Flesch-Kincaid Grade Research Articles

Quality and readability of online information about piriformis syndrome

AimIn this study, we aimed to investigate the quality and readability of websites related to Piriformis Syndrome(PS). MethodOn November 14, 2023, we searched the term "Piriformis Syndrome" in Google (https://www.google.com). We evaluated the top 200 uniform resource locators(URLs) in query results for typology, Journal of the American Medical Association(JAMA) scores, the Flesch-Kincaid reading ease(FRE) score, Flesch-Kincaid grade(FKG) level, Gunning-Fog index, and Simple Measure of Gobbledygook(SMOG) grade level. The JAMA scoring system was used to assess quality, and FRE, FKG, Gunning-Fog index and SMOG scores were used to assess the readability of online information. Content analysis was performed for etiology, symptoms, diagnosis, and treatment. Treatment options were evaluated as exercise, physical therapy agents, drug therapy, invasive treatments, and surgery. ResultsOf the 138 websites evaluated, 39 were classified as high-quality websites. Scientific publications and health portal websites were found to have high-quality scores. When the readability parameters of the websites were compared in terms of quality, there was no significant difference between high-quality websites and low-quality websites in terms of FRE and FKG scores(p > 0.05), but there was a significant difference in Gunning-Fog index and SMOG scores(p = 0.030, p = 0.010 respectively). The quality score of the top 10 websites was higher than the rest(p = 0.002). When the contents of the websites were analyzed, there was a significant difference only in terms of diagnosis. Scientific websites mentioned diagnosis the most, while commercial websites mentioned it the least. When the treatment content was analyzed, there was a significant difference in terms of surgery. Non-profit websites mentioned it the most, while commercial websites mentioned it the least. ConclusionHigh-quality websites were slightly more difficult in the readability parameters. However, the proportion of high-quality websites was quite low. These results may encourage those producing PS-related online information to improve the quality and readability of content and content coverage.

Readability of Online Patient Education Materials for the 10 Most Common Hand Conditions.

Background Millions of individuals every day turn to the internet for assistance in understanding their hand conditions and potential treatments. While online educational resources appear abundant, there are concerns about whether resources meet the readability recommendations agreed upon by the American Medical Association (AMA) and the National Institutes of Health (NIH). Identifying educational resources that are readable for the majority of patients could improve a patient's understanding of their medical condition, subsequently improving their health outcomes. Methods The readability of the top five websites for the 10 most common hand conditions was examined using the Flesch-Kincaid (FK) analysis, comprising the FK reading ease and FK grade level. The FK reading ease score is an indicator of how difficult a text is to comprehend, while the FK grade level score is the grade level an individual reading a particular text would need to fully understand the text. Results The average FK reading ease was 56.00, which correlates with "fairly difficult (high school)". The average FK corresponded to an eighth-grade reading level, far above the sixth-grade reading level recommendation set by the AMA and NIH. Conclusion Patient education, satisfaction, and the patient-physician relationship can all be improved by providing patients with more readable educational materials. Our study shows there is an opportunity for drastic improvement in the readability of online educational materials. Guiding patients with effective search techniques, advocating for the creation of more readable materials, and having a better understanding of the health literacy barriers patients face will allow hand surgeons to provide more comprehensive care to patients.

(040) EVALUATING CHATGPT AS A SOURCE OF PATIENT EDUCATION MATERIALS ON DYSPAREUNIA

Abstract Introduction Dyspareunia, or female sexual pain, has an estimated prevalence of up to 18% worldwide. It is a complex condition with various physical and psychological etiologies, making it a challenge for patients to understand. Physicians spend significant time on patient education and providing educational materials to patients. ChatGPT is an artificial intelligence (AI) language model that generates human-like conversational text. Objective The aim of our study is to evaluate the understandability, quality, and readability of written patient educational material on topics related to dyspareunia generated by ChatGPT in English. Methods Five existing and accessible patient education handouts related to the topic of dyspareunia were identified and used as reference material. We prompted ChatGPT to create patient education leaflets on dyspareunia, female sexual dysfunction, vaginismus, and vulvodynia. The DISCERN instrument and Patient Education Materials Assessment (PEMAT) were used to assess each leaflet’s quality, understandability, and actionability. Readability of the patient education materials was assessed with the Flesch-Kincaid Grade (FKG) level. Results ChatGPT created four different patient education materials. The document created on “dyspareunia” scored 90% on understandability 75% on actionability, 42 on DISCERN, and 14.4 FKG level compared to the UpToDate (88%, 50%, 50, and 7.6) and the International Urogynecologic Association (IUGA) (100%, 0%, 80, and 13.6) on the same subject. The ChatGPT handout on “female sexual dysfunction” scored 70% on understandability, 50% on actionability, 37 on DISCERN, and 12.9 FKG Level compared to the American Urogynecologic Society (AUGS) (90%, 50%, 52, and 13) handout on the same subject. The ChatGPT handout on “vaginismus” scored 81% on understandability, 25% on actionability, 41 on DISCERN, and 11.3 FKG Level compared to the International Society for the Study of Vulvovaginal Disease (ISSVD) (90%, 0%, 44, 11.4) handout on the same subject. The ChatGPT handout on “vulvodynia” scored 81% on understandability, 25% on actionability, 36 on DISCERN, and 11.5 FKG Level compared to the ISSVD (90%, 25%, 46, 10.5) handout on the same subject. Conclusions The average PEMAT understandability scores suggest that the reference handouts (91.6%) are more understandable than the AI-generated materials (80.5%). The ChatGPT-generated handouts also fell short in quality according to the average DISCERN scores (39 vs. 54.4). The average FKG level for the AI-generated information was 12.525 compared to 11.22 for the reference patient education materials. Overall, ChatGPT was not able to create patient education handouts on topics related to dyspareunia that were as understandable or readable as the existing handouts. The ChatGPT-generated handouts did, however, score higher in actionability on average (50) than the reference handouts (25), which may give patients a false sense of trust in these AI-generated materials. Our study indicates that ChatGPT is not yet an ideal tool for the creation of patient education materials, nor is it a reliable information source for patients. Disclosure No.

Unlocking Health Literacy: The Ultimate Guide to Hypertension Education From ChatGPT Versus Google Gemini.

Background Google Gemini (Google, Mountain View, CA) represents the latest advances in the realm of artificial intelligence (AI) and has garnered attention due to its capabilities similar to the increasingly popular ChatGPT (OpenAI, San Francisco, CA). Accurate dissemination of information on common conditions such as hypertension is critical for patient comprehension and management. Despite the ubiquity of AI, comparisons between ChatGPT and Gemini remain unexplored. Methods ChatGPT and Gemini were asked 52 questions derived from the American College of Cardiology's (ACC) frequently asked questions on hypertension, following a specified prompt. Prompts included: no prompting (Form 1), patient-friendly prompting (Form 2), physician-level prompting (Form 3), and prompting for statistics/references (Form 4). Responses were scored as incorrect, partially correct, or correct. Flesch-Kincaid (FK) grade level and word count were recorded. Results Across all forms, scoring frequencies were as follows: 23 (5.5%) incorrect, 162 (38.9%) partially correct, and 231 (55.5%) correct. ChatGPT showed higher rates of partially correct answers than Gemini (p = 0.0346). Physician-level prompts resulted in a higher word count across both platforms (p < 0.001). ChatGPT showed a higher FK grade level (p = 0.033) in physician-friendly prompting. Gemini exhibited a significantly higher mean word count (p < 0.001); however, ChatGPT had a higher FK grade level across all forms (p > 0.001). Conclusion To our knowledge, this study is the first to compare cardiology-related responses from ChatGPT and Gemini, two of the most popular AI chatbots. The grade level for most responses was collegiate level, which was above average for the National Institutes of Health (NIH) recommendations, but on par with most online medical information. Both chatbots responded with a high degree of accuracy, with inaccuracies being rare. Therefore, it is reasonable that cardiologists suggest either chatbot as a source of supplementary education.

Adequacy of prostate cancer prevention and screening recommendations provided by an artificial intelligence-powered large language model.

We aimed to assess the appropriateness of ChatGPT in providing answers related to prostate cancer (PCa) screening, comparing GPT-3.5 and GPT-4. A committee of five reviewers designed 30 questions related to PCa screening, categorized into three difficulty levels. The questions were formulated identically for both GPTs three times, varying the prompts. Each reviewer assigned a score for accuracy, clarity, and conciseness. The readability was assessed by the Flesch Kincaid Grade (FKG) and Flesch Reading Ease (FRE). The mean scores were extracted and compared using the Wilcoxon test. We compared the readability across the three different prompts by ANOVA. In GPT-3.5 the mean score (SD) for accuracy, clarity, and conciseness was 1.5 (0.59), 1.7 (0.45), 1.7 (0.49), respectively for easy questions; 1.3 (0.67), 1.6 (0.69), 1.3 (0.65) for medium; 1.3 (0.62), 1.6 (0.56), 1.4 (0.56) for hard. In GPT-4 was 2.0 (0), 2.0 (0), 2.0 (0.14), respectively for easy questions; 1.7 (0.66), 1.8 (0.61), 1.7 (0.64) for medium; 2.0 (0.24), 1.8 (0.37), 1.9 (0.27) for hard. GPT-4 performed better for all three qualities and difficulty levels than GPT-3.5. The FKG mean for GPT-3.5 and GPT-4 answers were 12.8 (1.75) and 10.8 (1.72), respectively; the FRE for GPT-3.5 and GPT-4 was 37.3 (9.65) and 47.6 (9.88), respectively. The 2nd prompt has achieved better results in terms of clarity (all p < 0.05). GPT-4 displayed superior accuracy, clarity, conciseness, and readability than GPT-3.5. Though prompts influenced the quality response in both GPTs, their impact was significant only for clarity.

Readability of Online Information for Parents Concerning Paediatric In-Toeing: An Analysis of the Most Popular Online Public Sources.

Background Parents often access online resources to educate themselves on their child's condition.In-toeing, also referred to as pigeon toeing, is a common paediatric condition that has a variety of causes and is oftena cause of concern for parents. With the increasing usage of the internet, parents of children with this condition may look to the web for answers.However, to be understood by the average adult, online health information must be written at an elementary school reading level.We hypothesised that currently available online resources regarding in-toeing would score poorly on objective measures of readability and understandability. Methods Patient education materials were identified via three commonly used online search engines (Google.com, Yahoo.com, and Bing.com). The terms "intoeing" and "pigeon toeing" were used for the search. From the top 50 search results, websites were included if directed at educating patients and their families regarding in-toeing. News articles, non-text material (video), industry websites, and articles not related to in-toeing were excluded. The readability was analysed using a specialised website www.readable.com to produce the following three scores: Gunning Fog Index (GFI), Flesch Reading Ease (FRE), and Flesch-Kincaid Grade (FKG). Understandability was calculated using the 19-point Patient Education Materials Assessment Tool (PEMAT). Results After removing duplicates, 84 unique websites were assessed for inclusion. A total of 48 websites and articles (57.14%) met the inclusion criteria. Of note, 23 articles out of 84 (27.38%) were excluded as they were intended for healthcare professionals. The means for the FRE, FKG, and GFI were 57.92 (±12.26), 7.92 (±1.91), and 9.35 (±2.36), respectively. Less than half of online resources had an FRE score at or higher than the recommended reading level for the general population. Mean understandability scores were 69.63% (±11.55%), with only 45.83% of articles being greater than the 70% requirement of adequate understandability. Conclusion Overall, online in-toeing educational materials scored poorly with respect to readability and understandability. Given the popularity of online resources in patient education, we should seek to improve this situation.Articles that are easier to read are thus more accessible to the general public and will aid in the shared decision-making process.Improved patient and parent satisfaction and overall standard of care can be expected.

The Language of Health Promotion in British and Russian Digital Media: A Comparative Study

The research explores the language of health promotion used in Health matters and Tak zdorovo – the national healthcare websites of the UK and Russia. The objective is to assess readability of the British and Russian texts as well as to reveal language properties and cultural implications of health promotion in national digital media. The comparative design of the study involves qualitative (contextual and interpretative) and quantitative (Compleat Lexical Tutor v.8.5 and Flesch-Kincaid grade) methods. The topic distribution results show that physical activity, healthy eating and weight control, tobacco smoking, alcohol dependence, mental health are raised in both cultures, however, the British corpus puts more emphasis on mental health issues compared to the Russian one. There are differences in 'positive' vs 'negative' approach in covering alcohol consumption issues. The findings on readability reveal higher rates of lexical density and lexical variety in the Russian corpus in comparison to the British one. However, the overall lexical coverage and readability index in the British (K-3) and Russian corpora (SIS – 8.68) are equally low, which means that the language of health promotion in both cultures is easy to understand. The Russian language of advice demonstrates frequent use of imperatives. The British corpus employs less categorical recommendation forms including modal verbs, create partnering communication styles and demonstrate a higher use of visual forms of health promotion. The findings revealing differences in rhetoric strategies (rational reasoning in British digital media vs emotional reasoning in Russian digital media) can be attributed to national and cultural implications.

A quality analysis of internet patient information for immediate, sequential, bilateral cataract surgery (ISBCS).

Due to surgical capacity pressures, induced by the COVID-19 pandemic, immediate bilateral simultaneous cataract surgery (ISBCS) has been utilised increasingly throughout the U.K. This surgical method comes with both novel risks and benefits, so the consent process must be modified. Prior randomised trials have demonstrated that appropriate online information may act as an adjunct to the surgical consent process. This study aims to assess the quality of available internet information for ISBCS. Terms searched were 'bilateral cataract surgery patient information', 'double cataract surgery patient information', and 'immediate sequential bilateral cataract surgery patient information'. The Google search engine was used. The DISCERN instrument and JAMA benchmarks were used to assess healthcare information for quality. The Flesch Reading Ease Score (FRE), Flesch Kincaid Grade (FKG) Level and Gunning Fog Score (GFS) were used to assess for readability. HONcode certification was used to assess transparency and quality. Forty-six websites were found. The average DISCERN score was 41.3, meaning a "fair" quality which is below what many patients would anticipate discovering when trying to find information. National Healthcare Service websites had higher DISCERN scores than private healthcare-provided websites (p < 0.01; 95% CI: 1.13-1.88.). Fair patient information for ISBCS has been demonstrated. Specific internet information sources with appropriate information should be further developed, with cited sources, and patients signposted to them if felt appropriate.

Does IFRS convergence affect the readability of annual reports by Indian listed companies?

PurposeThe purpose of this study is to investigate the influence of IFRS convergence on annual report readability in an emerging market context, with an emphasis on the contents of management discussion and analysis (MD&A), notes to the accounts (Notes) and the whole annual report.Design/methodology/approachThe study performs firm-fixed effect regression on a sample of 143 Indian listed companies over a period spanning from 2012 to 2021 to examine the influence of IFRS convergence on readability. This assessment primarily focuses on broader spectrums of readability dimensions, namely annual report length and complexity, wherein complexity is measured using the Gunning Fog, Flesch Reading ease and Flesch-Kincaid grade index.FindingsAs Indian firms shift to IFRS reporting, the findings suggest that annual reports have become significantly lengthier and more complex, causing deterioration in readability. The Notes section, in particular, exhibits the most significant increase in length and complexity, followed by the entire annual report and MD&A section. Furthermore, the findings also indicate that the complexity of the Notes section is instrumental in the observed complexity growth of the whole annual report in the post-IFRS period.Research limitations/implicationsThe current study employs readability indices rather than directly taking into consideration the opinions of actual users of annual reports to determine readability. As a result, the study does not provide direct evidence on how information in annual reports affects users' readability.Practical implicationsThe findings provide insightful information to managers and policymakers about the difficulties stakeholders may encounter while reading IFRS-based annual reports, which ultimately impact their investment decisions. Thus, there is an important managerial implication from this, depending upon the severity of complexity corporations participate in while complying with IFRS in the post-IFRS period.Originality/valueAnalyzing the influence of exogenous information shock, such as IFRS convergence, on readability is critical, particularly for emerging markets like India, where a lack of financial literacy and weaker enforcement already have detrimental effects on the capital market. In light of this, the current study provides a comprehensive examination of the impact of IFRS convergence on annual report readability and contributes to the growing IFRS literature in the less explored emerging market context.

Quality and Readability of Online Information on Cerebral Palsy

Objective The aim of this study was to investigate the readability and reliability of online content related to cerebral palsy (CP) and to classify sites that contain quality and readable information. Method On April 30, 2022, the term “cerebral palsy” was searched on the Google search engine. The categories, quality, content, readability, Alexa rank values, and backlink numbers of the sites were analyzed. The Journal of American Medical Association score and HONcode seal were used for quality assessment, and the Flesch–Kincaid grade (FKG) and the Simple Measure of Gobbledygook (SMOG) were used for readability assessment. Results Of the 155 sites, 46 had high-quality content. The quality of health portal and scientific publishing sites appeared to be high. The top 10 sites were determined to be of significantly higher quality (p = .017) than the remaining sites. The average readability values of the sites were not at the recommended level. Conclusion Despite the abundance of information available on CP-related websites, most of them were not of high quality. Additionally, many websites did not reach the recommended readability levels. Revision of existing online content related to CP and production of new high-quality content in line with readability recommendations is urgently required.

How understandable are the patient education materials about flat foot on the Internet for parents?

Flat foot is a common reason for parents to visit orthopedic clinics. As the Internet has become an easy-search platform, parents often seek online educational materials before seeking out a professional. The aim of this study was to investigate the quality, readability, and understandability of such online materials for parents. An Internet search was performed for "flat foot" and "pes planus" using the Google search engine. The readability was evaluated using 6 different grading systems: Flesch Reading Ease Score, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Fry Readability score, Gunning Fog Index tests, and Automated Readability Index. The Patient Education Materials Assessment Tool test was used to assess the understandability. For quality assessment, the Journal of American Medical Association benchmark criteria and Health on the Net code were applied. One hundred nine websites were included and evaluated for readability, understandability, and quality. The mean readability grade for all websites was 10.5 ± 2.0. The mean Gunning Fog Index tests and Flesch-Kincaid Grade Level scores for all websites were 12.4 ± 2.2 and 9.7 ± 2.1 sequentially. The mean Coleman-Liau index score was 10.0 ± 1.5, and the average Fry Readability score was 9.9 ± 2.0. The automated readability index for all websites was 10.3 ± 2.5. The average Flesch Reading Ease score for all educational materials was 59.3 ± 10.1. The average Patient Education Materials Assessment Tool score for all educational materials was 81% (range, 70-87%). The mean Journal of American Medical Association benchmark criterion for all websites was 1.0, with a range from 1.0 and 2.0. Eighteen (16.5%) websites had Health on the Net certificates. Readability, understandability, and quality of patient education materials about flat feet on the Internet vary and are often worse than professional recommendations.

Quality and readability of online information on hand osteoarthritis.

Objectives: This study aimed to evaluate the quality and readability of web pages providing information about hand osteoarthritis using several authorized methods.Methods: A web page exploration was performed using the Google internet search engine. The three search terms, "hand osteoarthritis," "finger osteoarthritis," and "hand OA," were used and the top 100 ranked websites were selected and divided into six categories. The Health on the Net Foundation (HON) grade scale, an instrument for judging the quality of written consumer health information on treatment choice (DISCERN instrument), and the Ensuring Quality Information for Patients (EQIP) score were used to evaluate the quality of each website. The Flesch-Kincaid reading ease (FRE) score, Flesch-Kincaid grade (FKG) level, Gunning-Fog index, and Simple Measure of Gobbledygook grade level were used to evaluate website readability.Results: Among 300 websites, 57 websites were selected following exclusion criteria. News portal websites, including the online version of newspapers and periodicals, showed the highest score in all three quality evaluation tools. Only four websites were regarded as high-quality websites based on the HON grade scale (n = 3) and the EQIP score (n = 1). Each type of website showed an average FKG level higher than 7th grade and obtained an average FRE score of less than 80 points, indicating an inappropriate level for a layperson to read.Conclusions: The online information about hand osteoarthritis is low quality and difficult to read for the general public. There is a need to enhance the quality and readability of web-based information related to hand osteoarthritis for patients to obtain credible information and receive proper treatment for the disease.

Complicating the already complex? Readability scores in bladder exstrophy and its treatment

PurposeClassic bladder exstrophy (CBE), is a complex congenital malformation affecting formation of the lower abdominal wall and bladder. This study evaluates the readability of common online resources regarding CBE and its treatment. We hypothesize that high levels of reading comprehension are reflected in these resources, which may not be suitable to the general population for understanding this condition.MethodsThe search terms “bladder exstrophy” and “bladder exstrophy treatment” were reviewed on the Google search engine. The first 100 search results for each search query were collected. The readability of each webpage was assessed using a combination of four independent validated formulae: the Gunning-Fog index (GFI), SMOG grade (Simple Measure of Gobbledygook), Dale-Chall index (DCI), and the Flesch-Kincaid grade (FKG).ResultsA total of 200 search results were examined using the two search queries, yielding 72 unique webpages that fit the inclusionary criteria. The mean readability scores across all websites were a GFI of 14.3, SMOG score of 10, DCI of 9.06, and a FKG of 11.6. These scores correlate to adjusted grade levels of college sophomore, 11th grade, college, and 11th grade respectively. There was no significant difference of readability between website categories across GFI (p = 0.32), SMOG (p = 0.38), DCI (p = 0.33), and FKG (p = 0.36).ConclusionThis study demonstrates that online health information regarding CBE and its treatment is written at least the 11th grade reading level or above. This highlights the necessity to simplify online resources pertaining to CBE.

Functional endoscopic sinus surgery: assessing the readability and quality of online information.

The aim of this study was to assess the readability and quality of online information on functional endoscopic sinus surgery (FESS). The term 'functional endoscopic sinus surgery' was entered into the Google, Bing and Yahoo search engines. The first 30 websites for each search engine were screened. Readability was assessed using the Flesch-Kincaid Reading Ease Score (FRES), Flesch-Kincaid Grade (FKG), Simple Measure of Gobbledygook (SMOG) Index, and Gunning Fog Index (GFI). Quality was assessed using the DISCERN instrument. Spearman's correlation between quality and readability was calculated. Thirty-three websites met the inclusion criteria. The mean and standard deviations for the FRES, FKG, SMOG, GFI, and DISCERN scores were 49 (13.1), 10.9 (2.5), 10.2 (1.9), 13.6 (2.4), and 51.1 (12.8), respectively. A positive correlation was noted between the FRES and DISCERN (R=0.357, p=0.041). Online information on FESS is generally written above the recommended reading levels and of fair quality.

The Quality of Online Information for the Treatment of Knee Osteoarthritis: A Google Study.

Introduction Affecting more than 30 million adults annually, osteoarthritis (OA) is the most common joint disorder in the United States. A variety of management options for knee OA exists, includingphysical therapy, weight loss, intra-articular corticosteroid injections, and total joint arthroplasty. With many treatments available, patients often utilize the internet to educate themselves about their condition and management options. The purpose of this study was to evaluate the quality, transparency, and readability of online information for the treatment of knee OA. Methods The search terms "knee," "arthritis," and "treatment" were entered into an incognito mode Google browser. Websites were classified by type (commercial, academic, nonacademic medical practice, government/patient advocacy, and other) and graded on content quality, transparency, and readability using the following scores, respectively: modified DISCERN, Journal of American Medical Association (JAMA) Benchmark, and Flesch-Kincaid (FK) grade level. Results Of the 95 websites evaluated, commercial (mean, 38.2) and academic (37.3) sites had the highest total DISCERN scores, which were significantly greater than nonacademic medical practice (31.8) and government/patient advocacy sites (33.4) (p≤0.035). Nonacademic medical practice sites had the lowest mean total DISCERN (31.8) and JAMA (1.47) scores and the highest FK grade level readability (9.5). There was a significant positive correlation between mean total DISCERN and JAMA scores (r=0.46, p<0.001). Conclusion The mean overall quality of websites regarding the treatment of OA was good as evidenced by greater modified DISCERN scores. However, website quality ranged from poor to excellent, indicating that some websites are still missing key information patients may find useful when assessing treatment options online.

Osteoporotic Vertebral Fractures: An Analysis of Readability and Quality of Web-Based information

IntroductionVertebral compression fractures are among the most common fragility fractures with significant morbidity and mortality. With an aging population, the incidence of these fractures is on the rise. In this age of social and electronic media, there is a plethora of online information available. While access to healthcare information has increased, most of these websites remain beyond the comprehension of their target audience.ObjectiveTo assess the readability and quality of online information regarding osteoporotic vertebral fractures.MethodsA search for the terms osteoporotic vertebral fractures, osteoporotic spinal fractures, and fragility spinal fractures was performed using the top five search engines. Eighty-three websites were identified and analyzed. Quality assessment was done using the DISCERN and Journal of the American Medical Association (JAMA) tools while readability was analyzed using the Flesch Reading Ease Score (FRES), Flesch Kincaid Grade (FKG), and Gunning Fog Index (GFI).ResultsThe mean DISCERN score was 39.55 while the mean JAMA was 2.2. Readability testing revealed a mean FRES score of 49.26 with 16 websites having a score of > 60, FKG 8.38, and GFI of 9.51. 33 websites had an FKG score of 8 or below 8.ConclusionThe above results indicate that web-based information relating to osteoporotic vertebral fractures is of variable quality and readability. Although 40 % of websites are at the eighth grade or below level, only 16 % of websites are above the FRES score of 60, which makes online information difficult to comprehend by an average patient.

Evaluation of the quality of information online for arthroscopic Bankart repair.

The purpose of this study was to evaluate the quality and readability of information online for patients searching terms related to arthroscopic Bankart repair (ABR). Google, Yahoo and Bing were searched with terms related to ABR. The quality of information was assessed using the Journal of the American Medical Association (JAMA) Benchmark criteria, DISCERN Score, and the Flesch-Kincaid Reading Ease & Grade Level. The presence of the HONcode marker was noted. Additionally, we used a scoring system specific to content relating to the ABR (AB score), a 1-20 Likert scale. Websites were also categorised according to the source: academic institution, physician, allied healthcare, commercial, media or social media. Statistical analysis was performed using GraphPad Prism. Ninety-six unique websites were evaluated, with the most common website category being physician websites (52) and academic institution websites (24). There were nine websites with the HONcode marker. The average JAMA Benchmark criteria score was 1.95 (1-4), the average DISCERN score was 48.8 (20-78), with an average Flesch-Kincaid reading ease of 50.9 (11-96) and grade level of 8 (1-18). The average AB score was 5.9 (0-18), and there was a strong correlation with a higher DISCERN score (r=0.57), but not JAMA score (r=0.18) or Flesch-Kincaid grade (r=0.16). Websites with the HONcode marker did not score higher in any criteria than those without it (p>0.05). The quality of information on physician websites was better than (statistically insignificant) non-physician websites; however, the readability of information in the former was poorer (statistically significant) than the latter. There was wide variability in the quality and readability online of the information on ABR, and the AB scoring system was shown to correlate strongly with increased quality.

Readability and quality levels of websites that contain written information about anterior cruciate ligament injury: A survey of Turkish websites.

This study aimed to evaluate the contents and readability levels of informative texts about anterior cruciate ligament (ACL) on Turkish websites. In this cross-sectional study, online searches were performed using the Google, Yandex, and Yahoo search engines on 16, 17, and 18 November 2020, respectively. In these three search engines, 'anterior cruciate ligament', 'anterior cruciate ligament surgery', 'ACL', and 'ACL surgery' were entered in Turkish. The first 10 pages from each search on the websites were collected. The websites were divided into 3 groups according to their sources. Group 1 was classified as websites prepared by private hospitals or medical centers; group 2, as individual websites of orthopedics and traumatology physicians; and group 3, as non-profit websites providing general health information that does not fall into these two groups. The websites were analyzed based on both the website interface and a specific content scoring guide by two reviewers. The Flesch Kincaid (FK) grade level and the Flesch reading ease (FRE) score were used to determine the readability of information on the websites. Eighty-five unique websites were evaluated. The mean quality score of all the websites was 10.4 ± 4.5 with a maximum score of 25 (range=3-21). No significant difference in quality score was found between the groups. The mean FK grade score of all the websites was 11.2 ± 1.7 (range=7.9-15.3). The mean FRE score of all the websites was 46.8 ± 7.7 (range=24.1-63.7). No statistically significant differences in FK grade and FRE score were found between the groups. Although 59 websites (69%) had a third-party seal indicating the certification of one of the organizations established to provide a standard of health information on the Internet, only 21 websites (25%) were updated in the year before the search. The readability level of the informative texts about the ACL on the Turkish websites was above the educational level in Turkey. In addition, the quality score of the Turkish websites related to ACL was low. The content of the informative texts should be organized while taking into account the patients' literacy level.

Evaluating the Quality and Readability of Online Resources on Unspecified Kidney Donation

Unspecified kidney donation (UKD) refers to transplantation from donors unrelated and unknown to the recipient. UKD has contributed to the expansion of the live donor pool in several countries. The United Kingdom Transplant Community has set maximizing UKDs as a priority. The Internet raises awareness and potentially influences the decision-making regarding UKD. This is the first study assessing the quality and readability of online material on UKD. Google was searched for the terms "kidney donation" and one of "unspecified," "altruistic," "non-directed," "anonymous," or "good Samaritan," as well as "giving or donating a kidney to a stranger." Two independent assessors reviewed the top 100 websites. Quality was assessed using the Journal of the American Medical Association criteria, the DISCERN instrument and Health On the Net Code certification. Readability was assessed using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade (FKG), and Simple Measure of Gobbledygook (SMOG) scores. Only 6% of websites displayed HONcode certification. The mean (± SD) JAMA and DISCERN scores of 1.96 (± 1.00) and 32.34 (± 11.19) indicate poor quality. The mean (± SD) FRE, FKG, and SMOG scores of 52.92 (± 13.62), 10.60 (± 2.72), and 9.64 (± 2.22) reveal poor readability. The difference in JAMA and DISCERN scores according to website classification was significant (P < .001, P=.014) with websites from medical, nonprofit, and governmental organizations scoring amongst the lowest, while comprising most search results (61%). Transplant centers and medical organizations should prioritize improving their online resources to lower the risk of individuals pursuing UKD based on unrealistic expectations or being discouraged unjustly.

119 Evaluating the Quality and Readability of Online Information on Unspecified Kidney Donation

Abstract Introduction Living kidney transplantation from donors bearing no genetic or emotional relationship with the recipient, is known as unspecified kidney donation (UKD). UKD can create multiple living donor transplantation opportunities and shorten the national waiting list for cadaveric organs. Consequently, the UK Living Donor Kidney Transplantation 2020 Strategy, has prioritised maximising UKDs. The Internet has an established role in raising awareness, offering support, and potentially influencing the decision for or against UKD. This is the first study assessing the quality and readability of online material related to UKD. Method Google was used to search for the following terms: ‘kidney donation’ and one of ‘unspecified’, ‘altruistic’, ‘non-directed’, ‘anonymous’ or ‘good Samaritan’ as well as ‘giving or donating a kidney to a stranger’. Two independent assessors reviewed the top 100 websites and assessed their quality using the Journal of the American Medical Association (JAMA) criteria, the DISCERN instrument and HONcode (Health on the Net Code) certification. Readability was assessed using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade (FKG) and Simple Measure of Gobbledygook (SMOG) scores. Results Only 6% of websites displayed a HONcode stamp. The mean (± SD) JAMA and DISCERN scores of 1.96 (±1.00) and 32.34 (±11.19) respectively, indicate poor quality. The mean (± SD) FRE, FKG and SMOG scores of 52.92 (±13.62), 10.60 (±2.72) and 9.64 (±2.22), respectively, reveal poor readability. Conclusions Transplant centres and medical organisations should prioritise improving the standards of online material on UKD. This enables informed and ethical decision-making when attempting to expand the living donor pool.