Poster 307: A Standardized Method that Improves Readability of Patient Education Materials in Sports Medicine Knee Injuries

OBJECTIVES: Sports-related knee injuries such as anterior cruciate ligament (ACL) or meniscus tears are very common, and there are ample resources for knee injury-related patient education materials (PEMs). However, the anatomy, pathology, and treatment plans of knee injuries are often described in terms that are obscure to patients. While the internet has become a vast resource for medical information, online PEMs in orthopaedics have consistently been shown to be written above the NIH- recommended sixth-grade reading level to the detriment of patient health literacy. The purpose of this study is to develop a standardized method to improve readability of orthopaedic PEMs without diluting their critical content by reducing the use of complex words (>3 syllables) and shortening sentence length to <15 words. METHODS: OrthoInfo, a patient education website developed by the Academy of American Orthopedic Surgeons, was queried for PEMs relevant to the care of athletic injuries of the knee. Inclusion criteria were PEMs that were unique, pertained to topics of knee pathology in sports medicine, and written in a prose-format. Exclusion criteria were information presented in video or slideshow format, or topics not pertaining to knee pathology in sports medicine. Readability of PEMs was evaluated using seven unique readability formulas before and after applying a standardized method to improve readability while preserving critical content (reducing the use of >3 syllable words and ensuring sentence length is <15 words). Paired samples t-tests were conducted to assess the relationship between reading levels of the original PEMs and reading level of edited PEMs. RESULTS: Reading levels differed significantly between the 23 original PEMs and edited PEMs across all seven readability formulas (p<0.01). Mean Flesch Kincaid Grade Level of original PEMs (9.8±1.4) was significantly increased compared to that of edited PEMs (6.4±1.1) (p=1.9x10(-13)). 4.0% of original PEMs met NIH recommendations of a sixth-grade reading level compared to 48.0% of modified PEMs. CONCLUSIONS: A standardized method that reduces the use of >3 syllable words and ensures sentence length is <15 words significantly reduces the reading-grade level of PEMs for sports-related knee injuries. Orthopaedic organizations and institutions should apply this simple standardized method when creating PEMs to enhance health literacy.