Readability of patient education materials in radiation oncology – are we improving?

Abstract Introduction Prior research suggests that patient education materials for radiotherapy from various professional groups are written at reading levels above national recommendations of sixth- to eighth-grade. Since publication of these initial findings, many materials from these sources have been updated or newly created. However, the extent to which readability was considered in the design of these new documents remains unknown. Therefore, the goal of this investigation was to evaluate readability of online education materials for radiotherapy, comparing readability of updated materials with those included in the previous study. Methods Patient education materials related to radiation oncology were identified from websites of the three professional societies used in the original investigation (ACR, ACS, ASTRO). The documents included in the first analysis were used as a comparator. In order to allow for accurate evaluation across groups, materials were matched by content; when necessary, documents were combined from the original cohort to create topically equivalent materials to reflect those currently available on society websites. Identified materials were analyzed using seven validated readability indices and results are reported in grade level equivalents. Original materials were also reanalyzed with the same method. Results ACS materials had the lowest average baseline levels (9.4-11.3 grade level) and also showed improved readability in the more recent materials (8.0-10.5 grade level). By contrast, the ASTRO materials had high average baseline readability levels (11.1-13.9 grade level) that actually worsened in the more recent materials (11.7-16.2 grade level). The number of documents meeting national recommendations did not improve in the updated cohort. Conclusion Despite evidence that readability levels of patient education materials in radiation oncology are unacceptably high, the readability of newly created materials is not consistently improving across professional societies. While certain groups may incorporate readability in the design of educational documents, more consistent consideration across all organizations is needed.