Analysis of online patient education materials in pediatric ophthalmology.
BACKGROUND
Patients increasingly consult online resources for healthcare information. The American Medical Association (AMA) and National Institutes of Health (NIH) recommend that online education resources be written between a 3rd- and 7th-grade level. This study assesses whether online health information abides by these guidelines.


METHODS
Ten pediatric ophthalmology conditions were entered into a commonly used search engine, Google.com, and analyzed using 10 validated readability scales. Scientific articles and articles written on patient forums were excluded. The 10 conditions--amblyopia, cataract, conjunctivitis, corneal abrasion, nystagmus, retinoblastoma, retinopathy of prematurity, strabismus, stye, and glaucoma--were also searched and analyzed separately from widely used websites, including Wikipedia and WebMD, as well as those of professional societies, including the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and the American Optometric Association (AOA).


RESULTS
The majority of articles were written above recommended guidelines. All scales showed that the 100 articles were written at a mean grade-level of 11.75 ± 2.72. Only 12% of articles were written below a 9th-grade level and only 3% met recommended criteria. The articles accrued separately from Wikipedia, WebMD, AAPOS, and AOA also had average grade levels above the recommended guidelines.


CONCLUSIONS
The readability of online patient education material exceeds NIH and AMA guidelines. This disparity can adversely affect caregiver comprehension of such resources and contribute to poor decision making. Pediatric ophthalmology online articles are generally written at a level too high for average caregiver comprehension. Revision of articles can increase satisfaction, improve outcomes, and facilitate the patient-ophthalmologist relationship.
Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey.
Ann M
AM
John
Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey. Electronic address: Elizabethjohn17@gmail.com.
Elizabeth S
ES
John
Department of Medicine, Hahnemann University Hospital, Drexel University College of Medicine, Philadelphia, Pennsylvania.
David R
DR
Hansberry
Department of Radiology, Rutgers New Jersey Medical School, Newark, New Jersey.
Prashant J
PJ
Thomas
Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey.
Suqin
S
Guo
D032882:Comprehension; D003194:Computer-Assisted Instruction / Q000592:standards*; D005128:Eye Diseases; D057220:Health Literacy; D006801:Humans; D020407:Internet; D009316:National Institutes of Health (U.S.) / Q000592:standards; D009885:Ophthalmology / Q000193:education*; D010353:Patient Education as Topic / Q000592:standards*; D010372:Pediatrics / Q000193:education*; D011932:Reading; D012955:Societies, Medical; D013664:Teaching Materials / Q000592:standards*; D014481:United States