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      Functional endoscopic sinus surgery: assessing the readability and quality of online information

      Author(s): 1 , 1
      Publication date Created:
      Publication date (Print):
      Journal: The Annals of The Royal College of Surgeons of England
      Publisher: Royal College of Surgeons of England

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          Abstract

          Introduction

          The aim of this study was to assess the readability and quality of online information on functional endoscopic sinus surgery (FESS).

          Methods

          The term ‘functional endoscopic sinus surgery’ was entered into the Google, Bing and Yahoo search engines. The first 30 websites for each search engine were screened. Readability was assessed using the Flesch–Kincaid Reading Ease Score (FRES), Flesch–Kincaid Grade (FKG), Simple Measure of Gobbledygook (SMOG) Index, and Gunning Fog Index (GFI). Quality was assessed using the DISCERN instrument. Spearman’s correlation between quality and readability was calculated.

          Results

          Thirty-three websites met the inclusion criteria. The mean and standard deviations for the FRES, FKG, SMOG, GFI, and DISCERN scores were 49 (13.1), 10.9 (2.5), 10.2 (1.9), 13.6 (2.4), and 51.1 (12.8), respectively. A positive correlation was noted between the FRES and DISCERN (R=0.357, p=0.041).

          Conclusions

          Online information on FESS is generally written above the recommended reading levels and of fair quality.

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          Most cited references16

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          DISCERN: an instrument for judging the quality of written consumer health information on treatment choices.

          D Charnock, S Shepperd, G Needham … (1999)
          To develop a short instrument, called DISCERN, which will enable patients and information providers to judge the quality of written information about treatment choices. DISCERN will also facilitate the production of new, high quality, evidence-based consumer health information. An expert panel, representing a range of expertise in consumer health information, generated criteria from a random sample of information for three medical conditions with varying degrees of evidence: myocardial infarction, endometriosis, and chronic fatigue syndrome. A graft instrument, based on this analysis, was tested by the panel on a random sample of new material for the same three conditions. The panel re-drafted the instrument to take account of the results of the test. The DISCERN instrument was finally tested by a national sample of 15 information providers and 13 self help group members on a random sample of leaflets from 19 major national self help organisations. Participants also completed an 8 item questionnaire concerning the face and content validity of the instrument. Chance corrected agreement (weighted kappa) for the overall quality rating was kappa = 0.53 (95% CI kappa = 0.48 to kappa = 0.59) among the expert panel, kappa = 0.40 (95% CI kappa = 0.36 to kappa = 0.43) among information providers, and kappa = 0.23 (95% CI kappa = 0.19 to kappa = 0.27) among self help group members. Higher agreement levels were associated with experience of using the instrument and with professional knowledge of consumer health information. Levels of agreement varied across individual items on the instrument, reflecting the need for subjectivity in rating certain criteria. The trends in levels of agreement were similar among all groups. The final instrument consisted of 15 questions plus an overall quality rating. Responses to the questionnaire after the final testing revealed the instrument to have good face and content validity and to be generally applicable. DISCERN is a reliable and valid instrument for judging the quality of written consumer health information. While some subjectivity is required for rating certain criteria, the findings demonstrate that the instrument can be applied by experienced users and providers of health information to discriminate between publications of high and low quality. The instrument will also be of benefit to patients, though its use will be improved by training.
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            A new readability yardstick.

            Rudolph Flesch (1948)
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              Consumer health information seeking on the Internet: the state of the art.

              R. Cline (2001)
              Increasingly, consumers engage in health information seeking via the Internet. Taking a communication perspective, this review argues why public health professionals should be concerned about the topic, considers potential benefits, synthesizes quality concerns, identifies criteria for evaluating online health information and critiques the literature. More than 70 000 websites disseminate health information; in excess of 50 million people seek health information online, with likely consequences for the health care system. The Internet offers widespread access to health information, and the advantages of interactivity, information tailoring and anonymity. However, access is inequitable and use is hindered further by navigational challenges due to numerous design features (e.g. disorganization, technical language and lack of permanence). Increasingly, critics question the quality of online health information; limited research indicates that much is inaccurate. Meager information-evaluation skills add to consumers' vulnerability, and reinforce the need for quality standards and widespread criteria for evaluating health information. Extant literature can be characterized as speculative, comprised of basic 'how to' presentations, with little empirical research. Future research needs to address the Internet as part of the larger health communication system and take advantage of incorporating extant communication concepts. Not only should research focus on the 'net-gap' and information quality, it also should address the inherently communicative and transactional quality of Internet use. Both interpersonal and mass communication concepts open avenues for investigation and understanding the influence of the Internet on health beliefs and behaviors, health care, medical outcomes, and the health care system.
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                Author and article information

                Journal
                Title: The Annals of The Royal College of Surgeons of England
                Abbreviated Title: annals
                Publisher: Royal College of Surgeons of England
                ISSN (Print): 0035-8843
                ISSN (Electronic): 1478-7083
                Publication date Created: September 2023
                Publication date (Print): September 2023
                Volume: 105
                Issue: 7
                Pages: 639-644
                Affiliations
                [1 ]University Hospitals Birmingham NHS Foundation Trust, UK
                Article
                DOI: 10.1308/rcsann.2022.0123
                PubMed ID: 36374281
                SO-VID: 86c60e6f-82e8-47ae-a901-2d867ad5017e
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