Mammography Patient Information at Hospital Websites: Most Neither Comprehensible Nor Guideline Supported.
OBJECTIVE
Ongoing controversy regarding screening mammography guidelines has created confusion for many patients. Given recommendations that patient educational material be prepared at or below the 7th grade reading level of average Americans, the purpose of this study was to assess the readability of online mammography information offered by hospitals nationwide.


METHODS
During 2015, online mammography patient educational materials were identified for all Medicare-recognized hospitals nationwide for which screening mammography metrics were publicly available. Patient educational materials were assessed using six validated readability score algorithms. All references to official screening guidelines were captured.


RESULTS
Of 4105 hospitals nationwide, 3252 had websites and confirmable screening mammography services. Of those, 1753 (54%) offered mammography information material online. Only 919 (28%) referenced any professional society guidelines. After excluding information not formatted in HTML and shorter than 100 words (to improve algorithm reliability), 1524 hospital mammography webpages were assessed for grade level scores. Nationally, the mean of each readability score for all hospitals varied between the 10th and 14th grade levels, all higher than the recommended 7th grade level (p < 0.001). At the individual hospital level, only 14 hospitals (0.4%) had mean scores at or below the 7th grade level.


CONCLUSIONS
Of U.S. hospitals that offer screening mammography and have websites, only 54% provide online mammography educational material. Of those, only 0.4% present information at a reading level comprehensible to average Americans, and only 28% offer specific information to help patients reconcile conflicting guidelines. Health systems offering mammography should strive to better meet women's health information and literacy needs.
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, Rm 125 D, Atlanta, GA 30322.
Gelareh
G
Sadigh
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, Rm 125 D, Atlanta, GA 30322.
Kush
K
Singh
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, Rm 125 D, Atlanta, GA 30322.
Kirven
K
Gilbert
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, Rm 125 D, Atlanta, GA 30322.
Ramsha
R
Khan
2 Department of Educational Theory and Practice, University of Georgia, Athens, GA.
Abigail M
AM
Duszak
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, Rm 125 D, Atlanta, GA 30322.
Richard
R
Duszak
D000465:Algorithms; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D032882:Comprehension; D005260:Female; D006761:Hospitals; D006801:Humans; D020407:Internet; D008327:Mammography; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D014481:United States
health literacy; online patient educational material; readability; screening mammography