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Mortimer Adler and Charles Van Doren's classic How to Read a Book gives useful guidance. It explains how to evaluate whether a book is worth reading. It also gives you tips for getting the most out of the books that you read. Their advice on reading also suggests some tips for better writing. Pick an important topic and say something important about it. Do your research and organize your presentation. Keep your writing clear and simple. Make clear and reasoned arguments and anticipate the objections that your audience may raise. Above all, make sure that your title, front matter, back matter, and book cover tell the reader what your book is about and why it is worth reading. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of patients with a cochlear implant (CI) is usually an elective, complex and interdisciplinary process. As an important source of information, patients often access the internet prior to treatment. The quality of internet-based information regarding thematic coverage has not yet been analysed in detail. Therefore, the aim of this study was to analyse the information on CI care available on the internet regarding its thematic coverage and readability. Material methods: Eight search phrases related to CI care were defined as part of the study. A checklist for completeness of thematic coverage was then created for each search phrase. The current German CI clinical practice guideline and the white paper on CI care in Germany were used as a basis. As a further parameter, readability was assessed using Flesch Reading Ease Scores. The search phrases were used for an internet search with Google. The first ten results were then analysed with regard to thematic coverage, readability and the provider of the website. Results: A total of 80 websites were identified, which were set up by 54 different providers (16 providers were found in multiple entries) from eight different provider groups. The average completeness of thematic coverage was 41.6 ± 28.2%. Readability according to the Flesch Reading Ease Score was categorised as "hard to read" on average (34.7 ± 14.2 points, range: 0–72). There was a negative statistically significant correlation between the thematic coverage of content and readability (Spearman's rank correlation: r = − 0.413, p = 0.00014). Summary: The completeness of thematic coverage of information on CI care available on the internet was highly heterogeneous and had a significant negative correlation with the readability. This result should be taken into account by both the providers of internet information and by patients when using internet-based information on CI care and help to further improve the quality of web-based information. [ABSTRACT FROM AUTHOR]

BACKGROUND: Assessment of readability and reliability of online resources for orthopedic patients is an area of growing interest, but there is currently limited reporting on this topic for patellar instability (PI) and medial patellofemoral ligament reconstruction (MPFLR). METHODS: Utilizing the Searchresponse.io dataset, we analyzed inquiries related to PI and MPFLR. Readability and reliability were assessed using the Automated Reading Index, Flesch Reading Ease, and the JAMA benchmark criteria. RESULTS: Analysis of 363 frequently asked questions from 130 unique websites revealed a predominant interest in fact-based information. Readability assessments indicated that the average grade level of the resources was significantly higher than the 6th grade level and reliability varied between resources. CONCLUSION: Although the internet is an easily accessible resource, we demonstrate that PI and MPFLR resources are written at a significantly higher reading level than is recommended, and there is inconsistent reliability amongst resources with medical practice websites demonstrating the lowest reliability. [ABSTRACT FROM AUTHOR]

Purpose: This study assesses readability, suitability, and accountability of online uveitis patient education materials (PEMs). Methods: Two uveitis specialists reviewed the top 10 websites on Google for keyword "uveitis," with a PubMed review control. Readability was assessed using an online calculator, suitability using the Suitability Assessment of Materials (SAM) tool, and accountability using JAMA benchmarks. Results: The mean SAM score was 21.05, indicating that websites were on average adequately suitable to educate patients. WebMD Uveitis website scored the highest at 25.5, while allaboutvision.org scored the lowest at 18.0. The average Flesch Reading Ease (FRE) score was 44.0 (95% CI: 34.2, 53.8). The average reading grade score was 11.0 (95% CI: 9.4, 12.6). WebMD Uveitis page scored highest on readability. The average accountability score among sites was 2.36 out of 4. Conclusions: Uveitis websites are only adequately suitable as PEMs, and all are above the recommended reading level. Uveitis specialists should advise patients on quality of online PEMs. [ABSTRACT FROM AUTHOR]

Objective: Safe home tracheostomy care requires engagement and troubleshooting by patients, who may turn to online, AI‐generated information sources. This study assessed the quality of ChatGPT responses to such queries. Methods: In this cross‐sectional study, ChatGPT was prompted with 10 hypothetical tracheostomy care questions in three domains (complication management, self‐care advice, and lifestyle adjustment). Responses were graded by four otolaryngologists for appropriateness, accuracy, and overall score. The readability of responses was evaluated using the Flesch Reading Ease (FRE) and Flesch–Kincaid Reading Grade Level (FKRGL). Descriptive statistics and ANOVA testing were performed with statistical significance set to p <.05. Results: On a scale of 1–5, with 5 representing the greatest appropriateness or overall score and a 4‐point scale with 4 representing the highest accuracy, the responses exhibited moderately high appropriateness (mean = 4.10, SD = 0.90), high accuracy (mean = 3.55, SD = 0.50), and moderately high overall scores (mean = 4.02, SD = 0.86). Scoring between response categories (self‐care recommendations, complication recommendations, lifestyle adjustments, and special device considerations) revealed no significant scoring differences. Suboptimal responses lacked nuance and contained incorrect information and recommendations. Readability indicated college and advanced levels for FRE (Mean = 39.5, SD = 7.17) and FKRGL (Mean = 13.1, SD = 1.47), higher than the sixth‐grade level recommended for patient‐targeted resources by the NIH. Conclusion: While ChatGPT‐generated tracheostomy care responses may exhibit acceptable appropriateness, incomplete or misleading information may have dire clinical consequences. Further, inappropriately high reading levels may limit patient comprehension and accessibility. At this point in its technological infancy, AI‐generated information should not be solely relied upon as a direct patient care resource. [ABSTRACT FROM AUTHOR]

Background: This study assesses the quality and readability of Arabic online information about orthodontic pain. With the increasing reliance on the internet for health information, especially among Arabic speakers, it's critical to ensure the accuracy and comprehensiveness of available content. Our methodology involved a systematic search using the Arabic term for (Orthodontic Pain) in Google, Bing, and Yahoo. This search yielded 193,856 results, from which 74 websites were selected based on predefined criteria, excluding duplicates, scientific papers, and non-Arabic content. Materials and methods: For quality assessment, we used the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmarks, and the Health on the Net (HON) code. Readability was evaluated using the Simplified Measure of Gobbledygook (SMOG), Flesch Reading Ease Score (FRES), and Flesch-Kincaid Grade Level (FKGL) scores. Results: Results indicated that none of the websites received the HONcode seal. The DISCERN assessment showed median total scores of 14.96 (± 5.65), with low overall quality ratings. In JAMA benchmarks, currency was the most achieved aspect, observed in 45 websites (60.81%), but none met all four criteria simultaneously. Readability scores suggested that the content was generally understandable, with a median FKGL score of 6.98 and a median SMOG score of 3.98, indicating middle school-level readability. Conclusion: This study reveals a significant gap in the quality of Arabic online resources on orthodontic pain, highlighting the need for improved standards and reliability. Most websites failed to meet established quality criteria, underscoring the necessity for more accurate and trustworthy health information for Arabic-speaking patients. [ABSTRACT FROM AUTHOR]

Background: A Patient Information Leaflet (PIL) is a widely accepted counselling aid to educate patients. The current study aimed to prepare and validate an easy-to-understand PIL explicitly tailored for patients with Heart Failure with reduced Ejection Fraction (HFrEF). Its psychometric properties were evaluated to confirm its reliability and readability. Materials and Methods: Information was curated from credible sources and validated by experts using the Lawshe method. Readability and design were assessed with metrics like the Flesch Reading Ease (FRE) Score, Flesch-Kincaid Grade Level (FKGL), and the Baker-Able Leaflet Design (BALD) index. A user testing questionnaire was also developed and validated for reliability through test-retest methods. This same questionnaire evaluated the PIL's readability before and after exposure to the PIL, ensuring it effectively communicated crucial information to the target population. Results: The English PIL scored 76.9 on FRE and four on FKGL, showing good readability. BALD scores were 29 (English) and 25 (Kannada and Malayalam), denoting excellent design quality across languages. A psychometric evaluation of 60 HFrEF patients (English [n=15], Malayalam [n=15], Kannada [n=30]) using a reliable UTQ (ICC=0.94) significantly improved the score from 36.81±10.6 to 88.29±10.11 (p<0.001), highlighting the ease of understanding. Moreover, 92% of patients provided favourable opinions about the PIL, describing it as well-designed and well-written. Conclusion: This study underscores the significance of a well-developed and validated PIL as a potent educational resource, aiding health professionals in designing and assessing PIL using robust scientific methodologies. [ABSTRACT FROM AUTHOR]

Objective: To assess the readability and the comprehensiveness of patient‐reported outcome measures (PROMs) utilized in primary headache disorders literature. Background: As the health‐care landscape has evolved toward a patient‐centric model, numerous PROMs have been developed to capture treatment outcomes in patients with headache disorders. For these PROMs to advance our understanding of headache disorders and their treatment impact, they must be easy to understand (i.e., reading grade level 6 or less) and comprehensively capture what matters to patients with headache. The aim of this study was to (a) assess the readability of PROMs utilized in headache disorders literature, and (b) assess the comprehensiveness of PROMs by mapping their content to a health‐related quality of life framework. Methods: In this scoping review, recently published systematic reviews were used to identify PROMs used in primary headache disorders literature. Readability analysis was performed at the level of individual items and full PROM using established readability metrics. The content of the PROMs was mapped against a health‐related quality‐of‐life framework by two independent reviewers. Results: In total, 22 PROMs (15 headache disorders related, 7 generic) were included. The median reading grade level varied between 7.1 (interquartile range [IQR] 6.3–7.8) and 12.7 (IQR 11.8–13.2). None of the PROMs were below the recommended reading grade level for patient‐facing material (grade 6). Three PROMs, the Migraine‐Treatment Assessment Questionnaire, the Eurolight, and the European Quality of Life 5 Dimensions 3 Level Version, were between reading grade levels 7 and 8; the remaining 19 PROMs were above reading grade level 8. In total, the PROMs included 425 items. Most items (n = 134, 32%) assessed physical function (e.g., work, activities of daily living). The remaining items assessed physical symptoms (n = 127, 30%; e.g., pain, nausea), treatment effects on symptoms (n = 65, 15%; e.g., accompanying symptoms relief, headache relief), treatment impact (n = 56, 13%; e.g., function, side effects), psychological well‐being (n = 41, 10%; e.g., anger, frustration), social well‐being (n = 29, 7%; e.g., missing out on social activities, relationships), psychological impact (n = 14, 3%; e.g., feeling [not] in control, feeling like a burden), and sexual well‐being (n = 3, 1%; e.g., sexual activity, sexual interest). Some of the items pertained to treatment (n = 27, 6%), of which most were about treatment type and use (n = 12, 3%; e.g., medication, botulinum toxin), treatment access (n = 10, 2%; e.g., health‐care utilization, cost of medication), and treatment experience (n = 9, 2%; e.g., treatment satisfaction, confidence in treatment). Conclusion: The PROMs used in studies of headache disorders may be challenging for some patients to understand, leading to inaccurate or missing data. Furthermore, no available PROM comprehensively measures the health‐related quality‐of‐life impact of headache disorders or their treatment, resulting in a limited understanding of patient‐reported outcomes. The development of an easy‐to‐understand, comprehensive, and validated headache disorders–specific PROM is warranted. Plain Language Summary: Patient‐reported outcome measures (PROMs) are used so we can better understand headache disorders (HDs) and how well treatments work; to be most effective, they should be specific to HDs and easy for patients to understand. This study looked at the reading grade level of 22 PROMs used in HD studies and what quality of life topics they covered; the reading grade level ranged from 7.1 to 12.7, higher than the recommended grade level of 6. Most items in the PROMs focused on physical function, symptoms, and treatment effects, but none did a good job of learning about HDs' impacts on quality of life, revealing a need for the development of an improved, easy‐to‐understand HD‐specific PROM. [ABSTRACT FROM AUTHOR]

Background/Aim: Childhood dental trauma poses a prevalent concern, and the limited knowledge of lay caregivers toward the needed immediate actions can adversely affect a child's well‐being. This study aimed to create and validate an educational comic book for lay individuals, designed to guide immediate actions in dental trauma cases, and assess its effects toward enhancing reader knowledge. Methodology: The four‐stage study involved: (1) Literature review and script development; (2) Version 1 of the comic book creation (including illustrations, layout, and design) and Flesch Readability Index (FI) calculation; (3) Version 1 validation by expert judges, assessed by the Content Validity Index (CVI); (4) Version 1 refinement based on the judges' feedback, recalculation of FI, and a pilot test (CVI) involving lay individuals who validated the final material (Version 2). The validation process involved 67 participants, including 13 specialist judges and 54 elementary school teachers. Results: The CVI for Version 1 was calculated at 0.89 (89%), indicating a favorable level of agreement on the evaluated criteria. The FI was determined as 91.1%, indicating a high level of readability. The FI for Version 2 was 92.1% (indicating a very easy level of comprehension). The CVI calculated for the target audience after the pilot test was 0.99 (99%), denoting a substantial agreement among the participants. In assessing the level of knowledge, a significant increase was observed in the rate of correct answers after the comic book was read by lay individuals (p < 0.05), inasmuch as the percentage rose from 50.5% before to 81.2% after reading it. Conclusion: The educational comic book proved valid in terms of readability, appearance, and content. Furthermore, it had a positive impact on gaining the knowledge needed to take the appropriate actions, thus making it a valuable tool for guiding the lay population in cases of dental trauma. [ABSTRACT FROM AUTHOR]

Objective: The objective of the current study was to assess the quality of large language model (LLM) chatbot versus physician‐generated responses to patient‐generated rheumatology questions. Methods: We conducted a single‐center cross‐sectional survey of rheumatology patients (n = 17) in Edmonton, Alberta, Canada. Patients evaluated LLM chatbot versus physician‐generated responses for comprehensiveness and readability, with four rheumatologists also evaluating accuracy by using a Likert scale from 1 to 10 (1 being poor, 10 being excellent). Results: Patients rated no significant difference between artificial intelligence (AI) and physician‐generated responses in comprehensiveness (mean 7.12 ± SD 0.99 vs 7.52 ± 1.16; P = 0.1962) or readability (7.90 ± 0.90 vs 7.80 ± 0.75; P = 0.5905). Rheumatologists rated AI responses significantly poorer than physician responses on comprehensiveness (AI 5.52 ± 2.13 vs physician 8.76 ± 1.07; P < 0.0001), readability (AI 7.85 ± 0.92 vs physician 8.75 ± 0.57; P = 0.0003), and accuracy (AI 6.48 ± 2.07 vs physician 9.08 ± 0.64; P < 0.0001). The proportion of preference to AI‐ versus physician‐generated responses by patients and physicians was 0.45 ± 0.18 and 0.15 ± 0.08, respectively (P = 0.0106). After learning that one answer for each question was AI generated, patients were able to correctly identify AI‐generated answers at a lower proportion compared to physicians (0.49 ± 0.26 vs 0.97 ± 0.04; P = 0.0183). The average word count of AI answers was 69.10 ± 25.35 words, as compared to 98.83 ± 34.58 words for physician‐generated responses (P = 0.0008). Conclusion: Rheumatology patients rated AI‐generated responses to patient questions similarly to physician‐generated responses in terms of comprehensiveness, readability, and overall preference. However, rheumatologists rated AI responses significantly poorer than physician‐generated responses, suggesting that LLM chatbot responses are inferior to physician responses, a difference that patients may not be aware of. [ABSTRACT FROM AUTHOR]

Introduction: The multiple treatment options available to patients with thyroid nodules can generate uncertainty and confusion. Radiofrequency ablation (RFA) and ethanol ablation (EA) are two alternative modalities to manage thyroid nodules. As patients more frequently utilize online resources to guide their decision-making, the quality of such resources must be evaluated. The goal of this study was to assess the quality of online patient materials relating to RFA and EA compared to standard thyroidectomy. Methods: The terms "thyroidectomy," "thyroid radiofrequency ablation," and "thyroid ethanol ablation" were searched on Google. Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Patient Education Materials Assessment Tool (PEMAT) understandability and actionability were calculated for each website. Statistical analysis was conducted on SPSS Statistics. Google trends were used to determine search interest for each term (May 2016 – May 2021). Results: Of the 77 websites that met our inclusion criteria (30 thyroidectomy sites, 30 RFA sites, and 17 EA sites), the average FRE, FKGL, and SMOG scores of the RFA websites were significantly worse than those of the thyroidectomy websites (p < 0.05). The FKGL and SMOG scores of the EA websites were significantly worse than those of the thyroidectomy websites (p < 0.05). The average understandability and actionability scores for thyroidectomy websites were significantly higher than those of RFA and EA websites (p < 0.05). Conclusion: Ablation websites have lower search interest, readability, validity, understandability, and actionability scores in comparison to traditional thyroidectomy websites. Our findings emphasize the need to consider readability and PEMAT scores when developing online educational resources for ablative alternatives to thyroidectomy to allow for greater patient accessibility. [ABSTRACT FROM AUTHOR]

Background: Social media is a popular source of information about food and nutrition. There is a high degree of inaccurate and poor-quality nutrition-related information present online. The aim of this study was to evaluate the quality and accuracy of nutrition-related information posted by popular Australian Instagram accounts and examine trends in quality and accuracy based on author, topic, post engagement, account verification and number of followers. Methods: A sample of posts by Australian Instagram accounts with ≥ 100,000 followers who primarily posted about nutrition was collected between September 2020 and September 2021. Posts containing nutrition-related information were evaluated to determine the quality and accuracy of the information. Quality was assessed using the Principles for Health-Related Information on Social Media tool and accuracy was assessed against information contained in the Australian Dietary Guidelines, Practice-based Evidence in Nutrition database, Nutrient Reference Values and Metafact. Results: A total of 676 posts were evaluated for quality and 510 posts for accuracy, originating from 47 Instagram accounts. Overall, 34.8% of posts were classified as being of poor quality, 59.2% mediocre, 6.1% good and no posts were of excellent quality. A total of 44.7% of posts contained inaccuracies. Posts authored by nutritionists or dietitians were associated with higher quality scores (β, 17.8, CI 13.94–21.65; P < 0.001) and higher accuracy scores (OR 4.69, CI 1.81–12.14, P = 0.001) compared to brands and other accounts. Information about supplements was of lower accuracy (OR 0.23, CI 0.10–0.51, P < 0.001) compared to information about weight loss and other nutrition topics. Engagement tended to be higher for posts of lower quality (β -0.59, P = 0.012), as did engagement rate (β -0.57, P = 0.016). There was no relationship between followers or account verification and information quality or accuracy and no relationship between engagement and accuracy. Conclusions: Nutrition-related information published by influential Australian Instagram accounts is often inaccurate and of suboptimal quality. Information about supplements and posts by brand accounts is of the lowest quality and accuracy and information posted by nutritionists and dietitians is of a higher standard. Instagram users are at risk of being misinformed when engaging with Australian Instagram content for information about nutrition. [ABSTRACT FROM AUTHOR]

Words read correctly per minute (WCPM) is the reporting score metric in oral reading fluency (ORF) assessments, which is popularly utilized as part of curriculum-based measurements to screen at-risk readers and to monitor progress of students who receive interventions. Just like other types of assessments with multiple forms, equating would be necessary when WCPM scores are obtained from multiple ORF passages to be compared both between and within students. This article proposes a model-based approach for equating WCPM scores. A simulation study was conducted to evaluate the performance of the model-based equating approach along with some observed-score equating methods with external anchor test design. [ABSTRACT FROM AUTHOR]

Medication guides (MGs) provide patients with important information about certain prescription drugs to help them take these drugs safely. We surveyed US residents about their perceptions of MG readability and understandability. We randomly sampled 5204 US residents (age 18+) from Ipsos's KnowledgePanel to complete a two-part survey. Only respondents who reported receiving an MG with their prescription drugs (n  = 3852) completed part 2, which included two key items: How easy to [(1) read/ (2) understand ] are the MGs that you have received from a pharmacy along with your prescription medicines? (1 =  Very easy, 5 =  Very difficult ; reverse-coded). Health literacy (HL) and demographic data were also collected. After weighting our data, we found that 85% of respondents who reported receiving an MG perceived this information as 'very easy' (27.3%), 'somewhat easy' (28.3%) or 'about average' (29.3%) to read. Eighty-seven percent of respondents who reported receiving an MG perceived it as 'very easy' (27.6%), 'somewhat easy' (30.2%) or 'about average' (29.5%) to understand. ANOVAs revealed higher average perceived MG reading and comprehension ease scores among respondents presumed to have adequate versus inadequate HL (ps  ≤ 0.0006). Younger or less-educated respondents and non-Hispanic Blacks perceived MGs as easier to read and understand, on average, than their counterparts (p s ≤ 0.0001). Many of these relationships remained intact in models predicting perceived MG reading and comprehension ease (p s ≤ 0.001). Adjusted R 2 values across models were small, however (≤0.06). Our findings suggest most US residents (18+) who received MGs perceived them to be 'about average' to 'very easy' to read and understand. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to assess the quality, readability, content, accessibility, and structure of online resources for patients with upper limb spasticity. Design: This was a cross sectional study examined Internet searches across three search engines related to patient resources for upper limb spasticity. Search phrases for either hand or upper limb spasticity were used. The top 20 Websites from each search were evaluated using the four readability metrics and the DISCERN scale for quality assessment. YouTube videos with exact search phrases were evaluated using DISCERN. Descriptive statistical analyses were performed using SPSS software. Results: Thirty-six Websites and 33 videos met the inclusion criteria for this study. The average Flesh-Kincaid Grade Level of the Websites was 11.7 ± 3.1, showing low Website readability. According to this index, only two Websites were written at the suggested sixth-grade level (5.4%). With a maximum score of 75, the mean DISCERN score for both Websites and videos scored in the “good” range (53.5 ± 8 and 50.5 ± 6.6), respectively. Conclusions: Current online resources for upper limb spasticity are good in quality but are written above the health literacy level of American citizens. Organizations should consider reviewing their present materials and developing high-quality patient education materials that are easier to understand. [ABSTRACT FROM AUTHOR]

Negated text is a difficult text construction that readers encounter in various forms throughout their lives. Despite a wealth of research on its impact, including potential strategies to improve comprehension, readers maintain poor comprehension when encountering this text construction. Given its large potential impact on reading texts like medical paperwork or insurance documents, it is important to understand not only what makes the construction difficult but also what can help a reader better process the information communicated in this way. The present research explored the impact of rereading on older adults' comprehension and metacomprehension of negated text. Results demonstrated that while rereading was beneficial for older adults' comprehension overall, this benefit was not specific to negated text. Moreover, metacomprehension data demonstrated that both young and older readers are aware of the difficulty they have in understanding negated text, but corresponding comprehension remains low. Results suggest that an additional reading of a passage containing negated text helped to mitigate the comprehension deficits associated with text that has been negated. This demonstrates that the comprehension accuracy can be improved for negated text under these circumstances. Future research should explore what specific factors associated with re-reading helps to improve comprehension accuracy. [ABSTRACT FROM AUTHOR]

This article discusses the readability of COVID-19 information provided by commercial cruise lines on their websites. The study found that the readability of the information did not meet reference target values, indicating a need for improvement. Only 6% of cruise line websites met the readability targets, compared to one-fourth of airline websites. The article suggests that authors should utilize resources and tools to improve the readability of health-related information for passengers, in order to enhance health literacy and compliance with public health directives. The findings of this study are relevant even four years after the COVID-19 outbreak, and the methodology can be applied to other infectious diseases in the future. [Extracted from the article]

Yang Hsien-yi (楊憲益) and Gladys Yang's Selections from Records of the Historian is one of the classic English translations of the Shiji (史記) by Sima Qian (司馬遷). Yang and Yang used distinctive translation strategies in their translation process: faithfulness to the original text, recreation of a classic, flexibility as necessary, and ensuring readability. The translators preserved the structure of the Shiji whenever possible and accentuated the culturally unique thought systems of the Shiji through the strategy of foreignization. However, in places where the narrative form of the original text is likely to cause confusion to English language readers, they were flexible with organization in order to reduce the mental burden to readers. When there are no English equivalents for the Chinese terms used in the Shiji, they also adopted a strategy of domestication. Yang and Yang added explanatory content as appropriate to make their translation accessible in English. [ABSTRACT FROM AUTHOR]

The purpose of this study is to evaluate the readability and quality of Internet information related to vocal health, voice disorders and voice therapy. This is a cross-sectional study. Eighty-two websites were included. Websites were then analyzed; their origin (clinic/hospital, non-profit, government), quality (Health On the Net [HON] certification and DISCERN scores) and readability (Ateşman readability formula and Bezirci-Yılmaz new readability formula) were assessed. Statistical analysis was used to examine differences between website origin and quality and readability scores and correlations between readability instruments. Of the 82 websites, 93% were of private clinic/hospital, 6% were of non-profit organisation and 1% were of government. None of the 82 websites were HON certification, and the mean score of the item determining the general quality measure in DISCERN was 1.83 in a five-point scale. The mean of Ateşman readability formula value was calculated as 50.46 (±8.16). This value is defined as 'moderately hard' according to the readability scale. The average of Bezirci-Yılmaz new readability formula value is 13.85 (±3.48). This value is defined as 13th and 14th grade. The quality of Internet-based health information about the voice is generally inadequate, and the sites examined in this study may be limited due to high readability levels. This may be a problem in people with poor literacy skills. For this reason, it is very important for speech and language therapists and other health professionals to evaluate and monitor the quality and readability of Internet-based information. [ABSTRACT FROM AUTHOR]

Appropriate education and information are the keystones of patient autonomy. Surgical societies support this goal through online informational publications. Despite these recommendations, many of these sources do not provide the appropriate level of reading for the average patient. Multiple national organizations, including the AMA and NIH, have recommended that such materials be written at or below a 6th-grade level. We therefore aimed to evaluate the readability of patient information publications provided by the American Society of Metabolic and Bariatric Surgery (ASMBS). Patient information publications were collected from the ASMBS webpage (https://asmbs.org/patients) and evaluated for readability. Microsoft Office was utilized to calculate Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores. Flesch Reading Ease (FRE) is a 0-100 score, with higher scores equating to easier reading (≥80 = 6th-grade reading level). Flesch-Kincaid Grade Level (FKGL) rates text on a US grade school level. Qualitative and univariate analyses were performed. Eleven patient information publications were evaluated. None of the publications achieved an FRE score of 80 or an FKGL of a 6th-grade reading level. The average FRE score was 35.8 (range 14.9-53.6). The average FKGL score was 13.1 (range 10.1-17.5). The publication with the highest FRE and lowest FKGL (best readability) was that for benefits of weight loss. The brochure with the lowest FRE and highest FKGL (worst readability) was that for Medical Tourism. Although the ASMBS patient information publications are a trusted source of patient literature, none of the 11 publications met the recommended criteria for patient readability. Further refinement of these will be needed to provide the appropriate reading level for the average patient. • Readability is critical to improving patient education materials. • Multiple health societies recommend a readability at or below the 6th grade. • The ASMBS provides online materials for prospective and current patients. • All of the patient information brochures on the ASMBS read at an inappropriately high level. [ABSTRACT FROM AUTHOR]

Open data portals have been implemented in numerous countries to provide accessible, usable, and reproducible data. This study aims to assess the readability of datasets from Open Data Pakistan. Using the URL (https://opendata.com.pk/) in an online readability checking tool, six well-known readability formulas were employed, including Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, Gunning Fog Score, Smog Index, Coleman Liau Index, and Automated Readability Index. The average score of each formula was calculated to analyze the standard readability of the open data portal. Additionally, the website was explored to evaluate the overall status of open datasets, showcases, and features like "Connect" on Open Data Pakistan. The findings indicated that the Open Data Pakistan website has a reading difficulty, scoring an average of 47.4 out of 100, making it challenging for the general public to read. However, the overall analysis suggested that the readability status of open data in Pakistan is satisfactory. These results offer insights into improving the readability of open data for enhanced citizen participation and informed decision-making. Moreover, the study has implications for policymakers and stakeholders regarding the readability of Open Data Pakistan, emphasizing the importance of considering readability in open data publication policies and guidelines, with a recommendation to decrease the percentage of open data portals categorized as hard to read. [ABSTRACT FROM AUTHOR]

The Prison Rape Elimination Act (PREA) was implemented to prevent sexual assault within correctional facilities. To communicate PREA principles to inmates, written materials including handbooks, policies, and brochures are utilized. This research evaluates the readability of PREA messaging, employing three established metrics: Flesh Reading Ease Score, Flesch–Kincaid Grade Level, and Simple Measure of Gobbledygook. Findings reveal significant deviation from recommended reading targets for both the general (7th–8th grade) and inmate (5th–6th grade) populations. Prison Rape Elimination Act policies averaged a 16th-grade level, raising concerns regarding the efficacy of PREA implementation and compliance in light of potential comprehension challenges. [ABSTRACT FROM AUTHOR]

Disinfectants purchased from retail outlets form the cornerstone of infection control and prevention within the domestic household. The growing utilisation of the concept of "hospital-at-home" places greater emphasis on domestic disinfection by the householder in helping to prevent the acquisition of infections within the home. No reports or data exist that indicate how readable the information provided on disinfectants is, which would help householders use disinfectants optimally. The aim of this study was therefore to quantitatively examine the readability (Flesch Reading Ease; Flesch–Kinkaid Grade Level; text metrics) of consumer (public)-facing information (n = 108) of domestic household disinfectants sourced from (i) UK high street supermarket chains (n = 4) and (ii) disinfectant manufacturers (n = 6). The readability of all supermarket and manufacturer information (n = 108) gave a mean Flesch Reading Ease score of 51.7 (target ≥ 60) and a Flesch–Kinkaid Grade Level score of 8.1 (target ≤ 8), thereby failing to achieve readability reference target values. Authors preparing information on the domestic use of disinfectants should be aware of the value of quantitative readability metrics and online tools to help support their writing of such information in order to produce materials which are within target readability values, thereby further supporting health literacy in this population and disinfectant efficacy. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges and uncertainty surrounding the "concise and focused" key information section required in the informed consent form of federally funded studies following the 2017 revision of the Common Rule, with ongoing concerns.

Purpose: The purpose of the research was to find out if there are any differences in the readability score between abstracts published in scientific journals from library and information science with and without an impact factor. Therefore, the author made a comparison between the readability of abstracts from one journal with (Journal of Documentation) and one journal without (Knjižnica or Library) an impact factor. Design/methodology/approach: As a measure of readability, the Flesch Reading Ease Readability Formula was used. Then, with the help of statistical experts, a comparison of the readability scores between the abstracts of two selected journals was performed. Findings: The results showed that some statistically important differences exist between the abstracts published in the Journal of Documentation and Knjižnica. The statistically important differences were found in the number of words and sentences in abstracts and in the readability of abstracts included in the research. Therefore, it can be said that there exists a statistically important difference between abstracts with and without an impact factor. Originality/value: The primary purpose was to find out whether there is a statistically important difference in the readability score of abstracts with and without an impact factor in the field of library and information science. Some similar research studies have been conducted in other scientific fields. [ABSTRACT FROM AUTHOR]

Lay summaries exist to bridge the gap that separates the scientific community from the general public. To foster improved science communication, this study examined the overall quality and readability of published lay summaries across peer-reviewed journals. We obtained 200 lay summaries published in four science journals: eLife, PLOS Medicine, Proceedings of the National Academy of Science (PNAS), and the Journal of Hepatology. Over 900 students across three semesters participated as raters of each summary using a rubric developed to assess the overall quality, accuracy, and accessibility of lay summaries across these journals. The Flesch Reading Ease formula was used to determine the readability of the highest and lowest scoring summaries from each journal. eLife and the Journal of Hepatology had the highest and lowest mean scores for overall quality of 15.6 and 11.7 out of 20, respectively. There were statistically significant differences in accuracy and accessibility found across all journals (p<0.0001). eLife had the highest scoring lay summary for readability. The differences in and lack of consistent scoring across journals with the rubric indicate that deficits exist in the overall quality and readability of published lay summaries. These findings may support the development of guidelines that incorporate elements of the rubric used to write effective lay summaries. [ABSTRACT FROM AUTHOR]

Background: Patients with severe mental illnesses like schizophrenia may benefit from a variety of patient education materials. Despite the availability of various resources, it is essential to assess the extent to which patients can comprehend the materials provided. Objective: This study aims to evaluate the reliability and readability of the patient information leaflet (PIL) for schizophrenia. Method: A quasi-experimental study was conducted for a period of 6 months in the departments of psychiatry. Patients with a diagnosis of schizophrenia were recruited for the study. A user-testing questionnaire was developed and validated with the help of an expert committee to assess reliability. Later, translated versions of the questionnaire were then administered to the patients based on their language preference and evaluated by test-retest analysis. The readability was assessed using pre-validated and translated versions of the PIL. Initially, baseline scores of patient knowledge were assessed using a reliable user-testing questionnaire. Later, their responses were reassessed again using the same questionnaire after reading the PIL. Results: A total of 45 patients participated in the study. From the total sample, 20 participants were randomly selected for reliability assessment. Intraclass-correlation coefficient (ICC), a statistical tool of reliability, give.6 for Kannada,.7 for Malayalam and 1 for the English version of the questionnaire. The overall patient's knowledge was found to be improved from 50.4 to 76.4 after reading the PIL. Conclusion: Patients with schizophrenia were able to comprehend the information available on the PIL. Therefore, further research is needed to determine its efficacy in a larger population. [ABSTRACT FROM AUTHOR]

Online patient education materials (PEMs) often exceed the recommended 6th grade reading level. This can negatively affect transmasculine patients' understanding of treatment plans, increasing barriers to care and worsening health outcomes and patient satisfaction. This study assessed the readability of online English and Spanish PEMs regarding phalloplasty and urethroplasty. The English and Spanish terms for phalloplasty and urethroplasty were queried on Google. The first fifty results were grouped into institutional (government, medical school, teaching hospital), noninstitutional (private practice, news channel, blog, etc.), and academic (journal articles, book chapters) categories. Readability scores were generated using the Simple Measure of Gobbledygook and Spanish Simple Measure of Gobbledygook scales. All PEMs exceeded recommended reading levels. For both procedures, English PEMs had an average reading level approximately of a university sophomore and Spanish PEMs had an average reading level approximately of a high school junior. For both procedures, English PEMs were harder to read than Spanish PEMs overall (P < 0.001) and when compared across the three categories between the two languages (P < 0.001). For Spanish urethroplasty PEMs, noninstitutional PEMs were more difficult to read than institutional PEMs (P < 0.05). Online information for phalloplasty and urethroplasty should be revised and/or standardized materials should be created by trans-affirming health-care providers and national organizations in order to more fully educate the public and prospective patients prior to intervention. A well-informed patient population will improve patient decision-making and surgeon-patient communication, ultimately leading to better health outcomes. [ABSTRACT FROM AUTHOR]

Background: Bruxism patients often access the web to search for information. Unfortunately, the low text readability of online material and the limited medical literacy in the general population may prevent patients' understanding of health information. Objective(s): We aimed to assess the home page's readability of the top 10 patients‐oriented bruxism‐related websites and the educational level required to approach them. Methods: Using the word bruxism in the "no country redirect" extension of Google Chrome browser (www.google.com/ncr), we identified the first 10 patient‐oriented English language websites. The readability of the material was determined using six commonly recommended readability tests (1): Gunning Fog Index (GFI), Coleman Liau Index (CLI), Automated Readability Index (ARI) Simple Measure of Gobbledygook (SMOG), Flesch Kincald Grade Level (FKGL), Flesh Reasing Ease (FRE). Results: The USA National Institutes of Health requirements, which call for websites to be readable at a 6th to 7th‐grade level, were not followed by any of the most popular websites. Conclusion: The average consumer frequently finds the health information on the Internet to be too complex to understand, which can lead to misinterpretation, a delay in diagnosis, and poorer health consequences. [ABSTRACT FROM AUTHOR]

This study attempts to validate ChatGPT, as well as corpus linguistic features, in predicting the difficulty level of the College Scholastic Ability Test(CSAT). The Observed Proportion Correct (Pc) of the 2021 to 2024 CSAT mock tests was compared with those provided by ChatGPT-3.5, ChatGPT-4.0 and 10 corpus-based linguistic features, including Type, Token, TTR, AWL, Lexical Density, Average Words per Sentence, Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning-Fog Index. The research findings are as follows: First, ChatGPT-4.0 bettter predicted item difficulty compared to ChatGPT-3.5. Second, the Predicted Proportion Correct (Pc) of ChatGPT-3.5, ChatGPT-4.0 and some corpus features showed a high correlation with observed Pc. The observed Pc was largely accounted for by the difficulty predicted by ChatGPT-3.5 and ChatGPT-4.0, where ChatGPT-4.0’s predicted Pc demonstrated higher explanatory power than ChatGPT-3.5. Third, a regression model for predicting the difficulty of CSAT was established with ChatGPT and such corpus-based variables as the Gunning-Fog Index and Lexical Diversity. Overall, the findings endorse the potential use of ChatGPT, along with salient corpus linguistic features, as a suitable tool for predicting item difficulties prior to actual test administration. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the effect of the size of pesticide pictograms on comprehensibility and their adherence to principles of familiarity, compatibility, and standardization. Pictograms usually involve complex details, and space limitation demands size reductions, which reduces overall comprehensibility, especially in agriculture and healthcare. Two experiments were conducted. In experiment 1, the effect of different sizes of pictograms on comprehension was tested. In experiment 2, the level of compliance for different ergonomic principles on different sizes of pictograms was investigated. Results of experiment 1 indicated significant variation in comprehension level (p <.05), with maximum comprehension for the size 15 mm × 15 mm (87.6%) and minimum comprehension for the size 7 mm × 7 mm (69.4%). Results of experiment 2 indicated significant variation in compliance of ergonomic principles with different pictogram sizes (p <.05), with maximum compliance for the size 15 mm × 15 mm (7.7, 7.7, 7.6) and minimum compliance for the size 7 mm × 7 mm (6.3, 6.3, 6.3). A significant increase in the comprehensibility of pictograms and their adherence to familiarity, compatibility, and standardization was observed with the increase in the sizes of pictograms. The smallest size of pictograms with a mean comprehension level ≥ 65% and scores for familiarity, compatibility, and standardization ≥ 7 (on a scale of 1 to 10) was 10 mm × 10 mm. The potential application of this research is to identify the most comprehensible size of pictograms that adhere to the principles of familiarity, compatibility, and standardization. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the readability and quality of current online information on Bell's palsy. Method: A Google search using the terms 'Bell's palsy' and 'facial palsy' was performed separately. The first three pages of results were analysed. Readability was assessed using Flesch Reading Ease Score, Flesch–Kincaid Grade Level, the Gunning-Fog Index and the Simple Measure of Gobbledygook. Quality was assessed using the Discern tool. Spearman's correlation between quality and readability was calculated. Results: A total of 31 websites met the inclusion criteria. The mean Flesch Reading Ease Score, Flesch–Kincaid Grade Level, the Gunning Fox Index and the Simple Measure of Gobbledygook scores were 52.45 (95 per cent confidence interval = 47.01–57.86), 10.50 (95 per cent confidence interval = 9.42–11.58), 12.76 (95 per cent confidence interval = 11.68–13.85) and 9.36 (95 per cent confidence interval = 8.52–10.20), respectively. The average Discern score was 44 (95 per cent confidence interval = 40.88–47.12). A negligible correlation was noted between the Discern and Flesch Reading Ease Score (rs = −0.05, p = 0.80). Conclusion: Online information on Bell's palsy is generally of fair quality but is written above the recommended reading age guidance in the UK. [ABSTRACT FROM AUTHOR]

Aim: To construct evidence-based sensitive quality indicators for patients' rapid rehabilitation care after combined pancreaticoduodenectomy (PD) and to provide a reference for clinical nursing professionals to scientifically evaluate the quality of patients' rehabilitation post-PD. Background: Since PD is associated with higher surgical risk and anastomotic complications, it leads to higher complication rates and longer postoperative recovery cycles. This reiterates the need for rapid recovery of patients after PD; however, the evaluation of sensitive nursing care indicators regarding rapid recovery post-PD has not yet been established to date. Methods: Based on the Donabedian structure-process-result theory model, we used available literature, semi-structured interviews, the Delphi method, and hierarchical analysis to establish a sensitive indicator system for patients' rapid rehabilitation after PD and evaluate the importance of such indicators. Results: There were two rounds of expert correspondence, and the effective recovery rate of the questionnaires of these rounds was 100%. The expert authority coefficients, as well as the Kendall coordination coefficients of the expert opinions, were 0.859 and 0.872 as well as 0.423 and 0.431, with statistically significant differences (p < 0.05), respectively. Consequently, we developed a sensitive quality index system for patients' rapid rehabilitation care after combined PD, including 3 first-level, 12 s-level, and 23 third-level indexes, respectively. Conclusion: The constructed sensitive quality index system developed for patients' rapid rehabilitation nursing care after combined PD is standardized, practical, and aligned with the specialty characteristics. Furthermore, this might help greatly in improving the quality and safety of patients' rapid rehabilitation nursing care after combined PD, standardizing nursing management skills, and enhancing nursing quality. [ABSTRACT FROM AUTHOR]

In the digital age, the internet has become a primary source for patient education in orthodontics. However, the effectiveness of these online resources largely depends on their readability and comprehensibility. The main aim of our research was to assess the readability of the ten most popular websites dedicated to orthodontic treatment. Additionally, we aimed to ascertain the educational level required to comprehend the information provided on these websites. The selection of the top 10 patient-centric English language websites was conducted through a search query for "orthodontic treatment" on the Google Chrome browser. The assessment of text readability was conducted by employing six different readability indices, The readability formulas website (https://readabilityformulas.com) was utilized as a resource for this purpose. The researchers calculated the average Flesch Reading Ease index score to be 58.60, with a standard deviation of 10.17. According to GFI, these websites necessitate an average of 12.52 years of formal education, with a standard variation of 2.15, in order to aid understanding. The mean grade level was found to be 10.40, with a standard deviation of 1.90. Our research indicates that internet resources are crucial in orthodontic education for Generation Z, serving as a platform for efficient learning, particularly during the COVID-19 pandemic in creating a general knowledge a level of moderate-complexity. Orthodontic professionals and website developers should be encouraged to consider the readability of their content to ensure it meets the needs of a diverse patient population. However, the utilization of internet information should not be regarded as a comprehensive replacement for a comprehensive treatment process. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals frequently encounter various forms of aggression, ranging from verbal abuse to physical assaults, which can compromise both their occupational well-being and patient-care quality. Despite its prevalence and serious consequences, workplace aggression is often underreported due to a lack of standardized assessment tools. This study aims to develop a valid Italian version of the Hospital Aggressive Behaviour Scale-Users. Methods: The scale's structure was evaluated using exploratory (EFA) and confirmatory (CFA) factor analyses on two samples of healthcare professionals during and after the pandemic. Reliability, measurement invariance, and nomological validity were examined. Results: EFA revealed a two-factor structure comprising eight items (χ2 = 59.651, df = 13, p = 0.00; CFI = 0.98; TLI = 0.95; RMSEA = 0.07; SRMR = 0.02), distinguishing non-physical and physical aggression, and meeting all recommended criteria. CFA confirmed this structure, demonstrating good reliability and outperforming alternative models. The same factor structure was confirmed in standard (χ2 = 35.01, df = 19, p = 0.00; CFI = 0.99; TLI = 0.99; RMSEA = 0.03; SRMR = 0.02) and emergency (χ2 = 30.65, df = 19, p = 0.04; CFI = 0.98; TLI = 0.97; RMSEA = 0.06; SRMR = 0.04) contexts. Full residual invariance was found across job tenure groups. Aggression was positively associated with emotional exhaustion, psychological distance, psychosomatic symptoms, post-traumatic stress symptoms, and turnover intentions while negatively related to job satisfaction. Nurses and healthcare assistants reported higher levels of aggression than doctors. Conclusions: This study provides a reliable, context-specific instrument for documenting and analysing outsider aggression. The insights can inform targeted interventions, contributing to a healthier hospital environment. [ABSTRACT FROM AUTHOR]

The widespread implementation of artificial intelligence technologies provides an appealing alternative to traditional search engines for online patient healthcare education. This study assessed ChatGPT-3.5's capabilities as a source of obstructive sleep apnea (OSA) information, using Google Search as a comparison. Ten frequently searched questions related to OSA were entered into Google Search and ChatGPT-3.5. The responses were assessed by two independent researchers using the Global Quality Score (GQS), Patient Education Materials Assessment Tool (PEMAT), DISCERN instrument, CLEAR tool, and readability scores (Flesch Reading Ease and Flesch–Kincaid Grade Level). ChatGPT-3.5 significantly outperformed Google Search in terms of GQS (5.00 vs. 2.50, p < 0.0001), DISCERN reliability (35.00 vs. 29.50, p = 0.001), and quality (11.50 vs. 7.00, p = 0.02). The CLEAR tool scores indicated that ChatGPT-3.5 provided excellent content (25.00 vs. 15.50, p < 0.001). PEMAT scores showed higher understandability (60–91% vs. 44–80%) and actionability for ChatGPT-3.5 (0–40% vs. 0%). Readability analysis revealed that Google Search responses were easier to read (FRE: 56.05 vs. 22.00; FKGL: 9.00 vs. 14.00, p < 0.0001). ChatGPT-3.5 delivers higher quality and more comprehensive OSA information compared to Google Search, although its responses are less readable. This suggests that while ChatGPT-3.5 can be a valuable tool for patient education, efforts to improve readability are necessary to ensure accessibility and utility for all patients. Healthcare providers should be aware of the strengths and weaknesses of various healthcare information resources and emphasize the importance of critically evaluating online health information, advising patients on its reliability and relevance. [ABSTRACT FROM AUTHOR]

The present paper reports on the findings of an empirical comparative study on the extent to which explicitation is employed in the translation of a scientific text as conducted by Google Neural Machine Translation (GNMT) vs its post-edited (PE) version. A recent report released in English by the World Meteorological Organization in September 2023 was selected as the source text for the present study. The purpose of the study is to reveal how domain-specific acronyms and technical terms are lexically expanded (explicitated) in a GNMT output compared to its post-edited (PE) version as performed by a team of professional translators at a translation service provider in Amman-Jordan. Explicitation in translation can be obligatory or optional. The type of explicitation investigated in the present study is optional, pragmatic explicitation. The results show that GNMT has its limitations in dealing with scientific terms and acronyms in translating scientific texts from English into Arabic. In contrast, human post-editing explicitated domainspecific terms and acronyms producing a text with a higher level of readability and naturalness for domain expert readers and non-expert readers. [ABSTRACT FROM AUTHOR]

While patient education materials (PEMs) across various specialties have been reported as being too difficult to read, the quality and understandability of PEMs related to scar management have not been assessed. In this study, we report the breadth of scar management interventions and readability of online PEMs authored by academic societies and university hospitals. Websites of academic medical societies and university hospitals with scar revision PEMs were assessed for relevance. PEM readability was assessed via Flesch Reading Ease, Flesch–Kincaid Grade Level, and Gunning-Fox Index scores. Understandability and actionability were evaluated using the Patient Education Material Assessment Tool (PEMAT). A total of 26 scar revision PEMs met the inclusion criteria. The most commonly mentioned scar management interventions were scar revision surgery (73%) and laser scar revision (70%), with minimal emphasis on noninvasive methods like scar massage or sun protection. Readability analysis yielded a mean Flesch reading level of 8.8. Overall, PEMAT understandability of online scar treatment PEMs was moderate, with a median of 76.0% (IQR 71.5%-80.5%). PEMs from all specialties and institution types were lacking in actionability, with median actionability of 40.8% (IQR 38.1%-60.0%). Online scar revision PEMs included a wide breadth of scar management interventions; however, the least costly interventions, such as sun protection and scar massage, were not commonly included. PEMs for scar management could be improved by simplifying language, including visual aids, and including checklists or specific steps, patients can take to take action on scar management interventions. [ABSTRACT FROM AUTHOR]

Introduction: Health literacy is the ability of individuals to use basic health information and services to make well-informed decisions. Low health literacy among surgical patients has been associated with nonadherence to preoperative and/or discharge instructions as well as poor comprehension of surgery. It likely poses as a barrier to patients considering foregut surgery which requires an understanding of different treatment options and specific diet instructions. The objective of this study was to assess and compare the readability of online patient education materials (PEM) for foregut surgery. Methods: Using Google, the terms "anti-reflux surgery, "GERD surgery," and "foregut surgery" were searched and a total of 30 webpages from universities and national organizations were selected. The readability of the text was assessed with seven instruments: Flesch Reading Ease formula (FRE), Gunning Fog (GF), Flesch-Kincaid Grade Level (FKGL), Coleman Liau Index (CL), Simple Measure of Gobbledygook (SMOG), Automated Readability Index (ARI), and Linsear Write Formula (LWF). Mean readability scores were calculated with standard deviations. We performed a qualitative analysis gathering characteristics such as, type of information (preoperative or postoperative), organization, use of multimedia, inclusion of a version in another language. Results: The overall average readability of the top PEM for foregut surgery was 12th grade. There was only one resource at the recommended sixth grade reading level. Nearly half of PEM included some form of multimedia. Conclusions: The American Medical Association and National Institute of Health have recommended that PEMs to be written at the 5th–6th grade level. The majority of online PEM for foregut surgery is above the recommended reading level. This may be a barrier for patients seeking foregut surgery. Surgeons should be aware of the potential gaps in understanding of their patients to help them make informed decisions and improve overall health outcomes. [ABSTRACT FROM AUTHOR]

Complex medical terminology utilized in clinical documentation can present barriers to patients understanding their medical findings. We aimed to generate easy-to-understand summaries of clinical radiology reports using large language models (LLMs) and evaluate their safety and quality. Eight board-certified physician reviewers evaluated 1982 LLM-generated radiology report summaries (computed tomography, magnetic resonance imaging, ultrasound, and x-ray) for safety and quality, using predefined rating criteria and the corresponding original radiology reports for reference. Physician reviewers determined 99.2% (1967 out of 1982) of the LLM-generated summaries to be safe. The reviewers scored the quality of the LLM-generated summaries from "5—Very Good" to "1—Very Poor," respectively, as follows: 80.6%, 11.1%, 5.7%, 1.7%, and 0.9%. Safety varied significantly across imaging modality (P =.002). Large language models can be used to generate safe and high-quality summaries of clinical radiology reports. Further investigation is warranted to determine the impact of LLM-generated summaries on patient perception of understanding, knowledge of their medical conditions, and overall experience. [ABSTRACT FROM AUTHOR]

Background: Behavioural intention (BI) has been predicted using other variables by adopting the technology acceptance model (TAM). However, few studies have examined whether BI can predict learning performance. Objectives: The present study used an extended TAM to investigate whether students' BI is a predictor of their listening learning performance (LLP) through vocabulary learning performance (VLP) in the context of mobile vocabulary‐assisted listening learning by using two mobile learning tools. Methods: A total of 129 college students with a pre‐intermediate level of English were recruited as participants, and a 10‐week mobile vocabulary‐assisted, listening‐learning course was conducted in 2022. In each task of this course, the students had to learn target words from a listening passage on Quizlet and then engage in listening activities on Randall's ESL Cyber Listening Lab. Quantitative responses obtained through an online questionnaire were analysed through partial‐least‐squares structural equation modelling. Results: The analysis results indicated that BI significantly predicted LLP through VLP. Perceived ease of use (PEU) and perceived usefulness (PU) were significant antecedents of BI. However, PEU did not significantly predict PU because of the difficulty of navigating between the two technological tools used in this study. The extended model demonstrated its effectiveness in explaining listening learning performance, as evidenced by an explained variance (R2) of 69%. Conclusion: The extended model validates the influence of BI on learning performance and it can also draw teachers' focus toward the significance of enhancing students' BI to improve their listening learning performance. Pedagogical implications based on the results are provided in this paper. Lay Description: What is already known about this topic?: TAM was used to study learners' acceptance of mobile‐assisted language learning.TAM incorporates latent variables to explore mobile‐assisted language learning.Investigating factors influencing BI is a primary research focus in extended TAM literature.Mobile tools could improve listening learning and vocabulary retention. What this paper adds to that: Learning performance was considered as a dependent variable in an extended TAM.BI might predict students' learning performance in vocabulary and listening in an extended TAM.Teachers used two mobile tools to design mobile vocabulary‐assisted listening tasks.Pre‐learning the target words facilitate students' listening learning performance. Implications for practice and/or policy: We show the importance of BI on predicting listening learning performance.The impact of BI on other factors became another focus of TAM research.Results highlight pre‐learning target words' importance for better listening performance.Existing mobile tools improve listening performance, avoiding new system development. [ABSTRACT FROM AUTHOR]

Background: Inferior Vena Cava (IVC) filters have become an advantageous treatment modality for patients with venous thromboembolism. As the use of these filters continues to grow, it is imperative for providers to appropriately educate patients in a comprehensive yet understandable manner. Likewise, generative artificial intelligence models are a growing tool in patient education, but there is little understanding of the readability of these tools on IVC filters. Methods: This study aimed to determine the Flesch Reading Ease (FRE), Flesch–Kincaid, and Gunning Fog readability of IVC Filter patient educational materials generated by these artificial intelligence models. Results: The ChatGPT cohort had the highest mean Gunning Fog score at 17.76 ± 1.62 and the lowest at 11.58 ± 1.55 among the Copilot cohort. The difference between groups for Flesch Reading Ease scores (p = 8.70408 × 10−8) was found to be statistically significant albeit with priori power found to be low at 0.392. Conclusions: The results of this study indicate that the answers generated by the Microsoft Copilot cohort offers a greater degree of readability compared to ChatGPT cohort regarding IVC filters. Nevertheless, the mean Flesch–Kincaid readability for both cohorts does not meet the recommended U.S. grade reading levels. [ABSTRACT FROM AUTHOR]

Purpose: This project examines ChatGPT's potential to enhance the readability of patient educational materials about interventional radiology (IR) procedures. Methods and Materials: The descriptions of IR procedures from the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) were used as the original text. Readability scores were calculated using three metrics: Flesch Reading Ease (FRE), Gunning Fog (GF), and the Automated Readability Index (ARI) using an online calculator (https://readabilityformulas.com). FRE is scored on a scale of 0–100, where 100 indicates easy-to-read texts, and GF and ARI represent the grade level required to comprehend the text. The DISCERN instrument measured credibility and reliability. ChatGPT was prompted to simplify the texts to a fifth-grade reading level, with subsequent recalculation of readability and DISCERN scores for comparison. Statistical significance was determined using a Wilcoxon Signed-Rank Test. Articles were subsequently organized by subgroups and analyzed. Results: 73 interventional radiology procedures from CIRSE were analyzed. The original FRE score was 47.2 (Difficult), improved to 78.4 (Fairly Easy) by ChatGPT. GF and ARI scores dropped from 14.4 and 11.2 to 7.8 and 5.8, respectively, after simplification, showing significant improvement (p < 0.001). However, the average DISCERN score decreased from 3.73 to 2.99 (p < 0.001) post-ChatGPT simplification. Conclusion: This study shows ChatGPT's ability to make interventional radiology descriptions more readable but highlights its struggle to maintain the original's reliability, suggesting the need for human review and prompt engineering to enhance outcomes. Level of Evidence: Level 6. [ABSTRACT FROM AUTHOR]

This study examined the heterogeneity of literacy profiles for adolescents with and without a specific learning disability (SLD) in the U.S. state of Florida Student subgroups displaying common patterns of performance in word-level skills and reading comprehension were identified through latent profile analysis. Results indicate most of the total sample demonstrated below-average performance in one or both areas with word-level skill difficulties being more common than difficulties in reading comprehension alone. Changes in reading performance by profile over time (Grades 6–8) were examined through a latent transition analysis revealing consistent patterns in the SLD sample and variable patterns in the typically developing sample. Resulting profiles were utilized to predict performance on an end-of-year broad reading comprehension measure indicating very little change in performance over time. Findings suggest large numbers of adolescents with concurrent word-level and reading comprehension difficulties likely need sustained intervention in word-level skills to support their reading comprehension. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the relationship between discourse comprehension and production in traumatic brain injury (TBI), especially for spoken language. This study examined to what extent narrative discourse comprehension accounts for narrative discourse production outcomes (story grammar, story completeness). A secondary aim was to provisionally test an assumption of a discourse model, the structure building framework (SBF), that discourse comprehension and production share cognitive processes by investigating the strength of the relationship between them. Method: Twenty-one individuals with TBI completed story comprehension and story retelling tasks. Discourse measures included the Discourse Comprehension Test, a picture story comprehension task, story grammar, and story completeness. Correlational and multiple regression analyses were performed using comprehension measures as predictors for production measures. Results: There were significant moderate-to-large correlations between all comprehension and production measures. Comprehension measures approached but did not reach significance for predicting story grammar performance but strongly predicted story completeness outcomes. Conclusions: The story comprehension measures likely tapped content aspects of discourse more so than organization. Results provided support for a link between content-focused discourse comprehension measures and discourse production outcomes, which may have clinical implications for approaches to discourse intervention. Findings were interpreted as providing preliminary support for the SBF's claim that discourse production deploys the same processes involved in discourse comprehension. [ABSTRACT FROM AUTHOR]

Background: To evaluate the accuracy, reliability, quality, and readability of responses generated by ChatGPT-3.5, ChatGPT-4, Gemini, and Copilot in relation to orthodontic clear aligners. Methods: Frequently asked questions by patients/laypersons about clear aligners on websites were identified using the Google search tool and these questions were posed to ChatGPT-3.5, ChatGPT-4, Gemini, and Copilot AI models. Responses were assessed using a five-point Likert scale for accuracy, the modified DISCERN scale for reliability, the Global Quality Scale (GQS) for quality, and the Flesch Reading Ease Score (FRES) for readability. Results: ChatGPT-4 responses had the highest mean Likert score (4.5 ± 0.61), followed by Copilot (4.35 ± 0.81), ChatGPT-3.5 (4.15 ± 0.75) and Gemini (4.1 ± 0.72). The difference between the Likert scores of the chatbot models was not statistically significant (p > 0.05). Copilot had a significantly higher modified DISCERN and GQS score compared to both Gemini, ChatGPT-4 and ChatGPT-3.5 (p < 0.05). Gemini's modified DISCERN and GQS score was statistically higher than ChatGPT-3.5 (p < 0.05). Gemini also had a significantly higher FRES compared to both ChatGPT-4, Copilot and ChatGPT-3.5 (p < 0.05). The mean FRES was 38.39 ± 11.56 for ChatGPT-3.5, 43.88 ± 10.13 for ChatGPT-4 and 41.72 ± 10.74 for Copilot, indicating that the responses were difficult to read according to the reading level. The mean FRES for Gemini is 54.12 ± 10.27, indicating that Gemini's responses are more readable than other chatbots. Conclusions: All chatbot models provided generally accurate, moderate reliable and moderate to good quality answers to questions about the clear aligners. Furthermore, the readability of the responses was difficult. ChatGPT, Gemini and Copilot have significant potential as patient information tools in orthodontics, however, to be fully effective they need to be supplemented with more evidence-based information and improved readability. [ABSTRACT FROM AUTHOR]

For common diseases such as lung cancer, patients often use the internet to obtain medical information. As a result of advances in artificial intelligence and large language models such as ChatGPT, patients and health professionals use these tools to obtain medical information. The aim of this study was to evaluate the readability of ChatGPT-generated responses with different readability scales in the context of lung cancer. The most common questions in the lung cancer section of Medscape® were reviewed, and questions on the definition, etiology, risk factors, diagnosis, treatment, and prognosis of lung cancer (both NSCLC and SCLC) were selected. A set of 80 questions were asked 10 times to ChatGPT via the OpenAI API. ChatGPT's responses were tested using various readability formulas. The mean Flesch Reading Ease, Flesch-Kincaid Grade Level, Gunning FOG Scale, SMOG Index, Automated Readability Index, Coleman-Liau Index, Linsear Write Formula, Dale-Chall Readability Score, and Spache Readability Formula scores are at a moderate level (mean and standard deviation: 40.52 ± 9.81, 12.56 ± 1.66, 13.63 ± 1.54, 14.61 ± 1.45, 15.04 ± 1.97, 14.24 ± 1.90, 11.96 ± 2.55, 10.03 ± 0.63 and 5.93 ± 0.50, respectively). The readability levels of the answers generated by ChatGPT are "collage" and above and are difficult to read. Perhaps in the near future, the ChatGPT can be programmed to produce responses that are appropriate for people of different educational and age groups. [ABSTRACT FROM AUTHOR]

This research study defines the performance in CPA Licensure Examination of DWCSJ graduates. Mainly, the nature of this study is a descriptive research using descriptive-correlational design to assess the variables of this study which included the profiles of the respondents in terms of grades in major subjects, IQ level, EQ status, and socioeconomic status; and their attitude towards CPA review as well as the relationship of these variables to their performance in CPA Licensure Examination. The questionnaire is the main research instrument used for the gathering of data. It composed of three parts: Socioeconomic status, EQ Status, and Attitude towards CPA Review. The researcher asked permission from the Office of the Registrar to obtain a copy of grades to be used in this research study and; to test the relationship of IQ level with their performance in licensure examination, the researcher seeks the consent of the Guidance Counselor for the results of respondent's IQ level. The regression analysis for multiple independent variables was used to find the degree of relationship between the variables under study. Multiple-regression stepwise technique was used to establish the relationship between the independent variables: grades in major subjects, IQ level, EQ status, attitude towards CPA review and socioeconomic status; and the dependent variable, performance in CPA Licensure Examination. The results showed that respondent's profiles in terms of grades in major subjects, EQ status and socioeconomic status; and attitude towards CPA review were best indicators of good performance in CPA Licensure Examination. The null hypothesis that there is no significant relationship between the respondents' profiles except IQ level and performance in CPA Licensure Examination, is therefore, rejected. Further, statistical research result ascertains the rejection of the null hypothesis of no significant relationship between the examinees' attitude towards CPA review and their level of CPA performance. It is essential to consider that the grades in major subjects, emotional quotient status, socioeconomic status and attitude towards CPA review could probably affects the performance of the students in the national professional examination such as CPA Licensure Examination. Henceforth, it is recommended to strictly implement the retention policy, devise a program concerning maintaining higher level of emotional quotient of every student, strengthen the sustainability of the JPIA's incentive program and increase awareness of the students about the notion of right attitude towards CPA review to improve the passing percentage in the national level examination such as Licensure Examination for Certified Public Accountant. [ABSTRACT FROM AUTHOR]

The medical information about anemia prevention produced by health-care professionals is difficult to understand because of its complicated terminology. To evaluate quantitatively for the first time the clarity of existing online information about anemia prevention in Japanese. On January 20, 2023, we used the keyword "anemia" to evaluate 200 websites, followed by use of the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) and the Clear Communication Index (CCI) to evaluate understandability and actionability. The PEMAT-P and CCI were both evaluated as excellent in terms of understandability and actionability, with cutoff values of 70% or higher and 90% or higher, respectively. We also evaluated readability using jReadability and quality using the Journal of the American Medical Association (JAMA) Benchmark Criteria and The Global Quality Scale (GQS). The PEMAT-P scores for understandability and actionability exceeded the cutoff value in 59 (29.5%) and 36 cases (18.0%), respectively, while the CCI exceeded the cutoff value in two cases (1.0%). With respect to web pages, nine (4.5%) were considered "readable" and 96 (48.0%) "neutral." These findings suggest that websites on anemia in Japanese have poor "understandability," "actionability," and "readability," and are therefore inaccessible to the general public. Improving existing anemia websites using indicators such as the PEMAT-P could improve behaviors related to anemia prevention. [ABSTRACT FROM AUTHOR]

Objective: Families increasingly use online resources to acquire medical information about their child's condition with little understanding of the legitimacy of the source of information or of the information itself. We evaluate the quality and readability of online information related to positional head shape conditions and identify unmet needs for healthcare providers to improve online patient education. Design: The search terms "flat head baby," "brachycephaly," and "plagiocephaly" were queried on the Google search engine and the first 20 websites for each were reviewed. Included websites were evaluated for quality using the DISCERN Instrument and readability using the Flesch-Kincaid Reading Grade Level (FKGL) and Flesch Reading Ease Score (FRES). Websites were categorized by upload source and results were compared using one-way ANOVA. Results: 38 websites met inclusion criteria. There was no significant correlation between DISCERN score and Google search rank between the three search terms. Professional organizations provided websites with the highest mean DISCERN score (56.3) and commercial websites with the lowest score (36.6, P =.003), indicating "good" and "poor" quality content, respectively. Readability assessments showed an overall average FKGL of 9.9 and FRES of 54.4, suggesting "fairly difficult". Hospitals provided the most website results and tended to publish lower quality information, yet are the most readable. Conclusions: High quality websites written at an appropriate reading level for the general public are lacking. A review of online resources for positional head shape conditions can be used to derive recommendations to improve the content of online patient education for pediatric healthcare. [ABSTRACT FROM AUTHOR]