Readability of patient-reported outcome questionnaires for use with persons who stutter

Objective: The purpose of this study was to examine the readability of several published patient-reported outcome (PRO) questionnaires for use with persons who stutter, and to compare the readability results to existing data about average reading levels for English-speaking adults living in the United States. Design: Published PRO questionnaires were identified that are traditionally completed by persons who stutter in a self-administered format. Method: Reading grade levels were analyzed using the Flesch Reading Ease, FOG, and FOR-CAST formulas as computed by a readability calculations software package. Descriptive statistics were computed across the questionnaires. Results: The results of this study demonstrate that many of the PRO questionnaires exceeded the fifth to sixth grade reading levels recommended by health literacy experts. Conclusions: The clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or their proxy. Likewise, developers of PRO questionnaires should consider reading level of respondents and include information about this when reporting psychometric data. Educational objectives: The reader will get an overview over the literature on patient-reported outcome (PRO) questionnaires and their use with persons who stutter and will be able to: (1) define readability, (2) describe how reading levels are determined for a given PRO questionnaire, (3) list the strengths and limitations of readability assessment in the evaluation of persons who stutter and (4) analyze the role of readability assessment in future PRO questionnaire development. (C) 2011 Elsevier Inc. All rights reserved.