Readability, quality, and reliability of online informational texts about ear tubes

Yıl 2026, Cilt: 19 Sayı: 1, 69 - 79, 30.03.2026

Kerem Ersin , Halil Berkay Saldırım , Mısra Eren

https://izlik.org/JA59ER72UE

Öz

Aim: The aim of this study is to evaluate the readability level and content quality of health information on Turkish internet websites about “Ear Tubes.” Considering that this procedure is frequently performed in young children, the study particularly aims to identify the challenges parents face in understanding online information and to assess the reliability of the available resources. Method: In August 2025, the first 100 internet websites retrieved through a “Google” search using the keyword “Kulak Tüpü” (Ear Tube) were analyzed. Internet websites were classified by source type and assessed with the Ateşman and Çetinkaya-Uzun readability formulas. In addition, the DISCERN instrument was used to calculate reliability, information quality, and overall quality scores. The presence of otolaryngologist authorship, academic affiliation, and references was also evaluated. Results: Among the reviewed internet websites, 59% were personal, 29% hospital-based, 8% newspapers, and 4% company-sponsored. Of the contents, 66% were prepared by ENT specialists, and 67% had academic affiliation. Overall readability levels were found to be “moderately difficult,” corresponding to an 8th–9th grade reading level (Ateşman p=0.284; Çetinkaya p=0.159). The mean DISCERN score was 51.9, indicating a “good” level of quality. Significant differences were observed by source type; newspaper, personal, and hospital internet websites scored significantly higher than company internet websites. Surprisingly, newspaper articles showed higher reliability (p=0.009) and information quality (p=0.015) scores. Content with references had significantly higher reliability (p=0.006), information quality (p=0.042), and total DISCERN (p=0.016) scores. ENT specialist–based content was superior in terms of information quality (p=0.001), overall quality (p=0.008), and total DISCERN (p=0.006). Similarly, content with academic affiliation showed significantly higher information quality (p=0.001), overall quality (p=0.012), and total DISCERN (p=0.009) scores. Conclusion: Turkish internet websites on ear tube–related content generally have moderate readability and “good” overall quality. However, further simplification is required to ensure compliance with international standards. Findings reveal an inconsistent distribution of quality across online health resources and highlight that parents face considerable barriers in accessing reliable and comprehensible information. The results further suggest that physicians should play an active role in bridging the online information gap by providing patients with trustworthy and accessible health information.

Anahtar Kelimeler

Digital content , ear tubes , health literacy , readability

Kulak tüpü hakkında çevrim içi bilgilendirme metinlerinin okunabilirlik, kalite ve güvenilirliği

https://izlik.org/JA59ER72UE

Öz

Amaç: Bu çalışmanın amacı, “Kulak Tüpü” hakkında Türkçe internet sitelerindeki sağlık bilgilerinin okunabilirlik düzeyini ve içerik kalitesini değerlendirmektir. Özellikle küçük çocuklara uygulanan bu yöntem için ebeveynlerin çevrim içi bilgilere erişimde karşılaştıkları okuduğunu anlama sorunlarını ve bilgi güvenilirliğini ortaya koymak hedeflenmiştir. Yöntem: “Google” arama motorunda Ağustos 2025’te “Kulak Tüpü” anahtar kelimesiyle ulaşılan ilk 100 internet sitesi incelenmiştir. Kaynak türüne göre sınıflandırılan siteler, Ateşman ve Çetinkaya-Uzun okunabilirlik formülleri ile analiz edilmiştir. Ayrıca DISCERN ölçeği kullanılarak güvenilirlik, bilgi kalitesi ve genel kalite puanları hesaplanmıştır. Sitelerin KBB uzmanı temelli olup olmaması, akademik afiliasyon durumu ve referans kullanımı da değerlendirilmiştir. Bulgular: İncelenen sitelerin %59’u kişisel, %29’u hastane, %8’i gazete ve %4’ü firma kaynaklıydı. İçeriklerin %66’sı KBB uzmanı tarafından hazırlanmış, %67’sinde akademik afiliasyon mevcuttu. Okunabilirlik düzeyi tüm gruplarda “orta güçlükte” bulunmuş ve 8–9. sınıf eğitim seviyesine karşılık gelmiştir (Ateşman p=0.284; Çetinkaya p=0.159). DISCERN toplam puanı 51.9 ile “iyi” seviyede saptanmıştır. Kaynak türüne göre farklılıklar belirlenmiş; gazete, kişisel ve hastane siteleri firma sitelerine kıyasla anlamlı derecede daha yüksek puanlar almıştır. Özellikle gazete haberlerinin beklenmedik biçimde daha yüksek güvenilirlik (p=0.009) ve bilgi kalitesi (p=0.015) puanına sahip olduğu görülmüştür. Referans içeren içeriklerde güvenilirlik (p=0.006), bilgi kalitesi (p=0.042) ve toplam DISCERN (p=0.016) puanları anlamlı düzeyde daha yüksektir. KBB temelli içerikler bilgi kalitesi (p=0.001), genel kalite (p=0.008) ve toplam DISCERN (p=0.006) açısından üstün bulunmuştur. Akademik afiliasyonu olan içeriklerde bilgi kalitesi (p=0.001), genel kalite (p=0.012) ve toplam DISCERN (p=0.009) puanları bakımından anlamlı düzeyde daha yüksek sonuç vermiştir. Sonuç: Türkçe internet sitelerindeki kulak tüpü içerikleri genel olarak orta düzeyde okunabilirliğe ve “iyi” düzeyde kaliteye sahiptir. Ancak uluslararası standartlarla uyumlu hale gelebilmesi için ek sadeleştirmelere ihtiyaç duyulmaktadır. Bulgular, internet sitelerindeki sağlık içeriklerinin kalite açısından tutarsız bir dağılım gösterdiğini ve ebeveynlerin güvenilir ve anlaşılır bilgiye ulaşma sürecinde önemli engellerle karşılaştığını ortaya koymaktadır. Ayrıca, hekimlerin süreçte aktif rol alarak çevrim içi bilgi boşluğunu dengelemeleri ve hastalara güvenilir, anlaşılır bilgilendirme sağlamaları gerektiği sonucuna ulaşılmıştır.

Anahtar Kelimeler

Dijital içerikler , kulak tüpü , okunabilirlik , sağlık okuryazarlığı

Kaynakça

• Rosenfeld RM, Keppel KL, Vaughan WK, Monjur TM. Plain Language Summary: Tympanostomy (Ear) Tubes in Children. Otolaryngology - Head and Neck Surgery (United States). 2022 Feb 1;166(2):207–16.
• Rosenfeld RM, Tunkel DE, Schwartz SR, Anne S, Bishop CE, Chelius DC, et al. Clinical Practice Guideline: Tympanostomy Tubes in Children (Update). Otolaryngology - Head and Neck Surgery (United States). 2022 Feb 1;166(1_suppl):S1–55.
• Newby MD, Zalzal HG, Ramadan J, Kellermeyer BM, Carr MM. Decision Quality Among Parents Who Are Offered Ventilation Tube Insertion for Their Children. Annals of Otology, Rhinology and Laryngology. 2020 Aug 1;129(8):748–54.
• Harris VC, Links AR, Hong P, Walsh J, Schoo DP, Tunkel DE, et al. Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement. Laryngoscope. 2018 Feb 1;128(2):496–501.
• Sanad SA, Mokhtar AM, Alharbi MO, Bukhari AF, Zawawi F. Qualitative Assessment of Quality and Readability of Patient-Directed Online Resources for Cochlear Implants in Children. Otolaryngology - Head and Neck Surgery (United States). 2023 Jul 1;169(1):143–50.
• Tsai J, Rosenheck RA. Use of the internet and an online personal health record system by US veterans: comparison of Veterans Affairs mental health service users and other veterans nationally. J Am Med Inform Assoc. 2012 Nov [cited 2025 Aug 28];19(6):1089.
• Kuehn BM. More Than One-Third of US Individuals Use the Internet to Self-diagnose. JAMA. 2013 Feb 27 [cited 2025 Aug 28];309(8):756–7.
• Yılmaz FH, Tutar MS, Arslan D, Çeri A. Readability, understandability, and quality of retinopathy of prematurity information on the web. Birth Defects Res. 2021;113(12).
• Raj S, Sharma VL, Singh AJ, Goel S. Evaluation of Quality and Readability of Health Information Websites Identified through India’s Major Search Engines. Adv Prev Med. 2016;2016.
• Zhang Y, Sun Y, Xie B. Quality of health information for consumers on the web: A systematic review of indicators, criteria, tools, and evaluation results. J Assoc Inf Sci Technol. 2015;66(10).
• Ateşman E. Türkçede Okunabilirliğin Ölçülmesi. Dil Dergisi, Sayı 58. 1997 Jan 1 [cited 2025 Sep 2].
• Çetinkaya G, Uzun L. Türkçe Metinlerin Okunabilirlik Düzeylerinin Tanımlanması ve Sınıflandırılması- ProQuest. [Ankara]: Ankara Üniversitesi; 2010 [cited 2025 Sep 2].
• Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health (1978). 1999 Feb 1 [cited 2025 Aug 29];53(2):105–11.
• Baker JF, Devitt BM, Lynch S, Green CJ, Byrne DP, Kiely PJ. Internet use by parents of children attending a dedicated scoliosis outpatient clinic. European Spine Journal. 2012 Oct;21(10):1972–7.
• Arulanandam B, Selvarajan A, Piche N, Sheldon S, Bloom R, Emil S, et al. Use of a risk communication survey to prioritize family-valued outcomes and communication preferences for children undergoing outpatient surgical procedures. J Pediatr Surg. 2022 May 1;57(5):788–97.
• Stephens JH, O’Keefe M, Schembri M, Baghurst PA. Parents Need More Support: A Qualitative Study of the Experiences of Australian Parents Who Are Waiting for Surgical Intervention for Their Children With Otitis Media. J Patient Exp. 2020 Oct;7(5):717–25.
• Claus LE, Links AR, Amos J, Dicarlo H, Jelin E, Koka R, et al. Parent Experience of Communication about Children’s Surgery: A Qualitative Analysis. Pediatr Qual Saf. 2021 May 19;6(3):E403.
• Eysenbach G, Köhler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. Br Med J. 2002 Mar 9;324(7337):573–7.
• Bange M, Huh E, Novin SA, Hui FK, Yi PH. Readability of patient education materials from radiologyinfo.org: Has there been progress over the past 5 years? American Journal of Roentgenology. 2019 Aug 6 [cited 2025 Sep 2];213(4):875–9.
• McKearney TC, McKearney RM. The quality and accuracy of internet information on the subject of ear tubes. Vol. 77, International Journal of Pediatric Otorhinolaryngology. 2013. p. 894–7.
• Wrigley Kelly NE, Murray KE, McCarthy C, O’Shea DB. An objective analysis of quality and readability of online information on COVID-19. Health Technol (Berl). 2021 Sep 1 [cited 2025 Sep 3];11(5):1093–9.
• Georgsson S, Carlsson T. Readability, understandability and language accessibility of Swedish websites about the coronavirus disease 2019: a cross-sectional study. BMC Med Inform Decis Mak. 2022 Dec 1 [cited 2025 Sep 3];22(1):1–9.
• Rossi NA, French KR, Evans CL, Ohlstein JF, Neve LD, Daram S, et al. Trending Tubes: A Social Media Analysis of Tympanostomy Tubes in Children. OTO Open. 2022 Mar 1;6(1).
• Polat E, Polat YB, Senturk E, Dogan R, Yenigun A, Tugrul S, et al. Evaluating the accuracy and readability of ChatGPT in providing parental guidance for adenoidectomy, tonsillectomy, and ventilation tube insertion surgery. Int J Pediatr Otorhinolaryngol. 2024 Jun 1;181.
• Tahir M, Usman M, Muhammad F, ur Rehman S, Khan I, Idrees M, et al. Evaluation of Quality and Readability of Online Health Information on High Blood Pressure Using DISCERN and Flesch-Kincaid Tools. Applied Sciences 2020, Vol 10, Page 3214. 2020 May 5 [cited 2025 Sep 3];10(9):3214.
• Kaicker J, Debono VB, Dang W, Buckley N, Thabane L. Assessment of the quality and variability of health information on chronic pain websites using the DISCERN instrument. BMC Med. 2010 Oct 12 [cited 2025 Sep 3];8:59.
• Tan DJY, Ko TK, Fan KS. The Readability and Quality of Web-Based Patient Information on Nasopharyngeal Carcinoma: Quantitative Content Analysis. JMIR Form Res. 2023 Nov 27 [cited 2025 Sep 3];7(1):e47762.
• Fackrell K, Hoare DJ, Smith S, McCormack A, Hall DA. An evaluation of the content and quality of tinnitus information on websites preferred by General Practitioners. BMC Med Inform Decis Mak. 2012 Jul 12 [cited 2025 Sep 3];12(1):1–13.
• Sahin E, Seyyar M. Assessing the scientific quality and reliability of YouTube videos about chemotherapy. Medicine (United States). 2023 Nov 10 [cited 2025 Sep 3];102(45).