Simple Measure Of Gobbledygook Research Articles

Enhancing Readability of Online Patient-Facing Content: The Role of AI Chatbots in Improving Cancer Information Accessibility.

Internet-based health education is increasingly vital in patient care. However, the readability of online information often exceeds the average reading level of the US population, limiting accessibility and comprehension. This study investigates the use of chatbot artificial intelligence to improve the readability of cancer-related patient-facing content. We used ChatGPT 4.0 to rewrite content about breast, colon, lung, prostate, and pancreas cancer across 34 websites associated with NCCN Member Institutions. Readability was analyzed using Fry Readability Score, Flesch-Kincaid Grade Level, Gunning Fog Index, and Simple Measure of Gobbledygook. The primary outcome was the mean readability score for the original and artificial intelligence (AI)-generated content. As secondary outcomes, we assessed the accuracy, similarity, and quality using F1 scores, cosine similarity scores, and section 2 of the DISCERN instrument, respectively. The mean readability level across the 34 websites was equivalent to a university freshman level (grade 13±1.5). However, after ChatGPT's intervention, the AI-generated outputs had a mean readability score equivalent to a high school freshman education level (grade 9±0.8). The overall F1 score for the rewritten content was 0.87, the precision score was 0.934, and the recall score was 0.814. Compared with their original counterparts, the AI-rewritten content had a cosine similarity score of 0.915 (95% CI, 0.908-0.922). The improved readability was attributed to simpler words and shorter sentences. The mean DISCERN score of the random sample of AI-generated content was equivalent to "good" (28.5±5), with no significant differences compared with their original counterparts. Our study demonstrates the potential of AI chatbots to improve the readability of patient-facing content while maintaining content quality. The decrease in requisite literacy after AI revision emphasizes the potential of this technology to reduce health care disparities caused by a mismatch between educational resources available to a patient and their health literacy.

Accuracy, readability, and understandability of large language models for prostate cancer information to the public.

Generative Pretrained Model (GPT) chatbots have gained popularity since the public release of ChatGPT. Studies have evaluated the ability of different GPT models to provide information about medical conditions. To date, no study has assessed the quality of ChatGPT outputs to prostate cancer related questions from both the physician and public perspective while optimizing outputs for patient consumption. Nine prostate cancer-related questions, identified through Google Trends (Global), were categorized into diagnosis, treatment, and postoperative follow-up. These questions were processed using ChatGPT 3.5, and the responses were recorded. Subsequently, these responses were re-inputted into ChatGPT to create simplified summaries understandable at a sixth-grade level. Readability of both the original ChatGPT responses and the layperson summaries was evaluated using validated readability tools. A survey was conducted among urology providers (urologists and urologists in training) to rate the original ChatGPT responses for accuracy, completeness, and clarity using a 5-point Likert scale. Furthermore, two independent reviewers evaluated the layperson summaries on correctness trifecta: accuracy, completeness, and decision-making sufficiency. Public assessment of the simplified summaries' clarity and understandability was carried out through Amazon Mechanical Turk (MTurk). Participants rated the clarity and demonstrated their understanding through a multiple-choice question. GPT-generated output was deemed correct by 71.7% to 94.3% of raters (36 urologists, 17 urology residents) across 9 scenarios. GPT-generated simplified layperson summaries of this output was rated as accurate in 8 of 9 (88.9%) scenarios and sufficient for a patient to make a decision in 8 of 9 (88.9%) scenarios. Mean readability of layperson summaries was higher than original GPT outputs ([original ChatGPT v. simplified ChatGPT, mean (SD), p-value] Flesch Reading Ease: 36.5(9.1) v. 70.2(11.2), <0.0001; Gunning Fog: 15.8(1.7) v. 9.5(2.0), p < 0.0001; Flesch Grade Level: 12.8(1.2) v. 7.4(1.7), p < 0.0001; Coleman Liau: 13.7(2.1) v. 8.6(2.4), 0.0002; Smog index: 11.8(1.2) v. 6.7(1.8), <0.0001; Automated Readability Index: 13.1(1.4) v. 7.5(2.1), p < 0.0001). MTurk workers (n = 514) rated the layperson summaries as correct (89.5-95.7%) and correctly understood the content (63.0-87.4%). GPT shows promise for correct patient education for prostate cancer-related contents, but the technology is not designed for delivering patients information. Prompting the model to respond with accuracy, completeness, clarity and readability may enhance its utility when used for GPT-powered medical chatbots.

Pregnancy Loss: A Comparative Analysis of Information Delivery Between ACOG FAQs and ChatGPT [ID 2683594

INTRODUCTION: Pregnancy loss is a sensitive topic, and clear, reliable information is crucial. This study compares the readability and accuracy of ChatGPT's responses to ACOG's frequently asked questions (FAQ) sheets on the subject. METHODS: Within the five FAQ sheets under “Pregnancy Loss,” 66 questions were assessed using ChatGPT-3.5. Readability scores, ie, Flesch–Kincaid Reading Ease, Flesch–Kincaid Grade Level, Gunning Fog Score, Smog Index, Coleman Liau Index, and Automated Readability Index were computed for each response. The quality of responses were also graded by two maternal–fetal medicine specialists using a 1–4 scale, where 1 represents a comprehensive response and 4 indicates an incorrect response. Statistical analysis utilized a two-tailed t-test. A weighted Cohen’s kappa coefficient evaluated interrater reliability. RESULTS: ACOG attained better readability scores over ChatGPT across all six metrics with statistical significance (P&lt;.001). Among grading, ACOG also outperformed ChatGPT in quality of information with a summative mean of 1.53 (SD 0.60) versus 1.85 (SD 0.90) with statistical significance (P&lt;.001). Grading for ACOG possessed a Cohen's kappa coefficient of 0.493, implying moderate agreement between graders. Grading for ChatGPT possessed a Cohen's kappa coefficient of 0.744, implying substantial agreement between graders. CONCLUSION: The responses by ACOG to frequently asked questions on pregnancy loss were both clearer and more comprehensive than those of ChatGPT with consistent agreement between graders. Although ChatGPT can be a convenient source of medical queries, further improvements ought to be made to these large-language models to provide clear and accurate information regarding pregnancy loss to patients.

Evaluation of online text-based information resources of gynaecological cancer symptoms.

Gynaecological cancer symptoms are often vague and non-specific. Quality health information is central to timely cancer diagnosis and treatment. The aim of this study was to identify and evaluate the quality of online text-based patient information resources regarding gynaecological cancer symptoms. A targeted website search and Google search were conducted to identify health information resources published by the Australian government and non-government health organisations. Resources were classified by topic (gynaecological health, gynaecological cancers, cancer, general health); assessed for reading level (Simple Measure of Gobbledygook, SMOG) and difficulty (Flesch Reading Ease, FRE); understandability and actionability (Patient Education Materials Assessment Tool, PEMAT, 0-100), whereby higher scores indicate better understandability/actionability. Seven criteria were used to assess cultural inclusivity specific for Aboriginal and Torres Strait Islander people; resources which met 3-5 items were deemed to be moderately inclusive and 6+ items as inclusive. A total of 109 resources were identified and 76% provided information on symptoms in the context of gynaecological cancers. The average readability was equivalent to a grade 10 reading level on the SMOG and classified as 'difficult to read' on the FRE. The mean PEMAT scores were 95% (range 58-100) for understandability and 13% (range 0-80) for actionability. Five resources were evaluated as being moderately culturally inclusive. No resource met all the benchmarks. This study highlights the inadequate quality of online resources available on pre-diagnosis gynaecological cancer symptom information. Resources should be revised in line with the recommended standards for readability, understandability and actionability and to meet the needs of a culturally diverse population.

An Analysis of the Readability of Online Sarcoidosis Resources.

Introduction Sarcoidosis is an inflammatory disease characterized by the formation of noncaseating granulomas in multiple organ systems. The presentation can vary widely; although some patients with sarcoidosis can be asymptomatic, sarcoidosis can also present in others with symptomatic multiorgan system involvement. Considering the potential severity of the disease, patients need to be well-informed about sarcoidosis to better manage their health. This study aims to assess the readability levels of online resources about sarcoidosis. Methods We conducted a retrospective cross-sectional study. The term "sarcoidosis" was searched online using both Google and Bing to find websites written in English. Each website was categorized by type: academic, commercial, government, nonprofit, and physician. The readability scores for each website were calculated using six different readability tests: the Flesch-Kincaid reading ease (FKRE), Flesch-Kincaid grade level (FKGL), Gunning fog score (GFS), Simple Measure of Gobbledygook (SMOG), automated readability index (ARI), and Coleman-Liau index (CLI). FKRE gives a score that corresponds to the difficulty of the text, while the remaining tests give a score that corresponds to a grade level in terms of reading ability. A one-sample t-test was used to compare all test scores with the national recommended standard of a sixth-grade reading level. Our null hypothesis was that the readability scores of the websites searched would not differ statistically significantly from the sixth-grade reading level and that there would be no significant differences across website categories. To evaluate the difference between the categories of websites, ANOVA testing was used. Results Thirty-four websites were analyzed. Each of the six readability tests for the websites had an average score, which corresponded to being significantly harder to read than the nationally recommended sixth-grade reading level (p<0.001). None of the mean readability scores showed a statistically significant difference across the five different website categories. Conclusions This is the first study, to our knowledge, to examine the readability of online English resources on sarcoidosis and calculate standardized readability scores for them. It implies that the online English material for sarcoidosis is above the health literacy recommended reading levels for patients. There is a need to simplify the material to be easier to read for patients.

Using Large Language Models to Generate Educational Materials on Childhood Glaucoma

PurposeTo evaluate the quality, readability, and accuracy of large language model (LLM) generated patient education materials (PEMs) on childhood glaucoma, and their ability to improve existing online information's readability. DesignCross-sectional comparative study. MethodsWe evaluated responses of ChatGPT-3.5, ChatGPT-4, and Bard to three separate prompts requesting they write PEMs on “childhood glaucoma.” Prompt A required PEMs be “easily understandable by the average American.” Prompt B required PEMs be written “at a 6th-grade level using Simple Measure of Gobbledygook (SMOG) readability formula.” We then compared responses’ quality (DISCERN questionnaire, Patient Education Materials Assessment Tool (PEMAT)), readability (SMOG, Flesch–Kincaid Grading Level (FKGL)), and accuracy (Likert Misinformation scale). To assess the improvement of readability for existing online information, Prompt C requested LLM rewrite 20 resources from a Google search of keyword “childhood glaucoma” to the American Medical Association-recommended “6th-grade level.” Rewrites were compared on key metrics such as readability, complex words (≥3 syllables), and sentence count. ResultsAll 3 LLM generated PEMs that were of high quality, understandability, and accuracy (DISCERN≥4, ≥70% PEMAT understandability, Misinformation score=1). Prompt B responses were more readable than Prompt A responses for all 3 LLM (p≤0.001). ChatGPT-4 generated the most readable PEMs compared to ChatGPT-3.5 and Bard (p≤0.001). Although Prompt C responses showed consistent reduction of mean SMOG and FKGL scores, only ChatGPT-4 achieved the specified 6th-grade reading level (4.8 ± 0.8 and 3.7 ± 1.9, respectively). ConclusionLLMs can serve as strong supplementary tools in generating high quality, accurate, and novel PEMs, and improving the readability of existing PEMs on childhood glaucoma.

Readability and Quality of Online Patient Education Materials Concerning Posterior Cruciate Ligament Reconstruction.

Objective This study aimed to assess the quality of online patient educational materials regarding posterior cruciate ligament (PCL) reconstruction. Methods We performed a search of the top-50 results on Google® (terms: "posterior cruciate ligament reconstruction,""PCL reconstruction,""posterior cruciate ligament surgery," and "PCL surgery") and subsequently filtered to rule out duplicated/inaccessible websites or those containing only videos (67 websites included). Readability was assessed using six formulas: Flesch-Kincaid Reading Ease (FRE), Flesch-Kincaid Grade Level (FKG), Gunning Fog Score (GF), Simple Measure of Gobbledygook (SMOG) Index, Coleman-Liau Index (CLI), Automated Readability Index (ARI); quality was assessed using the JAMA benchmark criteria and recording the presence of the HONcode seal. Results The mean FRE was 49.3 (SD 11.2) and the mean FKG level was 8.09. These results were confirmed by the other readability formulae (average: GF 8.9; SMOG Index 7.3; CLI 14.7; ARI 6.5). A HONcode seal was available for 7.4 % of websites. The average JAMA score was 1.3. Conclusion The reading level of online patient materials concerning PCL reconstruction is too high for the average reader, requiring high comprehension skills. Practice implications Online medical information has been shown to influence patient healthcare decision processes. Patient-oriented educational materials should be clear and easy to understand.

How good is ChatGPT at answering patients’ questions related to early detection of oral (mouth) cancer?

ObjectivesTo examine the quality, reliability, readability, and usefulness of ChatGPT in promoting oral cancer early detection. Study design108 patients-oriented questions about oral cancer early detection were compiled from expert panel, professional societies, and web-based tools. Questions were categorized into four topic domains and ChatGPT 3.5 was asked each question independently. ChatGPT answers were evaluated regarding quality, readability, actionability, and usefulness using. Two experienced reviewers independently assessed each response. ResultsQuestions related to clinical appearance constituted 36.1% (n=39) of the total questions. ChatGPT provided “very useful” responses to the majority of questions (75%; n=81). The mean Global Quality Score was 4.24 ±1.3 out of 5. The mean reliability score was 23.17 ± 9.87 out of 25. The mean understandability score was 76.6% ±25.9 out of 100, while the mean actionability score was 47.3% ± 18.9 out of 100. The mean FKS reading ease score was 38.4%± 29.9, while the mean SMOG index readability score was 11.65 ± 8.4. No misleading information was identified among ChatGPT responses. ConclusionChatGPT is an attractive and potentially useful resource for informing patients about early detection of oral cancer. Nevertheless, concerns do exist about readability and actionability of the offered information.

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

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

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

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

A health literacy analysis of online patient-directed educational materials about mycobacterium avium complex

IntroductionMycobacterium avium complex (MAC) is a complex lung infection requiring multi-disciplinary approach and management. Due to limited clinician-patient interactions, clinicians may refer patients to online resources to learn about the diagnosis, prognosis, and treatment of MAC. The American Medical Association (AMA) recommends educational materials be written at a sixth-grade reading level and the National Institutes of Health (NIH) recommends that patient education materials be written at an eighth-grade reading level; however, several evaluations found these materials inaccessible due to high literacy levels. To date, there has never been a health literacy assessment of MAC patient education materials. The study aims to assess the health literacy of online patient education materials about MAC. MethodsThe patient education materials were evaluated for readability, actionability, understandability and clarity. Readability was assessed through the Flesch-Kincaid Grade Level Scale (FkGL), SMOG Index, Coleman Liau Index (CLI), Gunning Fog Index (GFI), and Automated Readability Index (ARI). Actionability and understandability was evaluated using the Patient Education Materials Assessment Tool (PEMAT). The Centers for Disease Control (CDC) Clear Communication Index (CCI) was used to assess clarity. ResultsTen patient education resources were evaluated: CDC, Cleveland Clinic, Mayo Clinic, JAMA, American Thoracic Society (ATS), National Jewish Health, UpToDate, CHEST, WebMD, and Medline. The mean readability scores were as follows: FkGL (9.76), SMOG index (9.82), CLI (13.54), GFI (11.66), ARI (9.15). Four patient education materials were written at a sixth-grade reading level and eight patient education materials were written at an eighth-grade reading level. The majority of the materials received a passing score for understandability but failed to achieve a passing score for actionability. Cleveland Clinic, JAMA, and ATS all received a passing clarity score, indicating that they are easy to read. No patient education materials were available on UpToDate. ConclusionMost patient education materials scored poorly for actionability and clarity while scoring highly for readability and understandability. This study should serve as a guide for clinicians interested in offering online education materials to their patients. Increasing access to readable MAC educational materials should be a priority for those working at the intersection of public health, clinical care, and communications.

Application of generative language models to orthopaedic practice

ObjectiveTo explore whether large language models (LLMs) Generated Pre-trained Transformer (GPT)-3 and ChatGPT can write clinical letters and predict management plans for common orthopaedic scenarios.DesignFifteen scenarios were generated and ChatGPT...

Evaluating the Use of ChatGPT to Accurately Simplify Patient-centered Information about Breast Cancer Prevention and Screening.

Purpose To evaluate the use of ChatGPT as a tool to simplify answers to common questions about breast cancer prevention and screening. Materials and Methods In this retrospective, exploratory study, ChatGPT was requested to simplify responses to 25 questions about breast cancer to a sixth-grade reading level in March and August 2023. Simplified responses were evaluated for clinical appropriateness. All original and simplified responses were assessed for reading ease on the Flesch Reading Ease Index and for readability on five scales: Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, Automated Readability Index, and the Simple Measure of Gobbledygook (ie, SMOG) Index. Mean reading ease, readability, and word count were compared between original and simplified responses using paired t tests. McNemar test was used to compare the proportion of responses with adequate reading ease (score of 60 or greater) and readability (sixth-grade level). Results ChatGPT improved mean reading ease (original responses, 46 vs simplified responses, 70; P < .001) and readability (original, grade 13 vs simplified, grade 8.9; P < .001) and decreased word count (original, 193 vs simplified, 173; P < .001). Ninety-two percent (23 of 25) of simplified responses were considered clinically appropriate. All 25 (100%) simplified responses met criteria for adequate reading ease, compared with only two of 25 original responses (P < .001). Two of the 25 simplified responses (8%) met criteria for adequate readability. Conclusion ChatGPT simplified answers to common breast cancer screening and prevention questions by improving the readability by four grade levels, though the potential to produce incorrect information necessitates physician oversight when using this tool. Keywords: Mammography, Screening, Informatics, Breast, Education, Health Policy and Practice, Oncology, Technology Assessment Supplemental material is available for this article. © RSNA, 2023.

Online Resources for Robin Sequence; an Analysis of Readability.

The objective was to evaluate the readability of easily accessible parent-directed information concerning Robin Sequence (RS) online, compared to the American Medical Association (AMA)-recommended sixth grade (age 11-12) readability level. A Google search of the term “Pierre Robin Sequence information” was performed. The first ten websites were evaluated using six commonly used readability formulas. Sample texts from three websites were ‘translated’ by the authors, with the aim of achieving a sixth grade readability level. The following outcomes were used: Automated Readability Index (ARI), Coleman Liau Index (CLI), Gunning Fog Score, Simple Measure of Gobbledygook (SMOG), Flesch Kincaid Grade Level (FKGL), and Flesch Reading Ease (FRE) score. The mean pooled grade level of the top 10 included websites was 12.1 (age 17-18). The overall FRE Index was 45.8, which is equivalent to a College-grade reading level. The mean grade level by each test used was: Flesch-Kincaid Grade Level 11.6 (age 16-17), Gunning Fog Score 13.3 (age 18+), SMOG 10.0 (age 14-15), Coleman-Liau Index 13.8 (age 18+), and ARI 12.0 (age 17-18). The author-translated resources achieved pooled mean grade levels of 6.3-6.5. Parent-directed online materials concerning RS have a readability in excess of the AMA-recommended sixth grade reading level. Even though the condition is complex, more readable resources are achievable. Coproduction of parent-directed resources in association with public an patient involvement (PPI) contributors is encouraged.

(022) Utility of Artificial Intelligence in Patient Educational Materials for Men’s Sexual Health

Abstract Introduction ChatGPT is an artificial intelligence (AI) platform with expanding uses across society, including the solicitation of medical advice by patients. Traditionally, men’s health patients obtained educational information through the Urology Care Foundation (UCF) or institutional websites. Today, men are increasingly turning to social media and AI given improving technology and prevalent stigma surrounding sexual health issues. Previous studies have demonstrated the ability of ChatGPT to perform certain physician tasks, but studies of its patient-facing use are limited. Most online health educational information far exceeds the recommended American sixth grade reading level, as defined by the NIH and AMA. Hence, existing resources are largely inaccessible to large swaths of the population. In this study, we questioned whether AI holds may help improve the provision of health educational information for the public. Objective To conduct the first analysis of ChatGPT-created information regarding men’s sexual health conditions and provide statistical comparison with resources produced by UCF. Methods Frequently asked patient questions regarding erectile dysfunction, premature ejaculation, low testosterone, sperm retrieval, penile augmentation, and male infertility were compiled from the American Urological Association. Questions included definition of the condition, etiology, diagnostics, treatment, prognosis, and common patient concerns. Responses from UCF and ChatGPT were compared using the following validated readability formulas: Flesch Reading Ease, Flesch-Kincaid Grade Level, Gunning-Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, and Automated Readability Index. Descriptive analysis of word count, sentence length, syllable count, and word complexity was also performed. Furthermore, adjusted ChatGPT (ChatGPT-a) responses were generated by prompting the language model with the command “Explain it to me like I am in sixth grade.” Finally, all responses were further graded by two independent reviewers for accuracy and comprehensiveness. Statistical comparisons were made using Welch’s unpaired t-test. Results Readability scores are presented in Table 1. UCF was significantly more readable than ChatGPT for all six sexual medicine topics across all scoring metrics (all p&amp;lt;0.001). FKGL was 8.87 for UCF versus 14.83 for ChatGPT. ChatGPT responses were longer (278.3 versus 222.9 words) and included more complex words (28.1% versus 14.3%). When prompted with a command for more accessible language (ChatGPT-a), responses approached the readability of UCF across all metrics, including an average Flesch Reading Ease of 54.8 and FKGL of 9.6. UCF and ChatGPT had equal quality and accuracy on qualitative analysis. Conclusions Men’s health information provided by ChatGPT is less accessible when compared to UCF, although both platforms exceed the recommended sixth grade level. Given its sensitive nature, sexual medicine information is increasingly sought out online. Our findings indicate that AI can simplify online information to accommodate an individual user’s health literacy, but improvement in the current platform is needed. Future iterations of ChatGPT may be adapted towards the provision of medical information and trained on evidence-based literature, hence improving both readability and quality. As AI grows, providers must study this new platform to better understand and assist their patients. Disclosure No.

Thyroid Ethanol and Radiofrequency Ablation: A Call for Patient-Friendly Online Resources

Introduction: The multiple treatment options available to patients with thyroid nodules can generate uncertainty and confusion. Radiofrequency ablation (RFA) and ethanol ablation (EA) are two alternative modalities to manage thyroid nodules. As patients more frequently utilize online resources to guide their decision-making, the quality of such resources must be evaluated. The goal of this study was to assess the quality of online patient materials relating to RFA and EA compared to standard thyroidectomy. Methods: The terms “thyroidectomy,” “thyroid radiofrequency ablation,” and “thyroid ethanol ablation” were searched on Google. Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Patient Education Materials Assessment Tool (PEMAT) understandability and actionability were calculated for each website. Statistical analysis was conducted on SPSS Statistics. Google trends were used to determine search interest for each term (May 2016 – May 2021). Results: Of the 77 websites that met our inclusion criteria (30 thyroidectomy sites, 30 RFA sites, and 17 EA sites), the average FRE, FKGL, and SMOG scores of the RFA websites were significantly worse than those of the thyroidectomy websites (p < 0.05). The FKGL and SMOG scores of the EA websites were significantly worse than those of the thyroidectomy websites (p < 0.05). The average understandability and actionability scores for thyroidectomy websites were significantly higher than those of RFA and EA websites (p < 0.05). Conclusion: Ablation websites have lower search interest, readability, validity, understandability, and actionability scores in comparison to traditional thyroidectomy websites. Our findings emphasize the need to consider readability and PEMAT scores when developing online educational resources for ablative alternatives to thyroidectomy to allow for greater patient accessibility.

Assessment of the Readability and Quality of Online Information for Patients and Their Families Regarding Schizophrenia.

To our knowledge, this is the first study that specifically aims to assess the readability and quality of online information about schizophrenia. The analysis is performed on 93 of 195 websites that appeared in an advanced Google search of the term "schizophrenia" performed on a single day. The websites were categorized as commercial, nonprofit, professional, and government. The websites were evaluated using the Health on the Net Foundation (HON) code certificate, DISCERN tool, and Journal of the American Medical Association ( JAMA ) benchmark criteria for quality and the Flesch Reading Ease Formula, Flesch-Kincaid Grade Level (FKGL) Formula, Simple Measure of Gobbledygook, and Gunning Fog indices for readability. A total of 21.5% of all websites had a HON code certificate, 50.5% were accepted as high quality ( JAMA score ≥3), and 25.8% reached the recommended readability level (FKGL ≤8). Only three websites scored at a fifth- to sixth-grade reading level. Commercial and government websites had significantly lower DISCERN scores. Commercial websites had significantly lower Flesch Reading Ease Score and FKGL score than nonprofit websites. In conclusion, the current findings indicate that the quality of online information on schizophrenia is generally acceptable, but the readability is insufficient. Website creators, physicians, and health authorities should be more sensitive to the readability of online information about schizophrenia, considering the poor cognitive capacity of the patients and the unique nature of the disease.

Literacy-related factors and knowledge of patient rights charter: evidence from nurses in selected hospitals in Ghana.

Systems of across the world have developed and implemented patient rights policies to protect and improve the provider-patient relationship. The Patient Charter of Ghana was developed in 2002 to improve service quality and protect patients' rights. However, it is not yet known whether those at the frontline of healthcare delivery can read and understand the contents of the charter. While studies have explored the socioeconomic and institutional level factors related to awareness and knowledge of the Patient Rights Charter, there is a lack of literature on its readability and comprehensibility among nurses. This study assesses nurses' knowledge of the Patient Rights Charter and associated literacy-related factors. An exploratory cross-sectional design and quantitative methods were used to collect data on knowledge, comprehension, and readability of the Patient Rights Charter. 205 nurses from four district hospitals in the Central Region were recruited using proportional and total enumeration sampling. Data were collected using structured questionnaires and were processed using SPSS (version 26) and an online text readability consensus calculator (version 2.0). Descriptive and inferential statistical analyses were performed, and data were presented using simple frequencies, readability statistics, and regression output. The results show the charter is written at a higher reading grade level; Flesch-Kincaid Grade Level (13.36), Simple Measure of Gobbledygook (11.57), and Coleman-Liau Readability Index (14.2). The average reading grade level score was 14. The Gunning Fox Index (15.40) and the Flesch Reading Ease Score (34%) show the patient charter is difficult to read and will require at least 14 years of education to be able to read. 87.3% of nurses were able to read and comprehend the charter. Very few (8.3%) read at frustration level. Nurses' actual comprehension of the charter was the only significant predictor of knowledge of the charter. Comprehension of the patient charter is an important predictor of its knowledge. The results emphasize the need to enhance the readability and comprehensibility of the charter for providers. Hospitals can stimulate nurses' knowledge of the charter by simplifying the charter's language and deliberately educating nurses on its content.

Assessing the Readability of Online English and Spanish Language Patient Education Resources Provided by the American Society of Plastic Surgeons, American Society of Aesthetic Plastic Surgeons, and American Society of Reconstructive Microsurgeons.

The National Institutes of Health recommends that patient education materials (PEMs) be written at the sixth grade level. However, PEMs online are still generally difficult to read. The usefulness of online PEMs depends on their comprehensibility. This study assessed the readability of PEMs from national Plastic and Reconstructive Surgery (PRS) organization websites. Patient education materials were collected from 3 prominent PRS organizations-the American Society of Plastic Surgeons (ASPS), American Society of Aesthetic Plastic Surgeons (ASAPS), and the American Society of Reconstructive Microsurgeons (ASRM). ASPS PEMs were organized into reconstructive and cosmetic groups, and then further subdivided into English and Spanish subgroups. ASAPS and ASRM PEMs provided cosmetic and reconstructive comparison groups to ASPS, respectively. Readability scores were generated using the Simple Measure of Gobbledygook (SMOG) and the Spanish SMOG scales. Overall, all PEMs failed to meet readability guidelines. Within ASPS, Spanish PEMs were easier to read than English PEMs ( P < 0.001), and cosmetic PEMs were easier to read than reconstructive PEMs ( P < 0.05). There was no significant difference between ASPS cosmetic and ASAPS PEMs ( P = 0.36), nor between ASPS reconstructive and ASRM PEMs ( P = 0.65). ASAPS and ASRM did not have any Spanish PEMs, and 92% of all ASPS PEMs were in English. Although PRS societies strive to better educate the public on the scope of PRS, PRS ranks lowly in public understanding of its role in patient care. In addition, Spanish language PEMs from the 3 PRS organizations are severely lacking. Addressing these concerns will make online patient resources more equitable for various patient populations.

Development and Preliminary Validation of an Equine Brief Pain Inventory for Owner Assessment of Chronic Pain Due to Osteoarthritis in Horses.

An owner-completed questionnaire was designed to monitor the level of chronic pain and impact on quality of life in horses with osteoarthritis (OA). A standardized approach to develop and validate subjective-state scales for clinical use was followed. Scale items were generated through literature review, focus group meetings, and expert panel evaluation. The draft tool was tested for reading level and language ambiguity and piloted in 25 owners/caregivers of horses with osteoarthritis, with factor analysis performed on responses. The resulting revised questionnaire is currently undergoing validation in a larger sample population of 60 OA and 20 sound control horses. In the pilot group, 21 people (84%) found the questionnaire easy to complete and 22 people (88%) found it useful. It could be completed within 5 min by all participants. Readability scores (Flesch Reading Ease Score, Flesch-Kincaid grade level, SMOG index) indicated an English language reading level comparable to that of 6th to 7th grade in the U.S. system (age 11-12 years). Cronbach's alpha of all items in the tool was 0.957, indicating excellent inter-item correlation. Interim analysis for 23 OA horses from the sample population showed good test-retest reliability and higher scores compared to 5 control horses. Full validation must be completed for the instrument to be used in clinical practice.