2. Devin P. Pelcher, Pharm.D. Candidate Nova Southeastern University Jennifer Miles, Pharm.D. Candidate Nova Southeastern University Kevin A. Clauson, Pharm.D. Nova Southeastern University Qing Zeng-Trietler, Ph.D. Harvard Medical School SasikiranKandula, M.S. Harvard Medical School Special thanks to Lisa Ferguson and Jennifer Parker Authors
3. Introduction Use of the internet for finding health related information is increasing Survey conducted by Pew Research Center 74% of American adults are currently using the internet Internet Use Respir Care. 2008 Oct;53(10):1310-5. Pew Internet & American Life Project. Dec 2008
4. Introduction Internet Use use the internet to search for health and medical information Pew Internet & American Life Project. Dec 2008
5. Introduction Wikipedia is often among the top results returned during internet searches User-edited online encyclopedic reference that is freely accessible Since 2001 260 languages 2.5 millionarticles in English Professional language may be difficult for lay public to understand Wikipedia Wikipedia. Apr 2009
6. Introduction 2003 survey conducted by the NCES Majority of adults within two lowest literacy levels DHHS considers information written at: NCES: National Center for Education Statistics DHHS: Department of Health and Human Services Literacy 4th to 6th grade easy 7th to 9th grade average above 9th grade difficult NCES. Sept 2006 Respir Care. 2008 Oct;53(10):1310-5.
7. Objective Previous research has evaluated readability of various types of health-related information Informed consent forms, printed journals and other internet sites The purpose of this study was to investigate the readability of drug information in Wikipedia Respir Care. 2008 Oct;53(10):1310-5. J Community Health. 2005 Jun;30(3):213-9. BMJ.1992 Nov 2;305(6864):1263–1264.
8. Methods The sample consisted of the top 50 prescribed drugs Flesch-Kincaid Grade Level (FKGL) Result is reported as a grade level Sample & FKGL Instrument (.39 x ASL) + (11.8 x ASW) – 15.59 SFI Medical. 2008 Respir Care. 2008 Oct;53(10):1310-5.
9. Methods Wikipedia entries saved as HTML files and evaluated in raw text format Outcome measure ̶ FKGL of sample Wikipedia entries, reported as descriptive statistics The same outcome measure was repeated for HIReA and HIReA extracts FKGL Testing & Outcome
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12. Methods Text unit-length features # of characters/word, # sentences/paragraph, # of words/sentences HIReA Extract text features (four categories) 1 2 3 4 Syntactic features # of Parts-of-Speeches/sentence (e.g., verb, noun, pronoun, etc..) Familiarity scores of terms and concepts from open access collaborative (OAC) consumer health vocabulary Semantic features # of overlapping concepts in adjacent sentences Cohesion AMIA AnnuSymp Proc 2008:353-7.
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14. Mean grade level of 15.5 is substantially above the reading level considered to be difficult (9th grade) Discussion Further analysis is recommended to assess any correlation between word count, grammar/spelling recommendations and FKGL score Functionally literate individuals may still lack the skills needed to make adequate health decision Individuals with differing literacy levels can access Wikipedia so it may be best to write information at a level that is considered easy to read Respir Care. 2008 Oct;53(10):1310-5. NNLM. June 2008
15. Discussion Only the English version of Wikipedia was tested The sample of 50 drugs is a subset and may not be representative of all drugs within Wikipedia Words not found in the dictionary may be handled differently when scores are calculated using the same readability tools Limitations
16. The reading difficulty of the sample drugs in this study represents a potential barrier to accurate interpretation and comprehension of the drug information presented in Wikipedia Conclusion
17. For further information please contact: Devin Pelcher, USA pelcher@nova.edu (Please Reference Med2.0)
Editor's Notes
Note: The sentence that notes the two lowest literacy levels for the 2003 survey is an interpretation referring to the DHHS information. It is a cross reference between the data which suggests that the majority of adult literacy falls in the categories of intermediate, basic, below basic. Here the results of the NAAL study were a combined reference about the two lowest literacy levels using the DHHS categories – not the four categories the NAAL used.
ASL is the average sentence length (AVG#words/sentence) and ASW is average syllables per word (AVG#syllables/word).
HTML means “HyperText Markup language.” This was a way to preserve the web pages for further analysis later if found to be necessary.
In response to the question after the 9-18-09 Med2.0 presentation: The outlier just above ninth reading grade level (FKGL) score is Dyazide. It was only three sentences and was easier to read when compared to the other entries found in Wikipedia. Dyazide is not a good example of an easy to read document. It is simply easier to read than the other 49 drug entries in the sample.
HIReA uses an opposite rating scale with regards to the Y-axis. The more negative the number is, the more difficult a document is to read. This suggests that both statistical tools used to measure readability portray similar findings when regarding the sample as a whole.
Lexical is synonymous with text unit-length features.
