JAAOS - 2026-06-04 - Journal Article
A Patient-centered Approach to Analyzing the Quality, Credibility, and Readability of Spanish-language Online Patient Educational Materials on Pediatric Scoliosis.
Lopez JKM, Alegre DG, Holle AM, Cancio-Bello AM, Iturregui JM, Bennett DM, Esparza M
Topics
Key Takeaway
Zero of 61 Spanish-language online sources on pediatric scoliosis met the recommended <6th-grade reading level, and only 36% achieved adequate quality by Brief DISCERN criteria.
Summary Depth
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Summary
This study evaluated the quality, credibility, and readability of the top Spanish-language online patient education materials on pediatric scoliosis retrieved from Google, Yahoo, and Bing. Sixty-one sources were independently scored using JAMA Benchmark Criteria, Brief DISCERN, and the Fernández-Huerta Readability Index. Median readability corresponded to 8th–9th grade (target <6th grade), median JAMA score was 2/4, only 4 sites met all JAMA criteria, and only 36% met the Brief DISCERN threshold of >16; no significant difference existed between Physician/Hospital and Industry sources.
Key Limitation
The study measures website characteristics rather than patient comprehension or health outcomes, so the clinical impact of these readability and quality deficits on informed consent, brace compliance, or surgical decision-making remains unmeasured.
Original Abstract
INTRODUCTION
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.
METHODS
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.
RESULTS
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.
DISCUSSION AND CONCLUSION
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.