Online Resources for Migraine Surgery: Readability and Patient Understanding

Migraine is a prevalent neurological disorder that affects quality of life. Surgery is a specialized option for patients with chronic or refractory migraine and requires understanding complex information. As patients rely on online resources, health literacy-the ability to obtain, understand, and use health information-becomes crucial for informed decision-making. However, online medical information often exceeds recommended readability levels.

A systematic Google search for "migraine surgery" was performed, excluding duplicates, sponsored content, non-English websites, scientific journals, and multimedia-only sources. Texts from 31 articles across 11 websites were extracted and assessed using 6 validated readability indices: Gunning Fog Index, Coleman-Liau Index, Flesch-Kincaid, Automated Readability Index, Simple Measure of Gobbledygook Index, and Flesch Reading Ease. Mean scores were calculated, and analysis of variance with Tukey honestly significant difference test post hoc tests was used to evaluate differences between websites.

The mean readability level across all websites was higher than the National Institutes of Health and American Medical Association recommended sixth-grade level, corresponding instead to high school or early college-level texts. Flesch Reading Ease averaged 44.9 ("difficult"). Readability varied significantly between websites; some were more accessible, whereas others were highly complex. Technical terminology, long sentences, and limited formatting or visual aids contributed to poor readability.

Online patient information on migraine surgery is generally written at a level that is too difficult for the average reader, posing barriers to informed decision-making. Improving accessibility through simpler language, glossaries, and visual aids-and testing materials with users-could enhance patient understanding, autonomy, and engagement in healthcare decisions.