Assessment of Online Patient Materials for Acne Vulgaris: An Analysis of Readability and Patient Understanding
Elise Weisert, Dr. Lindy Ross
University of Texas Medical Branch at Galveston
Introduction: Patient-directed internet medical resources have become a mainstay for patient information regarding health concerns, diagnoses, and treatment. The American Medical Association has recommended that patient education materials should be written at a sixth-grade reading level, as most adults in the United States read at an eighth-grade level. Acne vulgaris is a common skin condition that affects up to 50 million individuals in the United States each year. This study evaluates the readability of commonly used internet resources for information about acne vulgaris.
Methods: The largest internet search engine was searched utilizing the term “acne”. The first 20 patient-directed websites were chosen for analysis; this included websites such as Wikipedia, Mayo Clinic, the American Academy of Dermatology, and WebMD. All pages one link away from the main page were downloaded and analyzed using validated readability software. Fry readability graphs were created as a visual index of readability.
Results: Fifty-five webpages from the top 20 websites were analyzed. The overall average reading level for articles exceeded the AMA recommendation for patient education materials from articles from all sites, and the average grade reading level was 10.44 by the Flesch Kincaid Grade Level. This finding was consistent regardless of which readability score was used, which also included the Flesch Kincaid Reading Ease, Gunning Fog Score, SMOG Index, Coleman Liau Index, and Automated Readability Index. Fry readability graphs demonstrated visually the advanced level of literacy needed to understand these materials.
Conclusion: Online patient resources exceed the recommended patient reading levels for the United States population. This is particularly concerning as acne vulgaris has an 85% prevalence among adolescents who may be accessing these sites for health information and resources. This study demonstrates the necessity of assessing readability before publishing online health materials to ensure understanding by the desired patient population.