Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Dec 20, 2023; 13(5): 439-445
Published online Dec 20, 2023. doi: 10.5662/wjm.v13.i5.439
Assessing the readability of online information about jones fracture
Khaled Farid Khaled Al-Kharouf, Faisal Idrees Khan, Greg AJ Robertson
Khaled Farid Khaled Al-Kharouf, Orthopaedic Surgery, Portsmouth Hospitals University, Portsmouth PO6 3 LY, United Kingdom
Faisal Idrees Khan, Internal Medicine, Tunbridge Wells Hospital, Tunbridge Wells E10 5NJ, United Kingdom
Greg AJ Robertson, Orthopaedic Surgery, Queen Alexandra Hospital, Portsmouth PO6 3LY, United Kingdom
Author contributions: Al-Kharouf KFK conceived the methodology for the manuscript, performed the literature search and analysis for the study, and wrote the manuscript; Khan FI performed the literature search and analysis for the study and wrote the manuscript; Robertson GA advised on the study, and reviewed and edited the manuscript.
Institutional review board statement: Not required, no human or animal involved in our study.
Informed consent statement: The dataset consisted of anonymized synthesize evidence from published studies. Thus, no informed consent for data sharing was required.
Conflict-of-interest statement: Khaled Farid Khaled Al-Kharouf, Faisal Idrees Khan, and Greg Robertson have no conflicts of interest to declare. None have received fees for serving as a speaker or a consultant for commercial organizations. None have received research funding from commercial organizations. All are employees of the UK National Health Service, though not of any commercial organizations. None own stocks or shares in related commercial organizations. None own patent related to the topic of this study.
Data sharing statement: Technical appendix and datasets are available from the corresponding author at kfk990@gmail.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Khaled Farid Khaled Al-Kharouf, MD, Doctor, Orthopaedic Surgery, Portsmouth Hospitals University, Cosham, Portsmouth PO6 3 LY, United Kingdom. kfk990@gmail.com
Received: March 26, 2023
Peer-review started: March 26, 2023
First decision: May 15, 2023
Revised: July 6, 2023
Accepted: September 14, 2023
Article in press: September 14, 2023
Published online: December 20, 2023
Abstract
BACKGROUND

Hand in hand with technological advancements, treatment modalities continue to grow. With the turn of the century, the internet has become the number one source of information for almost every topic. Thus, many patients look toward the internet as their primary source of information to learn about their respective medical conditions. The American Medical Association and National Institute of Health strongly recommend that online medical information be written at the 6th to 8th-grade level to aid comprehension by patients of all literacy backgrounds.

AIM

To assess the readability of online information regarding Jones fracture. Our hypothesis is that the reading level of medical information published on websites far exceeds the recommended reading level of 6th-8th grade as proposed by the American Medical Associate and National Institute of Health. The result of this study can help us formulate improved recommendations for publishing more comprehensible material and, thus, eventually improve patient compliance and clinical outcomes.

METHODS

The exact phrase “Jones fracture” was queried on the three most common search engines, Google, Yahoo!, and Bing, on December 28, 2022. As of December 2022, Google held 84%, Bing held 9%, and Yahoo! held 2% of the worldwide search engine market share. Web pages uniform resource locator from the first three pages of search results were recorded from each search engine. These web pages were classified according to academic, physician-sponsored, governmental and non-government organizations (NGO), commercial, and unspecified as per formally defined categories. Websites associated with an educational institution or medical organization were classified as academic. Websites with products for sale, corporate sponsorship, or advertisements were classified as commercial. Governmental websites or NGOs comprised those that received government subsidies or grants. Webpages that were independently owned by physicians or physician groups were respectively classed as physician sponsored. The remainder of websites that did not fall under the above categories were classified as unspecified.

RESULTS

A total of 93 websites were analyzed for reading assessment. A whopping 44% of websites were commercial, followed by 22% of physician-sponsored websites. Third place belonged to non-government organization websites holding a 15% share. The academic website held a meager 9% portion, while unspecified sites were 3%. The table illustrates mean readability scores, along with average cumulative grade level. The average grade level was 10.95 ± 2.28 for all websites, with a range of 6.18 to 18.90. Since P values were more than 0.05, there was not a significant statistical difference between the first page results and the results of all pages. Thus, we can rationalize that readability scores are consistent throughout all pages of a website.

CONCLUSION

Hand in hand with technological advancements, treatment modalities continue to grow. With the turn of the century, the internet has become the number one source of information for almost every topic. Thus, many patients look towards the internet as the primary source of information to learn about their respective medical conditions. Our study demonstrates that current online medical information regarding Jones fracture is written at an extraordinarily high-grade level, with an average grade level of all websites at 10.95, nearly an 10th-grade educational level. The American Medical Association and National Institute of Health strongly recommend that online medical information should be written at the 6th to 8th-grade level to aid comprehension by patients of all literacy backgrounds. On the contrary, most of the medical information evaluated was at an 10th-grade level, which far exceeds recommendations by AMA and NIH. This is particularly relevant because readability scores are directly proportional to the level of comprehension attained by readers, thus directly impacting patient outcomes. In conclusion, we suggest and encourage that all online reading materials should be re-written at the 6th to 8th-grade level in a public service effort to increase compliance with treatment goals and raise awareness of preventive measures.

Keywords: Jones fracture, Jones fracture treatment, Jones fracture management, Jones fracture prevention, Jones fracture types, Jones fracture location

Core Tip: With technological advancements, many patients look toward the internet as their primary source of information to learn about their respective medical conditions. The American Medical Association and National Institute of Health strongly recommend that online medical information be written at the 6th to 8th-grade level to aid comprehension by patients of all literacy backgrounds. Readability measures how easy a piece of text is to read. This, in turn, affects how much information people can understand and retain. Our study aims to assess the readability of online information regarding Jones fracture. A total of 93 websites were analyzed for reading assessment. The overall mean average grade level of all websites in the study was 10.95230 ± 2.27862, corresponding to a 10th-grade reading level. In Conclusion, most of the medical information evaluated was at an 11th-grade level, far exceeding AMA and NIH recommendations.