Background
Patients and carers increasingly access the Internet as a source of health information.
Poor health literacy is extremely common and frequently limits patient's comprehension
of health care information literature. We aimed to assess the readability of online
consumer-orientated stroke information using 2 validated readability measures.
Methods
The 100 highest Google ranked consumer-oriented stroke Web pages were assessed for
reading difficulty using the Flesch–Kincaid and Simple Measure of Gobbledygook (SMOG)
formulae.
Results
None of the included Web pages complied with the current readability guidelines when
readability was measured using the gold standard SMOG formula. Mean Flesch–Kincaid
grade level was 10.4 (95% confidence interval [CI] 9.97-10.9) and mean SMOG grade
12.1 (95% CI 11.7-12.4). Over half of the Web pages were produced at graduate reading
levels or above. Not-for-profit Web pages were significantly easier to read (P = .0006). The Flesch–Kincaid formula significantly underestimated reading difficulty,
with a mean underestimation of 1.65 grades (95% CI 1.49-1.81), P < .0001.
Conclusions
Most consumer-orientated stroke information Web sites require major text revision
to comply with readability guidelines and to be comprehensible to the average patient.
The Flesch–Kincaid formula significantly underestimates reading difficulty, and SMOG
should be used as the measure of choice.
Key Words
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Article info
Publication history
Published online: January 06, 2014
Accepted:
November 19,
2013
Received in revised form:
October 20,
2013
Received:
May 13,
2013
Footnotes
Sources of funding: None.
Disclosures: None.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.017
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
