Evaluating the Readability and Quality of Online Health Information Regarding Hemifacial Microsomia

Patients and parents increasingly rely on the internet to obtain medical information. The readability of these online webpages is significant, as lower literacy rates have been associated with poorer health outcomes. As such, the American Medical Association (AMA) and National Institutes of Health (NIH) recommend that health information be written between a 6th- and 8th-grade reading level. This study aimed to evaluate the readability and quality of online webpages discussing hemifacial microsomia (HFM).

Three of the largest online search engines were queried by 2 independent reviewers for "hemifacial microsomia." Readability was assessed using 6 readability tests: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG) Index, Coleman-Liau Index (CLI), and Automated Readability Index (ARI). The quality of online webpages was assessed using the DISCERN handbook and scale.

Thirteen webpages were included for analysis. The mean overall readability level was equivalent to a 13th-grade level. The mean readability grade level for each score used was: FKGL 12.4, GFI 15.7, SMOG Index 11.3, CLI 14.1, and ARI 13.2. The FRES was 36.8 (ie, difficult to read).

Online webpages providing information regarding HFM are too difficult for most Americans to read. The readability of online patient information should be a priority for health care providers and medical organizations that publish this information. By improving the readability and quality of online health information, patients and caregivers will better understand their condition, effectively encouraging active participation in the shared decision-making process.