alexa Readability evaluation of Internet-based patient education materials related to the anesthesiology field


Clinical Research on Foot & Ankle

Author(s): Gildasio S De Oliveira, Michael Jung, Kirsten J Mccaffery, Robert J McCarthy, Michael S Wolf

Abstract Share this page

Study Objective

The main objective of the current investigation was to assess the readability of Internet-based patient education materials related to the field of anesthesiology. We hypothesized that the majority of patient education materials would not be written according to current recommended readability grade level.


Online patient education materials describing procedures, risks, and management of anesthesia-related topics were identified using the search engine Google (available at using the terms anesthesia,anesthesiology, anesthesia risks, and anesthesia care.


Cross-sectional evaluation.




Assessments of content readability were performed using validated instruments (Flesch-Kincaid Grade Formulae, the Gunning Frequency of Gobbledygook, the New Dale-Chall Test, the Fry graph, and the Flesch Reading Ease score).

Main Results

Ninety-six Web sites containing Internet patient education materials (IPEMs) were evaluated. The median (interquartile range) readability grade level for all evaluated IPEMs was 13.5 (12.0-14.6). All the evaluated documents were classified at a greater readability level than the current recommended readability grade, P < .001. Readability grades were not significantly different among different IPEM sources. Assessment by the Flesch Reading Ease test classified all but 4 IPEMs as at least fairly difficult to read.


Internet-based patient education materials related to the field of anesthesiology are currently written far above the recommended readability grade level. High complexity of written education materials likely limits access of information to millions of American patients. Redesign of online content of Web sites that provide patient education material regarding anesthesia could be an important step in improving access to information for patients with poor health literacy.

This article was published in Journal of Clinical Anesthesia Home and referenced in Clinical Research on Foot & Ankle

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