Radiology reading material still too complex for all patients

Content featured on, a resource sponsored by the American College of Radiology and RSNA, is still too complex for all patients to understand, according to new findings published in the American Journal of Roentgenology.

“As more and more patients access health care information online, it is crucial that the readability of patient education materials written by leading professional societies be at an appropriate level to encourage patients to use medically accurate resources, as opposed to resources that may not be from reputable sources but may be written at an easier level,” wrote author Matthew Bange, University of Wisconsin School of Medicine and Public Health in Madison, and colleagues. “In 2012, materials found on were shown to be written at levels too high for a person with average reading skills to adequately comprehend. It is unknown whether progress has been made in the past five years.”

The researchers explored 131 educational articles available in 2017 on, using six different scales—the Flesch-Kincaid grade level, Flesch Reading Ease, Gunnin-Fog Index, Coleman-Liau Index, Automated Readability Index and the Simple Measure of Gobbledygook—to judge overall readability.

The mean readability of the content was greater than the 11th grade reading level, according to all six scales. No articles were written at less than a sixth-grade reading level, which is recommended by the American Medical Association, or an eighth-grade reading level, which is the average reading level of adults in the United States.

“These findings suggest that the readability of the articles on has not substantially changed since the original investigation performed in 2012, which reported readability between the 10th- and 14th-grade levels,” the authors wrote. “Our findings are consistent with the findings for patient education materials produced for many other medical specialties, including orthopedic surgery and oncology, which have also shown readability levels in excess of recommended levels.”

Insufficient health literacy is associated with worse patient outcomes, increased costs and longer hospitalizations. Improving the readability of this online content, Bange et al. observed, “could be an important step in improving healthcare literacy.”