Average Flesch-Kincaid Grade Level Research Articles

Trustworthiness, Value, Danger, and Readability of ChatGPT-Generated Responses to Health Questions Related to Pulmonary Arterial Hypertension.

To enhance outcomes for patients with pulmonary arterial hypertension (PAH), comprehensive and individualized therapy is needed. A large language model called Generative Pre-trained Transformer (ChatGPT) has the ability to provide expert yet patient-friendly care. We wanted to determine how well ChatGPT could accurately and consistently respond to inquiries on knowledge and management for PAH. When 20 PAH patients were diagnosed, they were asked what concerns they had about PAH and what they had researched online.In the evaluation, it was determined that patients frequently searched the Internet for answers to eight queries. These eight queries were posed to ChatGPT, and their responses were recorded. Ten experts in the field of PAH assessed the trustworthiness, value, and hazard of the answers generated by the ChatGPT. According to evaluations conducted by experts, the ChatGPT-generated responses were deemed trustworthy with an average score of 8.4 (7.7-9.2) and valuable with an average score of 7.9 (7.4-8.2). Based on the statistical analysis, it can be inferred that most professionals believed that the utilization of prompts provided by ChatGPT did not present a substantial risk, with a mean of 2.1 (1.7-2.5).The answers were assessed for readability using two different indicators, namely the Flesch-Kincaid Grade Level (FKGL) and the Simple Measure of Gobbledygook (SMOG). The average FKGL value was determined to be 13.52 ± 2.40, indicating a "difficult" level of readability. ChatGPT provides reliable PAH-related information, but it is important to seek professional medical advice before making any decisions regarding PAH. ChatGPT can only provide general information and support, but a qualified healthcare provider can offer tailored recommendations.

Can ChatGPT answer patient questions regarding reverse shoulder arthroplasty?

IntroductionIn recent years, artificial intelligence (AI) has seen substantial progress in its utilization, with Chat Generated Pre-Trained Transformer (ChatGPT) is emerging as a popular language model. The purpose of this study was to test the accuracy and reliability of ChatGPT's responses to frequently asked questions (FAQ) pertaining to reverse shoulder arthroplasty (RSA). MethodsThe ten most common FAQs were queried from institution patient education websites. These ten questions were then input into the chatbot during a single session without additional contextual information. The responses were then critically analyzed by two orthopedic surgeons for clarity, accuracy, and the quality of evidence-based information using The Journal of the American Medical Association (JAMA) Benchmark criteria and the DISCERN score. The readability of the responses was analyzed using the Flesch-Kincaid Grade Level. ResultsIn response to the ten questions, the average DISCERN score was 44 (range 38–51). Seven responses were classified as fair and three were poor. The JAMA Benchmark criteria score was 0 for all responses. Furthermore, the average Flesch-Kincaid Grade Level was 14.35, which correlates to a college graduate reading level. ConclusionOverall, ChatGPT was able to provide fair responses to common patient questions. However, the responses were all written at a college graduate reading level and lacked reliable citations. The readability greatly limits its utility. Thus, adequate patient education should be done by orthopedic surgeons. This study underscores the need for patient education resources that are reliable, accessible, and comprehensible. Level of evidenceIV.

Expanding Accessibility in Cleft Care: The Role of Artificial Intelligence in Improving Literacy of Alveolar Bone Grafting Information.

The American Medical Association (AMA) recommends patient education materials (PEMs) be written at or below a sixth grade reading level. This study seeks to determine the quality, readability, and content of available alveolar bone grafting (ABG) PEMs and determine if artificial intelligence can improve PEM readability. Review of free online PEMs. Online ABG PEMs were retrieved from different authoring body types (hospital/academic center, medical society, or private practice). None. Content was assessed by screening PEMs for specific ABG-related topics. Quality was evaluated with the Patient Education Material Assessment Tool (PEMAT), which has measures of understandability and actionability. Open-access readability software (WebFX) determined readability with Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning-Fog Index. PEMs were rewritten with ChatGPT, and readability metrics were reassessed. Quality, readability, and content of ABG PEMs. 34 PEMs were analyzed. Regarding quality, the average PEMAT-understandability score was 67.0 ± 16.2%, almost at the minimum acceptable score of 70.0% (p = 0.281). The average PEMAT-actionability score was low at 33.0 ± 24.1%. Regarding readability, the average Flesch Reading Ease score was 64.6 ± 12.8, categorized as "standard/plain English." The average Flesch-Kincaid Grade Level was 8.0 ± 2.3, significantly higher than AMA recommendations (p < 0.0001). PEM rewriting with ChatGPT improved Flesch-Kincaid Grade Level to 6.1 ± 1.3 (p < 0.0001). Available ABG PEMs are above the recommended reading level, yet ChatGPT can improve PEM readability. Future studies should improve areas of ABG PEMs that are most lacking, such as actionability.

Evaluation of the quality of Internet information on masseter botox injection for bruxism.

Botulinum toxin, commonly referred to as botox, is frequently used in facial aesthetics, but also has therapeutic applications in various medical and surgical conditions such as bruxism treatment. The aim of this research is to evaluate the information quality of only English resources available on the Internet regarding the use of botulinum toxin in the treatment of bruxism. The terms "Botox + Tooth Grinding" selected for this study were searched on the Internet using the Google Search Engine, and the URLs of the top 150 websites containing only English pages were recorded and examined. The websites were assessed using DISCERN tools, the Journal of the American Medical Association (JAMA) benchmark, and HONcode tools. The website readability evaluation involved utilizing the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Grade Level (FKGL). A total of 130 websites met the inclusion criteria. The total mean DISCERN score (section 1 + section 2) for all websites was 39.75/75 (range: 15-67). The average FRES of all websites was 52.79, and the average FKGL score of all websites was 10.72. Internet blog websites had significantly higher DISCERN (Section1) scores than other websites (p= 0.007). Only one website had the HON code. Internet blog websites showed better compliance with JAMA (authorship and currency) benchmarks. No statistically significant difference was determined related to FRES and FKGL scores between groups (p> 0.05). There is moderate and difficult-to-read information on the Internet about masseter botox injection for bruxism. Relevant guidelines are needed to improve the quality of websites about botulinum toxin for the treatment of bruxism.

Resources on lymphedema surgery: How effective are they for patients?

Online patient education materials (PEMs) on lymphedema surgery were assessed for quality, readability, and content. A total of 37 PEMs were identified, primarily authored by academic/medical organizations. Readability scores indicated materials were difficult to read, with an average Flesch-Kincaid Grade Level of 10.4. PEM Assessment Tools showed acceptable understandability (72.3%) but poor actionability (28.5%). PEMs often lacked information on surgical risks, postoperative care, and long-term follow-up. Simplifying language and adding visual aids could improve PEM effectiveness.

Evaluating ChatGPT's efficacy and readability to common pediatric ophthalmology and strabismus-related questions.

The rise in popularity of chatbots, particularly ChatGPT by OpenAI among the general public and its utility in the healthcare field is a topic of present controversy. The current study aimed at assessing the reliability and accuracy of ChatGPT's responses to inquiries posed by parents, specifically focusing on a range of pediatric ophthalmological and strabismus conditions. Patient queries were collected via a thematic analysis and posed to ChatGPT 3.5 version across 3 unique instances each. The questions were divided into 12 domains totalling 817 unique questions. All responses were scored on the response quality by two experienced pediatric ophthalmologists in a Likert-scale format. All questions were evaluated for readability using the Flesch-Kincaid Grade Level (FKGL) and character counts. A total of 638 (78.09%) questions were scored to be perfectly correct, 156 (19.09%) were scored correct but incomplete and only 23 (2.81%) were scored to be partially incorrect. None of the responses were scored to be completely incorrect. Average FKGL score was 14.49 [95% CI 14.4004-14.5854] and the average character count was 1825.33 [95%CI 1791.95-1858.7] with p = 0.831 and 0.697 respectively. The minimum and maximum FKGL scores were 10.6 and 18.34 respectively. FKGL predicted character count, R²=.012, F(1,815) = 10.26, p = .001. ChatGPT provided accurate and reliable information for a majority of the questions. The readability of the questions was much above the typically required standards for adults, which is concerning. Despite these limitations, it is evident that this technology will play a significant role in the healthcare industry.

The Use of Artificial Intelligence to Improve Readability of Otolaryngology Patient Education Materials.

The recommended readability of health education materials is at the sixth-grade level. Artificial intelligence (AI) large language models such as the newly released ChatGPT4 might facilitate the conversion of patient-education materials at scale. We sought to ascertain whether online otolaryngology education materials meet recommended reading levels and whether ChatGPT4 could rewrite these materials to the sixth-grade level. We also wished to ensure that converted materials were accurate and retained sufficient content. Seventy-one articles from patient educational materials published online by the American Academy of Otolaryngology-Head and Neck Surgery were selected. Articles were entered into ChatGPT4 with the prompt "translate this text to a sixth-grade reading level." Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL) were determined for each article before and after AI conversion. Each article and conversion were reviewed for factual inaccuracies, and each conversion was reviewed for content retention. The 71 articles had an initial average FKGL of 11.03 and FRES of 46.79. After conversion by ChatGPT4, the average FKGL across all articles was 5.80 and FRES was 77.27. Converted materials provided enough detail for patient education with no factual errors. We found that ChatGPT4 improved the reading accessibility of otolaryngology online patient education materials to recommended levels quickly and effectively. Physicians can determine whether their patient education materials exceed current recommended reading levels by using widely available measurement tools, and then apply AI dialogue platforms to modify materials to more accessible levels as needed. Level 5.

Large Language Models for Intraoperative Decision Support in Plastic Surgery: A Comparison between ChatGPT-4 and Gemini.

Background and Objectives: Large language models (LLMs) are emerging as valuable tools in plastic surgery, potentially reducing surgeons' cognitive loads and improving patients' outcomes. This study aimed to assess and compare the current state of the two most common and readily available LLMs, Open AI's ChatGPT-4 and Google's Gemini Pro (1.0 Pro), in providing intraoperative decision support in plastic and reconstructive surgery procedures. Materials and Methods: We presented each LLM with 32 independent intraoperative scenarios spanning 5 procedures. We utilized a 5-point and a 3-point Likert scale for medical accuracy and relevance, respectively. We determined the readability of the responses using the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) score. Additionally, we measured the models' response time. We compared the performance using the Mann-Whitney U test and Student's t-test. Results: ChatGPT-4 significantly outperformed Gemini in providing accurate (3.59 ± 0.84 vs. 3.13 ± 0.83, p-value = 0.022) and relevant (2.28 ± 0.77 vs. 1.88 ± 0.83, p-value = 0.032) responses. Alternatively, Gemini provided more concise and readable responses, with an average FKGL (12.80 ± 1.56) significantly lower than ChatGPT-4's (15.00 ± 1.89) (p < 0.0001). However, there was no difference in the FRE scores (p = 0.174). Moreover, Gemini's average response time was significantly faster (8.15 ± 1.42 s) than ChatGPT'-4's (13.70 ± 2.87 s) (p < 0.0001). Conclusions: Although ChatGPT-4 provided more accurate and relevant responses, both models demonstrated potential as intraoperative tools. Nevertheless, their performance inconsistency across the different procedures underscores the need for further training and optimization to ensure their reliability as intraoperative decision-support tools.

Evaluating Chat Generative Pre-trained Transformer Responses to Common Pediatric In-toeing Questions.

Chat generative pre-trained transformer (ChatGPT) has garnered attention in health care for its potential to reshape patient interactions. As patients increasingly rely on artificial intelligence platforms, concerns about information accuracy arise. In-toeing, a common lower extremity variation, often leads to pediatric orthopaedic referrals despite observation being the primary treatment. Our study aims to assess ChatGPT's responses to pediatric in-toeing questions, contributing to discussions on health care innovation and technology in patient education. We compiled a list of 34 common in-toeing questions from the "Frequently Asked Questions" sections of 9 health care-affiliated websites, identifying 25 as the most encountered. On January 17, 2024, we queried ChatGPT 3.5 in separate sessions and recorded the responses. These 25 questions were posed again on January 21, 2024, to assess its reproducibility. Two pediatric orthopaedic surgeons evaluated responses using a scale of "excellent (no clarification)" to "unsatisfactory (substantial clarification)." Average ratings were used when evaluators' grades were within one level of each other. In discordant cases, the senior author provided a decisive rating. We found 46% of ChatGPT responses were "excellent" and 44% "satisfactory (minimal clarification)." In addition, 8% of cases were "satisfactory (moderate clarification)" and 2% were "unsatisfactory." Questions had appropriate readability, with an average Flesch-Kincaid Grade Level of 4.9 (±2.1). However, ChatGPT's responses were at a collegiate level, averaging 12.7 (±1.4). No significant differences in ratings were observed between question topics. Furthermore, ChatGPT exhibited moderate consistency after repeated queries, evidenced by a Spearman rho coefficient of 0.55 ( P = 0.005). The chatbot appropriately described in-toeing as normal or spontaneously resolving in 62% of responses and consistently recommended evaluation by a health care provider in 100%. The chatbot presented a serviceable, though not perfect, representation of the diagnosis and management of pediatric in-toeing while demonstrating a moderate level of reproducibility in its responses. ChatGPT's utility could be enhanced by improving readability and consistency and incorporating evidence-based guidelines. Level IV-diagnostic.

Readability of Trauma-related Patient Education Materials From the American Academy of Orthopaedic Surgeons and Orthopaedic Trauma Association Websites.

Web-based resources serve as a fundamental educational platform for orthopaedic trauma patients; however, they are frequently written above the recommended sixth-grade reading level, and previous studies have demonstrated this for the American Academy of Orthopaedic Surgeons (AAOS) web-based articles. In this study, we perform an updated assessment of the readability of AAOS trauma-related educational articles as compared with injury-matched education materials developed by the Orthopaedic Trauma Association (OTA). All 46 AAOS trauma-related web-based ( https://www.orthoinfo.org/ ) patient education articles were analyzed for readability. Two independent reviewers used (1) the Flesch-Kincaid Grade Level (FKGL) and (2) the Flesch Reading Ease (FRE) algorithms to calculate the readability level. Mean readability scores were compared across body part categories. A one-sample t -test was done to compare mean FKGL with the recommended sixth-grade readability level and the average American adult reading level. A two-sample t -test was used to compare the readability scores of the AAOS trauma-related articles with those of the OTA. The average (SD) FKGL and FRE for the AAOS articles were 8.9 (0.74) and 57.2 (5.8), respectively. All articles were written above the sixth-grade reading level. The average readability of the AAOS articles was significantly greater than the recommended sixth-grade reading level ( P < 0.001). The average FKGL and FRE for all AAOS articles were significantly higher compared with those of the OTA articles (8.9 ± 0.74 versus 8.1 ± 1.14, P < 0.001 and 57.2 ± 5.8 versus 65.6 ± 6.6, P < 0.001, respectively). Excellent agreement was observed between raters for the FKGL 0.956 (95% confidence interval, 0.922 to 0.975) and FRE 0.993 (95% confidence interval, 0.987 to 0.996). Our findings suggest that after almost a decade, the readability of the AAOS trauma-related articles remains unchanged. The AAOS and OTA trauma patient education materials have high readability levels and may be too difficult for patient comprehension. A need remains to improve the readability of these commonly used trauma education materials.

Evaluating the Efficacy of Natural Language Processing Artificial Intelligence Models as a Patient Education Tool for Stature Lengthening Surgery and Reconstruction

Abstract Introduction: While traditionally a treatment for congenital deformities, limb-lengthening surgery has recently been utilized as a cosmetic solution for patients with less-than-desirable heights. Despite a growing rise in popularity, stature-lengthening surgery carries a host of social stigmas and ethical concerns. With the emergence of natural language processing artificial intelligence (NLP AI) models such as ChatGPT, patients interested in stature-lengthening surgery may turn to these chatbots for medical information instead of primary care providers. This study seeks to evaluate the quality and readability of NLP AI model responses to common questions regarding stature-lengthening surgery to ensure proper patient education and direction toward a licensed orthopedic surgeon. Materials and Methods: Eleven questions regarding limb-lengthening surgery were posed to ChatGPT version 3.5. All named authors reviewed the AI responses independently and utilized the following scoring systems to assess readability and quality: DISCERN, ChatGPT Response Accuracy Scoring (CRAS) developed by Mika et al., Flesch–Kincaid Reading Ease (FRES), and Flesch–Kincaid Grade Level (FKGL). Cohen’s kappa was utilized to determine the inter-rater reliability between each reviewer’s assigned DISCERN and CRAS scores. Results: The average DISCERN score across all independent reviewers was 55.2 ± 5.63, with an inter-rater reliability of 0.293, indicating good scores with fair agreement, respectively. The average CRAS score across all senior reviewers was 1.60 ± 0.63 with inter-rater reliability being 0.014, indicating none to slight agreement. The average FRES score was 14.8 ± 2.24, and the average FKGL score was 18.9 ± 11.0, indicating a required reading level of a college graduate. Conclusions: The results of our study show that NLP AI models provide generally high-quality responses to patient questions regarding stature-lengthening surgery. However, notable flaws were identified, including a high required education level for proper comprehension as well as an inability to cite source material used for each response.

Readability of American Society of Metabolic Surgery's Patient Information Publications

IntroductionAppropriate education and information are the keystones of patient autonomy. Surgical societies support this goal through online informational publications. Despite these recommendations, many of these sources do not provide the appropriate level of reading for the average patient. Multiple national organizations, including the AMA and NIH, have recommended that such materials be written at or below a 6th-grade level. We therefore aimed to evaluate the readability of patient information publications provided by the American Society of Metabolic and Bariatric Surgery (ASMBS). MethodsPatient information publications were collected from the ASMBS webpage (https://asmbs.org/patients) and evaluated for readability. Microsoft Office was utilized to calculate Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores. Flesch Reading Ease (FRE) is a 0-100 score, with higher scores equating to easier reading (≥80 = 6th-grade reading level). Flesch-Kincaid Grade Level (FKGL) rates text on a US grade school level. Qualitative and univariate analyses were performed. ResultsEleven patient information publications were evaluated. None of the publications achieved an FRE score of 80 or an FKGL of a 6th-grade reading level. The average FRE score was 35.8 (range 14.9-53.6). The average FKGL score was 13.1 (range 10.1-17.5). The publication with the highest FRE and lowest FKGL (best readability) was that for benefits of weight loss. The brochure with the lowest FRE and highest FKGL (worst readability) was that for Medical Tourism. ConclusionsAlthough the ASMBS patient information publications are a trusted source of patient literature, none of the 11 publications met the recommended criteria for patient readability. Further refinement of these will be needed to provide the appropriate reading level for the average patient.

From quality to clarity: evaluating the effectiveness of online ınformation related to septic arthritis

BackgroundThe aim of this study was to assess the content, readability, and quality of online resources on septic arthritis, a crucial orthopedic condition necessitating immediate diagnosis and treatment to avert serious complications, with a particular focus on the relevance to individuals from the general public.MethodsTwo search terms (“septic arthritis” and “joint infection”) were input into three different search engines on the Internet (Google, Yahoo, and Bing) and 60 websites were evaluated, with the top 20 results in each search engine. The websites underwent categorization based on their type, and their content and quality were assessed utilizing the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark, the Global Quality Score (GQS), and the Information Value Score (IVS). The readability of the text was assessed through the utilization of the Flesch Kincaid Grade Level (FKGL) and the Flesch Reading Ease Score (FKRS). The presence or absence of the Health on Net (HON) code was evaluated on each website.ResultsThe DISCERN, JAMA, GQS, FKGL, and IVS scores of the academic category were found to be substantially greater when compared with the physician, medical, and commercial categories. But at the same time, academic sites had high readability scores. Websites with HON code had significantly higher average FKGL, FCRS, DISCERN, JAMA, GQS, and IVS scores than those without.ConclusionThe quality of websites giving information on septic arthritis was variable and not optimal. Although the content of the academic group was of higher quality, it could be difficult to understand. One of the key responsibilities of healthcare professionals should be to provide high quality and comprehensible information concerning joint infections on reputable academic platforms, thereby facilitating patients in attaining a fundamental level of health literacy.

Evaluating the readability, quality and reliability of online patient education materials on transcutaneuous electrical nerve stimulation (TENS).

Increasing digitization also raises concerns regarding the reliability and comprehensibility of online health information. In this study, we aimed to examine the readability, reliability, and quality of internet-based patient education materials on "transcutaneous electrical nerve stimulation." On September 15, 2022, we used Google search engine to search the keyword "Transcutaneous Electrical Nerve Stimulation" and obtained information from 200 websites. The readability of the websites was evaluated using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, and Gunning Fog. The Journal of American Medical Association score and Health on the Net Foundation code of conduct were used to determine the reliability of the websites, whereas the DISCERN score and Global Quality Score were used to evaluate the quality of the websites. In the readability analysis of 102 websites that met the inclusion criteria of this study, we found that the Flesch Reading Ease Score was 47.91 ± 13.79 (difficult), average Flesch-Kincaid Grade Level and Simple Measure of Gobbledygook were 11.20 ± 2.85 and 10.53 ± 2.11 years, respectively, and average Gunning Fog score was 14.04 ± 2.74 (very difficult). Commercial websites constituted the highest proportion of websites (n = 36, 35.5%). Overall, 16.7% of the websites were found to be of high quality according to the Global Quality Score, 16 (15.7%) websites had Health on the Net Foundation code of conduct certification, and 8.8% of the websites were found to be highly reliable according to the Journal of American Medical Association scores. There was a statistically significant difference between website typologies and quality and reliability scores (P < .001). Compared with the sixth-grade level recommended by the American Medical Association and the National Institute of Health, the readability of transcutaneous electrical nerve stimulation-related internet-based patient education materials was considerably high, but they showed low reliability and moderate-to-poor quality. Thus, the quality, reliability, and readability of websites developed by health professionals play a major role in conveying accurate and easily understandable information.

Abstract 11740: Online Health Information for COVID 19 Vaccine Induced Myocarditis: Between the Myth and Truth

Objective: COVID-19 vaccine-induced myocarditis is becoming an important topic. As the internet is the leading source of information, it is crucial to evaluate the quality and readability of health information available to the general public as it has an impact on increasing awareness and encourage vaccinations. Methods: The top 30 websites of 2 different search engines (Google, Bing) were collected using the term “Covid vaccine induced myocarditis” on a newly installed Mozilla Firefox browser. Physician-oriented websites, non-relevant content (not connected to the search keyword), and duplicates were all excluded. The quality of the websites were evaluated using the DISCERN tool by two physician reviewers who are knowledgeable and were blinded to each other's findings. After that, the data was evaluated to come up with an aggregated score for each website. Readability was assessed using the Flesch-Kincaid Readability Ease (FKRE) and the Flesch-Kincaid Grade Level (FKGL) tool. Results: A total of 19 websites were assessed after exclusion criteria. The average overall quality for DISCERN was 3.4 out of 5 with a median of 3.46 while the average total DISCERN score was 48.2 out of 80: the highest total quality among them being 63 out of 80. The average FKRE was 48.5 out of 100, while the average FKGL was 8.7 out of 18 with the lowest grade being 6.2. Conclusion: Overall, the quality of the information was rated as moderate or “fair” with an average of 3.4 out of 5. Most of the websites were accurate in the information provided. However, those websites that were high quality did require a higher level of education to be able to comprehend. The average reading grade level was 8.7 grade, which is higher than the average American reads (8th grade). The highest quality website based on DISCERN was Health U.S news. All websites encouraged vaccinations and explained the rarity of getting myocarditis from COVID 19 vaccine.

S916 Evaluating the Quality and Readability of Online Information Regarding Contraceptive Use in IBD

Introduction: Women with inflammatory bowel disease (IBD) are often of childbearing age and discussions about contraception are an important aspect of their healthcare. Patients with IBD are increasingly turning to the internet for their information. This study sought to evaluate the quality and readability of online information related to contraception use in IBD patients. Methods: Google search engine was used to query “inflammatory bowel disease and contraception” to access the first 100 websites. Websites that were non-accessible, duplicates or videos without transcripts were excluded. Websites were categorized as academic/professional, informational, personal/blog or commercial. Quality of information was determined using the validated DISCERN score. Readability was determined using the validated Flesch-Kincaid Grade Level (FKGL) calculation. Acknowledgment of areas of uncertainty and references cited were noted. Statistical analysis was performed using ANOVA and two-tailed Fisher-Freeman-Halton exact testing with significance set at p< 0.05. Results: Eighty-three of 100 websites met the inclusion criteria. 39(47.0%) were academic, 36(43.4%) informational, 6(7.2%) personal and 2(2.4%) commercial. The average FKGL was 11.7 with a significantly higher grade for academic websites compared to informational or personal (13.4 vs 10.4 and 8.9; p=0.00001). The mean DISCERN was “Good” with a score of 49.0; academic websites had a significantly higher DISCERN than informational or personal (56.3 vs 46.9 and 43.8; p=0.0002). Academic websites had significantly more “Excellent” DISCERN scores than informational or personal (73.3% vs 23.3% and 16.7%; p=0.002) while personal websites had significantly more “Poor” DISCERN scores (33.3% vs 0% and 11.1%; p=0.007) (Figure). Areas of uncertainty (82.1% vs 55.6% and 16.7%; p=0.002) and cited references (100% vs 44.4% and 66.7%; p=0.00001) were addressed more so in academic websites compared to other websites. Conclusion: Our study shows that academic resources on IBD and contraception are of higher quality than either informational or personal/blog websites; also academic resources present more comprehensive and unbiased information. However, the reading level of all categories, particularly academic, is largely inaccessible to the average consumer. As the use of online resources for contraception in IBD continues to increase, further efforts should focus on developing information that is both more accessible and of higher quality.Figure 1.: Total DISCERN Score by Website Category (* denotes a statistically significant difference in total DISCERN score [Poor, Good, Excellent] among website categories)

Evaluation of Quality and Readability of Online Information on Treatments of Traumatic Dental Injuries

Background: Traumatic dental injuries is a common public health issue all over the world. The aim of this study was to investigate the quality and readability of web based information regarding treatments of traumatic dental injuries. Methods: An internet search was carried out using Google search engine with four different keywords (''treatment of broken teeth'', ''treatment of tooth trauma'', ''treatment of anterior tooth fractures in children'', ''fractured teeth treatments'') related to treatments of traumatic dental injuries. The duplicate websites, links to research studies, advertisements, discussion groups, videos and images were excluded from the evaluation. The quality of the written information regarding treatments of traumatic dental injuries in websites were analyzed with DISCERN toolkit. The readability of the written information was evaluated with Flesch-Kincaid grade level (FKGL), Flesch-Kincaid Reading Ease (FKRE) and Simple Measure of Gobbledygook reading grade level (SMOG) index. Results: A total of 120 webpages were identified but only 42 of them were remained after exclusion criterias. Among these websites, 25 (59.5%) of them were belonged to private dental clinics, 9 (21.4%) of them were belonged to informative pages about health and dentistry and 8 (19.1%) of them were belonged to professional organizations' websites. The average DISCERN score was 42.4 and ranged between 24 to 62. The average FKRE was 50.7 ± 14. which is equivalent to a reading level of 10th to 12nd grade. The average FKGL score for was 8.5 ± 2.8 and the average SMOG score was 7.3 ± 2.0 for all the websites. Conclusions: The results of the present study showed that the quality of information on the investigated websites was fair according to the DISCERN toolkit and too difficult to read and interpret for the general population. Healthcare information providers should focus on improving the quality and readability of the information regarding treatment of traumatic dental injuries.

Readability Analysis of Otolaryngology Consent Documents on the iMed Consent Platform.

The American Medical Association (AMA) and National Institutes of Health (NIH) recommend all patient information and consent materials be provided at the fourth- to sixth-grade level. The iMed Consent platform is used nationally by the Veterans Health Administration and private hospitals. We aimed to assess the readability of otolaryngology consents at the West Los Angeles Veterans Affairs (WLA-VA) hospital to determine whether they conform with AMA/NIH guidelines. A readability analysis of 27 otolaryngology iMed consent documents was performed. The main outcome measure was the Flesch-Kincaid Grade Level (FKGL). The setting of the study was an otolaryngology clinic at a major VA hospital. All consents used in the WLA-VA otolaryngology clinic for the month of October 2018 were analyzed using readability metrics. These included the Flesch Reading Ease (FRE) score, the FKGL, the Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), and Coleman-Liau Index (CLI). The following means of all consents were calculated for each of the readability metrics: FRE 56.3, FKGL 8.3, GFI 14.5, SMOG 11.3, and CLI 11.2. The standardized anesthesia and blood consent were analyzed separately with the following scores: FRE 45.1, FKGL 11.7, GFI 15.5, SMOG 14.6, and CLI 12.6. The average FKGL of the consents was found to be significantly above the sixth-grade level (P: .0013). The average grade level of the otolaryngology iMed consents reviewed was at a reading level above the AMA/NIH recommendations. This objective measure should be taken into consideration when revising the iMed system and in the creation of future standardized consents. Readability analysis does not take into consideration the significant variance that exists as part of the verbal consent process that takes place between patient and provider.

A quality assessment of Internet information regarding accelerated orthodontics

Abstract Objective The aim of the present study was to evaluate the quality of information uploaded onto the Internet regarding accelerated orthodontics. Materials and methods The selected search terms ‘accelerated orthodontics’, ‘rapid orthodontics’, ‘speed orthodontics’, ‘rapid braces’, and ‘speed braces’ were searched by three commonly used search engines (Google, Yahoo, and Bing), and the URLs of the top 50 websites were recorded. The websites were evaluated using DISCERN, HONcode, and the Journal of the American Medical Association (JAMA) benchmark instruments. The readability of the websites was evaluated by the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Grade Level (FKGL). Results The total mean DISCERN score (section 1 + section 2) for all websites was 29.50/75 (range: 15–68). The average FRES of all websites was 52.99 ± 31.91. Also, the average FKGL score of all websites was 10.73 ± 2.03. Professional health organisation websites had significantly higher DISCERN scores than other websites (p &lt; 0.001). Only three websites had the HONcode seal. Professional organisation and private dental practice websites showed better compliance with JAMA benchmarks. There was no statistically significant difference related to FRES and FKGL scores between groups (p &gt; 0.05). Conclusions Information regarding accelerated orthodontics found on the Internet is insufficient. It is recommended that orthodontic societies and orthodontists increase the quality of the websites which describe accelerated orthodontics.

How readable and reliable is online patient information on chronic rhinosinusitis?

This study aimed to assess the quality and readability of websites on chronic rhinosinusitis. A total of 180 results from 3 different search engines regarding 'chronic rhinosinusitis', 'sinusitis' and 'sinus infections' were analysed for readability using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score and Gunning Fog Index. The Discern tool was used to approximate information quality. From 180 total searches, 69 unique websites were identified. These had an average Flesch-Kincaid Grade Level of 9.75 (95 per cent confidence interval = 9.12-10.4), a Flesch Reading Ease Score of 45.0 (41.0-49.0) and a Gunning Fog Index of 13.7 (12.9-14.4), which equates to the average reading level of a college or university student. Discern scores were variable but consistently showed good-quality information. Chronic rhinosinusitis information is of a high quality but is for a reading level higher than that of the average adult. Standardising patient information should ensure adequate comprehension and improve patient compliance.