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///2018 Abstract Details
2018 Abstract Details2019-08-02T15:57:01-05:00

Readability, Content, Quality and Accuracy Assessment of Internet-Based Patient Education Materials Relating to Labor Epidural Analgesia

Abstract Number: T3A-5
Abstract Type: Original Research

Jessica Murphy MD, MSc1 ; Jessica Vaughn MD2; Katherine Gelber MD3; Andrew Geller MD4; Mark Zakowski MD5

Introduction: With 94% of pregnant women searching the internet for health information1, the quality of information is important. Web-based patient education materials (PEMs) related to labor analgesia are frequently above the sixth-grade reading level recommended by the US Dept of Health and Human Services2,3. Thus, we compared the readability, content, quality and accuracy of PEMs from professional society websites and the top search engine results.

Methods: We compared PEMs for “labor epidural” from the first ten Google results with the major anesthesiology and obstetric society websites (N=13). Readability was assessed utilizing the Flesch-Kincaid Grade Level (FKGL), Gunning Frequency of Gobbledygook (FOG), Simple Measure of Gobbledygook (SMOG), Flesh Reading Ease Score and Coleman-Liau indices. PEM content was reviewed for inclusion of specific topics related to labor epidural analgesia. Quality was assessed using the Patient Education Materials Assessment Tool for Print (PEMAT)4. PEMs were independently graded for accuracy by a panel of obstetric anesthesiologists. Society and non-society PEM readability, quality and accuracy scores were compared using the independent t-test and content was compared using the Chi-square test, with P<.05 significant.

Results: The society PEMs were more readable than non-society PEMs, though the mean of both groups was above the recommended sixth-grade reading level (Table 1). The mean PEMAT understandability and accuracy scores were significantly higher for society websites compared to non-society websites (Table 1). The most frequent topics included: benefits (96%), effects on labor (87%) and post-dural puncture headache (78%). Society websites more frequently mentioned alternative analgesic options and paralysis, while shivering and effect on labor or delivery was more frequently covered in non-society websites (Table 1).

Conclusions: Google results lead to non-society PEMs of variable quality and readability. Non-society PEMs should be improved or patients should be directed to society PEMs to be better informed about labor epidural analgesia. Inaccurate information may lead to incorrect expectations and conflict during labor with potentially lower satisfaction.


1. Huberty et al. Matern Child Health J 2013;17(8):1363–72

2. Boztas et al. Medicine 2017 Nov;96(45):e8526

3. Patel et al. Anesth Analg 2015 Nov;121(5):1295-300

4. Shoemaker et al. AHRQ Publication No. 14-0002-EF Nov 2013

SOAP 2018