Assessing Readability and Quality of Online Patient Directed Information on Hysterectomies

Abstract

Study Objective Hysterectomy is a commonly performed procedure. Accessible online patient information is highly important due to associated risks, implications of the procedure and potential treatment alternatives. The study aims to evaluate quality, comprehensiveness and readability of commonly accessed online patient information on hysterectomies. Design We included websites whose purpose was to provide hysterectomy information for patients. The first 25 webpages on 5 search engines were assessed by two reviewers. Quality of websites was assessed by validated tools for online material (DISCERN and JAMA benchmark). We assessed whether the websites included information on alternatives (including minimally invasive approaches), risks, and benefits. Lastly, readability scores were calculated using standardized tools to assess the grade level or years of education needed to comprehend the material (FKLG, Gunning FOG, SMOG, FRES). Setting N/A Patients or Participants Women seeking online information on hysterectomy to inform their treatment choices. Interventions Hysterectomy (On-line patient information). Measurements and Main Results Forty-seven websites were included according to our selection strategy. On average, websites were of good quality (53.2 ± 10.7 of 80, DISCERN criteria; 2.8 ± 1.2 of 4, JAMA criteria). The majority of websites described alternatives to hysterectomy (33/47, 70.2%) including minimally invasive options (21/47, 44.7%), and also described surgical risks (36/47, 76.6%) and benefits (46/47, 97.9%). However, website article readability corresponded to a grade 12 reading level (FKGL= 11.9 ± 2.3) or reading levels of 11 or 15 years of education (SMOG= 11.1 ± 1.7, Gunning FOG= 14.9 ± 2.4) suggesting these websites are difficult to read for the general population (40.7 ± 12.0 FRES). Conclusion Online patient information on hysterectomy is overall of good quality and contains the majority of the required information. However, the content is more difficult to read than the American Medical Association's recommendation for a grade six level. Website content creators should consider readability to make the content more accessible to patients.