Readability of patient education materials on cardiac magnetic resonance imaging

We assessed the readability level of online patient education materials (PEMs) for cardiac MRI (CMRI) to determine whether they meet the standard health literacy needs as determined by the US National Institutes of Health and the American Medical Association guidelines.

We evaluated the readability of CMRI PEMs from 5 websites using the Flesch-Kincaid Reading Ease (FKRE), Flesch-Kincaid grade level (FKGL), Gunning-Fog Index (GFI), Simple Measure of Gobbledygook index (SMOGI), Coleman-Liau Index (CLI), and Automated Readability Index (ARI). PEMs on the British Heart Foundation (BHF) website yielded the highest mean FKRE score, while the RadiologyInfo.org (RadInfo) website yielded the highest mean score on the CLI compared to all the other websites. Statistical analysis of individual predictors revealed that average words per sentence (P < 0.001) and average syllables per word (P < 0.001) were strong determinants of FKRE for the RadInfo PEMs. In contrast, sentences (P = 0.044), words (P = 0.046), average words per sentence (P = <0.001), and average syllables per word (P = <0.001) were significant predictors of FKRE for the InsideRadiology (InsRad) PEMs. The sensitivity analysis consistently confirmed the robustness and primary influence of average words per sentence and average syllables per word.

The BHF and American Heart Association emphasize accessible CMRI communication, whereas RadInfo, InsRad, and the European Society of Cardiology PEMs may be less suitable for low-health-literacy audiences. Strategies aimed at enhancing the comprehensibility of patient education materials should primarily focus on reducing the average complexity of words and shortening average sentence lengths.