Readability Analysis of Online Headache and Migraine Information
Authors: Russo Antonio , Lavorgna Luigi , Silvestro Marcello , Abbadessa Gianmarco , Bisecco Alvino , Trojsi Francesca , Tessitore Alessandro , Tedeschi Gioacchino , Bonavita Simona 
Published: May 2020

BackgroundAlthough migraine is recognized as one of the most common and disabling diseases in the world, it is nonetheless still underestimated, underdiagnosed, and undertreated. The fact that migraine patients often tend to access the Web to search for headache‐related information hinders patient‐doctor relationships and one should also bear in mind that, unfortunately, text readability and medical literacy in the overall population may be the reason why patients' understanding of health information is compromised.AimWe aimed to assess the readability of the home page of the top 10 patient – oriented migraine‐related websites and the educational level required to be in a position to broach them.MethodsOn April 15, 2018, we conducted a descriptive study on the international version of Google by entering the words “headache” and “migraine.” We then analyzed the overall level of readability of texts of the home pages of the top 10 patient‐oriented websites, by means of the Simple Measure of Gobbledygook Readability Calculator.ResultsEntering “headache” on the home pages of the top 10 patient‐oriented websites on Google we found that to understand these particular websites with ease, an average grade level of 12.4 (±1.5 standard deviation, SD) and an average 13.3 years of formal education (±1.7 SD) were required. Similarly, typing “migraine” on Google we found an average grade level of 10.8 (±1.2 SD) and an average of 12.5 years of formal education (±1.9 SD) were required. The most frequently viewed websites all failed to meet the USA National Institutes of Health guidelines, which recommend a range between 6th and 7th grade level readability.DiscussionThe present study shows the low readability level resulting from the top 10 patient‐oriented headache/migraine websites and the consequent barrier this creates in the dissemination of headache/migraine‐related medical information. Although the actual physicians, both primary care physicians and headache specialists are the principal source of understandable headache‐related information, only a minority of people consult these professionals. Given the foregoing, the majority of migraine patients is, therefore, unable to obtain adequate comprehensible health information on the Web. Furthermore, the existing gap between migraine‐related website content readability and the unmet need for migraine patients to obtain pertinent and correct information might well contribute to the worldwide neglect of migraine as a major public health problem.ConclusionPhysician experts in headache and migraine should actively cooperate in planning informative material to establish what information patients need to know, how they should use it, and how readable that material actually is. Readability ought to be established before the final website publication. Plain language ought to be used and written messages should be supplemented with visual content such as simple drawings. We recommend the setting up of a new dynamic, modern, plain‐talking, and efficient approach in communication aimed at catching the public’s attention with its readability and thus satisfying a migraine and headache web scenario.