Journal of Health Care Communications Open Access

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The Accuracy of Readability Formulas in Health Content: A Systematic Review

Brittany U. Carter*, Kinjalbahen Nayak and Isabella Vembenil

Background: Readability formulas are commonly used to assess the ease in which a reader can understand written text. It is unclear which is best to use when evaluating the readability of health content. This systematic review assessed the accuracy of readability formulas when evaluating health content targeting adults.
Methods: Searches of PubMed, Cochrane Library, and Education Resources Information Center from inception through January 31, 2024 were conducted. Two investigators independently reviewed abstracts and full-text articles against a set of a priori inclusion criteria. Studies evaluating the accuracy or validity of readability formulas when
applied to health content for adults were included. Data was analyzed qualitatively.
Results: Three fair-quality studies were included. One study found readability formulas frequently underestimated the document’s difficulty when compared to expert panel ratings. Another study found very low correlations between the readability formulas and user difficulty ratings. Another study found readability formulas were unable
to consistently identify problematic health survey questions among question pairs.
Conclusion: Evidence is limited regarding the accuracy of readability formulas for health content. Study limitations and those associated with the readability formulas likely contributed to the poor performance. More studies are needed to determine which is best to use for health content.

Published Date: 2024-03-04; Received Date: 2024-02-05