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Eysenbach G, Nădășan V, Ursachi T, Toboltoc PC, Benedek T. What Patients Find on the Internet When Looking for Information About Percutaneous Coronary Intervention: Multilanguage Cross-sectional Assessment. J Med Internet Res 2022; 24:e41219. [PMID: 36472906 PMCID: PMC9768670 DOI: 10.2196/41219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/07/2022] [Accepted: 11/17/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The internet provides general users with wide access to medical information. However, regulating and controlling the quality and reliability of the considerable volume of available data is challenging, thus generating concerns about the consequences of inaccurate health care-related documentation. Several tools have been proposed to increase the transparency and overall trustworthiness of medical information present on the web. OBJECTIVE We aimed to analyze and compare the quality and reliability of information about percutaneous coronary intervention on English, German, Hungarian, Romanian, and Russian language websites. METHODS Following a rigorous protocol, 125 websites were selected, 25 for each language sub-sample. The websites were assessed concerning their general characteristics, compliance with a set of eEurope 2002 credibility criteria, and quality of the informational content (namely completeness and accuracy), based on a topic-specific benchmark. Completeness and accuracy were graded independently by 2 evaluators. Scores were reported on a scale from 0 to 10. The 5 language subsamples were compared regarding credibility, completeness, and accuracy. Correlations between credibility scores on the one hand, and completeness and accuracy scores, on the other hand, were tested within each language subsample. RESULTS The websites' compliance with credibility criteria was average at best with scores between 3.0 and 6.0. In terms of completeness and accuracy, the website subsets qualified as poor or average, with scores ranging from 2.4 to 4.6 and 3.6 to 5.3, respectively. English language websites scored significantly higher in all 3 aspects, followed by German and Hungarian language websites. Only German language websites showed a significant correlation between credibility and information quality. CONCLUSIONS The quality of websites in English, German, Hungarian, Romanian, and Russian languages about percutaneous coronary intervention was rather inadequate and may raise concerns regarding their impact on informed decision-making. Using credibility criteria as indicators of information quality may not be warranted, as credibility scores were only exceptionally correlated with content quality. The study brings valuable descriptive data on the quality of web-based information regarding percutaneous coronary intervention in multiple languages and raises awareness about the need for responsible use of health-related web resources.
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Affiliation(s)
| | - Valentin Nădășan
- George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - Tatiana Ursachi
- George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - Paul-Cătălin Toboltoc
- George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania.,Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Theodora Benedek
- George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
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Abstract
AIMS Total joint replacement (TJR) is a high-cost, high-volume procedure that impacts patients' quality of life. Informed decisions are important for patients facing TJR. The quality of information provided by websites regarding TJR is highly variable. We aimed to measure the quality of TJR information online. METHODS We identified 10,800 websites using 18 TJR-related keywords (conditions and procedures) across the Australian, French, German and Spanish Google search engines. We used the Health on the Net (HON) toolbar to evaluate the first 150 websites downloaded for every keyword in each language. The quality of information on websites was inspected, accounting for differences by language and tertiles. We also undertook an analysis of English websites to explore types of website providers. RESULTS 'Total joint replacement' had the most results returned (150 million websites), and 9% of websites are HON-accredited. Differences in information quality were seen across search terms (p < 0.001) and tertiles (p < 0.001), but not between languages (p = 0.226). A larger proportion of HON-accredited websites were seen from keywords in the condition and arthroplasty categories. The first tertile contained the highest number of HON-accredited websites for the majority of search terms. Government/educational bodies sponsored the majority of websites. CONCLUSION Clinicians must consider the shortage of websites providing validated information, with disparities in both number and quality of websites for TJR conditions and procedures. As such, the challenge for clinicians is to lead the design of reliable, accurate and ethical orthopaedic websites online and direct patients to them. This stands to reward both parties greatly.
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Affiliation(s)
- Myles T. Davaris
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Melbourne, Australia
| | - Michelle M. Dowsey
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Melbourne, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Melbourne, Australia
| | - Peter F. Choong
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Melbourne, Australia
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Asafu-Adjei D, Mikkilineni N, Sebesta E, Hyams E. Misinformation on the Internet regarding Ablative Therapies for Prostate Cancer. Urology 2019; 133:182-186. [DOI: 10.1016/j.urology.2018.12.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/02/2018] [Accepted: 12/20/2018] [Indexed: 11/25/2022]
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Radiotherapy for prostate cancer: DISCERN quality assessment of patient-oriented websites in 2018. BMC Urol 2019; 19:42. [PMID: 31138209 PMCID: PMC6537434 DOI: 10.1186/s12894-019-0474-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/09/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Prostate cancer is the most commonly diagnosed cancer in men. Radiotherapy represents one major treatment option in different therapeutic settings. As patients increasingly rely on internet-based medical information, we examined the quality of information on radiotherapy and prostate cancer in websites used by laypersons. METHODS An Internet search from a patients` perspective was carried out using different search engines (Google, Yahoo and Bing, search terms: "prostate cancer" and "radiotherapy"). The quality of search results was analyzed with regard to the DISCERN score, HON code certification, the JAMA criteria and the ALEXA traffic rank. RESULTS In general, websites were of good quality. The highest quality was found for websites operated by charity organizations. No significant differences in results obtained via the above-mentioned tools were seen for the examined search engines, but Google revealed the most stable search results in terms of temporal changes. CONCLUSION Patients with prostate cancer can sufficiently inform themselves on general treatment options including radiotherapy on websites directed at laypersons. However, no simple strategy could identify high quality websites in general. For treating physicians, it is important to support patients in interpreting and ranking the vast quantity of information.
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Thomas J, Prabhu AV, Heron DE, Beriwal S. Reddit and Radiation Therapy: A Descriptive Analysis of Posts and Comments Over 7 Years by Patients and Health Care Professionals. Adv Radiat Oncol 2019; 4:345-353. [PMID: 31011680 PMCID: PMC6460228 DOI: 10.1016/j.adro.2019.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 01/23/2019] [Indexed: 01/29/2023] Open
Abstract
Purpose Reddit is a social media platform that allows health care professionals (HPs) to anonymously interact with patients. We analyzed content about radiation therapy (RT) on Reddit. Methods and Materials Reddit.com/r/cancer was queried with 20 search terms related to RT: IMRT, 3D-CRT, SBRT, EBRT, XRT, radiation, radiotherapy, RT, radio, rad, rads, gamma, gamma knife, gammaknife, cyber knife, cyberknife, cyber, brachytherapy, brachy, and cobalt. The search aimed to identify all posts discussing RT. A random sample of posts and their top 3 comments was selected to generate qualitative thematic codes per author consensus, which were used to characterize all posts and their top 3 voted comments. Posts were analyzed for time to first reply, mention of any specific RT modality, whether a self-identified HP responded, and time to first highly voted comment by an HP. Results Exactly 190 posts about RT by 178 users were shared from February 2011 to May 2018, and 468 replies by 295 users were also analyzed. Twenty-nine of these users (9.8%) were HPs; however, 48 of 181 top comments were contributed by HPs compared with 45 of 288 non–top comments by HPs (odds ratio, 1.95; 95% confidence interval [CI], 1.23-3.08; P < .004). The most common themes were treatment questions, chronology, and information; toxicities; and social support. The median time to first comment after posting was 64.0 minutes (95% CI, 53.0-82.0), and median time to first highly voted comment from an HP was 264.0 minutes (95% CI, 153.5-427.9; U = 4123.5; P < .0001 2-tailed). Fifty-three posts (27.9%) identified a specific RT modality, with proton therapy (7.4%), CyberKnife (5.3%), brachytherapy (4.2%), and whole brain radiation (4.2%) being the most common. Conclusions HPs did not reply often to RT posts and generally took longer to do so, but their replies were valued by users. Common themes included treatment questions, chronology, and treatment; toxicities; and social support. Proton therapy received notable attention.
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Affiliation(s)
- Joel Thomas
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Arpan V Prabhu
- Department of Radiation Oncology, UAMS Winthrop P. Rockefeller Cancer Institute, Little Rock, Arkansas.,Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Institute, Pittsburgh, Pennsylvania
| | - Dwight E Heron
- Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Institute, Pittsburgh, Pennsylvania
| | - Sushil Beriwal
- Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Institute, Pittsburgh, Pennsylvania
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Heiman H, Keinki C, Huebner J. EHealth literacy in patients with cancer and their usage of web-based information. J Cancer Res Clin Oncol 2018; 144:1843-1850. [PMID: 30006768 DOI: 10.1007/s00432-018-2703-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/04/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Our aim was to learn more about the association between the sources of information cancer patients and caregivers use and their eHealth literacy. METHODS We distributed a standardized questionnaire among participants of a lecture program on complementary and alternative medicine (CAM). RESULTS Among 182 attendants, the Internet was the third most important source of information (57%), preceded by the oncologist (67%) and print media (61%). Print media was associated with female participants and web-based information with younger ones. Regarding eHealth literacy, more than half (58.5%) had an above average eHEALS score. Nevertheless, the biggest concern was not being able to differentiate between reliable and not reliable websites. The correlation between a high eHealth literacy and regular search of web-based cancer information was significant (p < 0.001). CONCLUSION The number of people using the Internet as a source of cancer information has increased over the past years and will rise in the future. However, only half of the population has the knowledge and capability to access and differentiate the massive web-based data. Improving eHealth literacy within the public will expand the knowledge of regular patients and help them become a well-informed and equal partner in decision making.
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Affiliation(s)
- Hanna Heiman
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Christian Keinki
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Jutta Huebner
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
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Basch CH, Ethan D, MacLean SA, Fera J, Garcia P, Basch CE. Readability of Prostate Cancer Information Online: A Cross-Sectional Study. Am J Mens Health 2018; 12:1665-1669. [PMID: 29888641 PMCID: PMC6142125 DOI: 10.1177/1557988318780864] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Reading and understanding health information, both components of health literacy, can influence patient decisions related to disease management. Older adults, the population of males at greatest risk for prostate cancer, may have compromised capacity to understand and use health information. The purpose of this study was to determine the readability of prostate cancer materials on the Internet using five recommended readability tests. Using a cleared Internet browser, a search was conducted for "prostate cancer." The URLs of the first 100 websites in English were recorded to create the sample. The readability scores for each website were determined using an online, recommended service. This service generates five commonly recommended readability tests. All five tests revealed that the majority of websites had difficult readability. There were no significant differences identified between websites with .org, .gov, or .edu extension versus those with .com, .net, or other extension. It is apparent that the Internet is used often as a resource for health-related information. This study demonstrates that the large majority of information available on the Internet about prostate cancer will not be readable for many individuals.
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Affiliation(s)
- Corey H Basch
- 1 Department of Public Health, William Paterson University, Wayne, NJ, USA
| | - Danna Ethan
- 2 Department of Health Sciences, Lehman College, The City University of New York, New York, NY, USA
| | - Sarah A MacLean
- 3 Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph Fera
- 4 Department of Mathematics, Lehman College, The City University of New York, New York, NY, USA
| | - Phillip Garcia
- 1 Department of Public Health, William Paterson University, Wayne, NJ, USA
| | - Charles E Basch
- 5 Richard March Hoe Professor of Health and Education, Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
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Davaris M, Barnett S, Abouassaly R, Lawrentschuk N. Thoracic Surgery Information on the Internet: A Multilingual Quality Assessment. Interact J Med Res 2017; 6:e5. [PMID: 28500021 PMCID: PMC5446665 DOI: 10.2196/ijmr.6732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 02/02/2017] [Accepted: 02/21/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous data suggest that quality of Internet information regarding surgical conditions and their treatments is variable. However, no comprehensive analysis of website quality exists for thoracic surgery. OBJECTIVE The aim of this study was to quantify website quality in a multilingual setting using an international standard for assessment. METHODS Health On the Net (HON) principles may be applied to websites using an automated toolbar function. We used the English, French, Spanish, and German Google search engines to identify 12,000 websites using keywords related to thoracic conditions and procedures. The first 150 websites returned by each keyword in each language were examined. We compared website quality to assess for tertile (is the quality better in first, second, or third 50 websites returned) and language differences. A further analysis of the English site types was undertaken performing a comparative analysis of website provider types. RESULTS Overall, there are a considerable number of websites devoted to thoracic surgery: "lung cancer" returned over 150 million websites. About 7.85% (940/11,967) of websites are HON-accredited with differences by search term (P<.001) and tertiles (P<.001) of the first 150 websites, but not between languages. Oncological keywords regarding conditions and procedures were found to return a higher percentage of HON-accreditation. The percentage of HON-accredited sites was similar across all four languages (P=.77). In general, the first tertile contained a higher percentage of HON-accredited sites for every keyword. CONCLUSIONS Clinicians should appreciate the lack of validation of the majority of thoracic websites, with discrepancies in quality and number of websites across conditions and procedures. These differences appear similar regardless of language. An opportunity exists for clinicians to participate in the development of informative, ethical, and reliable health websites on the Internet and direct patients to them.
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Affiliation(s)
| | | | - Robert Abouassaly
- University Hospitals Case Medical Centre, Cleveland, OH, United States
| | - Nathan Lawrentschuk
- Austin Hospital, Department of Surgery, University of Melbourne, Melbourne, Australia
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Nicolaije KA, Ezendam NP, Pijnenborg JM, Boll D, Vos MC, Kruitwagen RF, van de Poll-Franse LV. Paper-Based Survivorship Care Plans May be Less Helpful for Cancer Patients Who Search for Disease-Related Information on the Internet: Results of the Registrationsystem Oncological Gynecology (ROGY) Care Randomized Trial. J Med Internet Res 2016; 18:e162. [PMID: 27392550 PMCID: PMC4958141 DOI: 10.2196/jmir.4914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/26/2015] [Accepted: 01/19/2016] [Indexed: 11/16/2022] Open
Abstract
Background The Institute of Medicine recommends Survivorship Care Plans (SCPs) for all cancer survivors. However, it is unclear whether certain patient groups may or may not benefit from SCPs. Objective The aim was to assess whether the effects of an automatically generated paper SCP on patients’ satisfaction with information provision and care, illness perceptions, and health care utilization were moderated by disease-related Internet use. Methods Twelve hospitals were randomized to either SCP care or usual care in the pragmatic cluster randomized Registrationsystem Oncological GYnecology (ROGY) Care trial. Newly diagnosed endometrial cancer patients completed questionnaires after diagnosis (N=221; response: 74.7%, 221/296), 6 months (n=158), and 12 months (n=147), including patients’ satisfaction with information provision and care, illness perceptions, health care utilization (how many times patients visited a medical specialist or primary care physician about their cancer in the past 6 months), and disease-related Internet use (whether patients used the Internet to look for information about cancer). Results In total, 80 of 221 (36.2%) patients used the Internet to obtain disease-related information. Disease-related Internet use moderated the SCP care effect on the amount of information received about the disease (P=.03) and medical tests (P=.01), helpfulness of the information (P=.01), and how well patients understood their illness (P=.04). All stratified analyses were not statistically significant. However, it appeared that patients who did not seek disease-related information on the Internet in the SCP care arm reported receiving more information about their disease (mean 63.9, SD 20.1 vs mean 58.3, SD 23.7) and medical tests (mean 70.6, SD 23.5 vs mean 64.7, SD 24.9), finding the information more helpful (76.7, SD 22.9 vs mean 67.8, SD 27.2; scale 0-100), and understanding their illness better (mean 6.6, SD 3.0 vs mean 6.1, SD 3.2; scale 1-10) than patients in the usual care arm did. In addition, although all stratified analyses were not significant, patients who did seek disease-related information on the Internet in the SCP care arm appeared to receive less information about their disease (mean 65.7, SD 23.4 vs mean 67.1, SD 20.7) and medical tests (mean 72.4, SD 23.5 vs mean 75.3, SD 21.6), did not find the information more helpful (mean 78.6, SD 21.2 vs mean 76.0, SD 22.0), and reported less understanding of their illness (mean 6.3, SD 2.8 vs mean 7.1, SD 2.7) than patients in the usual care arm did. Conclusions Paper SCPs appear to improve the amount of information received about the disease and medical tests, the helpfulness of the information, and understanding of the illness for patients who do not search for disease-related information on the Internet. In contrast, paper SCPs do not seem beneficial for patients who do seek disease-related information on the Internet. Trial Registration ClinicalTrials.gov NCT01185626; https://clinicaltrials.gov/ct2/show/NCT01185626 (Archived by WebCite at http://www.webcitation.org/6fpaMXsDn)
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Affiliation(s)
- Kim Ah Nicolaije
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.
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Saraswat I, Abouassaly R, Dwyer P, Bolton DM, Lawrentschuk N. Female urinary incontinence health information quality on the Internet: a multilingual evaluation. Int Urogynecol J 2015; 27:69-76. [PMID: 26353845 DOI: 10.1007/s00192-015-2742-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 05/12/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The quality of Internet information on female urinary incontinence is considered variable. No comprehensive analysis exists to support this. We compared the quality of current Internet information for common layperson terminology on female urinary incontinence across four Western languages and a comparative analysis of website sponsors. METHODS World Health Organization Health on the Net (HON) principles may be applied to websites using an automated toolbar function. We used the Google search engine; 10,200 websites were identified using keywords related to female urinary incontinence and treatments in English, French, German and Spanish. The first 150 websites in each language had HON principles examined, whilst a further analysis of site sponsorship was undertaken. RESULTS The total number of websites for each term is variable. "Female sling surgery" had the most websites with approximately 18 million, whereas "colposuspension" had the least with only 159,890 websites. Regardless of language, very few female urinary incontinence websites were HON accredited (p < 0.0001). Linguistically, French (18%) and English (16%) had the greatest percentage of HON-accredited sites. Tertiles (thirds) of the first 150 websites returned the higher percentage of HON-accredited websites (p < 0.0001). Websites were largely sponsored by physicians/surgeons. CONCLUSIONS The lack of validation of most female urinary incontinence websites should be appreciated by clinicians. Additionally, discrepancies exist in the quality and number of websites across conditions, languages and also between medical and alternative terms. Clinicians should participate in and encourage the development of informative, ethical and reliable health websites on the Internet and direct patients to them.
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Affiliation(s)
- Ishani Saraswat
- Department of Surgery, Austin Hospital, University of Melbourne, Suite 5, 210 Burgundy Street, Heidelberg, VIC, 3084, Australia
| | - Robert Abouassaly
- Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Peter Dwyer
- Faculty of Medicine, Dentistry and Health Sciences and Mercy Health, University of Melbourne, Melbourne, Australia
| | - Damien M Bolton
- Department of Surgery, Austin Hospital, University of Melbourne, Suite 5, 210 Burgundy Street, Heidelberg, VIC, 3084, Australia
| | - Nathan Lawrentschuk
- Department of Surgery, Austin Hospital, University of Melbourne, Suite 5, 210 Burgundy Street, Heidelberg, VIC, 3084, Australia. .,Olivia Newton-John Cancer Research Institute, Austin Hospital, Melbourne, Australia. .,Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
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Rider T, Malik M, Chevassut T. Haematology patients and the Internet--the use of on-line health information and the impact on the patient-doctor relationship. PATIENT EDUCATION AND COUNSELING 2014; 97:223-238. [PMID: 25053474 DOI: 10.1016/j.pec.2014.06.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 06/18/2014] [Accepted: 06/28/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Patients access on-line health information (OHI) to better understand their health. We aimed to determine which demographic factors influence OHI use. We also explored how OHI is used and subsequent implications to the patient-doctor relationship. METHODS We distributed a self-administered questionnaire to 202 haematology out-patients. RESULTS 62.3% used the internet and 54.3% used OHI. Higher education, (P<0.001, OR 34.62, 95% CI 5.20-230.66) and household incomes of £15000-25000 (P=0.023 OR 4.8 95% CI 1.236-18.59) were positively associated with OHI use. Those reassured after reading OHI had improved trust in their specialist (P<0.001, OR 52.1, 95% CI 12.3-221.1), improved confidence during consultations, (P<0.001, OR 23.0, 95% CI 2.8-188.2) and were improved decisions makers (P=0.008, OR 13.6, 95% CI 4.1-45.7). Those with increased trust in their haematologist also had improved confidence (P<0.001, OR 6.2, 95% CI 2.2-17.3) and improved decision making ability (P<0.001, OR 13.6, 95% CI 4.7-39.4). 74.6% of patients did not share OHI with their haematologist. CONCLUSIONS Two-thirds of participants were exposed directly or indirectly to OHI. OHI affects patients' view of their health and influences behaviour during consultations. PRACTICE IMPLICATIONS Haematologists could facilitate patients using OHI by recommending high quality websites and act supportively when patients share OHI.
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Affiliation(s)
- Tom Rider
- Department of Hematology, Brighton and Sussex University Hospital Trust, Brighton, UK
| | - Muzaffar Malik
- Institute of Postgraduate Medicine, Brighton and Sussex Medical School, Mayfield House, University of Brighton, Falmer, UK
| | - Timothy Chevassut
- Research Department, Brighton and Sussex Medical School, Brighton, UK.
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Shahrokni A, Mahmoudzadeh S, Lu BT. In Whom Do Cancer Survivors Trust Online and Offline? Asian Pac J Cancer Prev 2014; 15:6171-6. [DOI: 10.7314/apjcp.2014.15.15.6171] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Song H, Cramer EM, McRoy S. Information gathering and technology use among low-income minority men at risk for prostate cancer. Am J Mens Health 2014; 9:235-46. [PMID: 24951493 DOI: 10.1177/1557988314539502] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Health communication researchers, public health workers, and health professionals must learn more about the health information-gathering behavior of low-income minority men at risk for prostate cancer in order to share information effectively with the population. In collaboration with the Milwaukee Health Department Men's Health Referral Network, a total of 90 low-income adult men were recruited to complete a survey gauging information sources, seeking behavior, use of technology, as well as prostate cancer awareness and screening behavior. Results indicated participants primarily relied on health professionals, family, and friends for information about general issues of health as well as prostate cancer. The Internet was the least relied on source of information. A hierarchical regression indicated interpersonal information sources such as family or friends to be the only significant predictor enhancing prostate cancer awareness, controlling for other sources of information. Prostate screening behaviors were predicted by reliance on not only medical professionals but also the Internet. Practical implications of the study are discussed.
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Affiliation(s)
- Hayeon Song
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | | | - Susan McRoy
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Bidmon S, Terlutter R, Röttl J. What explains usage of mobile physician-rating apps? Results from a web-based questionnaire. J Med Internet Res 2014; 16:e148. [PMID: 24918859 PMCID: PMC4071227 DOI: 10.2196/jmir.3122] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 04/10/2014] [Accepted: 04/27/2014] [Indexed: 01/27/2023] Open
Abstract
Background Consumers are increasingly accessing health-related information via mobile devices. Recently, several apps to rate and locate physicians have been released in the United States and Germany. However, knowledge about what kinds of variables explain usage of mobile physician-rating apps is still lacking. Objective This study analyzes factors influencing the adoption of and willingness to pay for mobile physician-rating apps. A structural equation model was developed based on the Technology Acceptance Model and the literature on health-related information searches and usage of mobile apps. Relationships in the model were analyzed for moderating effects of physician-rating website (PRW) usage. Methods A total of 1006 randomly selected German patients who had visited a general practitioner at least once in the 3 months before the beginning of the survey were randomly selected and surveyed. A total of 958 usable questionnaires were analyzed by partial least squares path modeling and moderator analyses. Results The suggested model yielded a high model fit. We found that perceived ease of use (PEOU) of the Internet to gain health-related information, the sociodemographic variables age and gender, and the psychographic variables digital literacy, feelings about the Internet and other Web-based applications in general, patients’ value of health-related knowledgeability, as well as the information-seeking behavior variables regarding the amount of daily private Internet use for health-related information, frequency of using apps for health-related information in the past, and attitude toward PRWs significantly affected the adoption of mobile physician-rating apps. The sociodemographic variable age, but not gender, and the psychographic variables feelings about the Internet and other Web-based applications in general and patients’ value of health-related knowledgeability, but not digital literacy, were significant predictors of willingness to pay. Frequency of using apps for health-related information in the past and attitude toward PRWs, but not the amount of daily Internet use for health-related information, were significant predictors of willingness to pay. The perceived usefulness of the Internet to gain health-related information and the amount of daily Internet use in general did not have any significant effect on both of the endogenous variables. The moderation analysis with the group comparisons for users and nonusers of PRWs revealed that the attitude toward PRWs had significantly more impact on the adoption and willingness to pay for mobile physician-rating apps in the nonuser group. Conclusions Important variables that contribute to the adoption of a mobile physician-rating app and the willingness to pay for it were identified. The results of this study are important for researchers because they can provide important insights about the variables that influence the acceptance of apps that allow for ratings of physicians. They are also useful for creators of mobile physician-rating apps because they can help tailor mobile physician-rating apps to the consumers’ characteristics and needs.
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Affiliation(s)
- Sonja Bidmon
- Department of Marketing and International Management, Alpen-Adria Universitaet Klagenfurt, Klagenfurt am Woerthersee, Austria.
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Silk KJ, Perrault EK, Nazione S, Pace K, Hager P, Springer S. Localized prostate cancer treatment decision-making information online: improving its effectiveness and dissemination for nonprofit and government-supported organizations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:709-716. [PMID: 23907786 DOI: 10.1007/s13187-013-0515-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The current study reports findings from evaluation research conducted to identify how online prostate cancer treatment decision-making information can be both improved and more effectively disseminated to those who need it most. A multi-method, multi-target approach was used and guided by McGuire's Communication Matrix Model. Focus groups (n = 31) with prostate cancer patients and their family members, and in-depth interviews with physicians (n = 8), helped inform a web survey (n = 89). Results indicated that physicians remain a key information source for medical advice and the Internet is a primary channel used to help make informed prostate cancer treatment decisions. Participants reported a need for more accessible information related to treatment options and treatment side effects. Additionally, physicians indicated that the best way for agencies to reach them with new information to deliver to patients is by contacting them directly and meeting with them one-on-one. Advice for organizations to improve their current prostate cancer web offerings and further ways to improve information dissemination are discussed.
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Affiliation(s)
- Kami J Silk
- Michigan State University, 404 Wilson Road-CAS 477, East Lansing, MI, 48824, USA,
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Schook RM, Linssen C, Festen J, Schramel FM, Lammers E, Zaanen P, Postmus PE. Website visitors asking questions online to lung cancer specialists: what do they want to know? Interact J Med Res 2013; 2:e15. [PMID: 23919980 PMCID: PMC3742407 DOI: 10.2196/ijmr.1749] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 06/03/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In 2003 the Dutch Lung Cancer Information Centre (Longkanker Informatie Centrum) launched a website containing information on lung cancer accessible to anyone. OBJECTIVE Our study aim was to inventorize the information needs of the visitors of this website by analyzing the questions they asked the lung cancer specialists in the websites interactive section "Ask the Physician". METHODS The first 2000 questions posted up until May 2006 have been classified by visitors' wish, type of required information, identity, gender, and phase during treatment course. RESULTS Our results show that 1893 (1158/1893, 61%) of the questions were asked by a loved one/caregiver and (239/1893 13%) by patients. 1 out of 3 questions was asked by a daughter/grand-daughter. Most questions concerned specific information on lung cancer and lung cancer course (817/1893, 43%). The most inquired specific information topics were therapy side effects, diagnostics, general information on lung cancer, and regular therapy. Furthermore, questioners wanted to verify their own doctor's information (122/1893, 6%), a diagnosis (267/1893, 14%), and a prognosis (204/1893, 11%). CONCLUSIONS Lung cancer patients and their caregivers asked the most questions in the interactive website section. The most frequently requested information was more detailed information. These include specific information on lung cancer (regular therapy, diagnostics, and disease symptoms), verification of what the doctor has said, diagnosis, and prognosis. Most of the requested information could have been obtained from treating specialists, indicating that current information supply to lung cancer patients and their caregivers may not be matching their needs sufficiently. The further implementation of an online dialogue with lung cancer specialists might be a solution.
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Affiliation(s)
- Romane M Schook
- VU University Medical Center, Department of Pulmonary Diseases, Amsterdam, Netherlands.
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Weinberg JL, Guarino JM, Savoy ML, Horton T, Reed J. Identifying differences in communication technology preferences across the lifespan. J Am Geriatr Soc 2013; 60:2176-7. [PMID: 23148426 DOI: 10.1111/j.1532-5415.2012.04227.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Simone CB, Hampshire MK, Vachani C, Metz JM. The utilization of oncology web-based resources in Spanish-speaking Internet users. Am J Clin Oncol 2012; 35:520-6. [PMID: 21654312 PMCID: PMC3171691 DOI: 10.1097/coc.0b013e31821d4906] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES There currently are few web-based resources written in Spanish providing oncology-specific information. This study examines utilization of Spanish-language oncology web-based resources and evaluates oncology-related Internet browsing practices of Spanish-speaking patients. METHODS OncoLink (http://www.oncolink.org) is the oldest and among the largest Internet-based cancer information resources. In September 2005, OncoLink pioneered OncoLink en español (OEE) (http://es.oncolink.org), a Spanish translation of OncoLink. Internet utilization data on these sites for 2006 to 2007 were compared. RESULTS Visits to OncoLink rose from 4,440,843 in 2006 to 5,125,952 in 2007. OEE had 204,578 unique visitors and 240,442 visits in 2006, and 351,228 visitors and 412,153 visits in 2007. Although there was no time predilection for viewing OncoLink, less relative browsing on OEE was conducted during weekends and early morning hours. Although OncoLink readers searched for information on the most common cancers in the United States, OEE readers most often search for gastric, vaginal, osteosarcoma, leukemia, penile, cervical, and testicular malignancies. Average visit duration on OEE was shorter, and fewer readers surveyed OEE more than 15 minutes (4.5% vs. 14.9%, P < 0.001). CONCLUSIONS Spanish-speaking users of web-based oncology resources are increasingly using the Internet to supplement their cancer knowledge. Limited available resources written in Spanish contribute to disparities in information access and disease outcomes. Spanish-speaking oncology readers differ from English-speaking readers in day and time of Internet browsing, visit duration, Internet search patterns, and types of cancers searched. By acknowledging these differences, content of web-based oncology resources can be developed to best target the needs of Spanish-speaking viewers.
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Affiliation(s)
- Charles B Simone
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
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D'Agostino TA, Ostroff JS, Heerdt A, Dickler M, Li Y, Bylund CL. Toward a greater understanding of breast cancer patients' decisions to discuss cancer-related internet information with their doctors: an exploratory study. PATIENT EDUCATION AND COUNSELING 2012; 89:109-15. [PMID: 22722063 PMCID: PMC3462296 DOI: 10.1016/j.pec.2012.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 04/30/2012] [Accepted: 05/18/2012] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To investigate differences between breast cancer patients who do and do not discuss cancer-related internet information (CRII) with their doctors. METHODS 70 breast cancer patients completed questionnaires regarding internet use, discussions about CRII, and the doctor-patient relationship. RESULTS No significant differences were noted across patient, disease, or visit characteristics, or physician reliance between those who intended to discuss CRII and those who did not. Patients who intended to discuss CRII rated significantly higher pre-consultation anxiety levels. No significant differences in satisfaction, anxiety reduction, or trust in physician were found between patients who had discussed and those who had not. Patients' reasons for discussing or not discussing are detailed. CONCLUSION Factors influencing patients' decisions to discuss CRII are complex and differ from those identified as leading patients to seek internet information. Future research about internet discussions should investigate the impact of patients' preferred role in treatment, the doctor-patient relationship, anxiety level, attributes of CRII, and physician trust. PRACTICE IMPLICATIONS Understanding the characteristics of patients who do and do not discuss internet information is important given the impact internet information has on healthcare communication and the doctor-patient relationship, including the development of interventions aimed at improving such interactions.
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Tsai J, Rosenheck RA. Use of the internet and an online personal health record system by US veterans: comparison of Veterans Affairs mental health service users and other veterans nationally. J Am Med Inform Assoc 2012; 19:1089-94. [PMID: 22847305 DOI: 10.1136/amiajnl-2012-000971] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The Department of Veterans Affairs (VA) operates one of the largest nationwide healthcare systems and is increasing use of internet technology, including development of an online personal health record system called My HealtheVet. This study examined internet use among veterans in general and particularly use of online health information among VA patients and specifically mental health service users. METHODS A nationally representative sample of 7215 veterans from the 2010 National Survey of Veterans was used. Logistic regression was employed to examine background characteristics associated with internet use and My HealtheVet. RESULTS 71% of veterans reported using the internet and about a fifth reported using My HealtheVet. Veterans who were younger, more educated, white, married, and had higher incomes were more likely to use the internet. There was no association between background characteristics and use of My HealtheVet. Mental health service users were no less likely to use the internet or My HealtheVet than other veterans. DISCUSSION Most veterans are willing to access VA information online, although many VA service users do not use My HealtheVet, suggesting more education and research is needed to reduce barriers to its use. CONCLUSION Although adoption of My HealtheVet has been slow, the majority of veterans, including mental health service users, use the internet and indicate a willingness to receive and interact with health information online.
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Affiliation(s)
- Jack Tsai
- VA New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut, USA.
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Bylund CL, D'Agostino TA, Ostroff J, Heerdt A, Li Y, Dickler M. Exposure to and intention to discuss cancer-related internet information among patients with breast cancer. J Oncol Pract 2012; 8:40-5. [PMID: 22548010 DOI: 10.1200/jop.2011.000271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2011] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Previous studies have reported a significant number of patients with breast cancer seek cancer-related information from the Internet. Most studies have asked whether a patient has ever read Internet information since her diagnosis. The purpose of this study was to assess the frequency with which patients with breast cancer come to physician appointments having recently read and intending to discuss cancer-related information from the Internet. PATIENTS AND METHODS We asked 558 patients with breast cancer who were waiting to see their physicians about their experiences reading cancer-related information from the Internet and their intent to discuss the information in their current visit. RESULTS Fifteen percent reported reading cancer-related Internet information in the past month. Patients who had read such information in the past month were younger, had been diagnosed more recently, and were more likely to be attending a new visit. Of those who had read in the past month, 45% reported intending to discuss what they had read with their physician. Nineteen percent of patients reported having ever read breast cancer-related Internet information since their diagnosis. CONCLUSION The proportion of patients with breast cancer planning to discuss Internet information during their current physician visit was relatively small. Few characteristics were associated with recent Internet use or intent to discuss.
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Rogers SN, Rozek A, Aleyaasin N, Promod P, Lowe D. Internet use among head and neck cancer survivors in the North West of England. Br J Oral Maxillofac Surg 2012; 50:208-14. [DOI: 10.1016/j.bjoms.2011.03.264] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Accepted: 03/24/2011] [Indexed: 10/18/2022]
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Abstract
Background: Reliable information can improve patients’ knowledge of chemotherapy. As internet chemotherapy information (ICI) is increasingly viewed as a valuable patient education tool, we investigated the impact of ICI on patient care and analysed health professionals’ (HPs’) attitudes towards ICI. Methods: The following questionnaires were distributed: (1) self-administered questionnaire randomly given to 261 patients receiving chemotherapy (80% returned); and (2) separate questionnaire given to 58 HPs at the same UK Oncology Centre (83% returned). Results: Just over half of the patient respondents accessed the internet regularly. They were younger, with higher incomes and qualifications. Key search topics included chemotherapy modes of action, symptom management and treatment success, and most considered ICI useful. More than half wanted to discuss ICI with HPs but most did not get the opportunity. Although the majority of HP respondents supported the need for patients to retrieve ICI, most questioned the accuracy of ICI and did not routinely recommend its use. Conclusion: This study has shown that ICI is generally perceived by patients to be a valuable information resource. Given the potential impact of ICI, the following should be addressed in future studies: (1) inequalities in accessing ICI; (2) maintaining the quality of ICI (with clear guidance on recommended websites); (3) bridging the gap between the perception of ICI by patients and HPs; (4) integration of ICI with traditional consultation models.
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Lawrentschuk N, Sasges D, Tasevski R, Abouassaly R, Scott AM, Davis ID. Oncology Health Information Quality on the Internet: a Multilingual Evaluation. Ann Surg Oncol 2011; 19:706-13. [PMID: 22146882 DOI: 10.1245/s10434-011-2137-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Indexed: 11/18/2022]
Affiliation(s)
- Nathan Lawrentschuk
- Ludwig Institute for Cancer Research, Austin Hospital, Melbourne, Australia.
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Sajid MS, Shakir AJ, Baig MK. Information on the Internet about colorectal cancer: patient attitude and potential toward Web browsing. A prospective observational study. Can J Surg 2011; 54:339-43. [PMID: 21933528 DOI: 10.1503/cjs.011910] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Patients with colorectal cancer who seek to improve their knowledge of health and treatment options can now access in a few seconds data that would previously have required hours of research. Our aim was to evaluate the attitudes of patients toward Web browsing for information on colorectal cancer. METHODS We surveyed all patients attending a colorectal cancer follow-up clinic between January and August 2007 on their use of the Internet to obtain information on colorectal cancer. RESULTS In all, 439 patients with mean age of 68.6 years participated in the study. Of these, 24% reported using the Internet to obtain colorectal cancer information. Most participants used the Google search engine. Only 13% of participants confirmed that colorectal cancer information on the Internet was helpful in decision-making. Patients under the age of 65 years were more likely to have Internet access (p < 0.001), more likely to use the Internet to find colorectal cancer information (p = 0.005) and more likely to access a site recommended by a colorectal specialist (p = 0.002). Among Internet users, men were slightly more likely than women to use the Internet, although the difference was not significant (p = 0.20). CONCLUSION The Internet is a useful tool for disseminating information about colorectal cancer. The best sites are still difficult for patients to distinguish from the thousands of sites returned by search engines. This study demonstrates that the level of potential interest is sufficient to justify the development of a departmental or regional colorectal cancer network of websites and indicates areas of interest for patients.
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Affiliation(s)
- Muhammad S Sajid
- Department of Colorectal Surgery, Worthing Hospital, Worthing. West Sussex, United Kingdom.
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Online hypospadias support group data analysis. J Pediatr Surg 2011; 46:520-4. [PMID: 21376203 DOI: 10.1016/j.jpedsurg.2010.08.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 08/10/2010] [Accepted: 08/11/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although hypospadias is the most common malformation of the penis, this condition is virtually unknown to the general population. This lack of information may lead to psychological distress to both parents and patients. In this study the content of an Internet-based hypospadias support group is analyzed. MATERIALS AND METHODS All comments and postings made by members of an online support group between 2001 and 2008 were analyzed. No personalized data were used for evaluation. RESULTS At the end of 2008, the group consisted of 535 members. In the study period, 3050 postings were published. Major issues discussed in the group were (a) medical questions, exchange of medical knowledge, experience, and history; (b) psychological, ethical, and philosophical aspects; (c) practical questions and recommendations; (d) recommendations for surgeons; and (e) hypospadias in adults. CONCLUSIONS Online hypospadias support groups play an important role in how parents and patients cope with the condition. Surgeons dealing with hypospadias should be aware of the importance of Internet-based information in the field of hypospadias. They may benefit from the valuable feedback information from patients and parents to improve their practice and outcome.
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Radiation Therapy and Internet – What Can Patients Expect? Strahlenther Onkol 2010; 186:700-4. [DOI: 10.1007/s00066-010-2129-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
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Bylund CL, Gueguen JA, D'Agostino TA, Li Y, Sonet E. Doctor-patient communication about cancer-related internet information. J Psychosoc Oncol 2010; 28:127-42. [PMID: 20391071 DOI: 10.1080/07347330903570495] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article explores the effect of doctor-patient communication about cancer-related Internet information on self-reported outcomes. Two hundred and thirty cancer patients and caregivers completed an online survey regarding their experiences searching for and discussing with their doctors cancer-related Internet information. Participants who assertively introduced the Internet information in a consultation were more likely to have their doctor agree with the information. When doctors showed interest and involvement and took the information seriously, participants were less likely to report a desire to change the doctor's response. Taking the information seriously was also associated with greater satisfaction. This preliminary evidence that the doctor's response is associated with patient outcomes indicates the potential for improving patient-centered communication. In an effort to maximize patient-centered communication, doctors should be encouraged to take their patients and the information they present seriously, as well as show their patients that they are interested and involved.
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Affiliation(s)
- Carma L Bylund
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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A survey of Internet utilization among patients with cancer. Support Care Cancer 2010; 19:1183-90. [PMID: 20556435 DOI: 10.1007/s00520-010-0935-5] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 06/07/2010] [Indexed: 01/05/2023]
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Walsh MC, Trentham-Dietz A, Schroepfer TA, Reding DJ, Campbell B, Foote ML, Kaufman S, Barrett M, Remington PL, Cleary JF. Cancer information sources used by patients to inform and influence treatment decisions. JOURNAL OF HEALTH COMMUNICATION 2010; 15:445-463. [PMID: 20574881 DOI: 10.1080/10810731003753109] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Previous research has indicated that treatment staff often underestimate the informational needs of cancer patients. In this study, the authors determined the total number of information sources obtained and used to influence treatment decisions, and the clinical and demographic factors associated with the use of specific sources of information in cancer patients. Participants were identified by the statewide cancer registry and diagnosed in 2004 with breast, colorectal, lung, or prostate cancer. A self-administered mailed questionnaire elicited cancer treatments, demographics, and information sources used to make treatment decisions. Of those surveyed, 1,784 (66%) participated and responded to all questions regarding information use. Over 69% of study participants reported obtaining information from a source other than the treatment staff. Significant predictors of using additional information sources included younger age, higher income, higher education, complementary and alternative medicine (CAM) use, and reporting shared decision making (all p values <.01). Participants with a college degree were more likely to use the Internet (OR 3.7; 95% CI 1.5-9.0) and scientific research reports (OR 3.3; 95% CI 1.6-6.9) to influence treatment decisions compared with those without a high school degree. Support group use to influence treatment decisions was not associated with socioeconomic variables but did vary by cancer type and CAM use. The sources of information study participants obtained and used to influence treatment decisions varied strongly by socioeconomic and demographic variables. These findings provide a deeper understanding of the information needs of cancer patients and have implications for dissemination strategies that can minimize disparities in access to cancer information.
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Affiliation(s)
- Matthew C Walsh
- Paul P. Carbone Comprehensive Cancer Center, and Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Bylund CL, Gueguen JA, D'Agostino TA, Imes RS, Sonet E. Cancer patients' decisions about discussing Internet information with their doctors. Psychooncology 2009; 18:1139-46. [DOI: 10.1002/pon.1511] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lawrentschuk N, Abouassaly R, Hackett N, Groll R, Fleshner NE. Health information quality on the internet in urological oncology: a multilingual longitudinal evaluation. Urology 2009; 74:1058-63. [PMID: 19758687 DOI: 10.1016/j.urology.2009.05.091] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 05/13/2009] [Accepted: 05/19/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the quality of uro-oncological Web sites, to assess for language or disease differences across Western languages, and to perform a longitudinal comparison between 2004 and 2009. Uro-oncological Internet information quality is considered variable but no comprehensive analysis exists. METHODS Health on the Net (HON) principles may be applied to Web sites using an automated toolbar function. Using the Google search engine (http://www.Google.com), in 2004 and 2009, 2400 Web sites were assessed using the keywords prostate, bladder, kidney, and testicular cancer in English, French, German, and Spanish. The first 150 Web sites in each language had HON principles measured-a comparison between 2004 and 2009 was done. A further analysis of site sponsorship was undertaken. RESULTS Regardless of language or cancer type, most sites are not HON accredited. English has consistently more than English, French, Spanish, or German. For the respective languages in 2009, prostate has the most (29, 14%, 16%, 12%), followed by bladder (29%, 22%, 14%, 13%), kidney (25%, 15%, 10%, 13%), and testis (26%, 19%, 7.11%). Significant differences were found comparing language and organ groups. The quality improved from 2004 to 2009. Nonprofit organizations (51%), government and/or educational (39%), commercial (20%), with urologists last (14%) were accredited. CONCLUSIONS A lack of validation of most uro-oncological sites should be appreciated by urologists. Additionally, there is a discrepancy in quality and number of Web sites across uro-oncological diseases and major Western European languages, but with some improvement seen recently. We need to encourage informative, ethical, and reliable complimentary health Web sites on the Internet and direct patients to them.
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Affiliation(s)
- Nathan Lawrentschuk
- Division of Urology, University Health Network, University of Toronto, Toronto, Canada.
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Radiation therapists and the Internet: a perspective from Australia. JOURNAL OF RADIOTHERAPY IN PRACTICE 2009. [DOI: 10.1017/s1460396909006682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe Internet is an important information source for health practitioners; yet little is known of how radiation therapists (RTs) are currently using this vast information resource for their professional learning. In 2007, a four-page postal survey was sent to a random sample of 1,142 Medical Radiation Science practitioners with a response rate of 32.8%, which included 76 RTs. This paper reports and analyses the questionnaire responses from RTs on the use of the Internet to update their professional knowledge and issues affecting accessibility to the Internet in the workplace. This research provides an initial data set on the professional use of Internet-based tools and resources by Australian RTs. It has been shown that the Internet is an important information source widely used by RTs as they search the Internet (89%), access specific web pages (85%), use e-mail (84%) and listservs (49%) to update their professional knowledge. Although all RTs reported Internet access within their workplace, a number of factors have been identified which at present limit accessibility of current quality health and medical information through the Internet to RTs. A large number of RTs were unaware of Internet-based resources, such as Cochrane Library (48%) and GoogleScholar (42%), which support evidence-based practice (EBP) and research. RTs in teaching environments had greater access to computers with Internet access than their colleagues in non-teaching environments (p = 0.044). More RTs in the private sector (22%) reported they had ‘no’ access to the Internet in their workplace than their public sector colleagues (4%, p = 0.037). In addition, RTs in metropolitan workplaces had greater access to protected time during work hours for professional reading or study than their non-metropolitan colleagues (p = 0.000). These issues of non-uniformity of resources across workplaces and knowledge gaps within the profession must be addressed so that all RTs can avail themselves of high quality resources available through the Internet that support them in implementing EBP and meeting the mandatory requirement of updating their professional knowledge.
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Information Internet en langue française en oncologie ORL. ACTA ACUST UNITED AC 2009; 126:99-111. [DOI: 10.1016/j.aorl.2009.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Accepted: 05/04/2009] [Indexed: 11/24/2022]
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Or CKL, Karsh BT. A systematic review of patient acceptance of consumer health information technology. J Am Med Inform Assoc 2009; 16:550-60. [PMID: 19390112 DOI: 10.1197/jamia.m2888] [Citation(s) in RCA: 312] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation.
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Affiliation(s)
- Calvin K L Or
- Department of Manufacturing Engineering and Engineering Management, City University of Hong Kong (CKLO), Kowloon, Hong Kong, Department of Industrial and Systemns Engineering, University of Wisconsin-Madison (B-TK), Madison, WI, USA
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Fogel J, Ribisl KM, Morgan PD, Humphreys K, Lyons EJ. Underrepresentation of African Americans in online cancer support groups. J Natl Med Assoc 2008; 100:705-12. [PMID: 18595573 DOI: 10.1016/s0027-9684(15)31346-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Internet is increasingly important for many cancer survivors because it provides access to the latest information on cancer treatments and also allows them to receive support by participating in online cancer support groups. Unfortunately, little is known about why African-American cancer survivors are underrepresented in online cancer support groups. This article reviews the relevant literature and discusses three possible explanations for why African Americans are underrepresented in online cancer support groups: the digital divide/digital inequality, preferences for face-to-face support or culture-specific online support, and trust concerns. We conclude that a health inequity exists with regard to the utilization of information that can be obtained from online cancer support groups. However, with regard to the potential benefits of the psychosocial and emotional support aspect of online cancer support groups, a health inequity may not exist, as African Americans have other preferred avenues for obtaining needed support, and there is no evidence that this is detrimental to their health.
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Affiliation(s)
- Joshua Fogel
- Department of Economics, Brooklyn College, City University of New York, Brooklyn, NY, USA.
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Schiffman JD, Csongradi E, Suzuki LK. Internet use among adolescent and young adults (AYA) with cancer. Pediatr Blood Cancer 2008; 51:410-5. [PMID: 18506753 DOI: 10.1002/pbc.21616] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The Internet serves as an important resource for adult cancer patients, but little is known about Internet use among adolescent and young adults (AYA) with cancer. The aims of this study were to describe (1) cancer-specific websites which AYA with cancer visit and (2) Internet features desired by AYA on cancer-specific websites and how many current AYA cancer websites contain these features. PROCEDURE Individual phone interviews were conducted with a convenience sample of 16 AYA with cancer from across North America in June 2005. Content analysis of these interviews were coded and validated for desired website features. Current AYA cancer websites were identified on the Internet and the features on these sites were compared to the features desired by our sample. RESULTS Favorite websites visited by AYA with cancer (cancer-related and unrelated) were identified along with current Internet use. Twenty-one distinct cancer website features desired by AYA with cancer were described. Twenty-seven unique AYA cancer websites were found on the Internet during May-June 2006. Each site contained 7.7 (SD = 2.7) of the 21 features identified by participants as desirable, but the highest ranked features did not occur in the majority of these websites. CONCLUSIONS AYA with cancer indicate that they prefer to visit cancer websites that contain cancer-related information, provide the ability to chat with AYA with cancer, and offer some type of game. Although many websites exist for AYA with cancer, few individual sites contain the web features identified as most desired by AYA with cancer.
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Affiliation(s)
- Joshua D Schiffman
- Division of Pediatric Hematology-Oncology, Stanford University School of Medicine, Palo Alto, California, USA
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Simone CB, Vapiwala N, Hampshire MK, Metz JM. Internet-based survey evaluating use of pain medications and attitudes of radiation oncology patients toward pain intervention. Int J Radiat Oncol Biol Phys 2008; 72:127-33. [PMID: 18547743 DOI: 10.1016/j.ijrobp.2008.03.071] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Revised: 03/14/2008] [Accepted: 03/27/2008] [Indexed: 11/27/2022]
Abstract
PURPOSE Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy. METHODS AND MATERIALS An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at www.oncolink.org) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy. RESULTS Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p = 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief. CONCLUSIONS Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.
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Affiliation(s)
- Charles B Simone
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
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Neuhauser L, Kreps GL. Online cancer communication: meeting the literacy, cultural and linguistic needs of diverse audiences. PATIENT EDUCATION AND COUNSELING 2008; 71:365-377. [PMID: 18424046 DOI: 10.1016/j.pec.2008.02.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2008] [Accepted: 02/21/2008] [Indexed: 05/26/2023]
Abstract
OBJECTIVE This article provides an analysis of issues and empirical evidence related to literacy, cultural, and linguistic factors in online health and cancer communication, and recommendations to improve cancer communication for diverse audiences. METHODS We examined English-language online literature and selected books and policy documents related to literacy, cultural, and linguistic factors in health and cancer communication. RESULTS Studies about literacy, cultural, and linguistic factors in online cancer communication for diverse audiences are limited, but have increased during the past 15 years. Empirical evidence and theoretical guidance describe the critical importance of these factors, significant unmet needs among low-literate, multicultural and non-English-speaking populations, and strategies to improve communication. CONCLUSION Overall, online cancer communication has not met the literacy, cultural, and linguistic needs of diverse populations. The literature offers valuable recommendations about enhancing research, practice, and policy for better cancer communication. PRACTICE IMPLICATIONS Practitioners should understand the strengths and weaknesses of online cancer communication for vulnerable groups, guide patients to better Websites, and supplement that information with oral and tailored communication.
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Affiliation(s)
- Linda Neuhauser
- School of Public Health, 50 University Hall MC 7360, University of California, Berkeley, CA 94720-7360, USA.
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van de Poll-Franse LV, van Eenbergen MCHJ. Internet use by cancer survivors: current use and future wishes. Support Care Cancer 2008; 16:1189-95. [PMID: 18293014 DOI: 10.1007/s00520-008-0419-z] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 01/30/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the extent of internet access and use and patient characteristics associated with internet use. We also aimed to study when and at which sites cancer patients search for information, the self-reported effect on health care use, and patients' wishes with respect to future internet possibilities. MATERIALS AND METHODS We drew a sample of 390 patients diagnosed with breast (n = 128), prostate (n = 96), or gynecological (n = 89) cancer or lymphoma (n = 77) in four different hospitals in the period 2002-2004, who were 65 years or younger at diagnosis. These patients were sent a questionnaire that contained 45 questions about demographics and three broad applications of internet use: content, communication, community. RESULTS Of the 261 (75%) patients who responded, 60% used Internet by themselves, 9% via others, whereas 31% did not use the Internet. High education, young age, and high socio-economic status were all independently positively associated with internet use. Of the patients with complaints but pre-diagnosis, 41% searched the Internet for information about cancer daily to several times a week. After diagnosis, during treatment, and at follow-up, this was, respectively, 71%, 56%, and 4%. Although patients preferred to get reliable information from the Web site of their oncologist (88%), hospital (70%) or Dutch Cancer Society (76%), Web sites that are completely financed and created by pharmaceutical industries were mentioned most as source of information. Patients who used the Internet to find information about cancer felt themselves to be better informed about their disease (72%); only 3% thought that consulting the Internet increased the frequency of visiting their doctor, whereas 20% felt that information from the Internet influenced the treatment decision made by their doctor. Most patients who use the Internet would like to be able to access their own medical file (79%) or test results (81%) if possible. CONCLUSION Many cancer patients use the Internet to find reliable information about their disease and treatment. Patient information centers from hospitals should be strongly encouraged to improve disease and treatment information facilities on their hospital Web site, especially since most patients view their oncologist still as the most important source of information.
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Affiliation(s)
- Lonneke V van de Poll-Franse
- Comprehensive Cancer Centre South (IKZ), Eindhoven Cancer Registry, P.O. box 231, 5600 AE, Eindhoven, The Netherlands.
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Lévêque M, Dimitriu C, Gustin T, Jamart J, Gilliard C, Bojanowski MW. Évaluation de l'information sur Internet destinée aux patients francophones en neuro-oncologie. Neurochirurgie 2007; 53:343-55. [PMID: 17881014 DOI: 10.1016/j.neuchi.2007.07.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Accepted: 07/12/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Internet has become the first place where patients go to when seeking information about their disease. Little is known about the type and the quality of the medical information available on French-speaking websites, especially in the field of neuro-oncology. The purpose of this study was to evaluate the quality of these sites. MATERIALS AND METHODS We entered six key words "glioblastome", "méningiome", "métastase cérébrale", "neurinome de l'acoustique", "adénome à prolactine" and "lymphome primitif cérébral" into 2 different search engines and, for each key word, the first fifty websites were reviewed using the tool "DISCERN", and with the help of two neuro-oncologists, we rated their content in terms of quality and comprehension. RESULTS On 612 websites only 110 (18%) contained information that proved to be somewhat useful to patients. The average score for quality was 32, which is considered to be <<poor>>. According to our scoring system, 1.8% of websites were found to be "excellent", 11.8% "good", 24.5% "fairly good", 15.4% "average", 32.7% "poor" and 13.6% "very poor". Just over 50% of the websites were found to be clear. The study also showed that the order in which these websites were ranked in the search engine, their affiliation, their target or who financed them had little impact on quality. The websites were more likely to be of high quality if they were managed by doctors and had bibliographical references as well as a date indicating a recent website's update. DISCUSSION AND CONCLUSION This study shows that the search for medical information on the Internet is time consuming and often disappointing: very few websites provide information that is both clear and exhaustive. However, we also found that very few websites contained information that was seriously inaccurate. Given the growing popularity of the Internet, patients could certainly benefit from a high quality French speaking website that would specialize in cerebral tumors, as well as from a neuro-oncological portal that would take them to selected websites as it would save time and would be a guarantee for quality.
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Affiliation(s)
- M Lévêque
- Département de neurochirurgie, hôpital Notre-Dame du CHUM, 1560, rue Sherbrooke-Est, H2L 4M1 Montréal, Québec, Canada.
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Wilson JJ, Mick R, Wei SJ, Rustgi AK, Markowitz SD, Hampshire M, Metz JM. Clinical trial resources on the internet must be designed to reach underrepresented minorities. Cancer J 2007; 12:475-81. [PMID: 17207317 DOI: 10.1097/00130404-200611000-00007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Internet-based clinical trial information services are being developed to increase recruitment to studies. However, there are limited data that evaluate their ability to reach elderly and underrepresented minority populations. This study was designed to evaluate the ability of an established clinical trials registry to reach these populations based on expected Internet use. PATIENTS AND METHODS This study compares general Internet users to participants who enrolled in an Internet based colorectal cancer clinical trials registry established by OncoLink (www.oncolink.org) and the National Colorectal Cancer Research Alliance. Observed rates of demographic groupings were compared to those established for general Internet users. RESULTS Two thousand, four hundred and thirty-seven participants from the continental United States used the Internet to register for the database. New England, the Mid-Atlantic region, and the Southeast had the highest relative frequency of participation in the database, whereas the Upper Midwest, California, and the South had the lowest rates. Compared to general Internet users, there was an overrepresentation of women (73% vs. 50%) and participants over 55 years old (27% vs. 14%). However, there was an underrepresentation of minorities (10.3% vs. 22%), particularly African Americans (3.1% vs. 8%) and Hispanics (2.8% vs. 9%). DISCUSSION The Internet is a growing medium for registry into clinical trials databases. However, even taking into account the selection bias of Internet accessibility, there are still widely disparate demographics between general Internet users and those registering for clinical trials, particularly the underrepresentation of minorities. Internet-based educational and recruitment services for clinical trials must be designed to reach these underrepresented minorities to avoid selection biases in future clinical trials.
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Affiliation(s)
- John J Wilson
- Fox Chase Virtua Health Cancer Treatment Center, Voorhies, New Jersey 08043, USA.
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Wallington SF. The Internet as an Emerging Patient Education Tool Among African American Men With Prostate Cancer: An Exploratory Study. Am J Mens Health 2007; 2:106-21. [DOI: 10.1177/1557988306296156] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The lives of African American men with prostate cancer are greatly influenced by the information available to them, some of which is accessed on the Internet. Research indicates that the Internet can enhance consumer health knowledge but has not reached socioeconomic groups at highest risk for health disparities, such as African American men with prostate cancer. In this study, focus groups were used to explore the perceptions and uses of the Internet as a patient education tool among 39 African American men aged 39 years and older with diverse socioeconomic backgrounds. Nineteen (49%) participants reported using the Internet, 15 (38%) reported no use but indicated it was used on their behalf, and 5 (13%) reported no use and no use on their behalf. The findings revealed varying degrees of Internet use for information and social support. Prostate cancer diagnosis, poor patient—doctor communications, and accessibility influenced Internet use. Accessibility related more to lack of ease and familiarity with Internet use than lack of computer access. With training and awareness, the Internet has potential as a patient education tool among African American men with prostate cancer.
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Buntrock S, Hopfgarten T, Adolfsson J, Onelöv E, Steineck G. The Internet and prostate cancer patients: searching for and finding information. ACTA ACUST UNITED AC 2007; 41:367-74. [PMID: 17853004 DOI: 10.1080/00365590701303827] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To define the characteristics of prostate cancer patients who use the Internet. MATERIAL AND METHODS In October 2002, 511 prostate cancer patients from Stockholm-Gotland County completed a postal questionnaire consisting of 146 questions regarding use of the Internet, demographic factors, level of information about the disease and its treatment, quality of life and trade-off possibilities. RESULTS The response rate was 86.5% (n=511) and the mean age of the respondents was 71 years. A total of 210 men (41.1%) had access to the Internet. Eighty-two men (16.4%) had looked for information on prostate cancer, either by themselves or with the aid of others. Among men aged 50-60 years, 39% were Internet users, compared to 8% among men aged 75-80 years; the figures for university graduates versus those who had only attended elementary school were 33% and 3%, respectively. Fifty of the 82 men (61%) who searched for information regarded themselves as being satisfactorily informed by online information. CONCLUSIONS Of the men in this cohort, 16% searched the Internet for information regarding their prostate cancer. Young and well-educated men utilized the Internet more frequently than others, but they did not find information more often than older and less well-educated men. It is possible that the Internet promotes social inequality in obtaining healthcare in favor of well-educated, highly paid individuals.
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Affiliation(s)
- Stefan Buntrock
- Division of Clinical Cancer Epidemiology, Karolinska Institute, Stockholm, Sweden
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Wood CG, Wei SJ, Hampshire MK, Devine PA, Metz JM. The Influence of Race on the Attitudes of Radiation Oncology Patients Towards Clinical Trial Enrollment. Am J Clin Oncol 2006; 29:593-9. [PMID: 17148997 DOI: 10.1097/01.coc.0000236213.61427.84] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Enrollment of adult cancer patients in clinical trials remains low, particularly in the minority population. Understanding patient attitudes towards clinical trials during the recruitment process may enhance accrual. Unfortunately, data describing patient attitudes towards clinical trials are limited, particularly in the radiation oncology clinic setting. METHODS A piloted questionnaire assessing basic demographics and attitudes toward clinical trials was offered in 2 radiation oncology clinics between April 2003 and October 2003. The questionnaire was completed by 166 patients. The mean age of the patients completing the questionnaire was 56 years (range, 15-84 years). Of the 166 patients included in the analysis, 108 (65%) were White. The most common cancer diagnoses included prostate (19%), head and neck (16%), and breast (14%). RESULTS There was no statistical difference between Whites and non-Whites regarding their interest in learning about clinical trials (84.3% versus 84.9%, P = 0.92); nor was there a significant difference in the rate of previous or current trial enrollment (21.3% versus 34.0%, P = 0.08). White patients were more likely to gather information about clinical trials from the Internet (30.6% versus 11.3%, P = 0.007), and they were more likely to use physicians as a source of this information (50.0% versus 34.0%, P = 0.05). Non-White patients were more likely to obtain information about clinical trials from other patients (24.5% versus 12.0%, P = 0.04). In addition, more non-White patients believed they had been treated on clinical trials without their knowledge (21.6% versus 9.3%, P = 0.032). Patients differed somewhat in their expectations of clinical trials. More non-Whites indicated that they would need a >50% chance of benefiting from a trial (64.4% versus 45.0%, P = 0.03) to enroll on that trial, though there were no statistical differences in outlook towards potential toxicities associated with treatment on a clinical trial. CONCLUSIONS Minority patients historically enroll in clinical trials at a significantly lower rate. Our study of radiation oncology patients documents significant differences in attitudes towards clinical trials between Whites and non-Whites. Understanding the differences in attitudes may allow physicians to overcome barriers that would otherwise hinder the enrollment of non-White patients into clinical trials.
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Affiliation(s)
- Charles G Wood
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
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Newnham GM, Burns WI, Snyder RD, Dowling AJ, Ranieri NF, Gray EL, McLachlan SA. Information from the Internet: attitudes of Australian oncology patients. Intern Med J 2006; 36:718-23. [PMID: 17040358 DOI: 10.1111/j.1445-5994.2006.01212.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients require accurate information about their illness to make informed decisions. Many sources of information exist, although reliability is variable. Our objective was to investigate information seeking behaviour and attitudes toward health-related information from the Internet in a sample of Australian oncology patients. METHOD During their outpatient attendance, 109 patients completed a self-administered paper-pen format questionnaire. They were required to have a recent cancer diagnosis (<6 months ago) adequate English and no cognitive impairment. RESULTS Seventy-four per cent of questionnaires were returned. The majority of patients (78%) wanted as much information about their cancer diagnosis as possible and 90% reported receiving adequate information from their treating team. Despite this, more than half actively searched for additional information, with 77% using the Internet. Patients were trusting of information obtained from the Internet. More than half of information searchers discussed information obtained in their search with a health professional. The majority of patients did not believe that information searching adversely affected the doctor-patient relationship. CONCLUSION Information searching is common in ambulatory Australian oncology patients, with the Internet being a frequently used resource. To ensure patients find reliable and relevant information and to minimize the risk of harm, health professionals involved in treating oncology patients should provide guidance in finding information sources and assistance in interpreting the information obtained.
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Affiliation(s)
- G M Newnham
- Oncology Department, St Vincent's Hospital, Melbourne, Victoria, Australia.
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Black PC, Penson DF. Prostate Cancer on the Internet—Information or Misinformation? J Urol 2006; 175:1836-42; discussion 1842. [PMID: 16600774 DOI: 10.1016/s0022-5347(05)00996-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2005] [Indexed: 11/28/2022]
Abstract
PURPOSE We assessed the quality of information available to patients on prostate cancer on the Internet. MATERIALS AND METHODS The search engine Webcrawler was used with the search term "prostate cancer" to generate a list of 75 websites which were reviewed for currency, disclosure, attribution, interactivity and content. A rating tool was designed including 50 elements considered essential for a comprehensive review of prostate cancer, and each website was judged for degree of coverage and accuracy (each rated on a scale of 1 to 3) of information for each element. RESULTS Of the 75 sites 39 contained information about prostate cancer. Only 9 sites indicated a date of last update within 6 months. References were rarely given (in 5) and a disclaimer was provided on less than half of the sites (18). The sites covered a mean of 24 elements (range 6 to 43) with a mean coverage rating of 1.0 to 2.6 (1.8 overall). Of 943 elements covered on 39 sites, 94% were completely correct, 5% were mostly correct and 1% was mostly incorrect. CONCLUSIONS The information on the Internet is of sufficient quality to aid in patient decision making. However, there are numerous shortcomings especially related to currency, disclosure and attribution. Degree of coverage is highly variable and there is a deficiency in balance of evidence found on many sites. The urologist needs to be aware of such shortcomings when counseling patients on prostate cancer.
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Affiliation(s)
- Peter C Black
- University of Southern California/Norris Cancer Center, Los Angeles, California, USA.
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Helft PR, Eckles RE, Johnson-Calley CS, Daugherty CK. Use of the internet to obtain cancer information among cancer patients at an urban county hospital. J Clin Oncol 2005; 23:4954-62. [PMID: 16051948 DOI: 10.1200/jco.2005.09.621] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate rates, predictors, and barriers to use of the Internet to obtain cancer information among a cohort of cancer patients at an urban county hospital. PATIENTS AND METHODS Of 208 cancer patients approached, 200 patients completed a structured interview study examining Internet use, perceptions of the accuracy of Internet information, and barriers to use. RESULTS Only 10% of participants reported using the Internet themselves to obtain cancer information. Another 21% reported exposure to Internet information through proxies. The most common barrier to Internet use cited was lack of Internet access, with 44% reporting that they would use the Internet to obtain cancer information if they had Internet access. Younger age and more years of formal education were significantly associated with Internet use, although race and income were not. Less education, African American race, and female sex were associated with lower estimates of the accuracy of Internet information. Fewer years of formal education was associated with increased likelihood of reporting confusion after reading Internet information. CONCLUSION Very few cancer patients in this study of a cohort of generally disadvantaged individuals used the Internet themselves to obtain cancer information, although many more desired to do so. Significant opportunities for Web-based interventions aimed at improving cancer care outcomes in this population of cancer patients exist. However, further study will be needed to determine how to make such intervention accessible, trustworthy, and understandable to the disadvantaged.
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Affiliation(s)
- Paul R Helft
- Department of Medicine, Division of Hematology/Oncology, The Indiana University Cancer Center, Indianapolis, IN 46202, USA.
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Metz JM, Coyle C, Hudson C, Hampshire M. An Internet-based cancer clinical trials matching resource. J Med Internet Res 2005; 7:e24. [PMID: 15998615 PMCID: PMC1550658 DOI: 10.2196/jmir.7.3.e24] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Revised: 02/03/2005] [Accepted: 02/16/2005] [Indexed: 11/15/2022] Open
Abstract
Background Many patients are now accessing the Internet to obtain cancer clinical trials information. However, services offering clinical trials recruitment information have not been well defined. Objectives This study describes one of the first Web-based cancer clinical trials matching resources and the demographics of users who were successfully matched. Methods OncoLink is the Internet-based educational resource managed by the University of Pennsylvania Cancer Center (UPCC) and serves between 1 and 2 million pages per month to over 385000 unique IP addresses. OncoLink launched one of the first clinical trials matching resources on the Internet that allowed patients to enter demographic data through a secure connection and be matched to clinical trials. For patients with matches to potential trials, appointments were facilitated with the principal investigators. Results While we did not keep track of patients who could not be matched, 627 patients who submitted online applications between January 2002 and April 2003 were successfully matched for potential enrollment in clinical trials. The mean age of the patient population was 56 years (range 18–88 years). Males represented 60% of the patient population, and over 90% of users were Caucasian. Most of the applications were from patients with colorectal cancer (13%), lung cancer (14%), melanoma (10%), and non-Hodgkin's lymphoma (9%). Conclusions This report shows that a significant number of patients are willing to use the Internet for enrolling in clinical trials. Care must be taken to reach patients from a variety of socioeconomic and racial backgrounds. This Internet resource helps to facilitate a consultation with a cancer patient who is prescreened and motivated to enroll in clinical trials.
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Affiliation(s)
- James M Metz
- University of Pennsylvania Cancer Center, Philadelphia, PA, USA.
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Whitten P, Kreps GL, Eastin MS. Creating a framework for online cancer services research to facilitate timely and interdisciplinary applications. J Med Internet Res 2005; 7:e34. [PMID: 15998625 PMCID: PMC1550666 DOI: 10.2196/jmir.7.3.e34] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Revised: 06/23/2005] [Accepted: 06/24/2005] [Indexed: 11/29/2022] Open
Abstract
Researchers from a wide array of disciplines have conducted engaging and informative studies in recent years concerning the use of the Internet for cancer-related services. Typically, these publications provide key data related to utilization statistics, how online information can be used, what users want or expect from the Internet, outcomes or impacts, and quality and credibility of websites. These are important themes for understanding online cancer issues. However, this special issue of the Journal of Medical Internet Research seeks to recast these themes in a way that will facilitate pragmatic and applied means of employing data in prescriptive and interdisciplinary ways. This issue includes 14 papers that exemplify applications for the research framework recommended in this paper. This framework includes an expanded focus on the development and design of online cancer services, online consumer behavior/communication, behavior change, and living with cancer.
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Affiliation(s)
- Pamela Whitten
- College of Communication Arts and SciencesDepartment of Telecommunication, Information Studies and MediaMichigan State UniversityEast LansingMIUSA
| | - Gary L Kreps
- Department of CommunicationGeorge Mason UniversityFairfaxVAUSA
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