An Analysis of the Quality and Readability of Online Information For Osteoarthritis with Historical Comparison


Kieran Murray, Timothy Murray, Anna O’Rourke, Candice Low, Douglas James Veale


Rheumatology and Infectious Diseases, Saint Vincent's Hospital, Dublin 4 Radiology, Beaumont Hospital, Dublin 9


Osteoarthritis is the most common cause of disability in people over 65 years old and a major cost to society. Despite increasing availability and usage of online health information, quality and readability is variable.


This study reviews the quality and readability of online information regarding osteoarthritis and compares this to a 2003 study.


The frequency of four commonly used terms (“osteoarthritis”, “osteoarthrosis”, “degenerative arthritis”, “degenerative joint disease”) was reviewed across the three most popular English language search engines. Osteoarthritis was the most frequently used.
The first 25 pages, excluding paid advertisements, from each search engine for “osteoarthritis” were analyzed. Duplicate pages, inaccessible pages (behind a pay wall, not available for geographical reasons) and non-text pages were excluded. Website quality was scored using the validated Journal of the American Medical Association (JAMA) benchmark criteria and DISCERN criteria. Presence or absence of HONcode certification, age of content, content producer and author characteristics were noted. Readability was measured using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL) and Gunning-Fog Index (GFI).


Osteoarthritis was the most searched term (33,960,000 results). 37 unique websites were suitable for analysis.
One (2.7%) website met all four JAMA Criteria. Mean DISCERN quality of information for osteoarthritis websites was “fair”, comparing with the “poor” grading of a 2003 study. HONCode endorsed websites (43.2%) were of a statistically significantly higher quality, but not readability.
Readability varied by assessment tool from 8th to 12th grade level. This compares with the recommended 7– 8th grade level.


Quality of online health information for osteoarthritis is “fair”. 2.7% of websites met JAMA benchmark criteria for quality. HONcode certification was indicative of higher quality. Readability was equal to or more difficult than recommendations.