Abstract
With countless sites detailing disease management, treatment, and prognosis, patients
often turn to the internet for medical decision-making assistance. While such sites
provide ample patient education material, little is known about the reading level,
understandability, and actionability of information on these sites. In a limb preservation
population, assessing what information patients are interpreting becomes vital to
ensure care is not compromised. Internet searches of the terms “Charcot foot, diabetic
foot ulcer, foot ulcer, critical limb ischemia, gangrene, osteomyelitis, lymphedema,
DVT, pulmonary thrombosis, and amputation” were performed. The Flesch Kincaid Readability
score from the text from the first ten links with patient education information were
calculated. Understandability and actionability of each resource were then graded
by two reviewers. Across the 100 accessed websites, 10% maintained patient education
materials with at least one readability score at or below the recommended sixth grade
reading level. 73% of the materials revealed an understanding greater than the recommended
70%. 99% of materials maintained patient education materials with actionability less
than 70%. The Spearman Rho correlation revealed a statistically significant relationship
between understandability score and the order of each keyword's respective website
search position (Rho = -0.01; p = 0.002). Overall, many online limb preservation patient
education materials are written well above the recommended sixth grade reading level
with varying understandability and actionability scores. Online resources, as well
as physician offices, should examine their patient education materials to ensure they
are of an appropriate reading level and provide actions to be taken in case of emergencies.
Level of Evidence
Keywords
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Article info
Publication history
Publication stage
In Press Accepted ManuscriptFootnotes
No IRB approval was needed due to the nature of this systematic review.
No relevant financial disclosures are reported by the authors.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American College of Foot and Ankle Surgeons.
