Systemic Evaluation of Quality, Readability, and Integrity of Online Breast Reconstruction Resources.

The aim of this research is to evaluate the websites containing "coccydynia, coccyx trauma or fracture" in terms of readability, reliability, accuracy, and quality. Searches for "coccydynia, coccyx trauma, coccyx fracture" were carried out in the 3 most used search engines in the USA: Google, Yahoo, and Bing in February 2022. A total of 141 websites were rated by 2 different neurosurgeons for the "Global Quality Score" and "Alexa Popularity Rank." 97.2% of the sites examined include the definition of the disease, 66% include the importance of the disease, 92.9% include the symptoms of the disease, 88.7% include the treatment of the disease, 78% include the signs of the disease, 77.3% include the mechanism of the disease It has been determined that the websites examined within the scope of the research have high global quality score (GQS) and APR and are enriched with images to a large extent.

Bullous Pemphigoid: Readability, Quality, and Treatments of Online Health Resources

Readability and quality of online information on total ankle arthroplasty

Readability, quality, and timeliness of patient online health resources for urticaria

Bariatric surgery is a successful treatment for obesity, but barriers to surgery exist, including low health literacy. National organizations recommend patient education materials (PEM) not exceed a sixth-grade reading level. Difficult to comprehend PEM can exacerbate barriers to bariatric surgery, especially in the Deep South where high obesity and low literacy rates exist. This study aimed to assess and compare the readability of webpages and electronic medical record (EMR) bariatric surgery PEM from one institution. Readability of online bariatric surgery and standardized perioperative EMR PEM were analyzed and compared. Text readability was assessed by validated instruments: Flesch Reading Ease Formula (FRE), Flesch Kincaid Grade Level (FKGL), Gunning Fog (GF), Coleman-Liau Index (CL), Simple Measure of Gobbledygook (SMOG), Automated Readability Index (ARI), and Linsear Write Formula (LWF). Mean readability scores were calculated with standard deviations and compared using unpaired t-tests. 32 webpages and seven EMR education documents were analyzed. Webpages were overall "difficult to read" compared to "standard/average" readability EMR materials (mean FRE 50.5 ± 18.3 vs. 67.4 ± 4.2, p = 0.023). All webpages were at or above high school reading level: mean FKGL 11.8 ± 4.4, GF 14.0 ± 3.9, CL 9.5 ± 3.2, SMOG 11.0 ± 3.2, ARI 11.7 ± 5.1, and LWF 14.9 ± 6.6. Webpages with highest reading levels were nutrition information and lowest were patient testimonials. EMR materials were sixth to ninth grade reading level: FKGL 6.2 ± 0.8, GF 9.3 ± 1.4, CL 9.7 ± 0.9, SMOG 7.1 ± 0.8, ARI 6.1 ± 1.0, and LWF 5.9 ± 0.8. Surgeon curated bariatric surgery webpages have advanced reading levels above recommended thresholds compared to standardized PEM from an EMR. This readability gap may unintentionally contribute to barriers to surgery and affect postoperative outcomes. Streamlined efforts are needed to create materials that are easier to read and comply with recommendations.

Quality and Reliability of Publicly Accessible Information on Laser Treatments for Urinary Incontinence: What Is Available to Our Patients?

This project examines ChatGPT's potential to enhance the readability of patient educational materials about interventional radiology (IR) procedures. The descriptions of IR procedures from the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) were used as the original text. Readability scores were calculated using three metrics: Flesch Reading Ease (FRE), Gunning Fog (GF), and the Automated Readability Index (ARI) using an online calculator ( https://readabilityformulas.com ). FRE is scored on a scale of 0-100, where 100 indicates easy-to-read texts, and GF and ARI represent the grade level required to comprehend the text. The DISCERN instrument measured credibility and reliability. ChatGPT was prompted to simplify the texts to a fifth-grade reading level, with subsequent recalculation of readability and DISCERN scores for comparison. Statistical significance was determined using a Wilcoxon Signed-Rank Test. Articles were subsequently organized by subgroups and analyzed. 73 interventional radiology procedures from CIRSE were analyzed. The original FRE score was 47.2 (Difficult), improved to 78.4 (Fairly Easy) by ChatGPT. GF and ARI scores dropped from 14.4 and 11.2 to 7.8 and 5.8, respectively, after simplification, showing significant improvement (p < 0.001). However, the average DISCERN score decreased from 3.73 to 2.99 (p < 0.001) post-ChatGPT simplification. This study shows ChatGPT's ability to make interventional radiology descriptions more readable but highlights its struggle to maintain the original's reliability, suggesting the need for human review and prompt engineering to enhance outcomes. Level 6.

Online Patient Information on Domiciliary Oxygen Therapy: An Evaluation of Quality, Suitability, Reliability, Readability, and Content

The study aimed to assess the quality and readability of web-based information regarding the gingival recession. An internet search was done using two engines (Google and Bing) with the terms “gingival recession,” “gum recession,” and “receding gums.” Each search engine’s top 100 results for each query were filtered out. The websites’ reliability and level of quality were evaluated using the JAMA and DISCERN scores, respectively. Readability was analyzed by the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog index (GFI), Simple Measure of Gobbledygook (SMOG) index, the Coleman-Liau score (CL), the Linsear Write (LW) readability formula and the Automated Readability Index (ARI), via an online readability tool. Of the 151 websites, 81.5% were private dental clinics, 9.3% were advertising sites, 4.6% were national health services, and 4.6% were nonprofit organizations. 11.3% of the websites achieved all four JAMA benchmarks, and the JAMA average of all websites was 2.06. The mean FRES was 54.48, and the mean GFI was 12.82. The mean DISCERN scores for all websites were 43.64 and the DISCERN scores of the websites prepared by periodontologists were statistically significantly higher than the others. The online health information regarding gingival recession has fair reliability and difficult readability. It is essential to produce website information free from commercial bias and simple for patients to understand fully.

INTRODUCTION: Large language models (LLMs) have the potential to revolutionize reproductive health education by offering accessible contraception counseling. The CDC, NIH, and AMA recommend presenting patient educational materials at or below a sixth-grade reading level. In this study, we present a comparative analysis of the readability of responses generated by LLMs, including OpenAI's ChatGPT 4.0, OpenAI's ChatGPT 3.5, Google Bard, and Microsoft Bing, to common contraception questions. METHODS: Referencing common contraception questions outlined in a recent review, we presented GPT-4.0, GPT-3.5, Google Bard, and Microsoft Bing with six common contraception questions on June 10, 2023, ensuring no prior chat bias. The readability of LLM outputs was evaluated using Flesch–Kincaid Grade Level (FK), Gunning Fog (GF), Automated Readability Index (ARI), and Coleman–Liau (CL) indices. All index score outputs correspond to a reading grade level (RGL), eg, RGL of 6 represents a sixth-grade level. RESULTS: Of the four LLMs, Google Bard demonstrated the highest readability with an average RGL of 10.6 (GF 10.1, FK 9.6, ARI 11.4, CL 11.4), followed by GPT-3.5 at an average RGL of 13.6 (GF 13.3, FK 12.6, ARI 15.2, CL 16.5). Microsoft Bing and GPT-4.0 yielded responses with higher average RGLs of 14.2 and 15.4, respectively. CONCLUSION: Google Bard and GPT-3.5 offered the most readable responses to contraception questions; however, these models still provided responses significantly above the recommended sixth-grade reading level (RGL of 6). Large language models should undergo evaluation to ensure alignment with established readability standards to optimize patient comprehension in reproductive counseling applications.

To evaluate the quality & reliability, technical quality, and readability of patient-targeted online information on idiopathic intracranial hypertension. In this cross-sectional study, we searched Google and Bing search engines for the terms "idiopathic intracranial hypertension" and "pseudotumor cerebri." We evaluated the first 50 search outcomes for each search term. Peer-reviewed articles, targeted advertisements, book chapters, videos, personal blogs, websites intended for healthcare professionals, and non-English websites were excluded. Websites were classified as institutional or private. Two independent reviewers assessed each website for 1) quality and reliability using DISCERN, Health on the Net Code of Conduct (HONcode), and JAMA criteria and 2) technical quality based on 11 criteria. Readability was evaluated using 6 measures (Flesch-Kincaid Reading Ease score and grade level, Gunning Fog, Simple Measure of Gobbledygook (Smog) index, Coleman-Liau index, and automated readability index). Sixty-three websites (37 institutional) were included. The mean scores for the DISCERN, HONcode, and JAMA criteria were 3.6 ± 1 (1-4.8; 1: worse, 5: best), 10.3 ± 2.8 (2-16; 0: worse, 16: best), and 2 ± 1.3 (0-4; 0: worse, 4: best), respectively. The mean technical quality score was 0.8 ± 0.1 (0.5-1). The mean Flesch-Kincaid grade level score was 8.9 ± 1.8 (3.3-13.3). For Flesch-Kincaid grade level, 47 (74.6%) websites scored a grade level of 10 or less. For Gunning Fog Score, 35 websites (55.6%) scored from 7.3 to 10.8. For the Smog Index, 46 (73%) websites scored 5.7-8. The mean Coleman Liau Index was 16 ± 2.1 (9.6-22.2). For the automated readability index, 30 (50.7%) websites scored less than the eighth grade. No statistically significant difference was present between institutional and private websites except for JAMA, which scored higher in private websites (2.4 vs 1.7, P = 0.03). Our findings suggest that online information on idiopathic intracranial hypertension/pseudotumor cerebri for patients generally demonstrates moderate to good quality and reliability. Although most websites maintain credible technical quality, the readability exceeds recommended levels for the average American reader. This may impede understanding, emphasizing the need for future improvements.

Patients frequently use the internet as a source to obtain health information. The purpose of this study was to evaluate the quality and readability of online resources on the diagnosis and treatment of ankle osteochondral lesions (OCLs). Three search terms ("ankle cartilage defect," "cartilage injury," "ankle cartilage damage") were entered into 3 search engines (Google, Yahoo, and Bing). The first 20 websites from each search was collected excluding websites intended for health care providers. The quality of the websites were evaluated using the DISCERN instrument, JAMA benchmark, and a Quality rating criteria specific to ankle OCL. The readability was assessed using Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL). Statistical analysis was performed using one-way analysis of variance. A total of 41 websites were reviewed. The mean quality ratings were poor across the assessment tools: DISCERN = 38.5 ± 9.0 (range, 23.7-56.7) out of 80; JAMA = 1.0 ± 1.1 (range, 0-3.3) out of 4; and Quality rating criteria = 11.3 ± 4.6 (range, 4-20.7) out of 24. The mean FRE and FKGL were 40.7 ± 32.0 (range, -152.3 to 60.2) and 13.5 ± 10.8 (range, 8.4-80.7), respectively; higher than the recommended reading level for patients (fifth grade). The quality and readability of credible sources for ankle OCL were poor, which could lead to misinformation. This study should guide the improvement of online information on ankle OCL.

Aim: The study aimed to analyze the quality, adequacy and readability of websites created for patients with shoulder complaints associated with biceps tendon disorders. Methods: The terms 'shoulder injury', 'biceps tendinitis' and 'biceps tendon rupture' were searched in the most used search engines in United States (Google, Yahoo, and Bing). One hundred forty seven websites designed to inform patients were included in the study. The quality, popularity, adequacy and reliability were meausured. Results: Flesch reading ease scores of websites with content creation by health professionals were significantly lower than those without; in contrast, Flesch-Kincaid grade level (FKGL) and Koleman-Liau index scores were significantly higher (p&amp;lt;0.05). Global Quality Score and originality scores were greater in website created by health professionals. In addition, the percentage of websites with reference citations and addressing the importance, symptoms, treatment, signs and mechanism of the disease was significantly higher in websites with content creation by health professionals than in those without (p&amp;lt;0.05). The Gunning Fog, FKGL, Simple Measure of Gobbledygook, Automated readability index and Linear write formula scores were lower for websites with the HON code than those without the HON code. Also orginality score and Alexa Popularity Rank (APR) scores were lower in websites with HONcode than without HON code (p&amp;lt;0.05). Conclusion: Websites with HON code and prepared by healthcare professionals can provide sufficient and quality information to patients with biceps tendon disorders. The web content available for biceps tendon disorders is above the recommended reading level. Health professionals should be encouraged to increase the readability of the content.

The application of Search Engine Optimization (SEO) methods is an effective strategy to improve a website’s ranking on search engines, especially for local media such as Prodesanews.com. This study aims to analyze the implementation of SEO strategies, including on-page, off-page, and technical optimization on Prodesanews.com to increase visibility and organic traffic. This research employs a qualitative descriptive method with a case study approach, where data were collected through observations, in-depth interviews, and document analysis. The results indicate that the implementation of SEO has positively impacted Prodesanews.com's performance. On the on-page aspect, keyword optimization, meta tags, and site speed successfully increased the CTR by 1.6% and reduced the site loading time to under three seconds. Off-page strategies through building backlinks from 91 referring domains and social media promotion also increased impressions up to 365 in the last three months. Meanwhile, technical optimization such as the use of XML sitemaps and responsive design on mobile devices increased organic traffic by 35%. However, challenges like limited resources, Google algorithm changes, and low domain authority remain obstacles in SEO implementation. This study concludes that consistent SEO strategy application can enhance local media visibility in search engines, although its success requires resource support and regular monitoring. Strategic recommendations include strengthening quality backlinks, improving site speed, and diversifying locally based content to enhance Prodesanews.com’s competitiveness in the digital realm. The findings are expected to serve as a reference for other local media in leveraging SEO for growth and sustainability in the digital era.

Most patient education materials on shoulder conditions from the American Academy of Orthopaedic Surgeons exceed recommended readability levels