Grant Application

Nitin Agarwal, MD, and Robert M. Friedlander, MD, MA, Department of Neurological Surgery, University of Pittsburgh School of Medicine

Proposed Innovation

Informed consent is a critical part of patient care, but patients often do not understand the health care information presented to them. Patients frequently turn to the Internet to get information from professional medical websites, but the readability of patient education resources often exceeds the reading ability of the average American adult. This disconnect can negatively impact patient understanding, leading to poor health outcomes and unnecessary hospital readmission.

This project was designed to improve the readability and accessibility of UPMC patient education materials so patients can participate in shared decision making with a better understanding of disease processes and necessary treatments, and ability to follow physician instructions. It also aspired to identify the best way to educate patients about specific diseases and then create a teaching protocol for physicians to follow.


Through this project, UPMC patient education materials were analyzed and patients assessed to determine their level of understanding of literature regarding their diagnosis, treatment, and prognosis. Patient ratings for accessibility, reliability, and usability of selected patient resources were obtained as a benchmark using several website quality assessment tools. During the next phase of the project, patients will be followed at scheduled clinical visits and reassessed to determine their level of understanding of their disease and how it impacts their health. Patient outcomes will be evaluated and followed over a period of three years.


Information gathered from the analysis and evaluation was published in the Journal of Neurosurgery. In addition, team member Nitin Agarwal co-authored the newly released book, The Evolution of Health Literacy: Empowering Patients through Improved Education. 

Given the immediate impact revision of patient education materials may have on outcomes, the investigators hope to rapidly share and implement the project’s findings throughout the UPMC network. Ultimately, the investigators strive to create a national database for all disease conditions, providing patients access to accurate information pertaining to their health care needs.