Eltorai Adam E M, Sharma Pranav, Wang Jing, Daniels Alan H
Warren Alpert Medical School, Brown University, Box G-9247, Providence, RI, 02903, USA,
Clin Orthop Relat Res. 2015 Apr;473(4):1181-6. doi: 10.1007/s11999-014-4071-2. Epub 2014 Dec 5.
Advancing health literacy has the potential to improve patient outcomes. The American Academy of Orthopaedic Surgeons' (AAOS) online patient education materials serve as a tool to improve health literacy for orthopaedic patients; however, it is unknown whether the materials currently meet the National Institutes of Health/American Medical Association's recommended sixth grade readability guidelines for health information or the mean US adult reading level of eighth grade.
QUESTIONS/PURPOSES: The purposes of this study were (1) to evaluate the mean grade level readability of online AAOS patient education materials; and (2) to determine what proportion of the online materials exceeded recommended (sixth grade) and mean US (eighth grade) reading level.
Reading grade levels for 99.6% (260 of 261) of the online patient education entries from the AAOS were analyzed using the Flesch-Kincaid formula built into Microsoft Word software.
Mean grade level readability of the AAOS patient education materials was 9.2 (SD ± 1.6). Two hundred fifty-one of the 260 articles (97%) had a readability score above the sixth grade level. The readability of the AAOS articles exceeded the sixth grade level by an average of 3.2 grade levels. Of the 260 articles, 210 (81%) had a readability score above the eighth grade level, which is the average reading level of US adults.
Most of the online patient education materials from the AAOS had readability levels that are far too advanced for many patients to comprehend. Efforts to adjust the readability of online education materials to the needs of the audience may improve the health literacy of orthopaedic patients. Patient education materials can be made more comprehensible through use of simpler terms, shorter sentences, and the addition of pictures. More broadly, all health websites, not just those of the AAOS, should aspire to be comprehensible to the typical reader.
提高健康素养有可能改善患者的治疗效果。美国骨科医师学会（AAOS）的在线患者教育材料是提高骨科患者健康素养的一种工具；然而，目前尚不清楚这些材料是否符合美国国立卫生研究院/美国医学协会推荐的健康信息六年级可读性指南或美国成年人平均八年级的阅读水平。
问题/目的：本研究的目的是：（1）评估AAOS在线患者教育材料的平均年级可读性水平；（2）确定在线材料中超过推荐（六年级）和美国平均（八年级）阅读水平的比例。
使用Microsoft Word软件中内置的弗莱什-金凯德公式分析了AAOS 99.6%（261篇中的260篇）在线患者教育条目的阅读年级水平。
AAOS患者教育材料的平均年级可读性水平为9.2（标准差±1.6）。260篇文章中有251篇（97%）的可读性得分高于六年级水平。AAOS文章的可读性平均超过六年级水平3.2个年级。在260篇文章中，210篇（81%）的可读性得分高于美国成年人平均阅读水平的八年级。
AAOS的大多数在线患者教育材料的可读性水平对许多患者来说过于高深，难以理解。根据受众需求调整在线教育材料的可读性的努力可能会提高骨科患者的健康素养。通过使用更简单的术语、更短的句子和添加图片，可以使患者教育材料更易于理解。更广泛地说，所有健康网站，而不仅仅是AAOS的网站，都应该力求让普通读者能够理解。
