Grade Reading Research Articles

Artificial intelligence as a modality to enhance the readability of neurosurgical literature for patients.

In this study the authors assessed the ability of Chat Generative Pretrained Transformer (ChatGPT) 3.5 and ChatGPT4 to generate readable and accurate summaries of published neurosurgical literature. Abstracts published in journal issues released between June 2023 and August 2023 (n = 150) were randomly selected from the top 5 ranked neurosurgical journals according to Google Scholar. ChatGPT models were instructed to generate a readable layperson summary of the original abstract from a statistically validated prompt. Readability results and grade-level indicators (RR-GLIs) scores were calculated for GPT3.5- and GPT4-generated summaries and original abstracts. Two physicians independently rated the accuracy of ChatGPT-generated layperson summaries to assess scientific validity. One-way ANOVA followed by pairwise t-test with Bonferroni correction were performed to compare readability scores. Cohen's kappa was used to assess interrater agreement between the two rater physicians. Analysis of 150 original abstracts showed a statistically significant difference for all RR-GLIs between the ChatGPT-generated summaries and original abstracts. The readability scores are formatted as follows (original abstract mean, GPT3.5 summary mean, GPT4 summary mean, p value): Flesch-Kincaid reading grade (12.55, 7.80, 7.70, p < 0.0001); Gunning fog score (15.46, 10.00, 9.00, p < 0.0001); Simple Measure of Gobbledygook (SMOG) index (11.30, 7.13, 6.60, p < 0.0001); Coleman-Liau index (14.67, 11.32, 10.26, p < 0.0001); automated readability index (10.87, 8.50, 7.75, p < 0.0001); and Flesch-Kincaid reading ease (33.29, 68.45, 69.55, p < 0.0001). GPT4-generated summaries demonstrated higher RR-GLIs than GPT3.5-generated summaries in the following categories: Gunning fog score (0.0003); SMOG index (0.027); Coleman-Liau index (< 0.0001); sentences (< 0.0001); complex words (< 0.0001); and % complex words (0.0035). A total of 68.4% and 84.2% of GPT3.5- and GPT4-generated summaries, respectively, maintained moderate scientific accuracy according to the two physician-reviewers. The findings demonstrate promising potential for application of the ChatGPT in patient education. GPT4 is an accessible tool that can be an immediate solution to enhancing the readability of current neurosurgical literature. Layperson summaries generated by GPT4 would be a valuable addition to a neurosurgical journal and would be likely to improve comprehension for patients using internet resources like PubMed.

How teachers in Tanzania understand and implement phonics instructional approach for the teaching of reading in early grades

How teachers in Tanzania understand and implement phonics instructional approach for the teaching of reading in early grades

Utilization of Artificial Intelligence in the Creation of Patient Information on Laryngology Topics.

To evaluate and compare the readability and quality of patient information generated by Chat-Generative Pre-Trained Transformer-3.5 (ChatGPT) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) using validated instruments including Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease, DISCERN, and Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). ENTHealth.org and ChatGPT-3.5 were queried for patient information on laryngology topics. ChatGPT-3.5 was queried twice for a given topic to evaluate for reliability. This generated three de-identified text documents for each topic: one from AAO-HNS and two from ChatGPT (ChatGPT Output 1, ChatGPT Output 2). Grade level and reading ease were compared between the three sources using a one-way analysis of variance and Tukey's post hoc test. Independent t-tests were used to compare DISCERN and PEMAT understandability and actionability scores between AAO-HNS and ChatGPT Output 1. Material generated from ChatGPT Output 1 and ChatGPT Output 2 were at least two reading grade levels higher than that of material from AAO-HNS (p < 0.001). Regarding reading ease, ChatGPT Output 1 and ChatGPT Output 2 documents had significantly lower mean scores compared to AAO-HNS (p < 0.001). Moreover, ChatGPT Output 1 material on vocal cord paralysis had a lower PEMAT-P understandability compared to that of AAO-HNS material (p > 0.05). Patient information on the ENTHealth.org website for select laryngology topics was, on average, of a lower grade level and higher reading ease compared to that produced by ChatGPT, but interestingly with largely no difference in the quality of information provided. NA Laryngoscope, 2024.

Language and Literature Education Field: Some Aspects of Teaching in Primary Schools of National Minorities

The article explores teaching tools and certain aspects of teaching the Ukrainian language in primary grades, focusing on the instruction in the language of indigenous peoples/national minorities in general secondary education institutions in Ukraine and abroad. It presents the experiences of teachers, methodologists, authors of educational and methodological materials, and contemporary domestic and foreign scholars, based on a comparative analysis. Current trends in publishing textbooks and teaching aids are examined. The article highlights the experiences of Ukrainian and foreign educators regarding the relevance of educational support and the potential for engaging each child in meaningful individual and socially significant educational, research, and inquiry activities. It is determined that in textbooks and aids for the Ukrainian language and reading for grades 1-4, a concept has been pre-planned that considers the specifics of all sections and topics of the language and reading curriculum. The article proves that independent work effectively integrates the content of the studied material from language and literature, allowing for quick comprehension of the textbook, section, or topic, as well as enabling students to read and provide correct answers, with appropriate recommendations formulated. It is noted that modern realities require working with digital textbooks, necessitating additional teacher training to utilize them effectively. The article identifies the problems and prospects for further research, which include the development of digital skills for students and teachers, the need for educational institutions to be equipped with digital devices, and the formation of motivation among students, teachers, and parents for learning the Ukrainian language both in Ukraine and abroad.

Readability Metrics in Patient Education: Where Do We Innovate?

The increasing use of digital applications in healthcare has led to a greater need for patient education materials. These materials, often in the form of pamphlets, booklets, and handouts, are designed to supplement physician–patient communication and aim to improve patient outcomes. However, the effectiveness of these materials can be hindered by variations in patient health literacy. Readability, a measure of text comprehension, is a key factor influencing how well patients understand these educational materials. While there has been growing interest in readability assessment in medicine, many studies have demonstrated that digital texts do not frequently meet the recommended sixth-to-eighth grade reading level. The purpose of this opinion article is to review readability from the perspective of studies in pediatric medicine, internal medicine, preventative medicine, and surgery. This article aims to communicate that while readability is important, it tends to not fully capture the complexity of health literacy or effective patient communication. Moreover, a promising avenue to improve readability may be in generative artificial intelligence, as there are currently limited tools with similar effectiveness.

Physical Fitness, Executive Functions, and Academic Performance in Children and Youth: A Cross-Sectional Study

The aim of this cross-sectional study was to investigate the relationship between physical fitness, executive function, and academic performance in children and adolescents. A total of 131 students (49% female) aged 10–15 years from a public school in Rio de Janeiro were assessed in executive functions (hearts and flowers, Corsi’s block, and digit span tasks), academic performance (Portuguese, reading, math, and overall school grade), physical tests (touch test disc, agility, lower limb and upper limb explosive strength), and anthropometric measurements. Regression results showed that the composite of sports-related fitness measures was the best predictor of executive functions (β = 0.472; t = −6.075 p &lt; 0.001). Decision tree classifier analysis showed that the combination of factors that discriminated better and worse executive function groups were better performance in hand–eye coordination (TTD), math, and upper limb strength (ULEST). Sports-related fitness is significantly correlated with executive function. Hand–eye motor coordination has been identified as the most important predictor of improved cognitive outcomes, surpassing even academic skills. These findings should be considered in the design of physical activity programs in school settings, which may have a positive impact on child development, reflected in the reduction of academic and socioeconomic disparities.

Validity and reliability of a physical literacy knowledge, attitudes, self-efficacy and behaviors questionnaire for early childhood educators (PLKASB-ECE): An exploratory factor analysis.

Nurturing physical literacy in young children offers a unique opportunity to address global physical inactivity trend. Early childhood education and care (ECEC) environments, with their extensive reach into this age group, and early childhood educators, through their daily interactions with children, are strategically positioned to influence children's physical literacy development. However, enhancing educators' ability to foster physical literacy requires valid and reliable assessment tools to measure holistic physical literacy constructs (i.e., cognitive, affective, behavioral) to assess the impact of physical literacy educational interventions. The purpose of this study was to develop a holistic digital tool to measure physical literacy knowledge, attitudes, self-efficacy, and behaviors of early childhood educators (PLKASB-ECE) for both their professional teaching context as well as the educator's own personal physical literacy behaviours. This study was conducted in two phases. Phase 1 involved item generation and content validation. Phase 2 employed a cross-sectional validation study design to assess the psychometric properties of the PLKASB-ECE tool. Based on a literature review an initial 19-item instrument was developed that subsequently underwent three rounds of expert content validation. Six additional items were added, resulting in a final 25-item self-report measure with a readability score equivalent to an 8th grade reading level (Flesch-Kincaid Grade Level: 8.7). This included 1 global rating item, 2 qualitative response items, 7 knowledge items, and 15 items addressing physical literacy attitudes, self-efficacy and behaviors using a 7-point Likert response scale. The PLKASB-ECE tool was administered to 470 educators in Alberta, Canada between 2019 to 2022. The 15 items were subjected to exploratory factor analysis and resulted in a five-factor scale with one item not loading. The five-factor scale held with the final 14 items with loadings ranging from 0.481 to 0.886, Cronbach's alpha ranging from 0.70 to 0.82, with ordinal omega ranging from 0.72 to 0.82. Usability, as assessed by completion time, was 8.15 minutes. These findings demonstrate good indices of reliability and validity for the PLKASB-ECE tool. This tool will be valuable as a research outcome measure for assessing educational interventions aimed at enhancing educators' understanding, confidence, and strategies for fostering holistic concepts of physical literacy in young children within ECECs.

Accuracy of natural language processors for patients seeking inguinal hernia information.

NLPs such as ChatGPT are novel sources of online healthcare information that are readily accessible and integrated into internet search tools. The accuracy of NLP-generated responses to health information questions is unknown. We queried four NLPs (ChatGPT 3.5 and 4, Bard, and Claude 2.0) for responses to simulated patient questions about inguinal hernias and their management. Responses were graded on a Likert scale (1 poor to 5 excellent) for relevance, completeness, and accuracy. Responses were compiled and scored collectively for readability using the Flesch-Kincaid score and for educational quality using the DISCERN instrument, a validated tool for evaluating patient information materials. Responses were also compared to two gold-standard educational materials provided by SAGES and the ACS. Evaluations were performed by six hernia surgeons. The average NLP response scores for relevance, completeness, and accuracy were 4.76 (95% CI 4.70-4.80), 4.11 (95% CI 4.02-4.20), and 4.14 (95% CI 4.03-4.24), respectively. ChatGPT4 received higher accuracy scores (mean 4.43 [95% CI 4.37-4.50]) than Bard (mean 4.06 [95% CI 3.88-4.26]) and Claude 2.0 (mean 3.85 [95% CI 3.63-4.08]). The ACS document received the best scores for reading ease (55.2) and grade level (9.2); however, none of the documents achieved the readibility thresholds recommended by the American Medical Association. The ACS document also received the highest DISCERN score of 63.5 (57.0-70.1), and this was significantly higher compared to ChatGPT 4 (50.8 [95% CI 46.2-55.4]) and Claude 2.0 (48 [95% CI 41.6-54.4]). The evaluated NLPs provided relevant responses of reasonable accuracy to questions about inguinal hernia. Compiled NLP responses received relatively low readability and DISCERN scores, although results may improve as NLPs evolve or with adjustments in question wording. As surgical patients expand their use of NLPs for healthcare information, surgeons should be aware of the benefits and limitations of NLPs as patient education tools.

Readability of Patient-Reported Outcome Measures Used in Voice Disorders

ObjectivesThis study aims to evaluate Turkish patient-reported outcome measures (PROM) used in voice disorders using different readability formulas and to examine the relationship between text-based features and readability values. Study DesignA search was conducted to identify published Turkish PRO questionnaires related to dysphonia that are completed by patients. MethodsSearch was conducted to identify published PROM related to dysphonia that are completed by patients in a self-administered format. Reading grade levels were analyzed for voice-related PROM using the Ateşman readability and the Bezirci-Yılmaz new readability formulas as computed by a readability calculations software package. Text-based quantitative features are obtained. Descriptive statistics were also computed across the questionnaires. ResultsA total of 14 PROMs were found. In the analysis, the mean of the Ateşman readability values of the PROM was calculated as 70.66 (±5.55). This value is defined as 'easy', according to the Ateşman readability measures. The average Bezirci-Yılmaz new readability value is 6,03 (±1,07). This value corresponds to the 6th grade reading level in the Turkish education system. ConclusionsResults show that more than half of the PROMs in the Turkish language have the recommended reading level. PROMs allow healthcare professionals to objectively understand the patient's symptoms, both qualitatively and quantitatively. Therefore, it is critical that patients accurately understand and respond to these outcome measures. This is why developers should consider reading as a testable structure. Speech and language therapists should consider the reading level required to understand a specific PROMs in order to obtain the most useful information for treatment planning and outcome assessments.

How Prepared are Ethiopian English Teachers to Teach Early Grade Reading?

Purpose. This paper examines how prepared Ethiopian public primary school English teachers are to teach early grade reading. Methodology. A descriptive research design of mixed methods was employed. A sample of 125 English teachers in 20 randomly selected primary schools in Hawassa City Administration was the source of data. The researchers employed a knowledge assessment test, focus group discussions, and questionnaires to gather the necessary data. The analysis of quantitative data was carried out by using Statistical Package for Social Sciences (SPSS version 25.0). Results. It has been learned from the findings that primary English teacher preparation paid little attention to coursework and practicum to teach early reading. The results also revealed that English teachers felt somewhat prepared to teach early grade reading. There is serious knowledge limitation among English teachers that (12)9.6% of primary English teachers scored 50% and above, whereas (113)90.4% of teachers scored below 50%; the teachers’ average knowledge test score was 36.4%. The results have clearly indicated that it is statistically significant, the direct relationship among teacher preparation coursework emphasis, practicum attention statistically significant, direct relationship among teacher preparation coursework emphasis, practicum attention, and teachers’ felt preparedness at (p=0.001). Conclusions. The results have led to the conclusion that teacher preparation, both in its coursework and practicum, did not pay due attention to teaching early grade reading. That is, primary English teachers were inadequately prepared to teach early grade reading. Based on the results of this study, to improve the practice of early literacy instruction, English teachers’ knowledge and skills gaps need to be duly addressed. Further studies that investigate the current practice of early literacy teacher preparation and professional development should be conducted with a larger sample size and diverse contexts.

Utilization of Artificial Intelligence to Improve Equitable Healthcare Access for Breast Implant Patients

Abstract The recently mandated US Food and Drug Administration (FDA) patient decision checklists were developed with the goal of improving the informed decision-making process for patients considering breast implants. Yet, prior research has demonstrated that these checklists are written at reading levels far in excess of that recommended by the National Institutes of Health and the American Medical Association. Patients considering breast implants are required to sign these forms prior to surgery, even if they have little to no comprehension of their contents. This study aims to improve the accessibility, and therefore the utility, of the mandated FDA patient literature using the assistance of artificial intelligence (AI). Patient decision checklists were obtained from the three most utilized breast implant manufacturers in the United States– Allergan, Mentor, and Sientra. AI was then asked to synthesize a novel patient decision checklist, written at the 6th grade reading level, using these checklists as source material. The AI-assisted checklist was edited by plastic surgeons for both formatting and content. Readability analysis of all documents was performed using the Flesch Reading-Ease Score, Flesch-Kincaid Grade Level, Gunning-Fog Index, Coleman-Liau Index, Simplified Measure of Gobbledygook, and Automated Readability Index. Textual analysis included sentence count, word count, number and percentage of complex words, average number of words per sentence, and average number of syllables per word. The overall readability of Allergan, Mentor, and Sientra patient checklists correlated with the college reading level. These documents were of a statistically significantly higher reading level the AI-assisted checklist, which was written at the recommended 6th grade level. Text composition analysis similarly demonstrated substantial differences between the AI-assisted and FDA mandated literature. The currently mandated breast implant patient checklists are written at a college reading level and are inaccessible to the average patient. We propose a new patient decision checklist, generated with the assistance of artificial intelligence, in order to improve healthcare access within plastic surgery. This simplified material can be used as an adjunct to the current checklists in order to improve shared decision making.

Standard HIPAA Authorization Forms Decreased Response Rates for a Multi-site Pragmatic Trial.

The Health Insurance Portability and Accountability Act (HIPAA) aims to safeguard patient information; however, complex legal language may lead to confusion and mistrust, and hinder enrollment in clinical trials. To evaluate the effect of a standard HIPAA authorization included in mailed survey packets on study enrollment for a multi-site pragmatic trial. This study is nested within an advance care planning pragmatic trial at 50 primary care clinics across three University of California (UC) Health Systems. We included English and Spanish-speaking seriously ill patients. One third of eligible patients received and 2/3 did not receive the HIPAA authorization in their enrollment packet. We compared enrollment rates at 3months and assessed the readability, understandability, and actionability of the standard HIPAA form using the Federal Plain Language Guidelines Checklist for Plain Language, the Automatic Readability Checker consensus calculator (grade 8 is the average reading level for US adults), and the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P, 0-100%, 70% considered the minimum). Of 4632 eligible patients (mean age 71, 48% women, 11% Spanish-speaking, 40% racial/ethnic minority); 1543 received a mailed enrollment packet with a HIPAA form and 3089 did not. Patients mailed the HIPAA form were less likely to enroll (10.2% vs. 14.8%, p < 0.001). The standard HIPAA form scored at the 12th grade reading level, had a PEMAT-P Understandability score of 42%, had an Actionability score of 40%, and only met 50% of Federal Plain Language Guideline Checklist items. The inclusion of a standard HIPAA authorization in mailed enrollment packets for a large pragmatic trial led to lower rates of study enrollment. This study informs how HIPAA authorization forms should be redesigned to be more accessible to patients to prevent unnecessary barriers to research enrollment.

Millions of Students are (Still) Above Grade Level: Achievement and Achievement Variability in Mathematics and Reading Before and During COVID-19 in the United States

According to a 2017 article by Peters and colleagues, millions of students have already demonstrated they know the material slated to be taught that year. Consequently, grade-level standards are unlikely to be appropriately challenging for these students. In this paper, we conceptually replicated and extended this prior study. Using data from schools that administered the Renaissance Star assessment in Fall 2018 and Fall 2021, we quantified pre-COVID and mid-COVID average achievement and variance in achievement in mathematics and reading in fifth grade and estimated the grade level of instruction needed for students. Our results indicate that (a) achievement dropped during COVID-19 relative to pre-COVID, but the drop in mathematics was larger, and (b) achievement variability increased during COVID-19, but the variability in reading was slightly more pronounced. Further, our results replicated Peters et al.’s (2017) results showing that large numbers of students still performed above grade level, and substantial variability in achievement was present within schools.

Online Patient Resources for Birdshot Uveitis: How Readable are These Resources?

ABSTRACT Purpose Birdshot uveitis is a rare ophthalmic condition that can be challenging to control. The readability of online patient resources may impact the management of patients with birdshot. Thus, we examined the readability of online patient resources and identified differences in readability among sources and sections of websites. Methods We queried 3 search engines (Google, Yahoo, Bing) for search results based on a series of terms related to birdshot uveitis. One hundred and twenty results were retrieved and 17 articles were assessed for readability analysis using validated readability and grade-level metrics. Articles were scored based on their entire textual content and, when feasible, also based on sections (e.g. background, diagnosis, treatment). Statistical analyses were conducted using ANOVA and Tukey’s honestly significant difference. Results The websites analyzed were from hospitals and academic centers (5), private practices (3), patient advocacy organizations (4), and other non-profits (5). On average, online patient resources are too difficult to read according to readability scores and grade levels ranging from late high school to college graduate. Articles written by non-profits other than advocacy organizations had an average of 6.5% more complex words than articles written by hospitals and academic centers (p < 0.05). Multiple metrics revealed that the treatment sections were less readable than the causes and symptoms sections. Conclusion The readability of online patient resources for birdshot far exceeds reading levels recommended by the AMA, NIH, and patient safety organizations. Efforts should be made to improve the readability of patient education materials and patient understanding of their disease.

Teachers' strategies for training students' literacy and numeracy through media-based learning in Pansor Village

This community service is entitled teacher strategies in training students' literacy and numeracy through media-based learning at SDN 5 in Pansor village, Kayangan sub-district, North Lombok district. This service is carried out with several objectives, first, to increase awareness about the importance of learning numeracy literacy from an early age, second, to provide knowledge to the students of SDN 5 Sesait that learning numeracy literacy is not just by reading books but can use several tools. apart from books such as drawing media and ice cream sticks and so on. The method used is a face-to-face and direct practice method of learning literacy and numeracy using image-based media or using ice cream sticks by constructing a framework. The results obtained from this service or socialization are to outline the methods used by teachers to teach students mathematics and literacy using media-based learning. Numeracy literacy is one of the first steps or stages that must be trained in school. One of the factors causing media-based Literacy and Numeracy training to be held in Pansor Village, especially at SDN 5 Sesait, is the low ability in reading and arithmetic in grades 5 and 6 which is caused by contemporary factors, namely playing online games and playing social media, especially for children. elementary school children who are continuously without parental supervision.

Online Plain Language Tool and Health Information Quality

Complex and ineffective health communication is a critical source of health inequity and occurs despite repeated policy directives to provide health information that is easy to understand and applies health literacy principles. To evaluate the effectiveness of the Sydney Health Literacy Lab Health Literacy Editor, an easy-to-use online plain language tool that supports health information providers to apply health literacy guidelines to written health information. This randomized clinical trial, conducted online in Australia from May 2023 to February 2024, included a convenience sample of health information providers with no previous experience using the Health Literacy Editor. Analysts were blinded to study group. Participants were randomized 1:1 to the intervention or control group. Participants in the intervention group were provided access to the Health Literacy Editor and a 30-minute online training program prior to editing 3 prespecified health texts. The Health Literacy Editor gives objective, real-time feedback on words and sentences. Control participants revised the texts using their own standard health information development processes. The preregistered primary outcome was the text school grade reading score (using a validated instrument, the Simple Measure of Gobbledygook). Secondary outcomes were text complexity (percentage of text using complex language), use of passive voice (number of instances), and subjective expert ratings (5-point Likert scale corresponding to items on the Patient Education Materials Assessment Tool). A total of 211 participants were randomized, with 105 in the intervention group and 106 in the control group. Of 181 participants in the intention-to-treat analysis (mean [SD] age, 41.0 [11.6] years; 154 women [85.1%]), 86 were in the intervention group and 95 in the control group. Texts revised in the intervention group had significantly improved grade reading scores (mean difference [MD], 2.48 grades; 95% CI, 1.84-3.12 grades; P < .001; Cohen d, 0.99), lower text complexity scores (MD, 6.86; 95% CI, 4.99-8.74; P < .001; Cohen d, 0.95), and less use of passive voice (MD, 0.95 instances; 95% CI, 0.44-1.47 instances; P < .001; Cohen d, 0.53) compared with texts revised in the control group in intention-to-treat analyses. Experts rated texts in the intervention group more favorably for word choice and style than those in the control group (MD, 0.44; 95% CI, 0.25-0.63; P < .001; Cohen d, 0.63), with no loss of meaning or content. In this randomized clinical trial, the Health Literacy Editor helped users simplify health information and apply health literacy guidelines to written text. The findings suggest the tool has high potential to improve development of health information for people who have low health literacy. As an online tool, the Health Literacy Editor is also easy to access and implement at scale. ANZCTR Identifier: ACTRN12623000386639.

Appropriateness and readability of Google Bard and ChatGPT-3.5 generated responses for surgical treatment of glaucoma.

To evaluate the appropriateness and readability of the medical knowledge provided by ChatGPT-3.5 and Google Bard, artificial-intelligence-powered conversational search engines, regarding surgical treatment for glaucoma. In this retrospective, cross-sectional study, 25 common questions related to the surgical management of glaucoma were asked on ChatGPT-3.5 and Google Bard. Glaucoma specialists graded the responses' appropriateness, and different scores assessed readability. Appropriate answers to the posed questions were obtained in 68% of the responses with Google Bard and 96% with ChatGPT-3.5. On average, the responses generated by Google Bard had a significantly lower proportion of sentences, having more than 30 and 20 syllables (23% and 52% respectively) compared to ChatGPT-3.5 (66% and 82% respectively), as noted by readability. Google Bard had significantly (p<0.0001) lower readability grade scores and significantly higher "Flesch Reading ease score", implying greater ease of readability amongst the answers generated by Google Bard. Many patients and their families turn to LLM chatbots for information, necessitating clear and accurate content. Assessments of online glaucoma information have shown variability in quality and readability, with institutional websites generally performing better than private ones. We found that ChatGPT-3.5, while precise, has lower readability than Google Bard, which is more accessible but less precise. For example, the Flesch Reading Ease Score was 57.6 for Google Bard and 22.6 for ChatGPT, indicating Google Bard's content is easier to read. Moreover, the Gunning Fog Index scores suggested that Google Bard's text is more suitable for a broader audience. ChatGPT's knowledge is limited to data up to 2021, whereas Google Bard, trained with real-time data, offers more current information. Further research is needed to evaluate these tools across various medical topics. The answers generated by ChatGPT-3.5™ AI are more accurate than the ones given by Google Bard. However, comprehension of ChatGPT-3.5™ answers may be difficult for the public with glaucoma. This study emphasized the importance of verifying the accuracy and clarity of online information that glaucoma patients rely on to make informed decisions about their ocular health. This is an exciting new area for patient education and health literacy.

Readability Level of Spanish Language Online Health Information: A Systematic Review.

Introduction: Because there is limited online health information in Spanish and it is critical to raise health literacy among Spanish-speaking people, it is essential to assess the readability level of Spanish material. Method: This systematic review included all articles published up to January 3, 2024, and used the CINAHL, MEDLINE, and PubMed databases. The objective was to include the body of knowledge on published articles on the readability levels of Spanish-language, web-based health information intended for lay audiences. Results: There were 27 articles in the final review. Within these articles, 11 tools were used in the Spanish language text. Of the tools, INFLESZ was the most frequently used and the FRY formula, Flesch-Szigriszt Index, and Flesch Formula Index were least used. Most materials (85.2%) reported readability levels of online Spanish information above the 8th grade reading level. Conclusions: The findings show the lack of internet-based Spanish language health information and materials at a recommended (e.g., 5th to 8th grade) reading level. More research is needed to determine which readability tests are more accurate for calculating the readability of Spanish web health information.

Research on Narrative Reading Teaching Strategies in Upper Elementary Grades of Elementary Chinese Textbooks under the Concept of Learning Task Groups

This study delves into the strategies of teaching narrative text reading in higher grades of primary school under the Unified Edition Chinese Textbook, guided by the concept of Learning Task Groups. The concept, a novel educational approach, emphasizes designing a series of interconnected, progressively deepening learning tasks to stimulate students' interest in learning and foster their comprehensive thinking and learning abilities. Through methods such as questionnaires, interviews, and classroom observations, the study comprehensively analyzes the current state of narrative text reading instruction in higher grades. It highlights the challenges faced by teachers in designing and implementing learning tasks and proposes targeted improvement strategies. The implementation of the Learning Task Groups concept, as evidenced by specific case studies and practices, has been shown to effectively enhance students' reading comprehension, language expression, and innovative and critical thinking abilities. Despite challenges like limited resources and individual differences among students, the study suggests that enhancing teachers' professional capabilities and optimizing educational resources can further promote the effectiveness of teaching strategies. Finally, the paper provides comprehensive suggestions for education policymakers, educators, and frontline teachers, emphasizing the need to focus on the holistic development of students, advocating innovative teaching methods, and improve the quality of education to nurture well-rounded individuals equipped with critical thinking, innovative capabilities, and a sense of social responsibility.

Online resources for strabismus: an evaluation of readability, complexity, and suitability.

Over one-third of US adults have never attended college, creating a large disparity in the readability of online health materials. Decreased health literacy and accessibility to medical information negatively affect patients and well-informed patients are more likely to experience better health outcomes (1). The NIH and AMA recommend patient-intended education materials be written at a sixth-grade reading level (2), therefore, this study analyzed the accessibility of the top ten web pages for "strabismus." The first ten online resources returned in a Google search for "strabismus" were analyzed. Web pages were then assessed for the readability level (Simple Measure of Gobbledygook), complexity (PMOSE/IKIRSCH), and suitability (Suitability Assessment of Materials). Two independent raters assessed the complexity and suitability. Readability analysis of the strabismus resources revealed an average reading grade level of 11.4 ± 1.07. There was a statistical difference in the reading grade level between the .com and .gov, and the .org and .com websites (p = .029 and p = .031, respectively). Complexity analysis revealed a mean score of 6.50 ± 2.29, corresponding to an 8th-12th grade reading level. The suitability assessment showed a mean value of 70.3 10.1%, representing a "superior" score for the information provided to the reader. The inter-rater agreement was similar for the complexity and fair for the suitability analysis. On average, online resources for strabismus have a low complexity level. However, the majority of the top ten articles reviewed are above the recommended literacy level, indicating a need for revision. The vast amount of available online health resources have significantly affected the field of medicine. Most patients research their disease process using online sources and many reference this material before their initial ophthalmologic consultation. Considering that more than half of Americans read below the equivalent of a sixth-grade level and that the AMA/NIH recommend all patient-intended materials to be written above this level, there is a health literacy disconnect. This limits patients' ability to educate themselves about their medical conditions and participate in informed conversations regarding their healthcare. Patients who are unable to interpret health information accurately have increased rates of hospitalization, develop more medical conditions, and experience a higher rate of mortality. This preventable impediment to informed healthcare care magnifies the urgency for easily readable online resources that are formatted in a manner that is clear to understand and suitable for patients with lower health literacy.