BACKGROUND: A substantial amount of consumer health-related information is available on theInternet. Studies suggest that consumer comprehension may be compromised if content exceeds a 7th-grade reading level, which is the average American reading level identified by the United States Department of Health and Human Services (USDHHS). OBJECTIVE: To determine the readability of Internet-based consumer health information offered by organizations that represent the top 5 medicalrelated causes of death in America. We hypothesized that the average readability (reading grade level)of Internet-based consumer health information on heart disease, cancer, stroke, chronic obstructive
pulmonary disease, and diabetes would exceed the USDHHS recommended reading level. METHODS: From the Web sites of the American Heart Association, American Cancer Society, American Lung Association, American Diabetes Association, and American Stroke Association we randomly gathered 100 consumer-health-information articles. We assessed each article with 3 readability-assessment tools: SMOG (Simple Measure of Gobbledygook), Gunning FOG (Frequency of Gobbledygook), and FleschKincaid Grade Level. We also categorized the articles per the USDHHS readability categories: easy to
read (below 6th-grade level), average difficulty (7th to 9th grade level), and difficult (above 9th-grade level). RESULTS: Most of the articles exceeded the 7th-grade reading level and were in the USDHHS “difficult” category. The meanSD readability score ranges were: SMOG 11.802.44 to 14.401.47, Flesch-Kincaid 9.852.25 to 11.550.76, and Gunning FOG 13.103.42 to 16.052.31. The articles from the American Lung Association had the lowest reading-level scores with each of the readabilityassessment tools. CONCLUSIONS: Our findings support that Web-based medical information intended for consumer use is written above USDHHS recommended reading levels. Compliance with these recommendations may increase the likelihood of consumer comprehension