Usability of Patient Education–Oriented Cataract Surgery Websites

Abstract

PurposeTo assess the web accessibility and readability of patient-oriented educational websites for cataract surgery. DesignCross-sectional electronic survey. SubjectsWebsites with information dedicated to educating patients about cataract surgery. MethodsAn incognito search for “cataract surgery” was performed using a popular search engine. The top 100 patient-oriented cataract surgery websites that came up were included and categorized as institutional, private practice, or medical organization according to authorship. Each site was assessed for readability using four standardized reading grade-level formulas. Accessibility was assessed through multilingual availability, accessibility menu availability, complementary educational video availability, and conformance and adherence to the Web Content Accessibility Guidelines (WCAG) 2.0. A standard t-test and chi-squared analysis were performed to assess the significance of differences with regard to readability and accessibility among the three authorship categories. Main Outcome MeasuresThe main outcome measures were the website’s average reading grade level, number of accessibility violations, multilingual availability, accessibility menu availability, complementary educational video availability, accessibility conformance level, and violation of the perceivable, operable, understandable, and robust (POUR) principles according to the WCAG 2.0. Results32, 55, and 13 sites were affiliated with institutions, private practice, and other medical organizations, respectively. The overall mean reading grade was 11.8 ± 1.6, with higher reading levels observed in private practice websites compared to institutions and medical organizations combined (12.1 vs. 11.4; P=0.03). Fewer private practice websites had multiple language options compared to institutional and medical organization websites combined (5.5% vs. 20.0%; P=0.03). More private practice websites had accessibility menus than institutions and medical organizations combined (27.3% vs. 8.9%; P=0.038). The overall mean number of WCAG 2.0 POUR principle violations was 17.1 ± 23.1 with no significant difference among groups. Eighty-five percent of websites violated the perceivable principle. ConclusionsAvailable patient-oriented online information for cataract surgery may not be comprehensible to the general public. Readability and accessibility aspects should be considered when designing these resources.