Online Patient Education Materials for Orthognathic Surgery Fail to Meet Readability and Quality Standards

Abstract

The purpose of this study was to evaluate the readability and quality of online patient educational materials (PEMs) for orthognathic surgery. Two internet searches were performed using the search terms orthognathic surgery and jaw surgery. The presence of content related to the risks, benefits, procedure, and postoperative care was recorded. Readability was measured using 4 validated scales: Flesch-Kincaid grade level, Gunning Fog index, Coleman-Liau index, and Simple Measure of Gobbledygook index. Materials were readable if they were written at or below an eighth-grade reading level as recommended by the American Medical Association (AMA) and the National Institutes of Health (NIH). Quality was assessed using 2 metrics: the DISCERN instrument and the Journal of the American Medical Association benchmark criteria. A DISCERN score of 50 was set as the lower limit of acceptable quality. Mann-Whitney U and Fisher exact tests were used to compare the readability, quality, and presence of content between private practice and non-private practice PEMs. Fifty websites were included in the study after removing duplicates and applying exclusion criteria. On average, PEMs were written at a 13.4-grade level (range, 7.8 to 17.3). Nearly every website (n=49; 98%) mentioned the benefits of surgery; however, very few websites discussed the surgical procedure (n=12; 24%), postoperative care (n=10; 20%), and risks or complications (n=6; 12%). The mean DISCERN score was 25.5 of 80 (range, 18 to 63), and only 2 websites achieved DISCERN scores of acceptable quality. Private practice websites reported less content related to the surgical procedure (P=.03) and had lower DISCERN scores (P=.02). As a whole, online PEMs for orthognathic surgery failed to meet AMA and NIH readability recommendations and yielded poor quality scores. Increasing the presence of content related to treatment risks and postoperative care will help improve the quality of PEMs.