Jorge Luis González Pérez|Zachary A. Mosher|Shawna L. Watson|Evan D. Sheppard|Eugene W. Brabston|Gerald McGwin|Brent A. Ponce
Readability of Orthopaedic Patient-reported Outcome Measures: Is There a Fundamental Failure to Communicate?
University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham
background patientreported outcome measures proms increasingly used quantify patients perceptions functional ability american medical association nih suggest patient materials written 6th 8th grade reading levels respectively yet one recent study asserts proms comply recommendations suggests majority proms written high reading level selfadministered patient use notably study limited use one readability algorithm although commonly accepted standard readability algorithm healthcarerelated materials study using multiple readability equations heeding equal weight hopes yield broader allencompassing estimate readability thereby offering accurate assessment readability orthopaedic proms questionspurposes 1 proportion orthopaedicrelated proms orthopaedicrelated portions nih patient reported outcomes measurement information system promis written 6th 8th grade levels 2 correlation number questions prom reading level 3 using systematic edits based guidelines centers medicare medicaid services proportion proms achieved american medical association nihrecommended reading levels methods eightysix 86 independent orthopaedic general wellness proms drawn commonly referenced orthopaedic websites prior studies chosen analysis additionally owing increasing use orthopaedics four relevant short forms 11 adult physical health question banks promis included analysis documents analyzed reading grade levels using 19 unique readability algorithms descriptive statistics performed using spss version 220 results majority independent proms 64 86 74 written 6th grade level 81 86 94 written 8th grade level item banks 11 11 short forms four four promis written 6th grade reading level median reading grade level 86 independent proms 50 interquartile range iqr 4661 promis question banks median reading grade level 41 iqr 3548 adult short forms median reading grade level 42 iqr 4243 correlation appreciated median reading grade level number questions contained prom r 0081 p 0460 proms nihrecommended levels following edits five five achieved nih reading level goals three three five achieved american medical association goals editing proms improved readability 43 median grade level 89 iqr 8491 46 iqr 4664 difference medians 43 p 0008 conclusions patient literacy great influence healthcare outcomes readability important consideration patientdirected written materials study found 70 proms commonly used orthopaedics orthopaedicrelated portions promis written stringent recommendations 6th grade reading level 90 independent proms promis materials written 8th grade level additionally use centers medicare medicaid services guidelines editing high reading level proms yields satisfactory results clinical relevance fears widely incomprehensible proms may unfounded future research identify appropriate readability algorithm use healthcare sector revalidation proms readabilityimproving edits warranted