An infodemiological analysis of arabic online educational content on low back pain: Insights into quality and reliability

Background: Low back pain (LBP) is the leading cause of disability worldwide and is highly prevalent in Arabic-speaking countries. Many patients seek health information online, but the quality and reliability of Arabic resources remain unclear. This study evaluated the quality, reliability, and readability of Arabic websites on LBP. Design and methods: A cross-sectional study was conducted on July 15, 2025, using the Arabic keyword “low back pain” in Google, Yahoo, and Bing. The first 100 results per engine were screened in incognito mode. Eligible websites were Arabic, publicly accessible, and patient oriented. After exclusions, 95 websites were included. Websites were classified by affiliation and assessed using the DISCERN instrument (quality), Journal of the American Medical Association (JAMA) benchmarks (reliability), and automated readability indices (Flesch Reading Ease, Flesch-Kincaid Grade Level, SMOG). Results: Of 300 screened websites, 95 met inclusion criteria. Health portals and educational sites comprised 46.3%. Overall quality was moderate (mean DISCERN 45.9 ± 11.5), with 82.1% rated as moderate and only 4.2% as good. Reliability was low (mean JAMA 2.46 ± 1.1); only 20% met all four benchmarks. Authorship and currency were present in 36.8% and 26.3% of sites. Readability was high, with 96.8% achieving FRE ≥ 80. Top-ranked websites showed higher quality and reliability ( p < 0.001), though readability differences were minimal. DISCERN and JAMA correlated moderately (rho = 0.472, p < 0.001). Conclusions: Arabic websites on LBP are generally easy to read but often lack transparency, reliability, and evidence-based content. Strengthening online Arabic health resources through standardized quality frameworks is crucial to reduce misinformation and support informed decision-making.