Readability and quality of online patient materials in the websites of the Japanese Orthopaedic Association and related orthopaedic societies

Background: The purpose of this study was to quantify the readability and quality of patient materials on the websites of the Japanese Orthopaedic Association and related orthopaedic societies.Methods: We analyzed 143 online patient materials of seven societies, including the Japanese Ortho-paedic Association and related six societies. The readability of the text in the material was quantified using two web-based programs ("Obi-3" and "Readability Research Lab") and lexical density. The ma-terials with a difficulty level & LE; second grade of junior high school were classified as "average difficulty," and those & LE; sixth grade of elementary school were classified as "easy to read." The quality of the ma-terials was quantified using the validated Clear Communication Index, DISCERN, and Journal of American Medical Association benchmark criteria scores. The proportion of materials classified as sufficient quality was determined. The measurement values were compared among societies using Kruskal-Wallis tests.Results: The median difficulty level of the overall materials was the third grade of junior high school using the Obi-3 program. Only 44 (31%) were classified as average difficulty, and none were classified as easy to read. Based on lexical density, 31 (22%) materials were classified as average difficulty. The median Clear Communication Index score was 18 points out of 100. The median DISCERN and Journal of American Medical Association benchmark criteria scores were 27 (out of 75) and 0 (out of 4), respectively. Only one material met the criteria as having sufficient quality. There were significant differences among societies in the lexical density, Clear Communication Index, and DISCERN scores.Conclusions: The patient materials on the Japanese Orthopaedic Association and related society websites were too difficult to understand. Furthermore, the quality of the materials was not sufficient. Improvement in readability and quality may be necessary to enhance patient-physician communication.