Top Websites No Better than Lower Ranked Ones for Ophthalmology Content

Hong-Uyen Hua, MD

New research suggests the top 5 websites that appear on a Google search for “macular degeneration” do not necessarily have better quality, readability, or accessibility of online content.

Hong-Uyen Hua, MD, and colleagues evaluated the quality, readability, and content of online information from private practice and academic websites about macular degeneration. The findings, presented at the American Society of Retina Specialists 2020 (ASRS 2020) Virtual Sessions, demonstrated there were no statistically significant differences in the quality, accountability, or readability of academic versus private organization websites.

The team of investigators conducted a cross-sectional study in November 2019. They Google searched the term “macular degeneration” and included the top 31 ranked websites. A retina fellow and an ophthalmology resident reviewed the websites.

Websites were categorized as academic or private and the quality of each site was evaluated using validated DISCERN criteria and Health on Net principles (HONcode). The readability of each website was graded using 7 validated and widely used criteria to determine a consensus grade reading level.

Comparisons were performed using the Mann-Whitney test with Bonferroni correction. One comparison was conducted between academic and private sites, while 1 was performed between the top 5 ranked websites on Google and the 26 lower ranked websites.

The mean of each criterion across all 15 DISCERN questions was 2.761±.666. The mean for DISCERN credibility was 2.872±.772 and 2.635±.859 for DISCERN treatment criteria.

A total of 14 points were possible for the HONcode score. The mean score for all websites was 7.355±3.123.

The mean consensus reading grade level was 10.258±2.49. Accessibility was offered by 10 of 31 websites and Spanish translation was available on 10 of 31 websites.

When the team compared the top 5 websites versus the bottom 26 websites, there were no statistically significant differences in scores. There were also no statistically significant differences in scores between academic and private organizations. The top 5 websites’ mean DISCERN credibility score was higher, but after Bonferroni correction, the difference did not meet statistical significance (P=.01).

Overall, Hua and the team determined the top 5 websites that appeared on a Google search for “macular degeneration” did not necessarily have better quality, readability, or accessibility of online content. There was also no significant difference in the quality, accountability, or readability of academic versus private organization websites, which differed from prior evaluations of online ophthalmology content.

Only a fraction of the websites had Spanish translation and low vision accessibility features. The readability grade level was higher than recommended.

“Improving the quality, accountability, readability, and incorporating Spanish translation and low vision accessibility features can help improve patients’ health literacy regarding macular degermation, potentially leading to increased adherence to therapy plans and improved treatment outcomes,” Hua and the investigators concluded.

The study, “Critical Analysis of the Quality, Readability, and Content of Online Information Accessed by a Google Search of ‘Macular Degeneration,” was presented at ASRS 2020.