441 Assessing Readability of Online Patient Educational Material on Concussion and Return to Play

INTRODUCTION: Concussions are self-limited forms of mild traumatic brain injury (TBI). Gradual return to play (RTP) is crucial to minimizing the risk of second impact syndrome. Online patient educational materials (OPEM) are often used to guide decision making. Previous literature has reported that grade-level readability of OPEM are higher than recommended by the American Medical Association (AMA) and the National Institute of Health (NIH). METHODS: An online search engine was used to identify websites providing OPEM on concussion and RTP. Text specific to concussion and RTP were extracted from each website and readability was assessed using six standardized indices- Flesch Reading Ease (FRE), Flesch-Kincaid score, Gunning Fog Index, Coleman-Liau Index, Simple Measure of Gobbledygook (SMOG) Index and the Automated Readability Index. One-way analysis of variance (ANOVA) and Tukey’s post-hoc test was used to compare readability across sources of information. RESULTS: There were 59 concussion and RTP articles, and readability levels exceeded the recommended 6th grade level, irrespective of the source of information. Academic institutions published OPEM at simpler readability levels (higher FRE scores). Private organizations published OPEM at more complex (higher) grade-level readability levels in comparison to academic and non-profit institutions (P < 0.05). CONCLUSIONS: The readability of OPEM on RTP after concussions exceed the literacy of the average American. There is a critical need to modify the concussion and RTP OPEM in order to improve comprehension by a broad audience.