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Beyond readability: investigating coherence of clinical text for consumers.

ABSTRACT: A basic tenet of consumer health informatics is that understandable health resources empower the public. Text comprehension holds great promise for helping to characterize consumer problems in understanding health texts. The need for efficient ways to assess consumer-oriented health texts and the availability of computationally supported tools led us to explore the effect of various text characteristics on readers' understanding of health texts, as well as to develop novel approaches to assessing these characteristics.The goal of this study was to compare the impact of two different approaches to enhancing readability, and three interventions, on individuals' comprehension of short, complex passages of health text.Participants were 80 university staff, faculty, or students. Each participant was asked to "retell" the content of two health texts: one a clinical trial in the domain of diabetes mellitus, and the other typical Visit Notes. These texts were transformed for the intervention arms of the study. Two interventions provided terminology support via (1) standard dictionary or (2) contextualized vocabulary definitions. The third intervention provided coherence improvement. We assessed participants' comprehension of the clinical texts through propositional analysis, an open-ended questionnaire, and analysis of the number of errors made.For the clinical trial text, the effect of text condition was not significant in any of the comparisons, suggesting no differences in recall, despite the varying levels of support (P=.84). For the Visit Note, however, the difference in the median total propositions recalled between the Coherent and the (Original+Dictionary) conditions was significant (P=.04). This suggests that participants in the Coherent condition recalled more of the original Visit Notes content than did participants in the Original and the Dictionary conditions combined. However, no difference was seen between (Original+Dictionary) and Vocabulary (P=.36) nor Coherent and Vocabulary (P=.62). No statistically significant effect of any document transformation was found either in the open-ended questionnaire (clinical trial: P=.86, Visit Note: P=.20) or in the error rate (clinical trial: P=.47, Visit Note: P=.25). However, post hoc power analysis suggested that increasing the sample size by approximately 6 participants per condition would result in a significant difference for the Visit Note, but not for the clinical trial text.Statistically, the results of this study attest that improving coherence has a small effect on consumer comprehension of clinical text, but the task is extremely labor intensive and not scalable. Further research is needed using texts from more diverse clinical domains and more heterogeneous participants, including actual patients. Since comprehensibility of clinical text appears difficult to automate, informatics support tools may most productively support the health care professionals tasked with making clinical information understandable to patients.

SUBMITTER: Smith CA

PROVIDER: S-EPMC3278090 | biostudies-literature | 2011 Dec

REPOSITORIES: biostudies-literature

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Beyond readability: investigating coherence of clinical text for consumers.

Smith Catherine Arnott CA Hetzel Scott S Dalrymple Prudence P Keselman Alla A

Journal of medical Internet research 20111202 4

<h4>Background</h4>A basic tenet of consumer health informatics is that understandable health resources empower the public. Text comprehension holds great promise for helping to characterize consumer problems in understanding health texts. The need for efficient ways to assess consumer-oriented health texts and the availability of computationally supported tools led us to explore the effect of various text characteristics on readers' understanding of health texts, as well as to develop novel app ...[more]

PMID: 22138127

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Project description:ObjectiveDietary supplements are widely used. However, dietary supplements are not always safe. For example, an estimated 23 000 emergency room visits every year in the United States were attributed to adverse events related to dietary supplement use. With the rapid development of the Internet, consumers usually seek health information including dietary supplement information online. To help consumers access quality online dietary supplement information, we have identified trustworthy dietary supplement information sources and built an evidence-based knowledge base of dietary supplement information-the integrated DIetary Supplement Knowledge base (iDISK) that integrates and standardizes dietary supplement related information across these different sources. However, as information in iDISK was collected from scientific sources, the complex medical jargon is a barrier for consumers' comprehension. The objective of this study is to assess how different approaches to simplify and represent dietary supplement information from iDISK will affect lay consumers' comprehension.Materials and methodsUsing a crowdsourcing platform, we recruited participants to read dietary supplement information in 4 different representations from iDISK: (1) original text, (2) syntactic and lexical text simplification (TS), (3) manual TS, and (4) a graph-based visualization. We then assessed how the different simplification and representation strategies affected consumers' comprehension of dietary supplement information in terms of accuracy and response time to a set of comprehension questions.ResultsWith responses from 690 qualified participants, our experiments confirmed that the manual approach, as expected, had the best performance for both accuracy and response time to the comprehension questions, while the graph-based approach ranked the second outperforming other representations. In some cases, the graph-based representation outperformed the manual approach in terms of response time.ConclusionsA hybrid approach that combines text and graph-based representations might be needed to accommodate consumers' different information needs and information seeking behavior.

Project description:Semiconducting transition metal oxides such as [Formula: see text] are promising photo(electro)catalysts for solar water splitting and photoreduction of [Formula: see text] as well as for antibacterial, self-, water and air-cleaning coatings and admixtures in paints, building materials, on window glass or medical devices. In photoelectrocatalytic applications [Formula: see text] is usually used as photoanode only catalyzing the oxidation reaction. In coatings and admixtures [Formula: see text] works as heterogeneous catalyst and has to catalyze a complete redox cycle. While photoelectrochemical charge transport parameters are usually quite well accessible by electrochemical measurements, the quantitative description of photocatalytic properties is more challenging. Here, we present a systematic structural, photoelectrocatalytic, photocatalytic and antimicrobial study to understand if and how photoelectrochemical parameters can be used to predict the photocatalytic activity of [Formula: see text]. For this purpose [Formula: see text] thin films on flourine-doped tin oxide substrates were prepared and annealed at temperatures between 200 and 600 [Formula: see text]. The film morphologies and thicknesses were studied by GIXRD, FESEM, and EDX. Photoelectrochemical properties were measured by linear sweep voltammetry, photoelectrochemical impedance spectroscopy, chopped light chronoamperometry, and intensity modulated photocurrent/ photovoltage spectroscopy. For comparison, photocatalytic rate constants were determined by methylene blue degradation and Escherichea coli inactivation and correlated with the deduced photoelectrocatalytic parameters. We found that the respective photoactivities of amorphous and crystalline [Formula: see text] nanolayers can be best correlated, if the extracted photoelectrochemical parameters such as charge transfer and recombination rates, charge transfer efficiencies and resistances are measured close to the open circuit potential (OCP). Hence, the interfacial charge transport parameters at the OCP can be indeed used as descriptors for predicting and understanding the photocatalytic activity of [Formula: see text] coatings.

Project description:Background: From time to time, neuroimaging research findings receive press coverage and attention by the general public. Scientific articles therefore should be written in a readable manner to facilitate knowledge translation and dissemination. However, no published readability report on neuroimaging articles like those published in education, medical and marketing journals is available. As a start, this study therefore aimed to evaluate the readability of the most-cited neuroimaging articles. Methods: The 100 most-cited articles in neuroimaging identified in a recent study by Kim et al. (2016) were evaluated. Headings, mathematical equations, tables, figures, footnotes, appendices, and reference lists were trimmed from the articles. The rest was processed for number of characters, words and sentences. Five readability indices that indicate the school grade appropriate for that reading difficulty (Automated Readability Index, Coleman-Liau Index, Flesch-Kincaid Grade Level, Gunning Fog index and Simple Measure of Gobbledygook index) were computed. An average reading grade level (AGL) was calculated by taking the mean of these five indices. The Flesch Reading Ease (FRE) score was also computed. The readability of the trimmed abstracts and full texts was evaluated against number of authors, country of corresponding author, total citation count, normalized citation count, article type, publication year, impact factor of the year published and type of journal. Results: Mean AGL ± standard deviation (SD) of the trimmed abstracts and full texts were 17.15 ± 2.81 (college graduate level) and 14.22 ± 1.66 (college level) respectively. Mean FRE score ± SD of the abstracts and full texts were 15.70 ± 14.11 (college graduate level) and 32.11 ± 8.56 (college level) respectively. Both items indicated that the full texts were significantly more readable than the abstracts (p < 0.001). Abstract readability was not associated with any factors under investigation. ANCOVAs showed that review/meta-analysis (mean AGL ± SD: 16.0 ± 1.4) and higher impact factor significantly associated with lower readability of the trimmed full texts surveyed. Conclusion: Concerning the 100 most-cited articles in neuroimaging, the full text appears to be more readable than the abstracts. Experimental articles and methodology papers were more readable than reviews/meta-analyses. Articles published in journals with higher impact factors were less readable.

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Beyond readability: investigating coherence of clinical text for consumers.

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Beyond readability: investigating coherence of clinical text for consumers.

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