Readability of online patient education materials for cervical disc replacement

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Abstract
Purpose: Patients frequently utilize internet-based resources to seek information. Cervical disc replacement (CDR) is extensively marketed on the internet and patients may research their condition in preference to a fusion. Previous literature has recommended that the readability of patient education materials (PEM) should not exceed the 6th-grade(11–12 years old) United States reading level to optimize health literacy. This study aims to evaluate the readability of online patient education materials concerning cervical disc replacement. Methods: A Google search query was performed on March 1st, 2025 using the term” Cervical Disc Replacement patient information.” The first 25 websites meeting study inclusion criteria were analyzed for readability using Flesch-Kincaid, average reading level consensus, Gunning Fog, Coleman-Liau, SMOG, and Linsear Write indices. Descriptive statistics were reported. Results: The mean of the average reading levels by Flesch-Kincaid was 11.5 (1.29). The mean Flesch Kincaid Reading Ease score was 48.8 (8.12). The mean Gunning Fog Score was 12.9 (1.39), Flesch Kincaid grade level 10.6 (1.69), Coleman Liau 12.4 (1.48), SMOG 10.5 (1.3), Automated Readability Index 11.5 (2.12), Linear Write 69.4 (6.62). Zero PEMs were at or below the recommended sixth grade(11–12 years old) United States reading level. Four of the PEMs were considered general health information(GHI), twenty-one were considered clinical practice(CP). No differences were found between CP and GHI websites (P > 0.05). Conclusion: Creating appropriate patient education materials is integral to achieving optimal health literacy. The current readability of the most accessible PEMs related to CDR is inadequate. As it stands, many patients may not appropriately comprehend the description of their anticipated surgery.

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