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Readability of cerebrovascular diseases online educational material from major cerebrovascular organizations
  1. Avi A Gajjar1,2,
  2. Shray Patel3,
  3. Shrey V Patel4,
  4. Aditya Goyal2,
  5. Georgios S Sioutas1,
  6. Katherine L Gamel5,
  7. Mohamed M Salem1,
  8. Visish M Srinivasan6,
  9. Brian T Jankowitz1,
  10. Jan Karl Burkhardt1
  1. 1Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2Neurosurgery, Albany Medical College, Albany, New York, USA
  3. 3Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  4. 4Tufts University School of Medicine, Boston, Massachusetts, USA
  5. 5Campbell University School of Osteopathic Medicine, Buies Creek, North Carolina, USA
  6. 6University of Pennsylvania Hospital, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Jan Karl Burkhardt, Neurosurgery, Hospital of University of Pennsylvania, Philadelphia, PA, USA; jan.burkhardt{at}pennmedicine.upenn.edu

Abstract

Introduction The internet is an essential resource for patients and their loved ones to understand their medical conditions, and professional medical organizations have taken great strides to develop educational material targeting patients. The average American reads at a seventh to eighth grade reading level, hence it is important to understand the readability of this medical information to ensure patients comprehend what is being presented.

Methods In January 2023, online patient education material was downloaded from major cerebrovascular healthcare organizations and assessed using eight assessments, including Bormuth Cloze Mean, Bormuth Grade Placement, Coleman–Liau (grade levels), Coleman–Liau (predictive cloze scores), Flesch Reading Ease (FRE), and Fry.

Results A total of 32 files were extracted from six organizations and analyzed across 15 readability measures. None of the organizations met the federal government guidelines for grade-level readability. This held constant across all measured tests. Two organizations had above a postgraduate level. The FRE graphs do not identify any organizations with material below a ninth grade reading level, while the American Association of Neurological Surgeons (AANS) and the Society of Interventional Radiology (SIR) have a postgraduate readability level. The Fry graphs show similar results, with AANS/CNS Cerebrovascular Section, Society of NeuroInterventional Surgery (SNIS), SIR, and AANS having college-level readability. The lowest readability across all measures is only at an early seventh grade reading level.

Conclusions Current health literacy content for cerebrovascular patients is far above the recommended readability level. We provide straightforward suggestions for how major professional organizations should improve their informational material on cerebrovascular diseases to improve patient understanding.

  • Aneurysm
  • Brain
  • Political
  • Stroke

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/jnis-2023-021205

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors Conceptualization: AAG, GSS, MMS, VMS, BTJ, JKB. Data curation: AAG, SP, SVP, AG, GSS, KLG, MMS. Formal analysis: AAG. Funding acquisition: JKB. Investigation: AAG, SP, SVP, AG, GSS, KLG, MMS, VMS, BTJ, JKB. Methodology: AAG, MMS, VMS, BTJ, JKB. Project administration: VMS, BTJ, JKB. Resources: VMS, BTJ, JKB. Software: AAG, VMS, BTJ, JKB. Supervision: VMS, BTJ, JKB, GSS, MMS. Writing – original draft: AAG, SP, SVP, AG, GSS. Writing – review and editing: AAG, SP, SVP, AG, GSS, KLG, MMS, VMS, BTJ, JKB. Guarantor: JKB.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.