Gao Burke, Shamrock Alan G, Gulbrandsen Trevor R, O'Reilly Olivia C, Duchman Kyle R, Westermann Robert W, Wolf Brian R
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Orthop J Sports Med. 2022 Jul 28;10(7):23259671221089977. doi: 10.1177/23259671221089977. eCollection 2022 Jul.
Patients undergoing elective procedures often utilize online educational materials to familiarize themselves with the surgical procedure and expected postoperative recovery. While the Internet is easily accessible and ubiquitous today, the ability of patients to read, understand, and act on these materials is unknown.
To evaluate online resources about anterior cruciate ligament (ACL) surgery utilizing measures of readability, understandability, and actionability.
Cross-sectional study; Level of evidence, 4.
Using the term "ACL surgery," 2 independent searches were performed utilizing a public search engine (Google.com). Patient education materials were identified from the top 50 results. Audiovisual materials, news articles, materials intended for advertising or medical professionals, and materials unrelated to ACL surgery were excluded. Readability was quantified using the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index, and Gunning Fog Index. The Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) was utilized to assess the actionability and understandability of materials. For each online source, the relationship between its Google search rank (from first to last) and its readability, understandability, and actionability was calculated utilizing the Spearman rank correlation coefficient (ρ).
Overall, we identified 68 unique websites, of which 39 met inclusion criteria. The mean Flesch-Kincaid Grade Level was 10.08 ± 2.34, with no website scoring at or below the 6th-grade level. Mean understandability and actionability scores were 59.18 ± 10.86 (range, 33.64-79.17) and 34.41 ± 22.31 (range, 0.00-81.67), respectively. Only 5 (12.82%) and 1 (2.56%) resource scored above the 70% adequate PEMAT-P threshold mark for understandability and actionability, respectively. Readability (lowest value = .103), understandability (ρ = -0.13; = .441), and actionability (ρ = 0.28; = .096) scores were not associated with Google rank.
Patient education materials on ACL surgery scored poorly with respect to readability, understandability, and actionability. No online resource scored at the recommended reading level of the American Medical Association or National Institutes of Health. Only 5 resources scored above the proven threshold for understandability, and only 1 resource scored above it for actionability.
接受择期手术的患者经常利用在线教育材料来熟悉手术过程和预期的术后恢复情况。如今，互联网易于访问且无处不在，但患者阅读、理解并依据这些材料采取行动的能力尚不清楚。
利用可读性、可理解性和可操作性指标评估关于前交叉韧带（ACL）手术的在线资源。
横断面研究；证据等级，4级。
使用术语“ACL手术”，利用公共搜索引擎（Google.com）进行了2次独立搜索。从排名前50的结果中识别出患者教育材料。排除视听材料、新闻文章、用于广告或医学专业人员的材料以及与ACL手术无关的材料。使用弗莱什易读性、弗莱什-金凯德年级水平、晦涩难懂简易测量法、科尔曼-廖指数、自动可读性指数和冈宁雾指数对可读性进行量化。利用可打印材料患者教育材料评估工具（PEMAT-P）评估材料的可操作性和可理解性。对于每个在线来源，利用斯皮尔曼等级相关系数（ρ）计算其谷歌搜索排名（从第一到最后）与其可读性、可理解性和可操作性之间的关系。
总体而言，我们识别出68个独特的网站，其中39个符合纳入标准。平均弗莱什-金凯德年级水平为10.08±2.34，没有网站得分达到或低于6年级水平。平均可理解性和可操作性得分分别为59.18±10.86（范围，33.64 - 79.17）和34.41±22.31（范围，0.00 - 81.67）。分别只有5个（12.82%）和1个（2.56%）资源在可理解性和可操作性方面得分高于70%的PEMAT-P充分阈值。可读性（最低值 = 0.103）、可理解性（ρ = -0.13；P = 0.441）和可操作性（ρ = 0.28；P = 0.096）得分与谷歌排名无关。
关于ACL手术的患者教育材料在可读性、可理解性和可操作性方面得分较低。没有在线资源达到美国医学协会或国立卫生研究院推荐的阅读水平。只有5个资源得分高于已证实的可理解性阈值，只有1个资源得分高于可操作性阈值。
