title: Readability assessment of patient education materials on major otolaryngology association websites.
abstract: OBJECTIVE
  Various otolaryngology associations provide Internet-based patient education material (IPEM) to the general public. However, this information may be written above the fourth- to sixth-grade reading level recommended by the American Medical Association (AMA) and National Institutes of Health (NIH). The purpose of this study was to assess the readability of otolaryngology-related IPEMs on various otolaryngology association websites and to determine whether they are above the recommended reading level for patient education materials.
  
  
  METHODS
  Analysis of patient education materials from 9 major otolaryngology association websites.
  
  
  METHODS
  The readability of 262 otolaryngology-related IPEMs was assessed with 8 numerical and 2 graphical readability tools. Averages were evaluated against national recommendations and between each source using analysis of variance (ANOVA) with post hoc Tukey's honestly significant difference (HSD) analysis. Mean readability scores for each otolaryngology association website were compared.
  
  
  RESULTS
  Mean website readability scores using Flesch Reading Ease test, Flesch-Kincaid Grade Level, Coleman-Liau Index, SMOG grading, Gunning Fog Index, New Dale-Chall Readability Formula, FORCAST Formula, New Fog Count Test, Raygor Readability Estimate, and the Fry Readability Graph ranged from 20.0 to 57.8, 9.7 to 17.1, 10.7 to 15.9, 11.6 to 18.2, 10.9 to 15.0, 8.6 to 16.0, 10.4 to 12.1, 8.5 to 11.8, 10.5 to 17.0, and 10.0 to 17.0, respectively. ANOVA results indicate a significant difference (P < .05) between the websites for each individual assessment.
  
  
  CONCLUSIONS
  The IPEMs found on all otolaryngology association websites exceed the recommended fourth- to sixth-grade reading level.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA. Jean.Anderson.Eloy@gmail.com
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.forename: Shawn
authors.initials: S
authors.lastname: Li
authors.forename: Khushabu
authors.initials: K
authors.lastname: Kasabwala
authors.forename: Nitin
authors.initials: N
authors.lastname: Agarwal
authors.forename: David R
authors.initials: DR
authors.lastname: Hansberry
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.forename: Michael
authors.initials: M
authors.lastname: Setzen
mesh_terms: D032882:Comprehension; D006801:Humans; D020407:Internet; D010036:Otolaryngology; D010353:Patient Education as Topic