title: Assessment of online patient education materials from major ophthalmologic associations.
abstract: OBJECTIVE
  Patients are increasingly using the Internet to supplement finding medical information, which can be complex and requires a high level of reading comprehension. Online ophthalmologic materials from major ophthalmologic associations should be written at an appropriate reading level.
  
  
  OBJECTIVE
  To assess ophthalmologic online patient education materials (PEMs) on ophthalmologic association websites and to determine whether they are above the reading level recommended by the American Medical Association and National Institutes of Health.
  
  
  METHODS
  Descriptive and correlational design. Patient education materials from major ophthalmology websites were downloaded from June 1, 2014, through June 30, 2014, and assessed for level of readability using 10 scales. The Flesch Reading Ease test, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook test, Coleman-Liau Index, Gunning Fog Index, New Fog Count, New Dale-Chall Readability Formula, FORCAST scale, Raygor Readability Estimate Graph, and Fry Readability Graph were used. Text from each article was pasted into Microsoft Word and analyzed using the software Readability Studio professional edition version 2012.1 for Windows.
  
  
  METHODS
  Flesch Reading Ease score, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook grade, Coleman-Liau Index score, Gunning Fog Index score, New Fog Count, New Dale-Chall Readability Formula score, FORCAST score, Raygor Readability Estimate Graph score, and Fry Readability Graph score.
  
  
  RESULTS
  Three hundred thirty-nine online PEMs were assessed. The mean Flesch Reading Ease score was 40.7 (range, 17.0-51.0), which correlates with a difficult level of reading. The mean readability grade levels ranged as follows: 10.4 to 12.6 for the Flesch-Kincaid Grade Level; 12.9 to 17.7 for the Simple Measure of Gobbledygook test; 11.4 to 15.8 for the Coleman-Liau Index; 12.4 to 18.7 for the Gunning Fog Index; 8.2 to 16.0 for the New Fog Count; 11.2 to 16.0 for the New Dale-Chall Readability Formula; 10.9 to 12.5 for the FORCAST scale; 11.0 to 17.0 for the Raygor Readability Estimate Graph; and 12.0 to 17.0 for the Fry Readability Graph. Analysis of variance demonstrated a significant difference (P < .001) between the websites for each reading scale.
  
  
  CONCLUSIONS
  Online PEMs on major ophthalmologic association websites are written well above the recommended reading level. Consideration should be given to revision of these materials to allow greater comprehension among a wider audience.
authors: Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark.
authors: Grace
authors: G
authors: Huang
authors: Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark.
authors: Christina H
authors: CH
authors: Fang
authors: Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors: Nitin
authors: N
authors: Agarwal
authors: Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark.
authors: Neelakshi
authors: N
authors: Bhagat
authors: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark4Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark5Department of Neurological Surgery.
authors: Jean Anderson
authors: JA
authors: Eloy
authors: Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark.
authors: Paul D
authors: PD
authors: Langer
mesh_terms: D000574:American Medical Association; D032882:Comprehension; D003194:Computer-Assisted Instruction / Q000592:standards*; D057220:Health Literacy / Q000592:standards*; D006801:Humans; D020407:Internet; D009316:National Institutes of Health (U.S.) / Q000592:standards; D009885:Ophthalmology / Q000193:education / Q000458:organization & administration*; D010353:Patient Education as Topic; D011932:Reading; D012955:Societies, Medical; D013664:Teaching Materials; D014481:United States