Despite recommendations that patient education materials be written at or below a sixth-grade reading level, current resources fail to meet these standards, posing a significant challenge for patients seeking information on parathyroid disorders. Limited progress has been made in endocrine surgery. This study is the first to systematically evaluate the readability of online patient education materials specifically addressing parathyroid disease, including both surgical and nonsurgical aspects.

These findings echo a 2015 study that focused solely on parathyroid surgery materials, which similarly identified a lack of reading level–appropriate resources [27]. Reviews of online materials for other endocrine topics, including thyroid nodules, thyroid surgery, and ablation, likewise demonstrate that resources exceed recommended reading levels [28,29,30,31]. These results highlight the need to improve educational materials, as well-informed patients are better equipped to participate in their care and make critical management decisions. Collaboration among clinicians, educators, and patient advocates can facilitate the development of materials that are both accurate and accessible [9].

Inadequate readability of patient education materials is a persistent challenge across medical specialties. Eltorai and colleagues found that materials on the American Association for the Surgery of Trauma website exceeded recommended reading levels, highlighting a mismatch between material complexity and patients’ reading abilities [32]. Shahid and colleagues demonstrated that patients with limited health literacy have poorer comprehension of health information, which can reduce adherence to management plans, lower engagement in preventive measures, and increase hospital readmissions [33]. Complexity in materials may contribute to delays in seeking care or difficulties following medical instructions. Health literacy is a recognized risk factor for poorer outcomes [34]. Furthermore, Stormacq and colleagues identified that socioeconomically disadvantaged individuals face substantial challenges in evaluating and applying health information, often relying heavily on physicians or informal sources [35]. These findings suggest that complex materials may limit patient understanding, engagement, and the ability to make informed decisions.

Addressing deficiencies in patient education materials requires coordinated, evidence-based strategies that combine clinical expertise with health literacy principles. Tucker and colleagues reported that simplified language and reduced medical jargon improved comprehension and acceptability, although long-term impacts on outcomes remain unclear [36]. Incorporating visual aids and multimedia tools has been shown to enhance understanding. Mbanda and colleagues found that pictograms and videos improved comprehension and adherence among individuals with low literacy [37], and Galmarini and colleagues demonstrated similar benefits in a systematic review [38]. Future efforts should evaluate the impact of accessible materials on patient knowledge, engagement, and clinical outcomes.

Despite recommendations dating back over a decade, little progress has been made in producing grade-appropriate materials [39]. Patel and colleagues suggested diversifying resources using illustrations, diagrams, simplified language, shorter sentences, and clear formatting [27]. Newly created patient materials continue to exceed recommended reading levels.

Artificial intelligence (AI) has potential to improve readability. NYU Langone Health developed AI tools using ChatGPT, Gemini, and Claude to simplify patient education materials from organizations such as the American Heart Association and American Cancer Society. Nasra and colleagues reported reproducibility rates up to 90.7%, user satisfaction exceeding 85%, and 100% post-simplification readability scores with ChatGPT [40]. Limitations include lack of personalization and occasional reliability issues, highlighting the need for multidisciplinary review. Interdisciplinary education coordinated across nurses, physicians, and health educators can further improve outcomes and reduce redundancies [41].

The implications extend to minority and global patient populations. Minority patients in the United States demonstrate disproportionately lower health literacy, with over half of African American adults and more than 65% of Hispanic adults showing limited proficiency, compared to less than 35% of white adults [42, 43]. Given that over 71% of parathyroid materials in this study were above the 12th-grade level, these populations may face additional barriers to recognizing symptoms, understanding treatment options, and seeking specialized care [44, 45]. Immigrant and refugee populations face further obstacles due to language, cultural differences, and legal or administrative barriers [46,47,48].

This study has several limitations. Articles from scientific journals, blog posts, news articles, interviews, and commentary were excluded despite representing potential sources of patient information, as they are not recommended primary educational materials. Additionally, while the readability formulas employed are validated, they may not fully capture nuances related to sentence structure, medical jargon, punctuation, or the use of visual aids and illustrations, which can influence comprehension.