Evaluation of Online Shoulder Instability-Related Patient Education Materials

Author:

Arif Haad A.1ORCID,Morales Jose A.1,Howard Roland2,Silva Michael A.1,Sebt Seena1,Edmonds Eric W.34ORCID

Affiliation:

1. School of Medicine, University of California, Riverside, Riverside, CA, USA

2. Department of Sports Medicine, Rothman Orthopaedic Institute, Philadelphia, PA, USA

3. Division of Orthopaedic Surgery, Rady Children’s Hospital San Diego, San Diego, CA, USA

4. Department of Orthopedic Surgery, University of California, San Diego, San Diego, CA, USA

Abstract

Background: Younger patients are more likely than older patients to experience shoulder instability and to rely on online educational resources. Although the Internet has increased patient access to medical information, this may not translate to increased health literacy. Purpose: We sought to analyze the quality and readability of online information on shoulder instability. Methods: We conducted a Google search using 6 terms related to shoulder instability. We collected the first 20 non-sponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fox Index (GFI) instruments. Quality was assessed using a Quality Grading Sheet (QGS) and the validated DISCERN instrument. Results: A total of 64 of 120 patient educational materials (PEMs) met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 9.45 ± 0.552, 50.51 ± 3.4, and 11.5 ± 0.6, respectively. The mean DISCERN score and QGS rating were 33.09 ± 2.02 and 10.52 ± 1.28, respectively. While 49 (76.6%) articles discussed operative treatment for persistent shoulder instability, only 4 (6.3%) mentioned risks associated with surgery. Non-institutional sources had higher DISCERN scores than those from medical institutions. Conclusions: This review of online shoulder instability-related PEMs suggests that many do not meet current recommendations, with an average quality rating of “poor” and a mean ninth-grade reading level. Surgeons should be aware of the relative paucity of information on the risks and outcomes associated with operative treatment of shoulder instability contained in these PEMs.

Publisher

SAGE Publications

Reference33 articles.

1. Agency for Healthcare Research and Quality. Tip 6. Be cautious about using readability formulas. https://www.ahrq.gov/talkingquality/resources/writing/tip6.html. Accessed August 17, 2023.

2. Anterior Shoulder Instability Management: Indications, Techniques, and Outcomes

3. Assessing Readability of Patient Education Materials: Current Role in Orthopaedics

4. Barbara Bush Foundation. Literacy gap map. http://map.barbarabush.org. Accessed August 17, 2023.

5. Beus J. Why (almost) everything you knew about Google CTR is no longer valid. SISTRIX. https://www.sistrix.com/blog/why-almost-everything-you-knew-about-google-ctr-is-no-longer-valid/. Published July 14, 2020. Accessed August 17, 2023.

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