title: Comparative analysis of online patient education material pertaining to hepatitis and its complications.
abstract: OBJECTIVE
  Approximately 50% of patients leave the doctor's office with a poor understanding of their diagnosis. Online patient education websites are becoming a major source of information for many of the patients. Here, we determine the reading grade level of online patient education materials on hepatitis B, hepatitis C, cirrhosis, and hepatocellular cancer and compare it with the National Institutes of Health-recommended reading grade level of sixth to seventh grade or under.
  
  
  METHODS
  A Google search was performed to retrieve patient reading materials. Text was modified to remove medical terms that were defined within the article. Documents were then divided into categories of introduction, risk factors, symptoms, diagnosis, treatment, and prevention. Each document was then analyzed using six validated readability tests to determine the grade level and complexity on the basis of the number of words, syllables, or number of uncommon words.
  
  
  RESULTS
  Modified documents had a mean readability score of 10.23, although the recommended score is less than 7.0. Cirrhosis had the highest reading grade level, with a median of 11.3, whereas hepatitis B and hepatocellular carcinoma had the easiest readability, with a median of 9.5. Furthermore, treatment subsection was the most difficult, with a median score of 10.8.
  
  
  CONCLUSIONS
  Patient reading materials reviewed in this study were written well above the recommended reading grade level. These findings suggest review of patient education materials in an effort to close the gap between the average reading level and the reading materials.
authors.affiliation: aDepartment of Internal Medicine bDepartment of Gastroenterology and Hepatology, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA.
authors.forename: Rishabh
authors.initials: R
authors.lastname: Gulati
authors.forename: Mohammad
authors.initials: M
authors.lastname: Nawaz
authors.forename: Nikolaos T
authors.initials: NT
authors.lastname: Pyrsopoulos
mesh_terms: D022126:Access to Information; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D032882:Comprehension; D054626:Consumer Health Information; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D020407:Internet; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D010353:Patient Education as Topic / Q000379:methods*; D011314:Preventive Health Services; D011379:Prognosis; D011932:Reading; D012307:Risk Factors