Online Patient Resources for Ankle Instability

Abstract

Background: The Internet has drastically changed how patients access health-related information. There are several ways the public can access online health-related information such as search engines, blogs, support groups, and webinars. A recent study found that 45% of orthopedic patients searched for information online regarding their injury. Also, 78% believed they had better understanding of their condition after visiting these websites; furthermore, 41% felt the Internet supplied them with questions and concerns to discuss with their physicians. The aim of our study is to evaluate the accuracy, quality, and readability of online available information using the search terms "ankle sprain" and "ankle instability." Methods: Three search engines (Google, Bing, and Yahoo) were used to search for the terms "ankle sprain" and "ankle instability." The first 25 websites from each search were collected. Each website was assessed for quality, accuracy, and readability by 3 orthopedic residents blinded to the search term used. Websites were also evaluated for commercial bias and whether written by physicians or not. Results: Twenty sites were identified using Google, 14 using Bing, and 3 using Yahoo while the remaining 19 appeared in multiple search engines. Sixty-nine percent of the websites (39/56) were written by physicians whereas only 21% (12/56) were associated with commercial bias. The mean quality and accuracy of the websites written above a seventh-grade level was statistically significantly higher than those at or below a seventh-grade level (P ¼ .01). The mean accuracy of websites written by physicians was not statistically different from those not written by physicians (P ¼ .055). Conclusion: The current study highlights the poor quality and accuracy of online information related to ankle sprains, especially those with commercial bias. Furthermore, although websites written by or under supervision of physicians were found to be of superior quality, a majority of sites were found to have an unacceptably high reading level. Level of Evidence: Level IV, case series.

Ankle Fractures: The Current State of Online Patient Information

“…One study focusing on hallux valgus found that the average FKGL test score of available websites was 10.4, whereas another study focusing on ankle stability found an average FKGL test score of 10.1. 23,24…”

“…The overall design and analysis utilized in this study was similar to that of previous studies in orthopedics focusing on pathologies other than ankle fractures. 21,22,24,26 The search terms Broken Ankle , Ankle Fracture , and Fibular Fracture were chosen to simulate the spectrum of vocabulary patients suffering from an ankle fracture may use when researching their diagnosis. The term Fibular Fracture was meant to adhere to stricter medical terminology, whereas Broken Ankle was meant to represent a layman’s description of the pathology.…”

“…The quality and accuracy of each website were defined and measured in a manner similar to those of previous studies assessing patient online information for other orthopedic pathologies. 21,22,24,26 Any information available within 1 click of the parent website was assessed. Quality was determined via a grading rubric composed of 36 different criteria (Table 1).…”

“…Previous studies have utilized the FKGL test to assess the readability of patient education materials, and the FKGL test was implemented in this study to increase the ability to compare the results of this study with others. 10,13,23,24 The NDC test has also been used consistently and was used in this study to capture any difficulties in readability not captured by the FKGL test. 20,21,28,29 The NDC score is reported in 2-point grade ranges for grades 5 through 16, correlating to scores of 5.0 to 9.9.…”

“…Unfortunately, the 2 published studies in foot and ankle surgery that examine these 3 factors simultaneously have shown that at minimum, the foot and ankle literature related to hallux valgus and ankle instability adheres to the trend of accepting this trade-off as necessary. 23,24…”