Quality and readability of online information resources on insomnia

doi:10.1007/s11684-017-0524-9

Front. Med.

2017, Vol. 11

Issue (3) : 423-431 https://doi.org/10.1007/s11684-017-0524-9

RESEARCH ARTICLE

Quality and readability of online information resources on insomnia

Yan Ma¹(

), Albert C. Yang¹, Ying Duan², Ming Dong³, Albert S. Yeung⁴

¹. Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
². Sleep Medicine Center, Airforce General Hospital, Beijing 100142, China
³. IBM, Software Development Lab, Littleton, MA 01460, USA
⁴. Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA

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Abstract

The internet is a major source for health information. An increasing number of people, including patients with insomnia, search for remedies online; however, little is known about the quality of such information. This study aimed to evaluate the quality and readability of insomnia-related online information. Google was used as the search engine, and the top websites on insomnia that met the inclusion criteria were evaluated for quality and readability. The analyzed websites belonged to nonprofit, commercial, or academic organizations and institutions such as hospitals and universities. Insomnia-related websites typically included definitions (85%), causes and risk factors (100%), symptoms (95%), and treatment options (90%). Cognitive behavioral therapy for insomnia (CBT-I) was the most commonly recommended approach for insomnia treatment, and sleep drugs are frequently mentioned. The overall quality of the websites on insomnia is moderate, but all the content exceeded the recommended reading ease levels. Concerns that must be addressed to increase the quality and trustworthiness of online health information include sharing metadata, such as authorship, time of creation and last update, and conflicts of interest; providing evidence for reliability; and increasing the readability for a layman audience.

Keywords insomnia internet readability information quality health literacy cognitive behavioral therapy treatment

Corresponding Author(s): Yan Ma

Just Accepted Date: 07 April 2017 Online First Date: 16 May 2017 Issue Date: 29 August 2017

Cite this article:

Yan Ma,Albert C. Yang,Ying Duan, et al. Quality and readability of online information resources on insomnia[J]. Front. Med., 2017, 11(3): 423-431.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0524-9
https://academic.hep.com.cn/fmd/EN/Y2017/V11/I3/423

Tab.1 16 items of DISCERN and mean scores of the included websites

Tab.2 Readability score/index and equivalent readability level, US school grade level and UK School Age

Tab.3 Quality and readability of included 20 websites

Fig.1 Quality checklist items for included 20 websites.

Fig.2 Content checklist for the top 20 websites.

Fig.3 Recommended therapies by the top 20 websites.

1	Statistics Canada. Canadian Internet Use Survey-2009. 2010. Available from:
2	Atkinson NL, Saperstein SL, Pleis J. Using the internet for health-related activities: findings from a national probability sample. J Med Internet Res 2009; 11(1): e4 https://doi.org/10.2196/jmir.1035 pmid: 19275980
3	Ybarra ML, Suman M. Help seeking behavior and the Internet: a national survey. Int J Med Inform 2006; 75(1): 29–41 https://doi.org/10.1016/j.ijmedinf.2005.07.029 pmid: 16129659
4	Fallowfield LJ, Hall A, Maguire GP, Baum M. Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. BMJ 1990; 301(6752): 575–580 https://doi.org/10.1136/bmj.301.6752.575 pmid: 2242455
5	Gilmour JA, Huntington A, Broadbent R, Strong A, Hawkins M. Nurses’ use of online health information in medical wards. J Adv Nurs 2012; 68(6): 1349–1358 https://doi.org/10.1111/j.1365-2648.2011.05845.x pmid: 21999429
6	Kumar VS, Subramani S, Veerapan S, Khan SA. Evaluation of online health information on clubfoot using the DISCERN tool. J Pediatr Orthop B 2014; 23(2): 135–138 pmid: 24048196
7	Ma Y, Dong M, Mita C, Sun S, Peng CK, Yang AC. Publication analysis on insomnia: how much has been done in the past two decades? Sleep Med 2015; 16(7): 820–826 https://doi.org/10.1016/j.sleep.2014.12.028 pmid: 25979182
8	Pletneva N, Vargas A, Kalogianni K, Boyer C. Online health information search: what struggles and empowers the users? Results of an online survey. Stud Health Technol Inform 2012; 180: 843–847 pmid: 22874311
9	NETMARKETSHARE. Desktop Search Engine Market Share. Available from: (Accessed April 13, 2017)
10	Eysenbach G, Powell J, Kuss O, Sa ER. Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. JAMA 2002; 287(20): 2691–2700 https://doi.org/10.1001/jama.287.20.2691 pmid: 12020305
11	Feufel MA, Stahl SF. What do web-use skill differences imply for online health information searches? J Med Internet Res 2012; 14(3): e87 https://doi.org/10.2196/jmir.2051 pmid: 22695686
12	Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 1999; 53(2): 105–111 https://doi.org/10.1136/jech.53.2.105 pmid: 10396471
13	Ademiluyi G, Rees CE, Sheard CE. Evaluating the reliability and validity of three tools to assess the quality of health information on the Internet. Patient Educ Couns 2003; 50(2): 151–155 https://doi.org/10.1016/S0738-3991(02)00124-6 pmid: 12781930
14	Wilson P. How to find the good and avoid the bad or ugly: a short guide to tools for rating quality of health information on the internet. BMJ 2002; 324(7337): 598–602 https://doi.org/10.1136/bmj.324.7337.598 pmid: 11884329
15	Aldairy T, Laverick S, McIntyre GT. Orthognathic surgery: is patient information on the Internet valid? Eur J Orthod 2012; 34(4): 466–469 https://doi.org/10.1093/ejo/cjr046 pmid: 21459834
16	Batchelor JM, Ohya Y. Use of the DISCERN instrument by patients and health professionals to assess information resources on treatments for asthma and atopic dermatitis. Allergol Int 2009; 58(1): 141–145
17	Fast AM, Deibert CM, Hruby GW, Glassberg KI. Evaluating the quality of Internet health resources in pediatric urology. J Pediatr Urol 2013; 9(2): 151–156 https://doi.org/10.1016/j.jpurol.2012.01.004 pmid: 22281281
18	Kaicker J, Debono VB, Dang W, Buckley N, Thabane L. Assessment of the quality and variability of health information on chronic pain websites using the DISCERN instrument. BMC Med 2010; 8(1): 59 https://doi.org/10.1186/1741-7015-8-59 pmid: 20939875
19	Pusz MD, Brietzke SE. How good is Google? The quality of otolaryngology information on the internet. Otolaryngol Head Neck Surg 2012; 147(3): 462–465 https://doi.org/10.1177/0194599812447733
20	Zahedi R, Taheri B, Shahrzadi L, Tazhibi M, Ashrafi-rizi H. Quality of Persian addiction websites: a survey based on silberg, discern and wqet instruments (2011). Acta Inform Med 2013; 21(1): 46–50 https://doi.org/10.5455/aim.2012.21.46-50 pmid: 23572862
21	Cerminara C, Santarone ME, Casarelli L, Curatolo P, El Malhany N. Use of the DISCERN tool for evaluating web searches in childhood epilepsy. Epilepsy Behav 2014; 41: 119–121
22	Daraz L, Macdermid JC, Wilkins S, Gibson J, Shaw L. The quality of websites addressing fibromyalgia: an assessment of quality and readability using standardised tools. BMJ Open 2011; 1(1): e000152 https://doi.org/10.1136/bmjopen-2011-000152 pmid: 22021777
23	Tallgren M, Bäcklund M. Patient information about general anaesthesia on the internet. Anaesthesia 2009; 64(4): 408–415 https://doi.org/10.1111/j.1365-2044.2008.05813.x pmid: 19317707
24	Daraz L, MacDermid JC, Wilkins S, Shaw L. Tools to evaluate the quality of web health information: a structured review of content and usability. Int J Technol Knowl Soc 2009; 5: 3
25	Walsh TM, Volsko TA. Readability assessment of internet-based consumer health information. Respir Care 2008; 53(10): 1310–1315 pmid: 18811992
26	US National Library of Medicine. How to Write Easy-to-Read Health Materials 2013. Available from: . Page last updated on December 29, 2016
27	Weiss BD. Health Literacy: A Manual for Clinicians. Chicago, IL: American Medical Association, American Medical Foundation. 2003
28	Kincaid JP, Fishburne RP Jr, Rogers RL, Chissom BS. Derivation of new readability formulas (automated readability index, fog count and flesch reading ease formula) for navy enlisted personnel. DTIC Document, 1975
29	Davis TC, Mayeaux EJ, Fredrickson D, Bocchini JA Jr, Jackson RH, Murphy PW. Reading ability of parents compared with reading level of pediatric patient education materials. Pediatrics 1994; 93(3): 460–468 pmid: 8115206
30	McLaughlin GH. SMOG grading: a new readability formula. J Read 1969; 12(8): 639–646
31	Fitzsimmons PR, Michael BD, Hulley JL, Scott GO. A readability assessment of online Parkinson’s disease information. J R Coll Physicians Edinb 2010; 40(4): 292–296 https://doi.org/10.4997/JRCPE.2010.401 pmid: 21132132
32	Hesse BW, Nelson DE, Kreps GL, Croyle RT, Arora NK, Rimer BK, Viswanath K. Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey. Arch Intern Med 2005; 165(22): 2618–2624 https://doi.org/10.1001/archinte.165.22.2618 pmid: 16344419
33	Hu X, Bell RA, Kravitz RL, Orrange S. The prepared patient: information seeking of online support group members before their medical appointments. J Health Commun 2012; 17(8): 960–978 https://doi.org/10.1080/10810730.2011.650828 pmid: 22574697
34	Lv X, Ma Y, Feng F, Hong L, Wang J, Wang W. Personality development since childhood associated with adult chronic insomnia: a study by Wang’s Memory-Tracing Personality Development Inventory (WMPI). Glob J Health Sci 2016; 9(3): 80 https://doi.org/10.5539/gjhs.v9n3p80
35	Ma Y, Yeung A, Yang AC, Peng CK, Clain A, Alpert J, Fava M, Yeung AS. The effects of tai chi on sleep quality in Chinese American patients with major depressive disorder: a pilot study. Behav Sleep Med2016 Sep 27. [Epub ahead of print] doi: 10.1080/15402002.2016.1228643 https://doi.org/10.1080/15402002.2016.1228643 pmid: 27676270
36	Sun S, Hong L, Ma Y, Zhao Y, Qiao J. WO-109 A Chinese questionnaire-based survey: sleep medicine awareness in primary care. Sleep Med 2011; 12: S122 https://doi.org/10.1016/S1389-9457(11)70456-7
37	Ma Y, Sun S, Peng CK. Applications of dynamical complexity theory in traditional Chinese medicine. Front Med 2014; 8(3): 279–284 https://doi.org/10.1007/s11684-014-0367-6 pmid: 25204292
38	Ma Y, Zhou K, Fan J, Sun S. Traditional Chinese medicine: potential approaches from modern dynamical complexity theories. Front Med 2016; 10(1): 28–32 https://doi.org/10.1007/s11684-016-0434-2 pmid: 26809465
39	Ma Y, McCraty R. Heart rate variability in mind-body interventions. Complement Ther Med 2016; 29: A1–A2 https://doi.org/10.1016/j.ctim.2016.05.003 pmid: 27912965
40	Shi W, Shang P, Ma Y, Sun S, Yeh CH. A comparison study on stages of sleep: quantifying multiscale complexity using higher moments on coarse-graining. Commun Nonlinear Sci Numer Simul 2017; 44: 292–303 https://doi.org/10.1016/j.cnsns.2016.08.019
41	Ma Y, Sun S, Peng CK, Fang Y, Thomas RJ. Ambulatory blood pressure monitoring in Chinese obstructive sleep apnea patients. J Clin Sleep Med 2017;13(3):433–439 https://doi.org/10.5664/jcsm.6498 pmid: 27855748
42	Lu Y, Sun Y, Ma Y, Li H, Chang Y, Tong Y, Sun S. Investigation on the awareness of sleep medicine in a university of traditional Chinese medicine. Sleep Med 2015; 16(S1): S61 https://doi.org/10.1016/j.sleep.2015.02.153
43	Ma Y, Sun S. Knowledge update on complex sleep apnea. Chin J Tuberc Respir Dis (Zhonghua Jie He He Hu Xi Za Zhi) 2013; 36(9): 687–691 (in Chinese)
44	Tseng PH, Lee PL, Hsu WC, Ma Y, Lee YC, Chiu HM, Ho YL, Chen MF, Wu MS, Peng CK. A higher proportion of metabolic syndrome in Chinese subjects with sleep-disordered breathing: a case-control study based on electrocardiogram-derived sleep analysis. PLoS One 2017; 12(1): e0169394 https://doi.org/10.1371/journal.pone.0169394 pmid: 28081171
45	Hong L, Ma Y, Lin Y, Wang F, Tong C, Zhao X, Wang W. Correlation study of depression, anxiety and sleep disturbance. Int J Tradit Chin Med (Guo Ji Zhong Yi Zhong Yao Za Zhi) 2009; 31(2): 152–154 (in Chinese)
46	Hong L, Wei H, Ma Y, Wang W. Manifestation study on depression in comprehensive hospitals. Int J Tradit Chin Med (Guo Ji Zhong Yi Zhong Yao Za Zhi) 2010; 32(3): 259–261 (in Chinese)
47	Ma Y. Review on sleep belief and attitude. World J Sleep Med (Shi Jie Shui Mian Yi Xue Za Zhi) 2015; 2(6): 356–361 (in Chinese)
48	Ma Y, Dong M, Zhou K, Mita C, Liu J, Wayne PM. Publication trends in acupuncture research: a 20-year bibliometric analysis based on PubMed. PLoS One 2016; 11(12): e0168123 https://doi.org/10.1371/journal.pone.0168123 pmid: 27973611
49	Zhou K, Ma Y, Brogan MS. Dry needling versus acupuncture: the ongoing debate. Acupunct Med 2015; 33(6): 485–490
50	Xu H, Ma Y, Wang W. Patients’ independent choices to resistance. Med Philos (Humanist Soc Med Ed) (Yi Xue Yu Zhe Xue: Ren Wen She Hui Yi Xue Ban). 2010; 31(2): 44–46 (in Chinese)
51	Ma Y, Sun SC. Sleep medicine and blood pressure variation: significance to clinical application of anti-hypertensive medicines. World J Sleep Med (Shi Jie Shui Mian Yi Xue Za Zhi) 2014; (4): 235–238 (in Chinese)
52	McPherson AC, Gofine ML, Stinson J. Seeing is believing? A mixed-methods study exploring the quality and perceived trustworthiness of online information about chronic conditions aimed at children and young people. Health Commun 2014; 29(5): 473–482 https://doi.org/10.1080/10410236.2013.768325 pmid: 24099647
53	Tan BH, Kostapanagiotou K, Jilaihawi AN. A review of mesothelioma information on the World Wide Web. J Thorac Oncol 2009; 4(1): 102–104
54	Kaicker J, Dang W, Mondal T. Assessing the quality and reliability of health information on ERCP using the DISCERN instrument. Health Care Curr Rev 2013;1: 104. doi:10.4172/hccr.1000104
55	Ye Y. Correlates of consumer trust in online health information: findings from the health information national trends survey. J Health Commun 2011; 16(1): 34–49 https://doi.org/10.1080/10810730.2010.529491 pmid: 21086209
56	Hargrave DR, Hargrave UA, Bouffet E. Quality of health information on the Internet in pediatric neuro-oncology. Neuro-oncol 2006; 8(2): 175–182 https://doi.org/10.1215/15228517-2005-008 pmid: 16533758
57	Berland GK, Elliott MN, Morales LS, Algazy JI, Kravitz RL, Broder MS, Kanouse DE, Muñoz JA, Puyol JA, Lara M, Watkins KE, Yang H, McGlynn EA. Health information on the Internet: accessibility, quality, and readability in English and Spanish. JAMA 2001; 285(20): 2612–2621 https://doi.org/10.1001/jama.285.20.2612 pmid: 11368735
58	D’Alessandro DM, Kingsley P, Johnson-West J. The readability of pediatric patient education materials on the World Wide Web. Arch Pediatr Adolesc Med 2001; 155(7): 807–812 https://doi.org/10.1001/archpedi.155.7.807 pmid: 11434848
59	Graber MA, Roller CM, Kaeble B. Readability levels of patient education material on the World Wide Web. J Fam Pract 1999; 48(1): 58–61 pmid: 9934385

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