ArticleCureus2026
Assessing the Readability of Online Keloid Resources.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKeloids are fibroproliferative scars that can disproportionately affect individuals with skin of color. Given the complexity of treatment options, many patients seek guidance through online health resources. However, these materials may not be written at a level accessible to the general public, particularly those with limited health literacy.
objectiveTo evaluate the readability of the top 100 Google search results for "keloid scar" and determine whether these online patient education materials (PEMs) meet the readability standards recommended by the American Medical Association (AMA).
methodsA Google search was conducted on April 29, 2025, using incognito mode with cleared cookies to minimize bias. The first 100 websites were screened, with exclusions for duplicate content, insufficient text (<250 words), scientific articles, clinician-targeted pages, and non-educational material. A total of 40 websites met the inclusion criteria. Readability was assessed using six validated formulas: Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook (SMOG), Gunning Fog, Coleman-Liau, Automated Readability Index, and Linsear Grade Level. Mean grade-level scores were calculated and stratified by source type.
resultsOnly 12.5% (5/40) of keloid-related PEMs had an average grade-level score at or below the AMA's recommended sixth-grade threshold. The average readability across all materials was at the 10th-grade level (mean=9.54; range 6.00-12.84). When considering individual formulas, the highest reading level assigned per resource ranged from grade 11.09 to 15.02. Government websites had the lowest mean readability (sixth-grade level), while "Other" sources scored highest (mean=10.38). Academic/hospital-based sites (mean=9.26), commercial (mean=9.79), and non-profit sources (mean=9.53) also exceeded recommended levels. A one-way analysis of variance (ANOVA) showed no significant difference in readability across source types (p=0.122). LIMITATIONS: Only English-language, text-based materials were analyzed; multimedia content and regional search variations were not assessed.
conclusionsOnline PEMs related to keloid scars exceed recommended readability levels, potentially limiting their utility for patients with low health literacy. These findings underscore the need for more accessible, culturally inclusive materials, especially for populations disproportionately affected by keloids.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.