Dermatology Department, Rowan House, University Hospitals Plymouth NHS Trust, Plymouth, UK.
British Association of Dermatologists, London, UK.
Clin Exp Dermatol. 2022 Apr;47(4):684-691. doi: 10.1111/ced.15012. Epub 2021 Dec 15.
The British Association of Dermatologists (BAD) develops and produces patient information leaflets (PILs) for British clinicians and the general public, and its website provides access to all the PILs. Health literacy across the UK remains variable. Readability instruments assess the comprehensibility of text, predominately using a composite of sentence length and/or word-syllable number. Instruments usually report text readability categorized by United States (US) grades; ideally, health literature should be rated at US grade ≤ 6 (UK Year 7; age 11-12 years).
In collaboration with the BAD, PILs on the BAD website (n = 203) were downloaded for readability assessment. PILs were processed prior to analysis using Readability Studio software (Oleander Software, Vandalia, OH, USA). Established readability metrics were used: Flesch-Kincaid (FK), Simple Measure of Gobbledygook (SMOG), Gunning fog index (GFI), Fry, FORCAST and Flesch Reading Ease (FRE).
The mean (95% CI) US grade levels for all BAD PILs were: 9.8 (9.7-10.0) for FK, 12.1 (12.0-12.3) for SMOG, 11.8 (11.6-11.9) for GFI, 11.5 (11.1-11.8) for Fry and 10.7 (10.6-10.8) for FORCAST. For FRE, the level is reported from a normal spectrum of 0-100, and was found to be 52.2 (95% CI 34.0-78.0) in this study. In the UK context, the mean readability levels of the BAD PILs were rated as Year 10 (age 14-15 years) for FK and Year 13 (aged 17-18 years) for SMOG. For FK, outputs, only 1.0% of PILs (2 of 203) were the recommended US grade ≤ 6 according to FK, and for SMOG rating, none was rated at this level.
The majority of BAD PILs have been written at a level that will be challenging for some patients to read. Reducing sentence length and aiming for shorter words will improve accessibility.
英国皮肤科医师协会 (BAD) 为英国临床医生和公众编写和制作患者信息传单 (PIL)，其网站提供所有 PIL 的访问途径。英国的健康素养参差不齐。可读性工具评估文本的可理解性，主要使用句子长度和/或单词音节数的组合。这些工具通常报告按美国 (US) 等级分类的文本可读性；理想情况下，健康文献的等级应低于 6 级（英国 7 年级；年龄 11-12 岁）。
与 BAD 合作，从 BAD 网站下载了 203 份 PIL 进行可读性评估。在使用 Readability Studio 软件（美国 Vandalia 的 Oleander Software）进行分析之前，对 PIL 进行了预处理。使用了已建立的可读性指标：Flesch-Kincaid（FK）、简单测度混杂度（SMOG）、Gunning 迷雾指数（GFI）、Fry、FORCAST 和 Flesch 阅读舒适度（FRE）。
所有 BAD PIL 的平均（95%CI）美国等级分别为：FK 为 9.8（9.7-10.0），SMOG 为 12.1（12.0-12.3），GFI 为 11.8（11.6-11.9），Fry 为 11.5（11.1-11.8），FORCAST 为 10.7（10.6-10.8）。对于 FRE，该水平报告的范围为 0-100，在本研究中为 52.2（95%CI 34.0-78.0）。在英国背景下，BAD PIL 的平均可读性水平被评为 FK 的 10 年级（14-15 岁）和 SMOG 的 13 年级（17-18 岁）。对于 FK，只有 2%的 PIL（203 份中的 2 份）的输出符合 FK 推荐的美国等级≤6，而对于 SMOG 评级，没有一份达到这一水平。
大多数 BAD PIL 的编写水平对一些患者来说阅读具有挑战性。减少句子长度并争取使用较短的单词将提高可访问性。
