How easy is it to read hearing-related webpages in Japanese?

Purpose: To assess the readability of hearing-related information on the internet in the Japanese language and compare the readability between webpages by origin, type of organisation, and author. This study also aimed to assess the quality of that information using the Health on the Net Foundation (HONcode) certification. Method: Hearing-related search terms were identified by native Japanese speakers, resulting in five keywords. The keywords 聴覚障害 (hearing impairment), 難聴 (hearing loss), 補聴器 (hearing aid), 聞こえない (cannot hear), and 耳 (ear), were entered into the Japanese country code top-level domain (ccTLD) versions of the Google (google.com.jp) and Yahoo (yahoo.co.jp) search engines. The first 10 webpages retrieved from each search were recorded, resulting in 100 webpages. Information regarding webpage origin, type of organisation, author and HONcode certification status was also recorded. These were then matched against the inclusion/exclusion criteria, resulting in 28 unique webpages, whose readability was assessed using the Japanese Text Readability System formula: https://jreadability.net/en/. Descriptive statistics and a Box-Plot were used to assess the validity of the statistical data. A Chi Square test was used to determine whether the webpages were evenly distributed amongst the various characteristics recorded, and a univariate analysis of variance (UNIANOVA) was used to determine whether there were significant differences in readability of online hearing-related information between webpages. Results: All but one of the 28 webpages had a JReadability level of Upper Intermediate or higher. 75% of the webpages were categorised as “profit”, these webpages had significantly higher readability levels than “non-profit” webpages. The majority of the webpages originated from Japan. The author categorised as “professional” and “non-professional” was evenly distributed amongst the webpages. Readability levels did not significantly differ based on type of organisation, and author. None of the identified webpages had HONcode certification. Conclusion: The results of this study indicated that the majority of online hearingrelated information in the Japanese language is difficult to read. The clinical implications of these findings and the limitations of the study are discussed. As internet penetration rates continue to rise it is important that the issue of poor readability is addressed, and that further research is done to investigate whether the quality of online hearing-related information meets acceptable standards to inform patients