Quality, readability, and transparency of Arabic online health information on temporomandibular disorders: An infodemiological analysis of 408 websites.

OBJECTIVES: Temporomandibular disorders (TMDs) are a common cause of chronic orofacial pain, and patients are increasingly using the Internet to locate health information. However, the quality of web-based information, especially in Arabic, has not been previously evaluated. METHODOLOGY: In this study, we analyzed 408 Arabic language websites, including those for medical centers, dental centers, non-profit organizations, and universities. The DISCERN instrument, Journal of the American Medical Association standards, and Health On the Net (HONcode) certification were used to assess quality and reliability. Adapted Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Simplified Measure of Gobbledygook (SMOG) indices were used as measures of readability. RESULTS: Quality and transparency varied significantly across website affiliations (p < 0.001). Only 11% of sites had a HONcode certification, 31.4% included source attributions, and 59.6% disclosed authorship. The overall mean DISCERN quality scores ranged between 3.33 and 3.87 (scale 1-5). The quality varied significantly between affiliated websites (p < 0.001). Video content was present on 6.9% of the websites and audio content on 0.03% of websites. No validated Arabic-language instruments exist for readability assessment, so the FRE, FKGL, and SMOG indices (all developed for English) produced unrealistic values (mean FRE = 174.41), and given the scale of 0-100, it was impossible to reach any conclusions. CONCLUSION: Significant shortcomings were found in terms of transparency, evidence attribution, and balance in the presentation of TMD information online in Arabic. We recommend the creation of evidence-based, methodological, and patient-centered Arabic digital health content on TMDs.