{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:25:21Z","timestamp":1790871921073,"version":"4.1.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2017,8,24]],"date-time":"2017-08-24T00:00:00Z","timestamp":1503532800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>Background: The American Medical Association (AMA) and National Institutes of Health (NIH) recommend that patient education materials be written at no higher than a sixth-grade reading level. Methods: We examined 100 online educational materials for the 10 hand conditions most commonly treated by hand surgeons, as reported by the American Society for Surgery of the Hand. The listed conditions were carpal tunnel syndrome, basal joint arthritis of the thumb, de Quervain syndrome, Dupuytren\u2019s contracture, ganglion cysts, hand fractures, trigger finger, extensor tendon injuries, flexor tendon injuries, and mallet finger. Following a Google search for each condition, we analyzed the 10 most visited websites for each disorder utilizing the Flesch-Kincaid formula. Results: The average grade reading level of the 100 websites studied was 9.49 with a reading ease of 53.03 (\u201cfairly difficult high school\u201d). Only 29% of the websites were at or below the national average of an eighth-grade reading level. Carpal tunnel syndrome had the highest average grade reading level at 10.32 (standard deviation: 1.52), whereas hand fractures had the lowest at 8.14 (2.03). Every hand condition in this study had an average readability at or above the ninth-grade reading level. Conclusions: The most frequently accessed materials for common maladies of the hand exceed both the readability limits recommended by the AMA and NIH, and the average reading ability of most US adults. Therefore, the most commonly accessed websites pertaining to hand pathology may not be comprehended by the audience for which it is intended.<\/jats:p>","DOI":"10.1177\/1558944717726138","type":"journal-article","created":{"date-parts":[[2017,8,24]],"date-time":"2017-08-24T06:07:24Z","timestamp":1503554844000},"page":"705-714","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":35,"title":["Readability of the Most Commonly Accessed Online Patient Education Materials Pertaining to Pathology of the Hand"],"prefix":"10.1177","volume":"13","author":[{"given":"Sheriff D.","family":"Akinleye","sequence":"first","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garret","family":"Garofolo-Gonzalez","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Montuori","sequence":"additional","affiliation":[{"name":"SUNY Downstate Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya Deza","family":"Culbertson","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hashem","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Marc","family":"Edelstein","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,8,24]]},"reference":[{"key":"bibr1-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1016\/S0897-1897(96)80254-0"},{"key":"bibr2-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1380-y"},{"key":"bibr3-1558944717726138","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.6.1027"},{"key":"bibr4-1558944717726138","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200011000-00004"},{"key":"bibr5-1558944717726138","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0287"},{"key":"bibr6-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1097\/00006416-200109000-00011"},{"key":"bibr7-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2002.10603.x"},{"key":"bibr8-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1097\/00000446-199612000-00022"},{"key":"bibr9-1558944717726138","first-page":"1305","volume":"23","author":"Doak LG","year":"1996","journal-title":"Oncol Nurs Forum"},{"key":"bibr10-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-014-4071-2"},{"key":"bibr11-1558944717726138","unstructured":"Fox S. Online health search 2006. Pew Internet and American Life Project. http:\/\/www.pewinternet.org\/2006\/10\/29\/online-health-search-2006\/. Published October 29, 2006. Accessed July 31, 2017."},{"key":"bibr12-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1177\/1090198105277329"},{"key":"bibr13-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1007\/s11552-014-9657-3"},{"key":"bibr14-1558944717726138","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2008.03.070217"},{"key":"bibr15-1558944717726138","doi-asserted-by":"publisher","DOI":"10.21236\/ADA006655"},{"key":"bibr16-1558944717726138","volume-title":"Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey","author":"Kirsch IS","year":"1993"},{"key":"bibr17-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2006.03928.x"},{"key":"bibr18-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2011.08.020"},{"key":"bibr19-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0193-8"},{"key":"bibr20-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2009.04.008"},{"key":"bibr21-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1142\/S0218810404002121"},{"key":"bibr22-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1007\/s11552-014-9643-9"},{"key":"bibr23-1558944717726138","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.03.003"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944717726138","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1558944717726138","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944717726138","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:29:04Z","timestamp":1777447744000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1558944717726138"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,24]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1177\/1558944717726138"],"URL":"https:\/\/doi.org\/10.1177\/1558944717726138","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,24]]}}}