Quality and readability of publicly accessible information on menopausal hormone replacement therapy in Canada: What are our patients reading?

Abstract

Objectives To assess the quality and readability of the top 24 menopausal hormone replacement therapy (HRT) websites. Methods The top 24 websites from Google, Bing, and Yahoo were identified using the search term “hormone replacement therapy”. Five menopause specialists assessed website content quality using the DISCERN Instrument, Journal of the American Medical Association (JAMA) benchmarks, and Abbott's Scale. One reviewer evaluated website credibility using the Health on the Net Foundation Code of Conduct (HONcode) certification, and website readability using the Simple Measure of Gobbledygook (SMOG), Flesch-Kincaid Grade Level (FKGL) and Flesch-Kincaid Read Ease (FKRE) formulae. Results Scores for quality of information varied. The mean JAMA score was low at 2.3±1.1 (out of 4). Only one website met all benchmarks. Fourteen websites (58%) had a good/excellent DISCERN score, while four (17%) had a poor/very poor score. For Abbott's Scale, both the mean authorship score at 2.2±1.0 (out of 4) and mean content score at 45.9±9.8 (out of 100) were low. Inter-rater reliability was high for all tools. Fifteen websites (63%) were HONcode certified. The mean FKRE score was 42.7±10.3, mean FKGL was 12.3±1.9 and mean SMOG grade level was 11.3±1.5. Only one website presented content at a reading level recommended for the public. Websites meeting more JAMA benchmarks were significantly less readable (p Conclusions Although good quality menopausal HRT information exists online, several resources are inaccurate or incomplete. Overall, these resources are not considered comprehensible by the public. There is a need to disseminate accurate, comprehensive, and understandable menopausal HRT information online.