Aim: This study aimed to examine the readability and word count of reports provided to adult patients following diagnostic audiological assessment.

Method: A total of 165 diagnostic reports were obtained from three clinical settings, comprising four clinics – one in New Zealand (university clinic) and three in the United States (two private practice clinics, one ear nose and throat (ENT) clinic). Mean reading grade level (RGL) of each report was ascertained using three commonly used readability measures: Flesch Kincaid (F-K), Gunning Fog Index (FOG) and Simple Measure of Gobbledygook (SMOG). Word count for each report was recorded. Mean RGL and word count was compared between the three clinical settings. In a subset of analyses of reports sampled from the US private practice setting, the variables report addressee (health care practitioner (HCP) or patient) and medical referral (referral versus no referral) were examined for their effect on mean RGL and word count of reports.

Results: The mean RGL of all reports sampled was 11.82, far exceeding the international health literacy recommendation to keep health information materials below the sixth RGL. Reports from the New Zealand university setting were longer and more difficult to read when compared to US private practice and ENT settings. Reports sampled from the US private practice setting were longer and more difficult to read than those sampled from the ENT setting. In the US private practice clinic setting, reports addressed to patients were shorter and easier to read than those addressed to HCPs with the patient copied in. Medical referral did not affect mean RGL or word count.

Conclusion: All diagnostic reports sampled exceeded the recommended level of six. The mean RGL and word count of reports differed by clinic setting and report addressee. Future research should aim to redesign and evaluate patient-friendly diagnostic reports that harness the use of plain language to support patient understanding.