Dr. Google - assessing quality of information and readability of internet searches available to the patient

Abstract

Introduction: With the dawn of the internet era, assessing information seems to be within the reach of our fingertips, as seen by the increasing google search trends. There is, however, no assurance on the quality, validity and readability of the available information This study aims to assess the quality of information and the degree of readability on the internet regarding inguinal hernia in adults. Methods: We used ‘Google’ as our primary search engine and ran a search for the term ‘INGUINAL HERNIA’. The analysis was confined to the first 20 searches aimed at adult patients. Each website was then analysed with the JAMA benchmark, DISCERN tool, the presence or absence of the health on the internet seal (HON). The pages were also scored using the Flesch Kincaid Grade Level (FKGL) Flesch Reading Ease (FRE) score, and automated readability index (ARI). Results: The average JAMA score was 2.84 with seven of the twenty webpages reaching a maximum of four points (35%). The majority scored two or below. The average DISCERN score was 53.2% with only one website achieving a maximum of 80 (5%). A fifth of the pages scored less than 50% of the total. The HON seal was present only in four of the twenty webpages (20%). The median FRE value for the pages was 43.9 (IQR 42.8-58.4). Four (21%) of the 19 pages read above the minimum readability standard of 60. The FKGL score gave a median of 11.25 (IQR 9.05-12.0) with seven pages (36.8%) reaching a standard of eight. The median for ARI was 16.8 (IQR 15.2-16.8) with 16 pages that read above standard. A Spearman bivariate analysis of FKGL against FRE showed a significant negative correlation (-0.933, p=0.01)) and a bivariate analysis of FKGL against ARI showed a positive correlation (0.342, p=0.01). All the pages were in English and free. Conclusions: Although there are many websites related to inguinal hernia, a large proportion were poorly written with shortcomings. These need to be addressed to ensure the patients’ accessibility to reliable, easy to read information on the internet.