{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:26:12Z","timestamp":1784003172414,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,2,9]],"date-time":"2016-02-09T00:00:00Z","timestamp":1454976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients use several online resources to learn about vocal cord paralysis (VCP). The objective of this study was to assess the readability and understandability of online VCP patient education materials (PEMs), with readability assessments and the Patient Education Materials Evaluation Tool (PEMAT), respectively. The relationship between readability and understandability was then analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Setting<\/jats:title><jats:p>Descriptive and correlational design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Online PEMs were identified by performing a Google search with the term \u201cvocal cord paralysis.\u201d After scientific webpages, news articles, and information for medical professionals were excluded, 29 articles from the first 50 search results were considered. Readability analysis was performed with 6 formulas. Four individuals with different educational backgrounds conducted understandability analysis with the PEMAT. Fleiss\u2019s Kappa interrater reliability analysis determined consistency among raters. Correlation between readability and understandability was determined with Pearson\u2019s correlation test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The reading level of the reviewed articles ranged from grades 9 to 17. Understandability ranged from 29% to 82%. Correlation analysis demonstrated a strong negative correlation between materials\u2019 readability and understandability (<jats:italic>r<\/jats:italic> = \u22120.462, <jats:italic>P<\/jats:italic> &lt;. 05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Online PEMs pertaining to VCP are written above the recommended reading levels. Overall, materials written at lower grade levels are more understandable. However, articles of identical grade levels had varying levels of understandability. The PEMAT may provide a more critical evaluation of the quality of a PEM when compared with readability formulas. Both readability and understandability should be used to evaluate PEMs.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599815626146","type":"journal-article","created":{"date-parts":[[2016,2,9]],"date-time":"2016-02-09T21:48:52Z","timestamp":1455054532000},"page":"460-464","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Readability and Understandability of Online Vocal Cord Paralysis Materials"],"prefix":"10.1002","volume":"154","author":[{"given":"Vini","family":"Balakrishnan","sequence":"first","affiliation":[{"name":"University Voice and Swallowing Center Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine School of Medicine Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachariah","family":"Chandy","sequence":"additional","affiliation":[{"name":"University Voice and Swallowing Center Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine School of Medicine Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Hseih","sequence":"additional","affiliation":[{"name":"University Voice and Swallowing Center Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine School of Medicine Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh\u2010Lan","family":"Bui","sequence":"additional","affiliation":[{"name":"University Voice and Swallowing Center Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine School of Medicine Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil P.","family":"Verma","sequence":"additional","affiliation":[{"name":"University Voice and Swallowing Center Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine School of Medicine Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,2,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(03)00179-8"},{"key":"e_1_2_8_3_1","unstructured":"Pew Research Center.Internet user demographics.http:\/\/www.pewinternet.org\/data\u2010trend\/internet\u2010use\/latest\u2010stats\/. 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