Availability and readability of online patient information on clubfoot: Assessment of paediatric hospital clubfoot web pages

Abstract

Purpose To determine the availability and readability of online patient information (OPI) provided by paediatric hospitals in the United States using clubfoot as a model condition Methods The websites of the top 95 paediatric hospitals identified using US News & World Report were included. The names of paediatric hospitals and the terms “clubfoot”, “clubfeet” and “talipes equinovarus” were entered into the Google search engine. Readability was assessed using five validated metrics and the composite grade level (CGL). The number of unpaid monthly visits was calculated with the Ahrefs Organic Traffic Score (OTS) tool. Data for paediatric hospitals were compared with the same metrics for the top ten Google search results. Results Of 95 paediatric hospitals, 29 (30.5%) did not have at least one web page dedicated to clubfoot. The 128 web pages representing 66 paediatric hospitals had an average CGL of 9.4, representing a readability level requiring some high school education. The mean OTS for all paediatric hospitals was 116 estimated visits per month, which was significantly less than that for the top ten Google clubfoot search results (3035.1; p < 0.0001). Conclusion Paediatric hospital web pages on clubfoot were visited much less frequently than those from the top ten Google search results. Only two web pages (1.6%) from paediatric hospitals offered OPI on clubfoot that met the American Medical Association recommended reading level (sixth-grade level). Paediatric hospitals should create OPI on clubfoot with appropriate readability and accessibility for patient families. Level of Evidence N/A

Readability of Online Patient Educational Materials in Pediatric Orthopaedics: A Systematic Review

“…Pruneski et al 6 reported that websites of pediatric academic societies found from search engines had slightly better readability scores than other websites. However, Xie et al 7 found no difference in the average readability of institution-specific websites compared with articles accessed through Google searches.…”

“…Seven studies assessed the readability of online articles from Pediatric Orthopaedic Society of North America (POSNA), AAOS, AAP, Scoliosis Research Society (SRS), and institution-specific websites (Table 2). 7,11,13,[15][16][17]19 Each study evaluating academic society websites reported mean readability scores of at least an eighth-grade level per the Flesch-Kincaid Grade or Fry Test scale. Only one single article among the three studies was determined to be below a sixth-grade reading level.…”

“…Pruneski and colleagues found that online PEMs for slipped capital femoral epiphysis had a mean readability above the 10th-grade reading level 6 . Examining the readability of pediatric hospital webpages, Xie et al 7 found only 1.6% (2 of 95) of webpages were at the recommended sixth-grade reading level.…”

Readability of online patient educational materials for common orthopaedic paediatric conditions within Australasia

“…Two studies from the USA by Conger et al and Xie et al respectively, have shown that PEMs for DDH and talipes equinovarus have poor readability with average reading grades above recommended levels. 16,17 An Irish study by Mc Carthy and Taylor analysed SUFE specific PEMs, showing only 2 of 21 (9.5%) websites were at an acceptable reading grade below eighth-grade. 5 An overall sample size of 76 for our study is reasonable compared to previous literature, especially given the relatively smaller populations of Australia and New Zealand compared to other western countries.…”

“…and Xie et al . respectively, have shown that PEMs for DDH and talipes equinovarus have poor readability with average reading grades above recommended levels 16,17 . An Irish study by Mc Carthy and Taylor analysed SUFE specific PEMs, showing only 2 of 21 (9.5%) websites were at an acceptable reading grade below eighth‐grade 5 …”