Reading Level of Internet Medical Information for Common Diagnoses
The National Institutes of Health (NIH) recommend that health materials be written at a grade 6-7 reading level, which has generally not been achieved in online reading materials. Up to the present time, there have not been any assessments focused on the reading level of online educational materials across the most popular consumer Web sites for common internal medicine diagnoses. In this study, we examined the readability of open-access online health information for 9 common internal medicine diagnoses.
Nine of the most frequently encountered inpatient and ambulatory internal medicine diagnoses were selected for analysis. In November and December 2014, these diagnoses were used as search terms in Google, and the top 5 Web sites across all diagnoses and a diagnosis-specific site were analyzed across 5 validated reading indices.
On average, the lowest reading grade-level content was provided by the NIH (10.7), followed by WebMD (10.9), Mayo Clinic (11.3), and diagnosis-specific Web sites (11.5). Conversely, Wikipedia provided content that required the highest grade-level readability (14.6). The diagnoses with the lowest reading grade levels were chronic obstructive pulmonary disease (10.8), followed by diabetes (10.9), congestive heart failure (11.7), osteoporosis (11.7) and hypertension (11.7). Depression had the highest grade-level readability (13.8).
Despite recommendations for patient health information to be written at a grade 6-7 reading level, our examination of online educational materials pertaining to 9 common internal medicine diagnoses revealed reading levels significantly above the NIH recommendation. This was seen across both diagnosis-specific and general Web sites. There is a need to improve the readability of online educational materials made available to patients. These improvements have the potential to greatly enhance patient awareness, engagement, and physician–patient communication. The Internet has a ubiquitous presence in the physician–patient encounter. Oftentimes a patient arrives at a clinical visit having read a number of online education materials about their diagnosis. Information presented by the patient can invite shared decision-making and be a starting point for communication in the medical setting. Up to the present time, there have not been any assessments focused on the reading level of online educational materials across the most popular consumer Web sites for common internal medicine diagnoses. According to the 2006 National Assessment of Literacy Report, 22% of Americans have Basic health literacy and a further 14% have Below Basic health literacy.1 The National Institutes of Health (NIH) recommends that health materials be written at a grade 6-7 reading level. However, a recent study demonstrated that none of the online patient educational resources provided by 16 professional medical organizations met a sixth-grade reading level.
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-Nora Hutchinson, MD, CM, MPhil, Grayson L. Baird, MS, Megha Garg, MD, MPH
This article originally appeared in the June 2016 issue of The American Journal of Medicine.