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Nayudu K, Malik R, Sanchez-Melendez S, Hazen TJ, Patil MK, Nambudiri VE. Phototherapy for vitiligo: Quality and readability of online health information. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12958. [PMID: 38489300 DOI: 10.1111/phpp.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 02/12/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND/PURPOSE Vitiligo is a depigmenting disorder that affects up to 2% of the population. Due to the relatively high prevalence of this disease and its psychological impact on patients, decisions concerning treatment can be difficult. As patients increasingly seek health information online, the caliber of online health information (OHI) becomes crucial in patients' decisions regarding their care. We aimed to assess the quality and readability of OHI regarding phototherapy in the management of vitiligo. METHODS Similar to previously published studies assessing OHI, we used 5 medical search terms as a proxy for online searches made by patients. Results for each search term were assessed using an enhanced DISCERN analysis, Health On the Net code of conduct (HONcode) accreditation guidelines, and several readability indices. The DISCERN analysis is a validated questionnaire used to assess the quality of OHI, while HONcode accreditation is a marker of site reliability. RESULTS Of the 500 websites evaluated, 174 were HONcode-accredited (35%). Mean DISCERN scores for all websites were 58.9% and 51.7% for website reliability and treatment sections, respectively. Additionally, 0/130 websites analyzed for readability scored at the NIH-recommended sixth-grade reading level. CONCLUSION These analyses shed light on the shortcomings of OHI regarding phototherapy treatment for vitiligo, which could exacerbate disparities for patients who are already at higher risk of worse health outcomes.
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Affiliation(s)
- Krithika Nayudu
- Medical College of Georgia, Augusta University, Augusta, Georgia, USA
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Rhea Malik
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Stephanie Sanchez-Melendez
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Ponce Health Sciences University, School of Medicine, Ponce, Puerto Rico, USA
| | - T J Hazen
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Mihir K Patil
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Carle Illinois College of Medicine, University of Illinois Urbana Champaign, Champaign, Illinois, USA
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Malik R, Chen J, Lau C, Sandoval A, Nambudiri VE. Generalized pustular psoriasis: Quality and readability of online health information. Exp Dermatol 2023; 32:1317-1321. [PMID: 36815282 DOI: 10.1111/exd.14775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/13/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Abstract
Generalized pustular psoriasis (GPP) is a multisystem disease with potentially life-threatening adverse effects. As patients increasingly seek health information online, and as the landscape for GPP changes, the quality of online health information (OHI) becomes progressively more important. This paper is the first of its kind to examine the quality, comprehensiveness and readability of online health information for GPP. Similar to pre-existing studies evaluating OHI, this paper examines 5 key search terms for GPP- 3 medical and 2 laymen. For each search term, the results were evaluated based on HONcode accreditation, an enhanced DISCERN analysis and a number of readability indices. Of the 500 websites evaluated, 84 (16.8%) were HONcode-accredited. Mean DISCERN scores of all websites were 74.9% and 38.6% for website reliability and treatment sections, respectively, demonstrating key gaps in comprehensiveness and reliability of GPP-specific OHI. Additionally, only 4/100 websites (4%) analysed for readability were written at the NIH-recommended sixth-grade level. Academic websites were significantly more difficult to read than governmental websites. This further exacerbates the patient information gap, particularly for patients with low health literacy, who may already be at higher risk of not receiving timely medical care.
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Affiliation(s)
- Rhea Malik
- Harvard Medical School, Boston, MA, USA
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Jeffrey Chen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Charles Lau
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Aaron Sandoval
- Harvard Medical School, Boston, MA, USA
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Vinod E Nambudiri
- Harvard Medical School, Boston, MA, USA
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
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Yousif R, Zheng DX, Chang IA, Wong C, Trinidad J, Carr DR. Readability of online patient educational materials for transgender dermatologic care. J Am Acad Dermatol 2022; 87:922-924. [PMID: 34995677 DOI: 10.1016/j.jaad.2021.12.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/19/2021] [Accepted: 12/24/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Rame Yousif
- Department of Dermatology, University of Toledo College of Medicine, Toledo, OH
| | - David X Zheng
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH.
| | - Irene A Chang
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Christina Wong
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - John Trinidad
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - David R Carr
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH
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Heffernan A, Hu A. Quality and readability of online information on idiopathic subglottic stenosis. Laryngoscope Investig Otolaryngol 2021; 6:1068-1076. [PMID: 34667850 PMCID: PMC8513414 DOI: 10.1002/lio2.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/15/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Idiopathic subglottic stenosis (ISS) is a chronic condition characterized by disease recurrence and multiple surgeries. These frustrated patients may utilize the internet to research their condition. The aim of this study was to determine the quality and readability of online ISS information. METHODS "Idiopathic subglottic stenosis" was entered into Google. The first 50 websites that met inclusion criteria were extracted. The DISCERN instrument, Flesch Reading Ease Score (FRES), and Flesch-Kincaid Grade Level (FKGL) assessed the quality and readability, respectively. Means, SDs, Pearson correlation coefficients, and two-tailed Student's t-test were calculated. RESULTS The 50 websites consisted of 17 patient-targeted and 33 professional-targeted websites, plus 30 major and 20 minor websites. The overall DISCERN, FRES, and FKGL scores were 2.81 ± 0.99, 27.75 ± 15.27, and 13.65 ± 2.79, respectively (mean ± SD). Patient-targeted websites had significantly lower quality (DISCERN [P < .00]) but were easier to read (lower FKGL [P < .00], higher FRES [P < .00]) than professional-targeted websites. Minor websites had a significantly lower quality (DISCERN [P < 0.00]) but were easier to read (lower FKGL [P < .00], higher FRES [P < .00]) than major websites. There was a positive correlation between overall quality and difficulty in readability. CONCLUSION The quality of online ISS information was suboptimal. Resources were too difficult to comprehend and readability scores were above AMA and NIH recommendations. Improved online information is required to properly educate this patient population. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Austin Heffernan
- Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Amanda Hu
- Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryUniversity of British ColumbiaVancouverBritish ColumbiaCanada
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Miller R, Doria-Anderson N, Shibanuma A, Sakamoto JL, Yumino A, Jimba M. Evaluating Local Multilingual Health Care Information Environments on the Internet: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136836. [PMID: 34202254 PMCID: PMC8296914 DOI: 10.3390/ijerph18136836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
For foreign-born populations, difficulty in finding health care information in their primary language is a structural barrier to accessing timely health care. While such information may be available at a national level, it may not always be relevant or appropriate to the living situations of these people. Our objective was to explore the quality of online multilingual health information environments by pilot-testing a framework for assessing such information at the prefectural level in Japan. The framework consisted of five health care domains (health system, hospitals, emergency services, medical interpreters, and health insurance). Framework scores varied considerably among prefectures; many resources were machine-translated. These scores were significantly associated with foreign population proportion and the number of hospitals in each prefecture. Our multilingual health care information environment (MHCIE) framework provides a measure of health access inclusivity, which has not been quantified before. It is adaptable to other international contexts, but further validation is required.
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Affiliation(s)
- Russell Miller
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (R.M.); (N.D.-A.); (J.L.S.); (A.Y.); (M.J.)
| | - Nicholas Doria-Anderson
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (R.M.); (N.D.-A.); (J.L.S.); (A.Y.); (M.J.)
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (R.M.); (N.D.-A.); (J.L.S.); (A.Y.); (M.J.)
- Correspondence: ; Tel.: +81-3-3812-2111
| | - Jennifer Lisa Sakamoto
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (R.M.); (N.D.-A.); (J.L.S.); (A.Y.); (M.J.)
| | - Aya Yumino
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (R.M.); (N.D.-A.); (J.L.S.); (A.Y.); (M.J.)
- Kawasaki Health Cooperative Association, Asao Clinic, Kawasaki 210-0833, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (R.M.); (N.D.-A.); (J.L.S.); (A.Y.); (M.J.)
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