Abstract
Background
Nutrition plays an essential role in inflammatory bowel disease (IBD). Optimizing nutritional status can help prevent malnutrition, osteoporosis, and may be an effective primary therapy for many patients. Patients with IBD are increasingly turning to the Internet for information. This study evaluated the readability and quality of online resources discussing nutrition for IBD.
Methods
Google search engine was used to query “nutrition and inflammatory bowel disease” to access the first 100 websites. Websites that were non-accessible, duplicates, videos without transcripts or evaluated animal models were excluded. Websites were categorized as informational or academic/professional. Readability was determined using the validated Flesch-Kincaid Grade Level Calculation. The quality of the information was determined using the validated DISCERN score. Websites were reviewed for inclusion of a discussion of shared decision making between patients and physicians. Statistical analysis was performed using a two-tailed Fisher’s Exact Test and a two-sample T-test with a significance value set at p <0.05.
Results
89 of 100 websites met the inclusion criteria. 50 (56.2%) websites were informational and 39 (43.8%) were academic. The average Flesch-Kincaid Grade level was 13.2, with no significant difference between informational and academic websites (13.1 and 13.4 grade levels, respectively; p=0.760). The average DISCERN score was “good” without significant difference between informational and academic websites (45.75 and 45.74, respectively; p=0.994).
Academic websites had significantly more “excellent” DISCERN scores than informational websites (76% and 24%, respectively; p = 0.0054). There were no significant difference in “good” or “poor” DISCERN scores between academic and informational websites (p=0.527 and p=0.095, respectively) (Figure 1). Shared decision making between patient and physician was discussed among 33.7% of all sources, significantly more often among informational than academic sources (60% and 0%, respectively; p=0.0001).
Discussion
Patients often self-manage their symptoms using easily accessible online resources. While our study demonstrated near identical DISCERN scores between academic and informational websites, the average Flesch-Kincaid Grade Level exceeded the NIH recommended 6th grade reading level. Informational websites, however, were more likely to encourage shared decision making between physician and patient. It may be important for academic online resources to specifically emphasize communication that encourages shared decision making between IBD patients and physicians. As the use of online resources continues to increase, further efforts should focus on developing informational resources written at a grade level which is applicable to the general public.
Towards Developing a Framework to Analyze the Qualities of the University Websites
