Evaluation of Readability Levels of Online Hallux Valgus Content
Keywords:
Comprehension, Hallux Valgus, Health Literacy, Internet, ReadabilityAbstract
Purpose: This study aimed to evaluate the readability levels of Turkish web-based information related to hallux valgus, a common forefoot deformity.
Methods: A descriptive content analysis was conducted. Using the keyword “Halluks Valgus,” Turkish web pages accessible via Google Turkey were screened in November 2025. Among the first 97 search results, 46 eligible pages containing textual health information were included based on predefined criteria. Readability levels were assessed using the Ateşman Readability Index. Each text was analyzed through an online tool to obtain structural linguistic metrics, and readability scores were classified according to the Ateşman scale. Descriptive statistics were calculated using IBM SPSS 25.0.
Results: Among the included online sources, 44.7% were authored by physicians, 36.2% by hospitals, and 19.1% by other providers. Author information was available in 66% of the content, while 72.3% of pages were up-to-date. The mean Ateşman score was 57.91±6.04, indicating a moderate difficulty level. Overall, 89.4% of texts were categorized as moderately difficult, 2.1% as easy, and 8.5% as difficult. More than half of the content corresponded to an 11th–12th grade reading level.
Conclusion: Turkish online materials on hallux valgus generally require a high reading level and exhibit moderate readability. The frequent use of technical terminology and long sentence structures may limit accessibility for individuals with low health literacy. Improving clarity, simplifying language, and ensuring regular content updates may enhance the effectiveness and usability of digital health communication.
References
1. Cai, Y., Song, Y., He, M. et al. Global prevalence and incidence of hallux valgus: a systematic review and meta-analysis. J Foot Ankle Res 16, 63 (2023).
2. Ettinger, S., Spindler, F. T., Marschall, U., Polzer, H., Stukenborg-Colsman, C., †, & Baumbach, S. F. (2025). Hallux Valgus: Prevalence and Treatment Options. Deutsches Arzteblatt international, 122(11), 308–314. https://doi.org/10.3238/arztebl.m2025.0068
3. Phelps, C. R., Shepard, S., Hughes, G., Gurule, J., Scott, J., Raszewski, J., ... & Vassar, M. (2023). Insights into patients questions over bunion treatments: a Google study. Foot & Ankle Orthopaedics, 8(3), 24730114231198837.
4. Bujnowska-Fedak, Maria M., Joanna Waligóra, and Agnieszka Mastalerz-Migas. "The internet as a source of health information and services." Advancements and innovations in health sciences. Cham: Springer International Publishing, 2019. 1-16.
5. Drewniak, D., Glässel, A., Hodel, M., & Biller-Andorno, N. (2020). Risks and benefits of web-based patient narratives: systematic review. Journal of medical Internet research, 22(3), e15772.
6. Halain, A. A., Yoong, T. L., Chan, C. M., Ibrahim, N. A., & Abdullah, K. L. (2022). Development and validation of an educational information web page for family members with relatives in the Intensive Care Unit (ICU). Nurse Education in Practice, 61, 103324.
7. Kelly, L., Jenkinson, C., & Ziebland, S. (2013). Measuring the effects of online health information for patients: item generation for an e-health impact questionnaire. Patient education and counseling, 93(3), 433-438.
8. Lemire, M., Paré, G., Sicotte, C., & Harvey, C. (2008). Determinants of Internet use as a preferred source of information on personal health. International journal of medical informatics, 77(11), 723-734
9. Zhang, Y., & Kim, Y. (2022). Consumers’ evaluation of web-based health information quality: meta-analysis. Journal of medical Internet research, 24(4), e36463.
10. Kalyoncu, R., & Memiş, M. (2024). Türkçe İçin Oluşturulmuş Okunabilirlik Formüllerinin Karşılaştırılması ve Tutarlılık Sorgusu. Ana Dili Eğitimi Dergisi, 12, 417–436.
11. T.C. Sağlık Bakanlığı (2018). Türkiye Sağlık Okuryazarlığı Araştırması-2. Ankara: Sağlık Araştırmaları Genel Müdürlüğü
12. Ateşman, E. (1997). Türkçede okunabilirliğin ölçülmesi. Dil Dergisi, 58, 71–74.
13. Bezirci, B., & Yılmaz, A. E. (2010). Metinlerin Okunabilirliğinin Ölçülmesi Üzerine Bir Yazılım Kütüphanesi ve Türkçe için Yeni Bir Okunabilirlik Ölçütü. DEUFMD, 12(3), 49-62.
14. Çetinkaya, A., & Uzun, L. (2010). Okunabilirlik: Kavramlar, ölçütler, yöntemler. Int J Billing, 6(1), 73–95.
15. Yaran, M., & Özkan, E. (2022). Ergoterapi ile İlgili Çevrimiçi Bilgilerin Kalitesi ve Okunabilirliği. ERED, 10, 45–52.
16. Turan Dizdar, H., Kent, A. E., & Işık, İ. (2024). Quality and Readability of Turkish Language Internet Materials About Tinnitus: Cross-Sectional Research Türkiye Klinikleri Sağlık Bilimleri Dergisi, 9(3).
17. Sezin, R. K., & Biçen, Ş. N. (2023). Readability and Quality Levels of Online Patient Information Texts Regarding Hoarseness of Voice. J. Ear Nose Throat Head Neck Surg., 31(3), 170–178.
18. Yılmaz, K., & Yaran, M. (2024). Skolyozla İlgili Çevrim İçi İçeriğin Okunabilirliğinin ve Hedef Kitleye Uygunluğunun Değerlendirilmesi. KTOKÜSB-D, 5, 256–264.
19. Tahir, E., Kent, A.E. (2021). Baş dönmesi ile ilgili internet kaynaklı hasta bilgilendirme metinlerinin okunabilirlik düzeyleri. KBB-Forum. 2021; 20(2):163-170.
20. Özbek, İ. C. (2025). Evaluation of Artificial Intelligence Supported Osteoarthritis Information Texts: Content Quality and Readability Analysis. J PMR Sci, 28(1), 21–29.
21. Önder, E., Gerdan, H., & Kesikbaş, G. (2025). Karpal Tünel Sendromu İçeriklerinin Okunabilirlik Düzeyleri: Klinik Bilgilere Erişim. Samsun Sağlık Bilimleri Dergisi, 10(2), 281-295.
22. Tartaglione, J. P., Rosenbaum, A. J., Abousayed, M., Hushmendy, S. F., & DiPreta, J. A. (2016). Evaluating the Quality, Accuracy, and Readability of Online Resources Pertaining to Hallux Valgus. Foot Ankle Spec, 9(1), 17-23. doi:10.1177/1938640015592840
23. Okuhara, T., Furukawa, E., Okada, H., & Kiuchi, T. (2024). Readability of online and offline written health information: a protocol of a systematic review of systematic reviews. BMJ Open, 14(12), e079756. doi:10.1136/bmjopen-2023-079756
24. Sentell, T. L., & Halpin, H. A. (2006). Importance of adult literacy in understanding health disparities. Journal of general internal medicine, 21(8), 862-866.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Gözde Kesikbaş Kurt, Elif Önder

This work is licensed under a Creative Commons Attribution 4.0 International License.

