Readability assessment of commonly used urological questionnaires

Area of Science:

• Urology
• Health Services Research
• Medical Informatics

Background:

• Patient-reported outcome measures (PROMs) are crucial in urology.
• Assessing the readability of these tools is essential for accurate data collection and patient comprehension.
• Previous analyses have not comprehensively evaluated the readability of frequently used urological questionnaires.

Purpose of the Study:

• To evaluate the readability of commonly utilized questionnaires in urology.
• To identify specific single-items within these questionnaires that may pose comprehension difficulties for patients.
• To inform the development and interpretation of urological health surveys.

Main Methods:

• Screened European Association of Urology guidelines for recommended questionnaires.
• Analyzed 13 urological questionnaires for overall and single-item readability.
• Employed multiple established readability assessment tools: Flesch-Kincaid grade level (FKGL), Simple Measure of Gobbledygook grade level (SMOG), Coleman-Liau Index (CLI), Gunning-Fog Index, and Flesch Reading Ease.

Main Results:

• Readability scores ranged from 2.7th to 16.7th grade level across questionnaires.
• The International Consultation on Incontinence Questionnaires-Female Lower Urinary Tract Symptoms short form (FLUTS-SF) demonstrated the easiest readability.
• The International Index of Erectile Function (IIEF-5) exhibited the most challenging readability, with up to 80% of its items exceeding recommended grade levels based on FKGL.

Conclusions:

• Most frequently used urology questionnaires generally exhibit satisfactory overall readability.
• However, inadequate readability was identified not only in entire questionnaires but also in many individual items.
• These findings necessitate careful consideration during result interpretation and the design of future health-related surveys.