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Trauma Mon. 2016 Feb 06;21(1):e20141. doi: 10.5812/traumamon.20141. eCollection 2016 Feb.

Readability of Trauma-Related Patient Education Materials From the American Academy of Orthopaedic Surgeons.

Trauma monthly

Adam E M Eltorai, Nathan P Thomas, Heejae Yang, Alan H Daniels, Christopher T Born

Affiliations

  1. Warren Alpert Medical School, Brown University, Providence, United States.
  2. Warren Alpert Medical School, Brown University, Providence, United States; Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Rhode Island Hospital, Providence, United States.

PMID: 27218045 PMCID: PMC4869433 DOI: 10.5812/traumamon.20141

Abstract

CONTEXT: According to the american medical association (AMA) and the national institutes of health (NIH), the recommended readability of patient education materials should be no greater than a sixth-grade reading level. The online patient education information produced by the american academy of orthopaedic surgeons (AAOS) may be too complicated for some patients to understand. This study evaluated whether the AAOS's online trauma-related patient education materials meet recommended readability guidelines for medical information.

EVIDENCE ACQUISITION: Ninety-nine articles from the "Broken Bones and Injuries" section of the AAOS-produced patient education website, orthoinfo.org, were analyzed for grade level readability using the Flesch-Kincaid formula, a widely-used and validated tool to evaluate the text reading level. Results for each webpage were compared to the AMA/NIH recommended sixth-grade reading level and the average reading level of U.S. adults (eighth-grade).

RESULTS: The mean (SD) grade level readability for all patient education articles was 8.8 (1.1). All but three of the articles had a readability score above the sixth-grade level. The readability of the articles exceeded this level by an average of 2.8 grade levels (95% confidence interval, 2.6 - 3.0; P < 0.0001). Furthermore, the average readability of the articles exceeded the average reading skill level of U.S. adults (eighth grade) by nearly an entire grade level (95% confidence interval, 0.6-1.0; P < 0.0001).

CONCLUSIONS: The majority of the trauma-related articles from the AAOS patient education website have readability levels that may make comprehension difficult for a substantial portion of the patient population.

Keywords: AAOS; Health Literacy; Online Health Information; Patient Education; Readability; Trauma

References

  1. Clin Orthop Relat Res. 2004 Apr;(421):50-3 - PubMed
  2. J Med Internet Res. 2001 Jul-Sep;3(3):E27 - PubMed
  3. Oncol Nurs Forum. 1996 Sep;23(8):1305-12 - PubMed
  4. South Med J. 1991 Oct;84(10):1172-5 - PubMed
  5. N Engl J Med. 1997 Jul 24;337(4):272-4 - PubMed
  6. JAMA. 2001 May 23-30;285(20):2612-21 - PubMed
  7. J Acquir Immune Defic Syndr. 2000 Dec 1;25(4):337-44 - PubMed
  8. Prev Med. 2001 Apr;32(4):313-20 - PubMed
  9. Health Qual Life Outcomes. 2013 Sep 11;11:153 - PubMed
  10. J Bone Joint Surg Am. 2000 Nov;82-A(11):1540-3 - PubMed
  11. Orthop Nurs. 2001 Sep-Oct;20(5):69-77 - PubMed
  12. Appl Nurs Res. 1996 Aug;9(3):139-43 - PubMed
  13. J Pediatr Orthop. 2002 Mar-Apr;22(2):261-4 - PubMed
  14. Iowa Orthop J. 2002;22:103-7 - PubMed
  15. Tenn Med. 2008 May;101(5):35-9 - PubMed
  16. JAMA. 2002 Jul 24-31;288(4):475-82 - PubMed
  17. J Hand Surg Am. 2009 Sep;34(7):1308-15 - PubMed
  18. Spine (Phila Pa 1976). 2009 Dec 1;34(25):2826-31 - PubMed
  19. Promot Health. 1987 Jul-Aug;8(4):6-8 - PubMed
  20. J Pediatr Orthop B. 2005 Mar;14(2):129-33 - PubMed
  21. Arch Intern Med. 1998 Jan 26;158(2):166-72 - PubMed
  22. J Am Board Fam Pract. 2004 Jan-Feb;17(1):44-7 - PubMed
  23. J Gen Intern Med. 2006 Aug;21(8):806-12 - PubMed
  24. Iowa Orthop J. 2003;23:80-2 - PubMed
  25. J Gen Intern Med. 1998 Dec;13(12):791-8 - PubMed
  26. Am J Med. 2005 Apr;118(4):371-7 - PubMed
  27. Arthroscopy. 2013 Jun;29(6):1108-12 - PubMed
  28. J Bone Joint Surg Am. 2005 Jun;87(6):1392-8 - PubMed
  29. J Bone Joint Surg Am. 2008 Jan;90(1):199-204 - PubMed
  30. Cancer Invest. 2001;19(2):193-200 - PubMed
  31. Chest. 1998 Oct;114(4):1008-15 - PubMed
  32. Oncol Nurs Forum. 1995 Oct;22(9):1345-51 - PubMed
  33. J Arthroplasty. 2012 May;27(5):716-9 - PubMed
  34. J Am Board Fam Pract. 1992 May-Jun;5(3):257-64 - PubMed
  35. Health Educ Behav. 2006 Jun;33(3):352-73 - PubMed
  36. J Clin Oncol. 2004 Jul 1;22(13):2617-22 - PubMed
  37. Foot Ankle Int. 2009 Apr;30(4):287-91 - PubMed
  38. Clin Orthop Relat Res. 2008 May;466(5):1245-50 - PubMed
  39. Cancer. 2012 Aug 1;118(15):3842-51 - PubMed
  40. Am J Public Health. 1997 Jun;87(6):1027-30 - PubMed
  41. Cancer. 1996 Nov 1;78(9):1912-20 - PubMed
  42. J Clin Oncol. 1998 Sep;16(9):3101-4 - PubMed
  43. Patient Educ Couns. 2003 Nov;51(3):267-75 - PubMed
  44. Am J Public Health. 2002 Aug;92(8):1278-83 - PubMed
  45. J Community Health. 2005 Jun;30(3):213-9 - PubMed

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