Restrepo Mariana, Stern Brocha Z, Burnett Garrett W, Park Chang, Poeran Jashvant
Department of Anesthesiology, Perioperative and Pain Medicine, Mount Sinai Health System, New York, NY, USA.
Department of Orthopaedic Surgery, Mount Sinai Health System, New York, NY, USA.
BJA Open. 2025 Mar 27;14:100388. doi: 10.1016/j.bjao.2025.100388. eCollection 2025 Jun.
With the increasing utilisation of regional anaesthesia for orthopaedic procedures, it is imperative that related online patient education materials (PEMs) be easily retrievable, comprehensive, and readable by the general population, irrespective of the language they are written in. Therefore, we compared the readability levels of online PEMs available in English and Spanish for anaesthesia related to total hip, knee, and shoulder joint replacements.
Six pairs (English and Spanish) of search terms were entered into Google and used to identify relevant online PEMs. Results for English search terms were analysed for readability using the Flesch Reading Ease (FRE), Fry Graph (FG), Simple Measures of Gobbledygook (SMOG) Index, and Gunning Fog Index scores, and for Spanish search terms using the Fernandez-Huerta Reading Ease (FHRE), the Gilliam-Peña-Mountain Grade Level (GPMGL), the Spanish SMOG (SOL), and Indice de Legibilidad de Flesch-Szigriszt (INFLESZ) scores. Scores were compared between languages if the Spanish-language calculator was a validated adaptation of the English one (FRE FHRE; FG GPMGL; SMOG SOL).
Overall, 180 and 146 relevant websites were retrieved across all six English language and Spanish-language search terms, respectively. Generally, the FRE and FG scores for the English search results corresponded to college-level material and the SMOG score reflected a 10th grade reading level. In contrast, the FHRE, GPMGL, and SOL scores for Spanish search results corresponded to 10th-12th grade reading levels, and the INFLESZ to 'Difficult'/'Normal' levels.
These findings reinforce past literature describing English and Spanish-language orthopaedic anaesthesia PEMs being written at far higher reading levels than the recommended 5th to 8th grade reading level. Interestingly, English PEMs were less readable than their Spanish counterparts, yet, they were more available than related Spanish PEMs overall.
随着区域麻醉在骨科手术中的应用日益增加，至关重要的是，相关的在线患者教育材料（PEM）应易于获取、全面且普通大众都能读懂，无论其使用何种语言编写。因此，我们比较了以英语和西班牙语提供的有关全髋关节、膝关节和肩关节置换麻醉的在线PEM的可读性水平。
将六对（英语和西班牙语）搜索词输入谷歌，用于识别相关的在线PEM。使用弗莱什易读性（FRE）、弗莱阅读图表（FG）、简单费解度测量（SMOG）指数和冈宁雾度指数分数分析英语搜索词的结果的可读性，使用费尔南德斯 - 韦尔塔易读性（FHRE）、吉利安 - 佩尼亚 - 芒廷年级水平（GPMGL）、西班牙语SMOG（SOL）和弗莱什 - 齐格里斯zt易读性指数（INFLESZ）分数分析西班牙语搜索词的结果。如果西班牙语计算器是英语计算器的经过验证的改编版本（FRE与FHRE；FG与GPMGL；SMOG与SOL），则比较两种语言的分数。
总体而言，分别通过所有六个英语和西班牙语搜索词检索到了180个和146个相关网站。一般来说，英语搜索结果的FRE和FG分数对应大学水平的材料，SMOG分数反映了十年级的阅读水平。相比之下，西班牙语搜索结果的FHRE、GPMGL和SOL分数对应十至十二年级的阅读水平，INFLESZ对应“困难”/“正常”水平。
这些发现强化了过去的文献描述，即英语和西班牙语的骨科麻醉PEM的编写水平远远高于推荐的五至八年级阅读水平。有趣的是，英语PEM的可读性低于其西班牙语对应版本，但总体上比相关的西班牙语PEM更易获取。
