Readability of Patient Educational Materials in Sports Medicine

Tiarnán Ó Doinn; James M Broderick; Rebecca Clarke; Niall Hogan

doi:10.1177/23259671221092356

Readability of Patient Educational Materials in Sports Medicine

Orthop J Sports Med. 2022 May 6;10(5):23259671221092356. doi: 10.1177/23259671221092356. eCollection 2022 May.

Authors

Tiarnán Ó Doinn¹, James M Broderick¹, Rebecca Clarke¹, Niall Hogan¹

Affiliation

¹ Department of Trauma and Orthopaedic Surgery, St. James's Hospital, Dublin, Ireland.

Abstract

Background: The internet has become an increasingly popular resource among sports medicine patients seeking injury-related information. Numerous organizations recommend that patient educational materials (PEMs) should not exceed sixth-grade reading level. Despite this, studies have consistently shown the reading grade level (RGL) of PEMs to be too demanding across a range of surgical specialties.

Purpose: To determine the readability of online sports medicine PEMs.

Study design: Cross-sectional study.

Methods: The readability of 363 articles pertaining to sports medicine from 5 leading North American websites was assessed using 8 readability formulas: Flesch-Kincaid Reading Grade Level, Flesch Reading Ease Score, Raygor Estimate, Fry Readability Formula, Simple Measure of Gobbledygook, Coleman-Liau Index, FORCAST Readability Formula, and Gunning Fog Index. The mean RGL of each article was compared with the sixth- and eighth-grade reading level in the United States. The cumulative mean website RGL was also compared among individual websites.

Results: The overall cumulative mean RGL was 12.2 (range, 7.0-17.7). No article (0%) was written at a sixth-grade reading level, and only 3 articles (0.8%) were written at or below the eighth-grade reading level. The overall cumulative mean RGL was significantly higher than the sixth-grade [95% CI for the difference, 6.0-6.5; P < .001] and eighth-grade (95% CI, 4.0-4.5; P < .001) reading levels. There was a significant difference among the cumulative mean RGLs of the 5 websites assessed.

Conclusion: Sports medicine PEMs produced by leading North American specialty websites have readability scores that are above the recommended levels. Given the increasing preference of patients for online health care materials, the imperative role of health literacy in patient outcomes, and the growing body of online resources, significant work needs to be undertaken to improve the readability of these materials.

Keywords: health literacy; patient education; readability; reading grade level; sports medicine.