{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:40:08Z","timestamp":1793068808844,"version":"4.5.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"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":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of the study is to assess the readability of online patient education materials (PEMs) for congenital hand differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The top 10 online, English-language PEMs for 10 conditions (polydactyly, syndactyly, trigger finger\/thumb, clinodactyly, camptodactyly, symbrachydactyly, thumb hypoplasia, radial dysplasia, reduction defect, and amniotic band syndrome) were compiled and categorized by source and country. Readability was assessed using 5 tools: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook Index (SMOG). To account for the potential effect of each condition\u2019s name in the aforementioned formulas, the analysis was repeated after replacing the name with a monosyllabic word\/s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean readability scores of the 100 PEMs were FRES 56.3, where the target was \u226580, FKGL 8.8, GFI 11.5, CLI 10.9, and SMOG 8.6, and the median grade score was 9.8, where the target grade was \u22646.9. Following adjustment, all readability scores improved significantly ( P &lt; .001). Postadjustment scores were FRES 63.8, FKGL 7.8, GFI 10.7, CLI 9.1, and SMOG 8.0, and the median grade score was 8.6. Only 1 webpage met the target level using all tools. Two-sample t test for country of publication (the United States and the United Kingdom) demonstrated that PEMs originating from the United Kingdom were easier to read using the preadjustment CLI ( P = .009) and median grade metrics ( P = .048). A 1-way analysis of variance revealed no influence of condition or source on readability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Most online PEMs for congenital hand differences are written above the recommended reading level of sixth grade, even when adjusted for the effect of the condition\u2019s name.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447231168907","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T01:44:40Z","timestamp":1683078280000},"page":"1146-1153","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Readability of Online Patient Education Materials for Congenital Hand Differences"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7302-9793","authenticated-orcid":false,"given":"Alexander J.","family":"Baldwin","sequence":"first","affiliation":[{"name":"Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"key":"bibr1-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181a80777"},{"key":"bibr2-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181e605be"},{"key":"bibr3-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1007\/5584_2019_396"},{"key":"bibr4-15589447231168907","volume-title":"Health Literacy Toolkit for Low- and Middle-Income Countries: A Series of Information Sheets to Empower Communities and Strengthen Health Systems","author":"World Health Organization Regional Office for South-East Asia","year":"2015"},{"key":"bibr5-15589447231168907","unstructured":"National Voices: People and Communities Board. A new relationship with people and communities: actions for delivering chapter 2 of the NHS Five Year Forward View. https:\/\/www.nationalvoices.org.uk\/sites\/default\/files\/public\/publications\/a_new_relationship_with_people_and_communities_0.pdf. Published 2017. Accessed October 16, 2022."},{"key":"bibr6-15589447231168907","volume-title":"Health Literacy: A Manual for Clinicians","author":"Weiss BD.","year":"2003"},{"key":"bibr7-15589447231168907","unstructured":"NHS Health Education England. Health literacy \u201chow to\u201d guide. Date unknown. https:\/\/library.nhs.uk\/wp-content\/uploads\/sites\/4\/2020\/08\/Health-literacy-how-to-guide.pdf. Accessed October 16, 2022."},{"key":"bibr8-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1080\/13548509608400003"},{"key":"bibr9-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1007\/s10897-008-9181-0"},{"key":"bibr10-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1177\/1558944717726138"},{"key":"bibr11-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004050"},{"key":"bibr12-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.11.027"},{"key":"bibr13-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2018.08.020"},{"key":"bibr14-15589447231168907","unstructured":"Statscounter GlobalStats. Search engine market share worldwide. https:\/\/gs.statcounter.com\/search-engine-market-share. Published 2022. Accessed August 20, 2022."},{"key":"bibr15-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2020.11.023"},{"key":"bibr16-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812442783"},{"key":"bibr17-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1177\/1090198105277329"},{"key":"bibr18-15589447231168907","unstructured":"Readability Formulas. Text readability consensus calculator. Date unknown. https:\/\/readabilityformulas.com\/freetests\/six-readability-formulas.php. Accessed August 20, 2022."},{"key":"bibr19-15589447231168907","doi-asserted-by":"publisher","DOI":"10.14740\/gr746w"},{"key":"bibr20-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221089977"},{"key":"bibr21-15589447231168907","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5729"},{"key":"bibr22-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2011.567449"},{"key":"bibr23-15589447231168907","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7.2.e20"},{"key":"bibr24-15589447231168907","volume-title":"OECD Skills Outlook 2013: First Results From the Survey of Adult Skills","author":"Organisation for Economic Co-Operation and Development","year":"2013"},{"key":"bibr25-15589447231168907","unstructured":"HLS-EU Consortium. Comparative report of health literacy in eight EU member states: the European Health Literacy Survey HLS-EU. http:\/\/cpme.dyndns.org:591\/adopted\/2015\/Comparative_report_on_health_literacy_in_eight_EU_member_states.pdf. Published 2012. Accessed October 16, 2022."},{"key":"bibr26-15589447231168907","volume-title":"Local Action on Health Inequalities. Improving Health Literacy to Reduce Health Inequalities","author":"Public Health England &amp; UCL Institute of Health Equity","year":"2015"},{"key":"bibr27-15589447231168907","volume-title":"The Health Literacy of America\u2019s Adults: Results From the 2003 National Assessment of Adult Literacy","author":"National Center for Education Statistics","year":"2006"},{"key":"bibr28-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2015.01.010"},{"key":"bibr29-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2020.08.008"},{"key":"bibr30-15589447231168907","volume-title":"Simply Put: A Guide for Creating Easy-to-Understand Materials","author":"US Department of Health &amp; Human Services and Centers for Disease Control and Prevention","year":"2009","edition":"3"},{"key":"bibr31-15589447231168907","doi-asserted-by":"publisher","DOI":"10.4103\/1357-6283.210517"},{"key":"bibr32-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1080\/07370010701316254"},{"key":"bibr33-15589447231168907","first-page":"1305","volume":"23","author":"Doak LG","year":"1996","journal-title":"Oncol Nurs Forum"},{"key":"bibr34-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2014.05.027"},{"key":"bibr35-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1136\/jech.53.2.105"},{"key":"bibr36-15589447231168907","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03540390074039"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447231168907","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15589447231168907","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447231168907","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:28:49Z","timestamp":1777447729000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15589447231168907"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,2]]},"references-count":36,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1177\/15589447231168907"],"URL":"https:\/\/doi.org\/10.1177\/15589447231168907","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,2]]}}}