Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 31, 2023
Date Accepted: Oct 25, 2023
The Readability and Quality of Online Patient Information on Nasopharyngeal Carcinoma: A Quantitative Content Analysis
ABSTRACT
Background:
The ever-evolving digital landscape and healthcare needs of the public have increased the need for more accessible information. Nasopharyngeal carcinoma (NPC) is characterised by the formation of cancerous cells in the tissues of the nasopharynx and strongly associated with exposure to the Epstein-Barr Virus (EBV). Access to high-quality, readable information could improve the early detection of the disease and provide support to patients during management.
Objective:
The aim is to evaluate the quality and readability of online information present on nasopharyngeal cancer using recognised scoring tools.
Methods:
Keywords including ‘nasopharyngeal cancer’, ‘nasopharyngeal carcinoma’, ‘nasal cancer’, ‘nose cancer’, ‘sinus cancer’, ‘pharyngeal cancer’, and ‘throat cancer’ were searched for using internet search engines: Google, Yahoo and Bing. Website authorships were classified: academic, commercial, or unspecified. Each website was assessed for readability using the Flesch Reading Ease score and the Flesch-Kincaid grade level. Quality of information was assessed using the JAMA and DISCERN tools and presence of a HONcode seal.
Results:
A total of fifty-seven websites were included in our study. Most common source of information were academic (26%; 15/57). The average JAMA and DISCERN scores of all websites were 2.80 (IQR 3) and 57.60 (IQR 19), respectively, with a median of 3.0 (range 1-4) and 61.00 (range 18-80), respectively. Industry healthcare websites had the highest JAMA score with a mean of 4.0, median 4.0. Academic websites had the highest DISCERN score with a mean of 77.5 (n = 6; 11%). Only one website had the HON code seal, achieved a JAMA score of 3 and a DISCERN score of 50. Significant differences were observed between the JAMA score of hospital websites and the scores of industry websites (P<.037), news services websites (P<.048), and charity/ non-governmental organisation websites (P <.027). General practitioner websites were also found to have a significantly lower JAMA score than charity websites (P <.045). Overall mean readability scores reflect an average reading age of 14.3 years old, which indicated that the websites as a group were fairly difficult to read.
Conclusions:
Internet information relating to nasopharyngeal cancer is of variable and suboptimal quality. Given this variability in quality, healthcare providers should direct patients to known sources of reliable, readable online information.
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