Research tools and protocols: readability of pediatric and adult patient-reported outcome measures in eosinophilic esophagitis.

Patient-reported outcome measures (PROs) in eosinophilic esophagitis (EoE) have been utilized as research tools to assess outcomes in clinical trials. To our knowledge, adult and pediatric EoE PROs have not previously been analyzed from a health literacy perspective. We aimed to evaluate the readability of the most utilized EoE PROs for adult and pediatric populations and assess whether these PROs met national health literacy recommendations of readability at or below the sixth-grade level. We conducted a readability analysis of thirteen EoE PROs using four readability measures: Flesch-Kincaid Grade Level, Gunning Fog, Simple Measure of Gobbledygook, and FORCAST. Across these four individual metrics, the mean readability levels (years of education required) for PROs were 4.1, 5.5, 7.1, and 9.6, respectively. The four pediatric EoE PROs (PedsQL EoE module parent report for teens, PedsQL EoE module teen report, PEESS children and teen report, and PEESS parent report) included in this study had mean readability levels of 6.4, 6.2, 5.9 and 6.0, respectively. The nine included adult EoE PROs (EoE-QoL-A, BEDQ, DSQ, EoE-IQ, EEsAI, EoE-SQ, PiEAQ, PROMIS Scale v1.0-Gastrointestinal Disrupted Swallowing, and Straumann Dysphagia Instrument) had mean readability levels ranging from 5.3 to 8.7 with a standard deviation of 1.2. The average readability for all included EoE PROs was 6.6. In conclusion, current EoE PROs as research tools are slightly above recommended readability levels. Future EoE PRO development could be strengthened by using shorter sentences, writing for the target audience, and utilizing input from age-appropriate patients.