A Patient-centered Approach to Analyzing the Quality, Credibility, and Readability of Spanish-language Online Patient Educational Materials on Pediatric Scoliosis.

Abstract

Ethnic, racial, and socioeconomic disparities are well-documented in orthopaedics, including pediatric scoliosis. Spanish-speaking patients face compounding disparities in accessing linguistically and culturally concordant physician-patient interactions and patient resources. This study contributes to existing literature by providing an updated and extended analysis of the quality, credibility, and readability of online Spanish-language patient educational materials on pediatric scoliosis. A search for the top 50 results of "escoliosis en los niños" (scoliosis in children) was conducted across search engines. Spanish-speaking patients are likely to interact with Google, Yahoo, and Bing. Duplicates were removed, primary review assessed inclusion and exclusion criteria, and secondary review evaluated relevance. Each source was assessed independently by two reviewers for the following: categorization, Journal of American Medical Association Benchmark Criteria, Brief DISCERN questionnaire, and the Fernández-Huerta Index for credibility, quality, and readability, respectively. Scores were compared using Wilcoxon rank-sum tests. Of the 61 sources, most were categorized as Physician/Community Hospital, Industry, and News. The median readability score aligned with an eighth-grade to ninth-grade reading level. No websites achieved the recommended reading level (<6th grade) for patient educational materials. The median Journal of American Medical Association Benchmark score was 2 (interquartile range, 1 to 3), with only four websites meeting all criteria. The median Brief DISCERN score was 14 (interquartile range, 11 to 18), with only 36% meeting the >16 threshold for adequate quality. No statistical differences were observed in quality, credibility, or readability between the two most common categories: Physician/Community Hospital and Industry. These findings revealed an insufficient standard of resources on pediatric scoliosis that Spanish-speaking patients are likely to access through online search engines. Given disparities in orthopaedic care for Spanish-speaking patients, this highlights a need for increased awareness among healthcare professionals and institutions to create accessible, credible, transparent, and readable resources on pediatric scoliosis in Spanish.