The quality of websites addressing fibromyalgia: an assessment of quality and readability using standardised tools

Background Patients living with fibromyalgia strongly prefer to access health information on the web. However, the majority of subjects in previous studies strongly expressed their concerns about the quality of online information resources. Objectives The purpose of this study was to evaluate existing online fibromyalgia information resources for content, quality and readability by using standardised quality and readability tools. Methods The first 25 websites were identified using Google and the search keyword ‘fibromyalgia’. Pairs of raters independently evaluated website quality using two structured tools (DISCERN and a quality checklist). Readability was assessed using the Flesch Reading Ease score maps. Results Ranking of the websites' quality varied by the tool used, although there was general agreement about the top three websites (Fibromyalgia Information, Fibromyalgia Information Foundation and National Institute of Arthritis and Musculoskeletal and Skin Diseases). Content analysis indicated that 72% of websites provided information on treatment options, 68% on symptoms, 60% on diagnosis and 40% on coping and resources. DISCERN ratings classified 32% websites as ‘very good’, 32% as ‘good and 36% as ‘marginal’. The mean overall DISCERN score was 36.88 (good). Only 16% of websites met the recommended literacy level grade of 6–8 (range 7–15). Conclusion Higher quality websites tended to be less readable. Online fibromyalgia information resources do not provide comprehensive information about fibromyalgia, and have low quality and poor readability. While information is very important for those living with fibromyalgia, current resources are unlikely to provide necessary or accurate information, and may not be usable for most people.
Article summary Article focus The purpose of the study was to gain a better understanding of the online information resources available for people with fibromyalgia and to evaluate those resources for content, quality and readability. To determine the content, website quality and readability of the most readily retrieved information available on the web when searching for fibromyalgia information. Key messages Most existing websites do not provide comprehensive information on fibromyalgia. Websites are highly variable in terms of quality. Higher quality websites do not present information in language/reading levels appropriate for the general population. Strengths and limitations of this study This study examines the quality of online fibromyalgia resources. Standardised quality and readability tools were used to assess quality and readability. There is no gold standard for comparison or ways to evaluate the quality of websites. The quality issue was discussed using critical appraisal tools designed for the lay public. The readability score may vary for some websites as it may be related to the use of technical terms such as fibromyalgia.