Abstract: FR-PO1120
Patient-Facing Information on US Kidney Transplant Center Websites Exceeds Recommended Reading Levels: A National Analysis
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Holub, Olena, University of Cincinnati, Cincinnati, Ohio, United States
- Randhawa, Divya, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
- Allen, Rebecca Jane, Mount Saint Joseph University, Cincinnati, Ohio, United States
- Pawar, Aditya S., Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
- Ladin, Keren, Tufts University, Medford, Massachusetts, United States
- Eckhoff, Devin, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
- Nakonechnyi, Alex A., University of Rochester Medical Center, Rochester, New York, United States
Background
Kidney transplantation is the preferred treatment for end-stage kidney disease. Patients increasingly rely on transplant center websites for information. Health communication guidelines recommend patient materials be written at approximately a sixth-grade reading level. We evaluated whether patient-facing content on kidney transplant center websites meets these standards.
Methods
We analyzed 255 U.S. kidney transplant center websites identified through the Scientific Registry of Transplant Recipients. Webpages were extracted and processed using a natural language pipeline. Non-English pages and those with fewer than five sentences were excluded. Readability was assessed using SMOG, Gunning Fog, Flesch–Kincaid, and a transformer-based model (DeBERTa v3).
Results
A total of 92,461 English webpages from 196 transplant center websites were analyzed. Median readability exceeded recommended sixth-grade levels across all measures (SMOG: 14.69; Gunning Fog: 15.78; Flesch–Kincaid: 12.92; transformer: 13.36). Across metrics, 82–97% of webpages exceeded grade 10 and 61–86% exceeded grade 12. At the website level (n = 158), nearly all centers had median readability above grade 12. Readability estimates were strongly correlated (ρ = 0.919–0.989, p < 0.001).
Conclusion
Patient-facing content on kidney transplant center websites is often written above recommended reading levels, creating a mismatch with patient literacy levels. This gap may limit patient understanding and delay engagement in care. Transplant centers should adopt plain-language standards and redesign web content to improve accessibility and transparency.
Readability Metric Summary for U.S. Kidney Transplant Websites
| Metric | Median (IQR) | Mean (SD) | MAD | 75th %ile | 90th %ile |
| SMOG Index | 14.69 (13.01–16.63) | 15.07 (3.19) | 1.81 | 16.63 | 18.75 |
| Gunning Fog Index | 15.78 (13.40–18.48) | 16.36 (4.90) | 2.52 | 18.48 | 21.42 |
| Flesch–Kincaid Grade Level | 12.92 (10.80–15.32) | 13.48 (4.50) | 2.25 | 15.32 | 18.04 |
| Transformer-Based Readability | 13.36 (11.33–15.48) | 13.53 (3.16) | 2.07 | 15.48 | 17.68 |
Distribution of Readability Levels Across SMOG, Gunning Fog, Flesch–Kincaid, and Transformer-Based Metrics.