Quality and accessibility of online patient self-education resources for breast reconstruction

With rising interest in breast reconstruction after mastectomy, patients are increasingly turning to online resources to supplement medical consultations. However, the quality and accessibility of these materials remain inconsistent. This study evaluates the readability, understandability, actionability, content coverage, and transparency of online breast reconstruction resources.

The top 20 Google search results were examined for five common breast reconstruction-related queries. Metrics assessed included SMOG readability level, PEMAT scores (understandability and actionability), content coverage, and a modified EQIP score for quality. Statistical analyses examined relationships among these variables and with factors like search rank, author type, and query.

Mean content coverage was 49 %, with significant gaps in preoperative planning, treatment side effects, and fat grafting. Readability was poor (mean SMOG 12.3). Understandability was high (80 %), but actionability (37 %) and quality (modEQIP of 40 %) were low. Academic authors produced shorter and lower-quality resources. Higher-ranked resources were generally longer and correlated with better performance across most metrics. Specific queries like 'DIEP flap' yielded narrower, lower-quality resources.

Online resources for breast reconstruction are highly variable and often fall short in readability, comprehensiveness, and transparency. Although understandability is generally acceptable, low actionability and inconsistent coverage hinder patient utility. Search engine rank modestly correlates with quality, suggesting some alignment between visibility and value. Improving these resources will require targeted efforts to simplify language, address topic gaps, and enhance actionable content-especially for specialized queries where quality remains lowest.