Available online 30 December 2022

Online information on incisional hernia repair assessed using five validated tools

Websites demonstrated poor overall quality and questionable reliability

All sites analyzed were written above the recommended 6th grade reading level

Patients increasingly access online materials for health-related information. Using validated assessment tools, we aim to assess the quality and readability of online information for patients considering incisional hernia (IH) repair.

The top three online search engines (Google, Bing, Yahoo) were searched in July 2022 for “Incisional hernia repair” and “Surgical hernia repair”. Included websites were classified as academic, hospital-affiliated, commercial, and unspecified. The quality of information was assessed using the Journal of the American Medical Association (JAMA) benchmark criteria (0–4), DISCERN instrument (16–80), and the presence of Health On the Net code (HONcode) certification. Readability was assessed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) tests.

25 unique websites were included. The average JAMA and DISCERN scores of all websites were 0.68 ± 1.02 and 36.50 ± 10.91, respectively. Commercial sites showed a significantly higher DISCERN mean score than academic sites (p = 0.034), while no significant difference was demonstrated between other website categories. 3 (12%) websites reported HONcode certification and had significantly higher JAMA (p = 0.016) and DISCERN (p = 0.045) mean scores than sites without certification. Average FRE and FKGL scores were 39.84 ± 13.11 and 10.62 ± 1.76, respectively, corresponding to college- and high school-level comprehensibility.

Our findings suggest online patient resources on IH repair are of poor overall quality and may not be comprehensible to the public. Patients accessing internet resources for additional information on IH repair should be made aware of these inadequacies and directed to sites bearing HONcode certification.

Incisional hernia

Hernia repair surgery

Online information

Patient education

Quality

Readability

© 2022 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.