DOCSLIB.ORG

SUFE and the Internet: Are Healthcare Information Websites Accessible to Parents?

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
SUFE and the Internet: Are Healthcare Information Websites Accessible to Parents? Open access Original research bmjpo: first published as 10.1136/bmjpo-2020-000782 on 20 October 2020. Downloaded from SUFE and the internet: are healthcare information websites accessible to parents? Andrea Mc Carthy , Colm Taylor To cite: Mc Carthy A, Taylor C. ABSTRACT What is known about the subject? SUFE and the internet: are Background Slipped upper femoral epiphysis is healthcare information an adolescent hip disorder requiring rapid surgical ► Slipped upper femoral epiphysis (SUFE) is a complex websites accessible to intervention. Faced with the prospect of their child parents? BMJ Paediatrics Open adolescent hip disorder. Caregivers may turn to the undergoing surgery, many fearful parents will turn to the 2020;4:e000782. doi:10.1136/ internet for information but find healthcare websites internet to provide information and reassurance. Previous bmjpo-2020-000782 offer conflicting advice, resulting in increased anx- studies have shown the orthopaedic information can be iety and reduced postoperative rehab compliance. ► Additional material is difficult to comprehend. published online only. To view Objective Assess the readability of healthcare websites please visit the journal online regarding slipped upper femoral epiphysis. (http:// dx. doi. org/ 10. 1136/ Methods The term Slipped Upper Femoral Epiphysis was What this study adds? bmjpo- 2020- 000782). searched in Google, Bing and Yahoo. The websites were evaluated using readability software with seven specialised ► The study shows that for websites regarding SUFE, the average Flesich Read Ease Score score is 52 Received 30 June 2020 readability tests including the Flesch- Kincaid Reading and the average reading grade level is 8.67. Both of Revised 28 August 2020 Grade Level, the Flesch Reading Ease Score, the Simple Accepted 6 September 2020 Measure of Gobbledygook, Coleman- Liau Index, Automated these figures do not comply with acceptable stan- Readability Index and the Gunning Fog Index. The reading dards for readability. It also offers suggested solu- grade level (RGL) was also calculated. tions to identified weaknesses within these websites A Flesich Read Ease Score (FRES) score above 65 and an RGL of sixth grade and under was considered acceptable. http://bmjpaedsopen.bmj.com/ Websites were also assessed for translation services. the proximal femoral metaphysis anteriorly 4 Results 21 unique websites were assessed. The average and superiorly relative to the epiphysis. The FRES was 52.5±15.4. Only 3 websites scored 65 or higher epiphysial plate is usually widened due to the (14%). There was a statistically significant difference presence of an unusually large hypertrophic between website scores based on affiliation, with physician zone. This increased area of hypertrophy websites having the overall highest mean(p=0.004). effects the normal cartilaginous architecture, The average RGL was 8.67±1.8. Only two websites met making it less organised and can result in the accepted RGL criteria (9.5%) while five websites were weak areas, where slippage can occur.5 6 marked as extremely difficult to understand (23.8%). Only On history and clinical examination, the five websites offered translations (23.8%). There was no signs and symptoms of SUFE include hip pain statistically significant difference in readability scores on September 26, 2021 by guest. Protected copyright. between websites which offered translation and those with potential radiation to the knee, short- which did not. ening of the affected limb, pain on internal 2 One- sample t- tests showed that both the RGL (p<0.001; rotation and an antalgic, out-toeing gait. CI 1.83 to 3.49) and the FRES (p<0.001, CI −19.4 to −5.4) It has an overall incidence of 10.8 per 100 scores were significantly different from the accepted 000, though this may be higher in African- standard. American and Hispanic cohorts.2 7 8 Conclusion Most websites reviewed were above SUFE has become increasingly prevalent in © Author(s) (or their the recommended RGL, making content inaccessible. employer(s)) 2020. Re-use the last decade due to the epidemic of obesity Improving readability and translation services would permitted under CC BY-NC. No and the associated incline in the number of commercial re- use. See rights enhance the internet’s usability as a healthcare tool for children who fall into the 95th percentile of parents. and permissions. Published by their weight category.9 Traditionally, the age BMJ. of presentation with SUFE was in children Orthopaedic Department, Cork INTRODUCTION between 10 and 16 but over the last decade, University Hospital Group, Cork, Ireland Slipped upper femoral epiphysis (SUFE) is an the average age of presentation has dropped; important adolescent hip disorder encoun- this has been theorised to be associated with 1 2 Correspondence to tered in orthopaedic surgical practice. SUFE the faster maturation of children in modern 8 Dr Andrea Mc Carthy; Andrea. can be categorised as a Salter-Harris type society. There may or may not be a history to Mc- Carthy@ ucdconnect. ie fracture,3 characterised by the slippage of trauma. Mc Carthy A, Taylor C. BMJ Paediatrics Open 2020;4:e000782. doi:10.1136/bmjpo-2020-000782 1 Open access bmjpo: first published as 10.1136/bmjpo-2020-000782 on 20 October 2020. Downloaded from SUFE is often suspected with the presentation of Table 1 Hits returned for each search engine an acutely limping child and this diagnosis is often confirmed with clinical examination and X-ray .10 An Search engine Hits returned accurate diagnosis combined with immediate treat- Google 998 000 ment is critical to prevent complications such as avas- Bing 80 600 11 cular necrosis. Despite explanations of the condition Yahoo 140 000 and its treatment provided by the orthopaedic surgeon caring for the child, many fearful parents will turn to the internet as a ‘quasi- second opinion’.12 Previous Search strategy studies have shown that 93% of parents in Canada will As this study was done using websites on the internet have consulted the internet about their child’s symp- and did not involve any patient consent or contact, toms before they have even presented to the emergency ethical approval was not needed. In May 2020, the term department.13 14 Thus, it is of the upmost importance slipped upper femoral epiphysis was searched for using the that the information on the internet be as inclusive and three main search engines (Google, Bing and Yahoo!). accessible to parents as possible to ensure adequate The first two pages of hits from each search engine were health literacy. analysed (n=60). The reason for this set limitation was Health literacy is defined as the ‘ability to interpret that previous studies have shown that most people do and understand basic information with such competence not look beyond the first two pages of website hits and as to be able to apply the information to the enhance- that the majority of people only look at the first page of ment of health’.15 Poor standards of health literacy is hits.28 Table 1 shows the amount of hits returned for each associated with higher inpatient hospital service utilisa- search engine. tion,16 increased postoperative complications,17 reduced Duplicate websites were removed and medical jour- postoperative compliance with rehabilitation,18 missed nals, sites requiring logins or composed solely of videos appointments and lower patient satisfaction.19 The key were also excluded. This is in accordance with previous to improving health literacy is to ensure that health studies which felt that medical journals would be beyond 29 consumers have the ability to understand the materials the capacity of the majority of the population. Of the available to them.20 initial 60 websites, this left 21 webpages to undergo According to the United States Department of Health further evaluation. A breakdown of this methodology is and Human Services (USDHSS), the average American shown in figure 1. The next step in the analysis was to 20 21 categorise the websites by type; these included academic, reads at an eighth grade level or lower. Previous http://bmjpaedsopen.bmj.com/ USDHSS reports state that over 88% of Americans physician, non- physician, commercial, media and news, 29 having a level of health literacy that is incompatible social media and non-specified. Academic refers to any with understanding the surgical management of ortho- website linked to a university while physician described paedic pathologies such as SUFE, resulting in negative postoperative outcomes and high economic costs.21–23 To encourage inclusivity and accessibility, the USDHSS has recommended that health education material be written at a reading grade level (RGL) of no higher than the sixth grade.23 24 However, previous studies have shown that this level is frequently exceeded, resulting in negative health on September 26, 2021 by guest. Protected copyright. outcomes.20 23–27 Based on our literature search, we have not found any previous study which has sought to determine the acces- sibility of information about SUFE on the internet. The aim of this study, therefore, was to assess the readability of information of the internet using specific readability scoring systems and to determine the RGL of each website analysed. Considering that modern society is multicultural, we also noted the presence or absence of translation services on each website. METHODS AND MATERIALS Figure 1 Flow diagram of methodology for screening Patient and public involvement websites. Internet search flow diagram, based on the Patients and the public were not involved in the designing Preferred Reporting Items for Systematic Reviews and Meta- of this study. Analyses statement. 2 Mc Carthy A, Taylor C. BMJ Paediatrics Open 2020;4:e000782. doi:10.1136/bmjpo-2020-000782 Open access bmjpo: first published as 10.1136/bmjpo-2020-000782 on 20 October 2020. Downloaded from Table 2 Definitions for each of the eadabilityr tests used Scoring Name of test basis Description of test Formula Flesch- Kincaid Grade Developed by the Navy to assess readability of technical (11.8 × ASW) + (0.39 × ASL) Reading Grade level documents.
Load more

Recommended publications
  • Text Complexity by Dr
    Author Monographs Text Complexity By Dr. Timothy Shanahan University of Illinois at Chicago Member, National Reading Panel; President, International Reading Association, 2006 Chair, National Literacy Panel and National Early Literacy Panel It would be too costly and All texts are not equal. Some texts inconvenient to perform the above- are harder to read and comprehend. explained process for every text, of Just as there are individual differences course, so a second fundamental in children, there are individual premise of readability measurement differences in the texts that we ask is that the measure must specifically children to read. Some children summarize only text features or read better than others, and there characteristics, and not how easily are a variety of reasons for these read the text has been in the past. On differences in reading abilities. The the basis of this enumeration of text same is true of texts. Some texts are features, the formula has successfully easier or harder, and there are several predicted reader comprehension for reasons for these differences. texts. The purpose of this essay is to describe what factors Readability measures have evolved since they first cause texts to differ and to explore the relationship of appeared. Now, most readability formulas only measure text difficulty and children’s learning. two factors: word complexity and sentence complexity (Klare, 1984). Thus, measuring the readability or What makes text complex? complexity of a text involves an evaluation of the words: counting the average number of letters or syllables, Since the 1920s, there has been interest in measuring checking the frequency of the words (common words text difficulty or readability (Lively & Pressey, 1923).
    [Show full text]
  • The Lexile Framework: Unnecessary and Potentially Harmful
    The Lexile Framework: Unnecessary and Potentially Harmful Stephen Krashen CSLA (California School Library Association) Journal 24(2): 25-26, 2001 The Lexile Framework attempts to solve a problem that doesn't exist. It is a readability formula that "stands firmly in the tradition of classic readability formulas" (Stenner, 1996, p. 23) that assigns reading levels to texts based on word frequency and sentence length. The Lexile Framework is intended to help teachers and librarians recommend supplementary reading that is at the right reading level: "For example, an eighth-grade girl who is interested in sports but is not reading at grade level might be able to handle a biography of a famous athlete. The teacher may not know, however, whether that biography is too difficult or too easy for the student. " All the teacher has to do is use the Lexile Framework on the text and the student and select a book at the right level. Then, "as the reader improves, new titles with higher text measures can be chosen to match the growing person (sic) measure, thus keeping the comprehension rate at the chosen level." (Stenner, 1996, p. 22). Not Necessary None of this is necessary, and it is probably harmful. There is a much easier way for readers to select texts: Are they comprehensible and interesting? It doesn't take long for a reader to determine this: All it takes is sampling a little of the text (reading it). Our eighth grader simply needs to have a look at a few biographies. Teachers and librarians can certainly help in text selection and they do this all the time, with great success.
    [Show full text]
  • How to Check a Readability Score with Microsoft Word
    How to Check a Readability Score with Microsoft Word Step 1: Open your Informed Consent document in Word. Step 2: Look at the top tool bar and click “Review.” It should the ninth option at the top in Word 365. Step 3: Click “Check Document” or “Spelling Check.” It should be on the right at the very top with the image of a green check mark and the letters ‘abc’. Step 4: A small window should pop up that reads “Readability Statistics,” like the one to the right. *If this window does not automatically pop up for you, try these steps: (1) Go to “File,” then “Options.” (2) Select “Proofing.” (3) Under “When correcting spelling and grammar in Word,” make sure the “Check grammar with spelling” check-box is selected. (4) Select “Show readability statistics.” (5) Try starting over with Step 2. If you still can’t get the readability statistics to show, please click the help button in the top tool bar for step-by-step instructions on how to enable this feature. Step 5: “Flesh-Kincaid Grade Level” in this window is the number the IRB is concerned with regarding readability for the population you are studying. Guidelines - Any population that requires an advanced degree (2-year degree or more) must have a reading level of 12.0 or below. - Children or other special populations (the elderly, prison inmates, etc.) must have a reading level of 3.0 or below. - The general public or any other population that does not fit into the other two categories must have a reading level of 8.0 or below.
    [Show full text]
  • Smog Readability Formula
    The Smog Readability Formula Adapted from McLaughlin, G. (1969). SMOG grading: A new readability formula. Journal of Reading, 12 (8). 639-646. The SMOG conversion tables were developed by Harold C. McGraw, Office of Educational Research, Baltimore Co. Public Schools, Towson, MD. The SMOG Readability Formula is a simple method you can use to determine the reading level of your written materials. If a person reads at or above a grade level, they will understand 90-100% of the information. Generally, you need to aim for a reading level of sixth grade or less. In addition, to ensure that the text is clear and readable, read your draft aloud. How to use the SMOG formula: 1. Count 10 sentences in a row near the beginning of your material. Count 10 sentences in the middle. Count 10 sentences near the end. (30 total sentences) 2. Count every word with three or more syllables in each group of sentences, even if the same word appears more than once. 3. Add the total number of words counted. Use the SMOG Conversion Table I to find the grade level. If your material has fewer than 30 sentences, follow the instructions for "SMOG on Shorter Passages" and use SMOG Conversion Table II. Word Counting Rules: • A sentence is any group of words ending with a period, exclamation point, or question mark. • Words with hyphens count-as-one-word. • Proper nouns are counted. • Read numbers out loud to decide the number of syllables. • In long sentences with colons or semicolons followed by a list, count each part of the list with the beginning phrase of the sentence as an individual sentence.
    [Show full text]
  • Generating and Rendering Readability Scores for Project Gutenberg Texts
    Generating and Rendering Readability Scores for Project Gutenberg Texts Ronald P. Reck RRecktek LLC. [email protected] and Ruth A. Reck University of California Davis, CA 95616 U.S.A. [email protected] Abstract Here the frequency distribution functions have been calculated for seven different types of readability measurements for over fourteen thousand texts from Project Gutenberg1 (PG). Other supporting measurements were also obtained: the average characters per word, the words per sentence, and the syllables per word. Three types of distributions have been demonstrated from the analysis of the metadata. While there are similarities among some of the scores, there is considerable interpretation yet to be made. The most complex and unique distribution function is found for the Flesch Reading Ease scores. Because of the computing intensity necessary to obtain these distributions it is only in the present age of information science that such a broad brush of characterization of a billion word data source can be made. It is essential that these be sorted by language to better interpret the meaning of the distributions. 1. Introduction Various readability measurements can serve as indicators to quantify the relative accessibility of written information. However, domain specific attributes such as complex terminology or language can direct readability scores towards higher values than the actual complexity of the text warrants. For instance, scientific writing is likely to contain long words that may not significantly increase the complexity of the writing to those familiar with the terms but make the readability value appear greater. Despite this and other limitations, readability measurements remain useful attributes for describing text, especially when the values are regarded as relative measurements from within a specific type of writing or language.
    [Show full text]
  • Readability Level Reading Formulas
    Tool 13. Assessing Readability Level Reading Formulas Readability measures are primarily based on factors such as the complexity of the printed materials by measuring the number of words in the sentence and the number of letters or syllables per word (i.e., as a reflection of word frequency.) A “score” reflects the grade level of the printed material. • The Flesch Reading Ease The Flesch Reading Ease is one of the oldest and most accurate formulas. It is a simple approach to assess the grade-level of the reader. • The Fry Graph Readability Formula Edward Fry developed readability tests based on graph. This graph-based test determined readability through high school. In 1977, Fry extended the graph to test through the college years. • The SMOG Readability Formula This is a simple method used to determine the reading level of written materials. The SMOG Readability Formula was developed by Harold C. McGraw. These formulas can be helpful but should not be your only evaluation tool because reading level is only one aspect of readability, and readability formulas are not always accurate with forms that have short sentences or phrases. The Flesch Reading Ease Readability Formula The specific mathematical formula is: RE = 206.835 – (1.015 x ASL) – (84.6 x ASW) RE = Readability Ease ASL = Average Sentence Length (i.e., the number of words divided by the number of sentences) ASW = Average number of syllables per word (i.e., the number of syllables divided by the number of words.) The output, i.e., RE is a number ranging from 0 to 100.
    [Show full text]
  • A Text Readability Continuum for Postsecondary Readiness
    Volume 19 ✤ Number 4 ✤ Summer 2008 ✤ pp. 602–632 A Text Readability Continuum for Postsecondary Readiness Gary L. Williamson North Carolina Department of Public Instruction Over the last 3 decades, a number of authors claimed that too many students were unprepared for the postsecondary world (e.g., Bock & Moore, 1986; Greene & Forster, 2003; Sum, 1999; oU.S. Department of Labor, 1991). To support this contention, some reports focused on student behaviors and attainments, such as high school dropout rates and/or graduation rates (e.g., Greene & Forster, 2003; Horn, 1998). Some focused on anal- ogous later events, such as the rates at which college students require remediation or fail to complete their programs of study (Parsad & Lewis, 2003; Rosenbaum, 2004). Others focused on the skill demands of the workplace in contrast to what stu- dents have been taught in school (Parker, 2004; Pennsylvania Department of Education, 2004). Still others focused on the literacy demands of citizenship (Kirsch, Jungeblut, Jenkins, & Kolstad, 1993). Traditional indicators of college readiness have included college transcripts, student course completions, and student performance (McCormick, 1999; Sanderson, Dugoni, Rasinski, Taylor, & Carroll, 1996). However, no one has examined the text demands of high school in contrast to those of college, the workplace, the mili- 602 Copyright © 2008 Prufrock Press, P.O. Box 8813, Waco, TX 76714 Although high school graduates may be able to successfully navigate high school course content, they may not be prepared to handle the readability of texts they encounter in various postsecondary endeavors. The average readability of high school texts is lower than the average readability of citizenship, workplace, community college, university, and graduate admissions text collections.
    [Show full text]
  • ARTICLES Readability, Logodiversity, and the Effectiveness of College
    ARTICLES Readability, Logodiversity, and the Effectiveness of College Science Textbooks Rebecca S. Burton Department of Biology, Alverno College, PO Box 343922, Milwaukee, WI 53234-3922 [email protected] Abstract: Textbooks are required in most introductory college science courses, but students may not be benefitting from the textbooks as much as their instructors might hope. Word use in the textbooks may influence textbook effectiveness. I tested whether either the amount of technical vocabulary or the readability had a significant effect on students’ ability to learn general biology concepts. I provided different versions of the same reading, then tested students on the content. On the topic with the lowest overall post-reading quiz scores, students who received readings with less technical vocabulary outperformed their peers (P = 0.03). Textbooks did not appear to be an important source of learning for students in this study; fewer than half the students reported that they were reading the assigned chapters near the start of the semester, and this number declined sharply. Students had difficulty correctly answering questions immediately after reading brief selections, indicating a low level of comprehension. Changes in textbooks and teaching strategies may improve student learning and reading compliance. Key words: readability, logodiversity, textbooks INTRODUCTION these grade level scores are based on length of Unless students can learn from their textbooks, sentences and length of words. These indices are there is little purpose in requiring them. generally intended for use in evaluating materials for Overwhelmingly, introductory college science K-12 schools or for the general public. Making courses use textbooks, but questions remain about sentences shorter and simpler will result in a lower what aspects of the actual prose result in greater grade level score, but may not make college biology student learning of scientific concepts.
    [Show full text]
  • Simply Put: a Guide for Creating Easy-To-Understand Materials
    Simply Put A guide for creating easy-to-understand materials What’s in this guide? Communication that is Clear and Understandable………………................................3 Where this Guide Fits into an Overall Communication Plan…………………….......4 Make Your Message Clear ........................................... ..............................................5 Text Appearance Matters ……….............. .................................................................9 Visuals Help Tell Your Story ....................................................................................10 Layout and Design………………………………….................................................17 Consider Culture…………………………...………………………………….…….23 Translations Take Your Message Further ..................................................................25 Testing for Readability ...............................................................................................27 Appendix A - Checklist for Easy-to-Understand Print Materials...............................29 Appendix B - Resources for Communication Planning .............................................30 Appendix C - Formulas for Calculating Readability .................................................31 Appendix D - Resources ............................................................................................38 Acknowledgements………………………………………………………………….43 Strategic and Proactive Communication Branch Division of Communication Services Office of the Associate Director for Communication Centers for Disease Control
    [Show full text]
  • The Principles of Readability
    The Principles of Readability By William H. DuBay Impact Information, 126 E. 18th Street, #C204, Costa Mesa, CA 92627, (949) 631-3309 Copyright The Principles of Readability 25 August 2004 2004 William H. DuBay. All Rights Reserved. Abstract The Principles of Readability gives a short history of literacy studies in the U.S. and a short history of research in readability and the readability formulas. Readers' Comments Please send all comments and suggestions regarding this document to: William DuBay Impact Information 126 E. 18th Street, #C204 Costa Mesa, CA 92627 Phone: (949) 631-3309 Email: [email protected] Website: http://www.impact-information.com Copyright © 2004 William H. DuBay Page ii Contents Introduction ..........................................................................................................1 Guidelines For Readability..........................................................................2 The readability formulas..............................................................................2 Are the readability formulas a problem? .....................................................2 What is readability?.....................................................................................3 Content ........................................................................................................3 The Adult Literacy Studies...................................................................................4 Grading the reading skills of students..........................................................4
    [Show full text]
  • Smart Language: Readers, Readability, and the Grading of Text 25 January 2007 © 2007 William H
    Smart Language Readers, Readability, and the Grading of Text William H. DuBay Impact Information Costa Mesa, California Copyright Smart Language: Readers, Readability, and the Grading of Text 25 January 2007 © 2007 William H. DuBay. All Rights Reserved. Abstract Smart Language gives a brief introduction to the adult literacy sur‐ veys and the research on readability and the readability formulas. Readersʹ Comments Please send all comments and suggestions regarding this document to: William DuBay Email: bdubay@impact‐information.com Website: http://www.impact‐information.com ISBN: 1‐4196‐5439‐X To George R. Klare 1922—2006 Teacher, writer, scientist, and friend Contents Introduction...............................................................................................................1 Writing for the Right Audience................................................................1 Writing for the Wrong Audience .............................................................2 What Is a Reading Grade Level? ..............................................................4 What is Readability? ..................................................................................4 The Readability Formulas .........................................................................6 How This Book is Organized....................................................................7 Part 1 How People Read ........................................................................................10 Chapter 1 The Adult Literacy Surveys .........................................................12
    [Show full text]
  • And Others TITLE the Dolch Basic Sight Vocabulary Investigation: a Replication and Validation
    DOCUMENT RESUME ED 094 329 CS 001 219 AUTHOR Johns, Jerry L.; And Others TITLE The Dolch Basic Sight Vocabulary Investigation: A Replication and Validation. PUB DATE 74 NOTE 30p.; Research study done at the Reading Clinic, Northern Illinois University EDRS PRICE MF-$0.75 HC-$1.85 PLUS POSTAGE DESCRIPTORS Basic Reading; *Beginning Reading; Readability; Reading; Reading Materials; *Reading Research; Reading Skills; *Sight Vocabulary; *Word Lists IDENTIFIERS *Dolch Word List ABSTRACT This study replicated and validated the Dolch basic sight vocabulary investigation. Dolch's method of compiling his list of 95 nouns was also replicated. Some discrepancies were found between the replication study and Dolch's investigations--a few words were left off the lists, although they apparently met all ..he criteria for inclusion, and a lack of consistency was noted in Dolch's choices for including words or his lists. It was concluded that pseudo-empirical is a correct description of Dolch's method in compiling his basic sight vocabulary. It was also determined that this list is still viable since it accounts for over 50 percent of the words currently used in reading materials for both children and adults. (Author) Y U.S DEPARTMENT OF HEALTH, EDUCATION A WELFARE NATIONAL INSTITUTE OF EDUCATION THIS DOCUMENT HAS BFEN REPRO DUCE[' E"ACTLY AS RECEIVED FROM THE PERSON OP ORGANIZATION ORIGIN ATING IT POINTS OF VIEW OR OPINIONS STATED DO NOT NECESSARILY REPRE SENT OFFICIAL NATIONAL INSTITUTE OF EDUCATION POSPION OR POLICY BEST COPY AVAILABLE The Dolch Basic Sight Vocabulary Investigation: A Replication and Validation Jerry L. Johns, Rose M.
    [Show full text]