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How readable are orthodontic patient information leaflets?

Liverpool University Dental Hospital and School of Dentistry, UK

Address for correspondence: J. E. Harrison, Orthodontic Department, Liverpool University Dental Hospital and School of Dentistry, Pembroke Place, Liverpool L3 5PS, UK. Email: Jayne.Harrison{at}rlbuh.nhs.uk

Objective: To assess the readability of published orthodontic patient information leaflets (PILs) and their eligibility for the Plain English Campaign’s Crystal Mark.

Design: A retrospective, observational study.

Setting: PILs available from professional organizations and commercial companies.

Materials and methods: Twenty-six orthodontic PILs were assessed. The entire text of each leaflet was reproduced in Microsoft Word, 2000. Readability statistics were obtained via the ‘Tools’ menu. The design elements of each leaflet were assessed. The leaflets were sent to the Plain English Campaign for assessment of their eligibility for the Crystal Mark.

Outcome measures: Leaflet and sentence length, passive percentage, Flesch Reading Ease score, Flesch Kincaid Grade Level, design percentage and eligibility for the Plain English Campaign’s Crystal Mark.

Results: Overall, nearly half of the leaflets (42.3%) were rated as ‘fairly difficult’ or ‘difficult’ to read. However, the BOS PILs were significantly better than the AAO leaflets in all but one outcome with the BOS leaflets being rated as ‘standard’ or ‘fairly easy’ to read, meaning that 70–80% of the UK population would be able to understand them. None of the PILs were eligible for the Plain English Campaign’s Crystal Mark.

Conclusions: The orthodontic PILs assessed were difficult to read and none were eligible for the Plain English Campaign’s Crystal Mark. However, the BOS leaflets were much easier to read and better designed than those produced by the AAO making them a useful tool to improve patients’ understanding of different treatment options and allowing them to be used in the informed consent process.

Key words: Readability, orthodontic, patient information leaflets (PILs), Crystal Mark

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