Is Online Oriented-Centred Information About Dry Mouth Trustworthy? An Infodemiologic Study.

BackgroundEarly orthodontic intervention during the primary or mixed dentition phase can effectively address malocclusion, mitigate detrimental oral habits, and enhance long-term oral and psychosocial outcomes. Although the American Association of Orthodontists recommends initiating orthodontic assessments for children at age seven, most caregivers consult the internet for information. The quality, reliability, and readability of Arabic-language internet sources regarding early orthodontic treatment remain deficient. This study aimed to assess Arabic websites on early orthodontic treatment in children using validated quality and readability instruments.MethodsIn October 2024, a Google search (Google Inc., Mountain View, CA, USA) was conducted using four Arabic search terms equivalent to “early orthodontic treatment in children.” The eligible websites were classified into different categories based on specialization, organizational affiliation, material type, and presentation style. Website quality was assessed using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmarks, and the Health on the Net (HON) Code. Readability was assessed using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Simplified Measure of Gobbledygook (SMOG) indices. Analysis of variance (ANOVA) and chi-square tests were used for statistical analysis, with p ≤ 0.05 considered statistically significant.ResultsThe initial 200 search results were screened, resulting in 63 eligible sites. The DISCERN assessment indicated that Arabic-language websites concerning early orthodontic treatment exhibited moderate overall quality. The findings from the Journal of the American Medical Association (JAMA) benchmark analysis reinforce these conclusions, with only six (9.5%) websites meeting all four items. None of the included websites was HONcode-certified. University-affiliated websites achieved significantly higher DISCERN and JAMA benchmark scores than commercial or nonprofit websites (p ≤ 0.05). All websites demonstrated high readability (mean FRES > 80), with university-affiliated content written at the most accessible level (p = 0.001).ConclusionsArabic websites on early orthodontic treatment generally display high readability and moderate informational quality. Nonetheless, major gaps remain in authorship transparency, source citations, and the disclosure of conflicts of interest. Increasing government participation and standardizing transparency practices are essential to ensure reliable, evidence-based Arabic orthodontic content for caregivers and patients.

Observational study. To evaluate the readability of commonly utilized patient-reported outcome measures (PROMs) in spine surgery. Although studies have evaluated patient education materials, discharge instructions, and informed consent forms in spine surgery, there is a dearth of literature on the readability of PROMs despite widespread health illiteracy. Without knowledge of PROM readability, it is unclear whether these measures are able to be understood by the average spine patient. We analyzed all commonly utilized nonvisual PROMs within the spinal literature and uploaded PROMs into an online readability calculator. The Flesch Reading Ease Score (FRES) and Simple Measure of Gobbledygook (SMOG) Index were collected. A FRES>79 or SMOG<7 was considered readable by the general population per American Medical Association and Centers for Disease Control guidelines. A stricter threshold recommended in health care (SMOG <6 or FRES>89) was then used to further review readability. Seventy-seven PROMs were included. Based on FRES, the mean readability of all PROMs was 69.2 ± 17.2 (range, 10-96.4), indicating an average eighth to ninth-grade reading level. The mean readability score categorized by the SMOG Index was 8.12 ± 2.65 (range, 3.1-25.6), representing an eighth-grade reading level. Compared with the reading level of the general population, 49 (63.6%) PROMs are written above the United States literacy level, according to FRES. Using stricter definitions of readability, 8 PROMs were considered readable, including PROM Information System pain behavior (FRES: 96.4 and SMOG: 5.2), PROM Information System sleep disturbance (SMOG: 5.6), Neck Pain and Disability Scale (SMOG: 4.3), and Zung Depression Scale (SMOG: 3.1). Most PROMs utilized in spine surgery require an average reading competency far above the average patient's comprehension. This may have a meaningful impact on understanding PROM instruments and may affect the accuracy of complete surveys and the rates of incompletion.

Online health information has become a primary resource for patients making decisions about dental treatments, including dental fillings, a common intervention for tooth restoration. Although readily accessible, concerns remain regarding the quality and readability of such information. Accurate, comprehensible content is crucial for informed decision-making and minimizing the risk of misinformation. This study systematically evaluated the quality and readability of online information on dental fillings. Using Google, Yahoo, and Bing, 178 websites were identified and analyzed, including medical centers, nonprofit organizations, and commercial sites. Quality was assessed using the DISCERN instrument and JAMA benchmarks, focusing on reliability, credibility, and source transparency. Readability was measured using the Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE) scores. Medical and dental center websites accounted for 58.4% of the analyzed resources. However, most websites demonstrated moderate quality, with an average DISCERN score of 2.87, falling short of high reliability and credibility standards. Readability analysis indicated that the information was moderately difficult to understand, with FKGL averaging 8.6 and FRE at 59.2, suggesting an 8th-grade reading level requirement. The quality and readability of online information on dental fillings were generally moderate, indicating room for improvement in clarity and trustworthiness. The findings highlighted a need for higher standards in online dental information to support patient education and informed decision-making. Improved guidance on trustworthy sources could enhance health literacy and foster better patient outcomes in dental care.

Readability Assessment of Online Tracheostomy Care Resources

Readability assessment of online tracheostomy care resources.

Orthodontic treatments aim to enhance dental aesthetics, functionality, and long-term oral health. Clear aligners have gained popularity as an aesthetic and convenient option for patients seeking orthodontic correction. However, the quality and readability of online Arabic patient-centered information regarding clear aligners has not been studied yet. The aim of our study is to investigate the quality and readability of Arabic patient-centered information about clear aligners. We conducted an extensive evaluation of Arabic web-based content pertaining to clear aligners using three prominent search engines. Eligible websites were categorized based on specialization, organizational affiliation, material type, and presentation style. We assessed website quality and reliability using the DISCERN instrument, Journal of American Medical Association (JAMA)benchmarks, and Health on the Net (HON) code. In addition, we measured readability using the Flesch Reading Ease Score (FRES), Simplified Measure of Gobbledygook (SMOG), and Flesch-Kincaid Grade Level (FKGL). Out of 600 search results, 195 websites met the inclusion criteria. None of the websites were HON-code accredited. DISCERN assessments revealed low content quality, with none of the websites achieving high-quality status. The JAMA benchmarks showed limited compliance with the four items, with currency being the most frequently achieved. Readability assessments indicated generally high readability, with FKGL scores suggesting easy comprehension for the average readers. While Arabic web-based information on clear aligners is highly readable, its credibility and quality require significant improvement. Websites should adhere to medical information standards, subject content to rigorous assessments, and seek accreditation to ensure reliability. Enhancing the accessibility and comprehensibility of health-related content will empower individuals to make informed health decisions. Addressing limitations, such as social media and video content evaluation, and conducting comparisons with English websites in future research will provide a more comprehensive understanding of the landscape of online orthodontic information.

Patient-reported outcome measures (PROMs) assess function, symptoms, and quality of life in surgical oncology. However, many exceed the National Institutes of Health (NIH) and American Medical Association (AMA) readability guidelines, which recommend materials be written at or below a sixth-grade reading level. This study evaluates the readability of 24 commonly used PROMs in surgical oncology. The Flesch Reading Ease Score (FRES) and Simple Measure of Gobbledygook (SMOG) Index were used to assess readability. A FRES ≥ 80 or SMOG < 7.0 indicated sixth-grade-level readability, per NIH/AMA guidelines. Spearman's correlation analyzed the relationship between FRES and SMOG scores. The mean FRES was 70 ± 14, and the mean SMOG was 8 ± 1, corresponding to an eighth- to ninth-grade reading level. Only seven PROMs met at least one readability threshold, while 75% exceeded the sixth-grade recommendation. Spearman's correlation (ρ = -0.75, p < 0.001) showed a strong inverse relationship between FRES and SMOG, though some PROMs exhibited notable discrepancies. Most surgical oncology PROMs exceed recommended readability levels, potentially limiting patient comprehension and data accuracy. Improving readability through simplified language, multimedia adaptations, and standardized readability benchmarks may enhance accessibility and clinical utility.

BackgroundEndodontic microsurgery (apicectomy) can be considered in cases of persistent infection that is resistant to conventional root canal treatment. The aim of this study was to evaluate the quality and readability of the available online information regarding the apicectomy procedure in Arabic.MethodsOnline search on the three most commonly used websites (Google, Yahoo, and Bing) using one keyword. The first 100 websites from each search were analyzed for quality and readability using DISCERN instrument scores, the Journal of the American Medical Association (JAMA) benchmarks, the Health On the Net (HON) seal, Flesch Reading Ease Scores (FRES), Flesch-Kincaid Grade Level (FKGL), and the Simplified Measure of Gobbledygook (SMOG) Index.ResultsSearching using the Arabic translation for "root end resection surgery" revealed 349,900 websites. Following the inclusion criteria, 31 websites were selected and evaluated in this study. The selected websites belonged to either non-profit organizations or commercial websites. The quality of most of the selected websites received a moderate score (83.9%) using the DISCERN tool. None of the selected websites obtained the HON seal. Quality evaluation using the JAMA benchmarks revealed that currency was the most achieved item (45.2%), followed by authorship (22.6%). Evaluation of the readability of the selected websites using the FRES, FKGL, and SMOG showed that the included websites were considered readable.ConclusionAlthough the included websites were readable, the quality of the websites was moderate. There is an urgent need to create more trustworthy and readable websites explaining the different endodontic treatments.

This study aims to compare the readability of patient education materials (PEM) of the American Society of Ophthalmic Plastic and Reconstructive Surgery to that of PEMs generated by the AI-chat bots ChatGPT and Google Bard. PEMs on 16 common American Society of Ophthalmic Plastic and Reconstructive Surgery topics were generated by 2 AI models, ChatGPT 4.0 and Google Bard, with and without a 6th-grade reading level prompt modifier. The PEMs were analyzed using 7 readability metrics: Flesch Reading Ease Score, Gunning Fog Index, Flesch-Kincaid Grade Level, Coleman-Liau Index, Simple Measure of Gobbledygook Index Score, Automated Readability Index, and Linsear Write Readability Score. Each AI-generated PEM was compared with the equivalent American Society of Ophthalmic Plastic and Reconstructive Surgery PEM. Across all readability indices, PEM generated by ChatGPT 4.0 consistently had the highest readability scores, indicating that the material generated by this AI chatbot may be most difficult to read in its unprompted form (Flesch Reading Ease Score: 36.5; Simple Measure of Gobbledygook: 14.7). Google's Bard was able to generate content that was easier to read than both the American Society of Ophthalmic Plastic and Reconstructive Surgery and ChatGPT 4.0 (Flesch Reading Ease Score: 52.3; Simple Measure of Gobbledygook: 12.7). When prompted to produce PEM at a 6th-grade reading level, both ChatGPT 4.0 and Bard were able to significantly improve in their readability scores, with prompted ChatGPT 4.0 being able to consistently generate content that was easier to read (Flesch Reading Ease Score: 67.9, Simple Measure of Gobbledygook: 10.2). This study suggests that AI tools, when guided by appropriate prompts, can generate accessible and comprehensible PEMs in the field of ophthalmic plastic and reconstructive surgeries, balancing readability with the complexity of the necessary information.

Background Haemorrhoids, anal fissures, and anal fistulae are common benign proctological conditions that heavily rely on self-management strategies to prevent morbidity. Online access to various treatment options has empowered patients in this regard. This study was conducted to assess the quality and readability of the available online information. Methods An online search using the Google search engine (Google, Inc., Mountain View, CA, USA) was carried out with the following terms: 'Treatment of Haemorrhoids', 'Treatment of Anal Fissure', and 'Treatment of Anal Fistula'. For each search term, the first 25 webpages developed for patient education were included. Thus, a total of 75 webpages were analysed for their quality using the DISCERN instrument and the Journal of the American Medical Association (JAMA) benchmarks. Their readability was assessed using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and the Simple Measure of Gobbledygook (SMOG). Results Across the three search terms, the average overall DISCERN score was 2.4 ± 0.8 (out of five), suggesting moderate to low-quality information. Only 16 (21%) webpages fulfilled all four JAMA benchmark criteria for quality. An average FRES score of 57.6 ± 9.0 indicated that the text was fairly difficult to read. FKGL and SMOG index levels of 8.0 ± 1.6 and 10.7 ± 1.0, respectively, correspond to the reading age range of 13- to 16-year-olds. Conclusion Available online information for patients with common proctological complaints is of suboptimal quality and is fairly difficult to read. It is essential to ensure that the information available meets high-quality standards and is readable by patients.

This study aimed to evaluate the quality, reliability, and readability of online patient-centered information related to the management of gummy smile. A systematic search was conducted using Google, Yahoo, and Bing to identify websites providing patient-oriented information on gummy smile treatments. A total of 257 websites met the inclusion criteria and were analyzed. Content quality was assessed using the DISCERN instrument, Journal of the American Medical Association (JAMA) benchmarks, and the Health on the Net (HON) code certification. Readability was evaluated using the Flesch Reading Ease Score (FRES), Flesch -Kincaid Grade Level (FKGL), Simplified Measure of Gobbledygook (SMOG) index, and Coleman -Liau index. The overall quality of online information was low to moderate, with a mean DISCERN score of 40 ± 9.9. Only 11 websites were certified by the HON code, indicating limited adherence to established standards for trustworthy health information. According to JAMA benchmarks, only two websites fulfilled all four criteria. Readability analysis demonstrated that the content was relatively complex, with a mean FRES of 60.1 ± 9.2 and a mean FKGL of 8.9 ± 1.8, exceeding the recommended reading level for the general public. Online patient-centered information regarding gummy smile is generally of suboptimal quality and readability. The limited number of reliable and easily understandable resources underscores the need for improved quality control, standardization, and patient-focused content development. Enhancing the accessibility and reliability of online information may support better patient understanding and informed decision-making in dental aesthetics.

This study assesses the quality and readability of Arabic online information about orthodontic pain. With the increasing reliance on the internet for health information, especially among Arabic speakers, it's critical to ensure the accuracy and comprehensiveness of available content. Our methodology involved a systematic search using the Arabic term for (Orthodontic Pain) in Google, Bing, and Yahoo. This search yielded 193,856 results, from which 74 websites were selected based on predefined criteria, excluding duplicates, scientific papers, and non-Arabic content. For quality assessment, we used the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmarks, and the Health on the Net (HON) code. Readability was evaluated using the Simplified Measure of Gobbledygook (SMOG), Flesch Reading Ease Score (FRES), and Flesch-Kincaid Grade Level (FKGL) scores. Results indicated that none of the websites received the HONcode seal. The DISCERN assessment showed median total scores of 14.96 (± 5.65), with low overall quality ratings. In JAMA benchmarks, currency was the most achieved aspect, observed in 45 websites (60.81%), but none met all four criteria simultaneously. Readability scores suggested that the content was generally understandable, with a median FKGL score of 6.98 and a median SMOG score of 3.98, indicating middle school-level readability. This study reveals a significant gap in the quality of Arabic online resources on orthodontic pain, highlighting the need for improved standards and reliability. Most websites failed to meet established quality criteria, underscoring the necessity for more accurate and trustworthy health information for Arabic-speaking patients.

Anosmia can have a significant impact on well-being and quality of life. Due to an ageing population and the coronavirus disease 2019, increasing numbers of patients are seeking online information on anosmia. This report systematically assesses the readability and quality of online information on anosmia. The terms 'anosmia' and 'loss of smell' were entered into Google. The first 50 websites generated for each search term were screened. Readability was assessed using the Flesch-Kincaid Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG) Index and Gunning Fog Index (GFI). Quality was assessed using the DISCERN instrument. Spearman's correlation between quality and readability was calculated. A total of 79 websites met the inclusion criteria. The mean and 95% confidence interval for the FRES, FKGL, SMOG, GFI and DISCERN scores were 46.31 (42.94-49.68), 12.00 (11.27-12.73), 10.70 (10.16-11.23), 14.62 (13.85-15.39) and 2.90 (2.69-3.11), respectively. Significant negative correlation was noted between the DISCERN and FRES (rs=-0.500; p<0.05). Online information on anosmia is written above the recommended reading age guidance in the UK, and has moderate deficiencies in quality. As a result, the information may be used inappropriately and could result in worse health outcomes. We recommend that patients are directed to websites produced by health providers or nonprofit organisations that develop material for patient health education. Online information on anosmia is of low readability and moderate quality. Healthcare professionals should direct patients towards high-quality resources written for the layperson.

Introduction Osteoarthritis (OA) is an age-related degenerative joint disease. There is a 25% risk of symptomatic hip OA in patients who live up to 85 years of age. It can impair a person's daily activities and increase their reliance on healthcare services. It is primarily managed with education, weight loss and exercise, supplemented with pharmacological interventions. Poor health literacy is associated with negative treatment outcomes and patient dissatisfaction. A literature search found there are no previously published studies examining the readability of online information about hip OA. Objectives To assess the readability of healthcare websites regarding hip OA. Methods The terms "hip pain", "hip osteoarthritis", "hip arthritis", and "hip OA" were searched on Google and Bing. Of 240 websites initially considered, 74 unique websites underwent evaluation using the WebFX online readability software (WebFX®, Harrisburg, USA). Readability was determined using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Reading Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index (CLI), and Automated Readability Index (ARI). In line with recommended guidelines and previous studies, FRES >65 or a grade level score of sixth grade and under was considered acceptable. Results The average FRES was 56.74±8.18 (range 29.5-79.4). Only nine (12.16%) websites had a FRES score >65. The average FKGL score was 7.62±1.69 (range 4.2-12.9). Only seven (9.46%) websites were written at or below a sixth-grade level according to the FKGL score. The average GFI score was 9.20±2.09 (range 5.6-16.5). Only one (1.35%) website was written at or below a sixth-grade level according to the GFI score.The average SMOG score was 7.29±1.41 (range 5.4-12.0). Only eight (10.81%) websites were written at or below a sixth-grade level according to the SMOG score. The average CLI score was 13.86±1.75 (range 9.6-19.7). All 36 websites were written above a sixth-grade level according to the CLI score. The average ARI score was 6.91±2.06 (range 3.1-14.0). Twenty-eight(37.84%) websites were written at or below a sixth-grade level according to the ARI score. One-sample t-tests showed that FRES (p<0.001, CI -10.2 to -6.37), FKGL (p<0.001, CI 1.23 to 2.01), GFI (p<0.001, CI 2.72 to 3.69), SMOG (p<0.001, CI 0.97 to 1.62), CLI (p<0.001, CI 7.46 to 8.27), and ARI (p<0.001, CI 0.43 to 1.39) scores were significantly different from the accepted standard. One-way analysis of variance (ANOVA) testing of FRES scores (p=0.009) and CLI scores (p=0.009) showed a significant difference between categories. Post hoc testing showed a significant difference between academic and non-profit categories for FRES scores (p=0.010, CI -15.17 to -1.47) and CLI scores (p=0.008, CI 0.35 to 3.29). Conclusions Most websites regarding hip OA are written above recommended reading levels, hence exceeding the comprehension levels of the average patient. Readability of these resources must be improved to improve patient access to online healthcare information which can lead to improved patient understanding of their own condition and treatment outcomes.

Patient-reported outcome measures (PROMs) are essential tools for assessing surgical effectiveness and capturing patient perspectives on functionality, symptoms, and quality of life. However, readability is critical for ensuring patients can understand and accurately complete them. The National Institutes of Health (NIH) and American Medical Association (AMA) recommend that patient materials be written at or below a sixth-grade reading level. In pediatric orthopaedic surgery, the Pediatric Outcomes Data Collection Instrument (PODCI), Pediatric Quality of Life Inventory (PedsQL), and Patient-Reported Outcomes Measurement Information System (PROMIS) instruments are among the most commonly utilized PROMs. This study evaluates whether PROMs used in pediatric orthopaedic registries meet NIH and AMA readability standards. A readability analysis was performed on 59 PROMs reported in pediatric orthopaedic registries. PROMs were categorized as validated or not validated for patients under 18 years of age. Primary readability metrics were the Flesch Reading Ease Score (FRES) and the Simple Measure of Gobbledygook (SMOG) Index. Scores were obtained using an online calculator and compared against NIH and AMA guidelines. A FRES ≥80 or SMOG <7 was considered reflective of a sixth-grade or lower reading level. The average FRES and SMOG Index for all PROMs were 69 ± 14 and 8 ± 1, respectively, corresponding to an eighth to ninth-grade reading level. Only 4 PROMs met both FRES and SMOG readability thresholds: Hospital Anxiety and Depression Scale, Knee Society-Function, Children's Revised Impact of Event Scale, and PedsQL. PROMs such as the International Knee Documentation Committee, Lower Extremity Functional Scale, Single Assessment Numeric Evaluation, University of California Los Angeles Activity Scale, and Kujala Score were among the least readable. Although PedsQL met both readability thresholds, PODCI and PROMIS instruments were written above the recommended sixth-grade reading level. Most PROMs used in pediatric orthopaedic surgery are written above the recommended sixth-grade reading level, potentially impacting patient comprehension and the reliability of collected data. Level IV-observational study.