The International Tinnitus Journal

Stapedotomy websites: do patients have access to good quality, readable information?

Author(s): Charles Dibor*, Mohammed Salem, Abdelrahman Ezzat Ibrahim, Liam Hyland, Khaled Elgogary

Introduction: Otosclerosis is a condition in which there is abnormal growth and remodelling of bone in the middle ear, with both genetic and environmental risk factors. This primarily affects the stapes footplate and otic capsule leading to progressive conductive or mixed hearing loss affecting multiple hearing frequencies. The gold standard of treatment for this condition is considered by many to be a stapedotomy. This is a surgical procedure which creates a fenestration in the stapes footplate (using a microdrill or a laser) and removes part of the stapes bone. Current guidelines recommend a hearing loss of greater than 20dB. Analysing online materials, that patients have access to, is of the upmost importance not only in checking that the most up-to-date information is being used but to also verify that the online materials are being set at an appropriate reading standard. This particular study aims to investigate the quality and readability of stapedotomy patient information websites. Method: Searches were performed using Google on the term “stapedotomy “. Iinclusion and exclusion criteria were applied and the first 16 websites that met the criteria were noted and further analysed for quality and readability using the DISCERN website quality measurement tool and Flesch Reading Ease (FRE) Score and Simple Measures of Gobbledygook (SMOG) readability assessment methods. Results: 11 or the 16 websites (69%) were rated as being of poor quality (DISCERN scores less than 39) and 5 (31%) were rated as being of average or fair quality (DISCERN scores between 39-50). None of the websites were rated as being of good quality. Based on the FRE Score, 31% of websites (5/16) were seen as “average to read” while the remaining 69% of websites (11/16) were graded as “difficult to read”. No websites were rated as “easy to read.” Despite most of them (94%) having a reading age below the average reading age of 9 years old based on the SMOG index. Discussion: Majority of the stapedotomy websites failed to mention alternative treatment options, the importance of shared decision making, discussing areas of uncertainty and emphasising the aims of the website. The authors of such websites may argue that these areas are not essential since key medical information is covered in clinical consultations. The DISCERN website is a UK based tool; however, the websites sampled here were from 5 different countries. Information that is displayed on these websites and deemed to be important will vary between each country and this has to be taken into consideration. However DISCERN has been used in other countries and has still be found to be reliable and effective so the findings here still have some credibility in spite of the diversity of countries represented among the websites. Conclusion:It is essential for patient understanding that authors continue to constantly improve the quality of patient information websites through the use of multiple readability indexes and tools such as the DISCERN framework. Further research is required to improve overall website designs.

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