Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA.
Semin Ophthalmol. 2022 Jan 2;37(1):71-76. doi: 10.1080/08820538.2021.1915341. Epub 2021 Apr 14.
The internet is an increasingly important resource for patients seeking health-related information. Because of this trend, the American Medical Association (AMA) and National Institutes of Health (NIH) recommend that online patient education materials (PEMs) be written between a third and seventh grade level. The present study evaluates the readability levels of ophthalmological PEMs provided by five major academic hospitals, quantifies the availability of accompanying videos and graphics, and examines the extent to which readability may be increased.
In March 2021, 397 PEMs from five major academic hospitals were extracted for subsequent analysis by seven validated readability assessments. The presence of an accompanying video or graphic was noted. Statistical significance was assessed using the Kruskal-Wallis test with Dunn's multiple comparisons test and the chi-square test.
Nearly all articles were written above the recommended reading level of 7 grade. After averaging the scales for each article, the median grade level was 11.7 (interquartile range [IQR], 10.7-12.7). The PEMs with the highest median reading level were provided by the Johns Hopkins University Wilmer Institute (12.6, IQR, 11.3 - 13.6). Only 13.6% and 13.1% of articles had an accompanying video and graphic, respectively. Reduction of sentence length beneath 15 words resulted in an improvement of readability by 2.7 grade levels.
The readability of online patient resources provided by major academic hospitals were above the literacy guidelines recommended by the NIH and AMA. Furthermore, most articles did not include a video or graphic, both of which could potentially improve patient understandability of educational materials. By altering these PEMs, as demonstrated here, institutions could increase the value these articles provide for patients and therefore the quality of the patient-physician relationship.
互联网是患者获取健康相关信息的日益重要的资源。由于这一趋势，美国医学协会（AMA）和美国国立卫生研究院（NIH）建议在线患者教育材料（PEM）的写作水平应介于三年级至七年级之间。本研究评估了五所主要学术医院提供的眼科 PEM 的可读性水平，量化了伴随视频和图形的可用性，并研究了提高可读性的程度。
2021 年 3 月，从五所主要学术医院提取了 397 篇 PEM 进行后续分析，使用七种经过验证的可读性评估方法。注意伴随视频或图形的存在。使用 Kruskal-Wallis 检验和 Dunn 的多重比较检验以及卡方检验评估统计学意义。
几乎所有文章的写作水平都高于推荐的 7 级阅读水平。在对每篇文章的量表进行平均后，中位数阅读水平为 11.7（四分位距 [IQR]，10.7-12.7）。阅读水平中位数最高的 PEM 由约翰霍普金斯大学威尔默研究所提供（12.6，IQR，11.3-13.6）。只有 13.6%和 13.1%的文章分别有伴随的视频和图形。将句子长度缩短至 15 个单词以下，可使可读性提高 2.7 个等级。
主要学术医院提供的在线患者资源的可读性高于 NIH 和 AMA 推荐的读写能力指南。此外，大多数文章都没有视频或图形，这两者都可以提高患者对教育材料的理解能力。通过改变这些 PEM，如这里所示，医疗机构可以提高这些文章为患者提供的价值，从而提高医患关系的质量。
