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Introduction Influenza is a major global health concern, with its rapid spread and mutation rate posing significant challenges in public health education and communication. Effective patient education materials (PEMs) are crucial for informed decision-making and improved health outcomes. This study evaluates the efficacy of online influenza PEMs using traditional readability tools and introduces the Contextual Health Education Readability Score (CHERS) to address the limitations of existing methods that do not capture the diverse array of visual and thematic means displayed. Materials and methods A comprehensive search was conducted to select relevant online influenza PEMs. This involved looking through Google's first two pages of results sorted by relevance, for a total of 20 results. These materials were evaluated using established readability tools (e.g., Flesch Reading Ease, Flesch-Kincaid Grade Level) and the Patient Education Materials Assessment Tool (PEMAT) for understandability and actionability. The study also involved the creation of CHERS, integrating factors such as semantic complexity, cultural relevance, and visual aid effectiveness. The development of CHERS included weighting each component based on its impact on readability and comprehension. Results The traditional readability tools demonstrated significant variability in the readability of the selected materials. The PEMAT analysis revealed general trends toward clarity in purpose and use of everyday language but indicated a need for improvement in summaries and visual aids. The CHERS formula was calculated as follows: CHERS = (0.4 × Average Sentence Length) + (0.3 × Average Syllables per Word) + (0.15 × Semantic Complexity Score) + (0.1 × Cultural Relevance Score) + (0.05 × Visual Aid Effectiveness Score), integrating multiple dimensions beyond traditional readability metrics. Discussion The study highlighted the limitations of traditional readability tools in assessing the complexity and cultural relevance of health information. The introduction of CHERS addressed these gaps by incorporating additional dimensions crucial for understanding in a healthcare context. The recommendations provided for creating effective influenza PEMs focused on language simplicity, cultural sensitivity, and actionability. This may enable further research into evaluating current PEMs and clarifying means of creating more effective content in the future. Conclusions The study underscores the need for comprehensive readability assessments in PEMs. The creation of CHERS marks a significant advancement in this field, providing a more holistic approach to evaluating health literacy materials. Its application could lead to the development of more inclusive and effective educational content, thereby improving public health outcomes and reducing the global burden of influenza. Future research should focus on further validating CHERS and exploring its applicability to other health conditions.

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English is a world language, and the ability to use English plays an important role in the improvement of college students' comprehensive quality and career development. However, quite a lot of Chinese college students feel that English learning is difficult; it is difficult to understand the learning materials, and they cannot effectively improve their English ability. This study uses a convolutional neural network to evaluate the readability of English reading materials. It provides students with English reading materials of suitable difficulty based on their English reading ability so as to improve the effect of English learning. Aiming at the high dispersion of students' English reading level, a text readability evaluation model for English reading textbooks based on deep learning is designed. First, the legibility dataset is constructed based on college English textbooks; second, the TextCNN text legibility evaluation model is constructed; finally, the model training is completed through parameter adjustment and optimization, and the evaluation accuracy rate on the self-built dataset reaches 90%. We use the text readability method based on TextCNN model to conduct experimental teaching, and divided the two groups into comparative experiments. The experimental results showed that the reading level and reading interest of students in the experimental group were significantly improved, which proved that the text readability evaluation method based on deep learning was scientific and effective. In addition, we will further expand the capacity of the English legibility dataset and invite more university classes and students to participate in comparative experiments to improve the generality of the model.

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Introduction: The present study aimed at investigating the readability of online sources on hereditary hearing impairment (HHI). Methods: In August 2022, the search terms "hereditary hearing impairment", "genetic deafness", hereditary hearing loss", and "sensorineural hearing loss of genetic origin" were entered into the Google search engine and educational materials were determined. The first 50 websites were determined for each search. The double hits were removed and websites with only graphics or tables were excluded. Websites were categorized into either a professional society, a clinical practice or a general health information website. The readability tests to evaluate the websites included: Flesch Reading Ease, Flesch-Kincaid grade level, Gunning-Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index. Results: Twentynine websites were included and categorized as from 4 professional societies, 11 from clinical practices and 14 providing general information. All analyzed websites required higher reading levels than sixth grade. On average 12-16 years of education is required to read and understand the websites focused on HHI. Although general health information websites have better readability, the difference was not statistically significant. Discussion: The readability scores of every type of online educational materials on HHI are above the recommended level indicating that not all patients and parents can comprehend the information they seek for on these websites.

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BACKGROUND: Given that nasal septoplasty is a common procedure in otolaryngology - head and neck surgery, the objective of this study was to evaluate the quality and readability of online patient education materials on septoplasty. METHODS: A Google search was performed using eight different search terms related to septoplasty. Six different tools were used to assess the readability of included patient education materials. These included the Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning-Fog Index, Simple Measure of Gobbledygook Index, Coleman-Liau Index, and Automated Readability Index. The DISCERN tool was used to assess quality and reliability. RESULTS: Eighty-five online patient education materials were included. The average Flesch-Reading Ease score for all patient education materials was 54.9 ± 11.5, indicating they were fairly difficult to read. The average reading grade level was 10.5 ± 2.0, which is higher than the recommended reading level for patient education materials. The mean DISCERN score was 42.9 ± 10.5 and 42% (36/85) of articles had DISCERN scores less than 39, corresponding to poor or very poor quality. CONCLUSION: The majority of online patient education materials on septoplasty are written above the recommended reading levels and have significant deficiencies in terms of their quality and reliability. Clinicians and patients should be aware of the shortcomings of these resources and consider the impact they may have on patients' decision making.

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PURPOSE: We intended to assess the readability of the German versions of commonly used urological questionnaires and identify questions that are potentially demanding for patients. MATERIALS AND METHODS: The Guidelines of the European Association of Urology were analyzed for recommended questionnaires. Readability of the German versions of these questionnaires including their respective single-items was analyzed using established readability assessment tools. RESULTS: A total of 13 questionnaires were analyzed. The calculated readability scores ranged between the 4.3th and 10.3th grade level. Easiest readability as calculated by median grade levels was found for the short and long forms of the International Consultation on Incontinence Questionnaires-Female and -Male Lower Urinary Tract Symptoms and the SF-Qualiveen (all median grade level 5.0). The short form of the International Index of Erectile Function showed the hardest readability (median grade level 10.0). Readability of the single-items varied widely between the assessed questionnaires with up to 80% (the International Index of Erectile Function) of their single-items being written above recommended grade levels. CONCLUSIONS: The majority of commonly used German urological questionnaires comply with recommended readability levels. Some questionnaires as well as single-items of most of the questionnaires clearly exceed recommended readability levels. This should be considered for interpretation of their results and when revising questionnaires.

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OBJECTIVE: To assess the readability and comprehensibility of web-based German-language patient education material (PEM) issued by urological associations. MATERIALS AND METHODS: German PEM available in June 2017 was obtained from the European Association of Urology (EAU), German (DGU), Swiss (SGU) and Austrian (ÖGU) Association of Urology websites. Each educational text was analyzed separately using 4 well-established readability assessment tools: the Amstad Test (AT), G-SMOG (SMOG), Wiener Sachtextformel (WS) and the Lesbarkeitsindex (LIX). RESULTS: The EAU has issued PEM on 8 topics, the DGU 22 and the SGU 5. The ÖGU refers to the PEMs published by the DGU. Calculation of grade levels (SMOG, WS, LIX) showed readability scores of the 7th-14th grades. The easiest readability was found for materials on Nocturia and Urinary Incontinence issued by the EAU. Kidney Cancer and Infertility, issued by the DGU had the hardest readability. The EAU achieved the best median AT score, followed by the SGU, and the DGU. CONCLUSION: Remarkable differences between readability were found for the PEMs issued by EAU, DGU and SGU. Materials published by the EAU were the easiest to read. Improving the readability of certain PEMs is of crucial importance to meet patient needs and act in the interests of a growing, self-informing German-speaking patient community.

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PURPOSE: To assess the readability of the web-based patient education material provided by the European Association of Urology. MATERIALS AND METHODS: English patient education materials (PEM) as available in May 2017 were obtained from the EAU website. Each topic was analyzed separately using six well-established readability assessment tools, including Flesch-Kincaid Grade Level (FKGL), SMOG Grade Level (SMOG), Coleman-Liau Index (CLI), Gunning Fog Index (GFI), Flesch Reading Ease Formula (FRE) and Fry Readability Graph (FRG). RESULTS: A total of 17 main topics were identified of which separate basic and in-depth information is provided for 14 topics. Calculation of grade levels (FKGL, SMOG, CLI, GFI) showed readability scores of 7th-13th grade for basic information, 8th-15th grade for in-depth information and 7th-15th grade for single PEM. Median FRE score was 54 points (range 45-65) for basic information and 56 points (41-64) for in-depth information. The FRG as a graphical assessment revealed only 13 valid results with an approximate 8th-17th grade level. CONCLUSION: The EAU provides carefully worked out PEM for 17 urological topics. Although improved readability compared to similar analyses was found, a simplification of certain chapters might be helpful to facilitate better patient understanding.

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OBJECTIVE: To characterize education materials provided to patients undergoing colorectal cancer surgery to gain a better understanding of how to design readable, suitable, comprehensible materials. METHOD: Mixed method design. Deductive quantitative analysis using a validated suitability and comprehensibility assessment instrument (SAM+CAM) was applied to patient education materials from 27 Swedish hospitals, supplemented by language technology analysis and deductive and inductive analysis of data from focus groups involving 15 former patients. RESULTS: Of 125 patient education materials used during the colorectal cancer surgery process, 13.6% were rated 'not suitable', 76.8% 'adequate' and 9.6% 'superior'. Professionally developed stoma care brochures were rated 'superior' and 44% of discharge brochures were 'not suitable'. Language technology analysis showed that up to 29% of materials were difficult to comprehend. Focus group analysis revealed additional areas that needed to be included in patient education materials: general and personal care, personal implications, internet, significant others, accessibility to healthcare, usability, trustworthiness and patient support groups. CONCLUSION: Most of the patient education materials were rated 'adequate' but did not meet the information needs of patients entirely. Discharge brochures particularly require improvement. PRACTICE IMPLICATIONS: Using patients' knowledge and integrating manual and automated methods could result in more appropriate patient education materials.

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