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Budge J, Lenti L, Azhar B, Roy I, Loftus I, Holt P. Quality Assessment of Elective Abdominal Aortic Aneurysm Repair Patient Information on the Internet Using the Modified Ensuring Quality Information for Patients Tool. Eur J Vasc Endovasc Surg 2024; 67:738-745. [PMID: 38185375 DOI: 10.1016/j.ejvs.2024.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/07/2023] [Accepted: 01/04/2024] [Indexed: 01/09/2024]
Abstract
OBJECTIVE This study aimed to assess the quality of patient information material regarding elective abdominal aortic aneurysm (AAA) repair on the internet using the Modified Ensuring Quality Information for Patients (MEQIP) tool. METHODS A qualitative assessment of internet based patient information was performed. The 12 most used search terms relating to AAA repair were identified using Google Trends, with the first 10 pages of websites retrieved for each term searched. Duplicates were removed, and information for patients undergoing elective AAA were selected. Further exclusion criteria were marketing material, academic journals, videos, and non-English language sites. The remaining websites were then MEQIP scored independently by two reviewers, producing a final score by consensus. RESULTS A total of 1 297 websites were identified, with 235 (18.1%) eligible for analysis. The median MEQIP score was 18 (interquartile range [IQR] 14, 21) out of a possible 36. The highest score was 33. The 99th percentile MEQIP scoring websites scored > 27, with four of these six sites representing online copies of hospital patient information leaflets, however hospital sites overall had lower median MEQIP scores than most other institution types. MEQIP subdomain median scores were: content, 8 (IQR 6, 11); identification, 3 (IQR 1, 3); and structure, 7 (IQR 6, 9). Of the analysed websites, 77.9% originated from the USA (median score 17) and 12.8% originated in the UK (median score 22). Search engine ranking was related to website institution type but had no correlation with MEQIP. CONCLUSION When assessed by the MEQIP tool, most websites regarding elective AAA repair are of questionable quality. This is in keeping with studies in other surgical and medical fields. Search engine ranking is not a reliable measure of quality of patient information material regarding elective AAA repair. Health practitioners should be aware of this issue as well as the whereabouts of high quality material to which patients can be directed.
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Affiliation(s)
- James Budge
- St George's Vascular Institute, St George's University Hospitals NHS Foundation Trust, London, UK; and St George's University of London, London, UK.
| | - Lorenzo Lenti
- St George's Vascular Institute, St George's University Hospitals NHS Foundation Trust, London, UK; and St George's University of London, London, UK
| | - Bilal Azhar
- St George's Vascular Institute, St George's University Hospitals NHS Foundation Trust, London, UK; and St George's University of London, London, UK
| | - Iain Roy
- St George's Vascular Institute, St George's University Hospitals NHS Foundation Trust, London, UK; and St George's University of London, London, UK
| | - Ian Loftus
- St George's Vascular Institute, St George's University Hospitals NHS Foundation Trust, London, UK; and St George's University of London, London, UK
| | - Peter Holt
- St George's Vascular Institute, St George's University Hospitals NHS Foundation Trust, London, UK; and St George's University of London, London, UK
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Marcasciano M, Vittori E, Ciriaco AG, Torto FL, Giannaccare G, Scorcia V, D'Alcontres FS, Chang C, Colica C, Greco M. A Systematic Quality Assessment of Online Resources on Eyelid Ptosis Using the Modified Ensuring Quality Information for Patients (mEQIP) Tool. Aesthetic Plast Surg 2024; 48:1688-1697. [PMID: 38360956 DOI: 10.1007/s00266-024-03862-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Eyelid ptosis is an underestimated pathology deeply affecting patients' quality of life. Internet has increasingly become the major source of information regarding health care, and patients often browse on websites to acquire an initial knowledge on the subject. However, there is lack of data concerning the quality of available information focusing on the eyelid ptosis and its treatment. We systematically evaluated online information quality on eyelid ptosis by using the "Ensuring Quality Information for Patients" (EQIP) scale. MATERIALS AND METHODS Google, Yahoo and Bing have been searched for the keywords "Eyelid ptosis," "Eyelid ptosis surgery" and "Blepharoptosis." The first 50 hits were included, evaluating the quality of information with the expanded EQIP tool. Websites in English and intended for general non-medical public use were included. Irrelevant documents, videos, pictures, blogs and articles with no access were excluded. RESULTS Out of 138 eligible websites, 79 (57,7%) addressed more than 20 EQIP items, with an overall median score of 20,2. Only 2% discussed procedure complication rates. The majority fail to disclose severe complications and quantifying risks, fewer than 18% clarified the potential need for additional treatments. Surgical procedure details were lacking, and there was insufficient information about pre-/postoperative precautions for patients. Currently, online quality information has not improved since COVID-19 pandemic. CONCLUSIONS This study highlights the urgent requirement for improved patient-oriented websites adhering to international standards for plastic and oculoplastic surgery. Healthcare providers should effectively guide their patients in finding trustworthy and reliable eyelid ptosis correction information. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Marco Marcasciano
- Department of Experimental and Clinical Medicine, Unit of Plastic and Reconstructive Surgery, Magna Graecia University, Catanzaro, Italy.
| | - Emanuele Vittori
- Department of Plastic and Reconstructive Surgery, University Hospital of Messina AOU Gaetano Martino, Messina, Italy
| | - Antonio Greto Ciriaco
- Department of Experimental and Clinical Medicine, Unit of Plastic and Reconstructive Surgery, Magna Graecia University, Catanzaro, Italy
| | - Federico Lo Torto
- Unit of Plastic and Reconstructive Surgery, Department of Surgery, "Sapienza" University of Rome, P. Valdoni Policlinico Umberto I, Rome, Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Cantanzaro, Italy
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Cantanzaro, Italy
| | - Francesco Stagno D'Alcontres
- Department of Plastic and Reconstructive Surgery, University Hospital of Messina AOU Gaetano Martino, Messina, Italy
| | - Chad Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Caterina Colica
- Unità Operativa Complessa Oculistica Ospedale Grassi, ASL Roma-3 Ostia, Roma, Italy
| | - Manfredi Greco
- Department of Experimental and Clinical Medicine, Unit of Plastic and Reconstructive Surgery, Magna Graecia University, Catanzaro, Italy
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Chien S, Miller G, Huang I, Cunningham DA, Carson D, Gall LS, Khan KS. Quality assessment of online patient information on upper gastrointestinal endoscopy using the modified Ensuring Quality Information for Patients tool. Ann R Coll Surg Engl 2024. [PMID: 38376380 DOI: 10.1308/rcsann.2022.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION Websites and online resources are increasingly becoming patients' main source of healthcare information. It is paramount that high quality information is available online to enhance patient education and improve clinical outcomes. Upper gastrointestinal (UGI) endoscopy is the gold standard investigation for UGI symptoms and yet little is known regarding the quality of patient orientated websites. The aim of this study was to assess the quality of online patient information on UGI endoscopy using the modified Ensuring Quality Information for Patients (EQIP) tool. METHODS Ten search terms were employed to conduct a systematic review. for each term, the top 100 websites identified via a Google search were assessed using the modified EQIP tool. High scoring websites underwent further analysis. Websites intended for professional use by clinicians as well as those containing video or marketing content were excluded. FINDINGS A total of 378 websites were eligible for analysis. The median modified EQIP score for UGI endoscopy was 18/36 (interquartile range: 14-21). The median EQIP scores for the content, identification and structure domains were 8/18, 1/6 and 9/12 respectively. Higher modified EQIP scores were obtained for websites produced by government departments and National Health Service hospitals (p=0.007). Complication rates were documented in only a fifth (20.4%) of websites. High scoring websites were significantly more likely to provide balanced information on risks and benefits (94.6% vs 34.4%, p<0.001). CONCLUSIONS There is an immediate need to improve the quality of online patient information regarding UGI endoscopy. The currently available resources provide minimal information on the risks associated with the procedure, potentially hindering patients' ability to make informed healthcare decisions.
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Affiliation(s)
- S Chien
- NHS Greater Glasgow and Clyde, UK
- University of Glasgow, UK
| | | | - I Huang
- NHS Greater Glasgow and Clyde, UK
| | | | - D Carson
- NHS Greater Glasgow and Clyde, UK
| | - L S Gall
- NHS Greater Glasgow and Clyde, UK
| | - K S Khan
- University of Glasgow, UK
- NHS Lanarkshire, UK
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Wei K, Fritz C, Rajasekaran K. Answering head and neck cancer questions: An assessment of ChatGPT responses. Am J Otolaryngol 2024; 45:104085. [PMID: 37844413 DOI: 10.1016/j.amjoto.2023.104085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/01/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To examine and compare ChatGPT versus Google websites in answering common head and neck cancer questions. MATERIALS AND METHODS Commonly asked questions about head and neck cancer were obtained and inputted into both ChatGPT-4 and Google search engine. For each question, the ChatGPT response and first website search result were compiled and examined. Content quality was assessed by independent reviewers using standardized grading criteria and the modified Ensuring Quality Information for Patients (EQIP) tool. Readability was determined using the Flesch reading ease scale. RESULTS In total, 49 questions related to head and neck cancer were included. Google sources were on average significantly higher quality than ChatGPT responses (4.2 vs 3.6, p = 0.005). According to the EQIP tool, Google and ChatGPT had on average similar response rates per criterion (24.4 vs 20.5, p = 0.09) while Google had a significantly higher average score per question than ChatGPT (13.8 vs 11.7, p < 0.001) According to the Flesch reading ease scale, ChatGPT and Google sources were both considered similarly difficult to read (33.1 vs 37.0, p = 0.180) and at a college level (14.3 vs 14.2, p = 0.820.) CONCLUSION: ChatGPT responses were as challenging to read as Google sources, but poorer quality due to decreased reliability and accuracy in answering questions. Though promising, ChatGPT in its current form should not be considered dependable. Google sources are a preferred resource for patient educational materials.
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Affiliation(s)
- Kimberly Wei
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Christian Fritz
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
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Taha A, Taha-Mehlitz S, Bach L, Ochs V, Bardakcioglu O, Honaker MD, Cattin PC. Robotic colorectal surgery: quality assessment of patient information available on the internet using webscraping. Comput Assist Surg (Abingdon) 2023; 28:2187275. [PMID: 36905397 DOI: 10.1080/24699322.2023.2187275] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
The primary goal of this study is to assess current patient information available on the internet concerning robotic colorectal surgery. Acquiring this information will aid in patients understanding of robotic colorectal surgery. Data was acquired through a web-scraping algorithm. The algorithm used two Python packages: Beautiful Soup and Selenium. The long-chain keywords incorporated into Google, Bing and Yahoo search engines were 'Da Vinci Colon-Rectal Surgery', 'Colorectal Robotic Surgery' and 'Robotic Bowel Surgery'. 207 websites resulted, were sorted and evaluated according to the ensuring quality information for patients (EQIP) score. Of the 207 websites visited, 49 belonged to the subgroup of hospital websites (23.6%), 46 to medical centers (22.2%), 45 to practitioners (21.7%), 42 to health care systems (20,2%), 11 to news services (5.3%), 7 to web portals (3.3%), 5 to industry (2.4%), and 2 to patient groups (0.9%). Only 52 of the 207 websites received a high rating. The quality of available information on the internet concerning robotic colorectal surgery is low. The majority of information was inaccurate. Medical facilities involved in robotic colorectal surgery, robotic bowel surgery and related robotic procedures should develop websites with credible information to guide patient decisions.
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Affiliation(s)
- Anas Taha
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland
| | - Stephanie Taha-Mehlitz
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland
| | - Laura Bach
- Faculty of Medicine, University of Erlangen, Erlangen, Germany
| | - Vincent Ochs
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland
| | | | - Michael D Honaker
- Department of Surgery, East Carolina University Brody School of Medicine, Greenville, NC, USA
| | - Philippe C Cattin
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland
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Weng LC, Huang HL, Tsai YH, Tsai HH, Lee WC, Shieh WY. The effect of a web-based self-care instruction on symptom experience and quality of life in living liver donors: A randomized controlled trial. Heliyon 2023; 9:e17333. [PMID: 37484234 PMCID: PMC10361383 DOI: 10.1016/j.heliyon.2023.e17333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Living liver donors need help to manage symptom distress and improve their quality of life. This study aims to test the effectiveness of a web-based symptom self-care instruction on symptom experience and health-related quality of life of living liver donors. Methods This study was a randomized controlled trial. Participants were recruited from January 2019 to August 2020. Participants in the experimental group had access to a web-based symptom self-care instruction, which included text and video. The control group received routine care. The primary outcomes were symptom distress and quality of life. Results A total of 90 living liver donors recruited in this study were assigned randomly to the web group (n = 46) and control group (n = 44). The symptom distress was significantly negatively correlated with quality of life at each data collection time. There was an interaction effect with the participants in the web group experiencing more symptom distress at three months after surgery than the control group (B = 3.616, 95% CI: 7.163-3.990, p = 0.046). There was no significant effect on the quality of life. Conclusion Patients in the web-based self-care group had higher symptom distress than those in the control group three months after surgery, but there was no difference in quality of life. Future studies could add some interactive elements to the website and include a larger sample size. Registration This study was registered at the Chinese Clinical Trial Registry (ChiCTR1900020518).
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of General Surgery, Liver Transplantation, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Science, Taipei, Taiwan
| | - Yu-Hsia Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Cardiovascular Medicine, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
| | - Hsiu-Hsin Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery, Liver Transplantation, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
| | - Wann-Yun Shieh
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
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van Klaveren CW, de Jong PG, Hendriks RA, Luk F, de Vries AP, van der Boog PJ, Rabelink A, Reinders ME. Didactical characteristics of Dutch websites about kidney transplantation targeted for kidney patients and living donors: An exploratory study. PEC INNOVATION 2022; 1:100026. [PMID: 37213764 PMCID: PMC10194093 DOI: 10.1016/j.pecinn.2022.100026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 05/23/2023]
Abstract
Objective The aim was to explore the origin, content topics, teaching modes (instruction, interaction, and assessment), and corresponding social-epistemological dimensions (choices in knowledge transfer vs. knowledge building, and individual vs. group learning) of web-based information on kidney transplantation targeted for patients and living donors. Methods Dutch websites on kidney transplantation were retrieved using the search engine Google.nl. From 24 websites, 250 webpages were examined on origin, content topics, teaching modes, and corresponding social-epistemological dimensions. Results The majority of the websites had a professional organization as origin (20/24). The number and distribution of content topics varied among the websites. Of the 16 different teaching modes found, 11 were instructional, 4 were interactional, and 1 assessment mode was found. The websites offered almost exclusively teaching modes on individual and passive learning, whereas group learning and interactive knowledge building was hardly encountered. Conclusion The diversity in teaching modes and social-epistemological dimensions of Dutch websites on kidney transplantation targeted for patients and living donors is limited. The websites only provided a partial view on kidney transplantation; information regarding contact with others, e.g. support, was limited. A more balanced availability of teaching approaches and content topics is desirable to fit with the didactical goals to make well-considered health decisions.
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Affiliation(s)
- Charlotte W. van Klaveren
- Division of Nephrology and Transplant Center, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Corresponding author.
| | - Peter G.M. de Jong
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée A. Hendriks
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, the Netherlands
| | - Franka Luk
- Division of Nephrology and Transplant Center, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Aiko P.J. de Vries
- Division of Nephrology and Transplant Center, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Paul J.M. van der Boog
- Division of Nephrology and Transplant Center, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - A.J. Rabelink
- Division of Nephrology and Transplant Center, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Marlies E.J. Reinders
- Division of Nephrology and Transplant Center, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Erasmus MC Transplant Institute, Department of Internal Medicine, University Medical Center Rotterdam, Rotterdam, the Netherlands
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A quality assessment of online patient information regarding tonsillitis using the EQIP tool. Int J Pediatr Otorhinolaryngol 2022; 159:111224. [PMID: 35785584 DOI: 10.1016/j.ijporl.2022.111224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/10/2022] [Accepted: 06/25/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Tonsillitis is a common paediatric condition. The decision to seek medical attention and consent to treatment is usually made by parents or guardians. With increased accessibility of the internet, online medical information plays an increasingly significant role in the decision-making process. Little is known regarding the quality of online patient information on tonsillitis, as this has not been previously studied. OBJECTIVE The aim of our study was to identify the quality of information regarding tonsillitis on websites intended for the public. METHODS We conducted a systematic review of online information on tonsillitis using the following search terms: "Tonsillectomy", "Tonsillitis", "Adenotonsillectomy" and "Tonsil". The first three pages of returned websites were captured and each website was examined using the validated Ensuring Quality Information for Patients (EQIP) tool (score 0-36). RESULTS A total of 92 websites met the inclusion criteria for analysis. The overall median EQIP score was 19 with an interquartile range of 17-22 and a maximum of 32. More than half of all websites originated from the USA (61%) and hospitals were the most common source of information (29%). Most websites failed to describe the quantitative benefits or address the medical intervention costs and insurance issues. Half of the websites included both tonsillectomy and antibiotics as treatments for tonsillitis. Only 68% included complications of tonsillitis or tonsillectomy. CONCLUSIONS The assessment of the quality of online patient information websites regarding tonsillitis by the EQIP tool indicates that most websites were of poor credibility, with minimal information regarding treatment choices and complications. To improve awareness of tonsillitis, there is a need for more informative and patient-centred websites that are compatible with the international quality standard for patient information.
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Shamil E, Scenza GD, Ghani SA, Fan KS, Ragulan S, Salem J, Šurda P, D'Souza AR. A Quality Assessment of Online Patient Information Regarding Rhinoplasty. Facial Plast Surg 2021; 38:530-538. [PMID: 34583412 DOI: 10.1055/s-0041-1735622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
There is a large demand for online patient information for patients considering rhinoplasty. While there are many resources available, the quality and content of the information provided are unknown. This study aimed to assess the quality of the most popular information available online, using the "Ensuring Quality Information for Patients" (EQIP) tool to evaluate the content, structure, and readability of patient information on websites. Search terms including nose operation, nose job, nose reshaping, nose tip surgery, rhinoplasty, septorhinoplasty, were identified using Google AdWords and Trends. Unique links from the first 10 pages for each term were identified and evaluated with websites written in English and for general non-medical public use were included. 295 websites met the eligibility criteria with a median overall EQIP score of 17. Only 33% contained balanced information on the risks and benefits. Bleeding and infection risk was only mentioned in 29% and 27% of websites, respectively. Two percent described complication rates of the procedures and only 20% of articles explained further surgery may be required to achieve patient cosmetic or functional satisfaction. Information regarding rhinoplasty available online is currently of poor quality. The lack of effective risk counselling, possible outcome management, and complications may likely lead to unrealistic expectations of rhinoplasty. It is crucial the risks of surgery are communicated to the patient to ensure they can make an informed decision. Improved education through online resources would likely help to promote more realistic patient expectations.
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Affiliation(s)
- Eamon Shamil
- Department of Ear, Nose and Throat, St George's University Hospitals NHS Foundation Trust, Tooting, London, United Kingdom
| | - Gabriela Di Scenza
- St. George's University Medical School, Cranmer Terrace, London, United Kingdom
| | - Shahi Abdul Ghani
- St. George's University Medical School, Cranmer Terrace, London, United Kingdom
| | - Ka Siu Fan
- St. George's University Medical School, Cranmer Terrace, London, United Kingdom
| | - Suthaharan Ragulan
- Department of Ear, Nose and Throat, St George's University Hospitals NHS Foundation Trust, Tooting, London, United Kingdom
| | - Joseph Salem
- Department of Ear, Nose and Throat, St George's University Hospitals NHS Foundation Trust, Tooting, London, United Kingdom
| | - Pavol Šurda
- Department of Ear, Nose and Throat, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Alwyn Ray D'Souza
- Department of Otolaryngology, Lewisham and Greenwich NHS Trust Ringgold Standard Institution, London, United Kingdom
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Quality of Patient Information on Lipofilling in the Internet. Dermatol Surg 2021; 47:e86-e90. [PMID: 33625156 DOI: 10.1097/dss.0000000000002752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients interested in aesthetic surgery actively search the Internet, a source that contains important but biased information. OBJECTIVE The aim of this study was to assess the quality of patient information on autologous fat grafting available on the Internet. MATERIALS AND METHODS The quantitative and qualitative assessment of websites was based on a modified Ensuring Quality Information for Patients tool (EQIP-36 items). Websites were identified through the most popular search engines (Google, Yahoo, Bing, Ask, and AOL). RESULTS After duplicate and irrelevant sources were excluded, 608 remaining websites were assessed. Only 164 websites addressed >17 of the 36 items. Scores tended to be higher for academic centers and professional societies than for websites developed by private practitioners. The EQIP score achieved by websites ranged between 0 to 28, with a median value of 14 points. CONCLUSION The quality of patient information on lipofilling available on the Internet is very poor, and research on existing websites reveals substantial shortcomings. There is an urgent need for sources offering superior quality and unbiased information on lipofilling for patients who intend to undergo this procedure.
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Ghani S, Fan KS, Fan KH, Lenti L, Raptis D. Using the Ensuring Quality Information for Patients Tool to Assess Patient Information on Appendicitis Websites: Systematic Search and Evaluation. J Med Internet Res 2021; 23:e22618. [PMID: 33729160 PMCID: PMC8035662 DOI: 10.2196/22618] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/07/2020] [Accepted: 03/17/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Appendicitis is a common surgical problem among the young adult population, who are likely to use the internet to obtain medical information. This information may determine the health-seeking behavior of an individual and may delay medical attention. Little is known regarding the quality of patient information on appendicitis on the internet, as this has not been previously studied. OBJECTIVE The aim of our study was to identify the quality of information regarding appendicitis on websites intended for the public. METHODS We conducted a systematic review of information on appendicitis available online using the following 4 search terms in google: "appendicitis," "appendix," "appendectomy," and "appendicectomy". The top 100 websites of each search term were assessed using the validated Ensuring Quality Information for Patients (EQIP) tool (score 0-36). RESULTS A total of 119 websites met the eligibility criteria for evaluation. The overall median EQIP score for all websites was 20 (IQR 18-22). More than half the websites originated from the USA (65/119, 54.6%), and 45.4% (54/119) of all websites originated from hospitals, although 43% (23/54) of these did not mention qualitative risks from surgery. Incidence rates were only provided for complications and mortality in 12.6% (15/119) and 3.3% (4/119) of all websites, respectively. CONCLUSIONS The assessment of the quality and readability of websites concerning appendicitis by the EQIP tool indicates that most sites online were of poor credibility, with minimal information regarding complication rates and mortality. To improve education and awareness of appendicitis, there is an immediate need for more informative and patient-centered websites that are more compatible with international quality standards.
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Affiliation(s)
- Shahi Ghani
- St George's, University of London, London, United Kingdom
| | - Ka Siu Fan
- St George's, University of London, London, United Kingdom
| | - Ka Hay Fan
- Imperial College London, London, United Kingdom
| | - Lorenzo Lenti
- St George's, University of London, London, United Kingdom
| | - Dimitri Raptis
- Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, United Kingdom
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Fan KS, Ghani SA, Machairas N, Lenti L, Fan KH, Richardson D, Scott A, Raptis DA. COVID-19 prevention and treatment information on the internet: a systematic analysis and quality assessment. BMJ Open 2020; 10:e040487. [PMID: 32912996 PMCID: PMC7485261 DOI: 10.1136/bmjopen-2020-040487] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the quality of information regarding the prevention and treatment of COVID-19 available to the general public from all countries. DESIGN Systematic analysis using the 'Ensuring Quality Information for Patients' (EQIP) Tool (score 0-36), Journal of American Medical Association (JAMA) benchmark (score 0-4) and the DISCERN Tool (score 16-80) to analyse websites containing information targeted at the general public. DATA SOURCES Twelve popular search terms, including 'Coronavirus', 'COVID-19 19', 'Wuhan virus', 'How to treat coronavirus' and 'COVID-19 19 Prevention' were identified by 'Google AdWords' and 'Google Trends'. Unique links from the first 10 pages for each search term were identified and evaluated on its quality of information. ELIGIBILITY CRITERIA FOR SELECTING STUDIES All websites written in the English language, and provides information on prevention or treatment of COVID-19 intended for the general public were considered eligible. Any websites intended for professionals, or specific isolated populations, such as students from one particular school, were excluded, as well as websites with only video content, marketing content, daily caseload update or news dashboard pages with no health information. RESULTS Of the 1275 identified websites, 321 (25%) were eligible for analysis. The overall EQIP, JAMA and DISCERN scores were 17.8, 2.7 and 38.0, respectively. Websites originated from 34 countries, with the majority from the USA (55%). News Services (50%) and Government/Health Departments (27%) were the most common sources of information and their information quality varied significantly. Majority of websites discuss prevention alone despite popular search trends of COVID-19 treatment. Websites discussing both prevention and treatment (n=73, 23%) score significantly higher across all tools (p<0.001). CONCLUSION This comprehensive assessment of online COVID-19 information using EQIP, JAMA and DISCERN Tools indicate that most websites were inadequate. This necessitates improvements in online resources to facilitate public health measures during the pandemic.
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Affiliation(s)
- Ka Siu Fan
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - Nikolaos Machairas
- Department of HPB Surgery and Liver Transplant, Royal Free Hospital, London, UK
| | - Lorenzo Lenti
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | | | - Aneya Scott
- St George's University Hospitals NHS Foundation Trust, London, UK
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Engelmann J, Fischer C, Nkenke E. Quality assessment of patient information on orthognathic surgery on the internet. J Craniomaxillofac Surg 2020; 48:661-665. [PMID: 32518020 PMCID: PMC7255739 DOI: 10.1016/j.jcms.2020.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/03/2020] [Accepted: 05/18/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the quality of online information for patients on orthognathic surgery. MATERIALS AND METHODS A selection of search terms specific for orthognathic surgery was chosen and 150 websites were identified using the Internet search engines Google, Yahoo and Bing. Irrelevant websites were excluded. The remaining websites were assessed with a modified Ensuring Quality Information for Patients (EQIP) tool. EQIP evaluates the quality of medical patient information by measuring the three key aspects of content, structure, and identification data. RESULTS 48 relevant websites were identified. EQIP values ranged between 2 and 28 (median 13.65). While 37 of the 48 websites described details of the surgical procedures, only 13 mentioned possible risks and complications of the surgery. No differences were found between the websites of private practices, dentists and public hospitals, universities, or others (p = 0.66). Websites found by Google had a significantly lower EQIP score compared with Yahoo and Bing (11.12 vs. 16.60 for Yahoo and 16.23 for Bing; p = 0.012). The better the rank of the website, the higher the EQIP score (r = -0.411, p = 0.004). CONCLUSIONS The results of this study reflected a large variation of quality of information on orthognathic surgery on the Internet. Therefore, surgeons must be aware that they might be confronted with unrealistic expectations of patients, who may underestimate the potential risks and drawbacks of orthognathic surgery.
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Affiliation(s)
- Johannes Engelmann
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Austria.
| | - Carmen Fischer
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Austria
| | - Emeka Nkenke
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Austria
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Quality of Information About Bariatric Surgery on the Internet: A Two-Continent Comparison of Website Content. Obes Surg 2020; 30:1736-1744. [DOI: 10.1007/s11695-019-04375-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Raptis DA, Sinanyan M, Ghani S, Soggiu F, Gilliland JJ, Imber C. Quality assessment of patient information on the management of gallstone disease in the internet - A systematic analysis using the modified ensuring quality information for patients tool. HPB (Oxford) 2019; 21:1632-1640. [PMID: 31174998 DOI: 10.1016/j.hpb.2019.03.355] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/21/2019] [Accepted: 03/04/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The internet has become a fundamental source of medical information for patients, however, little is known about the quality of patient information regarding the management of gallstone disease (GD). METHODS A systematic review of information on GD in the internet was performed. The top 100 websites for every different search term and search engine were assessed using the validated EQIP tool (Score 0-36). RESULTS A total of 2000 websites were identified and 212 (11%) were eligible for analysis. The overall median EQIP score of all websites was 15 (IQR 13-18). Of all websites, 63% originated from North America however, these represented the lowest median EQIP score of 15. Only 41% of the websites differentiated between clinical presentations and 19% provided emergency information. Only 3% of the websites reported complication rates, ranging from 3 to 36%. CONCLUSION This is a comprehensive assessment of online patient information on GD using the EQIP tool. The assessment of the quality of websites concerning GD by the EQIP tool indicates that the majority of sites were of low-quality information. There is an immediate need for better informative and educational websites regarding GD that are compatible with international quality standards.
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Affiliation(s)
- Dimitri A Raptis
- Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, NHS Foundation Trust, UCL Partners, London, UK
| | - Milena Sinanyan
- Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, NHS Foundation Trust, UCL Partners, London, UK; South Hampstead High School, London, UK
| | - Shahi Ghani
- Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, NHS Foundation Trust, UCL Partners, London, UK; St. Georges University of London, London, UK
| | - Fiammetta Soggiu
- Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, NHS Foundation Trust, UCL Partners, London, UK
| | - Jack J Gilliland
- Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, NHS Foundation Trust, UCL Partners, London, UK
| | - Charles Imber
- Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, NHS Foundation Trust, UCL Partners, London, UK.
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Vetter D, Ruhwinkel H, Raptis DA, Bueter M. Quality Assessment of Information on Bariatric Surgery Websites. Obes Surg 2019; 28:1240-1247. [PMID: 29110245 DOI: 10.1007/s11695-017-2983-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to assess the quality of patient information on bariatric surgery in the internet using the modified Ensuring Quality Information for Patients (EQIP) tool. METHODS Systematic review of information on bariatric surgery in the internet by entering common search terms into five search engines. The top 100 websites of every search term and search engine were assessed using the validated EQIP tool (maximum score, 36), which entails points for content, structure, and identification data of a given website. Websites at or above the 99th percentile were analyzed separately (n = 8). RESULTS The median EQIP score of all included websites (n = 463) was 17 (IQR 15-19). While information on the medical problem, the indication for surgery, or the treatment alternatives was present in 84% of all websites, only 10% of the included websites contained adequate information on postoperative complications. Although quantitative information on incidence (37.5%) and treatment of complications (12.5%) was significantly better in the top 99th percentile websites, the content of relevant information such as occurrence and treatment of complications was still very limited. CONCLUSION The overall quality of patient information on bariatric surgery in the internet is relatively poor. Especially incidence of complications and their treatment are rarely reported even on websites with a 99th percentile EQIP score.
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Affiliation(s)
- Diana Vetter
- Department of Abdominal Surgery- and Transplantation, University Hospital of Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
| | | | - Dimitri A Raptis
- Department of Abdominal Surgery- and Transplantation, University Hospital of Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
| | - Marco Bueter
- Department of Abdominal Surgery- and Transplantation, University Hospital of Zurich, Rämistrasse 100, Zurich, 8091, Switzerland.
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Mogul DB, Lee J, Purnell TS, Massie AB, Ishaque T, Segev DL, Bridges JF. Barriers to access in pediatric living-donor liver transplantation. Pediatr Transplant 2019; 23:e13513. [PMID: 31215155 PMCID: PMC9421564 DOI: 10.1111/petr.13513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 12/13/2022]
Abstract
Children receiving a LDLT have superior post-transplant outcomes, but this procedure is only used for 10% of transplant recipients. Better understanding about barriers toward LDLT and the sociodemographic characteristics that influence these underlying mechanisms would help to inform strategies to increase its use. We conducted an online, anonymous survey of parents/caregivers for children awaiting, or have received, a liver transplant regarding their knowledge and attitudes about LDLT. The survey was completed by 217 respondents. While 97% of respondents understood an individual could donate a portion of their liver, only 72% knew the steps in evaluation, and 69% understood the donor surgery was covered by the recipient's insurance. Individuals with public insurance were less likely than those with private insurance to know the steps for LDLT evaluation (44% vs 82%; P < 0.001). Respondents with public insurance were less likely to know someone that had been a living donor (44% vs 56%; P = 0.005) as were individuals without a college degree (64% vs 85%; P = 0.007). Nearly all respondents generally trusted their healthcare team. Among respondents, 82% believed they were well-informed about LDLT but individuals with public insurance were significantly less likely to feel well-informed (67% vs 87%; P = 0.03) and to understand how donor surgery might impact donor work/time off (44% vs 81%; P = 0.001). Substantial gaps exist in parental understanding about LDLT, including its evaluation, potential benefits, and complications. Greater emphasis on addressing these barriers, especially to individuals with fewer resources, will be helpful to expand the use of LDLT.
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Affiliation(s)
- Douglas B. Mogul
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Joy Lee
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN
| | - Tanjala S. Purnell
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Allan B. Massie
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Tanveen Ishaque
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
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Karamitros GA, Kitsos NA. Clefts of the lip and palate: is the Internet a trustworthy source of information for patients? Int J Oral Maxillofac Surg 2018; 47:1114-1120. [PMID: 29622479 DOI: 10.1016/j.ijom.2018.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 12/31/2017] [Accepted: 03/07/2018] [Indexed: 12/15/2022]
Abstract
Great numbers of patients use the Internet to obtain information and familiarize themselves with medical conditions. However, the quality of Internet-based information on clefts of the lip and palate has not yet been examined. The goal of this study was to assess the quality of Internet-based patient information on orofacial clefts. Websites were evaluated based on the modified Ensuring Quality Information for Patients (EQIP) instrument (36 items). Three hundred websites were identified using the most popular search engines. Of these, 146 were assessed after the exclusion of duplicates, irrelevant sites, and web pages in languages other than English. Thirty-four (23.2%) web pages, designed mostly by academic centres and hospitals, covered more than 22 items and were classified as high-score websites. The EQIP score achieved by websites ranged between 4 and 30, out of a total possible 36 points; the median score was 19 points. The top five high-scoring web pages are highlighted. The overall quality of Internet-based patient information on orofacial clefts is low. Also, the majority of web pages created by medical practitioners have a marketing perspective and in order to attract more patients/customers avoid mentioning the risks of the reconstructive procedures needed.
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Affiliation(s)
- G A Karamitros
- Medical School, Aristotle University of Thessaloniki, Greece.
| | - N A Kitsos
- Faculty of Medicine, University of Southampton, Southampton, UK
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Karamitros GA, Kitsos NA, Sapountzis S. Systematic Review of Quality of Patient Information on Phalloplasty in the Internet. Aesthetic Plast Surg 2017; 41:1426-1434. [PMID: 28698939 DOI: 10.1007/s00266-017-0937-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 06/24/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND An increasing number of patients, considering aesthetic surgery, use Internet health information as their first source of information. However, the quality of information available in the Internet on phalloplasty is currently unknown. This study aimed to assess the quality of patient information on phalloplasty available in the Internet. METHODS The assessment of the Web sites was based on the modified Ensuring Quality Information for Patients (EQIP) instrument (36 items). Three hundred Web sites were identified by the most popular Web search engines. RESULTS Ninety Web sites were assessed after, duplicates, irrelevant sources and Web sites in other languages rather than English were excluded. Only 16 (18%) Web sites addressed >21 items, and scores tended to be higher for Web sites developed by academic centers and the industry than for Web sites developed by private practicing surgeons. The EQIP score achieved by Web sites ranged between 4 and 29 of the total 36 points, with a median value of 17.5 points (interquartile range, 13-21). The top 5 Web sites with the highest scores were identified. CONCLUSIONS The quality of patient information on phalloplasty in the Internet is substandard, and the existing Web sites present inadequate information. There is a dire need to improve the quality of Internet phalloplasty resources for potential patients who might consider this procedure. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Zuk G, Reinisch KB, Raptis DA, Fertsch S, Guggenheim M, Palma AF. Dupuytren Disease: Is There Enough Comprehensive Patient Information on the Internet? Interact J Med Res 2017. [PMID: 28642214 PMCID: PMC5500780 DOI: 10.2196/ijmr.7822] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Dupuytren disease is a chronic nonmalign fibroproliferative disorder that causes finger contractures via proliferation of new tissue under the glabrous skin of the hand, resulting in multiple functional limitations for the patient. As many surgical therapy options exist, patients suffering from this condition actively search for information in their environment before consulting a health professional. Objective As little is known about the quality of Web-based patient information, the aim of this study was to conduct its systematic evaluation using a validated tool. Methods A total of 118 websites were included, and qualitative and quantitative assessment was performed using the modified Ensuring Quality Information for Patients (EQIP) tool. This standardized and reproducible tool consists of 36 items to assess available information in three categories: contents, identification, and structure data. Scientific data with restricted access, duplicates, and irrelevant websites were not included. Results Only 32 websites addressed more than 19 items, and the scores did not significantly differ among the website developers. The median number of items from the EQIP tool was 16, with the top websites addressing 28 out of 36 items. The quality of the newly developed websites did not increase with passing time. Conclusions This study revealed several shortcomings in the quality of Web-based information available for patients suffering from Dupuytren disease. In the world of continuously growing and instantly available Web-based information, it is the health providers’ negligence of the last two decades that there are very few good quality, informative, and educative websites that could be recommended to patients.
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Affiliation(s)
- Grzegorz Zuk
- Hospital of Wetzikon, Department of Surgery, Wetzikon, Switzerland
| | | | - Dimitri A Raptis
- Cantonal Hospital of Olten, Department of Surgery, Olten, Switzerland
| | - Sonia Fertsch
- Sana Hospital, Department of Plastic and Esthetic Surgery, Düsseldorf, Germany
| | - Merlin Guggenheim
- Department of Plastic Surgery and Hand Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Adrian F Palma
- Hospital of Wetzikon, Department of Surgery, Wetzikon, Switzerland
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What Are Your Patients Reading Online About Soft-tissue Fillers? An Analysis of Internet Information. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e824. [PMID: 27536503 PMCID: PMC4977152 DOI: 10.1097/gox.0000000000000840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/08/2016] [Indexed: 11/26/2022]
Abstract
Background: Soft-tissue fillers are increasingly being used for noninvasive facial rejuvenation. They generally offer minimal downtime and reliable results. However, significant complications are reported and patients need to be aware of these as part of informed consent. The Internet serves as a vital resource to inform patients of the risks and benefits of this procedure. Methods: Three independent reviewers performed a structured analysis of 65 Websites providing information on soft-tissue fillers. Validated instruments were used to analyze each site across multiple domains, including readability, accessibility, reliability, usability, quality, and accuracy. Associations between the endpoints and Website characteristics were assessed using linear regression and proportional odds modeling. Results: The majority of Websites were physician private practice sites (36.9%) and authored by board-certified plastic surgeons or dermatologists (35.4%) or nonphysicians (27.7%). Sites had a mean Flesch-Kincaid grade level of 11.9 ± 2.6, which is well above the recommended average of 6 to 7 grade level. Physician private practice sites had the lowest scores across all domains with a notable lack of information on complications. Conversely, Websites of professional societies focused in plastic surgery and dermatology, as well as academic centers scored highest overall. Conclusions: As the use of soft-tissue fillers is rising, patients should be guided toward appropriate sources of information such as Websites sponsored by professional societies. Medical professionals should be aware that patients may be accessing poor information online and strive to improve the overall quality of information available on soft-tissue fillers.
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Systematic Review of Quality of Patient Information on Liposuction in the Internet. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e759. [PMID: 27482498 PMCID: PMC4956871 DOI: 10.1097/gox.0000000000000798] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 04/29/2016] [Indexed: 12/27/2022]
Abstract
Background: A large number of patients who are interested in esthetic surgery actively search the Internet, which represents nowadays the first source of information. However, the quality of information available in the Internet on liposuction is currently unknown. The aim of this study was to assess the quality of patient information on liposuction available in the Internet. Methods: The quantitative and qualitative assessment of Web sites was based on a modified Ensuring Quality Information for Patients tool (36 items). Five hundred Web sites were identified by the most popular web search engines. Results: Two hundred forty-five Web sites were assessed after duplicates and irrelevant sources were excluded. Only 72 (29%) Web sites addressed >16 items, and scores tended to be higher for professional societies, portals, patient groups, health departments, and academic centers than for Web sites developed by physicians, respectively. The Ensuring Quality Information for Patients score achieved by Web sites ranged between 8 and 29 of total 36 points, with a median value of 16 points (interquartile range, 14–18). The top 10 Web sites with the highest scores were identified. Conclusions: The quality of patient information on liposuction available in the Internet is poor, and existing Web sites show substantial shortcomings. There is an urgent need for improvement in offering superior quality information on liposuction for patients intending to undergo this procedure.
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Robinson JR, Huth H, Jackson GP. Review of information technology for surgical patient care. J Surg Res 2016; 203:121-39. [PMID: 27338543 PMCID: PMC4939767 DOI: 10.1016/j.jss.2016.03.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 03/16/2016] [Accepted: 03/22/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Electronic health records (EHRs), computerized provider order entry (CPOE), and patient portals have experienced increased adoption by health care systems. The objective of this study was to review evidence regarding the impact of such health information technologies (HIT) on surgical practice. MATERIALS AND METHODS A search of Medline, EMBASE, CINAHL, and the Cochrane Library was performed to identify data-driven, nonsurvey studies about the effects of HIT on surgical care. Domain experts were queried for relevant articles. Two authors independently reviewed abstracts for inclusion criteria and analyzed full text of eligible articles. RESULTS A total of 2890 citations were identified. Of them, 32 observational studies and two randomized controlled trials met eligibility criteria. EHR or CPOE improved appropriate antibiotic administration for surgical procedures in 13 comparative observational studies. Five comparative observational studies indicated that electronically generated operative notes had increased accuracy, completeness, and availability in the medical record. The Internet as an information resource about surgical procedures was generally inadequate. Surgical patients and providers demonstrated rapid adoption of patient portals, with increasing proportions of online versus inperson outpatient surgical encounters. CONCLUSIONS The overall quality of evidence about the effects of HIT in surgical practice was low. Current data suggest an improvement in appropriate perioperative antibiotic administration and accuracy of operative reports from CPOE and EHR applications. Online consumer health educational resources and patient portals are popular among patients and families, but their impact has not been studied well in surgical populations. With increasing adoption of HIT, further research is needed to optimize the efficacy of such tools in surgical care.
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Affiliation(s)
- Jamie R Robinson
- Department of Pediatric Surgery, Vanderbilt Children's Medical Center, Nashville, Tennessee; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Hannah Huth
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Gretchen P Jackson
- Department of Pediatric Surgery, Vanderbilt Children's Medical Center, Nashville, Tennessee; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
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Palma AF, Zuk G, Raptis DA, Franck S, Eylert G, Frueh FS, Guggenheim M, Shafighi M. Quality of information for women seeking breast augmentation in the Internet. J Plast Surg Hand Surg 2016; 50:262-71. [DOI: 10.3109/2000656x.2016.1154469] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Evaluating Written Patient Information for Eczema in German: Comparing the Reliability of Two Instruments, DISCERN and EQIP. PLoS One 2015; 10:e0139895. [PMID: 26440612 PMCID: PMC4595422 DOI: 10.1371/journal.pone.0139895] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 09/18/2015] [Indexed: 11/22/2022] Open
Abstract
Patients actively seek information about how to cope with their health problems, but the quality of the information available varies. A number of instruments have been developed to assess the quality of patient information, primarily though in English. Little is known about the reliability of these instruments when applied to patient information in German. The objective of our study was to investigate and compare the reliability of two validated instruments, DISCERN and EQIP, in order to determine which of these instruments is better suited for a further study pertaining to the quality of information available to German patients with eczema. Two independent raters evaluated a random sample of 20 informational brochures in German. All the brochures addressed eczema as a disorder and/or therapy options and care. Intra-rater and inter-rater reliability were assessed by calculating intra-class correlation coefficients, agreement was tested with weighted kappas, and the correlation of the raters’ scores for each instrument was measured with Pearson’s correlation coefficient. DISCERN demonstrated substantial intra- and inter-rater reliability. It also showed slightly better agreement than EQIP. There was a strong correlation of the raters’ scores for both instruments. The findings of this study support the reliability of both DISCERN and EQIP. However, based on the results of the inter-rater reliability, agreement and correlation analyses, we consider DISCERN to be the more precise tool for our project on patient information concerning the treatment and care of eczema.
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Gordon EJ, Mullee J, Butt Z, Kang J, Baker T. Optimizing informed consent in living liver donors: Evaluation of a comprehension assessment tool. Liver Transpl 2015; 21:1270-9. [PMID: 25990592 DOI: 10.1002/lt.24175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 04/29/2015] [Accepted: 05/16/2015] [Indexed: 02/07/2023]
Abstract
Adult-to-adult living liver donation is associated with considerable risks with no direct medical benefit to liver donors (LDs). Ensuring that potential LDs comprehend the risks of donation is essential to medically and ethically justify the procedure. We developed and prospectively evaluated the initial psychometrics of an "Evaluation of Donor Informed Consent Tool" (EDICT) designed to assess LDs' comprehension about the living donation process. EDICT includes 49 true/false/unsure items related to LD informed consent. Consecutive LDs undergoing evaluation at 1 academic medical center from October 2012 to September 2014 were eligible for participation in pretest/posttest interviews. Medical records were reviewed for postdonation complications. Twenty-seven LDs participated (96% participation rate). EDICT demonstrated good internal consistency reliability at pretest, 2 days before donating (Cronbach's α = 0.78), and posttest, 1 week after donating (α = 0.70). EDICT scores significantly increased over time (P = 0.01) and demonstrated good test-retest reliability (r = 0.68; P < 0.001). EDICT was associated with race/ethnicity (P = 0.02) and relationship to the recipient (P = 0.01; pretest), and income (P = 0.01) and insurance (P = 0.01; posttest), but not with decisional conflict, preoperative preparedness, satisfaction, or decisional regret (pretest and posttest). Donor complications did not impact postdonation EDICT scores. In conclusion, EDICT has promising measurement properties and may be useful in the evaluation of informed consent for potential LDs.
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Affiliation(s)
- Elisa J Gordon
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Jack Mullee
- Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Zeeshan Butt
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Joseph Kang
- Department of Epidemiology and Biostatistics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Talia Baker
- Division of Transplantation, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Gordon EJ, Rodde J, Skaro A, Baker T. Informed consent for live liver donors: A qualitative, prospective study. J Hepatol 2015; 63:838-47. [PMID: 26003265 DOI: 10.1016/j.jhep.2015.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/02/2015] [Accepted: 05/07/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Adult-to-adult live donor liver transplantation (LDLT) poses serious health risks and no direct health benefits to donors. Ensuring live donors' autonomy through informed consent is critical. We assessed live liver donors' (LD) comprehension, information needs, risk perceptions, and demographics. METHODS Semi-structured interviews were prospectively conducted with LDs after completing donor evaluation and informed consent at our transplant center. Likert scales measured informed consent domains. Open-ended responses underwent thematic analysis. RESULTS Thirty LDs participated (100% participation rate). Although 90% of LDs reported being informed about donation 'a great deal', only 66% reported understanding information about donation 'a great deal.' Many (40%) reported difficulty understanding medical terminology. Information LDs most desired to feel comfortable with their decision included: incidence and type of donor complications (67%), description of donation procedure (57%), and the process of donor preparation (43%). Most (83%) LDs rated risks to themselves as 'not at all' to 'somewhat' risky, and minimized these risks. CONCLUSIONS Although LDs perceived that they were adequately informed, their actual comprehension about donation was inadequate. Findings suggest the value of informed consent for preparation for the procedure and potential periprocedural risks rather than for decision-making. More comprehensible information disclosure may optimize informed consent.
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Affiliation(s)
- Elisa J Gordon
- Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
| | - Jillian Rodde
- Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Anton Skaro
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Talia Baker
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Frueh F, Palma A, Raptis D, Graf C, Giovanoli P, Calcagni M. Carpal tunnel syndrome: Analysis of online patient information with the EQIP tool. ACTA ACUST UNITED AC 2015; 34:113-21. [DOI: 10.1016/j.main.2015.04.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 04/19/2015] [Accepted: 04/29/2015] [Indexed: 12/17/2022]
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Bramstedt KA, Dave S. The silence of Good Samaritan kidney donation in Australia: a survey of hospital websites. Clin Transplant 2013; 27:E244-8. [PMID: 23383858 DOI: 10.1111/ctr.12087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2012] [Indexed: 12/27/2022]
Abstract
It is common for living donor candidates to use the Internet as a tool to enhance their decision-making process. Specifically, the websites of transplant hospitals can potentially be a vital source of information for those contemplating living donation. In an effort to explore the low incidence of Good Samaritan kidney donation (donations to strangers) in Australia, two raters conducted a nine-attribute website content analysis for all hospitals which participate in these transplants (n = 15). Overall, the concept of living donation is relatively silent on Australian hospital websites. Only four hospitals mention their living donor program, and only one mentions their Good Samaritan program. No site linked directly to Australia's AKX Paired Kidney Exchange Program - the only program which facilitates pair and chain transplants in Australia. Further, information about deceased donation is nearly absent as well. An individual with the altruistic desire to donate will generally find scant or absent information about donation at the website of their local transplant hospital, although this information could easily be present as an educational tool which supports the consent process. Using a hospital website to educate the public about a clinical service should not be viewed as ethically problematic (solicitation), but rather an ethical essential.
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