title: Health literacy and online educational resources: an opportunity to educate patients.
abstract: OBJECTIVE
  Given the increasing accessibility of material on the Internet and the use of these materials by patients as a source of health care information, the purpose of this study was to quantitatively evaluate the level of readability of resources made available on the European Society of Radiology website to determine whether these materials meet the health literacy needs of the general public as set forth by guidelines of the U.S. National Institutes of Health (NIH) and the American Medical Association (AMA).
  
  
  METHODS
  All 41 patient education articles created by the European Society of Radiology (ESR) were downloaded and analyzed with the following 10 quantitative readability scales: the Coleman-Liau Index, Flesch-Kincaid Grade Level, Flesch Reading Ease, FORCAST Formula, Fry Graph, Gunning Fog Index, New Dale-Chall, New Fog Count, Raygor Reading Estimate, and the Simple Measure of Gobbledygook.
  
  
  RESULTS
  The 41 articles were written collectively at a mean grade level of 13.0 ± 1.6 with a range from 10.8 to 17.2. For full understanding of the material, 73.2% of the articles required the reading comprehension level of, at minimum, a high school graduate (12th grade).
  
  
  CONCLUSIONS
  The patient education resources on the ESR website are written at a comprehension level well above that of the average Internet viewer. The resources fail to meet the NIH and AMA guidelines that patient education material be written between the third and seventh grade levels. Recasting these resources in a simpler format would probably lead to greater comprehension by ESR website viewers.
authors.affiliation: 1 Department of Radiology, New Jersey Medical School, Rutgers University, 150 Bergen St, Rm C320, Newark, NJ 07101-1709.
authors.forename: David R
authors.initials: DR
authors.lastname: Hansberry
authors.forename: Nitin
authors.initials: N
authors.lastname: Agarwal
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Baker
mesh_terms: D003194:Computer-Assisted Instruction / Q000145:classification / Q000706:statistics & numerical data*; D005060:Europe; D006266:Health Education / Q000145:classification / Q000706:statistics & numerical data*; D057220:Health Literacy / Q000145:classification / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000145:classification / Q000706:statistics & numerical data; D062527:Meaningful Use / Q000145:classification / Q000706:statistics & numerical data*; D009862:Online Systems / Q000145:classification / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000145:classification / Q000706:statistics & numerical data*; D061108:Social Media / Q000145:classification / Q000706:statistics & numerical data*
keywords: Internet; health literacy; patient education; radiology; readability