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Readability of Patient-Reported Outcome Measures in Adult Speech-Language Pathology Practice.

Paige Darien¹, Lori Letts¹, Allison Williams²

¹School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

American Journal of Speech-Language Pathology

|July 10, 2026

Summary

Patient-reported outcome measures (PROMs) in speech-language pathology often exceed recommended reading levels, impacting equitable use. Improving PROM readability is crucial for patient-centered care and accurate data collection.

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Area of Science:

Speech-language pathology
Health literacy
Patient-reported outcome measures

Background:

Patient-reported outcome measures (PROMs) are vital in adult speech-language pathology for assessing patient and caregiver perceptions of symptoms, functional status, and treatment effectiveness.
Ensuring PROMs are comprehensible and easily completed by all users is essential for data validity and equitable application.

Purpose of the Study:

This study aimed to evaluate the readability of validated English-language PROMs commonly used in adult speech-language pathology.
The research also examined variations in readability across different clinical domains within the field.

Main Methods:

Seventy-four validated PROMs from eight clinical domains in adult speech-language pathology were analyzed.
Patient-facing text was assessed using four readability indices: Flesch-Kincaid Grade Level, Coleman-Liau Index, SMOG, and FORCAST Grade Level.
Readability estimates were compared against a benchmark of a 6.0 grade level for health materials.

Main Results:

Readability estimates for most PROMs and clinical domains frequently surpassed recommended grade-level thresholds.
No single PROM achieved the benchmark across all four readability indices.
Only a limited number of PROMs, mainly in language and voice domains, met recommended readability levels when averaged across indices.

Conclusions:

Many validated PROMs in adult speech-language pathology possess readability levels exceeding recommended health literacy standards.
This readability gap may hinder independent completion and equitable access to these important assessment tools.
Consideration of readability alongside psychometric properties is recommended for developing, selecting, and implementing PROMs to ensure patient-centered and accessible care.