We consider a central part of PAL’s mission to be translating the worlds of pharmaceuticals and the law for average consumers. Why does this matter? Because both of these areas, medicines and the law, have a real impact on most people’s daily lives. Yet the details of both of them are far beyond what most people are able to understand. Take your average magazine drug ad — it has happy images of satisfied patients frolicking through fields of flowers, and then on the back it has the “brief summary.” That’s the 6-point type about the drug and all its indications, side effects, pharmacology, etc. These brief summaries are usually written in highly technical language that even most doctors would be hard pressed to understand. And consumers? Forget it.

When pharmaceuticals collide with the legal world, the confusion only gets worse. The law is littered with confusing, arcane, vague and downright impenetrable terms – many of them in Latin. How’s a consumer to understand, let alone navigate, that world?

So one of our goals is to help consumers understand and navigate those two areas, and thus to cut through what we see as the often-intentionally confusing terminology that is designed to prevent people from really understanding and acting as their own advocates. Of course, to do that, we need to be as clear as possible. We aim for this blog to be understandable to all consumers, not just pharmaceutical and health care wonks.

Are we succeeding? Well, the answer is unclear.

Literacy experts talk about “readability.” Readability is whether or not something can be read and understood by the majority of readers. You often hear it said that mainstream newspapers aim to write their articles at an 8th grade reading level. There are a variety of “tools” to measure whether something is readable. They look at sentence length, how many syllables there are in each word, how many sentences are in the passive voice, etc. They’re generally automated, and thus sometimes a bit arbitrary. For instance, the word “understandable” would score as less readable than the word “clear,” even though most 8th graders would easily understand both. So they’re a rough measure.

So how’s the PAL blog doing?

A website that supposedly grades the readability of blogs and websites is making the rounds in the blogosphere. It’s at www.criticsrant.com/bb/reading_level.aspx. No information is available about who wrote it, how they determine the readability, which of the various tools out there they use, etc. So its results must be taken with a grain of salt. Now, with all those disclaimers, here’s how the PAL blog rates:

This was very surprising to us when we first used the tool, which is here. This tool’s scale seems to from Elementary School to High School to College (Undergrad) to College (Postgrad) to Genius. We then decided to use another online tool, located here. That website provides actual results, rather than a one-word summary with no details on how it’s calculated. Here are some of our results:

Gunning Fog Index: 11.95 Flesch-Kincaid Grade: 8.10

Both the Gunning Fog Index and the Flesch-Kincaid Grade level aim to estimate how many years of education your reader has to have to understand your text. As you can see, the two produce very different results. Gunning Fog says that high school seniors (12th grade) can understand our blog. Flesch-Kincaid says 8th graders can. That’s a pretty huge spectrum, although I’m glad they conclude we’re still in the high school range. Although I’d like for the PAL blog to get as close to 8th grade level as possible, it’s probably never going to happen. We have no choice but to use pharmaceutical and legal words that tip the scale (including “pharmaceutical” itself!), even if most people understand them.

So I think it’s unlikely that our blog is really at “Genius” reading level, as the first tool claims. How could one tool put us at 8th grade level and another at “Genius?” It did lead me to wonder how other popular pharmaceutical blogs ranked. Here’s how the ones that I regularly read did:

Blog Flesh-Kincaid Grade Gunning Fog Index Criticsrant.com test
Pharmalot 6.5 9.0 College (postgrad)
GoozNews 8.9 12.59 College (undergrad)
PostScript 9.4 13.63 College (postgrad)
BrandweekNRx 5.46 8.66 Junior High School
PharmaGossip 7.48 11.26 College (postgrad)
Drug Channels 9.9 13.91 College (postgrad)
eDrugSearch Blog 5.92 10.09 Genius
PharmaMarketing Blog 9.06 13.01 College (undergrad)
PharmaFraud 8.66 12.52 College (undergrad)
TortDeform 6.78 10.29 High School
Wall Street Journal Health Blog 6.55 10.41 High School
The Carlat Psychiatry Blog 10.94 15.35 Genius

As you can see, there are some HUGE discrepancies between the Criticsrant.com tool and the Fleisch-Kincaid and Gunning-Fog. The criticsrant.com tool, for instance, puts Cary Byrd’s edrugsearch blog at “Genius” level but Fleisch-Kincaid ranks it at just about 6th Grade. Those must be some smart 6th graders!

So I’d advise bloggers to be wary of the criticsrant.com tool, at least until some more info is released about how they actually determine readability. But there’s still an invaluable lesson to be learned: Those of us who want to educate the public about prescription drugs, medicine, the law, consumer protection and any other important topic need to always strive to make what we write “readable” to as many people as possible. This means writing clearly, avoiding complicated words when simpler ones will do, not using the passive voice, and keeping sentences short. Think like Ernest Hemingway.

I also recommend a great free resource, The Health Literacy Style Manual, which was prepared for Covering Kids and Families by the Maximus Center for Health Literacy.