Readability Assessment of Internet-Based Patient Education Materials Related to Acoustic Neuromas

Introduction: The objectives of this study were (1) to assess the readability of Internet-based patient education materials related to acoustic neuromas (AN-IPEMs), using four widely validated readability indices; (2) to evaluate scores against the existing recommended sixth-grade reading level; and (3) to compare the readability scores of patient education materials (PEMs) produced by professional organizations, clinical practices, hospitals, and miscellaneous sources.

Materials and Methods: AN-IPEMs from 67 Web sites (9 professional societies, 33 clinical practices, 19 hospitals, and 6 miscellaneous sources) were assessed by Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (Gunning FOG). Scores were then evaluated against national recommendations by one-tailed t-tests and against each other using one-way ANOVAs.

Results: The average FKGL, SMOG, and Gunning FOG scores were all significantly higher than the recommended sixth-grade reading level suggested by the USDHHS (P < 0.0000, single sample one-tailed t-test). Zero articles, by all indices, had a reading level equal to or below the sixth-grade reading level. The FKGLs also varied among the various sources at a significant level (P = 0.01, one-way ANOVA independent samples). The average FKGLs of clinical practices and professional society AN-IPEMs were significantly higher than the average FKGLs of miscellaneous AN-IPEMs and hospital AN-IPEMs (both P ≤ 0.05, one-tailed t-tests assuming unequal variances).

Conclusions: AN-IPEMs are written at a level significantly higher than that suggested by national recommendations. Current AN-IPEMs may need to be revised and additional NIPEMs established to enhance patient comprehension and improve clinical outcomes.