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Hanci V, Otlu B, Biyikoğlu AS. Assessment of the Readability of the Online Patient Education Materials of Intensive and Critical Care Societies. Crit Care Med 2024; 52:e47-e57. [PMID: 37962133 DOI: 10.1097/ccm.0000000000006121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
OBJECTIVES This study aimed to evaluate the readability of patient education materials (PEMs) on websites of intensive and critical care societies. DATA SOURCES Websites of intensive and critical care societies, which are members of The World Federation of Intensive and Critical Care and The European Society of Intensive Care Medicine. SETTING Cross-sectional observational, internet-based, website, PEMs, readability study. STUDY SELECTION The readability of the PEMs available on societies' sites was evaluated. DATA EXTRACTION The readability formulas used were the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog (GFOG). DATA SYNTHESIS One hundred twenty-seven PEM from 11 different societies were included in our study. In the readability analysis of PEM, the FRES was 58.10 (48.85-63.77) (difficult), the mean FKGL and SMOG were 10.19 (8.93-11.72) and 11.10 (10.11-11.87) years, respectively, and the mean GFOG score was 12.73 (11.37-14.15) (very difficult). All readability formula results were significantly higher than the recommended sixth-grade level ( p < 0.001). All PEMs were above the sixth-grade level when the societies were evaluated individually according to all readability results ( p < 0.05). CONCLUSIONS Compared with the sixth-grade level recommended by the American Medical Association and the National Institutes of Health, the readability of PEMs in intensive and critical care societies is relatively high. PEMs in intensive and critical care societies should be prepared with attention to recommendations on readability.
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Affiliation(s)
- Volkan Hanci
- Anesthesiology and Reanimation Department, Dokuz Eylul University, Izmir, Tukey
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Hunter D, Oates R, Anderson N, Kok D, Sapkaroski D, Wright C. Validation testing of a language translation device for suitability in assisting Australian radiation therapists to communicate with Mandarin-speaking patients. Tech Innov Patient Support Radiat Oncol 2023; 26:100207. [PMID: 37274094 PMCID: PMC10232656 DOI: 10.1016/j.tipsro.2023.100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/27/2023] [Accepted: 04/14/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Clear, timely communication between practitioners and patients is key in ensuring equitable access to health services and optimal care. Australia's linguistically diverse population adds complexity to healthcare provision. This paper describes a validation study to assess clinical suitability of a language translation device, intended for use with Mandarin speaking patients undergoing radiotherapy (RT). Materials and methods After a comprehensive device selection process, common phrases used in RT practice were curated within one clinical center and translated by interpreters. Phrases were categorized by conversation type and readability (according to Flesch-Kincaid and FORCAST scores). Validation of device performance was undertaken by purposely selected radiation therapists (RTTs) who tested and evaluated the device using a survey with 5-point Likert scale responses. Statistical analysis was undertaken on Excel using Pearson's chi-square, z-test, interrater reliability/agreement and linear regression analyses. Results Six RTTs and two interpreters volunteered to participate in this study. 188 common phrases were spoken verbatim into the device and scored on a 5-point Likert scale, yielding an overall output accuracy of 66%. A z-test confirmed significance against prior comparative research and Linear regression analysis observed improved output between consecutive participants. 62.7% of interpreter scores were identical; a further 29.1% constituted a single point scoring variation. Poorer outcomes were observed with colloquial English and lower readability. Conclusions This study found the device produced suitable translation accuracy and identified language styles that should be avoided with use. Further research could consider clinical application, expanded languages and/or health disciplines, and development of a national RTT phrase list.
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Affiliation(s)
- Darren Hunter
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Monash University, Clayton, Victoria, Australia
| | - Richard Oates
- Radiation Therapy Services, Peter MacCallum Cancer Centre Bendigo, Victoria, Australia
| | - Nigel Anderson
- Radiation Oncology, Olivia Newton-John Cancer Wellness & Research Centre, Austin Health Heidelberg, Victoria, Australia
| | - David Kok
- Department of Radiation Oncology, Peter MacCallum Cancer Centre Moorabbin, Victoria, Australia
| | - Daniel Sapkaroski
- Radiation Therapy Services Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | - Caroline Wright
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Monash University, Clayton, Victoria, Australia
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Avila S, Ruiz MJ, Petereit D, Arya R, Callender B, Hasan Y, Kim J, Lee N, McCall A, Son C, Stack K, Asif S, Besecker T, Juneja A, Li Z, Naik P, Ranka T, Saxena P, Siegfried B, Ichikawa T, Golden DW. Communicating the Gynecologic Brachytherapy Experience (CoGBE): Clinician perceived benefits of a graphic narrative discussion guide. Brachytherapy 2023; 22:352-360. [PMID: 36681540 PMCID: PMC10175118 DOI: 10.1016/j.brachy.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Many current radiotherapy patient education materials are not patient-centered. An interprofessional team developed Communicating the Gynecologic Brachytherapy Experience (CoGBE), a graphic narrative discussion guide for cylinder, intracavitary, and interstitial high-dose-rate (HDR) gynecologic brachytherapy. This study assesses perceived clinical benefits, usability, and anxiety-reduction of CoGBE. METHODS AND MATERIALS An electronic survey was sent to members of the American Brachytherapy Society. Participants were assigned to assess one of the three modality-specific CoGBE versions using a modified Systems Usability Scale (SUS), modified state-trait anxiety index (mSTAI), and Likert-type questions. Free response data was analyzed using modified grounded theory. RESULTS Median modified SUS score was 76.3 (interquartile range [IQR], 71.3-82.5) and there were no significant differences between guide types. Median mSTAI was 40 (IQR, 40-43.3) for all guides collectively. The cylinder guide had a significantly higher median mSTAI than the intracavitary and interstitial guides (41.6 vs. 40.0 and 40.0; p = 0.04) suggesting the cylinder guide may have less impact on reducing anxiety. Most respondents reported that CoGBE was helpful (72%), would improve patient understanding (77%) and consultation memorability (82%), and was at least moderately likely to be incorporated into their practice (80%). Qualitative analysis themes included personalization and relatability (positive); generalizability (negative); illustrations (both). CONCLUSIONS Clinicians rate CoGBE as usable with potential to reduce patient anxiety, especially with more invasive treatment modalities including intracavitary or interstitial high-dose-rate. CoGBE has the potential to improve patient-clinician communication for a wider range of patients due to its accessible, adaptable, and patient-centered design.
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Affiliation(s)
- Santiago Avila
- Pritzker School of Medicine, The University of Chicago, Chicago, IL
| | - María J Ruiz
- Pritzker School of Medicine, The University of Chicago, Chicago, IL
| | | | - Ritu Arya
- Texas Oncology Arlington Cancer Center North, Arlington, TX
| | - Brian Callender
- Department of Medicine, The University of Chicago, Chicago, IL
| | - Yasmin Hasan
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - Josephine Kim
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Nita Lee
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Anne McCall
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - Christina Son
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - Kate Stack
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - Sabah Asif
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Tyler Besecker
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Arushi Juneja
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Zhongyang Li
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Pinakee Naik
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Tanvi Ranka
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Prachi Saxena
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Brian Siegfried
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Tomoko Ichikawa
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Daniel W Golden
- Pritzker School of Medicine, The University of Chicago, Chicago, IL; Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL.
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Šuto J, Marušić A, Buljan I. Linguistic analysis of plain language summaries and corresponding scientific summaries of Cochrane systematic reviews about oncology interventions. Cancer Med 2023; 12:10950-10960. [PMID: 36951519 PMCID: PMC10225178 DOI: 10.1002/cam4.5825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/05/2023] [Accepted: 03/09/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Cochrane plain language summaries (PLSs) are an important format to present high-quality healthcare evidence to patients with cancer and their families. They should be written in a way everyone can understand, since they serve as a tool in decision-making and present a bridge to overcome the gap between the healthcare users and professionals. OBJECTIVE The aim of the study was to assess the language characteristics of PLSs of Cochrane systematic reviews of oncology interventions in comparison with corresponding Cochrane scientific abstracts (SAs). METHODS In this cross-sectional study, we included all Cochrane PLSs and SAs of systematic reviews of oncology interventions available in the Cochrane Database of Systematic Reviews. We assessed text readability, measured using the Simple Measure of Gobbledygook (SMOG) index, and the prevalence of words related to different language tones (clout, authenticity, emotions and analytical tones). Two independent assessors categorized the conclusiveness of the efficacy of interventions into nine categories. RESULTS The overall median SMOG index for 275 PLSs was 13.0 (95% confidence interval [CI] 12.8-13.3). Readability scores did not differ across Cochrane Review Groups. SAs had a higher readability index than the corresponding PLSs (median = 16.6, 95% CI = 16.4-16.8). Regarding linguistic characteristics, PLSs were shorter than SAs, with less use of analytical tone, but more use of a positive emotional tone and authenticity. Overall, the 'Unclear' category of conclusiveness was the most common among all PLSs. Also, PLSs with 'No evidence' conclusions were the shortest and had the lowest SMOG index. CONCLUSION PLSs of Cochrane systematic reviews of oncological interventions have low readability and most give unclear conclusions about the efficacy of interventions. PLSs should be simplified so that patients and their families can benefit from appropriate health information on evidence synthesis. Further research is needed into reasons for unclear language to describe evidence from oncology trials.
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Affiliation(s)
- Jelena Šuto
- Department of Oncology and RadiotherapyClinical Hospital Centre SplitSplitCroatia
| | - Ana Marušić
- Department of Research in Biomedicine in Health, Center for Evidence‐Based MedicineUniversity of Split School of MedicineSplitCroatia
| | - Ivan Buljan
- Department of Research in Biomedicine in Health, Center for Evidence‐Based MedicineUniversity of Split School of MedicineSplitCroatia
- Department of PsychologyUniversity of Split Faculty of Humanities and Social SciencesSplitCroatia
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5
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Avila S, Franco I, Bregio C, Haydon A, Macayan JPM, Rooney MK, Ichikawa T, Golden DW, Ortega P. Spanish Adaptation and Evaluation of Clinical Discussion Guides: Communicating the External Beam Radiotherapy Experience (CEBRE) en Español. Int J Radiat Oncol Biol Phys 2023; 116:166-175. [PMID: 36716894 DOI: 10.1016/j.ijrobp.2023.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/09/2022] [Accepted: 01/23/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE Cancer is the leading cause of death for the Hispanic/Latinx United States (US) community, which comprises 64% of the US population with limited English proficiency. Despite the common use of radiation therapy for cancer treatment, there is a dearth of radiation therapy educational materials-at appropriate reading levels-available in Spanish. To address the gap in patient-centered educational resources for communicating with Spanish-speaking patients about radiation therapy, we sought to linguistically and culturally adapt the Communicating the External Beam Radiotherapy Experience (CEBRE) clinical discussion guide series into Spanish. METHODS AND MATERIALS From January to December 2021, we developed and applied a stepwise methodology for Spanish adaptation of the discussion guides involving (1) professional translation; (2) interprofessional review for linguistic and cultural appropriateness and medical accuracy; (3) design review; and (4) evaluation for readability, understandability, and actionability using validated tools. We applied 4 indices for readability evaluation: Gilliam-Peña-Mountain, Läsbarhetsindex, Rate Index, and the Spanish Simple Measure of Gobbledygook. Two trained reviewers assessed understandability and actionability using the Patient Education Materials Assessment Tool. RESULTS After 2 revision rounds, 4 CEBRE en español discussion guides were produced through an interprofessional, iterative translation and linguistic/cultural adaptation process. Readability scores across the 4 guides ranged from 4.3 to 7.3 grade-level equivalents, thereby meeting the American Medical Association's 8th-grade standard. Patient Education Materials Assessment Tool analysis yielded near-perfect scores along understandability and actionability domains. CONCLUSIONS The stepwise linguistic/cultural adaptation process yielded a patient-centered guide that is appropriately readable, understandable, and actionable for Spanish-speaking patients receiving radiation therapy in the US. Future work should include an external evaluation of CEBRE en español by clinicians and patients. The methodology described can be applied to adapting resources for patient-centered communication in other fields of medicine and into other languages as part of an interprofessional approach to delivering equitable health care for all.
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Affiliation(s)
- Santiago Avila
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Idalid Franco
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Celyn Bregio
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Alicia Haydon
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - John Paul M Macayan
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Michael K Rooney
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tomoko Ichikawa
- Institute of Design, Illinois Institute of Technology, Chicago, Illinois
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Pilar Ortega
- Departments of Medical Education and Emergency Medicine, University of Illinois College of Medicine, Chicago, Illinois; Department of Diversity, Equity, and Inclusion, Accreditation Council for Graduate Medical Education, Chicago, Illinois.
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6
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Moon H, Lee GH, Cho YJ. Readability of Korean-Language COVID-19 Information from the South Korean National COVID-19 Portal Intended for the General Public: Cross-sectional Infodemiology Study. JMIR Form Res 2022; 6:e30085. [PMID: 35072633 PMCID: PMC8896563 DOI: 10.2196/30085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/01/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The coronavirus pandemic has increased reliance on the internet as a tool for disseminating information; however, information is useful only when it can be understood. Prior research has shown that web-based health information is not always easy to understand. It is not yet known whether the Korean-language COVID-19 information from the internet is easy for the general public to understand. OBJECTIVE We aimed to evaluate the readability of Korean-language COVID-19 information intended for the general public from the national COVID-19 portal of South Korea. METHODS A total of 122 publicly available COVID-19 information documents written in Korean were obtained from the South Korean national COVID-19 portal. We determined the level of readability (at or below ninth grade, 10th to 12th grade, college, or professional) of each document using a readability tool for Korean-language text. We measured the reading time, character count, word count, sentence count, and paragraph count for each document. We also evaluated the characteristics of difficult-to-read documents to modify the readability from difficult to easy. RESULTS The median readability level was at a professional level; 90.2% (110/122) of the information was difficult to read. In all 4 topics, few documents were easy to read (overview: 5/12, 41.7%; prevention: 6/97, 6.2%; test: 0/5, 0%; treatment: 1/8, 12.5%; P=.006), with a median 11th-grade readability level for overview, a median professional readability level for prevention, and median college readability levels for test and treatment. Difficult-to-read information had the following characteristics in common: literacy style, medical jargon, and unnecessary detail. CONCLUSIONS In all 4 topics, most of the Korean-language COVID-19 web-based information intended for the general public provided by the national COVID-19 portal of South Korea was difficult to read; the median readability levels exceeded the recommended ninth-grade level. Readability should be a key consideration in developing public health documents, which play an important role in disease prevention and health promotion.
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Affiliation(s)
- Hana Moon
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Geon Ho Lee
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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Atwood TF, Lamichhane N, Howell K, Weiss SE, Bird L, Pearson C, Joiner MC, Dominello MM, Burmeister J. Three discipline collaborative radiation therapy (3DCRT) special debate: A physicist's time is better spent in direct patient/provider interaction than in the patient's chart. J Appl Clin Med Phys 2022; 23:e13559. [PMID: 35170198 PMCID: PMC9194975 DOI: 10.1002/acm2.13559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Todd F Atwood
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, California, USA
| | - Narottam Lamichhane
- Department of Radiation Oncology, University of Maryland, Baltimore, Maryland, USA
| | - Krisha Howell
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Stephanie E Weiss
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | | | | | - Michael C Joiner
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Michael M Dominello
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jay Burmeister
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Gershenson Radiation Oncology Center, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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Quality Analysis of Online Patient Resources for Hepatocellular Carcinoma. J Clin Gastroenterol 2022; 56:64-71. [PMID: 33337639 DOI: 10.1097/mcg.0000000000001477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/30/2020] [Indexed: 12/10/2022]
Abstract
GOAL This study aims to evaluate the quality of online hepatocellular carcinoma (primary liver cancer) resources by using a validated tool to determine the strengths and limitations of hepatocellular carcinoma Web sites designed for patient education. BACKGROUND In recent years, online health information-seeking behavior has become more prevalent. Meanwhile, hepatocellular carcinoma incidence rates have also increased. However, there is currently limited literature assessing the quality of online hepatocellular carcinoma information. MATERIALS AND METHODS The term "hepatocellular carcinoma" was searched using the search engine Google and the meta-search engines Dogpile and Yippy. A validated rating tool was used to assign quality scores to 100 Web sites based on the domains of Web site affiliation, accountability, interactivity, structure and organization, readability, and content quality. Overall quality scores were tallied for all Web sites. RESULTS Noncommercial hepatocellular carcinoma Web sites received significantly higher overall quality scores compared with their commercial counterparts. Overall, 30% of the Web sites identified their author(s), 42% cited sources, and 33% were updated within the past 2 years. The majority of Web sites utilized at least 1 interactive feature and 4 structural tools. Average readability was at a grade 11.8 level using the Flesch-Kincaid grading system, which is significantly higher than the recommended grade 6 level. Definition and treatment were the most commonly covered topics, while prevention and prognosis were the least commonly covered. CONCLUSIONS The quality of online hepatocellular carcinoma information is highly variable. Health care professionals should be aware of its limitations and be proactive in guiding patients to reliable resources.
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Mailhot Vega RB, Sher DJ. ¡Aviso, Médicos!: The Effect of Direct Patient-Doctor Communication Cannot Be Overlooked. Int J Radiat Oncol Biol Phys 2021; 111:865-866. [PMID: 34655563 DOI: 10.1016/j.ijrobp.2021.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Raymond B Mailhot Vega
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida.
| | - David J Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
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Giannopoulos E, Snow M, Manley M, McEwan K, Stechkevich A, Giuliani ME, Papadakos J. Identifying gaps in consumer health library collections: a retrospective review. J Med Libr Assoc 2021; 109:656-666. [PMID: 34858098 PMCID: PMC8608165 DOI: 10.5195/jmla.2021.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The objective of this study was to determine if search request forms, which are used when a patron's request for information cannot be fulfilled at the time of contact with the library team, can be used to identify gaps in consumer health library collections. Case Presentation: Search request forms were collected from 2013 to 2020 and analyzed independently by two reviewers. Search request forms were included if they were complete and contained a record of how the request was fulfilled. Descriptive statistics were used to summarize patron characteristics. Search request forms were iteratively coded to identify themes in the data and determine if resources provided to patrons could be found within the library collection. The study team subsequently reviewed search request forms to determine reasons for identified gaps. Two hundred and forty-nine search request forms were analyzed. Six main content themes were identified: 1) understanding the cancer diagnosis, 2) cancer treatments, 3) understanding disease prognosis, 4) support during and after treatment, 5) natural health products and therapeutic effects in oncology, and 6) research literature. The majority of patrons were patients (53%). Over half (60%) of the submitted search request forms reflected collection gaps, and many (16%) contained queries for information about rare cancer diagnoses. The main reason that queries could not be satisfied was that there was limited consumer health information on the requested topics (53%). Conclusions: Search request forms are a useful resource for assessing gaps in consumer health library collections.
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Affiliation(s)
- Eleni Giannopoulos
- , Research Analyst, Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Michelle Snow
- , Librarian, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Mollie Manley
- , Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Katie McEwan
- , Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Andrew Stechkevich
- , Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Meredith Elana Giuliani
- , Radiation Oncologist, Medical Director Cancer Education, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Janet Papadakos
- , Codirector, Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre; Provincial Head, Patient Education Cancer Care Ontario; Assistant Professor, University of Toronto, Toronto, Ontario, Canada
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The readability of general practice websites: a cross-sectional analysis of all general practice websites in Scotland. Br J Gen Pract 2021; 71:e391-e398. [PMID: 33824159 PMCID: PMC8049218 DOI: 10.3399/bjgp.2020.0820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/28/2020] [Indexed: 12/01/2022] Open
Abstract
Background General practice websites are an increasingly important point of interaction, but their readability is largely unexplored. One in four adults struggle with basic literacy, and there is a socioeconomic gradient. Readable content is a prerequisite to promoting health literacy. Aim To assess general practice website readability by analysing text and design factors, and to assess whether practices adapted their website text to the likely literacy levels of their populations. Design and setting Websites for all general practices across Scotland were analysed from March to December 2019, using a cross-sectional design. Method Text was extracted from five webpages per website and eight text readability factors were measured, including the Flesch Reading Ease and the Flesch-Kincaid Grade Level. The relationship between readability and a practice population’s level of deprivation, measured using the Scottish Index of Multiple Deprivation (SIMD), was assessed. Overall, 10 design factors contributing to readability and accessibility were scored. Results In total, 86.4% (n = 813/941) of Scottish practices had a website; 22.9% (n = 874/3823) of webpages were written at, or below, the government-recommended reading level for online content (9–14 years old), and the content of the remaining websites, 77.1% (n = 2949/3823), was suitable for a higher reading age. Of all webpages, 80.5% (n = 3077/3823) were above the recommended level for easy-to-understand ‘plain English’. There was no statistically significant association between webpage reading age and SIMD. Only 6.7% (n = 51/764) of websites achieved all design and accessibility recommendations. Conclusion Changes to practice websites could improve readability and promote health literacy, but practices will need financial resources and ongoing technical support if this is to be achieved and maintained. Failure to provide readable and accessible websites may widen health inequalities; the topic will become increasingly important as online service use accelerates.
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Shirdarreh M, Aziza O, Pezo RC, Jerzak KJ, Warner E. Patients' and Oncologists' Knowledge and Expectations Regarding Tumor Multigene Next-Generation Sequencing: A Narrative Review. Oncologist 2021; 26:e1359-e1371. [PMID: 33823080 DOI: 10.1002/onco.13783] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/25/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Tumor multigene next-generation sequencing (NGS) is increasingly being offered to cancer patients to guide clinical management and determine eligibility for clinical trials. We undertook a review of studies examining the knowledge and attitudes of patients and oncologists regarding the primary results and potential secondary findings of such testing. MATERIALS AND METHODS A search was conducted through the MEDLINE database using the following keywords: "neoplasms" and "molecular sequencing / genome sequencing / tumor profiling / NGS / whole exome sequencing" and "patient / oncologist" and "knowledge / attitudes / satisfaction / experience / evaluation / perspective / practice / preference." Articles meeting the inclusion criteria and additional relevant articles from their references were selected. RESULTS From 1,142 publications identified by the search and 9 from references, 21 publications were included in the final review. Patients generally had positive attitudes toward tumor NGS despite relatively little knowledge of test-related genetics concepts, but their expectations often exceeded the reality of low clinical utility. Patients with higher education and greater genetics knowledge had more realistic expectations and a more altruistic view of the role of NGS. Attitudes toward disclosure of secondary findings were highly variable. Oncologists had poor to moderate genomic literacy; they communicated challenges with tempering patient expectations and deciding what information to disclose. CONCLUSION Patients considering undergoing tumor NGS should be provided with easily understandable resources explaining the procedure, goals, and probable outcomes, whenever possible based on evidence-based guidelines. Continuing medical education programs on this topic for oncology health care professionals should strive to improve their genomic literacy and instruct them on how to optimally present this information to their patients. IMPLICATIONS FOR PRACTICE Oncologists are increasingly offering tumor multigene testing to patients with advanced cancers to guide more "personalized" treatment and/or determine eligibility for clinical trials. However, patients often have inadequate understanding and unrealistic expectations. Oncologists must ensure that they themselves have sufficient knowledge of the benefits and limitations of testing and must provide their patients with appropriate educational resources. Prior to testing, patients should be told the likelihood of finding a mutation in their specific tumor type for which a targeted treatment or clinical trial is available. Patients also need clear information about the possibility and implications of secondary findings.
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Affiliation(s)
- Melika Shirdarreh
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Orly Aziza
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Rossanna C Pezo
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Katarzyna J Jerzak
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Ellen Warner
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
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Association Between Patient Education Videos and Knowledge of Radiation Treatment. Int J Radiat Oncol Biol Phys 2021; 109:1165-1175. [PMID: 33301819 DOI: 10.1016/j.ijrobp.2020.11.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Patient knowledge of radiation therapy (RT) before consult is typically limited, with many having misconceptions or fears. There exists a need to improve patient education in RT. Our purpose was to study the impact of patient education videos on patient-reported knowledge of RT, anxiety/fear, and satisfaction. METHODS AND MATERIALS At our institution, we created 2 RT educational videos: a general RT video and a breast cancer-specific video. Patients presenting for breast RT who agreed to participate (n = 107) were randomly assigned to receive a link to the videos (video group; n = 58) or not (no-video group; n = 49) before consultation. Pre- and postconsult surveys were administered assessing patient-reported measures on a 5-point Likert-type scale. RESULTS Patients in the video group reported significantly higher levels of confidence in their knowledge of radiation side effects, with 45.6.% at least somewhat confident versus 21.3% in the no-video group (P = .009; median on a 5-point Likert-type scale, 2 [interquartile range {IQR}, 2-3] versus 2 [IQR, 1-2], respectively [P = .012]). There was a trend toward higher knowledge of the radiation treatment process in the video group (median, 3 [IQR, 2-3] versus 2 [IQR, 2-3] for no-video group; P = .064). There were no significant differences in preconsult anxiety or fear between the groups, but of those who were assigned videos, 46.8% reported decreased anxiety afterward, and 66.0% felt more comfortable coming to a consult. While those in the no-video group hypothesized that a video would be helpful (median, 3; IQR, 3-4), those in the video group found them to be very helpful in real life (median, 4; IQR, 45; P = .0009). After the consult, all patients in both groups were satisfied. CONCLUSIONS Patient education videos increase patient-reported knowledge of RT and are found to be very helpful.
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Rooney MK, Santiago G, Perni S, Horowitz DP, McCall AR, Einstein AJ, Jagsi R, Golden DW. Readability of Patient Education Materials From High-Impact Medical Journals: A 20-Year Analysis. J Patient Exp 2021; 8:2374373521998847. [PMID: 34179407 PMCID: PMC8205335 DOI: 10.1177/2374373521998847] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Comprehensive patient education is necessary for shared decision-making. While patient–provider conversations primarily drive patient education, patients also use published materials to enhance their understanding. In this investigation, we evaluated the readability of 2585 patient education materials published in high-impact medical journals from 1998 to 2018 and compared our findings to readability recommendations from national groups. For all materials, mean readability grade levels ranged from 11.2 to 13.8 by various metrics. Fifty-four (2.1%) materials met the American Medical Association recommendation of sixth grade reading level, and 215 (8.2%) met the National Institutes of Health recommendation of eighth grade level. When stratified by journal and material type, general medical education materials from Annals of Internal Medicine were the most readable (P < .001), with 79.8% meeting the eighth grade level. Readability did not differ significantly over time. Efforts to standardize publication practice with the incorporation of readability evaluation during the review process may improve patients’ understanding of their disease processes and treatment options.
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Affiliation(s)
- Michael K Rooney
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gaia Santiago
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Subha Perni
- Harvard Radiation Oncology Program, Boston, MA, USA
| | - David P Horowitz
- Department of Radiation Oncology and Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - Anne R McCall
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
| | - Andrew J Einstein
- Division of Cardiology, Department of Medicine and Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - Reshma Jagsi
- Department of Radiation Oncology and Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
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15
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Gutiontov SI, Golden DW, McCloskey S, Shumway D, Sullivan DR, Wall TJ, Gunderson LL, Jagsi R. Informed Consent in Radiation Oncology. Int J Radiat Oncol Biol Phys 2021; 109:29-35. [PMID: 32911020 DOI: 10.1016/j.ijrobp.2020.08.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/10/2020] [Accepted: 08/31/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Stanley I Gutiontov
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Susan McCloskey
- Ronald Reagan UCLA Medical Center Department of Radiation Oncology, Los Angeles, California
| | - Dean Shumway
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Donald R Sullivan
- Department of Pulmonary and Critical Medicine, Oregon Health & Science University, Portland, Oregon
| | | | | | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
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16
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Atwood TF, Brown DW, Juang T, Moore KL, McConnell KA, Steers JM, Murphy JD, Mundt AJ, Pawlicki T. A review of patient questions from physicist-patient consults. J Appl Clin Med Phys 2020; 21:305-308. [PMID: 32519450 PMCID: PMC7484844 DOI: 10.1002/acm2.12942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 11/09/2022] Open
Abstract
Purpose To provide insight into the types of questions asked to medical physicists by patients during one‐on‐one physicist–patient consults at one institution. Materials and Methods Medical physicists trained in patient communication techniques met with patients to provide an overview of the treatment planning and delivery processes, discuss the patient's treatment plan, and answer any technical questions. From August 2016 to December 2019, 152 physicist–patient consults were conducted. In the initial months of the study (August 2016—December 2017), following each physicist–patient consult, all patient questions were documented by the physicists. For the remaining time period (January 2018—December 2019), any newly encountered questions were periodically added to the list. The questions were compiled into a comprehensive list and organized into categories. Results There were a total of 88 unique patient questions. These questions fit into four topical categories. Fifty‐four questions (61.4%) were in the “Treatment Planning and Delivery Questions” category, 15 questions (17.1%) were in the “General Radiation Questions or Concerns” category, 13 questions (14.8%) were in the “Safety and Quality Assurance Questions” category, and 6 questions (6.8%) were in the “Medical Questions” category. Overall, patients were primarily concerned about how radiation works, the treatment planning and delivery processes, and what is being done to keep them safe throughout their treatment. Conclusion Physicist–patient consults provided an opportunity to address the technical aspects of radiation therapy with patients in greater detail. The fact that patient questions could be conveniently grouped into only four topical categories indicates that it may be straightforward for other medical physicists to prepare for effectively addressing technical questions during physicist–patient consults.
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Affiliation(s)
- Todd F Atwood
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
| | - Derek W Brown
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
| | - Titania Juang
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
| | - Kevin L Moore
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
| | - Kristen A McConnell
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
| | - Jennifer M Steers
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
| | - James D Murphy
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
| | - Arno J Mundt
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
| | - Todd Pawlicki
- Department of Radiation Medicine & Applied Sciences, UC San Diego, La Jolla, CA, USA
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Scott BB, Johnson AR, Doval AF, Tran BN, Lee BT. Readability and Understandability Analysis of Online Materials Related to Abdominal Aortic Aneurysm Repair. Vasc Endovascular Surg 2019; 54:111-117. [DOI: 10.1177/1538574419879855] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Patients commonly use online materials as a source of health information. Since poor health literacy has been shown to correlate with negative outcomes, it is recommended that patient-directed materials be written at a sixth-grade reading level. This study evaluates the readability and understandability of commonly accessed online materials pertaining to both endovascular and open repair of abdominal aortic aneurysm. Methods: Searches for “endovascular repair abdominal aortic aneurysm” and “open repair abdominal aortic aneurysm” were performed on both Google and Bing, and the top 10 websites from each search engine were identified. Relevant websites (total N = 28, endovascular n = 15, open n = 15, and 2 redundant sites) with patient-directed content were analyzed. Readability was assessed using 9 established methods, and understandability was assessed using the Patient Education Materials Assessment Tool scoring system. Results: The average reading grade level for all sites was 12.8. Endovascular sites averaged a reading grade level of 13.6 with a range from 11.5 to 15.6. Open-repair websites had a grade-level average of 12.1 with a range from 9.9 to 14.1. Readability was found to be inversely related to understandability, with a Pearson correlation coefficient of −0.551 ( P = .003). No website was written at or below the recommended sixth-grade reading level. Conclusions: Patient-directed online health information pertaining to open and endovascular repair of abdominal aortic aneurysm exceeds the recommended sixth-grade reading level. Increasing complexity of health literature correlates with poor understandability. Modifications such as shorter sentences, fewer words with more than 6 letters, and increasing usage of clear visual aids can increase readability and understandability.
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Affiliation(s)
- Benjamin B. Scott
- Department of General Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Anna Rose Johnson
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Andres F. Doval
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Bao N. Tran
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Bernard T. Lee
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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