Not every picture tells a story: a content analysis of visual images in patient educational resources about gout.

OBJECTIVE: To evaluate what concepts about gout and its treatment are reflected in images in online educational resources about gout.

METHODS: A Google search was performed to identify English-language patient resources from medical and health organisations and health education websites in seven countries: Australia, Canada, Ireland, New Zealand, South Africa, UK and USA. Two raters independently coded the images in the resources into five main categories: clinical presentations of gout, monosodium urate (MSU) crystals/urate, medicines, food/healthy lifestyle, and other advice for people with gout.

RESULTS: One hundred and three resources were identified; 28 resources without images were excluded. Seventy-one educational resources with a total of 310 images were included in the study sample. Of the 310 images, clinical presentations of gout were depicted in 92 images (30%), food/healthy lifestyle in 73 images (24%), urate/MSU crystals in 50 (16%), medicines in 14 (5%). Urate-lowering medication was shown only in one image (0.3%) and just six images (2%) depicted a serum urate target. Ninety-one images (29%) did not convey specific information about gout.

CONCLUSION: Key concepts about gout and treatment are under-represented in the images used in educational resources for patients. A large proportion of the images do not convey useful information about gout or its management.