Readability of patient educational materials on ultrasound: a cross-sectional study

To evaluate the readability and quality of publicly available patient information pamphlets on ultrasound and assess their accessibility for patients with varying literacy levels.

This was a cross-sectional descriptive study using the publicly available online International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) patient information library. A total of 155 English-language patient information materials ("pamphlets") on pregnancy and gynecology topics available in early 2025 were analyzed. Readability was assessed using Readability Studio™ software and four validated indices: Gunning Fog, SMOG, Coleman-Liau, and Flesch Reading Ease (FRE). The DISCERN instrument, a validated 16-item tool, was applied independently to evaluate reliability, clarity, and balance of treatment information. The main outcomes measures were the grade level of readability and DISCERN quality scores.

Only one pamphlet (1 %) met the recommended eighth-grade readability standard. Most pamphlets (124; 80 %) were written at or above the 11th-grade level (mean Gunning Fog 14.8, SMOG 13.5, Coleman-Liau 12.9, FRE 45.2). The LIX index classified the majority as "difficult to technical." Despite the high reading level, DISCERN scores were uniformly high (4-5/5), indicating strong reliability, clarity, and balance of information, but poor accessibility for the average patient.

ISUOG patient information materials are accurate, reliable, and evidence-based but written well above recommended readability standards, limiting comprehension for many patients. Simplifying language, shortening sentences, and involving health-literacy and cultural experts may improve accessibility and promote global equity in patient education.