Abdominal imaging and patient education resources: enhancing the radiologist–patient relationship through improved communication
The relative ease of Internet access and its seemingly endless amount of information creates opportunities for Americans to research medical diseases, diagnoses, and treatment plans. Our objective is quantitative evaluation of the readability level of patient education websites, written for the lay public, pertaining to common radiologic diagnostic test, and radiologic diagnoses specific to abdominal imaging.
In October 2015, 10 search terms were entered in the Google search engine, and the top 10 links for each term were collected and independently examined for their readability level using 10 well-validated quantitative readability scales. Search terms included CT abdomen, MRI abdomen, MRI enterography, ultrasound abdomen, X-ray abdomen, cholecystitis, diverticulitis, hepatitis, inflammatory bowel disease, and pancreatitis. Websites not written exclusively for patients were excluded from the analysis.
As a group, the 100 articles were assessed at an 11.7 grade level. Only 2% (2/100) were written at the National Institutes of Health (NIH), and American Medical Association (AMA) suggested 3rd to 7th grade level to meet the 8th grade average reading level in the United States. In fact, 49% were written at a level that required a high school education or higher (greater than 12th grade).
With websites like radiologyinfo.org, generating over a million visitors a month, it is that clear there is a public interest in learning about radiology. However, given the discordance between the level of readability of the majority of the Internet articles and the NIH and AMA guidelines noted in this study on abdominal imaging readability, it is likely that many readers do not fully benefit from these resources on abdominal imaging.
KeywordsRadiology Patient education resources Readability Health literacy Diagnostics
Compliance with ethical standards
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Statement of informed consent was not applicable since the manuscript does not contain any patient data.
- 1.Perrin A, Duggan M (2015) Americans’ internet access: 2000–2015. Pew Research Center.Google Scholar
- 2.Fox S (2011) The social life of health information, 2011. Washington, DC: Pew Internet & American Life ProjectGoogle Scholar
- 5.Krane D (2005) The Harris Poll. 28th July. www.harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2005Vol5_Iss08pdf. Accessed April 2007.
- 6.Kiley R (2005) Does the internet harm health? Some evidence exists that the internet does harm health. BMJ Br Med J 324(7331):238. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122149/.
- 8.Commission TJ. What did the doctor say? Improving health literacy to protect patient safety. Health Care at the Crossroads series.Google Scholar
- 9.Weiss BD, Schwartzberg JG, Association AM (2007) Health literacy and patient safety: help patients understand [manual for clinicians]. Chicago, IL: AMA Foundation, p 2010Google Scholar
- 10.Lauder B, Gabel-Jorgensen N (2008) Recent research on health literacy, medication adherence, and patient outcomes. Home Heal Nurse 26(5):254–255Google Scholar
- 13.Kutner M, Greenburg E, Jin Y, Paulsen C (2006) The health literacy of America’s adults: results from the 2003 national assessment of adult literacy. NCES 2006-483. National Center for Education Statistics.Google Scholar
- 14.Kirsch IS, Jungeblut A, Jenkins L, Kolstad A (2002) Adult literacy in America: a first look at the results of the national adult literacy survey. Natl Cent Educ Stat :178. NCES 1993-275.Google Scholar
- 15.National Assessment of Adult Literacy. http://nces.ed.gov/naal/.
- 16.Weis BD (2003) American Medical Foundation. Health literacy: a manual for clinicians. Chicago: American Medical Association.Google Scholar
- 17.How to Write Easy-to-Read Health Materials. MedlinePlus. https://www.nlm.nih.gov/medlineplus/etr.html. Accessed 19 June 2016.
- 43.Scott TL, Gazmararian JA, Williams M V, Baker DW (2002) Health literacy and preventive health care use among medicare enrollees in a managed care organization. Med Care 40(5). http://journals.lww.com/lww-medicalcare/Fulltext/2002/05000/Health_Literacy_and_Preventive_Health_Care_Use.5.aspx.
- 47.Kincaid JP (1975) Derivation of new readability forumlas: “automated readability index, fog count and flesch reading ease formula) for navy enlisted personnel. Springfield, VA: National Technical Information ServiceGoogle Scholar
- 48.Chall JS (1995) Readability revisited: the new Dale–Chall readability formula. Northampton, MA: Brookline Books CambridgeGoogle Scholar
- 49.Caylor TG, Fox LC, Ford JP, Sticht JS (1973) Methodologies for determining reading requirements of military occupational specialties [Technical Report No. 73-5]. Alexandria, VA: Human Resources Research Organization; 1973.Google Scholar
- 50.Fry E (1968) A readability formula that saves time. J Read 11:513–578Google Scholar
- 51.Raygor AL (1977) The raygor readability estimate: a quick and easy way to determine difficulty. In: Pearson PD, (ed). Reading: theory, research, and practice—26th yearbook of the national reading conference. Clemson, SC: National Reading Conference.Google Scholar
- 52.McLaughlin GH (1969) SMOG grading: a new readability formula. J Read 12:639–646Google Scholar
- 54.Gunning R (1952) The technique of clear writing. New York: McGraw-HillGoogle Scholar
- 58.Weiss BD (2003) Health literacy: a manuel for clinicians. Chicago, IL: AMA FoundationGoogle Scholar
- 59.Center for Disease Control Prevention (2009) Simply put—a guide for creating easy to understand materials. U.S. Department of Health and Human Services.Google Scholar
- 60.RadiologyInfo.org. Reaches one million monthly visitors. http://www.acr.org/Quality-Safety/eNews/Issue-13-March-2016/RadiologyInfo-Reaches-1-Million-Visitors.Published. 2016.