Quantitative analysis of the level of readability of online emergency radiology-based patient education resources
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The vast amount of information found on the internet, combined with its accessibility, makes it a widely utilized resource for Americans to find information pertaining to medical information. The field of radiology is no exception. In this paper, we assess the readability level of websites pertaining specifically to emergency radiology.
Using Google, 23 terms were searched, and the top 10 results were recorded. Each link was evaluated for its readability level using a set of ten reputable readability scales. The search terms included the following: abdominal ultrasound, abdominal aortic aneurysm, aortic dissection, appendicitis, cord compression, CT abdomen, cholecystitis, CT chest, diverticulitis, ectopic pregnancy, epidural hematoma, dural venous thrombosis, head CT, MRI brain, MR angiography, MRI spine, ovarian torsion, pancreatitis, pelvic ultrasound, pneumoperitoneum, pulmonary embolism, subarachnoid hemorrhage, and subdural hematoma. Any content that was not written for patients was excluded.
The 230 articles that were assessed were written, on average, at a 12.1 grade level. Only 2 of the 230 articles (1%) were written at the third to seventh grade recommended reading level set forth by the National Institutes of Health (NIH) and American Medical Association (AMA). Fifty-two percent of the 230 articles were written so as to require a minimum of a high school education (at least a 12th grade level). Additionally, 17 of the 230 articles (7.3%) were written at a level that exceeded an undergraduate education (at least a 16th grade level).
The majority of websites with emergency radiology-related patient education materials are not adhering to the NIH and AMA’s recommended reading levels, and it is likely that the average reader is not benefiting fully from these information outlets. With the link between health literacy and poor health outcomes, it is important to address the online content in this area of radiology, allowing for patient to more fully benefit from their online searches.
KeywordsHealth literacy Readability Websites
Compliance with ethical standards
Competing interests statement
The authors declare that they have no conflict of interest.
- 1.Demographics of Internet Users (2011) In Internet and American Life Project. Pew Research Center, Washington D.CGoogle Scholar
- 2.Berkman ND et al (2011) Health literacy interventions and outcomes: an updated systematic review. Evid Rep Technol Assess (Full Rep) 199:1–941Google Scholar
- 3.(CDC), U.D.o.H.a.H.S.-C.f.D.C.a.P (2009) Simply put: A Guide for Creating Easy-to-Understand Materials. Atlanta, GAGoogle Scholar
- 4.BD, W (2003) Health literacy: a manual for clinicians, ed. A.M. foundation, Chicago: American Medical AssociationGoogle Scholar
- 5.How to Write Easy-to-Read Health Materials. [cited 2017 03/02]; Available from: https://www.nlm.nih.gov/medlineplus/etr.html
- 6.Prabhu, A.V., et al. Online palliative care and oncology patient education resources through Google: do they meet national health literacy recommendations? Practical Radiat OncolGoogle Scholar
- 13.Prabhu AV, Kim C, Crihalmeanu T, Hansberry DR, Agarwal N, DeFrances MC, Trejo Bittar HE (2017) An online readability analysis of pathology-related patient education articles: an opportunity for pathologists to educate patients. Hum Pathol 65:15–20. https://doi.org/10.1016/j.humpath.2017.04.020 CrossRefPubMedGoogle Scholar
- 14.Hansberry DR, Donovan AL, Prabhu AV, Agarwal N, Cox M, Flanders AE (2017) Enhancing the radiologist-patient relationship through improved communication: a quantitative readability analysis in spine radiology. AJNR Am J Neuroradiol 38(6):1252–1256. https://doi.org/10.3174/ajnr.A5151 CrossRefPubMedGoogle Scholar
- 15.Hansberry DR, Agarwal N, John ES, John AM, Agarwal P, Reynolds JC, Baker SR (2017) Evaluation of internet-based patient education materials from internal medicine subspecialty organizations: will patients understand them? Intern Emerg Med 12(4):535–543. https://doi.org/10.1007/s11739-017-1611-2 CrossRefPubMedGoogle Scholar
- 18.Hansberry DR, Agarwal N, Gonzales SF, Baker SR (2014) Are we effectively informing patients? A quantitative analysis of on-line patient education resources from the American Society of Neuroradiology. AJNR Am J Neuroradiol 35(7):1270–1275. https://doi.org/10.3174/ajnr.A3854 CrossRefPubMedGoogle Scholar
- 23.Prabhu, A.V., et al. Radiology online patient education materials provided by major university hospitals: do they conform to NIH and AMA guidelines? Current problems in diagnostic radiologyGoogle Scholar
- 25.Crihalmeanu, T., et al. Readability of online allergy and immunology educational resources for patients: implications for physicians. J Allergy Clin Immunol: In PracticeGoogle Scholar
- 28.J.P., K (1975) Deviation of new readability formulas (Automated Readability Index, Fog Count and Flesch Reading Ease Formula) for Navy enlisted personnel, N.T.I. Service, Editor. Springfield, VAGoogle Scholar
- 29.G.H., M., SMOG grading (1969) A new readability formula. J Read 12:639–646Google Scholar
- 31.R., G (1952) The technique of clear writing. Mcgraw-Hill, New YorkGoogle Scholar
- 32.J.S., C., Readability revisited (1995) The new Dale-Chall readability formula, ed. B.B. Cambridge. Northampton, MAGoogle Scholar
- 33.Caylor J.S., S.T.G, Fox L.C., et al. (1973) Methodologies for determining reading requirements of military occupational specialties, H.R.R. Organization, Editor: Alexandria, VAGoogle Scholar
- 34.E., F (1968) A readability formula that saves time. J Read 11:513–578Google Scholar
- 35.A.L., R (1977) The Raygor readability estimate: A quick and easy way to determine difficulty, in National Reading Conference. Clemson, SCGoogle Scholar
- 36.Hansberry DR, Ayyaswami V, Sood A, Prabhu AV, Agarwal N, Deshmukh SP (2017) Abdominal imaging and patient education resources: enhancing the radiologist-patient relationship through improved communication. Abdom Radiol (NY) 42(4):1276–1280. https://doi.org/10.1007/s00261-016-0977-3 CrossRefGoogle Scholar
- 44.Sarkar U, Karter AJ, Liu JY, Adler NE, Nguyen R, López A, Schillinger D (2010) The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system-results from the diabetes study of northern California (DISTANCE). J Health Commun 15(Suppl 2):183–196. https://doi.org/10.1080/10810730.2010.499988 CrossRefPubMedPubMedCentralGoogle Scholar
- 45.Sudore RL, Mehta KM, Simonsick EM, Harris TB, Newman AB, Satterfield S, Rosano C, Rooks RN, Rubin SM, Ayonayon HN, Yaffe K, for the Health, Aging and Body Composition Study (2006) Limited literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc 54(5):770–776. https://doi.org/10.1111/j.1532-5415.2006.00691.x CrossRefPubMedGoogle Scholar
- 46.Gutierrez N, Kindratt TB, Pagels P, Foster B, Gimpel NE (2014) Health literacy, health information seeking behaviors and internet use among patients attending a private and public clinic in the same geographic area. J Community Health 39(1):83–89. https://doi.org/10.1007/s10900-013-9742-5 CrossRefPubMedGoogle Scholar
- 48.Berland GK, Elliott MN, Morales LS, Algazy JI, Kravitz RL, Broder MS, Kanouse DE, Muñoz JA, Puyol JA, Lara M, Watkins KE, Yang H, McGlynn EA (2001) Health information on the internet: accessibility, quality, and readability in English and Spanish. JAMA 285(20):2612–2621. https://doi.org/10.1001/jama.285.20.2612 CrossRefPubMedPubMedCentralGoogle Scholar