The Readability of AAOS Patient Education Materials: Evaluating the Progress Since 2008.
BACKGROUND
The Internet has become a major resource for patients; however, patient education materials are frequently written at relatively high levels of reading ability. The purpose of this study was to evaluate the readability of patient education materials on the American Academy of Orthopaedic Surgeons (AAOS) web site.


METHODS
Readability scores were calculated for all patient education articles on the AAOS web site using 5 algorithms: Flesch Reading Ease, Flesch-Kincaid Grade Level, SMOG (Simple Measure of Gobbledygook) Grade, Coleman-Liau Index, and Gunning-Fog Index. The mean readability scores were compared across the anatomic categories to which they pertained.


RESULTS
Using a liberal measure of readability, the Flesch-Kincaid Grade Level, 3.9% of articles were written at or below the recommended sixth-grade reading level, and 84% of the articles were written above the eighth-grade reading level. Articles in the present study had a lower mean Flesch-Kincaid Grade Level than those available in 2008 (p < 0.00005). Articles categorized as "Hand & Wrist" or "Foot & Ankle" had significantly lower mean Flesch-Kincaid Grade Level scores than the mean for all categories (p < 0.0005).


CONCLUSIONS
Regardless of the algorithm used, the mean readability levels of AAOS articles are higher than generally recommended. Although the mean Flesch-Kincaid Grade Level was lower in the present study than it was in 2008, a need remains to improve the readability of AAOS patient education articles.


CONCLUSIONS
Ensuring that online patient education materials are written at an appropriate reading grade level would be expected to improve physician-patient communication.
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts heather_roberts@hms.harvard.edu.
Heather
H
Roberts
Harvard Medical School, Boston, Massachusetts Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts dzhang9@partners.org.
Dafang
D
Zhang
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts gdyer@mgh.harvard.edu.
George S M
GS
Dyer
D032882:Comprehension; D057220:Health Literacy; D006801:Humans; D020407:Internet; D009985:Orthopedics / Q000193:education*; D010353:Patient Education as Topic / Q000639:trends*