Readability and comprehensibility of patient education material in hand-related web sites

As patients are more frequently referring to the Internet for information on their musculoskeletal problems, the readability and comprehensibility of these educational materials becomes increasingly more important to most of the lay public. In this study, we investigated the readability of the currently available web sites of the American Society for Surgery of the Hand (ASSH) and the American Academy of Orthopaedic Surgeons (AAOS) that pertain to hand and wrist problems, to assess their usefulness as a source for patient information.

We analyzed all articles available in 2008 from the AAOS web site within the Patient Education Library under the heading, "Hand & Wrist" and from the ASSH web site under the heading, "Hand Conditions." A total of 83 articles were identified for hand conditions. Each article was analyzed by the Flesch-Kincaid program available in Microsoft Office Word software and the Dale-Chall grade-level assessor. These program models analyze all words in the specified text and return a grade level that corresponds to the difficulty level of the text.

The AAOS web sites contained 34 articles with a mean Flesch-Kincaid grade level of 8.5 and a mean Dale-Chall grade level of 8.8. The ASSH web site contained 49 articles showing a mean Flesch-Kincaid grade level of 10.4 and a mean Dale-Chall grade level of 10.8.

Our results suggest that the patient education materials found on the AAOS and ASSH web sites have readability scores that are higher than the recommended reading levels and thus may be too difficult to be understood by a substantial portion of the U.S. population.