# Readability and Quality of Online Information on Osteochondral Knee Injuries: An Objective Assessment

## TL;DR

This study finds that most online information about knee injuries is too complex and lacks quality, making it hard for patients to understand.

## Contribution

The paper objectively assesses readability and quality of online resources on osteochondral knee injuries using standardized metrics.

## Key findings

- Most online resources exceed recommended readability levels for general audiences.
- Only 5 out of 46 webpages met the sixth-grade reading level recommended for patient materials.
- The average JAMA quality score was low, indicating poor credibility of the resources.

## Abstract

Background

In the modern healthcare era, the internet serves as a major source of information for patients. However, prior studies have shown that online medical information frequently exceeds the recommended readability levels, limiting patient understanding. In the US, the average reading level is between seventh and eighth grade, while leading health organisations recommend that patient information not exceed a sixth-grade level. This study evaluates the readability and quality of publicly accessible online content related to osteochondral injuries of the knee.

Methods

A systematic search was conducted on Google (Google, Inc., Mountain View, CA), Bing (Microsoft® Corp., Redmond, WA), and Yahoo (Yahoo, Inc., New York, NY) using the terms “osteochondral defect knee” and “osteochondral injury knee.” The top 30 uniform resource locators (URLs), for each search term, from each search engine were screened. Readability of the content was assessed using four standardised readability metrics (Gunning Fog Index, Flesch-Kincaid Grade, Flesch Reading Ease, and Simple Measure of Gobbledygook (SMOG) index), while quality was measured based on the Journal of the American Medical Association (JAMA) benchmark criteria.

Results

Forty-six unique webpages were included in the analysis. The mean Flesch-Kincaid Grade Level was 10.1 ± 3.4, the mean Gunning Fog Index grade was 11.5 ± 4.1, the mean Flesch Reading Ease score was 43.8 ± 12.8, and the mean SMOG grade was 8.8 ± 2.9. Only five webpages were at or below a sixth-grade reading level. The mean JAMA score was 1.43 ± 1.46 out of four.

Conclusion

This study assessed the readability and credibility of online health information. The majority of online resources related to osteochondral knee injuries are difficult to read and lack key quality indicators. Improving both readability and reliability is essential to support patient comprehension, informed decision-making, and promote better health literacy.