Davis Kristin, Blades Caitlin, Larson Scott
Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Colorado Denver/ Anschutz Medical Campus, Aurora, CO, USA.
Strabismus. 2025 Mar;33(1):36-43. doi: 10.1080/09273972.2024.2408029. Epub 2024 Oct 1.
Over one-third of US adults have never attended college, creating a large disparity in the readability of online health materials. Decreased health literacy and accessibility to medical information negatively affect patients and well-informed patients are more likely to experience better health outcomes (1). The NIH and AMA recommend patient-intended education materials be written at a sixth-grade reading level (2), therefore, this study analyzed the accessibility of the top ten web pages for "strabismus."
The first ten online resources returned in a Google search for "strabismus" were analyzed. Web pages were then assessed for the readability level (Simple Measure of Gobbledygook), complexity (PMOSE/IKIRSCH), and suitability (Suitability Assessment of Materials). Two independent raters assessed the complexity and suitability.
Readability analysis of the strabismus resources revealed an average reading grade level of 11.4 ± 1.07. There was a statistical difference in the reading grade level between the .com and .gov, and the .org and .com websites ( = .029 and = .031, respectively). Complexity analysis revealed a mean score of 6.50 ± 2.29, corresponding to an 8th-12th grade reading level. The suitability assessment showed a mean value of 70.3 10.1%, representing a "superior" score for the information provided to the reader. The inter-rater agreement was similar for the complexity and fair for the suitability analysis.
On average, online resources for strabismus have a low complexity level. However, the majority of the top ten articles reviewed are above the recommended literacy level, indicating a need for revision.
The vast amount of available online health resources have significantly affected the field of medicine. Most patients research their disease process using online sources and many reference this material before their initial ophthalmologic consultation. Considering that more than half of Americans read below the equivalent of a sixth-grade level and that the AMA/NIH recommend all patient-intended materials to be written above this level, there is a health literacy disconnect. This limits patients' ability to educate themselves about their medical conditions and participate in informed conversations regarding their healthcare. Patients who are unable to interpret health information accurately have increased rates of hospitalization, develop more medical conditions, and experience a higher rate of mortality. This preventable impediment to informed healthcare care magnifies the urgency for easily readable online resources that are formatted in a manner that is clear to understand and suitable for patients with lower health literacy.
超过三分之一的美国成年人从未上过大学，这使得在线健康材料的可读性存在巨大差异。健康素养的降低和获取医疗信息的困难对患者产生负面影响，而信息充分的患者更有可能获得更好的健康结果（1）。美国国立卫生研究院（NIH）和美国医学协会（AMA）建议，面向患者的教育材料应编写到六年级阅读水平（2），因此，本研究分析了“斜视”相关的十大网页的可及性。
分析了在谷歌搜索“斜视”时返回的前十个在线资源。然后对网页进行可读性水平（简单晦涩度测量）、复杂度（PMOSE/IKIRSCH）和适用性（材料适用性评估）评估。两名独立评分者评估复杂度和适用性。
对斜视资源的可读性分析显示，平均阅读年级水平为11.4±1.07。.com与.gov网站以及.org与.com网站之间的阅读年级水平存在统计学差异（分别为P = 0.029和P = 0.031）。复杂度分析显示平均得分为6.50±2.29，对应8至12年级阅读水平。适用性评估显示平均值为70.3±10.1%，表明提供给读者的信息为“优秀”评分。评分者间在复杂度方面的一致性相似，在适用性分析方面为中等。
平均而言，斜视的在线资源复杂度水平较低。然而，所审查的十大文章中的大多数高于推荐的素养水平，这表明需要修订。
大量可用的在线健康资源对医学领域产生了重大影响。大多数患者通过在线资源研究他们的疾病过程，并且许多人在初次眼科咨询之前参考这些材料。鉴于超过一半的美国人阅读水平低于六年级水平，并且AMA/NIH建议所有面向患者的材料应编写到高于此水平，存在健康素养脱节的问题。这限制了患者自我了解其医疗状况并参与有关其医疗保健的明智对话的能力。无法准确解读健康信息的患者住院率增加，出现更多医疗状况，并且死亡率更高。这种对明智医疗保健的可预防障碍凸显了提供易于阅读的在线资源的紧迫性，这些资源的格式应清晰易懂且适合健康素养较低的患者。
