Readability of pediatric otolaryngology information by children's hospitals and academic institutions

Objectives/Hypothesis: Evaluate the readability of pediatric otolaryngology–related patient education materials from leading online sources. Study Design: Cross-sectional analysis. Methods: All pediatric otolaryngology–related articles from the online patient health libraries of the top 10 US News & World Report-ranked children's hospitals, top 5 Doximity-ranked pediatric otolaryngology fellowships, and the American Academy of Otolaryngology–Head and Neck Surgery were collected. Each article was copied in plain text format into a blank document. Web page navigation, appointment information, references, author information, appointment information, acknowledgements, and disclaimers were removed. Follow-up editing was also performed to remove paragraph breaks, colons, semicolons, numbers, percentages, and bullets. Readability grade was calculated using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, Gunning-Fog Index, Coleman-Liau Index, Automated Readability Index, and Simple Measure of Gobbledygook. Intraobserver and interobserver reliability were assessed. Results: A total of 502 articles were analyzed. Intraobserver and interobserver reliability were both excellent, with an intraclass correlation coefficient of 0.99 and 0.96, respectively. The average readability grade across all authorships and readability assessments exceeded the reading ability of the average American adult. Only 142 articles (28.3%) were written at or below the reading ability of the average American adult, whereas the remaining 360 articles (71.7%) were written above the reading level of the average adult. Conclusions: Current online health information related to pediatric otolaryngology may be too difficult for the average reader to understand. Revisions may be necessary for current materials to benefit a larger readership. Level of Evidence: NA Laryngoscope, 127:E138–E144, 2017.