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Published on: June 29, 2019
Readability and Suitability of Online Patient Education Materials for Glaucoma
Cole A Martin1, Saima Khan1, Rachel Lee2
1Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin, Austin, Texas.
Purpose:
To assess the quality, content, readability, and accountability of information about glaucoma found online.
Design:
Cross-sectional study.
Participants:
Thirteen websites containing patient education materials for glaucoma were analyzed in this study.
Methods:
An online Google search was conducted using the keyword "glaucoma." Thirteen medical website results were selected for analysis. Each website was assessed by 3 independent reviewers for suitability, readability, and accountability. The standardized Suitability Assessment of Materials (SAM) tool was used to evaluate the quality and content of information on each website. The Flesch Reading Ease (FRE) score, Flesch-Kincaid Grade Level (FKGL), Coleman-Liau Index (CLI), Simple Measure of Gobbledygook (SMOG) index, Automated Readability Index (ARI), and Linsear Write Formula (LWF) score were used to assess the readability of the websites. The Journal of the American Medical Association (JAMA) accountability benchmarks were used to evaluate each website's accountability.
Main Outcome Measures:
These included SAM, FRE, FKGL, CLI, SMOG index, ARI, and LWF scores as well as JAMA accountability benchmarks.
Results:
The average SAM score for all the websites included in this study was 18 points out of a possible 34 points. Eyewiki.org was the lowest-scoring website (11.7 ± 0.6 points), whereas aao.org and nei.nih.gov were the highest-scoring websites (26.0 ± 1.0 points and 26.0 ± 2.6 points, respectively). Three content graders in this study were in moderate agreement (kappa statistic = 0.50). The average FRE score among all the websites was 47.0 (95% confidence interval [CI], 39.3-54.7). The average reading grade score among all the websites was 11.2 (95% CI, 10.0-12.4). Two of the 13 websites (15.4%) satisfied all 4 JAMA accountability criteria.
Conclusions:
There is significant variation in the content and quality of freely available, online glaucoma education material. The material is generally either not suitable or only adequate for use. Most websites reviewed are written at a reading grade level higher than that recommended for patient education materials.
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