School of Information Systems and Technology, Claremont Graduate University, USA.
Int J Med Inform. 2013 Aug;82(8):717-30. doi: 10.1016/j.ijmedinf.2013.03.001. Epub 2013 Apr 29.
Low patient health literacy has been associated with cost increases in medicine because it contributes to inadequate care. Providing explanatory text is a convenient approach to distribute medical information and increase health literacy. Unfortunately, writing text that is easily understood is challenging. This work tests two text features for their impact on understanding: lexical simplification and coherence enhancement.
A user study was conducted to test the features' effect on perceived and actual text difficulty. Individual sentences were used to test perceived difficulty. Using a 5-point Likert scale, participants compared eight pairs of original and simplified sentences. Abstracts were used to test actual difficulty. For each abstract, four versions were created: original, lexically simplified, coherence enhanced, and lexically simplified and coherence enhanced. Using a mixed design, one group of participants worked with the original and lexically simplified documents (no coherence enhancement) while a second group worked with the coherence enhanced versions. Actual difficulty was measured using a Cloze measure and multiple-choice questions.
Using Amazon's Mechanical Turk, 200 people participated of which 187 qualified based on our data qualification tests. A paired-samples t-test for the sentence ratings showed a significant reduction in difficulty after lexical simplification (p<.001). Results for actual difficulty are based on the abstracts and associated tasks. A two-way ANOVA for the Cloze test showed no effect of coherence enhancement but a main effect for lexical simplification, with the simplification leading to worse scores (p=.004). A follow-up ANOVA showed this effect exists only for function words when coherence was not enhanced (p=.008). In contrast, a two-way ANOVA for answering multiple-choice questions showed a significant beneficial effect of coherence enhancement (p=.003) but no effect of lexical simplification.
Lexical simplification reduced the perceived difficulty of texts. Coherence enhancement reduced the actual difficulty of text when measured using multiple-choice questions. However, the Cloze measure results showed that lexical simplification can negatively impact the flow of the text.
低患者健康素养与医疗成本增加有关，因为它导致护理不足。提供解释性文本是一种方便的方法来分发医学信息和提高健康素养。不幸的是，编写易于理解的文本具有挑战性。这项工作测试了两个文本特征对理解的影响：词汇简化和连贯性增强。
进行了一项用户研究，以测试这些特征对感知和实际文本难度的影响。使用句子来测试感知难度。参与者使用 5 分李克特量表比较了原始句子和简化句子的八对。摘要用于测试实际难度。对于每个摘要，创建了四个版本：原始版本、词汇简化版本、连贯性增强版本和词汇简化及连贯性增强版本。使用混合设计，一组参与者使用原始和词汇简化文档（没有连贯性增强），而另一组参与者使用连贯性增强版本。使用 cloze 测试和多项选择题来衡量实际难度。
使用亚马逊的 Mechanical Turk，有 200 人参与了测试，其中 187 人符合我们的数据资格测试标准。对句子评分进行的配对样本 t 检验显示，词汇简化后难度显著降低（p<.001）。实际难度的结果基于摘要和相关任务。 cloze 测试的双因素方差分析显示，连贯性增强没有效果，但词汇简化有主要效果，简化导致得分更差（p=.004）。一项后续的方差分析表明，当连贯性没有增强时，这种效应仅存在于功能词中（p=.008）。相比之下，多项选择题的双因素方差分析显示，连贯性增强有显著的有益效果（p=.003），但词汇简化没有效果。
词汇简化降低了文本的感知难度。连贯性增强在使用多项选择题测量时降低了文本的实际难度。然而， cloze 测试结果表明，词汇简化可能会对文本的流畅性产生负面影响。
