title: Online Patient Resources for Liposuction: A Comparative Analysis of Readability.
abstract: BACKGROUND
  As patients strive to become informed about health care, inadequate functional health literacy is a significant barrier. Nearly half of American adults have poor or marginal health literacy skills and the National Institutes of Health and American Medical Association have recommended that patient information should be written at a sixth grade level. The aim of this study is to identify the most commonly used online patient information about liposuction and to evaluate its readability relative to average American literacy.
  
  
  METHODS
  An internet search of "liposuction" was performed and the 10 most popular websites identified. User and location data were disabled and sponsored results excluded. All relevant, patient-directed articles were downloaded and formatted into plain text. Articles were then analyzed using 10 established readability tests. A comparison group was constructed to identify the most popular online consumer information about tattooing. Mean readability scores and specific article characteristics were compared.
  
  
  RESULTS
  A total of 80 articles were collected from websites about liposuction. Readability analysis revealed an overall 13.6 grade reading level (range, 10-16 grade); all articles exceeded the target sixth grade level. Consumer websites about tattooing were significantly easier to read, with a mean 7.8 grade level. These sites contained significantly fewer characters per word and words per sentence, as well as a smaller proportion of complex, long, and unfamiliar words.
  
  
  CONCLUSIONS
  Online patient resources about liposuction are potentially too difficult for a large number of Americans to understand. Liposuction websites are significantly harder to read than consumer websites about tattooing. Aesthetic surgeons are advised to discuss with patients resources they use and guide patients to appropriate information for their skill level.
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: Joseph A
authors.initials: JA
authors.lastname: Ricci
authors.forename: Danielle J
authors.initials: DJ
authors.lastname: Chuang
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
mesh_terms: D032882:Comprehension; D054626:Consumer Health Information; D057220:Health Literacy; D006801:Humans; D020407:Internet; D015187:Lipectomy; D057386:Search Engine