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What Resources Are Available for Parents Online? A Readability, Quality, and Source Evaluation of Website and
Daniel S Hayes1, Elizabeth H Blank1, Ryan D Muchow1
1University of Kentucky College of Medicine, Department of Orthopaedic Surgery and Sports Medicine, Lexington, KY, USA.
Background:
Individuals frequently consult the internet when seeking information about their health. However, patient education materials (PEMs) published online are often written above the recommended sixth-to eighth-grade reading level. The readability and quality of online resources for inherited conditions are poorly studied. Additionally, little is known about the reading level of responses from artificial intelligence (AI) models when prompted with healthcare inquiries. We aimed to assess the readability and quality of online health information encountered when searching for inherited pediatric orthopaedic conditions, including outputs from popular large language model (LLM) chatbots.
Methods:
Twenty-three inherited pediatric orthopaedic conditions were queried using Google in three common search formats. First-page search results, including Google AI Overviews, were analyzed. Searches were replicated in three chatbots: Microsoft Copilot, ChatGPT, and Google Gemini. Readability was assessed using Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL).
Results:
Of 706 identified webpages, 355 met inclusion criteria. Most webpages were hosted by government agencies, academic hospitals, or nonprofit organizations. Mean readability levels were high (FRE 38.2; FKGL 12.1), substantially exceeding the recommended levels for patient-facing health information. Only 18% of webpages met eighth-grade readability standards. AI-generated outputs demonstrated similar readability (FRE 36.1; FKGL 12.3). Only 2% of AI responses met eighth-grade readability recommendations. However, when the input prompt included a request to improve readability, AI models lowered average output readability by nearly six grade levels (FRE 69.0; FKGL 6.8).
Conclusions:
Online information for inherited pediatric orthopaedic conditions is frequently written above recommended reading levels, and AI-generated content does not meaningfully improve accessibility unless specifically prompted to do so. Despite generally reputable website sources, limited readability and accountability highlight opportunities for orthopaedic surgeons and organizations to advocate for improved clarity, accessibility, and patient-centered communication.
Key Concepts:
(1)Online patient education materials for inherited pediatric orthopaedic conditions are written at a higher reading level than the recommended 8th grade level.(2)Only 18% of websites and 2% of AI-generated responses meet the ≤8th grade readability standard.(3)Most online resources come from reputable sources (government, academic hospitals, nonprofits) but still have poor readability.(4)AI-generated health information has similar readability to websites but is significantly shorter.(5)Improving readability, accessibility, and patient-centered communication is a key opportunity for orthopaedic providers and organizations.
Level Of Evidence:
V.
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