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Readability And Quality Of Online Information In Spanish Regarding Varicose Vein Treatment
Ana Paula Morales Allende, MD, Jeffrey Indes, MD, Sonia Talathi, MD.
Montefiore Medical Center, Bronx, NY, USA.

OBJECTIVES: We evaluated the readability and quality of information regarding varicose vein treatment in Spanish using a popular search engine. METHODS: A Google© search was performed using the key phrase “venas varicosas,” meaning “varicose veins” in Spanish. The 75 top ranked sites were analyzed by a native Spanish speaking surgeon. Each site was assessed independently for readability using the Fernández-Huerta Formula (FH, a Spanish adaptation of the Flesch Reading Ease score). Thirty-seven websites with bilingual pages were used to compare the readability of both Spanish and English information. Web site quality was assessed using the DISCERN instrument. The country of origin, page source, and issuance of Health on the Net (HoN) Certification was recorded. Statistical analyses were performed using unpaired t-tests and ANOVA variance. RESULTS: The cohort consisted of 59 websites, most of the entire cohort (46%) and the top 15 sites (60%) were Healthcare/Academic sites with 47% having a HoN Certification. The average FH score was 65.6, corresponding to the 8th to 9th grade level. There was no significant difference in FH scores across the entire cohort (p=0.4675) or the top 15 sites (p=0.2196). There was a significant difference in DISCERN scores within the entire cohort (p=0.0160) but not in the top 15 sites (p=0.0615). There was a significant difference (p=0.0068) in FH scores between USA, Europe, Canada and other regions. There was no significant difference (p=0.1263) in DISCERN scores between these regions. Bilingual websites had an average 8-9th grade reading level (FH score 66.1) in Spanish and 10-12th grade in English (FRES score 57.7). CONCLUSIONS: The access of Spanish-speaking patients to understandable information regarding varicose veins is limited due to the advanced grade level seen on all types of websites. The quality of the information significantly declines in 41% of websites catered to commercializing venous disease. Healthcare/academic sites made up the majority of the top 15 sites and provided quality information without sacrificing readability. Bilingual websites, comprising 93% of the top 15 sites, contain information that is more readable in Spanish than English. Given the growing Spanish-speaking demographic, it is important that vascular surgeons participate in the creation of educational content addressing this patient population and improve access to information on varicose veins.
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