title: Readability Assessment of Online Patient Abdominoplasty Resources.
abstract: BACKGROUND
  Limited functional health literacy is recognized as an important contributor to health disparities in the United States. As internet access becomes more universal, there is increasing concern about whether patients with poor or marginal literacy can access understandable healthcare information. As such, the National Institutes of Health and American Medical Association recommend that patient information be written at a sixth grade level. This study identifies the most popular online resources for patient information about abdominoplasty and evaluates their readability in the context of average American literacy.
  
  
  METHODS
  The two largest internet search engines were queried for "tummy tuck surgery" to simulate a patient search in lay terms. The ten most popular sites common to both search engines were identified, and all relevant articles from the main sites were downloaded. Sponsored results were excluded. Readability analysis of the articles was performed using ten established tests.
  
  
  RESULTS
  Online information about abdominoplasty from the ten most popular publically available websites had an overall average readability of 12th grade. Mean reading grade level scores among tests were: Coleman-Liau 11.9, Flesch-Kincaid 11.4, FORCAST 11.1, Fry 13, Gunning Fog 13.5, New Dale-Chall 11.8, New Fog Count 9.9, Raygor Estimate 12, and SMOG 13.4; Flesch Reading Ease index score was 46.
  
  
  CONCLUSIONS
  Online patient resources about abdominoplasty are uniformly above the recommended target readability level and are likely too difficult for many patients to understand. A range of readability identified among websites could allow surgeons to guide patients to more appropriate resources for their literacy skills.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Suite 5A, Boston, MA, 02215, USA.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Phillips
authors.forename: Christina R
authors.initials: CR
authors.lastname: Vargas
authors.forename: Danielle J
authors.initials: DJ
authors.lastname: Chuang
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
mesh_terms: D061645:Abdominoplasty; D032882:Comprehension; D057220:Health Literacy; D006801:Humans; D020407:Internet