Winning Abstracts from the 2015 Medical Student AbstractCompetition: Colorectal Cancer Screening Health Education Materials- How Effective are Online Education Sources?

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 understanding.

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 tests.

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.

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