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Accessibility

· 13 checks — Landmarks, headings, alt text, forms, and link quality rolled into one auditable list.
SCORE
57
GRADE
D
FIX
5
REVIEW
5
PASS
3
INFO
0
Checks
13
3 PASS 5 REVIEW 5 FIX
F
Favicon & Branding
Action
2 icon(s) detected
FIX
2 icon(s) detected
Info::
favicon.ico present at site root
Info::
HTML icon links detected
Info::
No apple-touch-icon detected
iOS devices use this when users add your site to their home screen. Add <link rel='apple-touch-icon' sizes='180x180' href='/apple-touch-icon.png'>.
favicon.ico Present
PNG Icons Present
Apple Touch Missing
SVG Favicon Missing
Manifest Icons Missing
Multiple Sizes Missing
D
Web Manifest
Action
Not found
FIX
Not found
Info::
No web manifest found
No manifest at standard paths (/manifest.json, /site.webmanifest). A manifest is optional but enables PWA features like home screen installation and standalone display.

No web manifest found.

D
Dark Mode Support
Action
No dark mode signals
FIX
No dark mode signals
Info::
No dark mode signals detected
Consider adding CSS with @media (prefers-color-scheme: dark) and <meta name='color-scheme' content='light dark'>.
Info::
Detection limited to meta tags and inline styles
External CSS files may contain prefers-color-scheme rules not visible to this scan.
Dark ModeNo Dark Mode Detected
color-scheme meta Not set Dark theme-color Not set CSS indicators Not detected

Detection limited to meta tags and inline styles.

D
Print Stylesheet
Action
No print styles
FIX
No print styles
Info::
No print-specific styles detected
When users print this page, they get the screen layout including navigation and non-essential elements. Add @media print rules to hide navigation and optimize layout for paper.
Print Stylesheet No Print Styles
Print stylesheet Not found Inline @media print Not detected
F
Navigation UX
Action
1 navigation pattern(s)
FIX
1 navigation pattern(s)
Info::
Search functionality detected
Got: role-search
Info::
3 navigation landmark(s) detected
Breadcrumbs
Search role='search' landmark
Skip Link
Labeled Navigation 3 <nav> element(s)
Back to Top
Hamburger Menu
Sticky Navigation Cannot reliably detect (CSS-based)
2 of 6 testable patterns navigation patterns detected. Limited navigation support. Consider adding breadcrumbs, search, and skip link.
B
Landmark Structure
10 landmarks
REVIEW
10 landmarks
Info::
<main> landmark present
Info::
3 <nav> landmark(s) found
Warning::
1 of 3 <nav> elements are unlabeled
Multiple navigations need aria-label to distinguish them for screen readers.
Warning::
Skip navigation link is missing (WCAG 2.4.1)
Add a skip link as the first focusable element so keyboard users can bypass repeated navigation.
Info::
Search landmark present
Page Structure — as a screen reader sees it
BANNER header NAV "Main" SEARCH MAIN ASIDE CONTENTINFO footer

Multiple navigations need aria-label to distinguish them for screen readers.

Why this matters

Some <nav> elements lack aria-label — screen-reader users hear 'navigation' multiple times with no way to distinguish them.

Learn more

When a page has multiple <nav> regions (primary, footer, breadcrumb), each needs aria-label or aria-labelledby. AT users navigate by landmark; identical 'navigation' announcements force them to enter each one to discover purpose.

Source: WAI-ARIA Authoring Practices

Add a skip link as the first focusable element so keyboard users can bypass repeated navigation.

Why this matters

Without a skip-nav link, keyboard users tab through every nav item before reaching content — every page, every visit.

Learn more

WCAG 2.4.1 (Bypass Blocks) requires a mechanism to skip past repeated content. The standard implementation is a 'Skip to main content' link that's the first focusable element, visually hidden until focused. Three lines of HTML + four of CSS.

Source: WCAG 2.1 SC 2.4.1

C
Alt Text Quality
Action
15 of 22 images have issues
REVIEW
15 of 22 images have issues
Critical::
15 image(s) missing alt attribute
Images without alt text are invisible to screen readers.
Info::
7 image(s) with good alt text
22 images 7 good alt text 15 missing
IssueCount
missing15 image(s)

Images without alt text are invisible to screen readers.

Why this matters

Each image without alt text is a WCAG 1.1.1 failure — invisible to screen-reader users, lost from Google Image Search.

Learn more

WCAG 2.1 Level A requires text alternatives for non-decorative images. Empty alt='' is fine for decorative; meaningful images need descriptive text. Common fixes: CMS audit + bulk add, build-time linter (alt-text-required ESLint rule), CI gate on Lighthouse a11y score.

Source: WCAG 2.1 SC 1.1.1 / WebAIM Million Report

B
Form Accessibility
2 of 3 controls have issues
REVIEW
2 of 3 controls have issues
Critical::
1 control(s) without accessible label
Form controls need a <label>, aria-label, or aria-labelledby for screen readers.
Got: <input type="submit" id="sitewide-search">
Warning::
1 control(s) rely on placeholder only
Placeholder text disappears on focus and is not a reliable label.
Got: <input type="text" name="search_word">
Info::
1 control(s) properly labeled
3 controls
1 labeled
1 placeholder only
1 unlabeled
ControlTypeLabelMethod
search_wordtextSearcharia-label
search_wordtext(Search Dove Medical Press)placeholder only
#sitewide-searchsubmit(none)none

Form controls need a <label>, aria-label, or aria-labelledby for screen readers.

<input type="submit" id="sitewide-search">

Why this matters

Form controls without labels — assistive tech announces 'edit text' with no context; users can't complete forms.

Source: WCAG 2.1 SC 3.3.2

Placeholder text disappears on focus and is not a reliable label.

<input type="text" name="search_word">

Why this matters

Placeholder-only labels disappear when the user starts typing — they must remember what the field was for.

Learn more

Placeholders are NOT labels. They vanish on input, fail color contrast checks (most are gray), and don't satisfy WCAG SC 3.3.2. Always use a real <label> alongside (or aria-labelledby).

Source: WCAG 2.1 SC 3.3.2 / Nielsen Norman

B
404 Error Page
HTTP 404, custom page
REVIEW
HTTP 404, custom page
Info::
Correct 404 status code returned
Got: HTTP 404
Info::
Custom styled 404 page
Info::
Navigation links present on 404 page
404 Page Quality Custom 404 Page
Status Code HTTP 404 Page Title Dove Press - Open Access Publisher of Medical Journals Custom Styling Navigation Homepage Link Search Form
A
Heading Hierarchy
15 headings
PASS
15 headings
Warning::
Multiple H1 headings (3 found)
A page should have only one H1. Multiple H1s dilute the document outline.
  • H1 Search peer-reviewed journals and articles
  • H1 Journals by Category duplicate H1
  • H1 Trending Articles duplicate H1
  • H2 Pathophysiology of Pain and Mechanisms of Neuromodulation: A Narrative Review (A Neuron Project)
  • H2 The State of 21st Century Acupuncture in the United States
  • H2 Tranexamic Acid for the Treatment of Hyperpigmentation and Telangiectatic Disorders Other Than Melasma: An Update
  • H2 Azithromycin in the Management of Upper Respiratory Tract Infections (URTIs): Indian Real-Life Experience
  • H2 Gray Hair: From Preventive to Treatment
  • H2 Hand Hygiene Compliance and Its Associated Factors Among Health Care Workers at Mogadishu Somali Turkiye Recep Tayyip Erdoğan Training and Research in a Tertiary Care Hospital
  • H2 Transcription Factor Forkhead Box Protein 3 (FOXP3) as a Prognostic Indicator for Postoperative Outcomes in Patients with Breast Cancer: Establishment of a Prognostic Nomogram
  • H2 Isoniazid Preventive Therapy Adherence and Its Predictors Among Soldiers on HIV Antiretroviral Therapy at a General Military Hospital in Uganda
  • H2 Impact of Isotretinoin on Blood Lipids and Liver Enzymes: A Retrospective Cohort Study in Saudi Arabia
  • H2 Red Blood Cell Distribution Width/Hematocrit Ratio: A New Predictor of 28 Days All-Cause Mortality of AECOPD Patients in ICU
  • H2 Exploring the Impact of Transformational and Transactional Style of Leadership on Nursing Care Performance and Patient Outcomes
  • H2 Relationship Between Growth Mindset and Self-Control Amongst Chinese Primary School Students: A Longitudinal Study

A page should have only one H1. Multiple H1s dilute the document outline.

Why this matters

Multiple H1s blur the page's primary topic — screen-reader users and Google both prefer one H1.

Learn more

HTML5's outline algorithm technically allows multiple H1s within sectioning content, but no browser implements it. In practice: one H1 per page. Use H2-H6 for subsections.

Source: WCAG 2.4.6 / Google Search Central

A+
Color Contrast (Screenshot)
20 text elements analyzed, 0 fail WCAG AA
PASS

Analyzes text contrast against the actual rendered page, including background images, gradients, and overlays that CSS-based tools cannot detect.

20 pass
Show all checked elements (20)
ElementRatioRequiredFGBGResult
h1 Search peer-reviewed…21.00:13.0:1
#000000
#FFFFFF
Pass
h1 Journals by Category21.00:13.0:1
#000000
#FFFFFF
Pass
h1 Trending Articles21.00:13.0:1
#000000
#FFFFFF
Pass
title Dove Medical Press -…21.00:14.5:1
#000000
#FFFFFF
Pass
a Skip to main content20.29:14.5:1
#000000
#FBFBFB
Pass
a Journals20.29:14.5:1
#000000
#FBFBFB
Pass
a Why Publish With Us?20.29:14.5:1
#000000
#FBFBFB
Pass
a Editorial Policies20.29:14.5:1
#000000
#FBFBFB
Pass
a Author Guidelines20.29:14.5:1
#000000
#FBFBFB
Pass
a Peer Review Guidelin…20.29:14.5:1
#000000
#FBFBFB
Pass
a Collections20.29:14.5:1
#000000
#FBFBFB
Pass
a Hot topics20.29:14.5:1
#000000
#FBFBFB
Pass
a Podcasts20.29:14.5:1
#000000
#FBFBFB
Pass
a Reprints20.29:14.5:1
#000000
#FBFBFB
Pass
a Submit New Manuscrip…20.29:14.5:1
#000000
#FBFBFB
Pass
a Menu20.29:14.5:1
#000000
#FBFBFB
Pass
a About20.29:14.5:1
#000000
#FBFBFB
Pass
span Contact20.29:14.5:1
#000000
#FBFBFB
Pass
a Sustainability20.29:14.5:1
#000000
#FBFBFB
Pass
a Press Center20.29:14.5:1
#000000
#FBFBFB
Pass

Methodology: The top 20 text elements by font size were checked. Background color was sampled from the desktop screenshot using a 5-point pattern. WCAG 2.1 AA requires 4.5:1 for normal text and 3:1 for large text.

A+
Lighthouse Accessibility Audits
Score 96/100 — 1 failing, 27 passed
PASS
96

Accessibility

These checks highlight opportunities to improve the accessibility of your web app. Automatic detection can only detect a subset of issues and does not guarantee the accessibility of your web app, so manual testing is also encouraged.

Best practices

Touch targets with sufficient size and spacing help users who may have difficulty targeting small controls to activate the targets. Learn more about touch targets.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
form > div > span > input#sitewide-search form > div > span > input#sitewide-search

These items highlight common accessibility best practices.

Interactive controls are keyboard focusable
Interactive elements indicate their purpose and state
The page has a logical tab order
Visual order on the page follows DOM order
User focus is not accidentally trapped in a region
The user's focus is directed to new content added to the page
HTML5 landmark elements are used to improve navigation
Offscreen content is hidden from assistive technology
Custom controls have associated labels
Custom controls have ARIA roles
`[aria-*]` attributes match their roles
`[aria-hidden="true"]` is not present on the document `<body>`
`[role]`s have all required `[aria-*]` attributes
`[role]` values are valid
`[aria-*]` attributes have valid values
`[aria-*]` attributes are valid and not misspelled
Buttons have an accessible name
Image elements have `[alt]` attributes
Input buttons have discernible text.
Form elements have associated labels
`[user-scalable="no"]` is not used in the `<meta name="viewport">` element and the `[maximum-scale]` attribute is not less than 5.
ARIA attributes are used as specified for the element's role
Elements use only permitted ARIA attributes
Background and foreground colors have a sufficient contrast ratio
Document has a `<title>` element
`<html>` element has a `[lang]` attribute
`<html>` element has a valid value for its `[lang]` attribute
Links are distinguishable without relying on color.
Links have a discernible name
Lists contain only `<li>` elements and script supporting elements (`<script>` and `<template>`).
List items (`<li>`) are contained within `<ul>`, `<ol>` or `<menu>` parent elements
Heading elements appear in a sequentially-descending order
Skip links are focusable.
Document has a main landmark.
Deprecated ARIA roles were not used
Image elements do not have `[alt]` attributes that are redundant text.
Identical links have the same purpose.
`[accesskey]` values are unique
`button`, `link`, and `menuitem` elements have accessible names
Elements with `role="dialog"` or `role="alertdialog"` have accessible names.
`[aria-hidden="true"]` elements do not contain focusable descendents
ARIA input fields have accessible names
ARIA `meter` elements have accessible names
ARIA `progressbar` elements have accessible names
Elements with an ARIA `[role]` that require children to contain a specific `[role]` have all required children.
`[role]`s are contained by their required parent element
Elements with the `role=text` attribute do not have focusable descendents.
ARIA toggle fields have accessible names
ARIA `tooltip` elements have accessible names
ARIA `treeitem` elements have accessible names
The page contains a heading, skip link, or landmark region
`<dl>`'s contain only properly-ordered `<dt>` and `<dd>` groups, `<script>`, `<template>` or `<div>` elements.
Definition list items are wrapped in `<dl>` elements
ARIA IDs are unique
No form fields have multiple labels
`<frame>` or `<iframe>` elements have a title
`<html>` element has an `[xml:lang]` attribute with the same base language as the `[lang]` attribute.
`<input type="image">` elements have `[alt]` text
The document does not use `<meta http-equiv="refresh">`
`<object>` elements have alternate text
Select elements have associated label elements.
No element has a `[tabindex]` value greater than 0
Cells in a `<table>` element that use the `[headers]` attribute refer to table cells within the same table.
`<th>` elements and elements with `[role="columnheader"/"rowheader"]` have data cells they describe.
`[lang]` attributes have a valid value
`<video>` elements contain a `<track>` element with `[kind="captions"]`
Tables have different content in the summary attribute and `<caption>`.
All heading elements contain content.
Uses ARIA roles only on compatible elements
Elements with visible text labels have matching accessible names.
Tables use `<caption>` instead of cells with the `[colspan]` attribute to indicate a caption.
`<td>` elements in a large `<table>` have one or more table headers.
All checks on this page are automated. Results are estimates - run targeted manual reviews when the score affects a release decision.

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