What Reading Level Should Hospital Information Be Created in
Abstruse
Background
The National Institutes of Health (NIH) recommend that wellness materials be written at a grade six-7 reading level, which has by and large not been achieved in online reading materials. Upward to the present time, in that location have not been any assessments focused on the reading level of online educational materials beyond the nearly popular consumer Spider web sites for common internal medicine diagnoses. In this study, we examined the readability of open up-access online health information for 9 common internal medicine diagnoses.
Methods
Ix of the most often encountered inpatient and ambulatory internal medicine diagnoses were selected for analysis. In November and Dec 2014, these diagnoses were used as search terms in Google, and the top 5 Web sites beyond all diagnoses and a diagnosis-specific site were analyzed across 5 validated reading indices.
Results
On average, the lowest reading class-level content was provided by the NIH (ten.7), followed by WebMD (10.ix), Mayo Dispensary (eleven.three), and diagnosis-specific Web sites (11.five). Conversely, Wikipedia provided content that required the highest grade-level readability (14.6). The diagnoses with the lowest reading grade levels were chronic obstructive pulmonary disease (x.viii), followed by diabetes (10.9), congestive heart failure (11.7), osteoporosis (11.7) and hypertension (11.7). Depression had the highest grade-level readability (13.viii).
Discussion
Despite recommendations for patient health information to be written at a grade 6-7 reading level, our examination of online educational materials pertaining to 9 mutual internal medicine diagnoses revealed reading levels significantly higher up the NIH recommendation. This was seen beyond both diagnosis-specific and general Spider web sites. There is a demand to meliorate the readability of online educational materials made available to patients. These improvements have the potential to profoundly heighten patient awareness, engagement, and md–patient communication.
Keywords
- Health literacy
- Internal medicine
- Online instruction
- Patient health information
- Readability
Clinical Significance
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The National Institutes of Wellness (NIH) recommends that health materials be written at a grade 6-7 reading level.
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Online educational materials for common internal medicine diagnoses have reading levels significantly above the NIH recommendation.
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Neither disease-specific nor general Spider web sites are meeting the NIH recommendation.
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There is a need to improve the readability of online patient education materials.
The Internet has a ubiquitous presence in the dr.–patient meet. Oftentimes a patient arrives at a clinical visit having read a number of online instruction materials about their diagnosis. Data presented past the patient can invite shared decision-making and be a starting point for communication in the medical setting. Upwards to the present fourth dimension, at that place have not been any assessments focused on the reading level of online educational materials across the virtually popular consumer Web sites for common internal medicine diagnoses.
Co-ordinate to the 2006 National Cess of Literacy Written report, 22% of Americans have Basic health literacy and a farther 14% have Below Basic health literacy.
one
- Kutner M.A.
- Greenberg Due east.
- Jin Y.
- Paulsen C.
The Health Literacy of America'southward Adults: Results From the 2003 National Cess of Developed Literacy.
- Google Scholar
The National Institutes of Health (NIH) recommends that health materials exist written at a grade six-vii reading level. However, a recent study demonstrated that none of the online patient educational resource provided by 16 professional person medical organizations met a sixth-course reading level.
2
- Agarwal N.
- Hansberry D.R.
- Sabourin Five.
- Tomei K.50.
- Prestigiacomo C.J.
A comparative analysis of the quality of patient education materials from medical subspecialties.
- Google Scholar
Objective
In this study, we examined the readability of open-admission online health information for 9 common internal medicine diagnoses.
Methods
Nine of the most frequently encountered inpatient and ambulatory internal medicine diagnoses were analyzed
3
- Pfuntner A.
- Wier L.Thousand.
- Stocks C.
Nigh frequent conditions in U.S. Hospitals, 2010. HCUP Statistical Cursory No. 148.
- Google Scholar
,
: pneumonia, osteoarthritis, congestive heart failure, sepsis, atrial fibrillation, chronic obstructive pulmonary disease, depression, hypertension, and diabetes. In November and Dec 2014, these diagnoses were used every bit search terms in the largest Internet search engine, Google, simulating the method by which the majority of online users admission wellness information.
5
- Eysenbach G.
- Köhler C.
How exercise consumers search for and assess health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews.
- Crossref
- PubMed
- Scopus (1275)
- Google Scholar
The top 5 Web sites beyond all diagnoses: Wikipedia.org, Mayoclinic.org, Webmd.com, Medicinenet.com, and NIH.gov, were selected. A diagnosis-specific site was also chosen for each search term, based on the top affliction-specific or organ-specific site for each diagnosis. Health information pertaining to each diagnosis was extracted from every Web site and standardized to remove citations, images, tables, videos, advertisements, and acknowledgments. Texts were analyzed using the following validated readability indices to determine reading form level: Flesch Kincaid Grade Level, Gunning Fog Score, SMOG index, Coleman Liau Index, and Automated Readability Index.
All statistical analyses were conducted using SAS Software 9.4 for Windows (SAS Institute, Inc, Cary, NC), using PROC GLIMMIX. Grade-level readability of online patient education materials by diagnosis was analyzed using a general estimating equation with sandwich estimation, nesting by readability algorithm scores. Plots of point estimates along with 95% confidence intervals were included.
Results
On boilerplate, the lowest reading grade-level content was provided past the NIH (10.7), followed past WebMD (10.9), Mayo Clinic (11.iii), and diagnosis-specific Web sites (11.5). Conversely, Wikipedia provided content that required the highest class-level readability (14.half dozen) (Figure 1). The diagnoses with the lowest reading form levels were chronic obstructive pulmonary disease (ten.viii), followed by diabetes (10.nine), congestive heart failure (11.7), osteoporosis (11.7) and hypertension (11.7). Conversely, depression had the highest class-level readability (xiii.viii) (Figure ii).
Effigy i Reading class level of online sources grouped by Spider web site. Overall, Wikipedia had the highest reading grade level (fourteen.6), while the National Institutes of Health (NIH) had the lowest (10.vii). The shaded region in pink demonstrates the 6-7 reading grade level recommended past the National Institutes of Health (NIH).
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Effigy ii Reading grade level of online sources grouped past diagnosis. Overall, online educational materials for chronic obstructive pulmonary disease had the lowest reading class level (10.8) and depression had the highest (thirteen.eight). The shaded region in pinkish demonstrates the six-7 reading grade level recommended by the NIH.
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Discussion
Despite recommendations for patient didactics materials to be written at a grade 6-seven reading level, our examination of online patient health information pertaining to 9 common internal medicine diagnoses revealed reading levels significantly above the NIH recommendation. This was seen beyond both diagnosis-specific and general Web sites. Additionally, sure diagnoses and online sources—depression and Wikipedia, respectively—were associated with higher reading levels. This may both advise an inherent complication in specific medical concepts that may not easily lend themselves to an online text explanation, and reflect utilise of like chief sources for Spider web site articles for specific diagnoses.
Although patient health data can exist a valuable resources, physicians should be cognizant that much of the online material currently available is written at a level that profoundly exceeds the readability of many patients. There is a demand to improve the readability of online educational materials made available to patients. These improvements have the potential to greatly enhance patient awareness, engagement, and dr.–patient communication.
References
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The Health Literacy of America's Adults: Results From the 2003 National Cess of Adult Literacy.
National Center for Education Statistics, Washington, DC 2006 () () -
A comparative analysis of the quality of patient education materials from medical subspecialties.
JAMA. 2013; 173 : 1257-1259 -
Near frequent weather condition in U.S. Hospitals, 2010. HCUP Statistical Cursory No. 148.
Agency for Healthcare and Research Quality, Rockville, MD January 2013 () () -
National Center for Health Statistics. National Ambulatory Medical Care Survey: 2010 summary tables. Hyattsville, Maryland: Public Wellness Service; 2010. Available at: http://world wide web.cdc.gov/nchs/data/ahcd/namcs_summary/2010_namcs_web_tables.pdf. Accessed August 2, 2015.
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How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews.
BMJ. 2002; 324 : 573-577
Article Info
Publication History
Published online: January 29, 2016
Footnotes
Funding: The authors take no funding sources to disembalm.
Conflict of Interest: The authors accept no conflicts of interest to disclose.
Authorship: All authors had admission to the data herein described and contributed to the writing of this manuscript.
Identification
DOI: https://doi.org/10.1016/j.amjmed.2016.01.008
Copyright
Published by Elsevier Inc.
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Source: https://www.amjmed.com/article/S0002-9343%2816%2930068-7/abstract