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

Ronak Shah, Jasmine Mahajan, Marko Oydanich, Albert S. Khouri

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate the quality and reliability of medical information, the technical quality of the presentation 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 intraocular 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 reviewers 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 categorized 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.

Original languageEnglish (US)
Pages (from-to)93-99
Number of pages7
JournalOphthalmology. Glaucoma
Issue number1
StatePublished - Jan 1 2023
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Ophthalmology


  • Glaucoma
  • Online information
  • Quality
  • Readability


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