Researchers used word processing software to test Web site readability
The National Institutes of Health recommends that patient education materials be written at the 4th through 6th grade level, since 90 million American adults read below high school levels.
However, only 4.8% of Web sites describing prostate cancer were written below a high school reading level, according to a Loyola University Medical Center study.
“This is problematic for one-third of Americans who seek to further educate themselves using online resources,” senior author Gopal Gupta, MD, and colleagues wrote.
The study, published online ahead of print in the Journal of Urology, used 62 Web sites identified by searching for “prostate cancer,” “prostate cancer treatment,” and “prostatectomy” on the Google, Yahoo, and Bing search engines. Word processing software was used by Gupta and colleagues to test the readability of the first 300 words of each Web site.
The Flesch-Kincaid test, which measures the reading grade level, and the Flesch reading ease test, which assigns a readability score of 0-100, were both used by researchers to assess Web site readability. (A Web site with a Flesch score of 90-100 would be easily understood by an 11-year-old; a score of 60-70 would be understood by 13- to 15-year-olds; and scores lower than 30 would be suited to college grads.) The assessments use formulas that incorporate total number of words, sentences, and syllables.
Of the sites examined, 63% were written above a 12th grade reading level. The median Flesch reading ease score for all sites was a relatively difficult 38.1, and the median reading level was 12th grade.
“It was discouraging to find that only 4.8% of these sites had information written for those below a high school reading level,” researchers wrote. “No sites in our study were written at the level recommended by the NIH (4-6th grade). Given that nearly one-third of the US population reads below high school level, this raises the concern that many patients will have difficulty comprehending online information about prostate cancer treatment options.”
Gupta and colleagues concluded: “Clinicians should be aware that some of their patients may not be able to read online information and should consciously guide patients with low literacy to not only high-quality Web sites, but also sites that are easy-to-read to prevent confusion and anxiety after being diagnosed with prostate cancer.”
Source: Loyola University Health System.