The International Tinnitus Journal

Readability and quality assessment of patient education websites related to eustachian tube balloon dilatation

Introduction: Eustachian Tube Dysfunction (ETD) occurs as a result of failure of the Eustachian Tube (ET) to equilibrate pressures between the middle ear and the atmosphere, via the nasopharynx. This leads to a plethora of symptoms including otalgia, temporary hearing loss, aural fullness and tinnitus. Eustachian Tube Balloon Dilatation (ETBD) has been proven, through numerous studies, to be a safe method of treating obstructive ETD. Method: 20 websites were located using Google and inclusion/exclusion criteria. The DISCERN website quality assessment tool was used together with Flesh Reading Ease score and Simple Measures of Gobbledygook (SMOG) index to assess readability. Results : Based in the DISCERN quality assessment tool, 55% of the selected websites (11/20) were rated as being of poor quality, 40% (8/20) were rated as being of average or fair quality and only 1 sites out of the 20 was graded to be of good quality. The majority of websites -16 out of 20 (80%) - were rated as “difficult to read”. 1/20 websites (5%) received an average reading grade. The remaining 3 websites (15%) were rated as “easy to read”. 18/20 websites (90%) had readability ratings below the average reading age of 9 years while the remaining 2 websites (10%) had a reading age of 9 years or greater. Discussion: Most of the ETBD websites scored poorly on the topic areas of the DISCERN assessment tool related to informed consent and discussing complications and these are clearly of great importance, irrespective of the country where the surgery is performed. Conclusion: Websites for patient information should be deigned to support a good doctor-patient relationship and the process of informed consent. Authors of Eustachian tube balloon dilatation patient information websites need to keep improving websites through the use of multiple readability indexes and tools and consideration of the DISCERN framework together with other design and usage factors that have a bearing on quality and readability but may not be captured by standardised assessment tools. A Multi-disciplinary teams approach involving IT staff and patients who can offer feedback may lead to better results.