Breast reconstruction post mastectomy- Let's Google it. Accessibility, readability and quality of online information.
BACKGROUND
This study evaluated the readability, accessibility and quality of information pertaining to breast reconstruction post mastectomy on the Internet in the English language.


METHODS
Using the Google©search engine the keywords "Breast reconstruction post mastectomy" were searched for. We analyzed the top 75 sites. The Flesch Reading Ease Score and Gunning Fog Index were calculated to assess readability. Web site quality was assessed objectively using the University of Michigan Consumer Health Web site Evaluation Checklist. Accessibility was determined using an automated accessibility tool. In addition, the country of origin, type of organisation producing the site and presence of Health on the Net (HoN) Certification status was recorded.


RESULTS
The Web sites were difficult to read and comprehend. The mean Flesch Reading Ease scores were 55.5. The mean Gunning Fog Index scores was 8.6. The mean Michigan score was 34.8 indicating weak quality of websites. Websites with HoN certification ranked higher in the search results (p = 0.007). Website quality was influenced by organisation type (p < 0.0001) with academic/healthcare, not for profit and government sites having higher Michigan scores. 20% of sites met the minimum accessibility criteria.


CONCLUSIONS
Internet information on breast reconstruction post mastectomy and procedures is poorly written and we suggest that Webpages providing information must be made more readable and accessible. We suggest that health professionals should recommend Web sites that are easy to read and contain high-quality surgical information. Medical information on the Internet should be readable, accessible, reliable and of a consistent quality.
Department of Surgery, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland. Electronic address: noellynch@rcsi.ie.
Noel P
NP
Lynch
Department of Surgery, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland. Electronic address: bronaghlang@gmail.com.
Bronagh
B
Lang
Department of Surgery, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland. Electronic address: angelovs@tcd.ie.
Sophia
S
Angelov
Department of Surgery, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland. Electronic address: sarahmcgarrigle82@gmail.com.
Sarah A
SA
McGarrigle
Department of Surgery, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland. Electronic address: Terence.j.boyle@gmail.com.
Terence J
TJ
Boyle
Department of Surgery, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland. Electronic address: dalazawi@stjames.ie.
Dhafir
D
Al-Azawi
Department of Surgery, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland. Electronic address: emconnolly@stjames.ie.
Elizabeth M
EM
Connolly
D000328:Adult; D001943:Breast Neoplasms; D032882:Comprehension; D054626:Consumer Health Information / Q000592:standards*; D005260:Female; D057220:Health Literacy; D006801:Humans; D020407:Internet / Q000592:standards*; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D057386:Search Engine / Q000592:standards*
Accessibility; Breast reconstruction; Internet; Mastectomy; Quality; Readability