P043 Readability assessment of British Journal of Dermatology plain language summaries

Abstract Plain language summaries (PLSs) are being increasingly implemented and required by regulatory bodies to improve accessibility of scientific research for the general population. In 2014, the British Journal of Dermatology (BJD) introduced freely available PLSs to improve patient access to high-quality dermatology research. Over 40% of adults in England do not have adequate literacy skills for health information. As such, when developing PLSs, the NHS recommend targeting a reading age of 9–11 years, up to 14 years in particularly complex medical information. While social media may remain more accessible, the misinformation risk underlines the important role of scientific journals in engaging the lay community in high-quality published research. Based on NHS guidelines, we assessed the readability level of published PLSs in the last 12 issues of the BJD, from 1 December 2022 to 16 November 2023. Multiple established readability metrics were used, including Flesch–Kincaid (FK), Simple Measure of Gobbledygook (SMOG), Gunning Fog Index (GFI), FORCAST, and Flesch Reading Ease (FRE). Only English-language PLSs were included for analysis. Ninety-nine English-language PLSs were published in those 12 BJD issues. According to FK, the mean readability US grade level was 13.0 [95% confidence interval (CI) 12.7–13.4]. A US grade level is one integer less than the UK year system (e.g. US grade 6 = UK year 7). As such, a US grade level of 13 corresponds to an age range of 18–20 years, or a college-level student. SMOG, an NHS-recommended readability instrument, evaluates text for 100% comprehensibility. Evaluating BJD PLSs using SMOG, the mean US grade level was 11.9 (95% CI 11.5–12.2), indicative of a 17–18-year reading age in the UK. The GFI analysis gave a mean US grade level of 16.2 (95% CI 15.7–16.6) for the PLSs, equating to a reading age of 22 years. The average grade level from FORCAST assessment was 11.5 (95% CI 11.4–11.7), giving a reading age of 17 years. Finally, using FRE testing, the mean output was 41.5 (95% CI 39.4–43.6), corresponding to the ‘difficult’ category in the Flesch read­ability chart, a reading age of 18 years or above. This research suggests that the BJD PLSs are not appropriately written for dermatology patients, according to the England population literacy level and NHS guidelines. Readability formulas, while potentially limited through lack of comprehension and reading ease assessment, provide authors guidance of appropriate literacy level PLS. By encouraging authors to use readability resources and PLS guidelines the BJD may improve patient engagement with the journal.