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Navigating the Whipple procedure patient educational materials: A readability and understandability analysis

Gabriela Rangel Brandao¹, Cristina Ponce¹, Manuel Castillo-Angeles²

¹Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.

American Journal of Surgery

|May 8, 2025

Abstract

Objective:

Pancreatoduodenectomy (PD) is a complex surgical procedure that is challenging to understand. We aimed to assess the readability, understandability, and actionability of online patient-directed materials for PD.

Methods:

We evaluated online patient-focused educational materials about PD. Through the Leapfrog ratings for "Pancreatic Resection for Cancer" we classified high-volume (HV) and low-volume (LV) hospitals. Readability was measured using multiple tools. Understandability and actionability were measured using the Patient Education Materials Assessment Tool for Printable materials (PEMAT-P). As an external control source of comparison, we analyzed the patient materials from three patient-focused organizations.

Results:

Out of 550 HV hospitals, 10 % had any online patient educational material about PD. Readability was at a median grade level of 12 (IQR 4). All exceeded the recommended sixth-grade readability level. Websites solely focused on PD had significantly higher understandability and actionability scores compared to those where the procedure was only a section within a broader topic such as pancreatic cancer. There was no difference in readability, understandability, or actionability among HV, LV and control groups.

Conclusions:

Online patient materials for PD were scarce, lengthy and difficult to comprehend. However, their understandability is crucial for providing patient education. Simplification of patient materials with clear guidance, visuals, and simple language, and strategies-focused research are needed.

Keywords:

Actionability Educational materials Pancreatic cancer Pancreatoduodenectomy Readability Understandability Whipple

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