Readability, understandability and actionability of BAUS and EAU patient education materials for common non-oncological urological conditions

Background and AimsPatient education materials (PEMs) support patient understanding and engagement in care. This study evaluated the readability, understandability and actionability of non-oncological urological PEMs produced by the British Association of Urological Surgeons (BAUS) and the European Association of Urology (EAU), and explored agreement between human and AI-assisted PEMAT-P assessment.Methods and ResultsA cross-sectional descriptive analysis assessed eight matched PEMs relating to urinary tract infection, urinary incontinence, benign prostatic enlargement/lower urinary tract symptoms, and nocturnal polyuria. Readability was assessed using Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index. Understandability and actionability were assessed using the Patient Education Materials Assessment Tool (PEMAT-P). Mean FKGL was 11.85 ± 2.77, SMOG 13.24 ± 2.39, Gunning Fog 14.09 ± 3.22, and FRE 48.5 ± 13.32. All materials exceeded the recommended reading level. Mean PEMAT-P understandability and actionability were 91.0% and 88.3%. Human-AI item-level agreement for understandability and actionability was 83.6% and 81.8%; Cohen's κ was 0.25 and 0.23, and Gwet's AC1 was 0.79 and 0.76.ConclusionThe materials exceeded recommended reading levels despite variable PEMAT-P scores. Human vs AI differences remained, requiring further evaluation of PEMs to establish the potential role of AI as an adjunct to human PEMAT-P assessment.