Impingement on the internet: evaluating the quality and readability of online subacromial impingement information

BMJ Open Sport Exerc Med. 2021 Nov 3;7(4):e001203. doi: 10.1136/bmjsem-2021-001203. eCollection 2021.

Abstract

Patients increasingly access the internet to learn about their orthopaedic conditions. Despite this, online information may be unregulated, of questionable quality and difficulty to read.

Objectives: Therefore, this study aimed to evaluate the readability and quality of the online information concerning subacromial impingement syndrome.

Methods: A search using Australia's three most popular online search engines was undertaken using the search terms 'subacromial impingement syndrome' and 'shoulder impingement'. The first 15 websites for each term were evaluated. Duplicates, advertisements and sponsored links were removed.The quality and readability of each website were calculated using the DISCERN and Flesch-Kincaid Reading Ease (FKRE) tools, respectively. The differences in quality and readability between each website type (healthcare/academic, commercial, news outlet, charitable/not-for-profit, layperson, government) was assessed using analysis of variance. The correlation between quality and readability was assessed using the Pearson correlation coefficient.

Results: The majority of 35 unique websites analysed were of 'poor'/'fair' quality (determined via the DISCERN instrument) and 'difficult' readability (per the FKRE tool), with no correlation established between the scores. There was no statistically significant difference in quality across website types, however layperson, news outlet and government websites were found to be significantly more readable than alternate website categories (p<0.05).

Conclusions: We determined that much of the online information concerning subacromial impingement syndrome may be difficult to read and/or of poor quality. By recognising the shortcomings of information accessed by patients online, it is hoped clinicians may be prompted to better educate their patients.

Keywords: injuries; orthopaedics; shoulder.