title: Clearly written, easily comprehended? The readability of websites providing information on epilepsy.
abstract: There is a general need for high-quality, easily accessible, and comprehensive health-care information on epilepsy to better inform the general population about this highly stigmatized neurological disorder. The aim of this study was to evaluate the health literacy level of eight popular English-written websites that provide information on epilepsy in quantitative terms of readability. Educational epilepsy material on these websites, including 41 Wikipedia articles, were analyzed for their overall level of readability and the corresponding academic grade level needed to comprehend the published texts on the first reading. The Flesch Reading Ease (FRE) was used to assess ease of comprehension while the Gunning Fog Index, Coleman-Liau Index, Flesch-Kincaid Grade Level, Automated Readability Index, and Simple Measure of Gobbledygook scales estimated the corresponding academic grade level needed for comprehension. The average readability of websites yielded results indicative of a difficult-to-fairly-difficult readability level (FRE results: 44.0±8.2), with text readability corresponding to an 11th academic grade level (11.3±1.9). The average FRE score of the Wikipedia articles was indicative of a difficult readability level (25.6±9.5), with the other readability scales yielding results corresponding to a 14th grade level (14.3±1.7). Popular websites providing information on epilepsy, including Wikipedia, often demonstrate a low level of readability. This can be ameliorated by increasing access to clear and concise online information on epilepsy and health in general. Short "basic" summaries targeted to patients and nonmedical users should be added to articles published in specialist websites and Wikipedia to ease readability.
authors.affiliation: Department of Neurological and Movement Sciences, Section of Clinical Neurology, University of Verona, Italy; Department of Neurology, Franz Tappeiner Hospital, Merano, Italy. Electronic address: dr.francescobrigo@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Brigo
authors.affiliation: Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands; Biomedical MR Imaging and Spectroscopy Group, Image Sciences Institute, University Medical Center Utrecht, The Netherlands.
authors.forename: Willem M
authors.initials: WM
authors.lastname: Otte
authors.affiliation: Department of Neuro-Psychiatry, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
authors.forename: Stanley C
authors.initials: SC
authors.lastname: Igwe
authors.affiliation: Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.
authors.forename: Frediano
authors.initials: F
authors.lastname: Tezzon
authors.affiliation: Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Nardone
mesh_terms: D032882:Comprehension; D004522:Educational Status; D004827:Epilepsy; D057220:Health Literacy; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D011932:Reading; D013664:Teaching Materials
keywords: Epilepsy; Health literacy; Internet; Readability; Wikipedia