Ami Saraiya1, Grayson L Baird2, Ana P Lourenco2. 1. Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: Asaraiya@lifespan.org. 2. Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Abstract
PURPOSE: To evaluate grade-level readability of dense breast notification letters (DBNs) and popular websites. METHODS: HIPAA-compliant, institutional review board-exempt study. As of April 2018, letter characteristics and grade-level readability were evaluated from states with mandated text using five readability metrics, one of which was the Flesch-Kincaid Grade Level. For states that had mandated DBNs in 2016, the 2016 data were compared with 2018. Readability was also assessed for common websites about dense breasts. RESULTS: Thirty states had mandated text for DBNs. All were written above a Flesch-Kincaid sixth-grade level. Eight state DBNs were around or below a Flesch-Kincaid eighth-grade level. Connecticut was the highest (19.4) and Alabama and New York lowest (both at 7.2). For all states, the mean readability score using the five metrics exceeded an eighth-grade level. Of states that had updated DBNs since 2016, only one state significantly improved readability (Missouri 13.1 to 8.5). All DBNs discussed that breast density may mask cancer on a mammogram, 20 discussed the association with increased risk of breast cancer, and 23 discussed supplemental screening. For websites, the range of Flesch-Kincaid grade-level readability was 6 to 11.3. The lowest was the American Cancer Society dense breast website (6.0) followed by ACR dense breast patient pamphlet (7.2). CONCLUSION: As of 2018, the mean readability score using five metrics for all state-mandated DBNs exceeded an eighth-grade reading level. Compared with 2016, only one state significantly decreased DBN grade-level readability. Publicly available websites performed relatively better.
PURPOSE: To evaluate grade-level readability of dense breast notification letters (DBNs) and popular websites. METHODS: HIPAA-compliant, institutional review board-exempt study. As of April 2018, letter characteristics and grade-level readability were evaluated from states with mandated text using five readability metrics, one of which was the Flesch-Kincaid Grade Level. For states that had mandated DBNs in 2016, the 2016 data were compared with 2018. Readability was also assessed for common websites about dense breasts. RESULTS: Thirty states had mandated text for DBNs. All were written above a Flesch-Kincaid sixth-grade level. Eight state DBNs were around or below a Flesch-Kincaid eighth-grade level. Connecticut was the highest (19.4) and Alabama and New York lowest (both at 7.2). For all states, the mean readability score using the five metrics exceeded an eighth-grade level. Of states that had updated DBNs since 2016, only one state significantly improved readability (Missouri 13.1 to 8.5). All DBNs discussed that breast density may mask cancer on a mammogram, 20 discussed the association with increased risk of breast cancer, and 23 discussed supplemental screening. For websites, the range of Flesch-Kincaid grade-level readability was 6 to 11.3. The lowest was the American Cancer Society dense breast website (6.0) followed by ACR dense breast patient pamphlet (7.2). CONCLUSION: As of 2018, the mean readability score using five metrics for all state-mandated DBNs exceeded an eighth-grade reading level. Compared with 2016, only one state significantly decreased DBN grade-level readability. Publicly available websites performed relatively better.
Authors: Jennifer L Ridgeway; Sarah M Jenkins; Bijan J Borah; Vera J Suman; Bhavika K Patel; Karthik Ghosh; Deborah J Rhodes; Aaron Norman; Edna P Ramos; Matt Jewett; Crystal R Gonzalez; Valentina Hernandez; Davinder Singh; Miranda Sosa; Carmen Radecki Breitkopf; Celine M Vachon Journal: Cancer Date: 2021-12-02 Impact factor: 6.860
Authors: Derek L Nguyen; Susan C Harvey; Eniola T Oluyemi; Kelly S Myers; Lisa A Mullen; Emily B Ambinder Journal: J Am Coll Radiol Date: 2020-07-30 Impact factor: 5.532