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Osteotomy around the knee: Assessment of quality,content and readability of online information
Institution:1. South West London Elective Orthopaedic Centre, Dorking Road, Epsom, Surrey KT18 7EG, United Kingdom;2. The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry SY10 7AG, United Kingdom;3. The Royal London Hospital, Whitechapel, London E1 1BB, United Kingdom;1. Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, OH, USA;2. Cleveland Clinic Florida, Department of Orthopedic Surgery, Weston, FL, USA
Abstract:BackgroundAs knee osteotomy surgery becomes increasingly accessible, more patients may turn to the Internet for information. This study examined the source, quality, content and readability of online information regarding osteotomy around the knee.MethodsThe first 70 websites returned by the top four search engines were identified using the key words: “knee osteotomy” and “high tibial osteotomy.” The websites were categorised by type and assessed using the DISCERN score, Journal of the American Medical Association (JAMA) benchmark criteria and a novel Knee Osteotomy-Specific Score (KOSS). The presence of the Health On the Net (HON) code accreditation seal was noted. Readability of each website was assessed using eight readability formulae. The mean reading grade level (RGL) was compared to the 6th and 8th grade reading levels. The mean RGL of each category was also compared.ResultsOf the 45 unique websites analysed, the majority were Physician (33%) and Journal websites (31%). The mean DISCERN score was 36.7 (±8.9) which is classified as ‘poor.’ The mean JAMA benchmark criteria score was 2.04 (±1.5) and Physician websites were most likely to be scored zero. The mean KOSS was 15.4 (±5.7). The highest scoring website was a Commercial site but, overall, Journal category sites provided the best quality information. Websites that bore the HONcode seal obtained higher DISCERN, JAMA benchmark criteria and Knee Osteotomy - Specific Scores.The cumulative mean RGL was 13.2 (±2.2) which exceeded the 6th grade level by an average of 7.2 grade levels and the 8th grade level by an average of 5.2 grade levels. No website (0%) was written at or below either the 6th or the 8th grade reading levels. The mean Flesch Reading Ease Score of all websites was 41.13 (±14.7) which is classified as ‘difficult.’ Journal websites had the highest RGL.ConclusionThe information available online regarding osteotomy around the knee varies tremendously in quality and completeness. Physician sites predominate, but these were among the lowest scoring of all websites. Even where high quality information is available, it is set at too high a level to be easily understood.Level of evidenceSurvey of materials – Internet.
Keywords:Knee osteotomy  Patient education  Internet  Quality of information  Readability  AMA"}  {"#name":"keyword"  "$":{"id":"k0035"}  "$$":[{"#name":"text"  "_":"American Medical Association  ANOVA"}  {"#name":"keyword"  "$":{"id":"k0045"}  "$$":[{"#name":"text"  "_":"Analysis of Variance  ARHQ"}  {"#name":"keyword"  "$":{"id":"k0055"}  "$$":[{"#name":"text"  "_":"Agency for Healthcare Research and Quality  CI"}  {"#name":"keyword"  "$":{"id":"k0065"}  "$$":[{"#name":"text"  "_":"Confidence Interval  FKGL"}  {"#name":"keyword"  "$":{"id":"k0075"}  "$$":[{"#name":"text"  "_":"Flesch-Kincaid Reading Grade Level  FRES"}  {"#name":"keyword"  "$":{"id":"k0085"}  "$$":[{"#name":"text"  "_":"Flesch Reading Ease Score  HONcode"}  {"#name":"keyword"  "$":{"id":"k0095"}  "$$":[{"#name":"text"  "_":"Health on the Net code  ICC"}  {"#name":"keyword"  "$":{"id":"k0105"}  "$$":[{"#name":"text"  "_":"Interclass Correlation Co-efficient  JAMA"}  {"#name":"keyword"  "$":{"id":"k0115"}  "$$":[{"#name":"text"  "_":"Journal of the American Medical Association  KOSS"}  {"#name":"keyword"  "$":{"id":"k0125"}  "$$":[{"#name":"text"  "_":"Knee Osteotomy-Specific Score  NIH"}  {"#name":"keyword"  "$":{"id":"k0135"}  "$$":[{"#name":"text"  "_":"National Institute of Health  OA"}  {"#name":"keyword"  "$":{"id":"k0145"}  "$$":[{"#name":"text"  "_":"Osteoarthritis  PEMs"}  {"#name":"keyword"  "$":{"id":"k0155"}  "$$":[{"#name":"text"  "_":"Patient Educational Materials  RGL"}  {"#name":"keyword"  "$":{"id":"k0165"}  "$$":[{"#name":"text"  "_":"Reading Grade Level  SD"}  {"#name":"keyword"  "$":{"id":"k0175"}  "$$":[{"#name":"text"  "_":"Standard Deviation  SMOG"}  {"#name":"keyword"  "$":{"id":"k0185"}  "$$":[{"#name":"text"  "_":"Simple Measure of Gobbledygook  TKR"}  {"#name":"keyword"  "$":{"id":"k0195"}  "$$":[{"#name":"text"  "_":"Total Knee Replacement  UKR"}  {"#name":"keyword"  "$":{"id":"k0205"}  "$$":[{"#name":"text"  "_":"Unicompartmental Knee Replacement
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