title: Quality and readability of online patient information for abdominal aortic aneurysms.
abstract: OBJECTIVE
  We assessed the quality and readability of patient information for abdominal aortic aneurysms (AAAs) on the World Wide Web, as accessed from the United Kingdom.
  
  
  METHODS
  Web sites returned by a simple Web search using the three largest search engines by market share were objectively and subjectively assessed for quality and readability. The Internet search engines Google, Yahoo!, and Bing were interrogated for the term "abdominal aortic aneurysm" and the first 50 hits screened. Organization type and Health on the Net status were recorded. Each unique site containing AAA information was scored for quality using the University of Michigan Consumer Health Web site Evaluation Checklist by two authors, and readability was calculated using the Flesch Reading Ease (FRE) score. Subjective content assessment was also undertaken.
  
  
  RESULTS
  Of 150 hits, 112 were relevant, with 55 unique sites for assessment. Overall, the FRE score was 39 (range, 29-47) and the Michigan score was 36 (range, 25-56), with good interobserver agreement (r(s) = 0.83; P = .01). Michigan and FRE scores were poorly correlated (r(s) = 0.064; P = .6). Sites containing discussion on the merits of endovascular/open repair and the concept of an intervention threshold had the highest Michigan scores (58.5 [50-59.75] vs 28 [13-36.5]; P < .001). Search engine ranking, Health on the Net status, country of origin, and organization type did not affect quality or readability.
  
  
  CONCLUSIONS
  The current quality and readability of online patient information for AAAs is poor and requires significant improvement. Clinicians treating patients with AAAs should be aware of the limitations of the online "lay literature."
authors.affiliation: Leeds Vascular Institute, the General Infirmary at Leeds, Leeds, United Kingdom. marc.bailey@doctors.org.uk
authors.forename: Marc A
authors.initials: MA
authors.lastname: Bailey
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Coughlin
authors.forename: Soroush
authors.initials: S
authors.lastname: Sohrabi
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Griffin
authors.forename: S Tawqeer
authors.initials: ST
authors.lastname: Rashid
authors.forename: Max A
authors.initials: MA
authors.lastname: Troxler
authors.forename: D Julian A
authors.initials: DJ
authors.lastname: Scott
mesh_terms: D022126:Access to Information; D017544:Aortic Aneurysm, Abdominal; D032882:Comprehension; D054626:Consumer Health Information / Q000592:standards*; D004739:England / Q000453:epidemiology; D017144:Focus Groups; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D010353:Patient Education as Topic / Q000592:standards*; D018709:Statistics, Nonparametric