Readability Analysis of Online Health Information about Overactive Bladder: Beyond the Abstract

Up to 43% of women and 27% of men have symptoms of overactive bladder (OAB), including urinary urgency, frequency, nocturia, and urge incontinence.1 In the past, patients’ first port of call for diagnostic information and management options was the doctor’s office. But in 2016, the ubiquity of Internet-connected mobile devices means that health information can be called up with a click of a mouse or a swipe of a screen.

Public awareness about OAB has also increased with direct-to-consumer advertising of anticholinergic medications and disease awareness campaigns. Therefore, it’s not surprising that more patients are going online for answers about their symptoms and treatment options before they see a physician.

What do patients see when they type “overactive bladder” into their search engines? And how readable are the search results by the average U.S. adult with an eighth-grade reading ability?2 In our readability analysis of the 57 most commonly found websites for OAB,3 we determined that the majority of online content far exceeds patients’ reading ability. Only 12% of the sources we examined would be readable by the average adult, raising concerns about potential misinterpretation of the condition or misunderstanding of the numerous effective interventions for OAB. We also assessed whether websites that are maintained by academic medical centers—often presumed to be the most reliable sources of health information—or certified by the international Health on the Net standard for high-quality online health content have easier readability. Surprisingly, neither of these factors predicted lower reading grade levels.

The findings underscore two perennial questions: Where can patients turn for readable, reliable information about their urological conditions, and to which online sources can urologists confidently direct their patients? Our study confirms the importance of carefully vetting patient education materials and reminds clinicians that even the most evidence-based, up-to-date information will have limited impact on patients’ decision-making if its readability is not carefully considered.

Written by: Kevin Koo, MD, MPH, MPhil, Kevin Shee, and Ronald L. Yap, MD, MBA

Read the abstract

1. Gormley EA, Lightner DJ, Burgio KL et al.: Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol 2012; 188: 2455.
2. US Department of Education and National Center for Education Statistics: The Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy. Accessed 15 October 2015
3. Koo K, Shee K, Yap RL: Readability analysis of online health information about overactive bladder. Neurourol Urodyn 2016. Epub ahead of print.
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