Health literacy and online educational resources: an opportunity to educate patients.

OBJECTIVE: Given the increasing accessibility of material on the Internet and the use of these materials by patients as a source of health care information, the purpose of this study was to quantitatively evaluate the level of readability of resources made available on the European Society of Radiology website to determine whether these materials meet the health literacy needs of the general public as set forth by guidelines of the U.S. National Institutes of Health (NIH) and the American Medical Association (AMA). MATERIALS AND METHODS: All 41 patient education articles created by the European Society of Radiology (ESR) were downloaded and analyzed with the following 10 quantitative readability scales: the Coleman-Liau Index, Flesch-Kincaid Grade Level, Flesch Reading Ease, FORCAST Formula, Fry Graph, Gunning Fog Index, New Dale-Chall, New Fog Count, Raygor Reading Estimate, and the Simple Measure of Gobbledygook. RESULTS: The 41 articles were written collectively at a mean grade level of 13.0 ± 1.6 with a range from 10.8 to 17.2. For full understanding of the material, 73.2% of the articles required the reading comprehension level of, at minimum, a high school graduate (12th grade). CONCLUSION: The patient education resources on the ESR website are written at a comprehension level well above that of the average Internet viewer. The resources fail to meet the NIH and AMA guidelines that patient education material be written between the third and seventh grade levels. Recasting these resources in a simpler format would probably lead to greater comprehension by ESR website viewers.

[Usability first. Model-based approach for the use-oriented risk analysis of medical devices]. / Usability First. Modellbasierter Ansatz zur nutzungsorientierten Risikoanalyse von Medizinprodukten.

Due to increasing automation, the number and complexity of technical components have increased in the medical context (e.g., in the clinic or in the home care sector) in recent years. Besides new effective and efficient therapeutic and diagnostic options, these devices entail a wide range of functions and very complex (often computer-based) user interfaces that may lead to human-induced risk potential. A systematic and early human risk analysis and a usability evaluation allow medical device manufacturers to identify and control risks within the human-machine interaction very efficiently. At the Department of Medical Engineering in the Helmholtz Institute for Biomedical Engineering at the RWTH Aachen University, a formal-analytical methodology and a corresponding software tool for prospective human-risk analysis and model-based usability evaluation has been developed. Based on a twofold approach, user interactive process sequences and their potential impacts on the overall process are identified and the resulting use-related risks are assessed. For this, the tasks are categorized (in system and user tasks) and modeled and temporally related within the framework of a high-level task analysis. Within a subsequent cognitive low-level task analysis, potentially critical parallel process sequences are then tested in order to detect a potential resource overload of the user. The subsequent corresponding human-risk analysis is developed according to a knowledge base (checklist) of taxonomies related to human error. The HiFEM (human-function effect modeling) methodology is universally applicable and can be used for the evaluation of human-computer interfaces as well as for the analysis of purely mechanical control interfaces and simple hand-held instruments (such as a scalpel and implant). In a comparative study, the HiFEM method clearly outperforms the classic FMEA (failure modes and effects analysis) process with regard to effectiveness, efficiency, learnability, and user satisfaction. Especially small and medium-sized enterprises that constitute the medical device industry can be supported by the new methodology in the context of risk management according to ISO 14971 as well as usability engineering in accordance with IEC 62366 and IEC 60601-1-6 as well as EN ISO 9241.

Evaluating documentation of dietetic care in Swedish medical records.

An adequate documentation in medical records is essential for patient safety and high quality care. The aim of this study was to evaluate documentation by dietitians in Swedish medical records. A retrospective audit of147 dietetic notes in electronic medical records was performed. The audit focused at documentation of essential parts of the dietetic care, as well as other quality aspects such as lingual clarity and structure of the documentation. The nutrition intervention showed to be the most documented part of dietetic care. However, the audit showed that several important parts of nutrition care were poorly documented, for instance nearly half of the audited records had no clear nutrition problem documented, and in most of the records, the goal of nutrition intervention was missing. The study shows that Swedish dietitians need to improve documentation in medical records, as a suggestion by implementing a more structured documentation model.

Data standard ≠ data quality.

The relationship between data quality and data standards has not been clearly articulated. While some directly state that data standards increase data quality, others claim the opposite. Depending on the type of data standard and the aspects of data quality considered, both arguments may in fact be correct. We deconstruct a typology of data standards and ap ply a dimensional definition of data quality to clearly articulate the relationship between the two, providing a framework for data quality planning.