(0744) The Understandability and Readability of Patient Education Materials for Xerostomia

Introduction: Most patient education materials (PEM) are written well above the average American adult reading grade levels of 7th to 8th grade. As such, ensuring that patients understand their diagnosis and treatment is of utmost importance. Xerostomia is a common pathology that can arise idiopathically or as a sequela of other head and neck treatments or diseases and may lead to a significantly lower quality of life. This study aims to identify questions patients have about xerostomia and analyze the understandability of current PEM.

Methods: “SEO minion” was used to identify the most common People Also Ask (PAA) Google search questions, from four primary search terms. PAA title, parent question and URLs were extracted. PAA questions were categorized using Rothwell’s classification into questions based on fact, value and policy. Sources that answered the questions were evaluated using the Flesch Kincaid Grade Level (FKGL) score to approximate the reading grade level, the Flesch Reading Ease (1-100) for readability, the JAMA benchmark criteria (0-4) for credibility and the Patient Education Materials Assessment Tool (PEMAT) for understandability.

Results: This analysis included 134 questions collected across four search terms. The majority of questions were value-based (55.55%) followed by fact-based (42.7%). Sources answering PAA questions were stratified by type with the majority being academic (29.91%) followed by medical or dental practice (27.35%). Mean JAMA benchmark criteria was 1.09 (1.17). Average grade reading level was 9.87 (2.83) which is higher than the recommended level of 6th grade by the American Medical Association (AMA). Average readability was 51.37 indicating the content is fairly difficult to read and the understandability was 79.92.

Conclusions: The majority of existing sources on xerostomia require vastly higher literacy than recommended. As patients increasingly seek medical information online, PEMs must be improved so more easily understood material is available. Physicians should seek out high-quality and understandable sources, such as those from government organizations.