JMIR Publications

ABSTRACT

Background:

Background:

Parents frequently turn to the internet for information regarding pediatric health symptoms such as chest pain. Although often benign, childhood chest pain is associated with high parental anxiety due to fears of underlying cardiac conditions. However, the readability, reliability, and overall quality of online resources on this topic remain largely unknown.

Objective:

Objective:

This study aimed to evaluate the readability, quality, and ethical certification of publicly available online information on childhood chest pain, and to determine whether these resources align with recommended health literacy standards.

Methods:

Methods:

A systematic web search was conducted using Google and Bing to identify websites addressing childhood chest pain. The first 200 search results from each engine were screened, and eligible English-language websites were assessed using validated readability formulas (Flesch-Kincaid Grade Level, SMOG Index, Gunning Fog Index, Automated Readability Index) and quality indicators (DISCERN score, JAMA benchmarks, HONcode certification). Websites were also categorized by type: government, professional organization, commercial, health portal, or scientific journal. Statistical analyses were conducted to compare readability and quality scores across website types.

Results:

Results:

A total of 68 websites met inclusion criteria. Most sites exceeded the recommended sixth-grade reading level, with scientific journals and health portals displaying the highest complexity. Government and professional organization websites demonstrated significantly higher DISCERN and JAMA scores compared to commercial and health portal sites (p < 0.05). Only 18% of websites displayed HONcode certification, with the highest rates observed among government sources. Spearman correlation showed a negative relationship between readability complexity and quality metrics.

Conclusions:

Conclusions:

Online information on childhood chest pain often fails to meet readability and quality standards, potentially impairing informed decision-making among parents with limited health literacy. Improved content design—featuring simplified language, ethical certification, and digital readability tools—may help bridge gaps in pediatric health communication. Future research should explore culturally tailored, AI-supported solutions to enhance the accessibility and equity of online health resources. Clinical Trial: This study did not involve human participants, patient data, or any form of clinical intervention. It was based entirely on publicly accessible web-based content and did not include any interaction with individuals or the collection of personal or identifiable information. As such, ethical approval was not required in accordance with institutional and national research guidelines.