Online reading material about breast lesions too advanced for many adults to understand

Online patient education materials on breast lesions requiring surgery may be too advanced for the general public to understand, according to new research published in Radiology

A team led by Randy C. Miles, MD, MPH, a breast radiologist at Massachusetts General Hospital in Boston, found that the average reading level of online education materials for breast lesions requiring surgery was above an 11th grade reading level—much higher than the sixth-grade reading level recommended by the American Medical Association for all patient education materials.  

“Online health information can be a valuable resource for patients searching for more information about their breast biopsy diagnosis, but it may lead to misinformation or confusion if the material is written at a reading level that is too complex for patients to comprehend,” Miles et al. wrote.   

The team identified websites commonly accessed for patient information on breast lesions requiring surgery, using three malignant and eight nonmalignant breast lesions that traditionally require a lumpectomy or excisional biopsy as search terms.

The researchers found nine websites with breast diagnosis information and downloaded patient education materials for each lesion from each website on May 15, 2018.  

Grade-level readability of downloaded content and associated terms for each lesion was then determined.

The average grade-level readability score of online patient education materials on breast lesions requiring surgery was 11.7, or an 11th grade reading level, according to the researchers. For specific websites, information on Wikipedia was written at the highest reading level (14.2) while information on the National Institutes of Health website was written at the lowest reading level (9.7).  

Additionally, patient education materials on malignant breast lesions were written at a higher reading level than those on nonmalignant breast lesions (12.3 versus 11.4). The grade-level readability scores on the terms “breast biopsy” (10.9), “breast cancer” (10.6) and “breast surgery” (11.1) were all written above a sixth-grade reading level.  

The researchers concluded that by addressing readability issues related to online patient educational materials as found in their study, health care providers can help reduce patient care barriers caused by low literacy—which disproportionately affects underserved groups.  

“Interdisciplinary breast care teams should focus on limiting the transition period between communication of biopsy results requiring surgery and subsequent clinical appointments; this will allow health care providers to more quickly address any questions that patients may have about their diagnosis and subsequent care,” the researchers concluded. “Increased emphasis on providing educational materials at the appropriate reading level to patients at their clinical visit may also help to counter misinformation from material encountered by patients online.”  

In an accompanying editorial, Tamara Miner Haygood, MD, PhD, a diagnostic radiologist at MD Anderson Cancer Center in Houston, also suggested that health care providers could direct patients to professional websites with easy-to-understand and accurate information they can control, such as websites belonging to professional organizations or associations. 

“At this moment, there is no one-size-fits-all solution to provide information to patients; however, if you are interested in improving your written communications, the article by Miles and colleagues is a good place to start,” Miner Haygood concluded.  

Similar research into the readability of dense breast notifications can be read here