An Objective Analysis of the Quality and Readability of Online Information on Breast Implant Illness

Breast implant illness (BII) has emerged as a significant concern for patients with breast implants, characterized by a range of symptoms, including fatigue, cognitive impairment, and joint pain. The growing recognition of BII has prompted increased scientific investigation. However, despite the rising prevalence of breast augmentation procedures, there remains a lack of consensus within the medical community regarding the diagnosis, etiology, and treatment of BII. This study aimed to evaluate the readability of online resources pertaining to BII to determine their accessibility to the general population. A systematic internet search was conducted using three major search engines (Google, Bing, and Yahoo) with the query "breast implant illness." After excluding duplicates and paid content, 28 unique websites were analyzed using five established readability indices: Flesch-Kincaid Reading Ease Score (FRES), Gunning-Fog Index, Coleman-Liau Index, Simplified Measure of Gobbledygook (SMOG), and Automated Readability Index. The results revealed a considerable range in the readability of online materials related to BII. The average FRES was 50.4, categorizing the material as "fairly difficult" to read. The Gunning-Fog Score averaged 9.3, suggesting a 9th-grade education level for comfortable comprehension. The SMOG Index indicated a reading level appropriate for individuals with at least 13 years of education. The Coleman-Liau Index suggested a reading level corresponding to a 21-year-old, while the Automated Readability Index pointed to a high school freshman level. These findings highlight a significant disparity between the readability of available information and the recommended standards set by the American Medical Association and the National Institutes of Health, which propose that patient education materials should be written at a 6th-grade reading level or lower. The study's results are consistent with research on the readability of online health information in other domains, identifying a mismatch between the reading level of the general public and the complexity of available health information. The importance of readability in online health information cannot be overstressed, particularly in the context of BII, where decisions may include elective surgery with inherent risks. The study calls for the development and implementation of standardized guidelines for creating online health materials that are accessible to a diverse audience. This includes simplifying language, using clear formatting, and incorporating visual aids to enhance comprehension.