Readability, understandability and actionability of BAUS and EAU patient education materials for common non-oncological urological conditions
Hai Wen Ho, Chandra Shekhar BiyaniBackground and Aims
Patient education materials (PEMs) support patient understanding and engagement in care. This study evaluated the readability, understandability and actionability of non-oncological urological PEMs produced by the British Association of Urological Surgeons (BAUS) and the European Association of Urology (EAU), and explored agreement between human and AI-assisted PEMAT-P assessment.
Methods and Results
A cross-sectional descriptive analysis assessed eight matched PEMs relating to urinary tract infection, urinary incontinence, benign prostatic enlargement/lower urinary tract symptoms, and nocturnal polyuria. Readability was assessed using Flesch Reading Ease (FRE), Flesch–Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index. Understandability and actionability were assessed using the Patient Education Materials Assessment Tool (PEMAT-P). Mean FKGL was 11.85 ± 2.77, SMOG 13.24 ± 2.39, Gunning Fog 14.09 ± 3.22, and FRE 48.5 ± 13.32. All materials exceeded the recommended reading level. Mean PEMAT-P understandability and actionability were 91.0% and 88.3%. Human–AI item-level agreement for understandability and actionability was 83.6% and 81.8%; Cohen's κ was 0.25 and 0.23, and Gwet's AC1 was 0.79 and 0.76.
Conclusion
The materials exceeded recommended reading levels despite variable PEMAT-P scores. Human vs AI differences remained, requiring further evaluation of PEMs to establish the potential role of AI as an adjunct to human PEMAT-P assessment.