Catherine Arnott Smith|Scott Hetzel|Prudence W. Dalrymple|Alla Keselman
Beyond Readability: Investigating Coherence of Clinical Text for Consumers
University of Wisconsin–Madison|University of Wisconsin–Madison|Drexel University|United States National Library of Medicine
basic tenet consumer health informatics understandable health resources empower public text comprehension holds great promise helping characterize consumer problems understanding health texts need efficient ways assess consumeroriented health texts availability computationally supported tools led us explore effect various text characteristics readers understanding health texts well develop novel approaches assessing characteristicsthe goal study compare impact two different approaches enhancing readability three interventions individuals comprehension short complex passages health textparticipants 80 university staff faculty students participant asked retell content two health texts one clinical trial domain diabetes mellitus typical visit notes texts transformed intervention arms study two interventions provided terminology support via 1 standard dictionary 2 contextualized vocabulary definitions third intervention provided coherence improvement assessed participants comprehension clinical texts propositional analysis openended questionnaire analysis number errors madefor clinical trial text effect text condition significant comparisons suggesting differences recall despite varying levels support p84 visit note however difference median total propositions recalled coherent originaldictionary conditions significant p04 suggests participants coherent condition recalled original visit notes content participants original dictionary conditions combined however difference seen originaldictionary vocabulary p36 coherent vocabulary p62 statistically significant effect document transformation found either openended questionnaire clinical trial p86 visit note p20 error rate clinical trial p47 visit note p25 however post hoc power analysis suggested increasing sample size approximately 6 participants per condition would result significant difference visit note clinical trial textstatistically results study attest improving coherence small effect consumer comprehension clinical text task extremely labor intensive scalable research needed using texts diverse clinical domains heterogeneous participants including actual patients since comprehensibility clinical text appears difficult automate informatics support tools may productively support health care professionals tasked making clinical information understandable patients