Quality and Readability of Online Information on Ankle Instability

Abstract

Category: Ankle; Sports; Trauma Introduction/Purpose: Ankle sprains are among the most common sports injuries and up to 60% of patients experience long- term ankle disability or develop chronic ankle instability. Proper patient information is essential in both conservative and surgical treatment. The rising role of the internet has revolutionized the way patients acquire health-related information. Nevertheless, inaccurate or outdated online resources could lead to misinformation about the nature of ankle instability and the treatment options. Aim of this study was to evaluate the quality, accuracy and readability of free available online resources regarding ankle instability. Methods: Three search terms (‘ankle instability’, ‘ankle instability treatment’, ‘ankle laxity’) were searched using the three biggest search engines (Google, Bing, Yahoo). Quality and accuracy of online patient information was evaluated by using the EQIP36 and a custom 25-item list based on recommendations of the AOFAS. Readability was assessed by evaluating the Flesch-Kincaid score. Results: A total of 102 online resources were included in this study. The mean 25-item-score was 9.45 (range 1-22) and the mean EQIP 36-score was 40.72 (range 17.65-65.71). The average Flesch-Kincaid score reached 110.60 (range 10-176) and 97% of evaluated websites exceeded the recommended 8th grade reading level for patient information. Quality was significantly higher with reading levels of college graduates (p<0.001). There was no difference regarding search terms or search engines. Conclusion: Available online information on ankle instability showed huge differences regarding the quality, readability and accuracy. Inappropriate advanced reading levels of high-quality websites could be incomprehensible to patients. Foot and ankle specialists should be aware of the low quality and readability of the majority of online resources and provide patients with adequate website-links.