title: The Readability of Online Resources for Mastopexy Surgery.
abstract: BACKGROUND
  As more patients use Internet resources for health information, there is increasing interest in evaluating the readability of available online materials. The National Institutes of Health and American Medical Association recommend that patient educational content be written at a sixth-grade reading level. This study evaluates the most popular online resources for information about mastopexy relative to average adult literacy in the United States.
  
  
  METHODS
  The 12 most popular sites returned by the largest Internet search engine were identified using the search term "breast lift surgery." Relevant articles from the main sites were downloaded and formatted into text documents. Pictures, captions, links, and references were excluded. The readability of these 100 articles was analyzed overall and subsequently by site using 10 established readability tests. Subgroup analysis was performed for articles discussing the benefits of surgery and those focusing on risks.
  
  
  RESULTS
  The overall average readability of online patient information was 13.3 (range, 11.1-15). There was a range of average readability scores overall across the 12 sites from 8.9 to 16.1, suggesting that some may be more appropriate than others for patient demographics with different health literacy levels. Subgroup analysis revealed that articles discussing the risks of mastopexy were significantly harder to read (mean, 14.1) than articles about benefits (11.6).
  
  
  CONCLUSIONS
  Patient-directed articles from the most popular online resources for mastopexy information are uniformly above the recommended reading level and likely too difficult to be understood by a large number of patients in the United States.
authors.affiliation: From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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: D000328:Adult; D032882:Comprehension; D054626:Consumer Health Information; D005260:Female; D057220:Health Literacy; D006801:Humans; D020407:Internet; D016462:Mammaplasty; D057386:Search Engine; D014481:United States