A Comprehensive Evaluation of the Readability of Online Healthcare Materials Regarding Distal Radius Fractures

Introduction Distal radius fractures (DRFs) are among the most common upper limb fractures reviewed in the emergency and orthopaedic departments. Approximately 40% of these fractures are unstable and require fixation to improve limb function. Confronted with an impending operation, many patients will access the internet, looking for information and reassurance. Previous studies have suggested that orthopaedic healthcare websites are beyond the comprehension of their target audience. Objective To assess the readability of healthcare websites regarding DRFs. Methods The terms distal radius fracture, broken wrist and wrist fracture were searched on Google and Bing. Of 101 websites initially considered, 52 unique websites underwent evaluation using readability software. Websites were assessed using two common methods for assessing readabilty; the Reading Grade Level (RGL) and the Flesch Reading Ease Score (FRES). In line with recommended guidelines and previous studies, an RGL of sixth grade and under and a FRES score above 65 was considered acceptable. Results The mean score for the FRES index was 56.67 (SD: ± 19.6), which resulted in the majority of pieces assessed being classified as 'fairly difficult to read'. The mean RGL was 8.61 (SD: ± 2.86); 17.3% of the websites assessed fulfilled the criteria of having an RGL of six or less. One way T-tests comparing the FRES and RGL mean scores against the acceptable standards showed that they failed to meet the acceptable indexes (FRES: P<0.004; 95% CI: -13.8 to -2.8; RGL: P<0.0001; CI: 1.8-3.4). ANOVA testing showed no significant difference based on category (FRES: P=0.791; RGL: P=0.101). Conclusion The level of comprehension required for online healthcare education materials related to distal radius fractures exceeds the recommended guidelines. Improving the readability content of these websites would enhance the internet's usability as an educational tool as well as improve patient post-operative outcomes.