A critical readability and quality analysis of internet‐based patient information on neck dissections

Grose, Elysia; Kim, Joo Hyun; Philteos, Justine; Levin, Marc; Lee, Jong Wook; Monteiro, Eric

doi:10.1016/j.wjorl.2021.07.001

Cited by 3 publications

(9 citation statements)

References 46 publications

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“…This is consistent with the studies conducted by Lee et al [ 76 ] and Hong et al [ 77 ], who reported no correlation between readability and quality scores. However, this differs significantly from the study conducted by Grose et al [ 71 ] and Raja and Patel [ 78 ], who reported positive correlations between DISCERN, FRES, and FKG, and therefore suggested that higher-quality websites are often more reliable and more likely to be readable. Thus, a more exhaustive investigation of the correlation between FKG, FRES, and DISCERN is required.…”

Section: Discussioncontrasting

confidence: 99%

“…Only 9% (5/57) of the websites achieved the recommended sixth grade or lower readability level. This is similar to observations by McKearney and McKearney [ 70 ] and Grose et al [ 71 ], who both reported an average reading level of 10th grade on websites discussing ear tubes and neck dissections, respectively. Websites with information with a reading grade higher than the recommended level were also reported by Raja and Fitzpatrick [ 29 ], De La Chapa et al [ 72 ], Crabtree and Lee [ 3 ], and Kim et al [ 73 ], thus demonstrating the poor readability of health care websites in general.…”

Section: Discussionsupporting

confidence: 90%

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The Readability and Quality of Web-Based Patient Information on Nasopharyngeal Carcinoma: Quantitative Content Analysis

Tan,

Ko,

Fan

2023

JMIR Form Res

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Background Nasopharyngeal carcinoma (NPC) is a rare disease that is strongly associated with exposure to the Epstein-Barr virus and is characterized by the formation of malignant cells in nasopharynx tissues. Early diagnosis of NPC is often difficult owing to the location of initial tumor sites and the nonspecificity of initial symptoms, resulting in a higher frequency of advanced-stage diagnoses and a poorer prognosis. Access to high-quality, readable information could improve the early detection of the disease and provide support to patients during disease management. Objective This study aims to assess the quality and readability of publicly available web-based information in the English language about NPC, using the most popular search engines. Methods Key terms relevant to NPC were searched across 3 of the most popular internet search engines: Google, Yahoo, and Bing. The top 25 results from each search engine were included in the analysis. Websites that contained text written in languages other than English, required paywall access, targeted medical professionals, or included nontext content were excluded. Readability for each website was assessed using the Flesch Reading Ease score and the Flesch-Kincaid grade level. Website quality was assessed using the Journal of the American Medical Association (JAMA) and DISCERN tools as well as the presence of a Health on the Net Foundation seal. Results Overall, 57 suitable websites were included in this study; 26% (15/57) of the websites were academic. The mean JAMA and DISCERN scores of all websites were 2.80 (IQR 3) and 57.60 (IQR 19), respectively, with a median of 3 (IQR 2-4) and 61 (IQR 49-68), respectively. Health care industry websites (n=3) had the highest mean JAMA score of 4 (SD 0). Academic websites (15/57, 26%) had the highest mean DISCERN score of 77.5. The Health on the Net Foundation seal was present on only 1 website, which also achieved a JAMA score of 3 and a DISCERN score of 50. Significant differences were observed between the JAMA score of hospital websites and the scores of industry websites (P=.04), news service websites (P<.048), charity and nongovernmental organization websites (P=.03). Despite being a vital source for patients, general practitioner websites were found to have significantly lower JAMA scores compared with charity websites (P=.05). The overall mean readability scores reflected an average reading age of 14.3 (SD 1.1) years. Conclusions The results of this study suggest an inconsistent and suboptimal quality of information related to NPC on the internet. On average, websites presented readability challenges, as written information about NPC was above the recommended reading level of sixth grade. As such, web-based information requires improvement in both quality and accessibility, and healthcare providers should be selective about information recommended to patients, ensuring they are reliable and readable.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 90%

The Readability and Quality of Web-Based Patient Information on Nasopharyngeal Carcinoma: Quantitative Content Analysis

Tan,

Ko,

Fan

2023

JMIR Form Res

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“…The mean FKGL level reported in 13 studies ranged from grade 8.8 to 14.8. [13][14][15][16][17][19][20][21][41][42][43] Pooling the data from these studies revealed a weighted FKGL mean grade of 10.78 (95% CI, 9.92-11.72), a weighted SMOG mean of 13.82 (95% CI, 12. 43-15.38), and a weighted FRE mean of 47.72 (95% CI, 41.94-54.31) (Figure 1).…”

Section: Readability Outcomesmentioning

confidence: 99%

“…43-15.38), and a weighted FRE mean of 47.72 (95% CI, 41.94-54.31) (Figure 1). 14,16,18,19,21,23,42,43 No studies reported a mean FKGL of grade 6. 42 The mean Coleman Liau index reported in 5 studies ranged between 10.0 and 12.8, while the reported mean SMOG score ranged between 10.6 and 16.0.…”

Section: Readability Outcomesmentioning

confidence: 99%

“…14,16,18,19,21,23,42,43 No studies reported a mean FKGL of grade 6. 42 The mean Coleman Liau index reported in 5 studies ranged between 10.0 and 12.8, while the reported mean SMOG score ranged between 10.6 and 16.0. 15,17,[41][42][43] All studies that evaluated readability using Gunning Fog index had a mean grade levelhigherthan11(95%CI,11.4-13.8).…”

Section: Readability Outcomesmentioning

confidence: 99%

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Readability of Patient Education Materials in Head and Neck Cancer

Armache,

Assi,

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportancePatient education materials (PEMs) can promote patient engagement, satisfaction, and treatment adherence. The American Medical Association recommends that PEMs be developed for a sixth-grade or lower reading level. Health literacy (HL) refers to an individual’s ability to seek, understand, and use health information to make appropriate decisions regarding their health. Patients with suboptimal HL may not be able to understand or act on health information and are at risk for adverse health outcomes.ObjectiveTo assess the readability of PEMs on head and neck cancer (HNC) and to evaluate HL among patients with HNC.Evidence ReviewA systematic review of the literature was performed by searching Cochrane, PubMed, and Scopus for peer-reviewed studies published from 1995 to 2024 using the keywords head and neck cancer, readability, health literacy, and related synonyms. Full-text studies in English that evaluated readability and/or HL measures were included. Readability assessments included the Flesch-Kincaid Grade Level (FKGL grade, 0-20, with higher grades indicating greater reading difficulty) and Flesch Reading Ease (FRE score, 1-100, with higher scores indicating easier readability), among others. Reviews, conference materials, opinion letters, and guidelines were excluded. Study quality was assessed using the Appraisal Tool for Cross-Sectional Studies.FindingsOf the 3235 studies identified, 17 studies assessing the readability of 1124 HNC PEMs produced by professional societies, hospitals, and others were included. The mean FKGL grade ranged from 8.8 to 14.8; none of the studies reported a mean FKGL of grade 6 or lower. Eight studies assessed HL and found inadequate HL prevalence ranging from 11.9% to 47.0%.Conclusions and RelevanceThese findings indicate that more than one-third of patients with HNC demonstrate inadequate HL, yet none of the PEMs assessed were developed for a sixth grade or lower reading level, as recommended by the American Medical Association. This incongruence highlights the need to address the readability of HNC PEMs to improve patient understanding of the disease and to mitigate potential barriers to shared decision-making for patients with HNC. It is crucial to acknowledge the responsibility of health care professionals to produce and promote more effective PEMs to dismantle the potentially preventable literacy barriers.

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IVC filter – assessing the readability and quality of patient information on the Internet

Ko,

Yun Tan,

Hadeed

2024

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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A critical readability and quality analysis of internet‐based patient information on neck dissections

Cited by 3 publications

References 46 publications

The Readability and Quality of Web-Based Patient Information on Nasopharyngeal Carcinoma: Quantitative Content Analysis

The Readability and Quality of Web-Based Patient Information on Nasopharyngeal Carcinoma: Quantitative Content Analysis

Readability of Patient Education Materials in Head and Neck Cancer

IVC filter – assessing the readability and quality of patient information on the Internet

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