Department of Medicine, Stanford University, Stanford, CA, United States.
Division of Cardiovascular Medicine and the Cardiovascular Institute, Stanford University, Stanford, CA, United States.
J Med Internet Res. 2022 Jan 11;24(1):e31284. doi: 10.2196/31284.
Lipoprotein(a) (Lp(a)) is a highly proatherogenic lipid fraction that is a clinically significant risk modifier. Patients wanting to learn more about Lp(a) are likely to use online patient educational materials (OPEMs). However, the readability of OPEMs may exceed the health literacy of the public.
This study aims to assess the readability of OPEMs related to Lp(a). We hypothesized that the readability of these online materials would exceed the sixth grade level recommended by the American Medical Association.
Using an online search engine, we queried the top 20 search results from 10 commonly used Lp(a)-related search terms to identify a total of 200 websites. We excluded duplicate websites, advertised results, research journal articles, or non-patient-directed materials, such as those intended only for health professionals or researchers. Grade level readability was calculated using 5 standard readability metrics (automated readability index, SMOG index, Coleman-Liau index, Gunning Fog score, Flesch-Kincaid score) to produce robust point (mean) and interval (CI) estimates of readability. Generalized estimating equations were used to model grade level readability by each search term, with the 5 readability scores nested within each OPEM.
A total of 27 unique websites were identified for analysis. The average readability score for the aggregated results was a 12.2 (95% CI 10.9798-13.3978) grade level. OPEMs were grouped into 6 categories by primary source: industry, lay press, research foundation and nonprofit organizations, university or government, clinic, and other. The most readable category was OPEMs published by universities or government agencies (9.0, 95% CI 6.8-11.3). The least readable OPEMs on average were the ones published by the lay press (13.0, 95% CI 11.2-14.8). All categories exceeded the sixth grade reading level recommended by the American Medical Association.
Lack of access to readable OPEMs may disproportionately affect patients with low health literacy. Ensuring that online content is understandable by broad audiences is a necessary component of increasing the impact of novel therapeutics and recommendations regarding Lp(a).
脂蛋白(a)[Lp(a)]是一种高度促动脉粥样硬化的脂质成分，是临床意义重大的风险修饰因子。希望更多地了解 Lp(a)的患者可能会使用在线患者教育材料（OPEM）。然而，OPEM 的可读性可能超过公众的健康素养水平。
本研究旨在评估与 Lp(a)相关的 OPEM 的可读性。我们假设这些在线材料的可读性将超过美国医学协会推荐的六年级水平。
使用在线搜索引擎，我们查询了 10 个常用 Lp(a)相关搜索词的前 20 个搜索结果，共识别出 200 个网站。我们排除了重复的网站、广告结果、研究期刊文章或非面向患者的材料，例如仅面向医疗保健专业人员或研究人员的材料。使用 5 种标准可读性指标（自动化可读性指数、SMOG 指数、Coleman-Liau 指数、Gunning Fog 得分、Flesch-Kincaid 得分）计算阅读水平的年级水平可读性，并使用广义估计方程根据每个搜索词的可读性进行建模，将 5 种可读性得分嵌套在每个 OPEM 中。
共确定了 27 个用于分析的独特网站。汇总结果的平均可读性得分是 12.2（95%置信区间 10.9798-13.3978）年级水平。根据主要来源，OPEM 分为 6 类：行业、大众媒体、研究基金会和非营利组织、大学或政府、诊所和其他。最可读的类别是由大学或政府机构发布的 OPEM（9.0，95%置信区间 6.8-11.3）。平均而言，可读性最差的 OPEM 是大众媒体发布的 OPEM（13.0，95%置信区间 11.2-14.8）。所有类别均超过美国医学协会推荐的六年级阅读水平。
缺乏易读的 OPEM 可能会不成比例地影响健康素养较低的患者。确保在线内容被广大受众理解是提高新型治疗方法和 Lp(a)建议影响力的必要组成部分。
