Readability of Online Patient Education Materials for Hallux Rigidus

BackgroundPatients frequently turn to online resources to better understand their diagnoses and treatment options. While prior research has shown that orthopaedic patient education materials (PEMs) often exceed the recommended reading level, little is known about the readability of information specifically related to foot and ankle conditions. This study aimed to assess whether online PEMs for Hallux Rigidus are written at or below the recommended sixth-grade reading level. We hypothesized that the readability of these materials would exceed this threshold.MethodsA Google search was conducted using the terms "Hallux Rigidus patient information" and "Big Toe Arthritis patient information." The first 25 websites from each search were analyzed. The Readability Scoring System Plus was used to assess the Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, SMOG Index, Automated Readability Index, and Linsear Write scores. Descriptive statistics were reported.ResultsFor "Hallux Rigidus patient information" and "Big Toe Arthritis patient information" respectively, the results were: Average Reading Level 10.2 (±1.7) and 10.3 (±1.9), Flesch-Kincaid Reading Ease score 9.95 (±2.3) and 10.1 (±2.7), Gunning Fog score 54.6 (±10.9) and 55.6 (±11.5), Flesch-Kincaid Grade Level 11.4 (±1.7) and 11.2 (±1.8), Coleman-Liau 9.41 (1.9) and 9.39 (2.3), SMOG 11.1 (2.0) and 11.1 (2.0), Automated Readability Index 9.17 (1.5) and 9.28 (1.7), and Linear Write 74.5 (7.8) and 74.4 (7.9). None of the analyzed PEMs met the recommended sixth-grade reading level. Of the 50 websites reviewed, 11 provided general health information. No significant difference was found in readability between clinical practice patient information and general health information.ConclusionAccessible and appropriately written PEMs are crucial for improving health literacy and ensuring patients understand their diagnoses and treatment options. Our findings indicate that online information about Hallux Rigidus is written at a level too advanced for the average patient, highlighting the need for more readable resources.Levels of Evidence:IV.

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Publication Details

Journal
Foot & Ankle Specialist
Published
2025-11-25
DOI
https://doi.org/10.1177/19386400251388030
Primary Topic
Health Literacy and Information Accessibility
Type
article
Field-Weighted Citation Impact
0.00
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article

Readability of Online Patient Education Materials for Hallux Rigidus

Selene G. Parekh, Mark A. Miller, David I. Pedowitz, Joseph A.S. McCahon et al.
Foot & Ankle Specialist
Health Literacy and Information Accessibility
article

Readability of Online Patient Education Materials for Hallux Rigidus

Selene G. Parekh, Mark A. Miller, David I. Pedowitz, Joseph A.S. McCahon, Adam J. Lencer, Joseph N. Daniel, Adam Kohring
article en

Abstract

BackgroundPatients frequently turn to online resources to better understand their diagnoses and treatment options. While prior research has shown that orthopaedic patient education materials (PEMs) often exceed the recommended reading level, little is known about the readability of information specifically related to foot and ankle conditions. This study aimed to assess whether online PEMs for Hallux Rigidus are written at or below the recommended sixth-grade reading level. We hypothesized that the readability of these materials would exceed this threshold.MethodsA Google search was conducted using the terms "Hallux Rigidus patient information" and "Big Toe Arthritis patient information." The first 25 websites from each search were analyzed. The Readability Scoring System Plus was used to assess the Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, SMOG Index, Automated Readability Index, and Linsear Write scores. Descriptive statistics were reported.ResultsFor "Hallux Rigidus patient information" and "Big Toe Arthritis patient information" respectively, the results were: Average Reading Level 10.2 (±1.7) and 10.3 (±1.9), Flesch-Kincaid Reading Ease score 9.95 (±2.3) and 10.1 (±2.7), Gunning Fog score 54.6 (±10.9) and 55.6 (±11.5), Flesch-Kincaid Grade Level 11.4 (±1.7) and 11.2 (±1.8), Coleman-Liau 9.41 (1.9) and 9.39 (2.3), SMOG 11.1 (2.0) and 11.1 (2.0), Automated Readability Index 9.17 (1.5) and 9.28 (1.7), and Linear Write 74.5 (7.8) and 74.4 (7.9). None of the analyzed PEMs met the recommended sixth-grade reading level. Of the 50 websites reviewed, 11 provided general health information. No significant difference was found in readability between clinical practice patient information and general health information.ConclusionAccessible and appropriately written PEMs are crucial for improving health literacy and ensuring patients understand their diagnoses and treatment options. Our findings indicate that online information about Hallux Rigidus is written at a level too advanced for the average patient, highlighting the need for more readable resources.Levels of Evidence:IV.

Foot & Ankle Specialist
Thomas Jefferson University Hospital (US), Stratford University (US), Rothman Orthopaedics (US)
Openalex Percentile: Top 47%
Health Literacy and Information Accessibility
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