Are adult thoracic patient education materials designed with patients in mind?

OBJECTIVE: Patients are increasingly using the internet to obtain health care information. US News and World Report Best Hospital rankings received more than 103 million views in 2021. Considering 21% of thoracic surgery patients are minorities, 27.9% are in the bottom quartile of household income, and 70% have Medicare/Medicaid or no insurance, online patient educational materials (PEMs) should be accessible and written at a level easily understood by majority of patients. We performed a comprehensive analysis of readability of websites containing patient-centered resources across all adult thoracic surgery areas. METHODS: Online PEMs on thoracic surgical procedures were collected from top 50 hospitals for pulmonology and lung surgery ranked by US News and World Report Best Hospital as of December 1, 2021. Text pertaining to thoracic surgical procedures was collected and divided into 4 procedural genres: esophageal, lung, transplant procedures, and other. Texts were analyzed using OleanderSoftware's Readability Suite through the Raygor readability test. RESULTS: Three hundred seventy-two articles met criteria for analysis. Websites were difficult to read; mean (standard deviation) readability score for all content required a 13.9 (3.6) grade level for comprehension. The mean (standard deviation) readability for esophageal, lung, lung transplant, and other surgeries were 14.5 (3.6), 13.1 (3.6), 11.5 (3.9), and 13.4 (3.7), respectively. CONCLUSIONS: Online PEMs required at least a college reading level to comprehend, well exceeding the sixth-grade level recommended by the American Medical Association. As digital health becomes increasingly relevant, improving the readability of online PEMs in adult cardiac surgery will facilitate equitable access to high-quality care.

Costs and benefits of genomics patents.

Genomics patents are controversial on religious, ethical, legal, and economic grounds. An economic approach is desirable for valuing the patent system generally, and genomics patents in particular, in terms of its stated constitutional objective, which is to 'promote progress'. Several types of criticisms and warnings have been issued regarding the suitability of genomics inventions for patent protection; here these are evaluated in the context of more general concerns about the efficacy of the patent system. As with the patent system more generally, it is difficult to specify an alternative mechanism for producing inventions that has attributes (such as decentralized resource allocation, speed of therapeutic discovery, and financing by beneficiaries) that are predictable enough to serve as a benchmark against which to judge the current regime, which is dominated by genomics patents. The current patent regime can be expected to produce commercializable therapies reasonably reliably, while many proposed alternatives hearken back to a regime that did not produce commercializable therapies with as great speed or variety. Therefore, the onus appears to lie on the critics to create a model with the desirable properties of the patent system, but with fewer of its acknowledged weaknesses, such as 'monopoly' pricing and 'patent thickets'.