A Comprehensive Evaluation of the Quality, Readability, and Technical Quality of Online Information on Glaucoma

Purpose: To evaluate the quality and reliability of medical information, the technical quality of the presen-tation of information, and the readability of informational websites that publish content on the definition, causes, symptoms, and treatment of glaucoma.Design: A cross-sectional study was conducted to assess information published on websites with regard to glaucoma. Subjects: The top 150 websites populated on a Google search using the keywords glaucoma, high intra-ocular pressure, and high eye pressure were chosen for evaluation.Methods: Two independent reviewers assessed quality and reliability of each website using the DISCERN, Health on the Net Code (HONcode), and Journal of the American Medical Association (JAMA) criteria. The re-viewers also evaluated technical quality by determining each website's ability to satisfy 10 unique features. Readability was assessed using the Readability Studio software (Oleander Software).Main Outcome Measures: Quality of information was analyzed using the DISCERN, HONcode, and JAMA criteria. To assess readability, the Bormuth Cloze Mean, Bormuth Grade Placement, Flesch Kincaid Reading Ease, Coleman-Liau Index, Gunning Fog Score, Simple Measure of Gobbledygook Index, Readability Score, Fry Estimate, Raygor Estimate, and the Overall Mean Readability metrics were used. A separate subanalysis cate-gorized websites into institutional and private categories.Results: Readability was poor among all websites, with most websites requiring a reading level higher than the 11th grade. The overall mean DISCERN score + standard deviation (SD) was 3.0 + 0.4, the mean HONcode score + SD was 9.6 + 1.8, and the mean JAMA score + SD was 2.1 + 1.1. The reviewers had moderate to excellent interrater reliability. Institutional websites (n = 39) had a higher mean DISCERN score (3.18 + 0.33 vs. 2.95 + 0.39, P < 0.05) and mean HONcode score (10.18 + 1.90 vs. 9.34 + 1.71, P < 0.05) than those of private websites (n = 111). Technical quality was higher among institutional websites (P < 0.05).Conclusions: An overwhelming majority of websites presented information of low quality, reliability, and readability. Institutional websites generally received higher scores than those received by private websites; however, overall scores were still substandard, which necessitates improvement of online information on glaucoma. Ophthalmology Glaucoma 2023;6:93-99 & COPY; 2022 by the American Academy of Ophthalmology