Clearly written, easily comprehended? The readability of websites providing information on epilepsy

There is a general need for high-quality, easily accessible, and comprehensive health-care information on epilepsy to better inform the general population about this highly stigmatized neurological disorder. The aim of this study was to evaluate the health literacy level of eight popular English-written websites that provide information on epilepsy in quantitative terms of readability. Educational epilepsy material on these websites, including 41 Wikipedia articles, were analyzed for their overall level of readability and the corresponding academic grade level needed to comprehend the published texts on the first reading. The Flesch Reading Ease (FRE) was used to assess ease of comprehension while the Gunning Fog Index, Coleman-Liau Index, Flesch-Kincaid Grade Level, Automated Readability Index, and Simple Measure of Gobbledygook scales estimated the corresponding academic grade level needed for comprehension. The average readability of websites yielded results indicative of a difficult-to-fairly-difficult readability level (FRE results: 44.0±8.2), with text readability corresponding to an 11th academic grade level (11.3±1.9). The average FRE score of the Wikipedia articles was indicative of a difficult readability level (25.6±9.5), with the other readability scales yielding results corresponding to a 14th grade level (14.3±1.7). Popular websites providing information on epilepsy, including Wikipedia, often demonstrate a low level of readability. This can be ameliorated by increasing access to clear and concise online information on epilepsy and health in general. Short "basic" summaries targeted to patients and nonmedical users should be added to articles published in specialist websites and Wikipedia to ease readability.

[1]  Frances McCarty,et al.  Use of computers and the Internet for health information by patients with epilepsy , 2008, Epilepsy & Behavior.

[2]  K. Wallston,et al.  The Diabetes Literacy and Numeracy Education Toolkit (DLNET) , 2009, The Diabetes educator.

[3]  R. Flesch A new readability yardstick. , 1948, The Journal of applied psychology.

[4]  N. Cotugna,et al.  EVALUATION OF LITERACY LEVEL OF PATIENT EDUCATION PAGES IN HEALTH-RELATED JOURNALS , 2005, Journal of Community Health.

[5]  R. Gunning The Technique of Clear Writing. , 1968 .

[6]  D. Thurman,et al.  Disparities in epilepsy: Report of a systematic review by the North American Commission of the International League Against Epilepsy , 2009, Epilepsia.

[7]  R. J. Cline,et al.  Consumer health information seeking on the Internet: the state of the art. , 2001, Health education research.

[8]  D W Baker,et al.  Health literacy among Medicare enrollees in a managed care organization. , 1999, JAMA.

[9]  Bo Lu,et al.  Health status and behavioral risk factors among persons with epilepsy in Ohio based on the 2006 Behavioral Risk Factor Surveillance System , 2008, Epilepsy & Behavior.

[10]  M. Coleman,et al.  A computer readability formula designed for machine scoring. , 1975 .

[11]  Bo Lu,et al.  Exercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005 , 2008, Epilepsy & Behavior.

[12]  N. Agarwal,et al.  Are We Effectively Informing Patients? A Quantitative Analysis of On-Line Patient Education Resources from the American Society of Neuroradiology , 2014, American Journal of Neuroradiology.

[13]  C. Chronaki,et al.  eHealth Trends in Europe 2005-2007: A Population-Based Survey , 2008, Journal of medical Internet research.

[14]  John O. Elliott,et al.  A health literacy assessment of the epilepsy.com website , 2009, Seizure.

[15]  S. Duncan,et al.  Men with epilepsy—The lost tribe? Results of a nationwide survey of men with epilepsy living in the UK , 2007, Seizure.

[16]  John O. Elliott,et al.  A health literacy assessment of the National Epilepsy Foundation Web site , 2007, Epilepsy & Behavior.

[17]  L. Baker,et al.  Use of the Internet and e-mail for health care information: results from a national survey. , 2003, JAMA.

[18]  E A Smith,et al.  Automated readability index. , 1967, AMRL-TR. Aerospace Medical Research Laboratories.

[19]  D. Hesdorffer,et al.  Erasing Epilepsy Stigma , 2014, Health promotion practice.

[20]  P. Wludyka,et al.  The association between health literacy and outcomes of care among epilepsy patients , 2009, Seizure.

[21]  D. Baker,et al.  Health literacy and the risk of hospital admission , 1998, Journal of General Internal Medicine.

[22]  A. S. Winton,et al.  Assessing the Readability of Mental Health Internet Brochures for Children and Adolescents , 2003 .

[23]  William J. Hussar,et al.  The Condition of Education , 2010 .

[24]  David A. Kindig,et al.  Health literacy : a prescription to end confusion , 2004 .

[25]  G. Harry McLaughlin,et al.  SMOG Grading - A New Readability Formula. , 1969 .

[26]  Terry Davis,et al.  The role of health literacy in patient-physician communication. , 2002, Family medicine.