Popular asthma websites for patient education vary in quality, readability.

Main Receptors:

• Readability ranges from eighth grade to junior college.
• No site achieved a perfect score according to the JAMA benchmark criteria.
• Doctors should ask their patients about their sources of information.

Popular websites that provide educational information about asthma to patients vary in readability and quality, according to a new study. Reports of Allergy, Asthma and Immunology.

Previous studies evaluating the readability and quality of online educational materials about asthma have been limited; Amog Reddy, BS, A student and colleagues at the Alabama College of Osteopathic Medicine wrote.

The researchers searched for “asthma” on Google and included the first 15 websites in their analysis. Next, they compiled information from these websites into a Word document, categorized as general descriptions, causes, symptoms, and management of asthma.

Using six different instruments, the researchers assessed the readability of this content in terms of sentence length, word difficulty, and multisyllabic words in each sentence. They also analyze content quality through tools that assess factors including authorship, attributes, disclosures, currency, reliability, integrity, and transparency.

American Medical Association guidelines recommend that patient education material be written at a sixth-grade level or below. All 15 pages were written above the sixth grade.

Average readability scores ranged from 8.664, or eighth grade level, for the CDC site to 13.178, or undergraduate level, for the Medical News Today website.

Based on the Flesch Reading Ease tool, none of the websites were “easy” to read, four were “average” and 11 were “difficult.”

Quality scores range from 0 to 3 based on the JAMA benchmark tool, which assigns one point each to authorship, ownership, transparency, and currency if they are included on the website.

No site scored perfectly on all four factors. Six sites had a score of 3, four had a score of 2, and three sites had a score of 1. The American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology both had a score of 0.

The DISCERN Instrument, which assesses document reliability and quality, gave poor ratings to three sites, fair ratings to six sites, and good ratings to five sites. Only one site, MedPlus.gov, is considered excellent.

Nine of the sites had HONcode certification, which recognizes honest and transparent advice, the researchers said. Websites must apply for this certification, with renewal fees ranging from $65 to $200.

All 15 websites written above sixth grade had significant room for improvement, according to the researchers. For example, the researchers suggested replacing references to “short-acting bronchodilators” with “rescue breathing.” Shorter sentence lengths, casual word choices, and a lack of medical jargon could improve results, they continued.

The researchers also suggested including information about data authorship, references used, conflicts of interest, and date of publication. More than half of these sites did not report to the physician author, the researchers continued.

However, the researchers noted that some websites may have met criteria such as conflict of interest statements or physician authorship reporting but were excluded due to unclear website reporting.

With these findings in mind, the researchers encourage their patients to check patient education information from specialists and professional asthma organizations to help them better understand and manage their asthma.