Readability of Printed Online Education Materials on Pituitary Tumors: Untangling a Web of Complexity

BACKGROUND

Patients are increasingly turning to the internet for health education. Due to the complex pathophysiology, clinic-diagnostic profile, and management spectrum of pituitary tumors, an evaluation of the readability of printed online education materials (POEMs) regarding this entity is warranted.

OBJECTIVE

(1) To apply established readability assessment tools to internet search results on the topic of pituitary tumors. (2) To identify sources of complexity in order to guide the creation POEMs that are in line with the reading level of the target audience.Methodology: After independent, neutral internet search for the phrase "pituitary tumor," the first 100 results were subjected to inclusion criteria matching. Analysis was performed using 5 readability assessment tools including Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Gunning-Fog Score (GFS), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG).

RESULTS

A total of 82 websites met inclusion criteria. All websites were found to be at a higher reading level (P < .01) than the United States Department of Health and Human Services (USDHHS) recommended sixth-grade level. Mean readability scores were as follows: FRE, 38.79; FKGL, 11.27; GFS, 12.83; CLI, 17.31; SMOG, 12.12. Intergroup comparison between FKGL, GFS, CLI, and SMOG yielded that CLI was significantly higher (P < .03). No significant differences in readability were noted between academic and other websites.

CONCLUSION

There is a significant misalignment between the reading level of patients and the readability of pituitary tumor POEMs. This may lead patients to misconceive their diagnoses, management options, and prognosis.

Evaluation of the Quality of Printed Online Education Materials in Cosmetic Facial Plastic Surgery

Importance: In the modern-day health care environment, it is expected that a large proportion of patients will utilize the Internet to gather health care-related information. However, online sources are often not subjected to adequate quality control measures. Objective: To evaluate the quality of printed online education materials (POEMs) pertaining to elective facial cosmetic surgery. Design, Setting, and Participants: This is a descriptive correlational study. Independent Internet searches for the terms "rhinoplasty," "rhytidectomy," "blepharoplasty," and "browlift" were carried out using the Google search engine. The top 20 web resources for each term were analyzed. Main Outcomes and Measures: All web resources were analyzed for HONcode certification. The DISCERN instrument was then used to determine reliability and specificity of information, whereas readability was assessed using the Flesch Reading Ease (FRE) score and the Flesch-Kincaid Grade Level (FKGL). Results: Of the resulting 80 web resources, 30% (n = 24) were HONcode certified. None of the surgical society web resources (n = 12) were HONcode certified, and only 42% (n = 8) of web resources associated with academic institutions were HONcode certified. Out of a maximum DISCERN score of 80, the mean (standard deviation [SD]) scores were 48 (11) for rhinoplasty, 50 (11) for rhytidectomy, 47 (11) for blepharoplasty, and 45 (10) for browlift. The mean DISCERN scores of the HONcode-certified web resources did not differ significantly from scores of uncertified web resources (p = 0.069). There was no significant difference in overall mean DISCERN scores for the different web resource categories. The mean (SD) FRE score was 45.7 (11.9), whereas the mean FKGL score was 10.7 (1.9). HONcode-certified web resources had significantly higher FRE scores (p = 0.028) and significantly lower FKGL scores (p = 0.0003). Conclusions and Relevance: A significant proportion of POEMs regarding elective cosmetic facial plastic surgery remains uncertified and of inadequate quality. This can negatively impact the informed decision-making process and increase the risk of poor outcomes and lower satisfaction rates.

Understandability and actionability of audiovisual patient education materials on sinusitis

BACKGROUND

Acute and chronic rhinosinusitis are debilitating diseases that affect from 5% to 16% of the population. YouTube is the second most commonly used search engine and is often utilized by patients to garner health information regarding various disease processes and their respective management options. An evaluation of these information resources for quality and reliability is warranted, especially in an era in which patients are increasingly turning to audiovisual (A/V) media to educate themselves regarding their ailments.

METHODS

The YouTube video database was searched using the term "sinusitis" from its inception through to November 2018. The first 50 videos populated under the relevance-based ranking option were collected and parsed by time and language. Of the 50 videos, 10 were eliminated either for length (≤1 minute or ≥20 minutes), language (any language other than English), and/or for later being removed by YouTube for copyright violations. The videos were then assessed using the Patient Education Materials Assessment Tool-Audio/Visual (PEMAT-A/V) by 2 independent reviewers for understandability and actionability.

RESULTS

A total of 40 videos were examined using the PEMAT-A/V tool. The average understandability score was 57.7%, whereas the average actionability score was 46.3%. Eleven videos (28%) had actionability scores of 0%. Videos most commonly addressed disease management options (38%). The second largest category was case presentations regarding surgical techniques (30%). There were only 6 videos focused primarily on education about the definition and common traits of sinusitis (15%).

CONCLUSION

Our results show a paucity of high-quality online A/V educational material pertaining to sinusitis, with a majority of videos being neither understandable nor actionable. As patients increasingly turn to internet video databases like YouTube for medical information, it is critical that physicians and institutions create A/V material that is accurate, understandable, and actionable.

An Appraisal of Printed Online Education Materials on Spasmodic Dysphonia

OBJECTIVE

The use of the Internet for seeking health-related information has increased exponentially. We aimed to comprehensively appraise the readability, understandability, actionability, and quality of printed online education materials (POEMs) pertaining to Spasmodic Dysphonia (SD).

STUDY DESIGN

Descriptive, correlational study.

METHODS

POEMs were identified using the Google search engine with the phrase "spasmodic dysphonia." The first 50 websites meeting criteria were included. Accreditation of POEMs was evaluated using Health on the Net Foundation Code of Conduct (HONcode) toolbar. Readability of the content was analyzed using the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) tests. Understandability and actionability was evaluated using the Patient Education Material Assessment Tool for Printed Materials. Overall quality of POEMs was appraised using the DISCERN instrument.

RESULTS

The overall mean [SD] FKGL and mean [SD] FRE score was 11.5 [2.5] and 42.1 [12.8], respectively. The mean understandability score was 65% [14], while the mean [SD] actionability score was only 17% [12]. The overall mean [SD] quality score for all websites was 43.5 [13]. Only four websites (8%) were HONcode certified. A moderately positive correlation was discovered between understandability and overall quality of POEMs (r = 0.38, P 0.01) CONCLUSIONS: POEMs pertaining to SD are written above recommended reading levels with subsequent poor understandability and actionability. We recommend that authors assess POEMs prior to publication to ensure alignment with the needs of the target audience.