Assessing Readability of Online Patient Education Materials for Spine Surgery Procedures

Increased patient reliance on Internet-based health information has amplified the need for comprehensible online patient education articles. As suggested by the AMA and NIH, spine fusion articles should be between a 4th and 6th grade readability level to increase patient comprehension, which may contribute to improved postoperative outcomes. Objective: To determine the average readability level of online healthcare education information relating to anterior cervical discectomy and fusion (ACDF) and lumbar fusion procedures. Design: Online Health-Education Resource Qualitative Analysis. Setting: Rush University Medical Center - Department of Orthopaedic Surgery. Methods: Three popular search engines were utilized to access patient education articles for common cervical and lumbar spine procedures. Relevant articles were analyzed for readability using Readability Studio Professional Edition software (Oleander Software, Ltd). Articles were stratified by organization type as follows: General Medical Websites (GMW), Healthcare Network/Academic Institutions (HNAI), and Private Practices (PP). Thirteen common readability tests were performed with the mean grade level for each readability test compared between subgroups using ANOVA analysis. Results: 79 ACDF and 231 lumbar fusion articles were determined to have a mean readability level of 10.7 ± 1.5 and 11.3 ± 1.6, respectively. GMW, HNAI, and PP subgroups had mean readability levels of 10.9 ± 2.9, 10.7 ± 2.8, and 10.7 ± 2.5 for ACDF and 10.9 ± 3.0, 10.8 ± 2.9, and 11.6 ± 2.7 for lumbar fusion articles. Of 310 total articles, only 6 (3 ACDF and 3 lumbar fusion) were written below the 7th grade reading level. Conclusions: Current online literature from medical websites containing information regarding ACDF and lumbar fusion procedures are written at a grade level higher than the suggested guidelines. Therefore, current patient education articles should be revised to accommodate the average readability level in the United States and may result in improved patient comprehension and postoperative outcomes