How clear and simple are for laypeople the Plain Language Summaries and abstracts in Spanish? A readability assessment of 2019 Cochrane Systematic Reviews

Article type
Authors
Meza N1, Madrid E1, Franco J2, Garnham R3, Olguin-Sepúlveda P3, Urrútia G4, Escobar-Liquitay C2, Perez-Bracchiglione J1
1Interdisciplinary Centre for Health Studies (CIESAL), Cochrane Associate Centre, School of Medicine, Universidad de Valparaíso
2Research Departament, Cochrane Associate Centre, Instituto Universitario Hospital Italiano
3Cochrane Associate Centre, School of Medicine, Universidad de Valparaíso
4Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau, CIBER Epidemiología y Salud Pública, Barcelona
Abstract
Background: Plain Language Summaries (PLS) of Cochrane Systematic Reviews (CSR) must be written and translated in clear and simple language to serve a relevant aim of knowledge translation, and must be accurately summarised in a succinct and readable style, as a way to deliver the results to a broad variety of audiences and cultures. Cochrane has approved standards for the elaboration of the message of PLS, and the regional Cochrane groups have an important role on implementing them correctly in their own languages. Although there have been published some investigations about readability of the PLS compared to abstracts have been, the readability of CSR in Spanish remains unclear.

Objectives: To analyse the readability of the Spanish language PLS and abstracts of CSR of interventions published during 2019.

Methods: We undertook a cross-sectional study assessing CSR published during 2019, which had been translated into Spanish language. We excluded protocols, withdrawn reviews, Cochrane Clinical Answers and non-intervention CSR (prognostic, diagnostic, etc).

We retrieved the CSR and extracted the following data: Title, authors, country of affiliation of the corresponding author, Review Group, and text of PLS and abstract in both English and Spanish (including titles).

We assessed the readability of the Spanish language abstracts and PLS using the readability INFLESZ scale (or Szigriszt Pazos' perspicuity formula) —validated for measuring readability of Spanish language texts—, which scores the difficulty to read a text from 0 (very hard) to 100 points (very easy) (see Table 1 of the attached figure).

We used means, standard deviations and frequencies for descriptive analyses, while for inferential analyses, we performed a two-sample mean-comparison by Student’s T test.

Results: We retrieved a total of 546 CSR of which 505 (92.49%) had PLS and abstract translated into Spanish. The resulting INFLESZ scores for abstracts were 56.68 (±6.59), while PLS scored 50.87 (±6.62), which was significantly different (p<0.001), i.e. PLS were less readable.

Conclusions: The Spanish language abstracts and PLS of CSR published during 2019 have a readability normal and moderately difficult, respectively, for laypeople according to the INFLESZ scale. Moreover, we found that PLS are significantly less readable than abstracts in all the assessed CSR. We conducted a parallel study on English abstracts and PLS and we understand that some of these differences in readibility can be carried in the translation of the original articles.

Patient or healthcare consumer involvement: Adequate health literacy is crucial for patients and consumers in order to be able to understand the health information regarding their conditions, and to take an active role in their health care. Low readability is an important barrier for spanish-speaking health staff and consumers to make the most in using such information.