Assessment of online patient education material for eye cancers: A cross-sectional study

Abstract

The objective of this study was to assess online American patient education material (PEM) related to eye cancers in order to determine the quality of the content and appropriateness of the contents' reading level as it relates to the American population. PEMs were extracted from fifteen American cancer and ophthalmology associations and evaluated for their reading level using ten validated readability scales. PEMs then had all words extracted and evaluated for their difficulty and familiarity. The quality of the PEMS were assessed according to DISCERN, Heath On the Net Foundation Code of Conduct (HONCode), and JAMA benchmarks. Overall, online PEMs from the associations were written at a 11th grade reading level, which is above the recommended 6th grade reading level. The difficult word analysis identified that 26% of words were unfamiliar. Only one of the fifteen association held a HONCode certification while no organization met the standards of all four JAMA benchmarks. The average score for DISCERN was 2.4 out of a total of 5 for the fifteen questions related to treatment option information quality. Consideration should be made to create PEMs at an appropriate grade reading level to encourage health literacy and ultimately promote health outcomes. Associations should also focus on incorporating easily identifiable quality indicators to allow patients to better identify reputable resources.

Fig 1

Depicts a compilation of the numerical readability analyses: Degrees of Reading Power and Grade Equivalent test, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook Index, Coleman-Liau Index, Gunning Fog Index, New Fog Count, New Dale-Chall, Ford, Caylor, Sticht (FORCAST) for (a) each of the eye cancer types which contained more than 10 patient education materials (PEMS) and (b) the top three PEM contributing associations including Cancer.net (C.net), the American Cancer Society (ACS), and the American Academy of Ophthalmology (AAO).

Fig 2. Depicts a compilation of the quality analyses: Heath On the Net Foundation Code of Conduct (HONCode), JAMA benchmarks, and DISCERN.

(a) the number of associations which have either never had a HONCode certification, has an expired HONCode certification, or holds a current HONCode certification (b) the number of organizations that display the quality indicators of JAMA benchmarks (c) the number of organizations which display zero, one, two, three, or all four of the JAMA benchmarks (d) the average score for each of the associations for each DISCERN question. Grey dashed line indicates average score.