Readability of Online Patient-Directed Content About Cystoscopy and Urodynamic Testing

The objective was to assess the readability of commonly accessed patient-focused websites about cystoscopy or urodynamic studies (UDS).

Keywords related to cystoscopy and UDS were searched in three commonly accessed search engines in 2024 and compared with a search from 2022. The top 25 search results from each search engine were assessed against the study inclusion/exclusion criteria. Readability scores (Flesch Reading Ease score [FRES], Flesch-Kincaid Grade Level [FKGL], Gunning Frequency of Gobbledygook [FOG], Simple Measure of Gobbledygook [SMOG]) were calculated for the websites included. Mean readability scores of websites were compared by procedure type and publisher using the Mann-Whitney test.

In 2024, a total of 75 patient-oriented websites were identified, 33 (44.0%) of which were about cystoscopy and 42 (56.0%) websites were about UDS. Cystoscopy websites were difficult to read (FRES median 56 [55-69]), requiring grade 8-11 reading level (Gunning FOG median 11.3 [10.3-12.3]; FKGL median 8 [7.11-8.84]) and 8 years of education to read (SMOG median 8.06 [7.41-8.71]). UDS websites were difficult to read (FRES median 56 [41-66]), requiring grade 9-11 reading level (Gunning FOG median 11.45 [9.5-13.7]; FKGL median 8.85 [6.93-10.88]) and 8 years of education to read (SMOG median 8.49 [7.11-9.98]). Websites in 2024 were significantly easier to read than websites in 2022 based on Gunning FOG (p value 0.0079), FKGL (p value 0.0001), and SMOG scores (p value 0.0001), but still did not meet the recommendation of grade 6 reading level.

Patient-focused online information about cystoscopy and UDS was harder to read than the American Medical Association-recommended grade 6 reading level of patient information. Readability of cystoscopy and UDS online information has improved over 2 years.