Readability of Patient Education Materials from the AAHS

To the Editor: Although the Internet is a free, ubiquitous, and publicly available source for patient education materials, the quality and ease of comprehending such online materials is often questionable [1, 3, 5]. One way of assessing patient education materials is by way of readability, which is defined as the reading level measured by grade level in school that an individual must possess to understand a particular written text [2]. Orthopedic patient education materials available in the Internet [2, 4, 6–10] have previously been reported to be written beyond the level of the average American adult (eighth grade level) and the level recommended by prominent health organizations (sixth grade level) [2]. While a previous study has evaluated the readability of hand surgery-related patient education materials from the American Academy of Orthopaedic Surgeons and the American Society for Surgery of the Hand (ASSH) [9], the online patient education materials provided by the American Association for Hand Surgery (AAHS) have never been evaluated for readability. Therefore, we sought to assess the readability of patient education materials available online by the AAHS. Over a 1-day period in January 2013, we compiled all patient education materials from the library on the AAHS website (http://handsurgery.org/public/); each article was copied and pasted into Microsoft Word as plaintext files and underwent follow-up editing as previously described [2]. Then, each article was subsequently evaluated for readability using the Microsoft Word software. A total of 12 articles was evaluated with an average readability level of 8.98; of these, three were at or below the eighth grade level (25 %) (“Flexion Contracture,” “Mallet Finger,” and “Trigger Finger”). These readability levels are lower than those previously reported for hand surgery-related patient education materials from the AAOS and ASSH [9], which had a mean of 9.6 (83 articles assessed) and 14 at or below the eighth grade level (16.8 %). Our findings are encouraging because they show that the AAHS appears to have written patient education materials that are perhaps easier to read than previously reported for hand surgery-related materials. However, all three major sources of hand surgery-related patient education materials (AAOS, ASSH, and AAHS) appear to be written higher, on average, than the average patient can comprehend. As the Internet promises to become ever more popular for obtaining health-care information, ensuring easily read patient education materials is an important task so that we can best serve not only our patients’ hands, but their heads as well.