# Evaluating the Readability and Understandability of Online Patient Educational Material for Percutaneous Coronary Intervention in Canada

## TL;DR

This study evaluates how easy to read and understand online patient education materials about heart procedures in Canadian hospitals are, finding most are too complex.

## Contribution

The study provides a readability and understandability assessment of PCI educational materials from Canadian hospitals using standardized tools.

## Key findings

- Most PCI educational content is written at a grade level higher than recommended for general readability.
- Print materials scored poorly on understandability and actionability compared to audiovisual materials.
- Only 71% of PCI-capable Canadian hospitals offer online educational resources for patients.

## Abstract

Percutaneous coronary intervention (PCI) is the most common treatment for coronary artery disease revascularization. Many patients undergoing PCI may seek educational information online, but the reliability of such resources remains uncertain. This study seeks to assess the readability and understandability of online patient resources for PCI from Canadian hospital sources.

We performed a descriptive study evaluating online educational materials pertaining to PCI hosted by all Canadian hospitals that perform the procedure. The primary outcomes were readability, assessed using the Flesch-Kincaid Grade Level (FKGL) and Scolarius score, and understandability plus actionability, as assessed using the Patient Education Materials Assessment Tool (PEMAT). Educational clinical material is recommended to be written at an FKGL between 6 and 8. A score between 50 and 89 on the Scolarius tool suggests the text is readable by most adults, and a PEMAT score >70% corresponds to an understandable and actionable educational material.

A total of 29 Canadian hospitals performing PCI and hosting unique educational content were identified. Only 71% of PCI-capable hospitals provide relevant online educational resources to patients. The average FKGL of the analyzed content was 10 (range 5-18) and the average Scolarius score was 127.8 (range 79-173). The average total PEMAT print score was 46.1%, whereas the average total PEMAT audiovisual score was 71.8%.

Most of the educational material pertaining to PCI created by Canadian hospitals is in English and print format, and of poor readability, understandability, and actionability. Audiovisual materials perform better but are sparsely used.