Readability of the Patient Education Section of the AOFAS Website

Foot Ankle Int. 2009 Apr;30(4):287-91. doi: 10.3113/FAI.2009.0287.


Background: One of the goals of the AOFAS website is to provide easily understandable information about orthopaedic foot and ankle conditions to the public. However, validation of this goal has not been conducted. Evaluation of text reading level is frequently performed using the Flesch-Kincaid formula (FKF). This study evaluated whether the patient information section of the AOFAS website meets recommended readability guidelines for medical information.

Materials and methods: Seventy-nine publicly accessible entries within the patient education section of the AOFAS website were analyzed for grade level readability using the FKF.

Results: Two entries were unable to be effectively evaluated using the FKF. The average grade reading level of all patient education entries was 8.3 (95% CI 7.8 to 8.9). Only 20.8% of entries were at or below a 6th grade reading level. Almost 30% were above the 8th grade level. The average grade levels of the constituent sections were: ;;Ailments and Conditions'', 8.7; ;;Steps to Recovery'', 7.1; ;;Adult Feet'', 8.3; ;;Children's Feet'', 7.5; ;;Foot Health and Fitness'', 7.8; ;;Shoes'', 8.5; and ;;Glossary'', 10.1. The percentage of entries within these sections below a 7th grade reading level were 13%, 30%, 0%, 0%, 43%, 24% and 0%, respectively.

Conclusion: The percentage of entries at or below the recommended 6th grade reading level on the AOFAS website compared favorably with other orthopaedic organizations' websites. However, the majority still exceeds a recommended reading level. To enhance the readability of patient education materials, we believe use of computer aided readability assessment tools should be considered in future website revisions.

MeSH terms

  • Adult
  • Child
  • Comprehension*
  • Computer Graphics
  • Educational Status
  • Foot*
  • Humans
  • Internet*
  • Language*
  • Musculoskeletal Diseases*
  • Patient Education as Topic*
  • Reproducibility of Results
  • Societies, Medical