Die Lesbarkeit von onlinebasierten Patienteninformationen in der Augenheilkunde

Pharmacological articles in the German magazine DIE ZEIT (THE TIME)-content, adequacy, and comprehensibility

The German weekly magazine DIE ZEIT (THE TIME) reaches more than one million readers per issue, mainly from high-income social classes. Pharmacological content is frequent in DIE ZEIT. As it therefore reaches many people who generally have no in-depth knowledge of pharmacology, it can be assumed that DIE ZEIT is an important primary source of information. It should be its task to depict the drugs widely used by the population and to present them correctly and comprehensibly. This study analyzes 71 articles from 2012 to 2022 in terms of form, content, and comprehensibility. The analysis shows that in DIE ZEIT, drug groups largely correspond to the prescription figures and disease prevalence in Germany, with cardiovascular, neuropsychiatric, and pain medications being frequently discussed. There are deviations in the case of oncological drugs, for example, which are discussed more frequently than prescribed. New drug approvals are reported less frequently, and when they are, it is usually about the research phase. DIE ZEIT often reports on findings that are less than a week old and frequently quotes trustworthy experts, but no scientific sources can be found in around a quarter of the articles. A COVID-19 effect can also be identified in the years 2020 to 2022, as reporting on drugs for the treatment of coronavirus disease 2019 (COVID-19) predominated. An important point of criticism was identified with regard to comprehensibility. Less than half of the articles achieved the cut-off value for general comprehensibility specified by the Textlab analysis program, and only one article achieved the value for target group-oriented comprehensibility. This analysis confirms the problem that science communication is often too complicated and incomprehensible. It discusses the tension between the prescribed drugs and the mission of DIE ZEIT to entertain and should serve as a basis for analyzing other newspapers. Finally, we make specific suggestions how presentation of pharmacological topics in lay media can be improved in the future.

Surgical Care in Specialist Ophthalmology Departments: Structure and Impact of the COVID-19 Pandemic

BACKGROUND

Specialist ophthalmology departments contribute to the surgical care of German patients. Outpatient and inpatient surgeries were restricted during the COVID-19 pandemic and led to a sharp decline in the number of cases in ophthalmological care. The aim of this analysis was to improve the understanding of the logistic structures of medical facilities as well as the effects of the pandemic.

MATERIAL AND METHOD

Based on reported process data, a sample of the specialist ophthalmological departments were examined based on operation and procedure codes (OPS) and data submitted between 01.01.2017 and 31.05.2021 according to the benchmarking programmes of the Professional Association of German Anaesthetists (BDA), the Professional Association of German Surgeons (BDC), and the Association for Operating Theatre Management (VOPM).

RESULTS

Eighteen ophthalmology departments from Germany were analysed. After the decline in the number of cases (by temporarily up to 48%) during the first wave of the pandemic, the case numbers of all interventions assessed as nonurgent continued to be reduced. While intravitreal injections hardly decreased during the first wave (- 16%), significant drops in the coverage of cataract surgery (- 79%), vitrectomies (- 35%), glaucoma surgery (- 59%), strabismus surgery (- 95%), and eyelid surgery (- 52%) were found. One exception was intravitreal injection, which stabilised at a lower level early on during the pandemic. Overall, the number of cases during the later phases of the pandemic were significantly reduced below the level of previous years, despite the maintenance of emergency care. The underuse was variable for different interventions.

CONCLUSION

In addition to self-reported figures, the analysed process data demonstrates the effect that various factors had on elective as well as urgent operations within hospital care during the pandemic. Despite partial stabilisation of some services, a relevant supply gap for outpatient and inpatient interventions was identified, with corresponding effects on the eye health of the population, while compensation or performance enhancement have not taken place to date. Facing the growing preload and the demographic development, future structures must therefore allow for an increase in the performance of specialist ophthalmological departments.

An evaluation of the efficacy of a supplemental computer-based tutorial to enhance the informed consent process for cataract surgery: an exploratory randomized clinical study

Background

To assess whether informing patients with a computer-based tutorial in addition to standard informed consent influences the patient’s attitude towards surgery and increases patient’s knowledge.

Methods

In this prospective, exploratory, randomized clinical study, patients scheduled for their first eye cataract surgery were randomly allocated to two groups, receiving standard face-to-face informed consent (control group) or additionally using an interactive computer-based tool (CatInfo) containing an audiovisual presentation about cataract and its treatment (study group). Cataract-related knowledge and decisional confidence (decisional conflict scale (DCS)) were assessed as well as one-month postoperatively decisional regret (decision regret scale (DRS)) and willingness to exchange face-to-face discussion time for the use of such a tool.

Results

The study comprised 134 patients, 64 patients in the study group and 70 in the control group. Patients in the study group answered more questions correctly, 16.3 ± 2.0 (median 16.5, 11.0–19.0) versus 15.5 ± 1.9 (median 16.0, 8.0–19.0; p = 0.01). Patients showed a high decisional confidence with a study group mean DCS score of 92.4 ± 9.8 (median 96.9, 65.6–100) and control group score of 91.6 ± 10.9 (median 95.3, 43.3–100; p = 0.52). Mean DRS score in the study group was 2.5 ± 8.0 (median 0, 0–40) and 4.3 ± 12.5 (median 0, 0–75) in the control group (p = 0.14). Of study group patients 23 (67.6%) were willing to trade time, on average 158 ± 180 s (median 120 s, 45–900). Satisfaction with the tool was high with a mean of 9.1 ± 1.3 out of 10 (median 9.7, 5.0–10).

Conclusions

Cataract-related knowledge was generally good, with slightly higher scores in the study group. In both groups, decisional confidence was high and regret after surgery was low. A tendency towards slightly higher decisional confidence and lower regret was found in the study group, although these differences were not statistically significant. Additional use of an interactive computer-based tool may prove useful in the informed consent process in a high-volume cataract outpatient setting.

Trial registration

ClinicalTrials.gov, NCT04975126. Retrospectively registered – July 23, 2021.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12886-022-02652-z.

Most YouTube Videos About Carpal Tunnel Syndrome Have the Potential to Reinforce Misconceptions

BACKGROUND

Studies of online health information have addressed completeness and adherence to evidence, which can be difficult because current evidence leaves room for debate about etiology, diagnosis, and treatment. Fewer studies have evaluated whether online health information can reinforce misconceptions. It can be argued that information with the potential to harm health by reinforcing unhelpful misconceptions ought to be held to a higher standard of evidence.

QUESTIONS/PURPOSES

(1) What is the prevalence and nature of health information in YouTube videos with the potential to reinforce common misconceptions about symptoms and treatment associated with carpal tunnel syndrome (CTS)? (2) What factors (such as the number of views, likes, and subscribers) are associated with Potential Reinforcement of Misconception scores of YouTube videos about CTS?

METHODS

After removing all personalized data, we searched for the term "carpal tunnel syndrome" on YouTube, reviewed the first 60 English-language videos that discussed the diagnosis and treatment of CTS, and collected available metrics. The primary outcome was the number of statements that could reinforce misconceptions about CTS, rated by two authors using a checklist. As a secondary outcome, we counted the number of statements that could help patients by reorienting or balancing common misconceptions, providing agency, and facilitating decisions, and we subtracted the number of potential misconceptions from this count. A modified version of the DISCERN instrument (a validated scoring system designed to gauge the quality and reliability of health information) was used to evaluate each video. We sought factors associated with the Potential Reinforcement of Misconception score-in both the negative-only and combined (positive and negative) variations-accounting for various YouTube metrics (such as the number of views, number of likes and dislikes, and duration) and the modified DISCERN score. The interrater reliability was excellent for both the Potential Reinforcement of Misconceptions checklist (ICC = 0.97; Pearson correlation [r] = 0.97) and DISCERN information quality score (ICC = 0.96; r = 0.97).

RESULTS

Seventy-eight percent of the YouTube videos (47 of 60 videos) contained at least one statement that could reinforce common misconceptions about CTS. The median number of potentially misconception-reinforcing statements was two (range one to three), with the most common statements being that CTS is caused by hand use (38%; 23 of 60 videos) and that splints can alter the natural history of the disease (37%; 22 videos). Videos that were more popular (higher number of views or likes) did not contain less potential reinforcement of misconceptions. In the multivariable analysis, we found a strong association between the DISCERN score and the CTS Potential Reinforcement of Misconceptions score (regression coefficient = 0.67; 95% CI 0.22-1.2; partial r2 = 0.13; p = 0.004) and a lower number of subscribers (calculated per one million subscribers: regression coefficient = -0.91; 95% CI -1.8 to -0.023; p = 0.045).

CONCLUSION

Potential reinforcement of misconceptions is prevalent in YouTube videos about CTS, more so in videos with lower information quality scores.

CLINICAL RELEVANCE

Online health information should be held to a standard of accuracy (alignment with best evidence), and where such evidence leaves room for debate, it should be held to a standard by which unhealthy misconceptions are not reinforced.

Public Interest in Cataract Surgery: Analysis and Implications of Google Trends Data from 14 European Countries

Purpose: Cataract surgery is the most common surgery performed in the European Union (EU) annually. Analysis of Google Trends (GT) data could give European eye care providers useful information regarding interest in cataract surgery and potential barriers making patients unwilling to undergo surgery.Methods: Data were collected using GT for cataract surgery and the two most related queries, for each of 14 included countries from January 2004 to December 2018. Case volumes were extracted from the Eurostat report for the calendar years 2004-2018.Results: The most related queries analysis demonstrated surgery outcomes, founding issues and understanding of the disease as potential factors for patients considering cataract surgery. Trend analysis showed that the total search volumes for "cataract surgery" gradually increased over the study period. Also, for "cataract", "after cataract surgery", "cataract surgery NHF" rising trends were revealed. Trends found for "cataract surgery price" and "cataract surgery complications" were inconclusive. Univariate linear regression analysis demonstrated statistically significant correlations between average annual search volumes of "cataract surgery" and the annual volume of cataract surgeries performed in included countries, according to Eurostat data (R² = 0.889, p = <.001). In addition, univariate linear regression analyses revealed similar, statistically significant correlation for each the most related queries.Conclusions: To the knowledge of the authors, this is the first and the only analysis of GT data in the ophthalmology literature to date. This study highlights this potentially powerful data set for European eye care providers.

Evaluation of the Content, Quality, and Readability of Patient Accessible Online Resources Regarding Cataracts

PURPOSE

To evaluate the content quality, accuracy, and readability of commonly visited websites by cataract patients contemplating cataract surgery.

SETTING

Freely available online information.

DESIGN

Cross-sectional study.

METHODS

Ten websites were evaluated in a cross-sectional study for content analysis using a grading sheet of 40 questions individually scored by three ophthalmologists. JAMA benchmarks were used to assess the quality. An online readability tool, Readable, was used to assess the readability.

RESULTS

There was a significant difference between the content and accuracy of each website according to a Kruskal-Wallis test (H = 22.623, P = .007). The average score for all websites using the grading sheet was 90.85 out of 160 points, or 57% (SD 29.93, CI 95%±17.69). There was no significant correlation between website rank on Google.com and content quality of the website (r = 0.049, P = .894). No websites complied with all 4 JAMA criteria for authorship. There was no significant correlation between content quality of each website and number of JAMA requirements met (r = -0.563, P = .09). The average Flesch Reading Ease Score for all websites was 52.64 (SD 11.94, CI 95%±7.40), and the average Mean Reading Grade was 10.72 (SD 1.58, CI 95%±0.98). There was a significant difference in Mean Reading Grades between websites (H = 23.703, P = .005). There was no significant correlation between content quality of the website and Mean Reading Grade (r = -0.552, P = .098).

CONCLUSION

Commonly accessed online resources on cataracts and cataract surgery are insufficient to provide patients with a clear and complete understanding of their condition as well as available medical and surgical treatment options.

Sign language instrument for assessing the knowledge of deaf people about Cardiopulmonary Resuscitation

Objective:

to build and validate the content on Cardiopulmonary Resuscitation (CPR) of a sign language instrument for assessing the knowledge of the deaf.

Method:

methodological study in which the content validity process was used by 22 specialists in cardiac arrest and 16 deaf people. In the validation of internal consistency, 113 deaf people participated. For the assessment of the deaf, the Assistive Technology Assessment Questionnaire was used and, in the content validity, an instrument with a Likert scale was used, which included the content, clarity, objectivity, organization and language. Items with a minimum agreement of 80% were considered valid, according to the Content Validity Index (CVI) and binomial test. The internal consistency was verified by Cronbach’s alpha.

Results:

The instrument contains 11 questions about the identification of cardiorespiratory arrest, activation by aid and high quality chest compression. It had a minimum content validity of 81% by the specialists, 90% by the deaf participants and internal consistency by the Cronbach alpha of 0.86, being considered high.

Conclusion:

the instrument can be used in research to survey the previous knowledge of deaf people about CPR, as well as in pre and/or post-testing studies that test educational interventions with this public.

Creation and validation of an educational video for deaf people about cardiopulmonary resuscitation

Objective:

to create and validate an educational video for teaching deaf students about cardiopulmonary resuscitation.

Method:

methodological study consisting in the creation of an educational video, validation of its content by 22 nurses with expertise in cardiorespiratory arrest, and evaluation by 16 deaf students. For data collection, the following validated instruments were used: the Instrument for Validation of Educational Content used for the validation by nurses and the Assistive Technology Assessment Questionnaire for the evaluation by deaf students. The criterion for validation was concordance higher than 80%, analyzed through the content validation index and binomial test.

Results:

the final version of the video lasted seven minutes and thirty seconds, covered the steps that should be performed by a lay person to help a victim of cardiorespiratory arrest, presented animations and the narration in the Brazilian sign language. All the items obtained agreement among nurses and of among deaf students equal or superior to 80%.

Conclusion:

the video was considered to present valid content by the judges and comprehensible content by deaf students. Thus the video represents an inclusive technology for health education of deaf people about cardiopulmonary resuscitation.