Written by Peter Liu
Spoon Feed
Altering patient health information to lower grade reading levels did not affect knowledge or patient perception of the information in the Readability Study RCT.
Keep your college degrees! No clear benefit writing to a lower grade level
Reacting to several US, UK, and Australian guidelines recommending that health information be written for a specific grade level, this RCT investigated whether lowering the grade reading level of written English health information improves patient knowledge, perceived reading ease, acceptability, and trustworthiness. Conducted online in Australia, 2,235 participants were randomized into four groups receiving prepared patient education materials on sciatica at grade 8, 10, 12, or 14 reading levels (SMOG readability index). Participants were subsequently tested on the material and given questionnaires to determine the secondary measures of participant perception of the material. No significant differences in knowledge scores or any other outcomes were found. These findings are generally good news for clinicians on the ground. They suggest that we can continue to focus on other aspects of our writing and communication (e.g. clarity, accuracy, empathy, etc.) rather than write to a specific grade level. However, the findings are based on a contrived environment (online medical study of a specific pain disorder), and were performed in a panel of participants with fairly high literacy (e.g. 47% had college degrees, all had internet access, and all could read independently). Therefore, the findings do not easily generalize to patients with a lower reading level than participants in this study.
How does this change my practice?
Ultimately, patient health literature should be individualized and written as clearly as possible. This study reassures me that for most patients with average-or-above reading levels, I can focus on substance and not style – especially if my writing style is within an 8-14 grade level.
Source
The Readability Study: A Randomised Trial of Health Information Written at Different Grade Reading Levels. J Gen Intern Med. 2024 Dec 20. doi: 10.1007/s11606-024-09200-z. Epub ahead of print. PMID: 39707098
