Key result
All seven evaluated health-related quality of life surveys contained a substantial percentage of items (50% to 100%) requiring more than 5 years of formal schooling, exceeding recommended readability levels.
Observational
Commonly used health-related quality of life surveys, including the Minnesota Living with Heart Failure Questionnaire, contain many items with high readability levels that may exceed the literacy skills of the general population.
May limit valid HRQoL assessment in low-literacy patients; leaves open need for more accessible instruments in future studies.
PURPOSE: To estimate readability of seven commonly used health-related quality of life instruments: SF-36, HUI, EQ-5D, QWB-SA, HALex, Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the NEI-VFQ-25. METHODS: The Flesch-Kincaid (F-K) and Flesch Reading Ease (FRE) formulae were used to estimate readability for every item in each measure. RESULTS: The percentage of items that require more than 5 years of formal schooling according to F-K was 50 for the EQ-5D, 53 for the SF-36, 80 for the VFQ-25, 85 for the QWB-SA, 100 for the HUI, HALex, and the MLHFQ. The percentage of items deemed harder than "easy" according to FRE was 50 for the SF-36, 67 for the EQ-5D, 79 for the QWB-SA, 80 for the VFQ-25, 100 for the HUI, HALex, and the MLHFQ. CONCLUSIONS: All seven surveys have a substantial number of items with high readability levels that may not be appropriate for the general population.
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Paz et al. (2009) conducted an observational in Health-related quality of life. Flesch-Kincaid and Flesch Reading Ease readability assessment vs. Recommended reading levels (5 years of formal schooling) was evaluated on Percentage of items requiring more than 5 years of formal schooling (Flesch-Kincaid). All seven evaluated health-related quality of life surveys contained a substantial percentage of items (50% to 100%) requiring more than 5 years of formal schooling, exceeding recommended readability levels.
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