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Scientific Session 13 — Chest Imaging

Wednesday, May 3, 2017

Abstracts 1085-3299

1085. Lung Cancer Screening Guidelines: How Readable Are Internet-Based Patient Education Resources?

Hansberry D1*,  Li Z1,  Cox M1,  Lakhani P1,  Sundaram B1 1. Thomas Jefferson University Hospitals, Philadelphia, PA

Address correspondence to D. Hansberry (

Objective: After the results of the National Lung Screening Trial, several national societies from multiple disciplines, including the National Comprehensive Cancer Network, American Lung Association, American Association for Thoracic Surgery, American Society of Clinical Oncologists, American College of Chest Physicians, American Thoracic Society, and American Cancer Society, have all endorsed the use of annual screening for lung cancer with low-dose chest CT for high-risk individuals. Given this recommendation, it is not unreasonable to believe there is an increased interest that has led patients to use the Internet as a resource for information. This study quantitatively evaluates the level of readability of patient education websites related to lung cancer screening guidelines written for the general public.

Materials and Methods: In August 2016, we searched four terms using the Google search engine, and the top 20 links were analyzed for their level of readability using 10 well-established readability scales including the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Coleman-Liau Index, Gunning Fog Index, New Dale-Chall, FORCAST Formula, Fry Graph, Raygor Reading Estimate, and the New Fog Count. Websites not written specifically for patients were excluded from the analysis. The search terms were “lung cancer screening,” “pulmonary nodule,” “low dose CT,” and “radiation.”

Results: The 80 articles were written at a mean 12.6 grade level (SD, 2.7). Of the 80 articles, only 2.5% were written at a level that met the American Medical Association (AMA) and National Institutes of Health (NIH) recommendations that patient education materials be written at a third to seventh grade level in order to meet the needs of the average American, who reads at the eighth grade level. Surprisingly, 62.5% of the articles required a high school education (greater than the 12th grade) to comprehend.

Conclusion: The ease, accessibility, and seemingly endless amount of information on the Internet create opportunities for the general populace to research information about lung cancer screening guidelines. With websites like garnering more than 1 million visitors a month, clearly the public is interested in learning more about radiology. Unfortunately, there is discordance between the level of readability of patient education resources for lung cancer screening guidelines and the AMA and NIH recommendations, which likely causes many readers to not fully benefit from the materials. Given this relatively new guideline, general interest is expected to continue to increase. Therefore, new patient education materials should meet the AMA and the NIH recommendations so that the information can be widely understood by the general American population.