What Patients See: Evaluating the Quality, Readability, and Ethnic Inclusivity of Online Resources for Breast...

Online resources about breast reconstruction are critical to guiding patients through decisions surrounding breast cancer treatment. Accordingly, the objective of this study was to assess the suitability of online materials for breast reconstruction.

A comprehensive Google search for "breast reconstruction" was performed, and the resulting sites were evaluated. The readability of each website was evaluated using 6 different readability metrics, and the quality of the websites was assessed with the Journal of the American Medical Association (JAMA) benchmark criteria. The percentage of sites with visual patient representations was ascertained, and the Fitzpatrick scale was used to assess the diversity of these representations. One-way analysis of variance was used to analyze the readability metrics and JAMA benchmark criteria across the various website categories.

From the 78 individual websites identified, 50 were from academic hospitals, 11 were government/nonprofit organizations, 7 were third-party informational websites, and 10 were private hospital/physician group websites. Across all categories, online breast reconstruction materials were written at an average reading level greater than the 10th grade. Academic hospital center websites had the lowest average JAMA benchmark scores (1.20 ± 0.53, P < 0.0001). Fifty percent of the identified breast reconstruction educational sites included some type of illustrations/visualization, and only 18.0% included representations other than White.

The current online patient education materials for breast reconstruction exceed the complexity appropriate for the dissemination of medical information to the general public. Concerted efforts should be made to enhance the readability, with special attention toward the incorporation of diverse illustrations/visualizations.