B. N. Tran1, M. Singh1, B. T. Lee1 1Beth Israel Deaconess Medical Center,Plastic And Reconstructive Surgery/Surgery,Boston, MA, USA
Introduction: As many as 72% of Americans use online health information to aid them in healthcare decision-making. It is, therefore, very important to have resources written at the recommended literacy level. Previous studies primarily focused on readability analysis of online lymphedema literature, consistently showing that they are too advanced for the average American to comprehend. This study expands such analysis to include complexity and suitability of these materials.
Methods: Top ten websites on lymphedema were identified using the most popular search engine, Google. Content of these websites was analyzed for readability, complexity, and suitability using Simple Measure of Gobbledygook (SMOG), PMOSE/iKIRSCH, and Suitability Assessment of Materials (SAM) respectively. PMOSE/iKIRSCH and SAM were performed by two independent raters. Fleiss’ kappa score was calculated to ensure inter-rater reliability.
Results: Lymphedema literature average SMOG reading grade level was 14.0, above the recommended sixth grade level per the American Medical Association and National Institute of Health. Overall PMOSE/iKIRSCH score was 6.7 corresponding to “low” complexity and requiring a 8th-12th grade education. Fleiss’ kappa score was 80% (p=0.04), interpreted as “substantial” agreement. Overall SAM score was 45% correlating to “adequate” suitability, however this is borderline low for “adequate” category (0-39% Not Suitable, 40-69% Adequate). Fleiss’ kappa score was 76% (p=0.06), interpreted as “substantial” agreement.
Conclusion: Online lymphedema literature is written above recommended level for readability and complexity. It is adequately suitable for intended audience. Overall, online lymphedema literature is too sophisticated for the average American reader. Further efforts to revise these materials are needed to improve patient’s comprehension and understanding.