B. B. Scott1, B. N. Tran2, A. F. Doval2, B. T. Lee2 1Beth Israel Deaconess Medical Center,Department Of General Surgery,Boston, MA, USA 2Beth Israel Deaconess Medical Center,Department Of Plastic And Reconstructive Surgery,Boston, MA, USA
Introduction: Patients commonly use online materials as a source of health information. Since poor health literacy has been shown to correlate with negative outcomes, the National Institutes of Health and American Medical Association recommend patient-directed materials be written at a sixth-grade reading level. This study evaluates the readability and understandability of commonly accessed online materials on both endovascular and open repair of abdominal aortic aneurysm.
Methods: Searches for “endovascular repair abdominal aortic aneurysm” and “open repair abdominal aortic aneurysm” were performed on both Google and Bing, and the top ten websites from each search engine were identified. Location services and user preferences were disabled. Sponsored content, medical device websites, and websites requiring a log-in were excluded. Relevant websites (total n=28, endovascular n=15, open n=15, two redundant sites) with patient directed content were analyzed. Readability was assessed using 9 established methods and understandability was assessed using the PEMAT scoring system.
Results: The average reading grade level across all sites was 12.8, with a range from 10.8 (New Fog Count) to 14.8 (Simple Measure of Gobbledygook). Endovascular sites averaged a reading grade level of 13.6 with a range from 11.5 (FORCAST) to 15.6 (Gunning Fog). Open repair websites had an average of 12.1 with a range from 9.9 (New Fog Count) to 14.1 (Simple Measure of Gobbledygook). Readability was found to be inversely related to understandability, with a Pearson correlation coefficient of -0.5603 (p=0.001942). Zero websites were rated as at or below the recommended sixth-grade reading level, and only 7.14% of the individual websites were rated by any readability measure as being at or below eighth-grade reading level.
Conclusion: Patient directed online health information regarding open and endovascular repair of abdominal aortic aneurysm exceeds the recommended sixth-grade reading level. Increasing complexity of health websites correlates with poor understandability. Modifications such as shorter sentences, fewer words with more than six letters, and increasing usage of clear visual aids can increase readability and understandability.
