Readability of online health information: A meta-narrative systematic review
Abstract
Online health information should meet the reading level for the general public (set at sixth-grade level). Readability is a key requirement for information to be helpful and improve quality of care. The authors conducted a systematic review to evaluate the readability of online health information in the United States and Canada. Out of 3743 references, the authors included 157 cross-sectional studies evaluating 7891 websites using 13 readability scales. The mean readability grade level across websites ranged from grade 10 to 15 based on the different scales. Stratification by specialty, health condition, and type of organization producing information revealed the same findings. In conclusion, online health information in the United States and Canada has a readability level that is inappropriate for general public use. Poor readability can lead to misinformation and may have a detrimental effect on health. Efforts are needed to improve readability and the content of online health information.
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The readability of online health information is often far above the recommended readability level.
“However, the readability of online health information is often far above the recommended readability level (Daraz et al., 2018; Valizadeh-Haghi et al., 2021).”
From Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India (2025) · cites this paper as Daraz et al., 2018
Cites
RAMESES publication standards: meta-narrative reviews
Wong, G., Greenhalgh, T., Westhorp, G., Buckingham, J., & Pawson, R. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-20 · Cited by 610 · see citing works
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Ayre, J., Mac, O., McCaffery, K., McKay, B. R., Liu, M., Shi, Y., Rezwan, A., & Dunn, A. G. (2024) · Journal of General Internal Medicine · doi:10.1007/s11606-023-08469-w · Cited by 124 · see citing works
Sillence, E., Blythe, J. M., Briggs, P., & Moss, M. (2019) · Journal of Medical Internet Research · doi:10.2196/11125 · Cited by 72 · see citing works
An objective analysis of quality and readability of online information on COVID-19
Wrigley Kelly, N. E., Murray, K. E., McCarthy, C., & O’Shea, D. B. (2021) · Health and Technology · doi:10.1007/s12553-021-00574-2 · Cited by 69 · see citing works
Ishikawa, H., Miyawaki, R., Kato, M., Muilenburg, J. L., Tomar, Y. A., & Kawamura, Y. (2025) · SSM - Population Health · doi:10.1016/j.ssmph.2025.101844 · Cited by 17 · see citing works
- Authors
- Daraz, L., Morrow, A. S., Ponce, O. J., Farah, W., Katabi, A., Majzoub, A., Seisa, M. O., Benkhadra, R., Alsawas, M., Larry, P., & Murad, M. H.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Daraz, Lubna
- ORCID
- Venue
- American Journal of Medical Quality
- Published
- 2018-01-18
- Volume
- 33
- Issue
- 5
- Pages
- 487-492
- ISSN
- 1062-8606 (ISSN-L)
- 1555-824X
- OpenAlex
- W2792805190
- Cited by
- 278
- References
- 1
- Citations by year
- 2026: 50 · 2025: 58 · 2024: 49 · 2023: 22 · 2022: 36 · 2021: 26 · 2020: 17 · 2019: 13 · 2018: 7
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Medical Quality (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Physical Sciences › Computer Science › Artificial Intelligence › Text Readability and Simplification
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- readability, online health information, health websites, health literacy, health misinformation, patient education, health information quality
- MeSH terms
- Cross-Sectional Studies, Humans, United States, Internet, Comprehension, Consumer Health Information, Health Literacy
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