Simple Measure Of Gobbledygook Research Articles

Limited Availability and Readability of Spanish Language Patient Educational Material: A Review of the Nation's Top Children's Hospitals.

Cleft lip with or without cleft palate (CL/P) is a common congenital facial pathology that occurs at higher incidences in Hispanic communities. The authors analyzed the availability and readability of Spanish-written patient education materials (PEMs) on CL/P from top-ranking U.S. children's hospitals to determine the presence of health literacy barriers. Availability of PEM was evaluated by 2 methods: (1) Google search and (2) evaluation of the official hospital websites. For each institution, a Google search was conducted using the phrase, "labio leporino y/o paladar hendido (translation: CL/P) + (hospital name)." In addition, each hospital website was assessed for Spanish PEM availability. Spanish PEMs were then categorized by whether they had been generated by an automated translation function or if they were independently written Spanish text. English PEM readability was assessed using the Simple Measure of Gobbledygook (SMOG). Spanish PEM readability was assessed using spanish orthgraphic length (Spanish Orthographic Length), the SMOG converted for the Spanish language. Unpaired 2-tailed t tests were used to compare readability. Of a total of 85 pediatric hospitals, 28 (37.3%) had Spanish PEM. Five (6.7%) hospitals created their own Spanish-language document. The average spanish orthgraphic length reading level was 9.49 compared with an average SMOG of 11.38 (P < 0.001). Institutions that did not provide Spanish PEM in any format had a significantly higher SMOG for English PEM of 12.13 compared with 11.38 of those that had SMOG with English PEM (P = 0.04). Health literacy barriers not only exist for Spanish PEM but also for English PEM, indicating an opportunity to improve communication.

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.

Miscellaneous Posters PO0301: Development of a Program Utilizing the Simple Measure of Gobbledygook (SMOG) Algorithm for Comprehending Patient-Generated Educational Content in the Field of Radiation Oncology

Miscellaneous Posters PO0301: Development of a Program Utilizing the Simple Measure of Gobbledygook (SMOG) Algorithm for Comprehending Patient-Generated Educational Content in the Field of Radiation Oncology

Can ChatGPT provide quality information about fever in children?

Artificial intelligence (AI) systems hold great promise in improving medical care and health problems. We aimed to evaluate the answers by asking the most frequently asked questions to ChatGPT for the prediction and treatment of fever, which is a major problem in children. The 50 questions most frequently asked about fever in children were determined, and we asked them to ChatGPT. We evaluated the responses using the quality and readability scales. While ChatGPT demonstrated good quality in its responses, the readability scale and the Patient Education Material Evaluation Tool (PEMAT) scale used with materials appearing on the site were also found to be successful. Among the scales in which we evaluated ChatGPT responses, a weak positive relationship was found between Gunning Fog (GFOG) and Simple Measure of Gobbledygook (SMOG) scores (r = 0.379) and a significant and positive relationship was found between FGL and SMOG scores (r = 0.899). This study sheds light on the quality and readability of information regarding the presentation of AI tools, such as ChatGPT, regarding fever, a common complaint in children. We determined that the answers to the most frequently asked questions about fire were high-quality, reliable, easy to read and understandable.

Assessing the Responses of Large Language Models (ChatGPT-4, Claude 3, Gemini, and Microsoft Copilot) to Frequently Asked Questions in Retinopathy of Prematurity: A Study on Readability and Appropriateness.

To assess the appropriateness and readability of responses provided by four large language models (LLMs) (ChatGPT-4, Claude 3, Gemini, and Microsoft Co-pilot) to parents' queries pertaining to retinopathy of prematurity (ROP). A total of 60 frequently asked questions were collated and categorized into six distinct sections. The responses generated by the LLMs were evaluated by three experienced ROP specialists to determine their appropriateness and comprehensiveness. Additionally, the readability of the responses was assessed using a range of metrics, including the Flesch-Kincaid Grade Level (FKGL), Gunning Fog (GF) Index, Coleman-Liau (CL) Index, Simple Measure of Gobbledygook (SMOG) Index, and Flesch Reading Ease (FRE) score. ChatGPT-4 demonstrated the highest level of appropriateness (100%) and performed exceptionally well in the Likert analysis, scoring 5 points on 96% of questions. The CL Index and FRE scores identified Gemini as the most readable LLM, whereas the GF Index and SMOG Index rated Microsoft Copilot as the most readable. Nevertheless, ChatGPT-4 exhibited the most intricate text structure, with scores of 18.56 on the GF Index, 18.56 on the CL Index, 17.2 on the SMOG Index, and 9.45 on the FRE score. This suggests that the responses demand a college-level comprehension. ChatGPT-4 demonstrated higher performance than other LLMs in responding to questions related to ROP; however, its texts were more complex. In terms of readability, Gemini and Microsoft Copilot were found to be more successful. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XXX-XXX.].

Assessing the readability and quality of online written information on epistaxis.

The objective of this study was to assess the readability and quality of online written information on epistaxis. The terms 'epistaxis' and 'nosebleed' were entered into Google. The first six webpages generated for each search term were screened. Readability was assessed using the Flesch-Kincaid Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG) Index and Gunning Fog Index (GFOG). Quality was assessed using the DISCERN instrument. Spearman's correlation between quality and readability was calculated. A total of 37 websites met the inclusion criteria. The mean and 95% confidence intervals for FRES, FKGL, SMOG and GFOG were 58.9 (55.3-62.5), 9.65 (8.74-10.6), 9.18 (8.57-9.8) and 12.5 (11.5-13.5), respectively. The DISCERN score was 34.3 (32.0-36.5). Weak negative correlation was noted between DISCERN and FRES (rs = -0.15, p = 0.36). Online information on epistaxis is generally of poor quality and low readability.

Improving Biomedical Science Literacy and Patient-Directed Knowledge of Tuberculosis (TB): A Cross-Sectional Infodemiology Study Examining Readability of Patient-Facing TB Information.

Tuberculosis (TB) continues be the leading cause of death globally due to an infectious agent. There is a paucity of data describing the readability of patient-facing TB information for service users. The aim of this study was to calculate the readability of multiple global TB information sources. Information on tuberculosis (n = 150 sources) included nine categories, Patient-facing information: WHO publications (n = 17), International governments (n = 19), Hospitals (n = 10), Non-government organisations (NGOs)/charities (n = 20), Cochrane Plain Language Summaries (n = 20); LabTestsOnlineUK (n = 4) and Scientific-facing information: Clinical trials (n = 20), Cochrane abstracts (n = 20), Scientific abstracts (n = 20). Readability was calculated using Readable software, defined by (i) Flesch Reading Ease (FRE), (ii) Flesch-Kincaid Grade Level (FKGL), (iii) Gunning Fog Index and (iv) SMOG Index and two text metrics [words/sentence, syllables/word]. Mean readability values for TB information for the FRE and FKGL were 35.6 ± 1.6 (standard error of mean (SEM)) (US Target ≥60; UK Target ≥90) and 12.3 ± 0.3 (US Target ≤8; UK Target ≤6), respectively, with mean words per sentence and syllables per word of 17.2 and 1.8, respectively. Cochrane Plain Language Summaries had similar readability scores to their matching scientific abstract (p = 0.15). LabTestsOnlineUK yielded a mean FRE score of 51.5 ± 1.2, a mean FKGL score of 10.2 ± 0.5 and text metric scores of 16.7 ± 2.3 and 1.6, for words per sentence and syllables per word, respectively. In descending order, TB information from international governments, hospitals and LabTestsOnlineUK were the most readable (FRE = 57.9, 54.1 and 51.5, respectively), whereas scientific abstracts and Cochrane abstracts were the most difficult to read (13.0 and 30.2, respectively). Patient-facing TB information analysed had poor readability. Effective communication of biomedical science concepts and information relating to TB is vital for service users to enhance their health literacy of tuberculosis, thereby promoting better clinical outcomes. Biomedical scientists are important custodians of scientific information for their service user populations, including other healthcare professionals within the TB multidisciplinary (MDT) team and patient service users. When preparing TB information, this should be checked and modified in real time employing readability calculators, to align with health readability targets.

Trustworthiness, Value, Danger, and Readability of ChatGPT-Generated Responses to Health Questions Related to Pulmonary Arterial Hypertension.

To enhance outcomes for patients with pulmonary arterial hypertension (PAH), comprehensive and individualized therapy is needed. A large language model called Generative Pre-trained Transformer (ChatGPT) has the ability to provide expert yet patient-friendly care. We wanted to determine how well ChatGPT could accurately and consistently respond to inquiries on knowledge and management for PAH. When 20 PAH patients were diagnosed, they were asked what concerns they had about PAH and what they had researched online.In the evaluation, it was determined that patients frequently searched the Internet for answers to eight queries. These eight queries were posed to ChatGPT, and their responses were recorded. Ten experts in the field of PAH assessed the trustworthiness, value, and hazard of the answers generated by the ChatGPT. According to evaluations conducted by experts, the ChatGPT-generated responses were deemed trustworthy with an average score of 8.4 (7.7-9.2) and valuable with an average score of 7.9 (7.4-8.2). Based on the statistical analysis, it can be inferred that most professionals believed that the utilization of prompts provided by ChatGPT did not present a substantial risk, with a mean of 2.1 (1.7-2.5).The answers were assessed for readability using two different indicators, namely the Flesch-Kincaid Grade Level (FKGL) and the Simple Measure of Gobbledygook (SMOG). The average FKGL value was determined to be 13.52 ± 2.40, indicating a "difficult" level of readability. ChatGPT provides reliable PAH-related information, but it is important to seek professional medical advice before making any decisions regarding PAH. ChatGPT can only provide general information and support, but a qualified healthcare provider can offer tailored recommendations.

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.

ChatGPT-3.5 and -4.0 Do Not Reliably Create Readable Patient Education Materials for Common Orthopaedic Upper- and Lower-Extremity Conditions

PurposeTo investigate if ChatGPT 3.5 and 4.0 can serve as a viable tool to create readable patient education materials (PEMs) for patients with common orthopaedic upper and lower extremity conditions. MethodsUtilizing ChatGPT versions 3.5 and 4.0, the authors asked the AI program a series of two questions pertaining to patient education for 50 common orthopaedic upper extremity and 50 common orthopaedic lower extremity pathologies. Two templated questions were created and used for all conditions. Readability scores were calculated using the Python library TextStat. Multiple readability test scores were generated, and a consensus reading level was created taking into account the results of 8 reading tests. ResultsChatGPT 3.5 produced only 2% and 4% of responses at the appropriate reading level for upper and lower extremity conditions, respectively, compared to 54% produced by ChatGPT 4.0 for both upper and lower extremity conditions (both p<0.0001). Following a priming phase, ChatGPT 3.5 did not produce any viable responses for either the upper or lower extremity conditions, compared to 64% for both upper and lower extremity conditions by ChatGPT 4.0 (both p<0.0001). Additionally, ChatGPT 4.0 was more successful than ChatGPT 3.5 in producing viable responses both pre- and post-priming phase based on all available metrics for reading level (all p<0.001), including Automated Readability scores, Coleman Liau Index, Dale Chall Score, Flesch Kincaid Grade, Flesch Reading Ease, Gunning Fog, Linsear Write Formula Score, and Simple Measure of Gobbledygook (SMOG) Index. ConclusionsOur results indicate that ChatGPT unreliably created readable PEMs for common orthopaedic upper and lower extremity conditions at the time of the study. Clinical RelevanceThe findings of this study suggest that ChatGPT, while constantly improving as evidenced by the advances from 3.5 to 4.0, should not be substituted for traditional methods of patient education at this time and in its current state may be utilized as a supplemental resource at the discretion of providers.

How Readable Is the Information the United Kingdom's Statutory Health and Social Care Professional Regulators Provide for the Public to Engage With Fitness to Practise Processes?

The public are an important source of notifications and evidence for the investigation of concerns by regulators of professionals. The website is an important source of information for the public, but the complexity of information presented to engage with the public is unknown. This study explored the readability of information provided for the public to engage with fitness to practise processes by examining the websites of the 13 UK statutory health and social care professional regulators. Six readability algorithms were utilised to calculate the readability scores of 180 general and 8 easy-read documents published for the 15 sites of the United Kingdom's 13 health and social care statutory professional regulatory bodies. These tests were the Flesch Kincaid Reading Ease, the Flesch Kincaid Grade Level, the Gunning Fog Score, the Simple Measure of Gobbledygook (SMOG) Index, the Coleman Liau Index and the Automated Readability Index (ARI). All the fitness to practise documents analysed in this study are written at a level too difficult for most of the general population to read, except one easy-read document. There was also considerable variation in readability across resources for the same regulator, which could be confusing. Regulatory bodies risk excluding a large proportion of UK adults who may want to engage with professional regulatory proceedings. This is the first comparative analysis of readability conducted independent of the regulators of the fitness to practise website documents of health and social care regulators. The public are a key source of evidence in regulatory proceedings. Regulators could improve public engagement by addressing the complexity of language used. Our advisory group of people with lived experience of involvement as members of the public in fitness to practise proceedings discussed the findings and contributed to the recommendations.

Quality and readability of online information about piriformis syndrome

AimIn this study, we aimed to investigate the quality and readability of websites related to Piriformis Syndrome(PS). MethodOn November 14, 2023, we searched the term "Piriformis Syndrome" in Google (https://www.google.com). We evaluated the top 200 uniform resource locators(URLs) in query results for typology, Journal of the American Medical Association(JAMA) scores, the Flesch-Kincaid reading ease(FRE) score, Flesch-Kincaid grade(FKG) level, Gunning-Fog index, and Simple Measure of Gobbledygook(SMOG) grade level. The JAMA scoring system was used to assess quality, and FRE, FKG, Gunning-Fog index and SMOG scores were used to assess the readability of online information. Content analysis was performed for etiology, symptoms, diagnosis, and treatment. Treatment options were evaluated as exercise, physical therapy agents, drug therapy, invasive treatments, and surgery. ResultsOf the 138 websites evaluated, 39 were classified as high-quality websites. Scientific publications and health portal websites were found to have high-quality scores. When the readability parameters of the websites were compared in terms of quality, there was no significant difference between high-quality websites and low-quality websites in terms of FRE and FKG scores(p > 0.05), but there was a significant difference in Gunning-Fog index and SMOG scores(p = 0.030, p = 0.010 respectively). The quality score of the top 10 websites was higher than the rest(p = 0.002). When the contents of the websites were analyzed, there was a significant difference only in terms of diagnosis. Scientific websites mentioned diagnosis the most, while commercial websites mentioned it the least. When the treatment content was analyzed, there was a significant difference in terms of surgery. Non-profit websites mentioned it the most, while commercial websites mentioned it the least. ConclusionHigh-quality websites were slightly more difficult in the readability parameters. However, the proportion of high-quality websites was quite low. These results may encourage those producing PS-related online information to improve the quality and readability of content and content coverage.

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.

Evaluating the readability of online patient information for cholangiocarcinoma.

264 Background: The digital age has facilitated the dissemination of free comprehensive information regarding the diagnosis and treatment of various cancers. Especially for rarer cancers, such as cholangiocarcinoma, patients heavily rely on online patient information (OPI) as a primary source of information. However, the usefulness of these websites is dependent on the readability of the information. The National Institute of Health (NIH) recommends OPI have a readability level of grade 8 or lower. We sought to assess the readability of OPI for cholangiocarcinoma. Methods: We utilized Google to identify the top ten websites utilizing the search query "cholangiocarcinoma". The readability score of each website was defined as the median of ten popular standardized readability scales - Flesch–Kincaid, Gunning Fog, Coleman–Liau, Simple Measure of Gobbledygook, Automated Readability Index, FORCAST, Raygor, Fry Graph, and New Dale Chall. These readability scales were obtained using www.readable.com. Group comparisons of readability score were performed for affiliation (i.e., academic, non-profit, or government) and website content (i.e., treatment modalities, complications, clinical trials, supportive care, and survivorship). Statistical analysis was done in RStudio. Pairwise comparisons were performed using the Wilcoxon rank sum test. Results: A total of 10 websites were analyzed with 4/10 (40%) affiliated with academic institutions, 3/10 (30%) affiliated with non-profit organization, and 3/10 (30%) affiliated with government websites. The median readability score for all 10 websites was 9.95 (IQR 9.15-10.75). The majority of the websites (9/10, 90%) websites had readability scores that did not satisfy the NIH recommendation for readability. Readability scores did not differ significantly between academic, government, and nonprofit websites (p=0.68). Readability also did not differ by website content. The correlation between word count and readability score was not statistically significant (r = 0.03, p = 0.92). Conclusions: We performed a first of its kind analysis to assess the readability of OPI for cholangiocarcinoma. The median readability of OPI for cholangiocarcinoma was at a 10th grade level and the majority of the websites did not satisfy the NIH guideline for readability. Surprisingly, government websites were not simpler to read than their academic and nonprofit counterparts. Our study underscores the need to develop OPI for cholangiocarcinoma that is easily readable for patients and their caregivers. Organizations publishing OPI may use readability scores to ensure their content is accessible for the general population.

Large language models: a new frontier in paediatric cataract patient education

Background/aimsThis was a cross-sectional comparative study. We evaluated the ability of three large language models (LLMs) (ChatGPT-3.5, ChatGPT-4, and Google Bard) to generate novel patient education materials (PEMs) and improve...

Content and readability of patient educational materials about neuromodulation for childhood movement disorders

Purpose To assess content and readability of online patient educational materials (PEMs) for paediatric deep brain stimulation (DBS) and intrathecal baclofen (ITB). Methods A content analysis of PEMs identified from top children’s hospitals, institutions affiliated with published neuromodulation research, and DBS and ITB device manufacturers was conducted. PEM content was analysed using a predetermined framework. Readability was assessed using the Simple Measure of Gobbledygook (SMOG). Results Of 109 PEMs (72 DBS; 37 ITB) identified, most (77 (71%)) originated in the United States. More ITB PEMs (27 (73%)) contained specific paediatric information than DBS PEMs (16 (22%)). PEMS more frequently described benefits (DBS: 92%; ITB: 89%) than risks (DBS: 49%; ITB: 78%). Frequent content included pre- and post-operative care, procedural details, and device information. Less common content included long-term lifestyle considerations, alternatives, patient experiences, and financial details. Median readability of PEMs was 13.2 (interquartile range [IQR]: 11.4–14.45) for DBS and 11.8 (IQR: 11–12.9) for ITB. Conclusions Available ITB and DBS PEMs often miss important broader details of the treatments, and have additional shortcomings such as poor readability scores. Our findings highlight need for more holistic content within neuromodulation PEMs, improved accessibility, and more balanced representation of risks and benefits.

Quality and Readability Analysis of Turbinoplasty on the Web.

This study aimed to assess the quality, credibility, and readability of online health information concerning turbinoplasty, given the increasing reliance on internet resources for health education. Using four search terms related to turbinoplasty, we analyzed 71 text-based webpages from Google.com, Bing.com, and Yahoo.com. Readability was evaluated using the Flesch-Kincaid grade level, Gunning-Fog Index, SMOG Index, and Coleman-Liau Index were utilized. Web page quality was computed through the DISCERN Instrument (DISCERN), the Journal of the American Medical Association benchmark criteria (JAMA), Novel Turbinoplasty Index (NTI), and presence of code certification by Health on The Net (HON). Seventy-one text-based web pages were assessed. Information quality was measured by an average DISCERN score of 47.4±7.40, indicating "fair" quality. The average readability was a grade level of 9.7±1.57, notably higher than AMA and NIH recommendations. Of all web pages, only 11 (15.49%) proficiently met all 4 listed JAMA criteria. Significant correlations between web page classification and average DISCERN (P=0.0042), as well as JAMA score (P<0.001) were discovered. The web pages that had HON code certification revealed significantly higher quality metrics such as DISCERN scores (P<0.001), JAMA scores (P<0.001), and NTI scores (P=0.038). Online health information for turbinoplasty is of "fair" quality, and the average readability is several grade levels above current AMA and NIH recommendations. Health care providers should aim to guide their patients on finding appropriate educational resources and should improve the readability of their patient education materials.

Evaluating Multi-Jurisdictional Enteric Illness Outbreak Messaging in Canada: A Content Analysis of Public Health Notices

ABSTRACT Effective risk communication during enteric illness outbreaks requires the provision of clear and consistent information to diverse audiences to reduce risk of exposure, inform behavior changes, and prevent illness. Most enteric illnesses are caused by pathogens transmitted through consumption of contaminated food or water, contact with animals, or person-to-person contact. When multi-jurisdictional outbreaks occur, the Public Health Agency of Canada posts web-based Public Health Notices (PHNs) to inform Canadians. This study evaluated the comprehensibility of PHNs to optimize federal risk communication approaches. Publicly available web-based PHNs (n = 42) from 2014–2022 were obtained. A codebook was developed using the Centers for Disease Control and Prevention’s (CDC) Clear Communication Index (CCI) and Health Belief Model (HBM) and systematically applied. A SMOG readability calculator was used to determine reading grade level. Descriptive statistics were calculated to summarize coded data. The average reading grade level was above Grade 12 (13.9 ± 1.1). PHNs communicated the nature of the risk (100%) and behavioral recommendations (96.5%) clearly. An active voice was sometimes used (61.9%), but numerical information was less commonly presented using best practices (38.1%). The HBM was fully incorporated in seven PHNs, with most PHNs using five of six constructs (66.7%). PHNs shared similar information in a consistent order (75.0%). Aligning PHNs to best practices in risk communication is recommended, including writing content at a reading grade level that supports comprehension by diverse audiences, following the CCI to increase clarity, including all HBM constructs to promote behavior change, and maintaining message consistency.

Evaluation of the Quality and Readability of Web-Based Information Regarding Foreign Bodies of the Ear, Nose, and Throat: Qualitative Content Analysis.

Foreign body (FB) inhalation, ingestion, and insertion account for 11% of emergency admissions for ear, nose, and throat conditions. Children are disproportionately affected, and urgent intervention may be needed to maintain airway patency and prevent blood vessel occlusion. High-quality, readable online information could help reduce poor outcomes from FBs. We aim to evaluate the quality and readability of available online health information relating to FBs. In total, 6 search phrases were queried using the Google search engine. For each search term, the first 30 results were captured. Websites in the English language and displaying health information were included. The provider and country of origin were recorded. The modified 36-item Ensuring Quality Information for Patients tool was used to assess information quality. Readability was assessed using a combination of tools: Flesch Reading Ease score, Flesch-Kincaid Grade Level, Gunning-Fog Index, and Simple Measure of Gobbledygook. After the removal of duplicates, 73 websites were assessed, with the majority originating from the United States (n=46, 63%). Overall, the quality of the content was of moderate quality, with a median Ensuring Quality Information for Patients score of 21 (IQR 18-25, maximum 29) out of a maximum possible score of 36. Precautionary measures were not mentioned on 41% (n=30) of websites and 30% (n=22) did not identify disk batteries as a risky FB. Red flags necessitating urgent care were identified on 95% (n=69) of websites, with 89% (n=65) advising patients to seek medical attention and 38% (n=28) advising on safe FB removal. Readability scores (Flesch Reading Ease score=12.4, Flesch-Kincaid Grade Level=6.2, Gunning-Fog Index=6.5, and Simple Measure of Gobbledygook=5.9 years) showed most websites (56%) were below the recommended sixth-grade level. The current quality and readability of information regarding FBs is inadequate. More than half of the websites were above the recommended sixth-grade reading level, and important information regarding high-risk FBs such as disk batteries and magnets was frequently excluded. Strategies should be developed to improve access to high-quality information that informs patients and parents about risks and when to seek medical help. Strategies to promote high-quality websites in search results also have the potential to improve outcomes.

Enhancing Health Literacy: Evaluating the Readability of Patient Handouts Revised by ChatGPT's Large Language Model.

To use an artificial intelligence (AI)-powered large language model (LLM) to improve readability of patient handouts. Review of online material modified by AI. Academic center. Five handout materials obtained from the American Rhinologic Society (ARS) and the American Academy of Facial Plastic and Reconstructive Surgery websites were assessed using validated readability metrics. The handouts were inputted into OpenAI's ChatGPT-4 after prompting: "Rewrite the following at a 6th-grade reading level." The understandability and actionability of both native and LLM-revised versions were evaluated using the Patient Education Materials Assessment Tool (PEMAT). Results were compared using Wilcoxon rank-sum tests. The mean readability scores of the standard (ARS, American Academy of Facial Plastic and Reconstructive Surgery) materials corresponded to "difficult," with reading categories ranging between high school and university grade levels. Conversely, the LLM-revised handouts had an average seventh-grade reading level. LLM-revised handouts had better readability in nearly all metrics tested: Flesch-Kincaid Reading Ease (70.8 vs 43.9; P < .05), Gunning Fog Score (10.2 vs 14.42; P < .05), Simple Measure of Gobbledygook (9.9 vs 13.1; P < .05), Coleman-Liau (8.8 vs 12.6; P < .05), and Automated Readability Index (8.2 vs 10.7; P = .06). PEMAT scores were significantly higher in the LLM-revised handouts for understandability (91 vs 74%; P < .05) with similar actionability (42 vs 34%; P = .15) when compared to the standard materials. Patient-facing handouts can be augmented by ChatGPT with simple prompting to tailor information with improved readability. This study demonstrates the utility of LLMs to aid in rewriting patient handouts and may serve as a tool to help optimize education materials. Level VI.