Readability of Dysphagia-Related Patient-Reported Outcome Measures: An Update

Purpose: The purpose of this study was to assess the readability of patient-reported outcome measures (PROMs) related to dysphagia. Method: This descriptive cross-sectional analysis involved a systematic search to identify dysphagia-related PROMs. Readability was assessed using the Coleman-Liau Index (CLI), FORCAST, Gunning Fog Index (FOG), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE) formulas. Results: All five PROMs exceeded the recommended fifth- to sixth-grade reading level across four of the five formulas. CLI scores ranged from 5.5 to 7.7, FORCAST from 9.6 to 10.8, FOG from 7.0 to 9.3, SMOG from 8.1 to 9.9, and FRE from 65 to 79. The average readability grade level ranged from 7.6 to 9.6. Quantitative features such as sentence length, syllable count, and multisyllabic word use further confirmed elevated reading complexity. Conclusions: Dysphagia-related PROMs are written at reading levels that may exceed the comprehension skills of many patients. Developers should incorporate readability assessments during instrument design and validation to enhance accessibility and ensure accurate, representative responses. Poor readability threatens the validity, reliability, and clinical applicability of PROMs, with potential implications for treatment planning and health outcomes. Clinicians must critically evaluate the reading demands of PROMs prior to administration.