Investigating Health Disparities in Online Pediatric Skull Fracture Information: An Analysis of Resource Quality and Readability.

Introduction Families often seek medical information online; this study assesses the accessibility of online pediatric skull fracture materials by evaluating the quality and readability of easily obtained sources. Methods Six terms were queried using Google (Google LLC, Mountain View, California, United States), Bing (Microsoft Corporation, Redmond, Washington, United States), and Yahoo (Yahoo Inc., New York City, New York, United States). Twenty-four unique websites were categorized as commercial, academic, or medical practice. Readability was assessed using Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL), while quality was measured using Quality Evaluation Scoring Tool (QUEST) and the DISCERN tool. Analysis of variance (ANOVA) compared readability and quality scores by authorship classification. Linear regression was performed for QUEST vs DISCERN scores and quality vs readability. Results Among 24 unique sites, 8 (33%) were commercial, 10 (42%) from academic institutions, and 6 (25%) from medical practices. Mean FRES and FKGL scores corresponded to an eighth-grade reading level. Mean DISCERN and QUEST scores were 48.8 ± 8.7 (Fair) and 15.0 ± 6.3 (Fair). ANOVA indicated no significant difference in readability scores by website type (p > 0.05). Linear regression revealed a significant correlation between QUEST and DISCERN scores (p = 0.011) but no significant correlation between readability and quality metrics (p = 0.31). Conclusions Online materials do not meet the American Medical Association's recommended sixth-grade level. Sites lacked proper source attribution and clear explanations of treatment options. QUEST and DISCERN both measure quality in comparable ways. Readability and quality were not significantly linked. Complex language, reflected in high readability scores, may hinder health literacy, especially among lower socioeconomic status populations. Efforts should focus on improving content quality while simplifying language to promote health equity.