Readability assessment of commonly used urological questionnaires

This study was performed to assess readability of the most commonly used questionnaires in urology including a separate analysis of their single-items to identify questions that might be especially demanding for patients.

The guidelines of the European Association of Urology were screened for recommended questionnaires. Readability was analyzed for complete questionnaires as well as their single-items separately using well established readability assessment tools, including Flesch-Kincaid grade level (FKGL), Simple Measure of Gobbledygook grade level (SMOG), Coleman-Liau Index (CLI), Gunning-Fog Index, and the Flesch Reading Ease formula.

A total of 13 questionnaires were included to the analysis. Calculation of grade levels (FKGL, SMOG, CLI, FGI) showed readability scores of 2.7th to 16.7th grade. Easiest readability as calculated by median grade levels was found for the short form of the International Consultation on Incontinence Questionnaires-Female Lower Urinary Tract Symptoms short form (FLUTS-SF) while the short form of the International Index of Erectile Function (IIEF-5) showed the hardest readability. Based on the FKGL between 0% (FLUTS-SF) and 80% (IIEF-5) of the single-items were written above the recommended grade levels.

The questionnaires that are used most frequently in urology mainly show a satisfactory overall readability. Inadequate readability levels were not only found for individual questionnaires but also for single-items of the majority of assessed questionnaires. This requires consideration for the interpretation of results and when developing novel health-related surveys.