{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:33:50Z","timestamp":1791974030574,"version":"4.4.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"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":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The National Institutes of Health (NIH) and the American Medical Association (AMA) recommend a sixth-grade reading level for patient-directed content. This study aims to quantitatively evaluate the readability of online information sources related to carpal tunnel surgery using established readability indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Web searches for \u201ccarpal tunnel release\u201d and \u201ccarpal tunnel decompression surgery\u201d queries were performed using Google, and the first 20 websites were identified per query. WebFX online software tools were utilized to determine readability. Indices included Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, Coleman Liau Index, Automated Readability Index, Gunning Fog Score, and the Simple Measure of Gobbledygook Index. Health-specific clickthrough rate (CTR) data were used in order to select the first 20 search engine results page from each query.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\u201cCarpal tunnel release\u201d had a mean readability of 8.46, and \u201ccarpal tunnel decompression surgery\u201d had a mean readability of 8.70. The range of mean readability scores among the indices used for both search queries was 6.17 to 14.0. The total mean readability for carpal tunnel surgery information was found to be 8.58. This corresponds to approximately a ninth-grade reading level in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The average readability of carpal tunnel surgery online content is three grade levels above the recommended sixth-grade level for patient-directed materials. This discrepancy indicates that existing online materials related to carpal tunnel surgery are more difficult to understand than the standards set by NIH and AMA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447241232095","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T01:11:17Z","timestamp":1709082677000},"page":"562-571","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Readability Study of Carpal Tunnel Release in 2023"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8789-370X","authenticated-orcid":false,"given":"Ankur","family":"Kayastha","sequence":"first","affiliation":[{"name":"Kansas City University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirthika","family":"Lakshmanan","sequence":"additional","affiliation":[{"name":"Kansas City University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Valentine","sequence":"additional","affiliation":[{"name":"Kansas City University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hunter D.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Kansas City University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kim","sequence":"additional","affiliation":[{"name":"Kansas City University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2529-5434","authenticated-orcid":false,"given":"Nicholas","family":"Pettinelli","sequence":"additional","affiliation":[{"name":"Kansas City University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Beaumont Bone &amp; Joint Institute, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200906000-00007."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2009.11.003"},{"key":"e_1_3_3_4_2","unstructured":"Carpal tunnel syndrome: signs & symptoms. The Hand Society. https:\/\/www.assh.org\/handcare\/condition\/carpal-tunnel-syndrome. Accessed February 8 2023."},{"key":"e_1_3_3_5_2","volume-title":"Carpal Tunnel Syndrome","author":"Sevy JO","year":"2022","unstructured":"Sevy JO, Varacallo M. Carpal Tunnel Syndrome. Treasure Island, FL: StatPearls Publishing; 2022."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5.4.e24."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17030880."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.6.552"},{"key":"e_1_3_3_9_2","volume-title":"Health Literacy: A Manual for Clinicians","author":"Weiss BD.","year":"2003","unstructured":"Weiss BD. Health Literacy: A Manual for Clinicians. Chicago, IL: American Medical Association Foundation and American Medical Association; 2003."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11552-014-9718-7."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1558944717726138"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000816960.79821.e3."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/15589447231168907."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16446."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2006.10.007."},{"issue":"12","key":"e_1_3_3_16_2","first-page":"993","article-title":"Carpal tunnel syndrome: diagnosis and management","volume":"94","author":"Wipperman J","year":"2016","unstructured":"Wipperman J, Goerl K. Carpal tunnel syndrome: diagnosis and management. Am Fam Physician. 2016;94(12):993-999.","journal-title":"Am Fam Physician"},{"key":"e_1_3_3_17_2","unstructured":"Search engine host market share United States of America. StatCounter Global Stats. https:\/\/gs.statcounter.com\/search-engine-host-market-share\/all\/united-states-of-america. Accessed August 22 2023."},{"key":"e_1_3_3_18_2","unstructured":"Google organic CTR history. Advanced Web Ranking. https:\/\/www.advancedwebranking.com\/ctrstudy\/. Accessed August 22 2023."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.45174."},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/13548509608400003."},{"key":"e_1_3_3_21_2","unstructured":"Readable. Free Readability Test Tool. https:\/\/www.webfx.com\/tools\/read-able\/. 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