Readability estimates for patient-reported outcome measures (PROMs) commonly used in head and neck cancer settings

Objectives Patient-reported outcome measures (PROMs) capture patients’ or caregivers’ perspectives on how their illness and it’s treatment affect their symptoms, functioning and overall health and well-being. More readable health surveys and PROMs are more likely to be understood by patients, which can support clearer conversations between patients and healthcare teams about symptoms, concerns, and care needs. We estimated the readability of PROMs relevant to head and neck cancer (HNC) assessing unmet needs, anxiety, and depression.Methods PROMs assessing unmet needs (n = 14), anxiety and depression (n = 16) appropriate for HNC populations were identified from systematic reviews. Readability of items and instructions was assessed using Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (F-KGL), and Gunning Fog Index (FOG) via an online readability calculator. Descriptive statistics were calculated in Microsoft Excel. Difficult words were defined as those with three or more syllables and were identified using the calculator.Results Using F-KGL, we assessed readability of both items and instructions and found 86% (12/14) of unmet needs measures and 50% (8/16) of anxiety and depression measures exceeded grade five reading level. Nearly 87% of individual items in unmet needs PROMs and 62% in anxiety and depression PROMs exceeded the grade 5 reading level. Most unmet needs measures contained numerous complex words, particularly Psychosocial Needs Assessment Tool (PNAT) (>500 words), while Mood and Anxiety Symptoms Questionnaire (MASQ) had the highest number among anxiety and depression measures (>50 words).Conclusions Two unmet needs measures and seven anxiety and depression measures met the grade five reading level. Results from this study may help in selecting appropriate PROMs in clinical and research settings. Future research should focus on readability of measures developed in or translated to other languages.