Assessing the readability of clinical documents in a document engineering environment

Previous work has established that specific linguistic markers present in specialised medical documents (clinical guidelines) can be used to support their automatic structuring within a document engineering environment. This technique is commonly used by the French Health Authority (la Haute Autorite de Sante) during elaboration of clinical guidelines to improve the quality of the final document. In this paper, we explore the readability of clinical guidelines. We discuss a structural measure of document readability that exploits the ratio between these linguistic markers (deontic structures) and the remainder of the text. We describe an experiment in which a corpus of 10 French clinical guidelines is scored for structural readability. We correlate these scores with measures of textual cohesion (computed using latent semantic analysis) and the results of a readability survey performed by a panel of domain experts. Our results suggest an association between the density of deontic structures in a clinical guideline and its overall readability. This implies that certain generic readability measures can henceforth be utilised in our document engineering environment.