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Updated: Dec 27, 2025

Oral Health Assessment by Lay Personnel for Older Adults
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Readability assessment of self-report hyperacusis questionnaires.

Magdalena Margol-Gromada1, Magdalena Sereda1,2, David M Baguley1,2,3

  • 1Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.

International Journal of Audiology
|March 6, 2020
PubMed
Summary

Readability assessments of five hyperacusis questionnaires revealed scores exceeding recommended grade levels. This impacts clinical interpretation and requires developer attention for improved accessibility.

Keywords:
Readabilityhealth literacyhyperacusisreduced sound toleranceself-report questionnaires

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Area of Science:

  • Audiology
  • Health Literacy
  • Clinical Assessment

Background:

  • Hyperacusis questionnaires are crucial for diagnosis and management.
  • Assessing the readability of these tools is essential for accurate patient comprehension and data interpretation.
  • Existing questionnaires may present comprehension challenges for patients.

Purpose of the Study:

  • To evaluate the overall readability of five widely used hyperacusis questionnaires.
  • To analyze the readability of individual items within these questionnaires.
  • To compare readability scores against established health literacy guidelines.

Main Methods:

  • A comparative analysis of five hyperacusis questionnaires (GUF, NAQ, HQ, SSTI, IHS).
  • Utilized established readability formulas: Flesh-Kincaid Grade Level (FKGL), Flesch Reading Ease (FRE), SMOG, and FORCAST.
  • Employed computerised readability calculation software for comprehensive analysis.

Main Results:

  • Readability scores varied across questionnaires, ranging from 7.7th to 12.7th grade level.
  • These scores surpassed the recommended 5th-6th grade level (AMA) and 7th-8th grade level (NIH).
  • 32%-70% of individual questionnaire items were written above recommended grade levels.

Conclusions:

  • All five assessed hyperacusis questionnaires exhibit readability levels at or above recommended standards.
  • This finding necessitates careful consideration by developers and clinicians during interpretation of patient-reported outcomes.
  • Improving questionnaire readability can enhance patient understanding and data validity.