Evaluating the quality of online patient education materials for gastric adenocarcinoma

Gastric adenocarcinoma, or gastric cancer, typically has a poor prognosis. The objective of this study was to assess the quality, understandability, actionability, and comprehensiveness of online resources for patients diagnosed with gastric adenocarcinoma, or gastric cancer as patients increasingly rely on online health information.

A systematic search using the term "stomach cancer" was conducted across three search engines (Google, Yahoo, and Bing) on three different browsers (Safari, Google Chrome, and Microsoft Edge) on 12/13/2024, with the top fifty websites recorded for each combination. Duplicates were removed and inclusion/exclusion criteria were applied. Quality was evaluated using the DISCERN instrument. The PEMAT-P was used to evaluate understandability and actionability. Readability was evaluated with the Flesch-Kincaid Reading Ease algorithm. Comprehensiveness was evaluated with author generated criteria based on national guidelines. Scores for each assessed metric were determined by two independent reviewers for each website and recorded, with any inter-reviewer discrepancies resolved by consensus. Statistical analysis was performed to compare results by website affiliation (academic, foundation or government) and search rank.

Thirty-seven websites evaluated (N = 17 academic, N = 13foundation and N = 7 government). The mean quality score (DISCERN) was 3.62 (SD 1.21), with no significant differences across affiliations or search positions. Thirty-five out of the 37 evaluated websites achieved an understandability (PEMAT-P) score above the recommended threshold of 70% (Mean 78.38%, SD 11.86%) and 14 websites exceeded the threshold for actionability (Mean 57.66%, SD 37.69%) with no significant differences across affiliations or search positions. Readability (Flesch-Kincaid) averaged a 10th-12th grade level, with a mean score of 51.88 (SD 8.93). Mean comprehensiveness was scored at 62.98% (SD 23.23%) across all websites without significant differences across affiliations or search positions, with over 85% of websites addressing epidemiology, risk factors, and symptomatology, but under 30% of websites including content on post-treatment complications or surveillance.

While most online resources for gastric cancer provided understandable information, they lacked actionability, were written above recommended reading levels, and offered limited content on long-term management. These shortcomings reflect broader trends seen across other patient resources and highlight the need for more actionable, readable, and comprehensive online patient education materials.