Hello, my name is Coleman Cush, presenting the project Assessing the Accuracy, Quality, and Readability of Online Patient Resources on Achilles Tendinitis on behalf of my collaborators Hoi Zhang, Brian Foster, and Gerard Cush out of Aurora Orthopedics in Milwaukee, Wisconsin, and Geisinger Medical Center in Danville, Pennsylvania. With the internet becoming an increasingly common source of information for patients, there must be some level of reliability on medical conditions such as Achilles tendinitis. Recent studies have indicated that consumers currently evaluate online medical sites by their perceived trustworthiness, expertise, and objectivity. Given the rising necessity for evaluating online medical resources, this study aimed to analyze the accuracy, quality, and readability of resources on Achilles tendinitis. We hypothesized that resources would not be at the levels necessary for effective mobile communication with the average patient. We searched the term Achilles tendinitis on the three most popular search engines of Google, Yahoo, and Bing, recording the first 50 sites from each search before excluding any duplicate resources or any resources that were not mainly written communication. The sites were placed into one of the following four categories for comparison, academic, private physician, third-party physician, and commercial. The quality of the resources was evaluated by two reviewers using two validated measures, the discern score developed by Britain's National Health Service for the evaluation of written patient-directed health information, utilized 16 questions on a one-to-five scale whose total sum represents a score that increases in quality with higher scores. The Journal of the American Medical Association has the JAMA benchmark that utilizes a binary scale for the four categories of authorship, attribution, disclosure, and currency with higher scores indicating higher quality. The accuracy of the resources was evaluated using a novel Achilles tendinitis-specific content rubric developed with a trained orthopedic surgeon and the AAOS OrthoInfo page as was done in previous studies. A maximum accuracy score of 20 was possible through the binary scoring of 20 pieces of information such as symptoms or diagnostic tools. The readability of the resources was evaluated using the Flesch-Kincaid grade level, FKGL, and Flesch Reading Ease, FRE formulas. These formulas use the average syllables per word and words per sentence to determine the complexity of a given test. The FKGL scores correspond directly to grade level and the FRE scores range from 0 to 100 with higher scores indicating more readability. It is noted that the average U.S. reading level is 8th grade. The search resulted in 77 unique sites of which 60 were included following exclusions. The overall mean discern score was 42.1 out of the possible 80 points and the average mean JAMA score was 2.2 out of the possible 4 points. The 42.1 discern score places it in the FAIR category which was also found in similar studies. The commercial group resources were found to have the highest average quality score which may indicate the commercial site's desire to draw consumers towards their sites. The 2.2 JAMA score was also found in similar recent studies. The average reading score from the FKGL test was 9.8 with a mean FRE score of 53.9. With the national average for the reading level being 8th grade, the given resources are found to require a 9th grade reading level on average too high for the average patient. The academic resources had the lowest average reading level at a score of 8.8 meaning more readable indicating that even the best Achilles tendonitis resources were still hovering around that national average level. Academic resources may be more readable because of their desire to provide knowledge to all levels of learners. The overall mean accuracy rubric score was 11.5 out of the possible 20 points indicating a low average accuracy. Such levels of accuracy were found in past studies also. This study has limitations including the user created rubric for the accuracy of the resources. Another limitation was that only two reviewers conducted the analysis of websites and graded the websites. One final limitation is the fact that the FKGL and FRE scores do not utilize visual images that help with readability and accuracy. In conclusion, online resources on Achilles tendonitis are written at a poor level of low quality, accuracy, and readability for the average patient. There was some statistical significance between the groups for the three study parameters. With patients looking to the internet more consistently for medical information, there is a larger demand for published online sources with higher quality, accuracy, and readability. Thank you.

Achilles tendinitis

online patient resources

search engines

resource evaluation

medical field