Skip to main content

Advertisement

SpringerLink
Log in

Evaluating the readability, understandability, and quality of online materials about chest pain in children

  • Original Article
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

An increasing number of individuals use the Internet to obtain health information. However, online health information is unregulated and highly variable. We aimed to assess the readability, understandability, and quality of online information available for “chest pain in children.” This analysis was performed in January 2020, by inputting the search term “chest pain in children” into Google. The 180 search results were evaluated/categorized. The readability was assessed using the Flesch reading ease score, the Gunning FOG readability score, the Flesch–Kincaid grade level, the Coleman–Liau score, the Simple Measure of Gobbledygook readability score, the Fry readability score, and the automated readability index (ARI). The quality was assessed through the Journal of the American Medical Association (JAMA) benchmark criteria. The understandability was evaluated by the Patient Education Materials Assessment Tool (PEMAT) for this study. Sixty-five websites were analyzed (academic and hospital websites (n = 30), physicians and health information websites (n = 35)). Among all websites, the average reading grade level was 9.99. There was no statistical difference between the two groups for the average readability level (p: 0.645). The mean PEMAT score for all websites was 65.09%. There was no statistical difference between the two groups for the average PEMAT score (p: 0.945). For both groups, the understandability score was below 70%. The average JAMA benchmark score was 2.43 ± 1.06, with a statistically significant difference between the academic and hospital websites (2.07 ± 0.91) and physician and health information websites (2.74 ± 1.09, p: 0.009).

Conclusion: The readability of online materials available for patients regarding “chest pain in children” was significantly higher than the grade 6 recommended by the National Institutes of Health. The current online health information related to pediatric chest pain may be too difficult for the average reader to read. The quality and understandability were not good for both groups. Improving the readability, understandability, and quality of pediatric health–related online materials has the potential to reduce parental anxiety, improve baseline medical knowledge, and even enhance the physician–parent alliance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Gesuete V, Fregolent D, Contorno S, Tamaro G, Barbi E, Cozzi G (2020) Follow-up study of patients admitted to the pediatric emergency department for chest pain. Eur J Pediatr 179(2):303–308

    Article  Google Scholar 

  2. Geggel RL (2004) Conditions leading to pediatric cardiology consultation in a tertiary academic hospital. Pediatrics 114:409–417

    Article  Google Scholar 

  3. Cava JR, Sayger PL (2004) Chest pain in children and adolescents. Pediatr Clin N Am 51:1553–1568

    Article  Google Scholar 

  4. Yeh TK, Yeh J (2015) Chest pain in pediatrics. Pediatr Ann 44(12):274–278

    Article  Google Scholar 

  5. Murray KE, Murray TE, O’Rourke AC, Low C, Veale DJ (2019) Readability and quality of online information on osteoarthritis: an objective analysis with historic comparison. Interact J Med Res 8(3):12855

  6. Rothrock SG, Rothrock AN, Swetland SB, Pagane M, Isaak SA, Romney J, Chavez V, Chavez SH (2019) Quality, trustworthiness, readability, and accuracy of medical information regarding common pediatric emergency medicine-related complaints on the Web. J Emerg Med 57(4):469–477

    Article  Google Scholar 

  7. Scott BB, Johnson AR, Doval AF, Tran BN, Lee BT (2020) Readability and understandability analysis of online materials related to abdominal aortic aneurysm repair. Vasc Endovasc Surg 54(2):111–117

    Article  Google Scholar 

  8. Bostock S, Steptoe A (2012) Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ 344:1602

    Article  Google Scholar 

  9. Al Khalili R, Shukla PA, Patel RH, Sanghvi S, Hubbi B (2015) Readability assessment of Internet-based patient education materials related to mammography for breast cancer screening. Acad Radiol 22(3):290–295

    Article  Google Scholar 

  10. Wong K, Levi JR (2017) Readability of pediatric otolaryngology information by children’s hospitals and academic institutions. Laryngoscope 127(4):138–144

    Article  Google Scholar 

  11. Shetty KR, Wang RY, Shetty A, Levi J, Aaronson NL (2020) Quality of patient education sections on otitis media across different website platforms. Ann Otol Rhinol Laryngol 129(6):591–598

    Article  Google Scholar 

  12. Alderson JH, O’Neil DC, Redmond CE, Mulholland D, Lee MJ (2019) Varicocele embolization: an assessment of the quality and readability of online patient information. Acad Radiol 6332(19):30384–30388

    Google Scholar 

  13. De Oliveira GS Jr, Jung M, McCaffery KJ, McCarthy RJ, Wolf MS (2015) Readability evaluation of Internet-based patient education materials related to the anesthesiology field. J Clin Anesth 27:401–405

    Article  Google Scholar 

  14. Patel CR, Sanghvi S, Cherla DV, Baredes S, Eloy JA (2015) Readability assessment of Internet-based patient education materials related to parathyroid surgery. Ann Otol Rhinol Laryngol 124(7):523–527

    Article  Google Scholar 

  15. Huang G, Fang CH, Agarwal N, Bhagat N, Eloy JA, Langer PD (2015) Assessment of online patient education materials from major ophthalmologic associations. JAMA Ophthalmol 133(4):449–454

    Article  Google Scholar 

  16. Shoemaker SJ, Wolf MS, Brach C (2014) Development of the patient education materials assessment tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient Educ Couns 96:395–403

    Article  Google Scholar 

  17. Silberg WM, Lundberg GD, Musacchio RA (1997) Assessing, controlling, and assuring the quality of medical information on the Internet: caveat lector et viewor—let the reader and viewer beware. JAMA 277(15):1244–1245

    Article  CAS  Google Scholar 

  18. Barajas-Gamboa JS, Klingler M, Landreneau J, Strong A, Al Zubaidi A, Sharadgah H, Del Gobbo GD, Abril C, Kroh M, Corcelles R (2020) Quality of information about bariatric surgery on the Internet: a two-continent comparison of website content. Obes Surg 30(5):1736–1744

    Article  Google Scholar 

  19. Saleeb SF, Li WY, Warren SZ, Lock JE (2011) Effectiveness of screening for life-threatening chest pain in children. Pediatrics 128(5):1062–1068

    Article  Google Scholar 

  20. Friedman KG, Kane DA, Rathod RH, Renaud A, Farias M, Geggel R, Fulton DR, Lock JE, Saleeb SF (2011) Management of pediatric chest pain using a standardized assessment and management plan. Pediatrics 128(2):239–245

    Article  Google Scholar 

  21. Collins SA, Griksaitis MJ, Legg JP (2014) 15-minute consultation: a structured approach to the assessment of chest pain in a child. Arch Dis Child Educ Pract Ed 99(4):122–126

    Article  Google Scholar 

  22. Pantell RH, Goodman BW, Goodman W (1983) Adolescent chest pain: a prospective study. Pediatrics 71:881–887

    CAS  PubMed  Google Scholar 

  23. Murray KE, Murray TE, O’Rourke AC, Low C, Veale DJ (2019) Readability and quality of online information on osteoarthritis: an objective analysis with historic comparison. Interact J Med Res 8(3):12855

    Article  Google Scholar 

  24. Rosenberg SA, Francis D, Hullett CR, Morris ZS, Fisher MM, Brower JV, Bradley KA, Anderson BM, Bassetti MF, Kimple RJ (2016) Readability of online patient educational resources found on NCI-designated cancer center web sites. J Natl Compr Cancer Netw 14(6):735–740

    Article  CAS  Google Scholar 

  25. Estacio EV, Whittle R, Protheroe J (2019) The digital divide: examining socio-demographic factors associated with health literacy, access and use of internet to seek health information. J Health Psychol 24(12):1668–1675

    Article  Google Scholar 

  26. Hansberry DR, Agarwal N, John ES, John AM, Agarwal P, Reynolds JC, Baker SR (2017) Evaluation of internet-based patient education materials from internal medicine subspecialty organizations: will patients understand them? Intern Emerg Med 12(4):535–543

    Article  Google Scholar 

  27. Charow R, Snow M, Fathima S, Giuliani ME, McEwan K, Winegust J, Papadakos J (2019) Evaluation of the scope, quality, and health literacy demand of Internet-based anal cancer information. J Med Libr Assoc 107(4):527–537

    Article  Google Scholar 

  28. Sax L, Razak A, Shetty K, Cohen M, Levi J (2019) Readability of online patient education materials for parents after a failed newborn hearing screen. Int J Pediatr Otorhinolaryngol 125:168–174

    Article  Google Scholar 

  29. Balakrishnan V, Chandy Z, Hseih A, Bui TL, Verma SP (2016) Readability and understandability of online vocal cord paralysis materials. Otolaryngol Head Neck Surg 154(3):460–464

    Article  Google Scholar 

  30. Doruk C, Enver N, Çaytemel B, Azezli E, Başaran B (2020) Readibility, understandability, and quality of online education materials for vocal fold nodules. J Voice 34(2):302.e15–302.e20

    Article  Google Scholar 

  31. Eysenbach G, Powell J, Kuss O (2002) Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. JAMA 287:2691–2700

    Article  Google Scholar 

  32. Alsaiari A, Joury A, Aljuaid M, Wazzan M, Pines JM (2017) The content and quality of health information on the Internet for patients and families on adult kidney cancer. J Cancer Educ 32(4):878–884

    Article  Google Scholar 

  33. Aldairy T, Laverick S, McIntyre GT (2012) Orthognathic surgery: is patient information on the Internet valid? Eur J Orthod 34:466–469

    Article  CAS  Google Scholar 

  34. Leira-Feijoo Y, Ledesma-Ludi Y, Seoane-Romero JM, Blanco-Carrión J, Seoane J, Varela-Centelles P (2015) Available web-based dental implants information for patients. How good is it? Clin Oral Implants Res 26:1276–1280

    Article  Google Scholar 

  35. Kandula S, Zeng-Treitler Q (2008) Creating a gold standard for the readability measurement of health texts. AMIA Annu Symp Proc 6:353–357

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Cardiology, University of Health Sciences Turkey, Konya Education and Research Hospital, 42075, Konya, Turkey

    Derya Arslan

  2. Department of Anesthesiology and Reanimation Clinic, Konya Numune Hospital, Konya, Turkey

    Mahmut Sami Tutar

  3. Department of Anesthesiology and Reanimation Clinic, University of Health Science Turkey, Konya Education and Research Hospital, Konya, Turkey

    Betul Kozanhan

Authors
  1. Derya Arslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mahmut Sami Tutar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Betul Kozanhan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Derya Arslan: Designing the article, reviewing the literature, writing the article

Mahmut Sami Tutar: Literature review, data analysis, preparation of tables and figures

Betül Kozanhan: Literature review

Corresponding author

Correspondence to Derya Arslan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics statement/confirmation of patient’s permission

Not required.

Additional information

Communicated by Peter de Winter

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arslan, D., Tutar, M.S. & Kozanhan, B. Evaluating the readability, understandability, and quality of online materials about chest pain in children. Eur J Pediatr 179, 1881–1891 (2020). https://doi.org/10.1007/s00431-020-03772-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-020-03772-8

Keywords

Search

Navigation