Quality and Readability of Online Information on Elbow Epicondylitis

Elbow epicondylitis (EEC) is a painful condition that affects the common flexor or extensor tendons of the elbow. This study aimed to evaluate the quality and readability of online information regarding EEC using several established methods.

Websites were examined using the Google search engine on September 13, 2024, to identify the top 100 ranked websites using the following search terms: "lateral epicondylitis," "medial epicondylitis," "golfer's elbow," "tennis elbow," and "elbow pain." The inclusion criteria were accessible English-language websites containing health information related to the search terms. Among the retrieved websites, those that were inaccessible, duplicate, non-English, irrelevant, and registration- or subscription-based websites, as well as those limited to scientific articles or video clips, were excluded. The websites were categorized into 5 groups. The quality of each website was evaluated using Health on the Net Foundation (HON) grade scale, instrument for judging the quality of written consumer health information on treatment choice (DISCERN instrument), and Ensuring Quality Information for Patients (EQIP) score. Additionally, website readability was assessed using Flesch-Kincaid reading ease (FRE) score, Flesch-Kincaid grade (FKG) level, Gunning-Fog index, Simple Measure of Gobbledygook (SMOG) grade level, and Coleman-Liau index.

Of 500 websites, 201 were selected based on exclusion criteria. News portals and non-profit websites generally exhibited higher quality than other website types. Although 17 websites were considered high quality, none were rated as such according to the DISCERN instrument. On average, each type of website had an FKG level above 7.7, and the average FRE score was below 54 points, indicating a challenging reading level for the general audience.

The quality of online information regarding EEC should be improved and made more accessible to the general public. Although the readability of this information remains inadequate, the results may indicate some improvement compared with those of previous studies. Given the high prevalence of EEC and the increasing use of web-based health information, further efforts could be made to enhance the readability and quality of online resources on EEC.