Examining the reading level of Internet medical information for common Internal Medicine diagnoses

Abstract Background The National Institutes of Health (NIH) recommend that health materials be written at a grade 6-7 reading level, which has generally not been achieved in online reading materials. Presently, there have not been any assessments focused on the reading level of online educational materials across the most popular consumer websites for common internal medicine diagnoses. In this study, we examined the readability of open access online health information for nine common internal medicine diagnoses. Methods Nine of the most frequently encountered inpatient and ambulatory internal medicine diagnoses were selected for analysis. In November and December 2014, these diagnoses were used as search terms in Google, and the top five websites across all diagnoses and a diagnosis-specific site were analyzed across five validated reading indices. Results On average, the lowest reading grade-level content was provided by the NIH (10.7), followed by WebMD (10.9), Mayo Clinic (11.3), and diagnosis-specific websites (11.5). Conversely, Wikipedia provided content that required the highest grade-level readability (14.6). The diagnoses with the lowest reading grade levels were chronic obstructive pulmonary disease (10.8), followed by diabetes (10.9), congestive heart failure (11.7), osteoporosis (11.7) and hypertension (11.7). Depression had the highest grade-level readability (13.8). Discussion Despite recommendations for patient health information to be written at a grade 6-7 reading level, our examination of online educational materials pertaining to nine common internal medicine diagnoses revealed reading levels significantly above the NIH recommendation. This was seen across both diagnosis-specific and general websites. There is a need to improve the readability of online educational materials made available to patients. These improvements have the potential to greatly enhance patient awareness, engagement and physician-patient communication.