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First Author: Elizabeth S. John, University of Central Florida
College of Medicine
Introduction: Colon cancer is the third most
common cause of cancer death in the United States, with
approximately 136,830 new cases being diagnosed annually. Various
diagnostic tests, such as colonoscopies, flexible sigmoidoscopies,
fecal occult blood tests (FOBT), CT colonoscopies, and virtual
colonography, are utilized to screen for and diagnose colon cancer.
The Internet has become a prominent tool patients utilize for
online health information to garner a more comprehensive
understanding of their conditions. This study investigates the
readability of online patient education articles about five common
colon cancer screening tools - colonoscopy, flexible sigmoidoscopy,
FOBT, CT colonoscopy, and virtual colonography - to determine if
they are written at a grade level that will facilitate patient
Methods: The five tests were searched online,
and the readability levels of the top twenty results for each test
were analyzed. One article was eliminated from analysis because the
text was too short. Scientific literature and articles on patient
blogs or forums were excluded as well. Ten validated readability
scales were used to measure the grade levels of each of the
articles. One-way ANOVA and Tukey Honestly Statistically Different
(HSD) post hoc analyses were performed on all the results to
determine if there were any statistically significant differences
among the readability of the literature on the five diagnostic
Results: The 99 articles were collectively
written at an 11.9 grade level, with none of the articles written
below a 7th grade level. There were significant differences among
the five categories of articles F(4,77) = 4.33, p = 0.0032 with CT
colonoscopy and virtual colonoscopy written at a more difficult
level compared to FOBT.
Conclusions and Relevance: As approximately 84
million American adults use the Internet to search for health and
medical information, with over 70% of patients reporting that the
information they garner from the Internet influences their
treatment decisions, it is imperative to investigate the
readability of online health information (2). The online articles
in this study were all written at much higher grade levels than the
NIH's and AMA's recommended 3rd to 7th grade levels (3-4). Because
online health information is becoming a more prevalent aspect of
patient care and compliance, patients could significantly benefit
from this modality of information if it were written at a level
that would facilitate understanding.
December 2015 Issue of IMpact