1363 Assessing the Readability of Patient Education Materials for Common Neurosurgical Conditions

INTRODUCTION: Adequate understanding of health information is a stronger determinant of health than several demographic factors including age, income, or employment status. However, existing neurosurgical patient education materials (PEMs) may be too complex for the average American that reads at an eighth-grade level and may contribute to poor health literacy. METHODS: Neurosurgical PEMs pertaining to stroke, laminectomy, pituitary tumors, epilepsy, and hydrocephalus published by the top 100 US hospitals as ranked by the U.S. News Health Report were collected. All PEMs were assessed, and common measures of reading level and difficulty were generated including: Flesch Kincaid Grade Level, Flesch Reading Ease (FRE), Gunning Fog Index (GFI), Automated Readability Index (ARI), Coleman-Liau Index, and the SMOG index readability score. RESULTS: The mean FRE score for PEMs on all 5 common neurosurgical conditions (stroke, laminectomy, pituitary tumors, epilepsy and hydrocephalus) were significantly greater than corresponding scores for an 8th-grade reading level (p<0.001). The mean Kincaid value ranged from 8.38 - 12.49. The mean ARI ranged from 10.25 - 14.30 across conditions. Mean Coleman-Liau scores range from 11.26 - 14.08. The mean GFI and SMOG Index ranged from 10.68 - 15.43 and 10.19 - 13.21, respectively. All mean scores were significantly greater than an 8th-grade reading level (p<0.01). CONCLUSIONS: Existing PEMs published by the top U.S. hospitals for common neurosurgical conditions may be too complicated for the average American that reads at an eighth-grade level. PEMs may not achieve the intended goal of health literacy and could be rewritten to better meet patient needs.