[Analysis of paediatric neuro-oncological information on the Internet in German language]

Info-pollution: a word of caution for the neurosurgical community

The medical-patient relationship is facing pollution of information all over the internet, for physician and patients is becoming tougher to keep updated with the highest quality of information. During the last 20 years multiple evaluation tools have been developed trying to find the best tool to assess high-quality information, to date DISCERN tool represents the most widely spread. Information can be found on the surface internet and in the deep web, constituting the biggest chunk of the internet, informing and controlling the quality of information is a formidable task. PubMed and Google Scholar are the most important tools for a physician to find information, although multiple others are available; awareness must be raised over improving current strategies for data mining high-quality information for the patients and the healthcare community.

Analysis of Internet-Based Search Patterns Utilized by Glioma Patients as Information Source

The aim of this study is to assess the Internet usage pattern amongst glioma patients and to characterize its impact in their decision-making and clinical interactions. Glioma patients attending a tertiary cancer center between June and December 2019 were invited to participate in this study. A 26-item survey consisting of closed and open-ended questions was distributed with a unique identifier. Quantitative data were analyzed with descriptive statistics using SPSS Statistical package, and qualitative data with grounded theory approach. Thirty-two patients completed the survey. Demographics varied in age, time since diagnosis, glioma type, and level of education. Eighty-one percent were identified as "Internet users" who sought online glioma information. Google was the most popular search engine (96%), with "glioma" being the most frequent search term. The selection of websites often relied on perceived credibility and top search hits. The most searched topic was prognosis (73%). The majority of patients found that online information was easy to understand, and this did not vary significantly amongst age groups. Website quality was always assessed by 60% of patients. Only 62% patients found the Internet a useful resource, and 70% patients found it facilitated their understanding. Most patients discussed their Internet findings with a physician, largely regarding concerns about reliability. There is variable glioma information available online. Patients with glioma use the Internet as a resource, with variable impact on their interactions and decision-making. This information can be used by physicians, educators, and website developers to support glioma patients' needs.

Evaluation of the Quality of Information Available on the Internet Regarding Chronic Ankle Instability

Background and objectives: Most Koreans obtain medical information from the Internet. Despite the vast amount of information available, there is a possibility that patients acquire false information or are dissatisfied. Chronic ankle instability (CAI) is one of the most common sports injuries that develops after an ankle sprain. Although the information available on the Internet related to CAI has been evaluated in other countries, such studies have not been conducted in Korea. Materials and Methods: The key term “chronic ankle instability” was searched on the three most commonly used search engines in Korea. The top 150 website results were classified into university hospital, private hospital, commercial, non-commercial, and unspecified websites by a single investigator. The websites were rated according to the quality of information using the DISCERN instrument, accuracy score, and exhaustivity score. Results: Of the 150 websites, 96 were included in the analysis. University and private hospital websites had significantly higher DISCERN, accuracy, and exhaustivity scores compared to the other websites. Conclusions: Accurate medical information is essential for improving patient satisfaction and treatment outcomes. The quality of websites should be improved to provide high-quality medical information to patients, which can be facilitated by doctors.

Academics versus the Internet: Evaluating the readability of patient education materials for cerebrovascular conditions from major academic centers

Background:

Health literacy profoundly impacts patient outcomes as patients with decreased health literacy are less likely to understand their illness and adhere to treatment regimens. Patient education materials supplement in-person patient education, especially in cerebrovascular diseases that may require a multidisciplinary care team. This study aims to assess the readability of online patient education materials related to cerebrovascular diseases and to contrast the readability of those materials produced by academic institutions with those of non-academic sources.

Methods:

The readability of online patient education materials was analyzed using Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) assessments. Readability of academic-based online patient education materials was compared to nonacademic online patient education materials. Online patient education materials from 20 academic institutions and five sources from the web were included in the analysis.

Results:

Overall median FKGL for neurovascular-related patient online education documents was 11.9 (95% CI: 10.8–13.1), reflecting that they are written at a 12th grade level, while the median FRE was 40.6 (95% CI: 34.1–47.1), indicating a rating as “difficult” to read. When comparing academic-based online patient education materials to other internet sources, there was no significant difference in FRE and FKGL scores (P = 0.63 and P = 0.26 for FKGL and FRE, respectively).

Conclusion:

This study demonstrates that online patient education materials pertaining to cerebrovascular diseases from major academic centers and other nonacademic internet sites are difficult to understand and written at levels significantly higher than that recommended by national agencies. Both academic and nonacademic sources reflect this finding equally. Further study and implementation are warranted to investigate how improvements can be made.

Évaluation de l'information sur Internet destinée aux patients francophones en neuro-oncologie

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.

Childhood brain tumour information on the Internet in the Chinese language

BACKGROUND

Internet information, now available in many different languages, can become a major source of information for patients and families in their own mother tongue. Chinese represent one of most frequently spoken language in the world. The aims of this study were to critically appraise the quantity and quality of Internet health information in childhood brain tumour in the Chinese language and to identify sufficient quality websites that can potentially be recommended to Chinese-speaking parents.

METHODS

Internet information on six common paediatric brain tumours was searched using six commonly used Chinese search engines. Websites were assessed systematically using two rating tools: DISCERN instrument and Checklist Rating System Instrument.

RESULTS

Out of 946 sites accessed, only 13 assessable Chinese websites, displaying Traditional Chinese characters and providing information on brain tumour, were identified. Only four sites included specific discussion on brain tumours in children. Ten websites failed to provide satisfactory information on brain tumour as rated by DISCERN instrument. Overall only 41% of the 13 specific items relevant to brain tumours were mentioned (Checklist Rating System Instrument).

CONCLUSION

Only a few satisfactory websites can be recommended to Chinese-speaking families for general information on brain tumour with caution from health care providers that such information may not apply to the child's individual condition.

Website quality indicators for consumers

BACKGROUND

The rating tool DISCERN was designed for use by consumers without content expertise to evaluate the quality of health information. There is some evidence that DISCERN may be a valid indicator of evidence-based website quality when applied by health professionals. However, it is not known if the tool is a valid measure of evidence-based quality when used by consumers. Since it is a lengthy instrument requiring training in its use, DISCERN may prove impractical for use by the typical consumer. It is therefore important to explore the validity of other simpler potential indicators of site quality such as Google PageRank.

OBJECTIVE

This study aimed to determine (1) whether the instrument DISCERN is a valid indicator of evidence-based Web content quality for consumers without specific mental health training, and (2) whether Google PageRank is an indicator of website content quality as measured by an evidence-based gold standard.

METHODS

This was a cross-sectional survey of depression websites using consumer and health professional raters. The main outcome measures were (1) site characteristics, (2) evidence-based quality of content as measured by evidence-based depression guidelines, (3) DISCERN scores, (4) Google PageRank, and (5) user satisfaction.

RESULTS

There was a significant association between evidence-based quality ratings and average DISCERN ratings both for consumers (r = 0.62, P = .001) and health professionals (r = 0.80, P < .001). Consumer and health professional DISCERN ratings were significantly correlated (r = 0.77, P < .001). The evidence-based quality score correlated with Google PageRank (r = 0.59, P = .002). However, the correlation between DISCERN scores and user satisfaction was higher than the correlation between Google PageRank and user satisfaction.

CONCLUSIONS

DISCERN has potential as an indicator of content quality when used either by experts or by consumers. Google PageRank shows some promise as an automatic indicator of quality.