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von Sneidern M, Saaedi A, Varelas AN, Eytan DF. Characterizing the Online Discourse on Facial Paralysis: What Patients Are Asking and Where They Find Answers. Facial Plast Surg Aesthet Med 2024. [PMID: 39093987 DOI: 10.1089/fpsam.2023.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
Background: With the rising popularity of online search tools, patients seeking information on facial palsy are increasingly turning to the Internet for medical knowledge. Objective: To categorize the most common online questions about Bell's palsy or facial paralysis and the sources that provide answers to those queries. Methods: Query volumes for terms pertaining to facial palsy were obtained using Google Search trends. The top 40 keywords associated with the terms "Bell's palsy" and "facial paralysis" were extracted. People Also Ask (PAA) Questions-a Google search engine response page feature-were used to identify the top questions associated with each keyword. Results: A total of 151 PAA Questions pertaining to the top 40 keywords associated with "Bell's palsy" and "facial paralysis" were identified. Etiology questions were most frequent (n = 50, 33.1%), meanwhile those pertaining to treatment were most accessible (119.5 average search engine response pages/question, 35.5%). Most sources were academic (n = 81, 53.6%). Medical practice group sites were most accessible (211.9 average search engine response pages/website, 44.8%). Conclusion: Most PAA questions pertained to etiology and were sourced by academic sites. Questions regarding treatment and medical practice sites appeared on more search engine response pages when compared with all other categories.
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Affiliation(s)
- Manuela von Sneidern
- Department of Otolaryngology-Head and Neck Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Arman Saaedi
- Department of Otolaryngology-Head and Neck Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Antonios N Varelas
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, New York University Grossman School of Medicine, New York, New York, USA
| | - Danielle F Eytan
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, New York University Grossman School of Medicine, New York, New York, USA
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Ho RA, Shaari AL, Cowan PT, Yan K. ChatGPT Responses to Frequently Asked Questions on Ménière's Disease: A Comparison to Clinical Practice Guideline Answers. OTO Open 2024; 8:e163. [PMID: 38974175 PMCID: PMC11225079 DOI: 10.1002/oto2.163] [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: 05/04/2024] [Revised: 06/01/2024] [Accepted: 06/08/2024] [Indexed: 07/09/2024] Open
Abstract
Objective Evaluate the quality of responses from Chat Generative Pre-Trained Transformer (ChatGPT) models compared to the answers for "Frequently Asked Questions" (FAQs) from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Clinical Practice Guidelines (CPG) for Ménière's disease (MD). Study Design Comparative analysis. Setting The AAO-HNS CPG for MD includes FAQs that clinicians can give to patients for MD-related questions. The ability of ChatGPT to properly educate patients regarding MD is unknown. Methods ChatGPT-3.5 and 4.0 were each prompted with 16 questions from the MD FAQs. Each response was rated in terms of (1) comprehensiveness, (2) extensiveness, (3) presence of misleading information, and (4) quality of resources. Readability was assessed using Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease Score (FRES). Results ChatGPT-3.5 was comprehensive in 5 responses whereas ChatGPT-4.0 was comprehensive in 9 (31.3% vs 56.3%, P = .2852). ChatGPT-3.5 and 4.0 were extensive in all responses (P = 1.0000). ChatGPT-3.5 was misleading in 5 responses whereas ChatGPT-4.0 was misleading in 3 (31.3% vs 18.75%, P = .6851). ChatGPT-3.5 had quality resources in 10 responses whereas ChatGPT-4.0 had quality resources in 16 (62.5% vs 100%, P = .0177). AAO-HNS CPG FRES (62.4 ± 16.6) demonstrated an appropriate readability score of at least 60, while both ChatGPT-3.5 (39.1 ± 7.3) and 4.0 (42.8 ± 8.5) failed to meet this standard. All platforms had FKGL means that exceeded the recommended level of 6 or lower. Conclusion While ChatGPT-4.0 had significantly better resource reporting, both models have room for improvement in being more comprehensive, more readable, and less misleading for patients.
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Affiliation(s)
- Rebecca A. Ho
- Department of Otolaryngology–Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Ariana L. Shaari
- Department of Otolaryngology–Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Paul T. Cowan
- Department of Otolaryngology–Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Kenneth Yan
- Department of Otolaryngology–Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
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Cheng JW, Christakis DA, Kieran K, Niessen BA, Fernandez N, Merguerian PA, Chang EK, Shnorhavorian M. Association between YouTube® videos and health literacy with postoperative healthcare utilization following pediatric urologic surgery: A randomized trial. J Pediatr Urol 2024; 20:226.e1-226.e9. [PMID: 38071113 DOI: 10.1016/j.jpurol.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Limited caregiver health literacy has been associated with poorer health outcomes in pediatric patients and may limit caregiver understanding of printed education resources. Postoperative healthcare utilization may be related to confusion about instructions or complications. OBJECTIVE To correlate caregiver health literacy and educational video intervention with postoperative healthcare utilization following ambulatory pediatric urologic surgery. STUDY DESIGN From July through December 2021, a randomized double-blinded trial assessed postoperative healthcare utilization following pediatric urologic surgery. Caregivers were randomized to receive standardized postoperative counseling and printed instructions (control) or access to English-language educational YouTube® videos with standardized postoperative counseling and printed instructions (intervention). Medical record abstraction was completed 30 days following surgery to identify postoperative healthcare utilization with calls, messages, add-on clinic visits, or presentation for urgent or emergent care, and postoperative complications. RESULTS Target enrollment was achieved with 400 caregivers with 204 in the intervention and 196 in the control groups. There was a 32.5 % overall rate of postoperative healthcare utilization. Health literacy was inversely associated with total postoperative healthcare utilization (p < 0.001). There was no difference in the incidence of postoperative healthcare utilization between the control and intervention groups (p = 0.623). However, on sub-analysis of caregivers with postoperative healthcare utilization (Summary Figure), there were fewer total occurrences in the intervention group (intervention median 1, IQR 1,2.3; control median 2, IQR 1,3; p < 0.001). For caregivers with limited health literacy, there was a greater associated reduction in median calls from 2 (IQR 0,2) to 0 (IQR 0,0.5) with video intervention (p = 0.016). On multivariate analysis, total postoperative healthcare utilization was significantly associated with limited caregiver health literacy (OR 1.08; p = 0.004), English as preferred language (OR 0.68; p = 0.018), and older patient age (OR 0.95; p = 0.001). DISCUSSION Current resources for postoperative education are limited as resources can be written above recommended reading levels and families can have difficulty recalling information discussed during postoperative counseling. Video intervention is an underutilized resource that can provide an additional resource to families with visual and auditory aids and be accessed as needed. CONCLUSION Caregiver health literacy was inversely associated with postoperative healthcare utilization. There was no difference in the incidence of postoperative healthcare utilization with video intervention. However, on subgroup analysis, supplemental videos were associated with fewer occurrences of postoperative healthcare utilization, especially in caregivers with limited health literacy. On multivariate regression, health literacy, preferred language, and patient age were significantly associated with total postoperative healthcare utilization.
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Affiliation(s)
- Julie W Cheng
- Seattle Children's Hospital, Division of Urology, United States; University of Washington, Department of Urology, United States; Oregon Health and Science University, Department of Urology, United States.
| | | | - Kathleen Kieran
- Seattle Children's Hospital, Division of Urology, United States; University of Washington, Department of Urology, United States.
| | - Brett A Niessen
- Seattle Children's Hospital, Patient and Family Education and Communication, United States.
| | - Nicolas Fernandez
- Seattle Children's Hospital, Division of Urology, United States; University of Washington, Department of Urology, United States.
| | - Paul A Merguerian
- Seattle Children's Hospital, Division of Urology, United States; University of Washington, Department of Urology, United States.
| | - Edward K Chang
- University of Washington, Department of Urology, United States.
| | - Margarett Shnorhavorian
- Seattle Children's Hospital, Division of Urology, United States; University of Washington, Department of Urology, United States.
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Kianian R, Carter M, Finkelshtein I, Eleswarapu SV, Kachroo N. Application of Artificial Intelligence to Patient-Targeted Health Information on Kidney Stone Disease. J Ren Nutr 2024; 34:170-176. [PMID: 37839591 DOI: 10.1053/j.jrn.2023.10.002] [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: 06/04/2023] [Revised: 09/25/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVE The American Medical Association recommends health information to be written at a 6th grade level reading level. Our aim was to determine whether Artificial Intelligence can outperform the existing health information on kidney stone prevention and treatment. METHODS The top 50 search results for "Kidney Stone Prevention" and "Kidney Stone Treatment" on Google, Bing, and Yahoo were selected. Duplicate webpages, advertisements, pages intended for health professionals such as science articles, links to videos, paid subscription pages, and links nonrelated to kidney stone prevention and/or treatment were excluded. Included pages were categorized into academic, hospital-affiliated, commercial, nonprofit foundations, and other. Quality and readability of webpages were evaluated using validated tools, and the reading level was descriptively compared with ChatGPT generated health information on kidney stone prevention and treatment. RESULTS 50 webpages on kidney stone prevention and 49 on stone treatment were included in this study. The reading level was determined to equate to that of a 10th to 12th grade student. Quality was measured as "fair" with no pages scoring "excellent" and only 20% receiving a "good" quality. There was no significant difference between pages from academic, hospital-affiliated, commercial, and nonprofit foundation publications. The text generated by ChatGPT was considerably easier to understand with readability levels measured as low as 5th grade. CONCLUSIONS The language used in existing information on kidney stone disease is of subpar quality and too complex to understand. Machine learning tools could aid in generating information that is comprehensible by the public.
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Affiliation(s)
- Reza Kianian
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Matthew Carter
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Ilana Finkelshtein
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Sriram V Eleswarapu
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Naveen Kachroo
- Department of Urology, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan.
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5
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Laal Mousavi SM, Mohammadzadeh N, Ayyoubzadeh SM, Mohajerzadeh L, Alidadi M. A mobile application for postoperative education of caregivers of children with congenital hypospadias: Requirement analysis. Health Sci Rep 2024; 7:e1942. [PMID: 38476587 PMCID: PMC10927925 DOI: 10.1002/hsr2.1942] [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: 09/14/2023] [Revised: 11/16/2023] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
Background and Aims Hypospadias, a congenital anomaly, can have long-term effects on sexual, urinary, and reproductive functions, making proper postoperative care essential for desirable outcomes, which could be facilitated through a mobile application for diseases with long-term complications. The aim of this study was to investigate the data and functional requirements or minimum data set of a postoperative education mobile application for caregivers of children with hypospadias. Methods A literature review of papers published until April 2023 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted to determine the data and functional requirements of a mobile application that provides postoperative education to caregivers of children with congenital hypospadias. Based on the results, a questionnaire was prepared, and its content validity and reliability were evaluated by CVI and CVR. Additionally, data was examined by 30 residents, specialists, and subspecialists in pediatric surgery using the Delphi approach. Results The study identified 28 data elements in three main categories: demographic data, clinical data, and application function. Functional requirements of the mobile application were suggested for use in designing the application. Also, the most critical data elements included the definition of disease, the importance of treatment, surgical preparation, bandage, hygiene, symptoms and infection, bleeding, and emergency condition. Conclusion The study will pave the way for developing postoperative educational applications for caregivers of children with congenital hypospadias. M-Health app developers and clinician specialists can utilize these findings to design practical applications that assist caregivers in managing the care of hypospadias patients.
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Affiliation(s)
- Seyed Mohsen Laal Mousavi
- Department of Health Information Management, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Niloofar Mohammadzadeh
- Department of Health Information Management, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Seyed Mohammad Ayyoubzadeh
- Department of Health Information Management, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Leily Mohajerzadeh
- Research Institute for Children's HealthShahid Beheshti University of Medical ScienceTehranIran
| | - Maryam Alidadi
- School of Allied Medical SciencesShahid Beheshti University of Medical SciencesTehranIran
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Browne R, Hurley CM, Carr S, de Blacam C. Online Resources for Robin Sequence; an Analysis of Readability. Cleft Palate Craniofac J 2024:10556656241234587. [PMID: 38373442 DOI: 10.1177/10556656241234587] [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
The objective was to evaluate the readability of easily accessible parent-directed information concerning Robin Sequence (RS) online, compared to the American Medical Association (AMA)-recommended sixth grade (age 11-12) readability level. A Google search of the term "Pierre Robin Sequence information" was performed. The first ten websites were evaluated using six commonly used readability formulas. Sample texts from three websites were 'translated' by the authors, with the aim of achieving a sixth grade readability level. The following outcomes were used: Automated Readability Index (ARI), Coleman Liau Index (CLI), Gunning Fog Score, Simple Measure of Gobbledygook (SMOG), Flesch Kincaid Grade Level (FKGL), and Flesch Reading Ease (FRE) score. The mean pooled grade level of the top 10 included websites was 12.1 (age 17-18). The overall FRE Index was 45.8, which is equivalent to a College-grade reading level. The mean grade level by each test used was: Flesch-Kincaid Grade Level 11.6 (age 16-17), Gunning Fog Score 13.3 (age 18+), SMOG 10.0 (age 14-15), Coleman-Liau Index 13.8 (age 18+), and ARI 12.0 (age 17-18). The author-translated resources achieved pooled mean grade levels of 6.3-6.5. Parent-directed online materials concerning RS have a readability in excess of the AMA-recommended sixth grade reading level. Even though the condition is complex, more readable resources are achievable. Coproduction of parent-directed resources in association with public an patient involvement (PPI) contributors is encouraged.
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Affiliation(s)
- R Browne
- Department of Plastic Surgery, Children's Health Ireland, Crumlin, Ireland
- Royal College of Surgeons, Ireland
| | - C M Hurley
- Department of Plastic Surgery, Children's Health Ireland, Crumlin, Ireland
- Royal College of Surgeons, Ireland
| | - S Carr
- Department of Plastic Surgery, Children's Health Ireland, Crumlin, Ireland
- Royal College of Surgeons, Ireland
| | - C de Blacam
- Department of Plastic Surgery, Children's Health Ireland, Crumlin, Ireland
- Royal College of Surgeons, Ireland
- Department of Paediatrics, Trinity College Dublin, Ireland
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Haffar A, Hirsch A, Morrill C, Garcia A, Werner Z, Gearhart JP, Crigger C. Clear as Mud: Readability Scores in Cloacal Exstrophy Literature and Its Treatment. Res Rep Urol 2024; 16:39-44. [PMID: 38370509 PMCID: PMC10871133 DOI: 10.2147/rru.s430744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/05/2024] [Indexed: 02/20/2024] Open
Abstract
Purpose This study examines the readability of online medical information regarding cloacal exstrophy (CE). We hypothesize that inappropriate levels of comprehension are required in these resources, leading to poor understanding and confusion amongst caregivers. Methods The Google and Bing search engines were used to search the terms "cloacal exstrophy" and "cloacal exstrophy treatment". The first 100 results for each were collected. Each webpage was analyzed for readability using four independent validated scoring systems: the Gunning-Fog index (GFI), SMOG grade (Simple Measure of Gobbledygook), Dale-Chall index (DCI), and the Flesch-Kincaid grade (FKG). Results Forty-seven unique webpages fit the inclusion criteria. Mean readability scores across all websites were GFI, 14.6; SMOG score, 10.8; DCI, 9.3; and FKG, 11.8, correlating to adjusted grade levels of college sophomore, 11th grade, college, and 11th grade, respectively. There were significant differences across all readability formulas. Non-profit websites were significantly less readable than institutional and commercial webpages (GFI p = 0.012, SMOG p = 0.018, DCI p = 0.021, FKG p = 0.0093). Conclusion Caregiver-directed health information regarding CE and its treatment available online is written at the 11th grade reading level or above. Online resources pertaining to CE must be simplified to be effective.
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Affiliation(s)
- Ahmad Haffar
- Robert D. Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Charlotte Bloomberg Children’s Hospital, Baltimore, MD, USA
| | - Alexander Hirsch
- Robert D. Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Charlotte Bloomberg Children’s Hospital, Baltimore, MD, USA
| | - Christian Morrill
- Robert D. Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Charlotte Bloomberg Children’s Hospital, Baltimore, MD, USA
| | - Adelaide Garcia
- Robert D. Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Charlotte Bloomberg Children’s Hospital, Baltimore, MD, USA
| | - Zachary Werner
- West Virginia University School of Medicine, Department of Urology, Division of Pediatric Urology, Morgantown, WV, USA
| | - John P Gearhart
- Robert D. Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Charlotte Bloomberg Children’s Hospital, Baltimore, MD, USA
| | - Chad Crigger
- Robert D. Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Charlotte Bloomberg Children’s Hospital, Baltimore, MD, USA
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Fung ACH, Lee MHL, Leung JL, Chan IHY, Wong KKY. Internet Health Resources on Nocturnal Enuresis: A Readability, Quality, and Accuracy Analysis. Eur J Pediatr Surg 2024; 34:84-90. [PMID: 37595631 DOI: 10.1055/a-2156-4833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
INTRODUCTION Nocturnal enuresis is a common yet quality-of-life-limiting pediatric condition. There is an increasing trend for parents to obtain information on the disease's nature and treatment options via the internet. However, the quality of health-related information on the internet varies greatly and is largely uncontrolled and unregulated. With this study, a readability, quality, and accuracy evaluation of the health information regarding nocturnal enuresis is carried out. MATERIALS AND METHODS A questionnaire was administered to parents and patients with nocturnal enuresis to determine their use of the internet to research their condition. The most common search terms were determined, and the first 30 websites returned by the most popular search engines were used to assess the quality of information about nocturnal enuresis. Each site was categorized by type and assessed for readability using the Gunning fog score, Simple Measure of Gobbledygook (SMOG) index, and Dale-Chall score; for quality using the DISCERN score; and for accuracy by comparison to the International Children's Continence Society guidelines by three experienced pediatric urologists and nephrologists. RESULTS A total of 30 websites were assessed and classified into five categories: professional (n = 13), nonprofit (n = 8), commercial (n = 4), government (n = 3), and other (n = 2). The information was considered difficult for the public to comprehend, with mean Gunning fog, SMOG index, and Dale-Chall scores of 12.1 ± 4.3, 14.1 ± 4.3, and 8.1 ± 1.3, respectively. The mean summed DISCERN score was 41 ± 11.6 out of 75. Only seven (23%) websites were considered of good quality (DISCERN score > 50). The mean accuracy score of the websites was 3.2 ± 0.6 out of 5. Commercial websites were of the poorest quality and accuracy. Websites generally scored well in providing their aims and identifying treatment benefits and options, while they lacked references and information regarding treatment risks and mechanisms. CONCLUSION Online information about nocturnal enuresis exists for parents; however, most websites are of suboptimal quality, readability, and accuracy. Pediatric surgeons should be aware of parents' health-information-seeking behavior and be proactive in guiding parents to identify high-quality resources.
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Affiliation(s)
- Adrian C H Fung
- Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Matthew H L Lee
- Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong, SAR, China
| | - Jessie L Leung
- Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Ivy H Y Chan
- Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Kenneth K Y Wong
- Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
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Mohile JM, Luzon JB, Agrawal G, Malhotra NR, Kan KM. Assessment of readability and quality of patient education materials specific to nocturnal enuresis. J Pediatr Urol 2023; 19:558.e1-558.e7. [PMID: 37248162 DOI: 10.1016/j.jpurol.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/14/2023] [Accepted: 05/01/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Bedwetting, or nocturnal enuresis (NE), is a common childhood disease. Families increasingly turn to free online resources for health education in order to navigate treatment options. OBJECTIVE We aim to determine the readability and quality of online health information that families may encounter when searching for information on pediatric NE. STUDY DESIGN The search term 'bedwetting' was queried in commonly used search engines. Included articles were further categorized as institutional/reference, commercial, non-profit/charitable, or personal. An online readability platform calculated 3 commonly used readability assessments as well as a consensus score. Quality was assessed by two independent pediatric urologists using a validated DISCERN instrument. Differences in readability were further assessed by article category type. RESULTS 36 websites were reviewed, 3 did not include treatment options and were not included in quality assessment. 55.6% of the articles were categorized as institutional/reference, 27.8% as non-profit/charitable, 11.1% as personal, and 5.6% as commercial. The average, standard deviation, and range of readability level were as follows: overall consensus score = 9.56 ± 2.09, FK Grade Level Formula score = 9.38 ± 2.17 (range 5.8-14.1), SMOG Index score = 8.89 ± 1.79 (range 6.4-12.9), and the GF Index score = 11.86 ± 2.34 (range 8.4-16.9). The overall consensus score, 9.56, correlates to a 9th-grade reading level. 16 articles were considered to be of 'good' quality, 12 of 'fair' quality, and 5 of 'poor' quality; according to the DISCERN scoring. There was no statistically significant difference in readability scores across website categories. Two articles included the outdated treatment option of intranasal DDAVP. DISCUSSION These findings are concordant with the increasing body of literature demonstrating that patient education materials are too difficult to read. Pediatric urologists should be aware of the readability and quality of available online content for common clinical presentations. They can ensure that institutional articles online are useful to patients by participating in the development and design of these materials. CONCLUSION We demonstrated that online articles that families encounter via a search engine query for bedwetting are written at a higher level than recommended and the majority are of 'fair' quality. There is much room for improvement for institutions to provide high quality, readable content that supports the needs of families seeking information on NE.
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Affiliation(s)
| | - Joan B Luzon
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Urology 5656, Palo Alto, CA 94304, USA.
| | - Gunjan Agrawal
- Flushing Hospital Medical Center, 4500 Parsons Blvd, Flushing, NY 11533, USA.
| | - Neha R Malhotra
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA.
| | - Kathleen M Kan
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Urology 5656, Palo Alto, CA 94304, USA.
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10
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Shah YB, Kieran NW, Klasko SK. Empathy in the age of science disinformation: implications for healthcare quality. BMJ LEADER 2023:leader-2022-000716. [PMID: 37192118 DOI: 10.1136/leader-2022-000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/25/2023] [Indexed: 05/18/2023]
Affiliation(s)
- Yash B Shah
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Nicholas W Kieran
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Stephen K Klasko
- Office of the President, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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11
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Hotz T, Zhou MT, Reissmann ME, Apoj M, Wason SEL, Wang DS. Assessing the readability and quality of online information about benign prostatic hyperplasia. World J Urol 2023; 41:257-262. [PMID: 36416925 DOI: 10.1007/s00345-022-04223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Benign prostatic hyperplasia (BPH) affects nearly half of men in their fifties. Patients often search the Internet to better understand their diagnosis, but online health information is not well regulated and can be difficult for patients to comprehend. This study aims to evaluate not only readability, but also the quality of online information about BPH, as well as the effect of commercial bias on readability and quality. METHODS Three search engines (Google, Bing, and DuckDuckGo) were used with broad search terms including "BPH," "BPH treatment," and "BPH surgery," to mimic a patient diagnosed with BPH seeking further information. 204 total websites were identified, of which 62 were unique websites. Among those unique websites, 23 were advertisements. Three readability formulas (Flesch-Kincaid Grade Level, Flesch-Kincaid Reading Ease, SMOG) were used to generate readability scores. DISCERN standardized questionnaire was used to evaluate website quality. RESULTS Average reading level of online information about BPH was significantly higher than the recommended level by the American Medical Association (AMA) and United States Department of Health and Human Services (USDHHS). Advertisements had significantly easier readability than nonadvertisements. Average website quality was "excellent" for nonadvertisements, but only "fair" for advertisements. CONCLUSION Although advertisements may hold optimal search result positions and have better readability than nonadvertisements, they have biased and lower quality information. It is important to guide patients to high quality online information of appropriate reading level. Continued efforts should be made to create and share with patients high quality resources with improved readability to facilitate comprehension and minimize misinformation.
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Affiliation(s)
- Tremearne Hotz
- Boston University School of Medicine, Boston, MA, 02118, USA
| | - Maya T Zhou
- Boston University School of Medicine, Boston, MA, 02118, USA
| | - Molly E Reissmann
- Department of Urology, Boston University School of Medicine/Boston Medical Center, 725 Albany Street, Shapiro 3B, Boston, MA, 02118, USA
| | - Michel Apoj
- Department of Urology, Boston University School of Medicine/Boston Medical Center, 725 Albany Street, Shapiro 3B, Boston, MA, 02118, USA
| | - Shaun E L Wason
- Department of Urology, Boston University School of Medicine/Boston Medical Center, 725 Albany Street, Shapiro 3B, Boston, MA, 02118, USA
| | - David S Wang
- Department of Urology, Boston University School of Medicine/Boston Medical Center, 725 Albany Street, Shapiro 3B, Boston, MA, 02118, USA.
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Muacevic A, Adler JR, Perez J, Wordekemper BE, Fu D, Colvin A, Deibert CM. Online Health Information for Penile Prosthesis Implants Lacks Quality and Is Unreadable to the Average US Patient. Cureus 2023; 15:e34240. [PMID: 36852349 PMCID: PMC9964715 DOI: 10.7759/cureus.34240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Online health information (OHI) has become widely accessible and affects patient decisions regarding their healthcare. The purpose of this study was to assess the readability, quality, and accuracy of information available to patients online about penile prosthesis implants (PPIs). METHODS We performed a Google search using the keywords "penile implant" and "penile prosthesis." The first 30 search results for both terms were analyzed, and advertisements, news articles, duplicates, and videos were excluded. Websites were categorized as institutional, commercial, and personal/patient support. Readability of each website was determined using the Flesch-Kincaid grade level (FKGL) readability formula within the readable tool. Quality was measured by Health On the Net (HON) certification status and the DISCERN scoring method. For website accuracy, a score of 1-4 (1=0-25%, 2=25-50%, 3=50-75%, and 4=75-100%) was assigned. RESULTS Forty-four websites met the criteria (23 institutional, 12 commercial, and 9 personal/patient support). The mean total FKGL score was 9.55. No statistical difference was detected between mean FKGL for each website category (p=0.69). Only eight websites (18%) scored ≤8th-grade reading level (average US adult level), while 36 (82%) were >8th-grade level. Mean total DISCERN sum score was 39.74/75, with no statistical difference in mean DISCERN score between website types (p=0.08). Over half (55%) of the websites were defined as "very poor" or "poor" quality by DISCERN scoring. Mean total overall quality rating was 2.67/5. HON certification was verified for only nine websites (20%). Twenty-five percent of websites were classified as 0-25% accurate, 23% were 25-50% accurate, 30% were 50-75% accurate, and 23% were 75-100% accurate. CONCLUSION Most information on the Internet about PPIs is reasonably accurate; however, the majority of websites are deficient in quality and unreadable to the average patient, irrespective of website type.
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Cheng JW, Fernandez N, Shnorhavorian M, Merguerian PA, Kieran K. Engagement of common pediatric urologic conditions on social media. J Pediatr Urol 2022; 18:236.e1-236.e7. [PMID: 35125286 DOI: 10.1016/j.jpurol.2021.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION As social media use continues to increase, parents and caregivers report using social media platforms as a source of health information. However, there are minimal regulations for social media content and health misinformation has been shared for various medical issues and urologic conditions. While internet content related to pediatric urology has been previously described, social media engagement for various pediatric urologic conditions have yet to be described. OBJECTIVE To evaluate the evidence supporting articles engaged on social media that are related to common pediatric urologic conditions. STUDY DESIGN A social media analysis tool was used to identify articles engaged through Facebook, Reddit, Twitter, and Pinterest between July 2020-2021. The top 5 articles related to toilet training, circumcision, cryptorchidism, testicular torsion, and hypospadias were identified. Article citations were reviewed and classified by Oxford levels of evidence. The content of each article was then reviewed and compared against supporting evidence on an independent literature search. Statistical analysis was completed with descriptive statistics, Mann-Whitney U, Wilcoxon signed rank, and bivariate correlation. RESULTS Of the 25 articles reviewed, 8 (32%) were affiliated with medical journals, hospitals, or academic institutions and 17 (68%) were on non-affiliated websites with advertisements. There was greater social media engagement for articles related to toilet training and circumcision than testicular torsion, hypospadias, and cryptorchidism. No articles cited level 1 evidence and 32% of articles cited no evidence. Literature search for article content demonstrated a discrepancy between the level of evidence cited by articles compared to the evidence available in the literature to support article content. There was greater social media engagement for articles with no cited or supporting evidence and those not affiliated with medical journals, hospitals, or academic institutions. DISCUSSION The findings in this study are consistent with trends reported for other urologic conditions, including genitourinary malignancy, female pelvic medicine and reconstructive surgery, nephrolithiasis, and sexual function. Parents without a medical background may have difficulty identifying whether articles shared on social media can be a reliable resource for health information. It is important to understand how information related to pediatric urologic conditions is engaged on social media so that misinformation can be addressed in clinical, online, and regulatory settings. CONCLUSION There was greater social media engagement for articles with no cited or supporting evidence and those not affiliated with medical journals, hospitals, or academic institutions.
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Affiliation(s)
- Julie W Cheng
- Seattle Children's Hospital, Division of Urology, 4800 Sand Point Way NE M/S OA.9.220, Seattle, 98105, WA, USA.
| | - Nicolas Fernandez
- Seattle Children's Hospital, Division of Urology, 4800 Sand Point Way NE M/S OA.9.220, Seattle, 98105, WA, USA
| | - Margarett Shnorhavorian
- Seattle Children's Hospital, Division of Urology, 4800 Sand Point Way NE M/S OA.9.220, Seattle, 98105, WA, USA
| | - Paul A Merguerian
- Seattle Children's Hospital, Division of Urology, 4800 Sand Point Way NE M/S OA.9.220, Seattle, 98105, WA, USA
| | - Kathleen Kieran
- Seattle Children's Hospital, Division of Urology, 4800 Sand Point Way NE M/S OA.9.220, Seattle, 98105, WA, USA
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14
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Kulkarni A, Wong M, Belsare T, Shah R, Yu Yu D, Coskun B, Holschuh C, Kakar V, Modrek S, Smirnova A. Quantifying the Quality of Web-Based Health Information on Student Health Center Websites Using a Software Tool: Design and Development Study. JMIR Form Res 2022; 6:e32360. [PMID: 35107423 PMCID: PMC8851325 DOI: 10.2196/32360] [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: 07/24/2021] [Revised: 10/29/2021] [Accepted: 11/28/2021] [Indexed: 11/26/2022] Open
Abstract
Background The internet has become a major source of health information, especially for adolescents and young adults. Unfortunately, inaccurate, incomplete, or outdated health information is widespread on the web. Often adolescents and young adults turn to authoritative websites such as the student health center (SHC) website of the university they attend to obtain reliable health information. Although most on-campus SHC clinics comply with the American College Health Association standards, their websites are not subject to any standards or code of conduct. In the absence of quality standards or guidelines, monitoring and compliance processes do not exist for SHC websites. Thus, there is no oversight of the health information published on SHC websites by any central governing body. Objective The aim of this study is to develop, describe, and validate an open-source software that can effectively and efficiently assess the quality of health information on SHC websites in the United States. Methods Our cross-functional team designed and developed an open-source software, QMOHI (Quantitative Measures of Online Health Information), that assesses information quality for a specified health topic from all SHC websites belonging to a predetermined list of universities. The tool was designed to compute 8 different quality metrics that quantify various aspects of information quality based on the retrieved text. We conducted and reported results from 3 experiments that assessed the QMOHI tool in terms of its scalability, generalizability in health topics, and robustness to changes in universities’ website structure. Results Empirical evaluation has shown the QMOHI tool to be highly scalable and substantially more efficient than manually assessing web-based information quality. The tool’s runtime was dominated by network-related tasks (98%), whereas the metric computations take <2 seconds. QMOHI demonstrated topical versatility, evaluating SHC website information quality for four disparate and broad health topics (COVID, cancer, long-acting reversible contraceptives, and condoms) and two narrowly focused topics (hormonal intrauterine device and copper intrauterine device). The tool exhibited robustness, correctly measuring information quality despite changes in SHC website structure. QMOHI can support longitudinal studies by being robust to such website changes. Conclusions QMOHI allows public health researchers and practitioners to conduct large-scale studies of SHC websites that were previously too time- and cost-intensive. The capability to generalize broadly or focus narrowly allows a wide range of applications of QMOHI, allowing researchers to study both mainstream and underexplored health topics. QMOHI’s ability to robustly analyze SHC websites periodically promotes longitudinal investigations and allows QMOHI to be used as a monitoring tool. QMOHI serves as a launching pad for our future work that aims to develop a broadly applicable public health tool for web-based health information studies with potential applications far beyond SHC websites.
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Affiliation(s)
- Anagha Kulkarni
- Department of Computer Science, San Francisco State University, San Francisco, CA, United States
| | - Mike Wong
- Department of Computer Science, San Francisco State University, San Francisco, CA, United States
| | - Tejasvi Belsare
- Department of Computer Science, San Francisco State University, San Francisco, CA, United States
| | - Risha Shah
- Department of Computer Science, San Francisco State University, San Francisco, CA, United States
| | - Diana Yu Yu
- Department of Computer Science, San Francisco State University, San Francisco, CA, United States
| | - Bera Coskun
- Department of Computer Science, San Francisco State University, San Francisco, CA, United States
| | - Carrie Holschuh
- School of Nursing, San Francisco State University, San Francisco, CA, United States
| | - Venoo Kakar
- Department of Economics, San Francisco State University, San Francisco, CA, United States
| | - Sepideh Modrek
- Department of Economics, San Francisco State University, San Francisco, CA, United States
| | - Anastasia Smirnova
- Department of English Language and Literature, San Francisco State University, San Francisco, CA, United States
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15
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Wang Z, Fan Y, Lv H, Deng S, Xie H, Zhang L, Luo A, Wang F. The Gap Between Self-Rated Health Information Literacy and Internet Health Information-Seeking Ability for Patients With Chronic Diseases in Rural Communities: Cross-sectional Study. J Med Internet Res 2022; 24:e26308. [PMID: 35099401 PMCID: PMC8845012 DOI: 10.2196/26308] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/28/2021] [Accepted: 12/28/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The internet has become one of the most important channels for residents to seek health information, particularly in remote rural areas in China. OBJECTIVE In this study, we aimed to explore the gap between self-rated health information literacy and internet health information seeking ability for patients with chronic diseases in rural communities and to preliminarily evaluate their barriers when seeking health information via the internet. METHODS Residents from rural communities near Bengbu City and with chronic diseases were included in this study. A self-rated questionnaire was used to evaluate their health information literacy, 3 behavioral competency tasks were designed to preliminarily evaluate their ability to seek health information on the internet and semistructured interviews were used to investigate their barriers to obtaining health information via the internet. A small audiorecorder was used to record the interview content, and screen-recording software was used to record the participants' behavior during the web-based operational tasks. RESULTS A total of 70 respondents completed the self-rated health information literacy questionnaire and the behavioral competence test, and 56 respondents participated in the semistructured interviews. Self-rated health information literacy (score out of 70: mean 46.21, SD 4.90) of the 70 respondents were moderate. Although 91% (64/70) of the respondents could find health websites, and 93% (65/70) of the respondents could find information on treatment that they thought was the best, 35% (23/65) of respondents did not know how to save the results they had found. The operational tasks indicated that most articles selected by the respondents came from websites with encyclopedic knowledge or answers from people based on their own experiences rather than authoritative health information websites. After combining the results of the semistructured interviews with the DISCERN scale test results, we found that most interviewees had difficulty obtaining high-quality health information via the internet. CONCLUSIONS Although the health information literacy level of patients with rural chronic disease was moderate, they lack the ability to access high-quality health information via the internet. The vast majority of respondents recognized the importance of accessing health information but were not very proactive in accessing such information.
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Affiliation(s)
- Zhuoxin Wang
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Yanyan Fan
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Hekai Lv
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
| | - Shanshan Deng
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Hui Xie
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Li Zhang
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Aijing Luo
- Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fuzhi Wang
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
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Vicente-Neira A, Prieto-Gómez V, Navarro-Brazález B, Lirio-Romero C, Bailón-Cerezo J, Torres-Lacomba M. Online Information on Painful Sexual Dysfunction in Women: Quality Analysis of Websites in SPANISH about Dyspareunia, Vaginismus and Vulvodynia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1506. [PMID: 35162525 PMCID: PMC8834735 DOI: 10.3390/ijerph19031506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 11/16/2022]
Abstract
The objective of this study was to evaluate the content, quality, and readability of websites containing information on dyspareunia, vaginismus, and vulvodynia in Spanish. Web pages were retrieved entering the terms "dyspareunia", "vaginismus", and "vulvodynia" in Google, Yahoo!, and Bing search engines. Two researchers employed the DISCERN and Bermúdez-Tamayo questionnaires to analyze the content and quality of the websites, and the INFLESZ scale to evaluate their readability. IBM SPSS® version 25 statistical software was employed for data analysis. The internet search yielded 262 websites, 91 of which were included after applying the selection criteria. Websites with information on dyspareunia obtained median scores of 24 (30-21) in the DISCERN, 38 (41.0-35.5) in the Bermúdez-Tamayo, and 55.3 (57.2-50.9) in the INFLESZ tools. The results for websites on vaginismus revealed median scores of 23.5 (30-20) in the DISCERN, 37 (42-35) in the Bermúdez-Tamayo, and 52.9 (55.6-46.4) in the INFLESZ. Finally, the median scores for vulvodynia sites was 25.5 (30-20) in the DISCERN, 38 (43-33.7) in the Bermúdez-Tamayo, and 54.2 (57.3-47.2) in the INFLESZ. These outcomes indicate that the quality of information in these websites is very low, while the overall quality of the web pages is moderate. Sites on vaginismus and vulvodynia were "somewhat difficult" to read, while readability was "normal" for websites on dyspareunia. Healthcare professionals should be aware of the shortcomings of these websites and address them through therapeutic education with resources containing updated, quality information. This raises the need for health professionals to generate these resources themselves or for experts and/or scientific societies in the field to check the quality and timeliness of the contents, regardless of whether or not the websites are endorsed with quality seals.
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Affiliation(s)
- Andrea Vicente-Neira
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (A.V.-N.); (B.N.-B.); (C.L.-R.); (J.B.-C.); (M.T.-L.)
| | - Virginia Prieto-Gómez
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (A.V.-N.); (B.N.-B.); (C.L.-R.); (J.B.-C.); (M.T.-L.)
- Department of Nursery, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursery, University of Castilla-La Mancha, 45071 Toledo, Spain
| | - Beatriz Navarro-Brazález
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (A.V.-N.); (B.N.-B.); (C.L.-R.); (J.B.-C.); (M.T.-L.)
| | - Cristina Lirio-Romero
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (A.V.-N.); (B.N.-B.); (C.L.-R.); (J.B.-C.); (M.T.-L.)
- Department of Nursery, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursery, University of Castilla-La Mancha, 45071 Toledo, Spain
| | - Javier Bailón-Cerezo
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (A.V.-N.); (B.N.-B.); (C.L.-R.); (J.B.-C.); (M.T.-L.)
- Department of Physical Therapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - María Torres-Lacomba
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (A.V.-N.); (B.N.-B.); (C.L.-R.); (J.B.-C.); (M.T.-L.)
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17
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Forgie EME, Lai H, Cao B, Stroulia E, Greenshaw AJ, Goez H. Social Media and the Transformation of the Physician-Patient Relationship: Viewpoint. J Med Internet Res 2021; 23:e25230. [PMID: 34951596 PMCID: PMC8742211 DOI: 10.2196/25230] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/25/2021] [Accepted: 10/26/2021] [Indexed: 12/29/2022] Open
Abstract
As many as 80% of internet users seek health information online. The social determinants of health (SDoH) are intimately related to who has access to the internet and health care as a whole. Those who face more barriers to care are more likely to benefit from accessing health information online, assuming the information they are retrieving is accurate. Virtual communities on social media platforms are beginning to serve as venues for seeking health information online because peers have been shown to influence health behavior more than almost anything else. As a positive mediator of health, social media can be used as a direct or indirect mode of communication between physicians and patients, a venue for health promotion and health information, and a community support network. However, false or misleading content, social contagion, confirmation bias, and security and privacy concerns must be mitigated to realize the full potential of social media as a positive mediator of health. This paper presents the shifting dynamics of how such communities are affecting physician-patient relationships. With the intersections between the SDoH, social media, and health evolving, physicians must take into consideration these factors when establishing their relationships with patients. We argue a paradigm shift in the physician-patient relationship is warranted, one where physicians acknowledge the impacts of the SDoH on information-seeking behavior, recognize the positive and negative roles of social media as a mediator of health through the lens of the SDoH, and use social media to catalyze positive changes in the physician-patient relationship. We discuss how the physician-patient relationship must evolve to accommodate for the ever-increasing role of social media in health and to best use social media as a tool to improve health outcomes. Finally, we present a fluid and multicomponent diagram that we believe will assist in framing future research in this area. We conclude that it is ineffective and even counterproductive for physicians to ignore the relationship between social media, the SDoH and health, their impact on one another, and the effect it has on designing the medical encounter and the delivery of care under the definition of precision medicine.
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Affiliation(s)
- Ella M E Forgie
- Department of Anthropology, University of Alberta, Edmonton, AB, Canada
| | - Hollis Lai
- Department of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Bo Cao
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | - Eleni Stroulia
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | | | - Helly Goez
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Bouhadana D, Nguyen DD, Raizenne B, Vangala SK, Sadri I, Chughtai B, Elterman DS, Zorn KC, Bhojani N. Assessing the Accuracy, Quality, and Readability of Information Related to the Surgical Management of Benign Prostatic Hyperplasia. J Endourol 2021; 36:528-534. [PMID: 34731024 DOI: 10.1089/end.2021.0641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: To assess the accuracy, quality, and readability of online educational health information in English related to the most common benign prostatic hyperplasia (BPH) guideline-approved surgical treatments. Methods: The terms "benign prostatic hyperplasia," "BPH," and all eight guideline-approved treatment modalities studied, were searched to retrieve the first five relevant websites and first two paid advertised websites related to the surgical treatment options for BPH. These modalities included transurethral resection of the prostate (TURP), GreenLight photovaporization, endoscopic enucleation of the prostate, Rezum, Urolift, Aquablation, open simple prostatectomy, and robotic simple prostatectomy (RSP). All relevant websites were assessed for their accuracy, quality, and readability using standardized scoring systems. Results: The mean accuracy score for each of the treatment modalities were all indicative of good accuracy, with 76%-99% of the information presented as being accurate. The median quality score was statistically different across the eight treatment modalities (p = 0.015). The median readability grade level was statistically different across the eight treatment modalities (p = 0.009). Websites that described TURP (median readability grade level, 9.00 [interquartile range (IQR) 8.00-10.80]) were significantly easier to read than those related to RSP (median readability grade level, 14.35 [IQR, 11.08-16.50]) (p = 0.011). No other statistically significant differences were found within the other treatment modality websites. Conclusions: The majority of websites retrieved were found to be of high accuracy, good quality, and poor readability. Additionally, it was found that none of the retrieved websites included descriptions for all the other included treatment modalities. Given these findings, the authors recommend the development of centralized resources with all guideline-approved treatment modalities and accurate, readable, and high-quality information related to the surgical treatment of BPH.
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Affiliation(s)
- David Bouhadana
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - David-Dan Nguyen
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Brendan Raizenne
- Division of Urology, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Sai K Vangala
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Iman Sadri
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Bilal Chughtai
- Department of Urology, Weill Cornell Medical College/New York Presbyterian, New York, New York, USA
| | - Dean S Elterman
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Kevin C Zorn
- Division of Urology, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Naeem Bhojani
- Division of Urology, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
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Ó Doinn T, Broderick JM, Abdelhalim MM, Quinlan JF. Readability of Patient Educational Materials in Pediatric Orthopaedics. J Bone Joint Surg Am 2021; 103:e47. [PMID: 33543881 DOI: 10.2106/jbjs.20.01347] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Parents are increasingly turning to the internet to seek pediatric health information. Numerous organizations advise that patient educational materials (PEMs) should not surpass the sixth-grade reading level. We aimed to assess the readability of online pediatric orthopaedic PEMs. METHODS The readability of 176 articles pertaining to pediatric orthopaedics from the American Academy of Orthopaedic Surgeons (AAOS), Pediatric Orthopaedic Society of North America (POSNA), and American Academy of Pediatrics (AAP) websites was assessed with the use of 8 readability formulae: the Flesch-Kincaid Reading Grade Level, the Flesch Reading Ease Score, the Raygor Estimate, the SMOG, the Coleman-Liau, the Fry, the FORCAST, and the Gunning Fog. The mean reading grade level (RGL) of each article was compared with the sixth and eighth-grade reading levels. The mean RGL of each website's articles also was compared. RESULTS The cumulative mean RGL was 10.2 (range, 6.6 to 16.0). No articles (0%) were written at the sixth-grade reading level, and only 7 articles (4.0%) were written at or below the eighth-grade reading level. The mean RGL was significantly higher than the sixth-grade (95% confidence interval [CI] for the difference, 4.0 to 4.4; p < 0.001) and eighth-grade (95% CI, 2.0 to 2.4; p < 0.001) reading levels. The mean RGL of articles on the POSNA website was significantly lower than the mean RGL of the articles on the AAOS (95% CI, -1.8 to -1.0; p < 0.001) and AAP (95% CI, -2.9 to -1.1; p < 0.001) websites. CONCLUSIONS Pediatric orthopaedic PEMs that are produced by the AAOS, the POSNA, and the AAP have readability scores that exceed recommendations. Given the increasing preference of parents and adolescents for online health information, the growing body of online PEMs, and the critical role that health literacy plays in patient outcomes, substantial work is required to address the readability of these materials.
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Affiliation(s)
- Tiarnán Ó Doinn
- Department of Trauma and Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
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Cai HC, King LE, Dwyer JT. Using the Google™ Search Engine for Health Information: Is There a Problem? Case Study: Supplements for Cancer. Curr Dev Nutr 2021; 5:nzab002. [PMID: 33937613 PMCID: PMC8059196 DOI: 10.1093/cdn/nzab002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/02/2020] [Accepted: 01/12/2021] [Indexed: 12/31/2022] Open
Abstract
We assessed the quality of online health and nutrition information using a Google™ search on "supplements for cancer". Search results were scored using the Health Information Quality Index (HIQI), a quality-rating tool consisting of 12 objective criteria related to website domain, lack of commercial aspects, and authoritative nature of the health and nutrition information provided. Possible scores ranged from 0 (lowest) to 12 ("perfect" or highest quality). After eliminating irrelevant results, the remaining 160 search results had median and mean scores of 8. One-quarter of the results were of high quality (score of 10-12). There was no correlation between high-quality scores and early appearance in the sequence of search results, where results are presumably more visible. Also, 496 advertisements, over twice the number of search results, appeared. We conclude that the Google™ search engine may have shortcomings when used to obtain information on dietary supplements and cancer.
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Affiliation(s)
- Hannah C Cai
- Frances Stern Nutrition Center, Tufts Medical Center and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | | | - Johanna T Dwyer
- Frances Stern Nutrition Center, Tufts Medical Center and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
- Department of Medicine, Tufts Medical School and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA
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Readability Metrics of Provider Postoperative Handouts in Urology. Urology 2020; 146:49-53. [DOI: 10.1016/j.urology.2020.08.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/19/2020] [Accepted: 08/26/2020] [Indexed: 11/21/2022]
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Li W, Liao J, Li Q, Baskota M, Wang X, Tang Y, Zhou Q, Wang X, Luo X, Ma Y, Fukuoka T, Ahn HS, Lee MS, Chen Y, Luo Z, Liu E. Public health education for parents during the outbreak of COVID-19: a rapid review. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:628. [PMID: 32566565 PMCID: PMC7290608 DOI: 10.21037/atm-20-3312] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background It is well-known that public health education plays a crucial role in the prevention and control of emerging infectious diseases, but how health providers should advise families and parents to obtain health education information is a challenging question. With coronavirus disease 2019 (COVID-19) spreading around the world, this rapid review aims to answer that question and thus to promote evidence-based decision making in health education policy and practice. Methods We systematically searched the literature on health education during COVID-19, severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) epidemics in Medline (via PubMed), Cochrane Library, EMBASE, Web of Science, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang Data from their inception until March 31, 2020. The potential bias of the studies was assessed by Joanna Briggs Institute Prevalence Critical Appraisal Tool. Results Of 1,067 papers found, 24 cross-sectional studies with a total of 35,967 participants were included in this review. The general public lacked good knowledge of SARS and MERS at the early stage of epidemics. Some people’s knowledge, attitude and practice (KAP) of COVID-19 had been improved, but the health behaviors of some special groups including children and their parents need to be strengthened. Negative emotions including fear and stigmatization occurred during the outbreaks. Reliable health information was needed to improve public awareness and mental health for infectious diseases. Health information from nonprofit, government and academic websites was more accurate than privately owned commercial websites and media websites. Conclusions For educating and cultivating children, parents should obtain information from the official websites of authorities such as the World Health Organization (WHO) and national Centers for Disease Control, or from other sources endorsed by these authorities, rather than from a general search of the internet or social media.
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Affiliation(s)
- Weiguo Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Jing Liao
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Qinyuan Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Muna Baskota
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xingmei Wang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Yuyi Tang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Qi Zhou
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Xiaoqing Wang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xufei Luo
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Yanfang Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Toshio Fukuoka
- Emergency and Critical Care Center, Department of General Medicine, Department of Research and Medical Education, Kurashiki Central Hospital, Kurashiki, Japan.,Advisory Committee in Cochrane Japan, Tokyo, Japan
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.,Korea Cochrane Center, Seoul, Korea
| | - Myeong Soo Lee
- Korea Institute of Oriental Medicine, Daejeon, Korea.,University of Science and Technology, Daejeon, Korea
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou 730000, China.,Chinese GRADE Center, Lanzhou 730000, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
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Chan KH, Panoch J, Carroll A, Wiehe S, Cain MP, Frankel R. Knowledge gaps and information seeking by parents about hypospadias. J Pediatr Urol 2020; 16:166.e1-166.e8. [PMID: 32061490 PMCID: PMC8562056 DOI: 10.1016/j.jpurol.2020.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/14/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Parents making complex decisions about hypospadias surgery may experience anxiety and uncertainty related to multiple sources of information with questionable reliability and limited relevance to their concerns. OBJECTIVE The purpose of this study was to identify knowledge gaps, information-seeking behaviors, and informational needs of parents making decisions about hypospadias surgery as an initial step in the development of a hypospadias decision aid. STUDY DESIGN We conducted semi-structured interviews with English-speaking parents (≥18 years of age) of children with hypospadias, inquiring about gaps in their knowledge, information-seeking behaviors, and perceived informational needs (Extended Summary Table). We conducted interviews until no new themes were identified, analyzing them iteratively using open, axial, and selective coding. We used grounded theory methods to develop an explanation of the information-seeking process about hypospadias surgery. RESULTS Of the 43 eligible parents, 16 mothers and 1 father (39.5%) of 16 patients participated: 7 preoperative and 9 postoperative with distal (8) and proximal (8) meatal locations. Parents were aged 21-43: 15 Caucasians and 2 African-Americans. Educational backgrounds and marital status varied across subjects. We identified five categories of knowledge gaps relating to hypospadias surgery: 1) epidemiology, 2) timing/technique, 3) perioperative experience, 4) long-term cosmetic outcome, and 5) long-term risk of complications. Information-seeking behaviors included searching the internet, discussing hypospadias with the child's pediatrician and/or urologist, and obtaining information from their social network. Most parents sought information online prior to and/or after consultation with the urologist, from parent blogs/forums, medical school/hospital websites, journal articles, and medical databases. Perceived informational needs included clear and reliable information online, images of mild degrees of hypospadias, and images of repaired hypospadias cases. According to the parents, video testimonials from other parents would help them relate to others in their social network and build confidence about the surgical process. DISCUSSION The findings of this study contribute to our understanding of parental decision-making about hypospadias surgery by highlighting specific knowledge gaps and informational needs for inclusion in a decision aid. Study limitations include a small sample size that is typical and expected for qualitative research studies and the underrepresentation of fathers, minorities, and same-sex couples. CONCLUSIONS The Internet is the primary source of information most parents use to address knowledge gaps about hypospadias. Parents expressed concerns about the reliability and clarity of information and identified informational needs including parent testimonials and a wide variety of hypospadias images for inclusion in a decision aid.
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Affiliation(s)
- Katherine H Chan
- Department of Urology, Indiana University School of Medicine, USA; Department of Pediatrics, Center for Pediatric and Adolescent Comparative Effectiveness Research, USA.
| | - Janet Panoch
- Department of Urology, Indiana University School of Medicine, USA
| | - Aaron Carroll
- Department of Pediatrics, Center for Pediatric and Adolescent Comparative Effectiveness Research, USA
| | - Sarah Wiehe
- Department of Pediatrics, Children's Health Services Research, USA
| | - Mark P Cain
- Department of Urology, Indiana University School of Medicine, USA
| | - Richard Frankel
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Cleveland Clinic Learner Institute, Cleveland, OH, USA
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Collins S, Brueton R, Graham TG, Organ S, Strother A, West SE, McKendree J. Parenting Science Gang: radical co-creation of research projects led by parents of young children. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:9. [PMID: 32161665 PMCID: PMC7053073 DOI: 10.1186/s40900-020-0181-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/13/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND Parents are increasingly searching online for information supported by research but can find it difficult to identify results relevant to their own experiences. More troublingly, a number of studies indicate that parenting information found online often can be misleading or wrong. The goal of the Parenting Science Gang (PSG) project was to use the power of the Internet to help parents ask questions they wanted to have answered by scientific research and to feel confident in assessing research evidence. METHODS By using Facebook to recruit groups and facilitate interactions, PSG was able to engage fully the target public of parents of young children in the radical co-production of scientific studies, while not creating an undue burden on time or restricting participants due to disability, financial status or location. By giving parents true partnership and control of creation of projects, PSG ensured that the chosen questions were ones that were of most relevance and interest to them. RESULTS This paper presents a summary of eight projects, with three in more detail, designed and implemented by PSG Facebook groups in collaboration with experts. Most projects had health related themes, often prompted by dissatisfaction with treatment of parents by health professionals or by feelings of being marginalised by pregnancy and motherhood, as well as by the lack of evidence for their questions and concerns. The PSG approach meant that these frustrations were channelled into actions. All eight of the PSG groups engaged in meaningful interactions with experts and co-produced studies with the groups defining the questions of interest. CONCLUSIONS This radically user-led design meant that the PSG staff and the collaborating experts had to live with a high degree of uncertainty. Nevertheless, PSG achieved its goal of academically productive, truly co-produced projects, but as important were the positive effects it had on many of the participants, both parents and experts. At the point of writing this paper, PSG projects have led to outputs including at least eight papers published, in press or in preparation, seven conference presentations, testimony to the Infant Feeding All-Party Parliamentary Group, and with more to come.
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Affiliation(s)
| | | | | | - Stephanie Organ
- The Science Communication Unit, Faculty of Health and Applied Sciences, Frenchay Campus Coldharbour Lane, University of the West of England, Bristol, BS16 1QY UK
| | | | - Sarah Elizabeth West
- Stockholm Environment Institute, Department of Environment and Geography, University of York, York, YO10 5NG UK
| | - Jean McKendree
- Stockholm Environment Institute, Department of Environment and Geography, University of York, York, YO10 5NG UK
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Salama A, Panoch J, Bandali E, Carroll A, Wiehe S, Downs S, Cain MP, Frankel R, Chan KH. Consulting "Dr. YouTube": an objective evaluation of hypospadias videos on a popular video-sharing website. J Pediatr Urol 2020; 16:70.e1-70.e9. [PMID: 31928900 PMCID: PMC7186156 DOI: 10.1016/j.jpurol.2019.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Parents who make decisions about hypospadias repair for their child may seek information from online platforms such as YouTube. OBJECTIVE The purpose of this study is to evaluate the health literacy demand of hypospadias videos on YouTube using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). STUDY DESIGN We performed a YouTube search using the term "hypospadias," limiting results to the first 100 videos. We excluded videos that were <1 min or >20 min and videos that were not in English or did not include subtitles. Two evaluators independently examined videos and determined PEMAT-A/V scores for understandability and actionability (i.e., ability to identify actions the viewer can take). Videos with scores >70% are understandable or actionable. The inter-rater reliability (kappa) and intraclass correlation coefficient (ICC) of PEMAT scores were calculated. Bivariate and multivariable linear regression models assessed the association of video characteristics with respective scores. RESULTS Of the 100 videos that were identified on YouTube, 47 (47%) were excluded leaving 53 for analysis: 14 were >20 min, 14 were <1 min, 9 had no audio or subtitles, 7 were not in English, 1 was a duplicate, 1 was unrelated to hypospadias, and 1 was deleted at the time of data analysis. Three (5.6%) were understandable (mean score 54.5%, standard deviation (SD) 14.9) and eight (15.1%) were actionable (mean score 21.8%, SD 16.6) (Extended Summary Figure). Kappa values ranged from 0.4 to 1. The ICC's were 0.55 and 0.33 for understandability and actionability, respectively. In the bivariate analysis, mean understandability scores were significantly higher for English language videos (p = 0.04), videos with animation (p = 0.002), and those produced by industry (p = 0.02). In the multivariable analysis, mean understandability scores were significantly higher for "expert testimonial" or "other" video types after adjusting for graphics type and overall tone (p = 0.04). Mean understandability scores were also significantly higher for videos with animation after adjusting for video type and overall tone (p = 0.01). Mean actionability scores were significantly higher for videos with a negative tone (p = 0.01). DISCUSSION The vast majority of hypospadias-related YouTube content is not appropriate for users with low health literacy although certain types of videos, such those with animation and expert testimonials, scored higher on understandability than other types. CONCLUSION Due to the lack of sufficient online informational content regarding hypospadias, we plan to engage parents of sons with hypospadias in the development of high-quality patient educational materials about hypospadias.
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Affiliation(s)
- Amr Salama
- Department of Urology, Indiana University School of Medicine, USA
| | - Janet Panoch
- Department of Urology, Indiana University School of Medicine, USA
| | - Elhaam Bandali
- Department of Urology, Indiana University School of Medicine, USA
| | - Aaron Carroll
- Department of Pediatrics, Center for Pediatric and Adolescent Comparative Effectiveness Research, USA
| | - Sarah Wiehe
- Department of Pediatrics, Children's Health Services Research Center, USA
| | - Stephen Downs
- Department of Pediatrics, Children's Health Services Research Center, USA
| | - Mark P Cain
- Department of Urology, Indiana University School of Medicine, USA
| | - Richard Frankel
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Cleveland Clinic Learner Institute, Cleveland, OH, USA
| | - Katherine H Chan
- Department of Urology, Indiana University School of Medicine, USA; Department of Pediatrics, Center for Pediatric and Adolescent Comparative Effectiveness Research, USA.
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Truong H, Salib A, Rowe CK. The Use of Social Media in Pediatric Urology-Forging New Paths or Crossing Boundaries? Curr Urol Rep 2019; 20:72. [PMID: 31620926 DOI: 10.1007/s11934-019-0928-y] [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: 10/25/2022]
Abstract
PURPOSE OF REVIEW There has been a remarkable change in how people connect, access, and share professional and medical information over social media. This perspective article describes opportunities, potential pitfalls, and guidelines for social media use by pediatric urology providers. RECENT FINDINGS Pediatric urologists have effectively used social media to connect and share expertise, augment scientific conference participation, promote themselves and their research, disseminate guidelines and best practices, participate in virtual journal clubs, and engage with patients and their families. Information shared over social media is not protected by copyright law, not confidential, not regulated, permanent, and subjected to public domain and scrutiny. Despite these potential pitfalls, social media is a useful tool if best practices are observed and online communication adheres to professional guidelines and organizational policy. Social media use in healthcare is here to stay and pediatric urologists have online visibility whether or not they choose to actively participate. Despite new legal, ethical, and professional considerations that social media introduces, a well-executed social media presence provides pediatric urologists a wealth of new opportunities for networking, research, and disseminating high-quality medical information online.
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Affiliation(s)
- Hong Truong
- Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, 1025 Walnut St, Suite 1112, Philadelphia, PA, 19107, USA. .,Division of Pediatric Urology, Connecticut Children's Medical Center, Hartford, CT, USA.
| | - Andrew Salib
- Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, 1025 Walnut St, Suite 1112, Philadelphia, PA, 19107, USA.,Division of Pediatric Urology, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Courtney K Rowe
- Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, 1025 Walnut St, Suite 1112, Philadelphia, PA, 19107, USA.,Division of Pediatric Urology, Connecticut Children's Medical Center, Hartford, CT, USA
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Ernst MM, Chen D, Kennedy K, Jewell T, Sajwani A, Foley C, Sandberg DE. Disorders of sex development (DSD) web-based information: quality survey of DSD team websites. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2019; 2019:1. [PMID: 31149017 PMCID: PMC6537388 DOI: 10.1186/s13633-019-0065-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/02/2019] [Indexed: 01/20/2023]
Abstract
Objectives Consumers rely on online health information, particularly for unusual conditions. Disorders of Sex Development (DSD) are complex with some aspects of care controversial. Accurate web-based DSD information is essential for decision-making, but the quality has not been rigorously evaluated. The purpose of the present study was to assess the quality of online health information related to DSD presented by 12 pediatric institutions comprising the NIH-sponsored DSD-Translational Research Network (DSD-TRN). Methods DSD-TRN sites identified team webpages, then we identified linked webpages. We also used each institution search engine to search common DSD terms. We assessed webpages using validated tools: the Simple Measure of Gobbledygook (SMOG) determined reading level, the Patient Education Materials Assessment Tool (PEMAT) evaluated content for understandability and actionability, and the DISCERN tool assessed treatment decision-making information (for hormone replacement and surgery). We developed a “Completeness” measure which assessed the presence of information on 25 DSD topics. Results The SMOG reading level of webpages was at or above high-school grade level. Mean (SD) PEMAT understandability score for Team Pages and Team Links was 68% (6%); on average these pages met less than 70% of the understandability criteria. Mean (SD) PEMAT actionability score was 23% (20%); few patient actions were identified. The DISCERN tool determined that the quality of information related to hormone treatment and to surgery was poor. Sites’ webpages covered 12–56% of the items on our Completeness measure. Conclusions Quality of DSD online content was poor, and would be improved by using a variety of strategies, such as simplifying word choice, using visual aids, highlighting actions patients can take and acknowledging areas of uncertainty. For complex conditions such as DSD, high-quality web-based information is essential to empower patients (and caregiver proxies), particularly when aspects of care are controversial.
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Affiliation(s)
- Michelle M Ernst
- 1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229 USA.,2Disorders of Sex Development Center, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., ML 3015, Cincinnati, OH 45229 USA
| | - Diane Chen
- 3Pritzker Department of Psychiatry and Behavioral Sciences, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 161B, Chicago, IL 60611 USA.,4Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 161B, Chicago, IL 60611 USA.,5Departments of Psychiatry and Behavioral Sciences, and Pediatrics, Northwestern University Feinberg School of Medicine, 446 E. Ontario Street, Chicago, IL 60611 USA
| | - Kim Kennedy
- 2Disorders of Sex Development Center, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., ML 3015, Cincinnati, OH 45229 USA
| | - Tess Jewell
- 6Oberlin College, 173 W. Lorain St., Oberlin, OH 44074 USA
| | - Afiya Sajwani
- 4Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 161B, Chicago, IL 60611 USA
| | - Carmel Foley
- 7Hofstra Northwell School of Medicine, 420 Lakeville Rd, Suite 110, New Hyde Park, NY 11042 USA
| | - David E Sandberg
- 8Department of Pediatrics and Susan B Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan Medical School, 300 North Ingalls St., Rm 6C23, Ann Arbor, MI 48109 USA
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