Readability of Printed Online Education Materials on Pituitary Tumors: Untangling a Web of Complexity

Michael J. Ye, Mohamedkazim M. Alwani, Jonathan L. Harper, Lauren M.Van Buren, Elhaam H. Bandali, Elisa A. Illing, Taha Z. Shipchandler, Jonathan Y. Ting

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Patients are increasingly turning to the internet for health education. Due to the complex pathophysiology, clinic-diagnostic profile, and management spectrum of pituitary tumors, an evaluation of the readability of printed online education materials (POEMs) regarding this entity is warranted. Objective: (1) To apply established readability assessment tools to internet search results on the topic of pituitary tumors. (2) To identify sources of complexity in order to guide the creation POEMs that are in line with the reading level of the target audience. Methodology: After independent, neutral internet search for the phrase “pituitary tumor,” the first 100 results were subjected to inclusion criteria matching. Analysis was performed using 5 readability assessment tools including Flesch Reading Ease (FRE), Flesch–Kincaid Grade Level (FKGL), Gunning-Fog Score (GFS), Coleman–Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Results: A total of 82 websites met inclusion criteria. All websites were found to be at a higher reading level (P <.01) than the United States Department of Health and Human Services (USDHHS) recommended sixth-grade level. Mean readability scores were as follows: FRE, 38.79; FKGL, 11.27; GFS, 12.83; CLI, 17.31; SMOG, 12.12. Intergroup comparison between FKGL, GFS, CLI, and SMOG yielded that CLI was significantly higher (P <.03). No significant differences in readability were noted between academic and other websites. Conclusion: There is a significant misalignment between the reading level of patients and the readability of pituitary tumor POEMs. This may lead patients to misconceive their diagnoses, management options, and prognosis.

Original languageEnglish
Pages (from-to)759-766
Number of pages8
JournalAmerican Journal of Rhinology and Allergy
Issue number6
StatePublished - Nov 1 2020


  • hypophyseal
  • hypophyseal tumor
  • hypophysectomy
  • online education
  • pituitary
  • pituitary adenoma
  • pituitary tumor
  • readability
  • skull base
  • transsphenoidal


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