Assessing the readability of patient-targeted online information on musculoskeletal radiology procedures

Skeletal Radiol. 2021 Jul;50(7):1379-1387. doi: 10.1007/s00256-020-03562-1. Epub 2021 Jan 3.

Abstract

Objective: To assess the readability of patient-targeted online information on musculoskeletal radiology procedures.

Methods: Eleven common musculoskeletal radiology procedures were queried in three online search engines (Google, Yahoo!, Bing). All unique patient-targeted websites were identified (n = 384) from the first three pages of search results. The reading grade level of each website was calculated using 6 separate validated metrics for readability assessment. Analysis of word and sentence complexity was also performed. Results were compared between academic vs. non-academic websites and between websites found on different pages of the search results. Statistics were performed using a t test.

Results: The mean reading grade level across all procedures was 10th-14th grade. Webpages for nerve block were written at a higher reading grade level on non-academic websites (p = 0.025). There was no difference in reading grade levels between academic and non-academic sources for all other procedures. There was no difference in reading grade levels between websites found on the first page of search results compared with the second and third pages. Across all websites, 16-22% of the words used had 3+ syllables and 31-43% of the words used had 6+ characters (complex words); 13-24% of the sentences used had 22+ words (complex sentences).

Conclusion: Patient-targeted online information on musculoskeletal radiology procedures are written at the 10th-14th grade reading level, which is well beyond the AMA and NIH recommendation. Readability can be lowered by decreasing text complexity through limitation of high-syllable words and reduction in word and sentence length.

Keywords: Health literacy; Musculoskeletal procedures; Patient education; Readability.

MeSH terms

  • Comprehension*
  • Humans
  • Radiology*
  • Search Engine