Introduction

The average American reads at the 8th grade level. The AMA and NIH recommend written health information directed at laypersons target a 6th grade reading level to ensure comprehension by the majority of adults. Veterinary oncologists routinely use written discharge summaries to disseminate complex information to owners. We hypothesized discharge summaries provided to owners of pets newly diagnosed with cancer are written at higher-than-recommended readability levels.

Methods

The readability of client-directed portions of 118 randomly selected discharge summaries written between June 2017 and January 2019 was analyzed using two previously validated readability calculators: the Flesch Kincaid Grade Level (FKGL) and the Flesch Reading Ease (FRE) test. Specifically, we examined text related to diagnosis, treatment options, medication(s), and follow-up plan.

Results

The average readability of all summaries determined via the FKGL and FRE were 11.9 (Med 11.9, SD 1.1, range 8.6–15.5; target ≤6) and 43 (Med 42.7, SD 5.9, range 25.5–58.1; target ≥60) respectively. When analyzed in their entirety, no discharge summary was written below an 8th grade reading level. Ninety-three percent (n=100) of summaries were difficult to read. There were no significant differences in FKGL or FRE scores among summaries of the four most common tumor types in our sample (p=0.52 and p=0.67, respectively.)

Conclusion

Written information targeted at owners of pets newly diagnosed with cancer exceeds the reading comprehension of the average adult. Simpler, shorter summaries incorporating pictures and infographics may improve owner understanding as well as client compliance and patient outcome.

Funding Information

There are no funding sources, or conflicts of interest to disclose.