So Difficult to Understand : Readability Index Analysis of Online Patient Information on Lymphoma from NCI- Designated Cancer Center.

Objectives - In current era of information technology, there is abundance of medical information for the patients and families. It is recommended that the online patient information (OPI) should be written no greater than sixth grade as per The National Institute of Health (NIH), American Medical Association, Department of Health & Human Services. We aim is to assess whether OPI on lymphoma from NCI-Designated Cancer Center (NCIDCC) and various cancer associations websites meet the current recommendations on a panel of readability indexes.

Methods - OPI from patient only section of NCIDCC and cancer associations websites were collected. This text was analyzed by 7 commonly used readability tests - Flesch Reading Ease score(FRE), Gunning Fog(GF), Flesch-Kincaid Grade Level(FKGL), The Coleman-Liau Index(CLI), The Simple Measure of Gobbledygook (SMOG) Index, Automated Readability Index(ARI) and Linsear Write Formula(LWF). Text from each article was pasted into Microsoft Word and analyzed using the online software Readability formulas.

Results - The mean FRE score is 55.4 (range 37.4-67.9) which corresponded to difficult level grade. The mean GF score is 12.9 (range 10.8-15.2) that comes between difficult and hard. The FKGL score is 9.9 (range 7.2-11.9) that corresponds to above the level of ninth grader.The mean CLI score is 11.09 (range 9-12) which represented text of twelfth grade. The mean SMOG index is 9.6 (range 8.1-11.1) which corresponded to greater than seventh grade level. While the mean ARI score was 10.5 (range 7.7-12.5) which represents readability suitable for people more than tenth grade. The mean LWF was 11.29 (range 7.8-14.4) that corresponds to tenth grade level of text.

Conclusion - The currently available OPI on lymphoma did not met the set national recommendations level on seven different validated readability indexes. Currently, available literature is difficult to understand and comprehend for average patient and their kins. There is a dire need to revise the currently available material for easy comprehension and understanding by the general patient population.