Readability, content, quality and accuracy assessment of internet-based patient education materials relating to labor analgesia

Background: With over 90% of parturients searching the internet for health information, the quality of information is important. Web-based patient education materials (PEMs) related to labor analgesia are frequently of low readability. This study compares the readability, content, quality and accuracy of labor analgesia-related PEMs from relevant healthcare society websites and the top internet search results. Methods: The first ten PEMs from Google searches for "labor epidural" and "labor pain relief" were compared with PEMs from North American and United Kingdom anesthesiology, obstetric and medical society websites. Readability was assessed utilizing five validated readability indices. Quality was assessed using Patient Education Materials Assessment Tool for Print (PEMAT). The PEMs were graded for accuracy by four obstetric anesthesiologists. Readability, quality and accuracy scores were compared using the independent t-test and content using Chi-square analysis. Results: Society PEMs were significantly more readable than non-society PEMs for three of five readability indices, though the mean of both groups was at or above an eighth-grade (average age 13-14 years-old) reading level. The PEMAT understandability and accuracy scores were significantly higher for society websites. The most frequently mentioned topics were benefits, effects of epidural analgesia on labor and delivery, definitions, post-dural puncture headache and alternative analgesics. Conclusions: Google search results for labor analgesia lead to PEMs of variable quality and readability. For readers to be better informed, web-based PEMs should be improved or women directed to society PEMs. Inaccurate information may lead to incorrect expectations and conflict during labor, with potentially lower maternal satisfaction. (C) 2019 Elsevier Ltd. All rights reserved.