Evaluating the Readability and Content Quality of Online Patient Education Materials for Peripheral Nerve Surgery

Introduction: Online patient education materials (OPEMs) are often first-line resources for patients seeking health information. However, equitable access and patient comprehension are limited by OPEM readability and quality. While the National Institutes of Health (NIH) and American Medical Association (AMA) recommend a 6th-grade readability level for OPEMs, it is unclear if commonly available material meets such criteria. This study assesses the readability, content quality, and qualitative characteristics of OPEMs on various peripheral nerve surgeries.

Methods: An online search was performed, using 11 common peripheral nerve surgeries as search terms (e.g., carpal tunnel release, ulnar nerve decompression). The first 20 unique search results for each search term were assessed. Results were excluded if they did not include patient-facing material. Readability (Flesch-Kincaid grade level), content quality (DISCERN), and qualitative characteristics were assessed across all OPEMs. T-tests, ANOVAs, and post-hoc pairwise analyses were subsequently performed.

Results: 160 OPEMs met the inclusion criteria for analysis. 97 (60.6%) were academic/hospital sites, 19 (11.9%) were online health reference sites, 41 (25.6%) were private practice sites, and 3 (1.9%) were other. The average Flesch-Kincaid grade level was 11.3, significantly greater than the NIH/AMA-6th grade recommendations (p < 0.001). The average DISCERN score was 45.2 (fair content quality). No significant difference in readability or content quality was observed by website type. 61 (38.1%) websites discussed the potential risks of surgery, while 67 (41.9%) included procedure-related photos and 36 (22.5%) included procedure-related videos.

Conclusion : The readability of online patient education materials for peripheral nerve surgery was found to significantly exceed NIH/AMA recommendations. Less than half of the websites assessed discussed surgical risks or included procedure-related photos or videos. Advances in material content and readability are needed to improve accessibility, approachability, and downstream patient decision-making and outcomes.