Popular asthma websites for patient education vary in quality, readability
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Key takeaways:
- Readability ranged from an eighth-grade level to freshman year of college.
- None of the sites achieved a perfect score based on JAMA benchmark criteria.
- Doctors should ask patients about their information sources.
Popular websites that provide educational information about asthma to patients varied in readability and quality, according to a study published in Annals of Allergy, Asthma & Immunology.
Previous studies assessing the readability and quality of educational material about asthma online have been limited, Amogh Reddy, BS, student at the Alabama College of Osteopathic Medicine, and colleagues wrote.
The researchers searched for “asthma” on Google and included the first 15 sites in their analysis. Next, they compiled information from these sites categorized as general descriptions, causes, symptoms and management of asthma into a Word document.
Using six different tools, the researchers assessed the readability of this content by sentence length, word difficulty and number of multisyllabic words in each sentence. They also analyzed content quality via tools that assessed factors including authorship, attributions, disclosures, currency, reliability, trustworthiness and transparency.
American Medical Association guidelines recommend that patient education material be written at a sixth-grade level or below. All 15 websites were written above a sixth-grade level.
Mean readability scores ranged from 8.664, or an eighth-grade level, for the CDC site, to 13.178, or an undergraduate freshman level, for the Medical News Today website.
Based on the Flesch Reading Ease tool, none of the websites were “easy” to read, four were “average” and 11 were “difficult.”
Quality scores varied from 0 to 3 based on the JAMA benchmark tool, which awards one point each for authorship, attribution, disclosure and currency if they are included on the website.
None of the websites received a perfect score with all four factors. Six sites had scores of 3, four had scores of 2 and three had scores of 1. The websites for the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma and Immunology both had scores of 0.
The DISCERN Instrument, which assesses document reliability and quality, yielded poor ratings for three sites, fair ratings for six sites and good ratings for five sites. Only one site, MedPlus.gov, was considered excellent.
Nine of the websites had HONcode certification, which recognizes trustworthy and transparent recommendations, the researchers said. Websites must apply for this certification, with renewal charges ranging from $65 to $200.
With all 15 websites written above a sixth-grade level, the researchers said, there was significant room for improvement. For example, the researchers recommended replacing references to “short-acting bronchodilators” with “rescue inhalers.” Shorter sentence lengths, casual word choices and a lack of medical jargon can improve scores as well, they continued.
Further, the researchers recommended including information about authorship of information, references used, conflicts of interest and publication date. More than half of these sites did not report a physician author, the researchers continued.
However, the researchers noted that some of the sites may have met metrics such as conflict of interest statements or physician authorship reporting but were not included due to obscure website reporting.
Considering these findings, the researchers encouraged practicing specialists and professional asthma organizations to screen patient education information so their patients can better understand and manage their asthma.
Perspective
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The results are significant and generally unsurprising. Despite the recommendation for a sixth-grade reading level, most of the health-based websites analyzed in the study used medical jargon, which makes their articles more challenging to comprehend. It is surprising that none of the 15 websites complied with the sixth-grade reading level and that 11 sites were classified as difficult to read. It seems that there is room for improvement across multiple areas for the various websites.
Based on my own experience in patient education, I can relate to these results. I discovered that much of the available information is not presented in a way that is easy for patients to comprehend. This is why I developed an interest in health communication and public health, as I believe it is crucial to create patient education resources that are both engaging and presented at a suitable reading level.
I think that social media has had a significant impact on patient education, especially as social media continues to grow. It has the potential to provide users with increased access to health information, improved patient engagement by allowing users to search and ask questions about conditions online, and greater empowerment by encouraging users to take control of their health with different tools and resources.
Although social media can provide a lot of good, users still must also be cautious about the potential for misinformation and medically inaccurate information. It is essential that people work closely with trustworthy online resources and/or their health care providers to ensure that they are receiving accurate and reliable information about their health.
Medical websites could benefit from having their writers and editors trained in health literacy. Health literacy would include using plain language that includes simple, easy-to-understand words and avoiding medical jargon. This can make information more accessible and understandable for users.
Also, websites should try to focus on visuals, such as images, videos and infographics. This can be an effective way to enhance patient education. Another important aspect is to make sure websites do not forget about making their resources accessible. For example, the images, colors, fonts and font sizes should be easy to read and available to screen readers. Organizations can also involve patients in the development of educational resources to help ensure that the information is both understandable and relevant to the user. Finally, these organizations should always try to evaluate the effectiveness of patient educational efforts to ensure that their materials are meeting the needs of patients. They should gather feedback and then make improvements to educational resources based on this feedback.
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