The nature and quality of periodontal related patient information on the world-wide web

Quality Assessment of Internet Information Regarding Periodontitis in Persons Living with HIV

The Internet is the most used source of HIV information second to information received from healthcare professionals. The aim of this study was to assess the quality of Internet information about periodontitis in people living with HIV (PLWH). An Internet search was performed on 18 April 2024 using the search terms "Periodontitis", "Periodontal disease", and "Gum disease" in combination with "HIV" in the most popular search engines (Google™, Bing™, and YAHOO!®). The first 20 results from each search term engine were pooled for analysis. Quality was assessed by JAMA benchmarks. Readability was assessed using the Flesch reading ease score (FRES). Origin of the site, type of author, and information details were also recorded. The quality of Internet information about periodontitis in PLWH varied. The mean JAMA score was 2.81 (SD = 1.0). The websites were generally fairly difficult to read (mean FRES = 57.1, SD = 15.0). Most websites provided some advice about self-treatment of oral problems, accompanied by a strong recommendation to seek professional dental care. In conclusion, advanced reading skills on periodontitis in PLWH were required and quality features were mostly not provided. Therefore, healthcare professionals should be actively involved in developing high-quality information resources and direct patients to evidence-based materials on the Internet.

Quality of Patient-Centered eHealth Information on Erosive Tooth Wear: Systematic Search and Evaluation of Websites and YouTube Videos

BACKGROUND

Due to the declining prevalence of dental caries, noncarious tooth defects such as erosive tooth wear have gained increased attention over the past decades. While patients more frequently search the internet for health-related information, the quality of patient-centered, web-based health information on erosive tooth wear is currently unknown.

OBJECTIVE

This study aimed to assess the quality of patient-centered, web-based health information (websites and YouTube videos) on erosive tooth wear.

METHODS

German-language websites were systematically identified through 3 electronic search engines (google.de, bing.de or yahoo.de, and duckduckgo.com) in September 2021. Eligible websites were independently assessed for (1) technical and functional aspects via the LIDA instrument, (2) readability via the Flesch reading-ease score, (3) comprehensiveness of information via a structured checklist, and (4) generic quality and risk of bias via the DISCERN instrument by 2 different reviewers. An overall quality score (ie, higher scores being favored) generated from all 4 domains was used as the primary outcome. Quality scores from each domain were separately analyzed as secondary outcomes and compared by the Friedman test. The effect of practice-specific variables on quality scores of websites from private dental offices was assessed using generalized linear modeling. Eligible YouTube videos were judged based on (1) the comprehensiveness of information, (2) viewers' interaction, and (3) viewing rate. The comprehensiveness of information was compared between websites and YouTube videos using the Wilcoxon rank-sum test.

RESULTS

Overall, 231 eligible websites and 7 YouTube videos were identified and assessed. The median overall quality of the websites was 33.6% (IQR 29.8%-39.2%). Secondary outcome scores amounted to 64.3% (IQR 59.8%-69.0%) for technical and functional aspects, 40.0% (IQR 34.0%-49.0%) for readability, 11.5% (IQR 3.9%-26.9%) for comprehensiveness of information, and 16.7% (IQR 8.3%-23.3%) for generic quality. While the comprehensiveness of information and generic quality received low scores, technical and functional aspects as well as readability resulted in higher scores (both Padjusted<.001). Regarding practice-specific variables, websites from private dental offices outside Germany (P=.04; B=-6.64, 95% CI -12.85 to -0.42) or from dentists who are a dental society member (P=.049; B=-3.55, 95% CI -7.09 to -0.01) resulted in lower readability scores (ie, were more difficult to read), while a shorter time since dentists' examination resulted in higher readability scores (P=.01; B=0.24 per year, 95% CI 0.05-0.43). The comprehensiveness of information from YouTube videos was 34.6% (IQR 13.5%-38.5%). However, the comprehensiveness of information did not vary between websites and YouTube videos (P=.09). Additionally, viewers' interaction (1.7%, IQR 0.7%-3.4%) and viewing rates (101%, IQR 54.6%-112.6%) were low.

CONCLUSIONS

The quality of German-language, patient-centered, web-based information on erosive tooth wear was limited. Especially, the comprehensiveness and trustworthiness of the available information were insufficient. Web-based information on erosive tooth wear requires improvement to inform patients comprehensively and reliably.

The quality of information provided by the most popular dementia videos on TikTok

Summary of background

Dementia is among the leading causes of death and disability worldwide, having a major impact not only on the affected person but also on all of society. The Internet is a popular and growing source of health-related information for patients, family members, carriers, and physicians. TikTok, one of the most popular social media platforms, is an important source for knowledge access and adoption. However, the quality of health information on TikTok has not been sufficiently studied.

Objective

To evaluate the quality of the information provided in the most popular videos on dementia shared on TikTok.

Study design

A cross-sectional study.

Methods

The top 100 most popular videos on TikTok obtained by searching the hashtag "dementia" were included in the study and grouped based on their source and content. The popularity of the videos was estimated based on the numbers of likes, comments, and shares. The quality of health-related information was evaluated using the DISCERN score and the Global Quality Score (GQS).

Results

Videos had a median duration of 33.29 s; the median number of likes was 635,100, with a total of 93,698,200 likes, 903,859 comments, and 5,310,912 shares. The source (uploader) of 65% of the videos was family members, while only 4% were uploaded by doctors. The content was lifestyle-related in 62% of the videos, while 12% of the videos were for fun. Videos had a median DISCERN score of 22.5 (IQR 20-27) and a median GQS of 2 (IQR 1-3). The videos uploaded by doctors had the highest quality scores and the lowest popularity.

Conclusion

The most popular dementia videos on TikTok are mostly shared by family members and are of poor quality. Given the major public health issues associated with dementia, experts must provide appropriate and active assistance to patients in interpreting the information identified.

Didactical characteristics of Dutch websites about kidney transplantation targeted for kidney patients and living donors: An exploratory study

Objective

The aim was to explore the origin, content topics, teaching modes (instruction, interaction, and assessment), and corresponding social-epistemological dimensions (choices in knowledge transfer vs. knowledge building, and individual vs. group learning) of web-based information on kidney transplantation targeted for patients and living donors.

Methods

Dutch websites on kidney transplantation were retrieved using the search engine Google.nl. From 24 websites, 250 webpages were examined on origin, content topics, teaching modes, and corresponding social-epistemological dimensions.

Results

The majority of the websites had a professional organization as origin (20/24). The number and distribution of content topics varied among the websites. Of the 16 different teaching modes found, 11 were instructional, 4 were interactional, and 1 assessment mode was found. The websites offered almost exclusively teaching modes on individual and passive learning, whereas group learning and interactive knowledge building was hardly encountered.

Conclusion

The diversity in teaching modes and social-epistemological dimensions of Dutch websites on kidney transplantation targeted for patients and living donors is limited. The websites only provided a partial view on kidney transplantation; information regarding contact with others, e.g. support, was limited. A more balanced availability of teaching approaches and content topics is desirable to fit with the didactical goals to make well-considered health decisions.

Evaluation of information quality on the internet for periodontal disease patients

OBJECTIVE

To evaluate the quality of accessible information on periodontal diseases on the Internet using different scales.

MATERIALS AND METHODS

A search was performed using the Google search engine with questions about periodontal disease symptoms. The first 30 web sites obtained after searching for each question were evaluated. Duplicate web sites, advertisements, discussion groups, links to research articles, videos, and images were excluded. A total of 90 web sites were included and evaluated with Health on the Net Code of Conduct Certification (HONCode) presence, Journal of American Medical Association (JAMA) benchmarks, and the quality criteria for consumer health information (DISCERN) toolkit.

RESULTS

Only 27.8% of the analyzed web sites contain HONCode certificates. No webpages fulfilled all JAMA criteria, whereas 32.2% of the web sites did not provide any of them. Majority of the web sites' (44.4%) overall rating score was 2 with the DISCERN instrument. In the DISCERN Section Scores comparison between various types of web sites, information web site scores were higher than Dental Health Center Web sites in Section 1 and Section 3 scores (p = .000 and p = .001, respectively).

CONCLUSION

Overall quality of periodontal information based on patients' questions on the Internet has serious shortcomings especially in terms of attribution and the quality of information on treatment choices.

Role of information and communication technology in promoting oral health at residential aged care facilities

Information and communication technology (ICT) can provide knowledge and clinical support to those working in residential aged care facilities (RACFs). This paper aims to: (1) review literature on ICT targeted at residents, staff and external providers in RACFs including general practitioners, dental and allied health professionals on improving residents’ oral health; (2) identify barriers and enablers to using ICT in promoting oral health at RACFs; and (3) investigate evidence of effectiveness of these approaches in promoting oral health. Findings from this narrative literature review indicate that ICT is not widely used in RACFs, with barriers to usage identified as limited training for staff, difficulties accessing the Internet, limited computer literacy particularly in older staff, cost and competing work demands. Residents also faced barriers including impaired cognitive and psychosocial functioning, limited computer literacy and Internet use. Findings suggest that more education and training in ICT to upskill staff and residents is needed to effectively promote oral health through this medium.

India's baby boomers: In driving need for dental care

The present paper aims to review the literature on increasing health care challenges and needs of a growing Indian geriatric population. It also focuses on the need to overcome the shortfalls in its current oral health status in elderly. This review is based on a PubMed database search engine published in the period from 1990 to 2010 in various dental journals. Different strategies are designed to provide better facilities and easy access of these facilities not only to elderly living in the city but to the one's in rural areas. It is emphasized that geriatric dentistry should be included in the educational systems to help resolve problems of oral health care for the elderly in India.

Coronary angioplasty and the internet: what can patients searching online expect to find?

OBJECTIVES

This study set out to assess the quality of online information available on coronary angioplasty.

BACKGROUND

Patients searching for healthcare information frequently use the Internet. However the lay reader may not be able to discern the robustness of evidence presented. At present, the overall quality and accuracy of online content regarding coronary angioplasty is unknown.

METHODS

The search term "coronary angioplasty" was entered into three popular search engines (Google, Yahoo, and Bing), and the first 50 webpages provided by each search engine pooled. Exclusion criteria consisted of duplicated sites, sites requiring a registration or login, and direct links to documents or videos. The remaining sites were analyzed using the LIDA instrument; a validated method for assessing websites based on accessibility, usability, and readability. Readability was also separately assessed using the Flesch Reading Ease Score (FRES).

RESULTS

Of 150 weblinks reviewed, 86 were excluded on the basis of the criteria listed above. The remaining 64 sites achieved mean scores of 50/60 (83%) on accessibility, 40/54 (74%) on usability, 32/51 (62%) on reliability, and 47.5 on FRES. Significant variability was noted among the LIDA scores, with no correlation between LIDA score and search engine ranking.

CONCLUSIONS

Although most websites are easy to access, content is frequently out-of-date and fails to be presented in an easily comprehensible format. A minority of websites display factually incorrect information. Clinicians should be wary of patients being misled by erroneous or commercially biased online content, and be able to redirect their patients to more robust, up-to-date sources.

The quality of patient-orientated Internet information on oral lichen planus: a pilot study

OBJECTIVE

This study examines the accessibility and quality Web pages related with oral lichen planus.

METHODS

Sites were identified using two search engines (Google and Yahoo!) and the search terms 'oral lichen planus' and 'oral lesion lichenoid'. The first 100 sites in each search were visited and classified. The web sites were evaluated for content quality by using the validated DISCERN rating instrument. JAMA benchmarks and 'Health on the Net' seal (HON).

RESULTS

A total of 109,000 sites were recorded in Google using the search terms and 520,000 in Yahoo! A total of 19 Web pages considered relevant were examined on Google and 20 on Yahoo! As regards the JAMA benchmarks, only two pages satisfied the four criteria in Google (10%), and only three (15%) in Yahoo! As regards DISCERN, the overall quality of web site information was poor, no site reaching the maximum score. In Google 78.94% of sites had important deficiencies, and 50% in Yahoo!, the difference between the two search engines being statistically significant (P = 0.031). Only five pages (17.2%) on Google and eight (40%) on Yahoo! showed the HON code.

CONCLUSION

Based on our review, doctors must assume primary responsibility for educating and counselling their patients.

Internet-Derived Information on Cleft Lip and Palate for Families with Affected Children

Objective:

To investigate the nature and readability of cleft lip and palate–related family information on the Internet.

Materials and Methods:

An Internet search for “cleft lip,” “cleft palate,” and “family information” was carried out using three search engines. Within each search, the first 25 relevant websites identified were downloaded and assessed for country of origin, authorship, domain, referencing, links, advertising, mention of orthodontics, illustrations, cleft-specificity, and content. Readability was determined using the Flesch Reading Ease Score, the Flesch-Kincaid Grade Level, and the Fog Scale Level. Data were analyzed by simple descriptive statistics.

Results:

The initial search returned in excess of 1,800,000 hits. A total of 49 websites were evaluated, excluding repetitions, with a wide range of information available. The websites assessed were mostly of U.S. origin, with a .org domain, authored by universities/hospitals, not cleft-specific, without advertisements, contained links but not references, mentioned orthodontics even if to a small extent, contained some form of illustrations, and varied greatly in quantity and quality of information presented. A wide range of readability scores was obtained, equating to reading ages from fourth grade to university graduate level, with a mean reading age at the eighth to ninth grade level.

Conclusions:

Cleft lip and palate–related information for families on the Internet is variable in content, quality, and readability. Clinicians should have the responsibility to guide and help parents with website retrieval, while authors of websites should aim to keep information readable and relevant to family demands.

Information about liver transplantation on the World Wide Web

Orthotopic liver transplant (OLTx) has evolved to a successful surgical management for end-stage liver diseases. Awareness and information about OLTx is an important tool in assisting OLTx recipients and people supporting them, including non-transplant clinicians. The study aimed to investigate the nature and quality of liver transplant-related patient information on the World Wide Web. Four common search engines were used to explore the Internet by using the key words 'Liver transplant'. The URL (unique resource locator) of the top 50 returns was chosen as it was judged unlikely that the average user would search beyond the first 50 sites returned by a given search. Each Web site was assessed on the following categories: origin, language, accessibility and extent of the information. A weighted Information Score (IS) was created to assess the quality of clinical and educational value of each Web site and was scored independently by three transplant clinicians. The Internet search performed with the aid of the four search engines yielded a total of 2,255,244 Web sites. Of the 200 possible sites, only 58 Web sites were assessed because of repetition of the same Web sites and non-accessible links. The overall median weighted IS was 22 (IQR 1 - 42). Of the 58 Web sites analysed, 45 (77%) belonged to USA, six (10%) were European, and seven (12%) were from the rest of the world. The median weighted IS of publications originating from Europe and USA was 40 (IQR = 22 - 60) and 23 (IQR = 6 - 38), respectively. Although European Web sites produced a higher weighted IS [40 (IQR = 22 - 60)] as compared with the USA publications [23 (IQR = 6 - 38)], this was not statistically significant (p = 0.07). Web sites belonging to the academic institutions and the professional organizations scored significantly higher with a median weighted IS of 28 (IQR = 16 - 44) and 24(12 - 35), respectively, as compared with the commercial Web sites (median = 6 with IQR of 0 - 14, p = .001). There was an Intraclass Correlation Coefficient (ICC) of 0.89 and an associated 95% CI (0.83, 0.93) for the three observers on the 58 Web sites. The study highlights the need for a significant improvement in the information available on the World Wide Web about OLTx. It concludes that the educational material currently available on the World Wide Web about liver transplant is of poor quality and requires rigorous input from health care professionals. The authors suggest that clinicians should pay more attention to take the necessary steps to improve the standard of information available on their relevant Web sites and must take an active role in helping their patients find Web sites that provide the best and accurate information specifically applicable to the loco-regional circumstances.

Perceptions of how the Internet has impacted on dentistry

OBJECTIVES

This study sought to identify how patient information on the Internet has influenced the delivery of oral care and the use practitioners themselves make of the Internet.

METHODOLOGY

Data were collected via a self completed 18 item postal questionnaire, sent to a random sample of 620 dentists on the GDC register in Wales.

RESULTS

In total 457 (74%) of the questionnaires were returned. One half of all practitioners stated that patients had asked them about material of relevance to dentistry obtained from the Internet, although in the majority of cases this happened less frequently than once a month. The most common topics enquired after were cosmetic procedures, dental amalgam and implants. A minority of dentists, 47 (11%) viewed the Internet as a threat to the dentist-patient relationship. However, 169 (39%) agreed information gained from the Internet had led to patients demanding inappropriate care or more complex treatment (135/31%). Having to take time to discuss Internet material was viewed as a burden by 93 practitioners. The potential of the Internet to widen inequalities in access to oral health information was agreed upon by one third of respondents. Concerns over the quality and reliability of Internet derived information, together with a lack of knowledge of appropriate sites, prevented dentists using the Internet as an oral health education resource. However, only 18.7% claimed never to use the Internet for their own Continuing Professional Development. Access for CPD purposes was mainly from home. Of those working in general practice, 54 had their own practice website, and a further 103 said this was something they were considering. Email was used to communicate with patients by 42 dentists, mainly to make appointments.

CONCLUSIONS

Views on the impact of the Internet were generally positive, but there is a long way to go before its full potential is realised.

The use of the Internet to access oral health-related information by patients attending dental hygiene clinics

BACKGROUND

The degree to which patients access the Internet for oral health-related information is unknown.

OBJECTIVES

This study was designed to determine if patients attending student dental hygiene clinics had: (1) accessed the Internet, (2) used the Internet as a source of information on both general health and oral health, (3) bought oral health care products on-line, and (4) were interested in being directed to appropriate on-line oral health resources by dental professionals.

METHODS

A self-complete questionnaire was administered to a quota sample of 280 new and returning patients attending the student dental hygiene clinic at either the Cardiff Dental Hospital or a nearby Primary Dental Care Unit.

RESULTS

A total of 269 (96%) patients consented to participate in the study. Of these, 147 (54.6%) had accessed the Internet, the majority (61.2%) from home. Internet use was significantly related to both patient age and level of education (P < 0.001). In total, 59 patients claimed accessing the Internet for information on general health topics. Only eight respondents had used the Internet for information on oral health/dental topics, with seven reporting that they found the information useful. On-line purchase of oral health products was reported by seven patients. However, 117 (43.5% of all respondents) patients indicated that they would be interested in the Internet as a future source of oral health information and 112 (41.6%) would appreciate being directed to appropriate sites by their dentist or dental hygienist.

CONCLUSIONS

Patients attending student dental hygiene clinics make little use of the Internet for oral health information. However, reported interest in future access is such that dental professionals should develop and harness the potential of the Internet as an educational resource.

Internet-derived Patient Information on Common Oral Pathologies: Is it Readable?

Background

The evolution of the Internet has made available to the public vast reserves of information, and it represents a tremendous educational resource. However, it is obviously important that information directed at patients is readable and understandable.

Objective

This study aimed to evaluate the readability of patient-related Internet sites presenting information on dental caries, periodontal disease, oral cancer and mouth ulcers.

Methodology

Four separate Internet searches seeking patient information on these pathologies were conducted in May 2003. In total, 5127 sites were identified. Within each search, the first 25 sites identified as of relevance to patients seeking information were downloaded (100 in total), and the readability determined using the Flesch reading score and the Flesch-Kinkaid reading level.

Results

A wide range of reading ease scores was obtained, equating to reading ages from seven years to university entry level. The mean reading age of the sites evaluated was 10–11 years of age, higher than the estimated reading age of the UK population in general (nine years). Scores were broadly similar across different pathologies.

Conclusions

Practitioners and other members of the dental team involved in patient education should be aware that additional advice and support may be required to help patients interpret material downloaded from the Internet. Furthermore, those practices presenting educational material on their practice website should bear in mind the need to ensure that it is pitched at a level appropriate to the intended audience.