Online Patient Education Materials on Iron Deficiency Anemia Are Too Difficult to Read and Low Quality: A Readability and Quality Analysis

Abstract

IntroductionPatients increasingly rely on online health information to understand and manage their diseases. Concerns about the quality and readability of these materials have been reported in the literature. Poor quality and difficult-to-read information lead to delayed diagnoses and adverse outcomes. We assessed the quality and readability of online health information about iron deficiency anemia (IDA) on Google. MethodWe searched for online web pages using the term "iron deficiency anemia" on Google. One hundred and twelve out of 200 web pages were included. We assessed web page typology, readability, the Journal of the American Medical Association (JAMA) score, the DISCERN score, and the Health on the Net Foundation certification (HONcode). Statistical analysis was performed with R version 4.2.2. ResultNon-profit and scientific journal web pages were the most common. Scientific journal web pages were of the highest quality. News web pages were the most readable. The first Google Page web pages did not have greater JAMA scores or lower Flesch-Kinkaid Reading Grade Level (FKGL) and Simple Measure of Gobbledygook (SMOG) scores. Forty-six percent of all web pages were high-quality. Web pages on the first Google page were more likely to have HONCode certification. ConclusionWe highlight gaps in the readability and quality of online information about IDA. Online web pages exceeded the recommended reading level for patients. Most web pages were low quality; only a quarter were HONcode-certified; and the first Google page web pages were not higher in quality than the later web pages on search.