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American Journal of Medical Quality, Vol. 21, No. 1, 49-56 (2006)
DOI: 10.1177/1062860605283572
© 2006 American College of Medical Quality

Variation in the Readability of Items Within Surveys

José L. Calderón, MD

RCMI-Health Services Research Center, Charles R. Drew University of Medicine & Science, Los Angeles, California, CA 90059 drcalderon{at}sbcglobal.net

Leo S. Morales, MD, PhD

David Geffen School ofMedicine and School of Public Health, University of California, Los Angeles

Honghu Liu, PhD

Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles

Ron D. Hays, PhD

Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles

The objective of this studywas to estimate the variation in the readability of survey items within 2 widely used health-related quality-of-life surveys: the National Eye Institute Visual Functioning Questionnaire–25 (VFQ-25) and the Short FormHealth Survey, version 2 (SF-36v2). Flesch-Kincaid and Flesch Reading Ease formulas were used to estimate readability. Individual survey item scores and descriptive statistics for each survey were calculated. Variation of individual item scores from the mean survey score was graphically depicted for each survey. The mean reading grade level and reading ease estimates for the VFQ-25 and SF-36v2 were 7.8 (fairly easy) and 6.4 (easy), respectively. Both surveys had notable variation in item readability; individual itemreadability scores ranged from 3.7 to 12.0 (very easy to difficult) for the VFQ-25 and 2.2 to 12.0 (very easy to difficult) for the SF-36v2. Because survey respondents may not comprehend items with readability scores that exceed their reading ability, estimating the readability of each survey item is an important component of evaluating survey readability. Standards for measuring the readability of surveys are needed.

Key Words: readability • survey research • vulnerable populations


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