The Journal of Bone and Joint Surgery (American). 2008;90:199-204.
doi:10.2106/JBJS.G.00347
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Readability of Patient Education Materials from the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society of North America Web Sites

Sameer Badarudeen, MB, BS1 and Sanjeev Sabharwal, MD1

1 University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Doctor's Office Center, 90 Bergen Street, Suite 7300, Newark, NJ 07103. E-mail address for S. Sabharwal: sabharsa{at}umdnj.edu

Investigation performed at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: While experts recommend that the readability of patient education materials should be less than the sixth grade level, the available information pertaining to orthopaedic diseases may be excessively complex for some to read and comprehend. The Flesch-Kincaid grade level is the most widely used tool to evaluate the readability score of a given text, with a lower grade level suggesting easier readability. The goal of our study was to assess the readability of pediatric orthopaedic patient education materials that were developed by the American Academy of Orthopaedic Surgeons (AAOS) and the Pediatric Orthopaedic Society of North America (POSNA) and were accessible to the general public through the Internet.

Materials and Methods: All articles from the "Children" section of the patient education library, "Your Orthopaedic Connection," on the AAOS web site and the "Parent/Patient" section on the POSNA web site were identified. The Flesch-Kincaid grade level of each article was determined with use of Microsoft Office Word software. The mean grade levels of articles that were available in 2001 were compared with those accessible in 2007.

Results: Fifty-seven unique articles were available in 2007 on both web sites compared with twenty-five articles available in 2001. The readability score of only one (2%) of the currently available articles was less than sixth grade level. The mean Flesch-Kincaid grade level of the currently available articles was 8.9 compared with 8.7 for the articles available in 2001 (p = 0.71).

Conclusions: Our findings suggest that most of the pediatric orthopaedic patient education materials available on the AAOS and POSNA web sites have readability scores that may be too high, making comprehension difficult for a substantial portion of the United States population.


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Readability of Online Educational Material
Colin F. Moseley, M.D., et al.
JBJS Online, 7 Feb 2008 [Full text]
Dr. Sabharwal et al. respond to Dr. Moseley, et al.
Sanjeev Sabharwal, M.D., et al.
JBJS Online, 19 Mar 2008 [Full text]