Rationale: The ease of Internet access creates opportunities for Americans to research medical information. The National Institutes of Health and American Medical Association recommend that patient education materials be written between the 3rd to 7th grade reading level to meet the health literacy needs of the average American. Our goal was to quantitatively evaluate the readability level of patient education articles pertaining to allergy and immunology.
Methods: In August 2016, we employed 17 search terms to search Google, and the top 10 links directed for patient use for each term were collected and individually analyzed for their readability level using 10 well-validated quantitative readability scales. The search terms included: allergy, anaphylaxis, allergic rhinitis, asthma, primary immunodeficiency disease, allergic bronchopulmonary aspergillosis, chronic obstructive pulmonary disease, Churg-Strauss Syndrome, eosinophilic esophagitis, gastroesophageal reflux disease, histamine toxicity, hypereosinophilic syndrome, respiratory syncytial virus, systemic mastocytosis, vocal cord dysfunction, epinephrine, and Benadryl.
Results: We identified 170 websites, of which 168 (99%) were of a sufficient length for analysis. Collectively the 168 articles were written at a 12.5 grade level. Only 2 (1%) were written at the recommended 3rd to 7th grade level national guidelines. Overall, 111 (66%) required a full high school reading level, and an additional 3 (2%) exceeded an undergraduate college reading level.
Conclusions: The vast majority of websites designed to provide patients with information about allergy and immunology medical conditions were written at a high school level or higher. Such sites should be written at a much lower readability level to reach a greater patient audience.