Favourable understandability, but poor actionability: An evaluation of online type 2 diabetes risk calculators.

Abstract

The study aim was to identify all freely available online diabetes risk calculators and to evaluate their suitability for patients with low health literacy. Online diabetes risk calculators were identified by an environmental scan. The Patient Education Material Assessment Tool for Printable Materials was used to determine understandability and actionability scores. A high-risk profile was used to compare the risk results obtained with each calculator. Thirty-five risk calculators were identified; 51% had no described model, 23% reported absolute risk and 31% used visual aids. The estimated risk for the same profile ranged from low to very high. The mean understandability score was 79% (SD = 19%) and the mean actionability score was 42% (SD = 30%). Online diabetes risk calculators are generally understandable, but not very actionable, and may not be completely suitable for use by patients with low health literacy. The estimated risk is highly variable depending on the underlying model used for the calculation. Patients and healthcare providers need to exercise caution when selecting a diabetes risk calculator.