Computer-Based Readability Testing of Information Booklets for German Cancer Patients

Area of Science:

• Health communication
• Medical writing
• Readability assessment

Background:

• Understandable health information is vital for patient adherence and outcomes.
• Readability testing instruments analyze sentence structure (e.g., Flesch-Reading Ease, Vienna-Formula) and vocabulary.
• The agreement between these different measurement approaches is not well-established.

Purpose of the Study:

• To investigate the agreement between sentence structure-based and vocabulary-based readability assessment instruments.
• To compare the scores generated by Flesch-Reading Ease (FRE), Vienna-Formula (WSTF), and a vocabulary-based method (SVM).
• To determine if these instruments can be used interchangeably for evaluating German cancer patient information booklets.

Main Methods:

• Collected 52 freely available German cancer patient information booklets.
• Computed mean understandability levels using FRE, WSTF, and SVM for 51 booklets.
• Assessed pairwise agreement using Bland-Altman plots and paired t-tests.

Main Results:

• Mean understandability scores were L_FRE=6.81, L_WSTF=7.39, and L_SVM=5.09.
• Sentence structure metrics (FRE, WSTF) yielded significantly different scores from each other (P<0.001).
• Vocabulary-based scores (SVM) were not interchangeable with sentence structure-based scores (FRE/WSTF).

Conclusions:

• Sentence structure and vocabulary-based readability instruments provide distinct assessments and are not interchangeable.
• Authors should consider both sentence structure and vocabulary when refining health information for specific target audiences.
• Automated readability analysis can support authors and health professionals in selecting and creating effective patient materials.