Readability assessment of patient educational materials for pediatric spinal deformity from top academic orthopedic institutions

Study design Cross-sectional analysis of patient educational materials from top pediatric orthopedic hospital websites. Objective To assess the readability of online educational materials of top pediatric orthopedic hospital websites for pediatric spinal deformity. Summary of background data The internet has become an increasingly popular source of health information for patients and their families. Healthcare experts recommend that the readability of online education materials be at or below a 6(th)-grade reading level. However, previous studies have demonstrated that the readability of online education materials on various orthopedic topics is too advanced for the average patient. To date, the readability of online education materials for pediatric spinal deformity has not been analyzed. Methods Online patient education materials from the top 25 pediatric orthopedic institutions, as ranked by the U.S. News and World Report hospitals for pediatric orthopedics, were accessed utilizing the following readability assessments: Flesch-Kincaid (FK), Flesch Reading Ease, Gunning Fog Index, Coleman-Liau Index, Simple Measure of the Gobbledygook Index (SMOG), Automated Readability Index, FORCAST, and the New Dale and Chall Readability. Correlations between academic institutional ranking, geographic location, and the use of concomitant multi-media modalities with FK scores were evaluated using a Spearman regression. Results Only 48% (12 of 25) of top pediatric orthopedic hospitals provided online information regarding pediatric spinal deformity at or below a 6(th)-grade reading level. The mean FK score was 9.0 +/- 2.7, Flesch Reading Ease 50.8 +/- 15.6, Gunning Fog Score 10.6 +/- 3.1, Coleman-Liau Index 11.6 +/- 2.6, SMOG index 11.7 +/- 2.0, Automated Readability Index 8.6 +/- 2.8, and Dale-Chall Readability Score 6.4 +/- 1.4. There was no significant correlation between institutional ranking, geographic location, or use of multimedia with FK scores. Conclusion Online educational material for pediatric spinal deformity from top pediatric orthopedic institutional websites are associated with poor readability.