Improving patient education resources could advance understanding of radiology’s importance

Revising written articles on to comply with the National Institutes of Health and American Medical Association grade level recommendations could result in better patient understanding and appreciation of radiology’s application to clinical practice, according to a study published in the March issue of the American Journal of Roentgenology.

Patient involvement in healthcare has grown as the Internet increasingly becomes perceived as an authoritative and reliable source of information. However, a majority of patients are not proficiently health literate, which impedes their understanding of the information they have researched. Though guidelines specify that patient education resources should be written at a third to seventh grade level to ensure effectiveness, most professional organizations with online patient materials are written at a much higher level.

Lead author David R. Hansberry, PhD, of the University of Medicine and Dentistry of New Jersey in Newark, and colleagues assessed the readability of patient education articles from, a website jointly sponsored by the American College of Radiology and the Radiological Society of North America, using a roster of standard assessment scales. The researchers examined 138 articles with ten common readability tools.

Results revealed that only seven of the 138 articles were written at a level below 10th grade and the lowest grade level of any article was 8.7, which is well above the average reading level of Americans. The average range was between 10th and 14th grade levels, exceeding the American Medical Association and the National Institutes of Health recommendations.

“The United States Department of Health and Human Services deems any text written above a ninth grade level to be too difficult for the average American,” wrote Hansberry and colleagues. “By this standard, the overwhelming majority of the articles, judged by these various scales, were difficult.”

The authors added that "the discordance between the general reading level of the public and the level of complexity of articles in may stimulate reassessment of their appropriateness in their current iteration. If online patient information was redesigned in accordance with a simpler arrangement of words and sentences, then it is likely that a broader patient population would derive benefit from the instruction and advice it provides.”