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Meredith and colleagues' claim that leaflets may not be understood by "over a third of those reading them" seems to rest on studies using readability formulas. The validity and usefulness of these studies have been questioned.4 Hawkey and Hawkey reported that a leaflet on diverticular disease with a Flesch reading ease score of 46 was rated as easy to understand by 78% of patients.3 Ley claimed that a text with such a
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