Assessing the Readability of Online English and Spanish Resources for Polydactyly and Syndactyly

Online patient education materials (PEMs) that are difficult to read disproportionately affect patients with low health literacy and educational attainment. Patients may not be fully informed or empowered to engage meaningfully with providers and advocate for their goals. We aim to assess the readability of online PEMs regarding polydactyly and syndactyly.

Google was used to query "polydactyly" and "syndactyly" in English and Spanish. The first 50 results were categorized into institutional (government, medical school, teaching hospital), noninstitutional (private practice, blog), and academic (journal articles, book chapters). Readability scores were generated using the Simple Measure of Gobbledygook and Spanish Simple Measure of Gobbledygook scales.

All polydactyly PEMs and >95% of syndactyly PEMs exceeded the National Institutes of Health recommended 6th-grade reading level. Altogether, English PEMs had an average reading level of a university freshman and Spanish PEMs had an average reading level of nearly a high school sophomore. For both diagnoses, English PEMs were harder to read than Spanish PEMs overall and when compared across the 3 categories between the 2 languages. Generally, noninstitutional PEMs were more difficult to read than their institutional counterparts.

To improve patient education, health literacy, and language equity, online resources for polydactyly and syndactyly should be written at the 6th-grade level. Currently, these PEMs are too advanced, which can make accessing, understanding, and pursuing healthcare decisions more challenging. Understanding health conditions and information is crucial to empower patients, regardless of literacy.