Abstract

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is currently the most common liver disease in the United States. Given the potential for significant morbidity and mortality risk, individuals increasingly access online sources for self-education. This study evaluated the quality, readability, and content of readily accessible online resources on NAFLD using validated assessment tools. METHODS: A search of the terms “fatty liver” was executed using the Google search engine to obtain the first 100 websites. Websites that were non-accessible, included videos without transcripts, focused on veterinary topics or were duplicates were excluded. Websites were categorized by intended audience: patient versus professional. Quality was evaluated using the validated DISCERN instrument with DISCERN scores rated as Excellent 56-75, Good 36–55, Poor < 36. Readability was determined using the validated Flesch-Kincaid Grade Level Calculation. Statistical analysis was conducted using a two-tailed Fisher’s Exact Test and a Two-Sample T-test, with a P-value set at <0.05. RESULTS: 100 websites were evaluated with 88 sites meeting inclusion criteria. 52 (59.1%) sites were intended for patients and 36 (40.9%) were for medical professionals. The average Flesch-Kincaid grade level was 12.7, with a significant difference (P = 0.009) between patient (11.9 grade level; range 6.3–18.6) and professional (13.8 grade level; range 7–19.7) websites. Professional sites were significantly (P = 0.0009) more likely to provide references (52.8%) than patient sources (17.3%). The mean DISCERN score was Good 47.7 with no significant difference in measured quality between patient (47.7; range 32–74) and professional (47.8; range 28–72) websites. CONCLUSION: Online NAFLD resources are readily available for patients and professionals. Based on the validated DISCERN tool, the quality of website information as rated as good. However, the patient reading level of medical information exceeded the NIH 6th grade reading level recommendation. Online sources targeted towards patients should be written in more patient-centered language. This study highlights the potential need for improvement in the current online medical information available to both patients and professionals regarding NAFLD and its spectrum of disorders. In addition, most websites disseminating medical information should be revised to include validated references and improve quality content.

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