Quality of Information About Bariatric Surgery on the Internet: A Two-Continent Comparison of Website Content

The Effect of Internet Information Pollution on Surgical Fear in Patients Undergoing Surgery

PURPOSE

This study aimed to determine the effect of internet information pollution on levels of surgical fear among patients undergoing surgery.

DESIGN

Observational study.

METHODS

This study was conducted with 407 patients scheduled for surgery in the surgical wards of a university hospital. Data were collected preoperatively using a patient information form, the Internet Information Pollution Scale, and the Surgical Fear Questionnaire.

FINDINGS

A very weak positive correlation was found between total internet information pollution score and total surgical fear score (r = 0.184; P < .001). In regression analysis of the impact of internet information pollution on total surgical fear score, the regression model was significant (F = 13.183; P < .001), with 2.9% of the total change in surgical fear score explained by the total internet information pollution score (R2 = 0.029).

CONCLUSIONS

The results of this study suggest that the information pollution surgical patients encounter on the internet may increase their surgical fear. We recommend directing patients to reliable information sources and attempting to control unreliable data sources to prevent online information pollution and reduce patients' surgical fear.

Assessment of electronic patient education materials for adolescent bariatric surgery candidates: An environment scan

Objective

Adolescents who opt for metabolic and bariatric surgery (MBS) will use the internet to learn about the procedure. The objective of this study is to assess the suitability of electronic patient education materials (ePEM) of North American centers that perform adolescent bariatric surgery.

Methods

Canadian and American bariatric centers that perform adolescent MBS were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program and Google web-based searches. Suitability of ePEM for the adolescent readership was evaluated using the Suitability Assessment of Materials (SAM).

Results

Sixty-five centers were evaluated from June to July 2020 with 41% citing adolescent specific material. Six percent of the ePEM were evaluated as 'not suitable', 69% were evaluated as 'adequate', and 25% were evaluated as 'superior'.

Conclusion

Adequate ePEM scoring was obtained, but centers had little resources tailored to adolescent patients. Further research is needed to evaluate all the resources provided to adolescents (i.e., resources provided by the health team) to ensure the tools are appropriate for the adolescent readership.

Innovation

This environmental scan provided insights to ePEM available for adolescents considering MBS.

Web-Based Content on Diet and Nutrition Written in Japanese: Infodemiology Study Based on Google Trends and Google Search

BACKGROUND

The increased availability of content of uncertain integrity obtained through the internet is a major concern. To date, however, there has been no comprehensive scrutiny of the fitness-for-purpose of web-based content on diet and nutrition.

OBJECTIVE

This cross-sectional study aims to describe diet- and nutrition-related web-based content written in Japanese, identified via a systematic extraction strategy using Google Trends and Google Search.

METHODS

We first identified keywords relevant for extracting web-based content (eg, blogs) on diet and nutrition written in Japanese using Google Trends. This process included identification of 638 seed terms, identification of approximately 1500 pairs of related queries (top) and search terms, the top 10% of which were extracted to identify 160 relevant pairs of related queries (top) and search terms, and identification of 107 keywords for search. We then extracted relevant web-based content using Google Search.

RESULTS

The content (N=1703) examined here was extracted following a search based on 107 keywords. The most common themes included food and beverages (390/1703, 22.9%), weight management (366/1703, 21.49%), health benefits (261/1703, 15.33%), and healthy eating (235/1703, 13.8%). The main disseminators were information technology companies and mass media (474/1703, 27.83%), food manufacturers (246/1703, 14.45%), other (236/1703, 13.86%), and medical institutions (214/1703, 12.57%). Less than half of the content (790/1703, 46.39%) clearly indicated the involvement of editors or writers. More than half of the content (983/1703, 57.72%) was accompanied by one or more types of advertisement. The proportion of content with any type of citation reference was 40.05% (682/1703). The themes and disseminators of content were significantly associated with the involvement of editors or writers, accompaniment with advertisement, and citation of reference. In particular, content focusing on weight management was more likely to clearly indicate the involvement of editors or writers (212/366, 57.9%) and to be accompanied by advertisement (273/366, 74.6%), but less likely to have references cited (128/366, 35%). Content from medical institutions was less likely to have citation references (62/214, 29%).

CONCLUSIONS

This study highlights concerns regarding the authorship, conflicts of interest (advertising), and the scientific credibility of web-based diet- and nutrition-related information written in Japanese. Nutrition professionals and experts should take these findings seriously because exposure to nutritional information that lacks context or seems contradictory can lead to confusion and backlash among consumers. However, more research is needed to draw firm conclusions about the accuracy and quality of web-based diet- and nutrition-related content and whether similar results can be obtained in other major mass media or social media outlets and even other languages.

Evaluating the readability, quality and reliability of online information on Behçet’s disease

There are concerns over the reliability and comprehensibility of health-related information on the internet. The goal of our research was to analyze the readability, reliability, and quality of information obtained from websites associated with Behçet’s disease (BD). On September 20, 2021, the term BD was used to perform a search on Google, and 100 eligible websites were identified. The Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog (GFOG) were used to evaluate the readability of the website. The JAMA score was used to assess the websites’ reliability, the DISCERN score and the Health on the Net Foundation code of conduct (HONcode) were used to assess quality, and Alexa was used to analyze their popularity. Sections of the text were evaluated, and the results revealed that the mean FRES was 35.49±14.42 (difficult) and the mean GFOG was 14.93±3.13 years (very difficult). According to the JAMA scores, 36% of the websites had a high reliability rating and 20% adhered to the HONcode. The readability was found to significantly differ from the reliability of the websites (p<0.05). Moreover, websites with scientific content were found to have higher readability and reliability (p<0.05). The readability of BD-related information on the Internet was found to be considerably higher than that recommended by the National Health Institute’s Grade 6, with moderate reliability and good quality. We believe that online information should have some level of readability and must have reliable content that is appropriate to educate the public, particularly for websites that provide with patient education material.

Knowledge and Attitudes Towards Obesity and Bariatric Surgery in University Students: a National Survey

BACKGROUND

Obesity has become a noticeable public health problem, especially in the young population. Bariatric surgery is growing in China but it is still new to the general public. Knowledge and attitudes towards obesity and bariatric surgery in university students are important to national health decision-making.

OBJECTIVES

To study the knowledge and attitudes towards obesity and bariatric surgery among Chinese university students.

METHODS

A self-designed questionnaire was distributed to university students to fill in online from June to July 2021.

RESULTS

A total of 3199 questionnaires were received, with an effective rate of 98.58% (3154 questionnaires). 65.44% of whom had normal BMI and 12.14% of whom were overweight or in obesity. More than 80% of them had a high knowledge of the common causes and complications of obesity but lacked knowledge of the relationship between obesity and bone and joint, tumor or cancer, and reproductive diseases. 51.55% of them thought they needed to lose weight, especially female students (P < 0.01). Only 39% had regular physical exercise habits, 58.62% of them could reasonably control their diet, and more than 2/3 of them (67.82%) often stayed up late. Safety (29.77%) and effectiveness (29.3%) of bariatric surgery were not well accepted. Among medical students, education positively affected knowledge and attitudes towards bariatric surgery (P < 0.05). Mass media and social platforms were the main sources for obtaining obesity and weight-loss information.

CONCLUSIONS

Chinese university students have insufficient knowledge of obesity and related complications, lack of scientific management of their own weight, and poor acceptance of bariatric surgery. More education is needed on this issue.

Bariatric surgery in the Middle East and North Africa: narrative review with focus on culture-specific considerations

There is an increasing volume of bariatric surgeries in the Middle East and North Africa (MENA), but the context of bariatric surgery in the region is not fully understood. Incorporating culture-specific considerations in the provision of care to patients who undergo bariatric surgery may help to optimize outcomes after surgery. We conducted a narrative review of published research studies on bariatric surgery in the MENA region, highlighting cultural and contextual aspects relevant to the care of bariatric surgery patients who undergo surgery in this geographic area. The authors searched the following online databases: PubMed, CINAHL, Embase, and Academic Search Elite from 2010-2020 for studies conducted in 18 countries in the MENA region. This narrative review identifies cultural-specific considerations that may affect bariatric care and outcomes in 6 domains: knowledge of bariatric surgery; mental health, body image, and quality of life; influence of family; religion and lifestyle; preoperative practices; and healthcare access. Provision of culturally congruent care may help patients to achieve the best possible outcomes after bariatric surgery. Results may inform efforts to provide safe and culture-specific care in the MENA region, as well as those who migrate or seek care in other countries. More research is warranted on this heterogeneous population to optimize postsurgery weight trajectory and psychosocial adjustment.

Evaluating the readability, understandability, and quality of online materials about chest pain in children

An increasing number of individuals use the Internet to obtain health information. However, online health information is unregulated and highly variable. We aimed to assess the readability, understandability, and quality of online information available for "chest pain in children." This analysis was performed in January 2020, by inputting the search term "chest pain in children" into Google. The 180 search results were evaluated/categorized. The readability was assessed using the Flesch reading ease score, the Gunning FOG readability score, the Flesch-Kincaid grade level, the Coleman-Liau score, the Simple Measure of Gobbledygook readability score, the Fry readability score, and the automated readability index (ARI). The quality was assessed through the Journal of the American Medical Association (JAMA) benchmark criteria. The understandability was evaluated by the Patient Education Materials Assessment Tool (PEMAT) for this study. Sixty-five websites were analyzed (academic and hospital websites (n = 30), physicians and health information websites (n = 35)). Among all websites, the average reading grade level was 9.99. There was no statistical difference between the two groups for the average readability level (p: 0.645). The mean PEMAT score for all websites was 65.09%. There was no statistical difference between the two groups for the average PEMAT score (p: 0.945). For both groups, the understandability score was below 70%. The average JAMA benchmark score was 2.43 ± 1.06, with a statistically significant difference between the academic and hospital websites (2.07 ± 0.91) and physician and health information websites (2.74 ± 1.09, p: 0.009).Conclusion: The readability of online materials available for patients regarding "chest pain in children" was significantly higher than the grade 6 recommended by the National Institutes of Health. The current online health information related to pediatric chest pain may be too difficult for the average reader to read. The quality and understandability were not good for both groups. Improving the readability, understandability, and quality of pediatric health-related online materials has the potential to reduce parental anxiety, improve baseline medical knowledge, and even enhance the physician-parent alliance.