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Readability of Cochrane Breast Cancer Group plain language summaries

Date and Location




Monday 23 September 2013 - 10:30 - 12:00


Presenting author and contact person

Presenting author

Mark Jeffery

Contact person

Chris Luis
Mark Jeffery
Abstract text
Background: Readability is an objective measure of the reading skill required to understand a written text. Guidelines suggest that information be written at an education level not greater than grade six. The Cochrane Collaboration provides free online, plain language summaries of Cochrane systemic reviews for healthcare consumers. The readability of these plain language summaries is unknown. Objectives: To assess if plain language summaries written by the Cochrane Breast Cancer Group (CBCG) meet recommended readability scores. A secondary aim was to improve plain language summary readability using: simpler language, shorter sentences and active voice. Methods: Two reviewers independently evaluated the readability of all reviews published by CBCG. The same reviewers individually re-wrote all plain language summaries using simpler language, shorter sentences and active voice to improve readability. Reviews published as "withdrawn" were excluded. Readability was assessed using Flesch Reading Ease and Flesch-Kincaid Grade Levels in Microsoft® Word 2010. Flesch Reading Ease generates a readability score from 0 (unreadable) to 100 (very easy). Flesch-Kincaid Grade Levels provide a readability score indicating the academic grade level required to read the text. Final average scores were calculated where a difference in scoring existed between reviewers. Results: Mean Flesch Reading Ease and Flesch-Kincaid Grade Levels were 26.8 (SD=11.3, range=3.0-52.0) and 15.0 (SD=2.3, range=10.9-20.0) respectively. No individual plain language summary met the recommended readability level. Most articles (83.3%) were written at college level. Our writing techniques significantly improved readability (p<0.001), mean Flesch Reading Ease was 52.5 (SD=9.0, range=34.1–72.5) and Flesch-Kincaid Grade Level 8.9 (SD=1.3, range=6.4–11.0). Conclusions: CBCG plain language summaries did not meet recommended readability levels for healthcare consumers. Writing using simple language, short sentences and active voice are useful tools the Cochrane Collaboration could recommend to authors to improve readability. This may improve healthcare consumer access to the high quality information in Cochrane systematic reviews.