Quality and Readability of Online Rhinoplasty Information: A Systematic Review and Meta-analysis.

Abstract

Patients increasingly rely on online resources for rhinoplasty education, yet the readability and reliability of these materials remain inconsistent. This systematic review and meta-analysis evaluated the quality and accessibility of online rhinoplasty-related patient education materials using DISCERN scores for reliability and Flesch-Kincaid Grade Level for readability. A systematic search identified 12 studies analyzing 882 websites and 259 videos. Meta-analyses were conducted using random-effects models. Subgroup analyses and meta-regression explored differences in information quality by source type and publication year. The pooled mean DISCERN score across 5 studies (n = 197) was 42.96 (95% confidence interval: 36.28-49.63), indicating moderate quality. Heterogeneity was high (I 2 = 93.8%, Q = 80.43, P < 0.0001), reflecting inconsistencies in study methodologies and content sources. Academic websites trended toward higher quality (mean DISCERN: 43.36) than private websites (36.40), but the difference was not statistically significant ( P = 0.05906). Readability analysis (n = 95) showed a pooled Flesch-Kincaid Grade Level of 10.31 (95% confidence interval: 10.26-10.37), well above the recommended 6th-8th grade level. Heterogeneity was minimal (I 2 = 0.0%, Q = 0.84, P = 0.3597), suggesting consistently excessive readability demands. No significant improvements in information quality were observed over time (pre-2020 DISCERN: 42.04 vs post-2020: 43.81; P = 0.8272). Online rhinoplasty materials remain difficult to read and of suboptimal quality, with no meaningful improvements over time. Standardized, accessible, and high-quality patient education resources are needed to support informed decision making.