Many can’t understand online breast density information—will that hurt notification legislation?
Online materials designed to better educate women on federal breast density legislation may be missing the mark.
New research published Dec. 12 in Academic Radiology determined that current materials meant to help women understand how breast density affects their risk of developing cancer are written above recommended comprehension levels. This, the authors suggested, may hinder the goals of recently passed legislation.
“Our findings demonstrate that OPEM (online patient educational materials) on breast density may be written at a level too difficult for the general public to comprehend, which may represent a barrier to educational goals of newly passed federal breast density legislation,” Randy C. Miles, MD, with Massachusetts General Hospital’s Department of Radiology, and colleagues wrote.
More than 35 states have implemented breast density legislation since Connecticut became the first to do so in 2009. And federal legislation, signed into law on Feb. 15, will soon require all mammography facilities to offer dense breast notification letters to women who undergo cancer screenings. As a result, more women will undoubtedly search online for information on the topic, the researchers wrote.
Many studies have already shown that more women are aware of breast density, but those same reports indicate stark socioeconomic disparities. One study published Nov. 19 in the Journal of the American College of Radiology found that nonwhite Hispanic women, those with less income and lower education were all less likely to know about breast density. Authors of that study called on federal notification language to help close that gap.
In the current study, Miles and colleagues searched “breast density” online to find the 50 most accessed websites as of Dec. 15, 2018. They excluded sponsored sites and research journal articles. Results from 41 websites were compared to the sixth-grade reading level parameters recommended by the American Medical Association.
None of the websites met those recommended reading levels. The average across all sites was an 11th grade reading level, with WebMD coming in at the lowest (8.5). Academic websites had the highest reading level (12), while nonprofit websites were written at an average grade level of 10.4.
Importantly, Miles et al. wrote, national reporting language is still being developed, but websites and healthcare providers can’t rely on such information to be reader-friendly.
“Medical terminology, in general, lends itself to higher grade reading levels, especially when use of simple words or less complex sentence structure may not be possible,” Miles and co-authors wrote. “If possible however, websites should aim to present content in plain language, reducing word and sentence complexity.”
Additionally, they noted, including resources such as videos, diagrams and pictures can help overcome potential confusion.
Going forward, “healthcare providers, especially primary care providers and breast imaging radiologists, will increasingly have to address the topic of breast density with their patients,” the authors explained. Such experts must also be aware of the limitations of online materials when having these discussions, they added.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.