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Otology/Neurotology

(407) Quality & Readability of Online Information Regarding Tympanoplasty with Mastoidectomy

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • Abbigayle J. Rawls

    M4 at the University of Kentucky College of Medicine
    University of Kentucky College of Medicine
    Bowling Green, Kentucky, United States

    • Co-Author(s)

  • CR

    Chase Rawls, n/a

    University of Kentucky College of Medicine-Bowling Green, KY, USA

  • BK

    Brian P. Kinealy, MD

    Resident
    University of Kentucky College of Medicine Department of Otolaryngology
    Lexington, Kentucky, United States

  • DZ

    Daniel M. Zeitler, MD

    Co-Director, Listen for Life Center
    Virginia Mason
    Seattle, Washington, United States

  • Matthew L. Bush, MD, PhD, MBA

    Professor and Vice Chair for Research
    University of Kentucky
    Lexington, KY, United States

  • PL

    Preston Leader, DO

    University of Kentucky College of Medicine Department of Otolaryngology, USA

  • David M. Adkins, MD

    Resident Physician
    University of Kentucky College of Medicine Department of Otolaryngology
    Lexington, Kentucky, United States

Disclosure(s):
Abbigayle J. Rawls: No relevant relationships to disclose.
Brian P. Kinealy, MD: No relevant relationships to disclose.
Daniel M. Zeitler, MD: No relevant relationships to disclose.
Matthew L. Bush, MD, PhD, MBA: No relevant relationships to disclose.
David M. Adkins, MD: No relevant relationships to disclose.


Introduction: The American Medical Association (AMA) recommends that all patient education materials should be written at a sixth-grade reading level or below. The present study aims to assess the quality and readability of health information pertaining to tympanoplasty with mastoidectomy for English and Spanish websites.

Methods: A cross-sectional website assessment was conducted across four search engines by searching the term “tympanoplasty with mastoidectomy.” The top 50 English and Spanish websites were utilized in the data collection. Websites that met inclusion criteria were then analyzed for readability and quality. Readability was assessed utilizing the Flesch Reading Ease Score (FRES) in English, and the Fernandez Huerta Formula (FHF) in Spanish. Quality was assessed using the DISCERN criteria, and by determining the presence of a Health on the Net (HONCode) certificate.

Results: 26 English and 30 Spanish websites met the inclusion criteria. Average readability was between a 10th-12th grade reading level for English and Spanish websites. The English websites were written at a significantly higher level of reading comprehension (average FRES=50.72, SD=10.1, 95% CI 46.8 to 54.6) compared to Spanish websites (average FHF=59.44, SD=7.41, 95% CI 56.8 to 62.1) (p=0.0002). A significant difference was found in the readability between the HONCode status of Spanish websites (p=0.047). A significant difference was found in the means of the HONCode Spanish and HONCode English websites (p= 0.015). Lastly, a significant difference in the means of the non-HONCode Spanish and non-HONCode English websites (p= 0.0014) was observed.

Conclusions: Websites written in English and Spanish regarding tympanoplasty with mastoidectomy were composed at reading levels that greatly exceeded AMA reading level recommendations. The assessed websites not only were inaccessible to patients, but they also lacked quality. Given the adverse health effects associated with health inequities including lack of access to quality information, it is apparent that there is a need for high-quality and accessible information for patients.