i-Base treatment guides are written in non-technical language.

Unless information is easy to understand it will exclude people. Notes for how to do this are included below.

All guides are available online as web pages and as PDF downloads.

Print copies can be ordered online. These are free to individuals and UK-based clinics and support groups.

We like our resources to be translated into over 30 languages.

This can include adapting the text when this is needed. See:
i-base.info/adapting-materials

Guidelines for patient information

  1. Information needs to be clear, concise, accurate, relevant and up-to-date.
  2. Information needs to include a date.
  3. The language should help explain each point. Each word is important. The word order in each sentence should be the most direct. (See below).
  4. When there is more than one treatment choice or explanation, we explain the differences.
  5. State clearly when something is not known.
  6. Include facts rather than general statements.
  7. Quantify adjectives.
    • Instead of “some people” or “most people” it is more useful to write “1 in 10″. This format is easier to understand than “10% of people”.
    • Instead of “soon” or “quickly” it is more useful to be specific. Give a rough idea in hours/days/weeks/years etc.
    • When referring to a test result being “high” or “low”, it is better to quantify this and include a reference range.

Non-technical language

  1. Information needs to be clear to read and easy to understand. It should be easy to read for as many people as possible.
  2. This involves taking care with how it is written.
  3. Many people do not have high literacy.
  4. Most people do not have formal medical training.
  5. English is not the first language for many people.
  6. Information is easier to understand if it uses simple short sentences. It is more more difficult if there are 30, 40, 50 or more words. If a sentence include many qualifying ideas it can be difficult to follow.
  7. Reading age of 12 is a good guide for medical information or information about health. This is similar to tabloid newspapers.

Words, sentences, paragraphs

There are easy ways to increase the percentage of people who will be able to read any text.

  1. Use words with 1-2 syllables rather than longer words.
  2. Use short sentences. Aim for 10-12 words on average. Use shorter sentences to make the text more clear and lively. No sentence should need more than 15 words.
  3. Use short paragraphs. Ideally 1-3 sentences per paragraph, using short sentences. Each paragraph to make one clear point.
  4. Include space between paragraphs so people can breathe as they read.
  5. Include a balance of space on every page so people are not hit with a wall of text.
  6. Use the active tense rather than passive voice or tense.
  7. If technical terms are important, explain them in non technical language.
  8. Include a glossary.
  9. Personal stories can make the information much more real.
  10. Check readability score online for any text (see below)

Layout

  1. A larger heading makes each section clear.
  2. Consider an introduction paragraph in a larger typeface or bold type.
  3. Use short subheadings to sign post through the text.
  4. Use bold formatting and/or a larger type subheadings that for body text.
  5. Text size should ideally be 12 point (12 pt).
  6. Leave space between lines with an additional half space between paragraphs.
  7. Leave space on the page – no more than 75% text, 50% is even better.
  8. Include pictures.
  9. Include graphs and tables if information would be clearer in this format.
  10. Include summaries with bullet points for conclusions.
  11. If printing in colour, ensure good contrast for text. Do not use white text against light tone backgrounds. Do not use dark text against dark backgrounds.
  12. Test a colour leaflet with a black and white photocopy. If anything can’t be easily read, the contrast needs to be changed.

Readability scores and plain English

There are several ways to measure how easy information is to read. One of the most widely used is the Flesch-Kincaid readability ease score.

The Flesch-Kincaid readability ease score usually ranges from 0 (very difficult) to 100 (very easy).

It is calculated using a formula that includes looking at the average length or words, sentences and paragraph. There is also a conversion to US school reading grade. (Sixth grade is about 11-12 year old reading age and 12th grade is about 18 year old reading age).

For reading ease scores:

  • 80–90 is ideal (11-12 year old reading age – US 6th grade). This can be difficult to achieve if medical terms are included.
  • 60–70 is a reading age of 13-15 and above 70 should be a minimum.
  • 30 and lower is graduate level (technical). Negative scores are possible.

i-Base guides aim for a reading age of 12 (US grade 6-7).

We aim for a reading score of 70 or higher.

This is so they reach the widest readership. Many people are not confident in reading technical information. It is not helpful to assume high literacy. Many people do not have English as a first language.

Online readability tools and free. They let you cut and past text and produce an instant result. You can edit the text to see how this changes the readability score.

For example, the information on this web page has a Flesch-Kincaid reading ease score of 72 and reading grade of 5.6. It has a SMOG index of 6.5 which is sometimes preferred for health information. There are an average of ten words per sentence.

The spelling and grammar check function in Microsoft Word includes the function to calculate the Flesch-Kincaid reading scores in a document. This is another easy way to check text. It also highlights issues relating to grammar, such as passive sentences. Active sentences are easier to understand.

3 September 2016