Background Parents often access online resources to educate themselves on their child's condition. In-toeing, also referred to as pigeon toeing, is a common paediatric condition that has a variety of causes and is often a cause of concern for parents. With the increasing usage of the internet, parents of children with this condition may look to the web for answers. However, to be understood by the average adult, online health information must be written at an elementary school reading level. We hypothesised that currently available online resources regarding in-toeing would score poorly on objective measures of readability and understandability. Methods Patient education materials were identified via three commonly used online search engines (Google.com, Yahoo.com, and Bing.com). The terms "intoeing" and "pigeon toeing" were used for the search. From the top 50 search results, websites were included if directed at educating patients and their families regarding in-toeing. News articles, non-text material (video), industry websites, and articles not related to in-toeing were excluded. The readability was analysed using a specialised website www.readable.com to produce the following three scores: Gunning Fog Index (GFI), Flesch Reading Ease (FRE), and Flesch-Kincaid Grade (FKG). Understandability was calculated using the 19-point Patient Education Materials Assessment Tool (PEMAT). Results After removing duplicates, 84 unique websites were assessed for inclusion. A total of 48 websites and articles (57.14%) met the inclusion criteria. Of note, 23 articles out of 84 (27.38%) were excluded as they were intended for healthcare professionals. The means for the FRE, FKG, and GFI were 57.92 (±12.26), 7.92 (±1.91), and 9.35 (±2.36), respectively. Less than half of online resources had an FRE score at or higher than the recommended reading level for the general population. Mean understandability scores were 69.63% (±11.55%), with only 45.83% of articles being greater than the 70% requirement of adequate understandability. Conclusion Overall, online in-toeing educational materials scored poorly with respect to readability and understandability. Given the popularity of online resources in patient education, we should seek to improve this situation. Articles that are easier to read are thus more accessible to the general public and will aid in the shared decision-making process. Improved patient and parent satisfaction and overall standard of care can be expected.
Keywords: femoral anteversion; in-toeing; metatarsus adductus; pigeon toeing; readability.
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