title: Readability and Understandability of Online Vocal Cord Paralysis Materials.
abstract: OBJECTIVE
  Patients use several online resources to learn about vocal cord paralysis (VCP). The objective of this study was to assess the readability and understandability of online VCP patient education materials (PEMs), with readability assessments and the Patient Education Materials Evaluation Tool (PEMAT), respectively. The relationship between readability and understandability was then analyzed.
  
  
  METHODS
  Descriptive and correlational design.
  
  
  METHODS
  Online PEMs were identified by performing a Google search with the term "vocal cord paralysis." After scientific webpages, news articles, and information for medical professionals were excluded, 29 articles from the first 50 search results were considered. Readability analysis was performed with 6 formulas. Four individuals with different educational backgrounds conducted understandability analysis with the PEMAT. Fleiss's Kappa interrater reliability analysis determined consistency among raters. Correlation between readability and understandability was determined with Pearson's correlation test.
  
  
  RESULTS
  The reading level of the reviewed articles ranged from grades 9 to 17. Understandability ranged from 29% to 82%. Correlation analysis demonstrated a strong negative correlation between materials' readability and understandability (r = -0.462, P < .05).
  
  
  CONCLUSIONS
  Online PEMs pertaining to VCP are written above the recommended reading levels. Overall, materials written at lower grade levels are more understandable. However, articles of identical grade levels had varying levels of understandability. The PEMAT may provide a more critical evaluation of the quality of a PEM when compared with readability formulas. Both readability and understandability should be used to evaluate PEMs.
authors: University Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine School of Medicine, Irvine, California, USA.
authors: Vini
authors: V
authors: Balakrishnan
authors: University Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine School of Medicine, Irvine, California, USA.
authors: Zachariah
authors: Z
authors: Chandy
authors: University Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine School of Medicine, Irvine, California, USA.
authors: Amy
authors: A
authors: Hseih
authors: University Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine School of Medicine, Irvine, California, USA.
authors: Thanh-Lan
authors: TL
authors: Bui
authors: University Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine School of Medicine, Irvine, California, USA. verma@uci.edu.
authors: Sunil P
authors: SP
authors: Verma
mesh_terms: D032882:Comprehension; D057220:Health Literacy; D006801:Humans; D010353:Patient Education as Topic; D011932:Reading; D013664:Teaching Materials; D014826:Vocal Cord Paralysis
keywords: Internet; PEMAT; patient education; patient education materials; readability; readability formula; understandability; vocal cord paralysis