Matthew R. Edmunds|Alastair K. Denniston|Kristien Boelaert|Jayne A. Franklyn|Omar M. Durrani
Patient Information in Graves' Disease and Thyroid-Associated Ophthalmopathy: Readability Assessment of Online Resources
University of Birmingham|Birmingham and Midland Eye Centre|University of Birmingham|University Hospitals Birmingham NHS Foundation Trust|University Hospitals Birmingham NHS Foundation Trust|University of Birmingham|University Hospitals Birmingham NHS Foundation Trust|University of Birmingham|Birmingham and Midland Eye Centre
internet vital source information patients hoping learn disease health literacy general population known poor us department health human services usdhhs recommending patientoriented literature written fourth sixthgrade reading level optimize comprehensibility study assessed readability online literature specifically graves disease gd thyroidassociated ophthalmopathy taoreadability content top 20 englishlanguage gd patientoriented online resources top 30 equivalent tao resources returned google search analyzed web pages identified using google search terms graves disease thyroidassociated ophthalmopathy respectively extraneous text eg hyperlinks affiliations disclaimers removed relevant text proceeded readability analysis using four validated measures flesch reading ease score fleschkincaid grade level simple measure gobbledygook gunningfog index readability compared usdhhs standardsoverall median word count interquartile range iqr range 990 iqr 846 1953867 median 18 words per sentence iqr 40 7528 median flesch reading ease score 46 iqr 13 2464 fleschkincaid grade level 11 iqr 30 7217 simple measure gobbledygook 13 iqr 20 9617 gunningfog index 13 iqr 30 9219 equivalent reading level 11th grade difficult usdhhs classification none web pages evaluated readability scores accordance published guidelines significant difference country origin web page website commercial status pages predominantly focused gd taoreadability scores online gd tao patientfocused materials inferior recommended screening online material well subsequent revision crucial increase future patient knowledge satisfaction compliance