Trinidad, Mari Charisse

INTRODUCTION: As the Internet has become the primary source of health information for most patients, there is limited information regarding the readability of available online information for patients in obstetrics and gynecology. METHODS: Twenty-four phrases from “Top Searches on ACOG” were used as search terms, using search engine optimization tools, mirroring likely patient search patterns. Contents were then analyzed for readability using four validated readability formulas, including Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index (GFOG). RESULTS: A total of 214 webpages were evaluated and majority had readability scores higher than currently recommended for patient-directed information. The mean FRES was 56.0 (range, 26.6 to 97.0), with majority (99%) of the sites scoring less than 80, correlating with a “difficult” level of reading. Mean readability grade levels were as follows: 6.86 for FKGL; 8.39 for SMOG; and 8.28 for GFOG. Of the 24 topic areas, only 11 (45.8%) had easily accessible patient related documents published by the American College of Obstetricians and Gynecologists. CONCLUSION: To our knowledge, this is the first study providing a broad assessment of readability of currently available online patient related information in obstetrics and gynecology. Consistent with other specialties, the readability of most online obstetrics and gynecology patient materials is unsatisfactory. While readability level is only one component of useful patient-oriented literature, there is a great need for effective and easily accessible online patient-oriented websites as health literacy can impact outcomes.

Lung diseases, such as bronchopulmonary dysplasia (BPD), wheezing, and asthma, remain significant causes of morbidity and mortality in the pediatric population, particularly in the setting of premature birth. Pulmonary outcomes in these infants are highly influenced by perinatal exposures including prenatal inflammation, postnatal intensive care unit interventions, and environmental agents. Here, there is strong evidence that perinatal supplemental oxygen administration has significant effects on pulmonary development and health. This is of particular importance in the preterm lung, where premature exposure to room air represents a hyperoxic insult that may cause harm to a lung primed to develop in a hypoxic environment. Preterm infants are also subject to increased episodes of hypoxia, which may also result in pulmonary damage and disease. Here, we summarize the current understanding of the effects of oxygen on the developing lung and how low vs. high oxygen may predispose to pulmonary disease that may extend even into adulthood. Better understanding of the underlying mechanisms will help lead to improved care and outcomes in this vulnerable population.