be used as a source for obtaining information related to health concerns. This study aims to analyze the quality and appropriateness of ChatGPT's responses to Urology case studies compared to those of a urologist. Data from 100 patient case studies, comprising patient demographics, medical history, and urologic complaints, were sequentially inputted into ChatGPT, one by one. A question was posed to determine the most likely diagnosis, suggested examinations, and treatment options. The responses generated by ChatGPT were then compared to those provided by a board-certified urologist who was blinded to ChatGPT's responses and graded on a 5-point Likert scale based on accuracy, comprehensiveness, and clarity as criterias for appropriateness. The quality of information was graded based on the section 2 of the DISCERN tool and readability assessments were performed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Reading Grade Level (FKGL) formulas. 52% of all responses were deemed appropriate. ChatGPT provided more appropriate responses for non-oncology conditions (58.5%) compared to oncology (52.6%) and emergency urology cases (11.1%) (p = 0.03). The median score of the DISCERN tool was 15 (IQR = 5.3) corresponding to a quality score of poor. The ChatGPT responses demonstrated a college graduate reading level, as indicated by the median FRE score of 18 (IQR = 21) and the median FKGL score of 15.8 (IQR = 3). ChatGPT serves as an interactive tool for providing medical information online, offering the possibility of enhancing health outcomes and patient satisfaction. Nevertheless, the insufficient appropriateness and poor quality of the responses on Urology cases emphasizes the importance of thorough evaluation and use of NLP-generated outputs when addressing health-related concerns.

Assessing the Readability of Online Health Information for Colonoscopy - Analysis of Articles in 22 European Languages.

Patients often search on the Internet information about different medical conditions and procedures. This study aimed to evaluate online health information on colonoscopy, focusing on quantity and comprehensibility of internet resources dedicated to the colonoscopy. This information could be used by European Union (EU) colorectal cancer (CRC) screening providers to address patient's unfilled educational needs, fear of colonoscopy, and other barriers that deter from CRC screening. The term "colonoscopy" translated into 22 official EU languages was searched using the Google search engine. For each translation, generated list of websites was assessed with Google Translate. The first 50 websites in each language were assessed for suitability. Records in other languages were excluded. Included websites were free, focused on patient education, and did not have password. Readability assessments were performed with Lix score. A total of 588 websites in Bulgarian, Croatian, Czech, Danish, Dutch, English, Estonian, Finnish, French, German, Greek, Hungarian, Italian, Latvian, Lithuanian, Polish, Portuguese, Romanian, Slovak, Slovenian, Spanish, and Swedish were evaluated. The overall mean Lix score was 56 ± 8 and was classified as very hard to comprehend. There were significant differences in mean Lix scores across the included languages (P<.001). There was not significant correlation (R2 = 0.1, P = 0.142) between Lix score and number of search hits. Although there was a wealth of online patient information on colonoscopy, the comprehensibility of the available information is low. Physician guidance to reliable resources could increase patient's willingness to undergo a screening colonoscopy.

Assessment of readability and quality of patient education materials specific to nocturnal enuresis

Bedwetting, or nocturnal enuresis (NE), is a common childhood disease. Families increasingly turn to free online resources for health education in order to navigate treatment options. We aim to determine the readability and quality of online health information that families may encounter when searching for information on pediatric NE. The search term 'bedwetting' was queried in commonly used search engines. Included articles were further categorized as institutional/reference, commercial, non-profit/charitable, or personal. An online readability platform calculated 3 commonly used readability assessments as well as a consensus score. Quality was assessed by two independent pediatric urologists using a validated DISCERN instrument. Differences in readability were further assessed by article category type. 36 websites were reviewed, 3 did not include treatment options and were not included in quality assessment. 55.6% of the articles were categorized as institutional/reference, 27.8% as non-profit/charitable, 11.1% as personal, and 5.6% as commercial. The average, standard deviation, and range of readability level were as follows: overall consensus score=9.56±2.09, FK Grade Level Formula score=9.38±2.17 (range 5.8-14.1), SMOG Index score=8.89±1.79 (range 6.4-12.9), and the GF Index score=11.86±2.34 (range 8.4-16.9). The overall consensus score, 9.56, correlates to a 9th-grade reading level. 16 articles were considered to be of 'good' quality, 12 of 'fair' quality, and 5 of 'poor' quality; according to the DISCERN scoring. There was no statistically significant difference in readability scores across website categories. Two articles included the outdated treatment option of intranasal DDAVP. These findings are concordant with the increasing body of literature demonstrating that patient education materials are too difficult to read. Pediatric urologists should be aware of the readability and quality of available online content for common clinical presentations. They can ensure that institutional articles online are useful to patients by participating in the development and design of these materials. We demonstrated that online articles that families encounter via a search engine query for bedwetting are written at a higher level than recommended and the majority are of 'fair' quality. There is much room for improvement for institutions to provide high quality, readable content that supports the needs of families seeking information on NE.

Automated strategy feedback can improve the readability of physicians’ electronic communications to simulated patients

Modern communication between health care professionals and patients increasingly relies upon secure messages (SMs) exchanged through an electronic patient portal. Despite the convenience of secure messaging, challenges include gaps between physician and patient expertise along with the asynchronous nature of such communication. Importantly, less readable SMs from physicians (e.g., too complicated) may result in patient confusion, non-adherence, and ultimately poorer health outcomes. The current simulation trial synthesizes work on patient-physician electronic communication, message readability assessments, and feedback to explore the potential for automated strategy feedback to improve the readability of physicians’ SMs to patients. Within a simulated secure messaging portal featuring multiple simulated patient scenarios, computational algorithms assessed the complexity of SMs written by 67 participating physicians to patients. The messaging portal provided strategy feedback for how physician responses might be improved (e.g., adding details and information to reduce complexity). Analyses of changes in SM complexity revealed that automated strategy feedback indeed helped physicians compose and refine more readable messages. Although the effects for any individual SM were slight, the cumulative effects within and across patient scenarios showed trends of decreasing complexity. Physicians appeared to learn how to craft more readable SMs via interactions with the feedback system. Implications for secure messaging systems and physician training are discussed, along with considerations for further investigation of broader physician populations and effects on patient experience.