Objective:

Analyze readability of online health education materials designed to provide epilepsy surgery information to patients.

Background:

Epilepsy surgery is an effective albeit underused treatment for refractory epilepsy. The workup and procedure explanations are complex and further compounded by the cognitive difficulties many people with epilepsy face. A previous United Kingdom study showed poor readability of online resources used for epilepsy surgery. However, there is still much to explore regarding the readability of resources in the United States, and what kinds of sites are associated with better readability.

Design/Methods:

A private browser was used to search Google for the top 100 search results for the terms “epilepsy+surgery”. Scientific papers, insurance pages, pay-wall access sites, and non-text content were excluded. The website text was re-formatted to exclude graphics, contact information, links, and headers. Readability metrics were calculated using an online readability tool (Datayze Readability Analyzer). Analysis was done through R using the Kruskal-Wallis test, and statistical assumptions were assessed.

Results:

Here we present the preliminary analysis of the top 100 items from a Google search yielding 76 websites and 24 exclusions. Websites were categorized as US based organizations or non-US, content from level 4 epilepsy centers, and if the sources were community health websites not associated with academic institutions. The Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) showed significantly better readability in community health websites (FRE p=.03, FKGL p=.03), non-level 4 epilepsy centers (FRE p=.002, FKGL p=.002), and international websites (FRE p=.02, FKGL =.03).

Conclusions:

Health information source characteristics associated with better readability levels included non-academic centers, non-level 4 epilepsy centers and community health information websites. This analysis suggests that academic centers, especially level 4 epilepsy centers, should consider involving community members, advocacy organizations and non-medical writers in the designing of online epilepsy surgery health education materials.