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Anandarajah A, Shato T, Humble S, Barnette AR, Brandt HM, Klesges LM, Sanders Thompson VL, Silver MI. The association of caregiver attitudes, information sources, and trust with HPV vaccine initiation among adolescents. Hum Vaccin Immunother 2024; 20:2300879. [PMID: 38174998 PMCID: PMC10773709 DOI: 10.1080/21645515.2023.2300879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024] Open
Abstract
This study described caregiver attitudes and the information sources they access about HPV vaccination for adolescents and determined their influence on human papillomavirus (HPV) vaccination initiation. An online survey was administered to 1,016 adults in July 2021. Participants were eligible if they were the caregiver of a child aged 9-17 residing in Mississippi, Arkansas, Tennessee, Missouri, and select counties in Southern Illinois. Multivariate logistic regression was used to estimate the association of caregiver attitudes and information sources with HPV vaccination. Information from doctors or healthcare providers (87.4%) and internet sources other than social media (31.0%) were the most used sources for HPV vaccine information. The highest proportion of caregivers trusted their doctor or healthcare providers (92.4%) and family or friends (68.5%) as sources of information. The HPV vaccine series was more likely to be initiated in children whose caregivers agreed that the vaccine is beneficial (AOR = 4.39, 95% CI = 2.05, 9.39), but less likely with caregivers who were concerned about side effects (AOR = 0.61, 95% CI = 0.42, 0.88) and who received HPV vaccination information from family or friends (AOR = 0.57, 95% CI = 0.35, 0.93). This study found that caregivers' attitudes, information sources, and trust in those sources were associated with their adolescent's HPV vaccination status. These findings highlight the need to address attitudes and information sources and suggest that tailored interventions considering these factors could increase HPV vaccination rates.
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Affiliation(s)
- Akila Anandarajah
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Thembekile Shato
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Sarah Humble
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Alan R. Barnette
- Department of Neonatology, Saint Francis Medical Center, Cape Girardeau, MO, USA
| | - Heather M. Brandt
- HPV Cancer Prevention Program, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Lisa M. Klesges
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Michelle I. Silver
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Nunes WB, Firmino RT, Marinho AMCL, Torres LDSB, Sousa MLC, Silva SED, Costa EMMDB, Perazzo MF, Granville-Garcia AF. Oral cancer: analysis of the clarity of publications in Instagram profiles of official health agencies in Brazil. CIENCIA & SAUDE COLETIVA 2024; 29:e20302022. [PMID: 38896688 DOI: 10.1590/1413-81232024296.20302022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/17/2023] [Indexed: 06/21/2024] Open
Abstract
This article aims to analyze the clarity and engagement measures of publications on oral cancer in the Instagram profiles of official health agencies in Brazil. An infodemiological study was conducted with 81 profiles. Data collected concerned content classification, account and media, manner of addressing the topic, number of posts, likes, comments, views and hashtags. The clarity of the educational publications was assessed with the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis involved Spearman's correlation and the Mann-Whitney test (α = 5%). A total of 775 publications on oral cancer were found. The average BR-CDC-CCI score was 69.8 (SD = 15.5). The clarity of the information was adequate in 9.5% of the educational publications. Positive correlations were found between the number of likes and engagement (comments [r = 0.49], views [r = 0.96]), number of hashtags (r = 0.13) and year of publication (r = 0.21). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score compared to the other profiles. Publications on oral cancer were correlated with engagement, year of publication and number of hashtags. Public agencies increased publications to reach the population, but the clarity of the content was low.
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Affiliation(s)
- Wanúbia Barbosa Nunes
- Programa de Pós-Graduação em Odontologia, Universidade Estadual da Paraíba. R. Baraúnas 351, Bairro Universitário. 58429-500 Campina Grande PB Brasil.
| | - Ramon Targino Firmino
- Unidade Acadêmica de Ciências Biológicas, Universidade Federal de Campina Grande. Patos PB Brasil
| | | | | | - Myrelle Leal Campos Sousa
- Programa de Pós-Graduação em Odontologia, Universidade Estadual da Paraíba. R. Baraúnas 351, Bairro Universitário. 58429-500 Campina Grande PB Brasil.
| | - Samara Ellen da Silva
- Programa de Pós-Graduação em Odontologia, Faculdade São Leopoldo Mandic. Campinas SP Brasil
| | - Edja Maria Melo de Brito Costa
- Programa de Pós-Graduação em Odontologia, Universidade Estadual da Paraíba. R. Baraúnas 351, Bairro Universitário. 58429-500 Campina Grande PB Brasil.
| | | | - Ana Flávia Granville-Garcia
- Programa de Pós-Graduação em Odontologia, Universidade Estadual da Paraíba. R. Baraúnas 351, Bairro Universitário. 58429-500 Campina Grande PB Brasil.
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Daraz L, Dogu C, Houde V, Bouseh S, Morshed KG. Assessing Credibility: Quality Criteria for Patients, Caregivers, and the Public in Online Health Information-A Qualitative Study. J Patient Exp 2024; 11:23743735241259440. [PMID: 38827225 PMCID: PMC11143846 DOI: 10.1177/23743735241259440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024] Open
Abstract
The increasing reliance on the Internet for health information has raised concerns about patients using unreliable and potentially harmful content. This study aimed to establish quality criteria to assist patients, caregivers, and the public in evaluating the reliability of online health information. We conducted focus group workshops with 25 participants recruited across Canada, proficient in either English or French. The participants included 13 females and 12 males, with the majority having a college or higher level of education. Through an in-depth analysis comparing various aspects, the participants determined 6 quality criteria: authorship, reliability, usefulness, accessibility, readability, and privacy & confidentiality. The findings from this study present a comprehensive list of quality criteria that will contribute to developing evidence-based quality benchmarks and policy frameworks in multiple languages. These criteria are not only valid but also well-suited to the diverse needs and preferences of patients and the public, providing a reliable framework for evaluating online health information through an evidence-based approach.
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Affiliation(s)
- Lubna Daraz
- School of Library and Information Science, Faculty of Arts and Sciences, University of Montreal, Montreal, Québec, Canada
| | - Cicek Dogu
- School of Library and Information Science, Faculty of Arts and Sciences, University of Montreal, Montreal, Québec, Canada
| | - Virginie Houde
- School of Library and Information Science, Faculty of Arts and Sciences, University of Montreal, Montreal, Québec, Canada
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Ghanem YK, Rouhi AD, Al-Houssan A, Saleh Z, Moccia MC, Joshi H, Dumon KR, Hong Y, Spitz F, Joshi AR, Kwiatt M. Dr. Google to Dr. ChatGPT: assessing the content and quality of artificial intelligence-generated medical information on appendicitis. Surg Endosc 2024; 38:2887-2893. [PMID: 38443499 PMCID: PMC11078845 DOI: 10.1007/s00464-024-10739-5] [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: 12/26/2023] [Accepted: 01/28/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Generative artificial intelligence (AI) chatbots have recently been posited as potential sources of online medical information for patients making medical decisions. Existing online patient-oriented medical information has repeatedly been shown to be of variable quality and difficult readability. Therefore, we sought to evaluate the content and quality of AI-generated medical information on acute appendicitis. METHODS A modified DISCERN assessment tool, comprising 16 distinct criteria each scored on a 5-point Likert scale (score range 16-80), was used to assess AI-generated content. Readability was determined using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores. Four popular chatbots, ChatGPT-3.5 and ChatGPT-4, Bard, and Claude-2, were prompted to generate medical information about appendicitis. Three investigators independently scored the generated texts blinded to the identity of the AI platforms. RESULTS ChatGPT-3.5, ChatGPT-4, Bard, and Claude-2 had overall mean (SD) quality scores of 60.7 (1.2), 62.0 (1.0), 62.3 (1.2), and 51.3 (2.3), respectively, on a scale of 16-80. Inter-rater reliability was 0.81, 0.75, 0.81, and 0.72, respectively, indicating substantial agreement. Claude-2 demonstrated a significantly lower mean quality score compared to ChatGPT-4 (p = 0.001), ChatGPT-3.5 (p = 0.005), and Bard (p = 0.001). Bard was the only AI platform that listed verifiable sources, while Claude-2 provided fabricated sources. All chatbots except for Claude-2 advised readers to consult a physician if experiencing symptoms. Regarding readability, FKGL and FRE scores of ChatGPT-3.5, ChatGPT-4, Bard, and Claude-2 were 14.6 and 23.8, 11.9 and 33.9, 8.6 and 52.8, 11.0 and 36.6, respectively, indicating difficulty readability at a college reading skill level. CONCLUSION AI-generated medical information on appendicitis scored favorably upon quality assessment, but most either fabricated sources or did not provide any altogether. Additionally, overall readability far exceeded recommended levels for the public. Generative AI platforms demonstrate measured potential for patient education and engagement about appendicitis.
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Affiliation(s)
- Yazid K Ghanem
- Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, 08103, USA.
- Cooper Medical School of Rowan University, Camden, NJ, USA.
| | - Armaun D Rouhi
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ammr Al-Houssan
- Department of Surgery, University of Connecticut, Hartford, CT, USA
| | - Zena Saleh
- Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, 08103, USA
| | - Matthew C Moccia
- Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, 08103, USA
| | - Hansa Joshi
- Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, 08103, USA
| | - Kristoffel R Dumon
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Young Hong
- Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, 08103, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Francis Spitz
- Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, 08103, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Amit R Joshi
- Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, 08103, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Michael Kwiatt
- Department of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, 08103, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
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Brody PA, Mehra M, Horinek M, Herzstein SM, Chan J. Assessing Patterns in Childhood Obesity Patient Education: A Quality of Online Health Information and Google Trends Analysis. Child Obes 2024; 20:289-299. [PMID: 37440174 DOI: 10.1089/chi.2023.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Background: Childhood obesity (CO) is rapidly increasing in prevalence and developing into a health crisis of developed nations. The condition is associated with increased risk of developing various comorbidities later in life. Current treatment algorithms primarily target family education. Thus, this study aims to understand the quality of information online regarding CO and common comorbidities, determine the readability of online information, and report patterns in public interest over time using Google Trends. Methods: Four validated quality of information tools and 6 readability tools were implemented across 36 websites derived from 4 Google searches. Pearson's correlation coefficient was used to determine the associations between Google Trends' relative search volumes (RSVs) and biennial BMI-based cumulative proportion of CO. Results: Results showed variable information quality among the websites as scores ranged from "fair" to "very poor." Using six readability formulas, no website scored at or below the sixth grade reading level recommended by the American Medical Association. Google Trends' RSVs for the term "Childhood Obesity" were repeatedly increased in the months that fall in the US academic school year (October-November and February-May), and decreased within months in the US vacation periods (December-January and June-September). Search volumes were also negatively correlated with CO and pediatric type 2 diabetes prevalence. Conclusions: In summary, while Google Trends analysis showed that schools may play a role in increasing interest and awareness online, quality of information and readability analysis displayed that the information and its accessibility are far too variable to be reliable.
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Affiliation(s)
- Pierce A Brody
- Department of Pediatrics, Medical College of Georgia, Augusta, Georgia, USA
| | - Mehul Mehra
- Department of Pediatrics, Medical College of Georgia, Augusta, Georgia, USA
| | - Madison Horinek
- Department of Pediatrics, Medical College of Georgia, Augusta, Georgia, USA
| | - Salome M Herzstein
- Department of Pediatrics, Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, Florida, USA
| | - Jacqueline Chan
- Department of Pediatrics Endocrinology, Medical College of Georgia, Augusta, Georgia, USA
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Zhou Z, Besson AJ, Hayes D, Yeung JMC. Ostomy Information on the Internet-Is It Good Enough? J Wound Ostomy Continence Nurs 2024; 51:199-205. [PMID: 38820217 DOI: 10.1097/won.0000000000001077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
PURPOSE The aim of this study was to determine which internet search engines and keywords patients with ostomies utilize, to identify the common websites using these terms, to determine what aspects of information they wanted, and to perform a quality and readability assessment for these websites. DESIGN A cross-sectional survey of persons with ostomies to identify search engines and terms, followed by a structured assessment of the quality and readability of the identified web pages. SUBJECT AND SETTINGS The sample comprised 20 hospitalized patients with ostomies cared for on a colorectal surgical ward of a tertiary care hospital located in Melbourne, Australia. There were 15 (75%) adult males and 5 (25%) adult females; their mean age was 52.2 years. Participants were surveyed between August and December 2020. METHODS Patients with newly formed ostomies were surveyed about which search engines and keywords they would use to look for information and for which questions regarding ostomies they wanted answers. In addition, 2 researchers then performed independent searches using the search terms identified by patient participants. These searches were conducted in August 2021, with the geographical location set to Australia. The quality of the websites was graded using the DISCERN, Ensuring Quality Information for Patients, and Quality Evaluation Scoring Tool scoring assessments, and their readability was graded using the Flesch Reading Ease Score tool. RESULTS Participants used Google as their primary search engine. Four keywords/phrases were identified: stoma for bowel surgery, ileostomy, colostomy, and caring for stoma. Multiple web pages were identified, 8 (21%) originated from Australia, 7 (18%) were from the United Kingdom, and 23 (61%) were from the United States. Most web pages lacked recent updates; only 18% had been undated within the last 12 months. The overall quality of the online information on ostomies was moderate with an average level of readability, deemed suitable for patient educational purposes. CONCLUSIONS Information for persons living with an ostomy can be obtained from multiple web pages, and many sites have reasonable quality and are written at a suitable level. Unfortunately, these websites are rarely up-to-date and may contain advice that may not be applicable to individual patients.
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Affiliation(s)
- Zheyi Zhou
- Zheyi Zhou, MD, Department of Surgery, Western Health, Footscray, Victoria, Australia
- Alex J. Besson, MD, Department of Surgery, Western Health, Footscray, Victoria, Australia
- Diana Hayes, Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia
- Justin M.C. Yeung, DM, FRCSEd (Gen Surg), FRACS, Department of Surgery, Western Health, Footscray, Victoria, Australia; Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia; Department of Surgery, Western Precinct, University of Melbourne, Parkville, Victoria, Australia; and Western Health Chronic Disease Alliance, Western Health, Footscray, Victoria, Australia
| | - Alex J Besson
- Zheyi Zhou, MD, Department of Surgery, Western Health, Footscray, Victoria, Australia
- Alex J. Besson, MD, Department of Surgery, Western Health, Footscray, Victoria, Australia
- Diana Hayes, Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia
- Justin M.C. Yeung, DM, FRCSEd (Gen Surg), FRACS, Department of Surgery, Western Health, Footscray, Victoria, Australia; Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia; Department of Surgery, Western Precinct, University of Melbourne, Parkville, Victoria, Australia; and Western Health Chronic Disease Alliance, Western Health, Footscray, Victoria, Australia
| | - Diana Hayes
- Zheyi Zhou, MD, Department of Surgery, Western Health, Footscray, Victoria, Australia
- Alex J. Besson, MD, Department of Surgery, Western Health, Footscray, Victoria, Australia
- Diana Hayes, Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia
- Justin M.C. Yeung, DM, FRCSEd (Gen Surg), FRACS, Department of Surgery, Western Health, Footscray, Victoria, Australia; Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia; Department of Surgery, Western Precinct, University of Melbourne, Parkville, Victoria, Australia; and Western Health Chronic Disease Alliance, Western Health, Footscray, Victoria, Australia
| | - Justin M C Yeung
- Zheyi Zhou, MD, Department of Surgery, Western Health, Footscray, Victoria, Australia
- Alex J. Besson, MD, Department of Surgery, Western Health, Footscray, Victoria, Australia
- Diana Hayes, Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia
- Justin M.C. Yeung, DM, FRCSEd (Gen Surg), FRACS, Department of Surgery, Western Health, Footscray, Victoria, Australia; Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia; Department of Surgery, Western Precinct, University of Melbourne, Parkville, Victoria, Australia; and Western Health Chronic Disease Alliance, Western Health, Footscray, Victoria, Australia
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Lim B, Chai A, Shaalan M. A Cross-Sectional Analysis of the Readability of Online Information Regarding Hip Osteoarthritis. Cureus 2024; 16:e60536. [PMID: 38887325 PMCID: PMC11181007 DOI: 10.7759/cureus.60536] [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] [Accepted: 05/17/2024] [Indexed: 06/20/2024] Open
Abstract
Introduction Osteoarthritis (OA) is an age-related degenerative joint disease. There is a 25% risk of symptomatic hip OA in patients who live up to 85 years of age. It can impair a person's daily activities and increase their reliance on healthcare services. It is primarily managed with education, weight loss and exercise, supplemented with pharmacological interventions. Poor health literacy is associated with negative treatment outcomes and patient dissatisfaction. A literature search found there are no previously published studies examining the readability of online information about hip OA. Objectives To assess the readability of healthcare websites regarding hip OA. Methods The terms "hip pain", "hip osteoarthritis", "hip arthritis", and "hip OA" were searched on Google and Bing. Of 240 websites initially considered, 74 unique websites underwent evaluation using the WebFX online readability software (WebFX®, Harrisburg, USA). Readability was determined using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Reading Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index (CLI), and Automated Readability Index (ARI). In line with recommended guidelines and previous studies, FRES >65 or a grade level score of sixth grade and under was considered acceptable. Results The average FRES was 56.74±8.18 (range 29.5-79.4). Only nine (12.16%) websites had a FRES score >65. The average FKGL score was 7.62±1.69 (range 4.2-12.9). Only seven (9.46%) websites were written at or below a sixth-grade level according to the FKGL score. The average GFI score was 9.20±2.09 (range 5.6-16.5). Only one (1.35%) website was written at or below a sixth-grade level according to the GFI score. The average SMOG score was 7.29±1.41 (range 5.4-12.0). Only eight (10.81%) websites were written at or below a sixth-grade level according to the SMOG score. The average CLI score was 13.86±1.75 (range 9.6-19.7). All 36 websites were written above a sixth-grade level according to the CLI score. The average ARI score was 6.91±2.06 (range 3.1-14.0). Twenty-eight (37.84%) websites were written at or below a sixth-grade level according to the ARI score. One-sample t-tests showed that FRES (p<0.001, CI -10.2 to -6.37), FKGL (p<0.001, CI 1.23 to 2.01), GFI (p<0.001, CI 2.72 to 3.69), SMOG (p<0.001, CI 0.97 to 1.62), CLI (p<0.001, CI 7.46 to 8.27), and ARI (p<0.001, CI 0.43 to 1.39) scores were significantly different from the accepted standard. One-way analysis of variance (ANOVA) testing of FRES scores (p=0.009) and CLI scores (p=0.009) showed a significant difference between categories. Post hoc testing showed a significant difference between academic and non-profit categories for FRES scores (p=0.010, CI -15.17 to -1.47) and CLI scores (p=0.008, CI 0.35 to 3.29). Conclusions Most websites regarding hip OA are written above recommended reading levels, hence exceeding the comprehension levels of the average patient. Readability of these resources must be improved to improve patient access to online healthcare information which can lead to improved patient understanding of their own condition and treatment outcomes.
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Affiliation(s)
- Brandon Lim
- Department of Medicine, School of Medicine, Trinity College Dublin, Dublin, IRL
| | - Ariel Chai
- Department of Medicine, School of Medicine, Trinity College Dublin, Dublin, IRL
| | - Mohamed Shaalan
- Department of Orthopaedics and Traumatology, The Mater Misericordiae University Hospital, Dublin, IRL
- Department of Trauma and Orthopaedics, St James's Hospital, Dublin, IRL
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Temel MH, Erden Y, Bağcıer F. Assessing Patients Perception: Analyzing the Quality, Reliability, Comprehensibility, and the Mentioned Medical Concepts of Traumatic Brain Injury Videos on YouTube. World Neurosurg 2024; 185:e907-e914. [PMID: 38458253 DOI: 10.1016/j.wneu.2024.02.150] [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: 02/05/2024] [Accepted: 02/28/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE The aim of this study is to analyze the quality, reliability, comprehensibility, and the mentioned medical concepts of traumatic brain injury (TBI) related videos on YouTube. METHODS "Traumatic brain injury (TBI)" and Google Trends related queries were used, and 328 videos were included. Categorization, quality assessment via a 5-point Global Quality Scale, reliability evaluation using a modified DISCERN scale, comprehensibility assessment using Flesch-Kincaid Reading Ease and Flesch-Kincaid Grade Level, and consensus-based classification for usefulness were performed. Target audience categorization was content-based. Text mining techniques were used to identify biomedical terms in video transcripts. RESULTS Most of the videos were intended for nonhealthcare professionals and deemed useful. The videos had intermediate quality and a moderate level of reliability. The comprehensibility of the videos exceeded the recommended levels. Videos predominantly covered TBI symptoms, the severity of the condition, its impact on individuals, and possibly strategies related to diagnosis and treatment. CONCLUSIONS Results suggest the requirement for higher quality and reliability in YouTube content about TBI. Emphasis should be placed on clear and accurate language to promote comprehensibility. Continued research, guidelines, education, and platform oversight can enhance the spread of reliable health information on social media, benefiting creators, and consumers in this field.
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Affiliation(s)
- Mustafa Hüseyin Temel
- Physical Medicine and Rehabilitation Clinic, Üsküdar State Hospital, Istanbul, Türkiye.
| | - Yakup Erden
- Physical Medicine and Rehabilitation Clinic, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Türkiye
| | - Fatih Bağcıer
- Physical Medicine and Rehabilitation Clinic, Basaksehir Cam Sakura City Hospital, Istanbul, Türkiye
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Şahin MF, Ateş H, Keleş A, Özcan R, Doğan Ç, Akgül M, Yazıcı CM. Responses of Five Different Artificial Intelligence Chatbots to the Top Searched Queries About Erectile Dysfunction: A Comparative Analysis. J Med Syst 2024; 48:38. [PMID: 38568432 PMCID: PMC10990980 DOI: 10.1007/s10916-024-02056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
The aim of the study is to evaluate and compare the quality and readability of responses generated by five different artificial intelligence (AI) chatbots-ChatGPT, Bard, Bing, Ernie, and Copilot-to the top searched queries of erectile dysfunction (ED). Google Trends was used to identify ED-related relevant phrases. Each AI chatbot received a specific sequence of 25 frequently searched terms as input. Responses were evaluated using DISCERN, Ensuring Quality Information for Patients (EQIP), and Flesch-Kincaid Grade Level (FKGL) and Reading Ease (FKRE) metrics. The top three most frequently searched phrases were "erectile dysfunction cause", "how to erectile dysfunction," and "erectile dysfunction treatment." Zimbabwe, Zambia, and Ghana exhibited the highest level of interest in ED. None of the AI chatbots achieved the necessary degree of readability. However, Bard exhibited significantly higher FKRE and FKGL ratings (p = 0.001), and Copilot achieved better EQIP and DISCERN ratings than the other chatbots (p = 0.001). Bard exhibited the simplest linguistic framework and posed the least challenge in terms of readability and comprehension, and Copilot's text quality on ED was superior to the other chatbots. As new chatbots are introduced, their understandability and text quality increase, providing better guidance to patients.
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Affiliation(s)
- Mehmet Fatih Şahin
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey.
| | - Hüseyin Ateş
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
| | - Anıl Keleş
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
| | - Rıdvan Özcan
- Department of Urology, Bursa State Hospital, Nilüfer, Bursa, 16110, Turkey
| | - Çağrı Doğan
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
| | - Murat Akgül
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
| | - Cenk Murat Yazıcı
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
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Arif HA, LeBrun G, Moore ST, Friscia DA. Analysis of the Most Popular Online Ankle Fracture-Related Patient Education Materials. FOOT & ANKLE ORTHOPAEDICS 2024; 9:24730114241241310. [PMID: 38577700 PMCID: PMC10989055 DOI: 10.1177/24730114241241310] [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] [Indexed: 04/06/2024] Open
Abstract
Background Given the increasing accessibility of Internet access, it is critical to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures. Methods After conducting a Google search using 6 terms related to ankle fractures, we collected the first 20 nonsponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using custom created Ankle Fracture Index (AFI). Results A total of 46 of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an "acceptable" quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth-grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations. Conclusion We found that online patient-facing materials on ankle fractures demonstrated an eighth-grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery while ensuring that readability levels remain below at least the eighth-grade level.
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Affiliation(s)
- Haad A. Arif
- School of Medicine, University of California Riverside, Riverside, CA, USA
| | | | - Simon T. Moore
- School of Medicine, University of California Riverside, Riverside, CA, USA
| | - David A. Friscia
- School of Medicine, University of California Riverside, Riverside, CA, USA
- Eisenhower Desert Orthopedic Center, Rancho Mirage, CA, USA
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11
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Roster K, Kann RB, Farabi B, Gronbeck C, Brownstone N, Lipner SR. Readability and Health Literacy Scores for ChatGPT-Generated Dermatology Public Education Materials: Cross-Sectional Analysis of Sunscreen and Melanoma Questions. JMIR DERMATOLOGY 2024; 7:e50163. [PMID: 38446502 PMCID: PMC10955394 DOI: 10.2196/50163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/02/2024] [Accepted: 02/06/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Katie Roster
- New York Medical College, New York, NY, United States
| | | | - Banu Farabi
- Dermatology Department, NYC Health + Hospital/Metropolitan, New York, NY, United States
| | - Christian Gronbeck
- Department of Dermatology, University of Connecticut HealthCenter, Framington, CT, United States
| | - Nicholas Brownstone
- Department of Dermatology, Temple University Hospital, Philadelphia, PA, United States
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, United States
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12
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Ayre J, Mac O, McCaffery K, McKay BR, Liu M, Shi Y, Rezwan A, Dunn AG. New Frontiers in Health Literacy: Using ChatGPT to Simplify Health Information for People in the Community. J Gen Intern Med 2024; 39:573-577. [PMID: 37940756 DOI: 10.1007/s11606-023-08469-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/06/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Most health information does not meet the health literacy needs of our communities. Writing health information in plain language is time-consuming but the release of tools like ChatGPT may make it easier to produce reliable plain language health information. OBJECTIVE To investigate the capacity for ChatGPT to produce plain language versions of health texts. DESIGN Observational study of 26 health texts from reputable websites. METHODS ChatGPT was prompted to 'rewrite the text for people with low literacy'. Researchers captured three revised versions of each original text. MAIN MEASURES Objective health literacy assessment, including Simple Measure of Gobbledygook (SMOG), proportion of the text that contains complex language (%), number of instances of passive voice and subjective ratings of key messages retained (%). KEY RESULTS On average, original texts were written at grade 12.8 (SD = 2.2) and revised to grade 11.0 (SD = 1.2), p < 0.001. Original texts were on average 22.8% complex (SD = 7.5%) compared to 14.4% (SD = 5.6%) in revised texts, p < 0.001. Original texts had on average 4.7 instances (SD = 3.2) of passive text compared to 1.7 (SD = 1.2) in revised texts, p < 0.001. On average 80% of key messages were retained (SD = 15.0). The more complex original texts showed more improvements than less complex original texts. For example, when original texts were ≥ grade 13, revised versions improved by an average 3.3 grades (SD = 2.2), p < 0.001. Simpler original texts (< grade 11) improved by an average 0.5 grades (SD = 1.4), p < 0.001. CONCLUSIONS This study used multiple objective assessments of health literacy to demonstrate that ChatGPT can simplify health information while retaining most key messages. However, the revised texts typically did not meet health literacy targets for grade reading score, and improvements were marginal for texts that were already relatively simple.
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Affiliation(s)
- Julie Ayre
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Rm 128C Edward Ford Building, Sydney, NSW, Australia.
| | - Olivia Mac
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Rm 128C Edward Ford Building, Sydney, NSW, Australia
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Rm 128C Edward Ford Building, Sydney, NSW, Australia
| | - Brad R McKay
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Rm 128C Edward Ford Building, Sydney, NSW, Australia
| | - Mingyi Liu
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Rm 128C Edward Ford Building, Sydney, NSW, Australia
| | - Yi Shi
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Rm 128C Edward Ford Building, Sydney, NSW, Australia
| | - Atria Rezwan
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Rm 128C Edward Ford Building, Sydney, NSW, Australia
| | - Adam G Dunn
- Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Rouhi AD, Ghanem YK, Yolchieva L, Saleh Z, Joshi H, Moccia MC, Suarez-Pierre A, Han JJ. Can Artificial Intelligence Improve the Readability of Patient Education Materials on Aortic Stenosis? A Pilot Study. Cardiol Ther 2024; 13:137-147. [PMID: 38194058 PMCID: PMC10899139 DOI: 10.1007/s40119-023-00347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 12/13/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION The advent of generative artificial intelligence (AI) dialogue platforms and large language models (LLMs) may help facilitate ongoing efforts to improve health literacy. Additionally, recent studies have highlighted inadequate health literacy among patients with cardiac disease. The aim of the present study was to ascertain whether two freely available generative AI dialogue platforms could rewrite online aortic stenosis (AS) patient education materials (PEMs) to meet recommended reading skill levels for the public. METHODS Online PEMs were gathered from a professional cardiothoracic surgical society and academic institutions in the USA. PEMs were then inputted into two AI-powered LLMs, ChatGPT-3.5 and Bard, with the prompt "translate to 5th-grade reading level". Readability of PEMs before and after AI conversion was measured using the validated Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook Index (SMOGI), and Gunning-Fog Index (GFI) scores. RESULTS Overall, 21 PEMs on AS were gathered. Original readability measures indicated difficult readability at the 10th-12th grade reading level. ChatGPT-3.5 successfully improved readability across all four measures (p < 0.001) to the approximately 6th-7th grade reading level. Bard successfully improved readability across all measures (p < 0.001) except for SMOGI (p = 0.729) to the approximately 8th-9th grade level. Neither platform generated PEMs written below the recommended 6th-grade reading level. ChatGPT-3.5 demonstrated significantly more favorable post-conversion readability scores, percentage change in readability scores, and conversion time compared to Bard (all p < 0.001). CONCLUSION AI dialogue platforms can enhance the readability of PEMs for patients with AS but may not fully meet recommended reading skill levels, highlighting potential tools to help strengthen cardiac health literacy in the future.
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Affiliation(s)
- Armaun D Rouhi
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yazid K Ghanem
- Department of Surgery, Cooper University Hospital, Camden, NJ, USA
| | - Laman Yolchieva
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Zena Saleh
- Department of Surgery, Cooper University Hospital, Camden, NJ, USA
| | - Hansa Joshi
- Department of Surgery, Cooper University Hospital, Camden, NJ, USA
| | - Matthew C Moccia
- Department of Surgery, Cooper University Hospital, Camden, NJ, USA
| | | | - Jason J Han
- Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
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14
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Wu VS, Sabud T, Smith A‘B, Lambert SD, Descallar J, Lebel S, Bamgboje-Ayodele A. The Evaluation of the Suitability, Quality, and Readability of Publicly Available Online Resources for the Self-Management of Fear of Cancer Recurrence. Curr Oncol 2023; 31:66-83. [PMID: 38248090 PMCID: PMC10814354 DOI: 10.3390/curroncol31010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Cancer survivors often rely on the internet for health information, which has varying levels of readability, suitability, and quality. There is a need for high-quality online self-management resources for cancer survivors with fear of cancer recurrence (FCR). This study evaluated the readability, suitability, and quality of publicly available online FCR self-management resources. A Google search using FCR-related keywords identified freely available FCR self-management resources for cancer survivors in English. Resource readability (reading grade level), suitability, and quality were evaluated using relevant assessment tools. Descriptive statistics and cluster analysis identified resources with higher suitability and quality scores. Mean resource (n = 23) readability score was grade 11 (SD = 1.6, Range = 9-14). The mean suitability score was 56.0% (SD = 11.4%, Range = 31.0-76.3%), indicating average suitability and the mean quality score was 53% (SD = 11.7%, Range = 27-80%), indicating fair quality. A cluster of 15 (65%) resources with higher suitability and quality scores was identified. There were no significant associations between suitability or quality scores and the type of organisation that published the resources. Online FCR self-management resources varied in readability, suitability and quality. Resources with higher quality and suitability scores relative to other resources are identified for use by healthcare professionals and cancer survivors. Resources that are more culturally appropriate, with lower reading grade levels and detailed self-management strategies are needed.
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Affiliation(s)
- Verena Shuwen Wu
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Tiyasha Sabud
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Allan ‘Ben’ Smith
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW 2006, Australia
| | - Sylvie D. Lambert
- Ingram School of Nursing, McGill University, Montreal, QC H3A 2M7, Canada;
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada
| | - Joseph Descallar
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Adeola Bamgboje-Ayodele
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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15
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Seneviratne NU, Ho SY, Boro A, Correa DJ. Readability and content gaps in online epilepsy surgery materials as potential health literacy and shared-decision-making barriers. Epilepsia Open 2023; 8:1566-1575. [PMID: 37805810 PMCID: PMC10690683 DOI: 10.1002/epi4.12842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023] Open
Abstract
OBJECTIVE Epilepsy surgery is an effective albeit underused treatment for refractory epilepsy, and online materials are vital to patient understanding of the complex process. Our goal is to analyze the readability and content inclusion of online patient health education materials designed for epilepsy surgery. METHODS A private browser setting was used on Google and Bing to identify the top 100 search results for the terms "epilepsy+surgery". Scientific papers, insurance pages, pay-wall access sites, and non-text content were excluded. The website text was reformatted to exclude graphics, contact information, links, and headers. Readability metrics were calculated using an online tool. Text content was analyzed for inclusion of important concepts (pre-surgical evaluation, complications, risks of continued seizures, types of surgery, complimentary diagrams/audiovisual material). Comparison of readability and content inclusion was performed as a function of organization types (epilepsy center, community health organization, pediatric-specific) and location (region, country). RESULTS Browser search yielded 82 distinct websites with information regarding epilepsy surgery, with 98.7% of websites exceeding the recommended 6th-grade reading level for health information. Epilepsy centers had significantly worse readability (Flesch-Kincaid Grade Level (FKGL) P < 0.01 and Flesch Reading Ease (FRE) P < 0.05). Content analysis showed that only 37% of websites discuss surgical side effects and only 23% mention the risks of continued seizures. Epilepsy centers were less likely to report information on surgical side effects (P < 0.001). UK-based websites had better readability (FKGL P < 0.01 and FRE P < 0.01) and were more likely to discuss side effects (P = 0.01) compared to US-based websites. SIGNIFICANCE The majority of online health content is overly complex and relatively incomplete in multiple key areas important to health literacy and understanding of surgical candidacy. Our findings suggest academic organizations, including level 4 epilepsy centers, need to simplify and broaden online education resources. More comprehensive, publicly accessible, and readable information may lead to better-shared decision-making.
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Affiliation(s)
| | - Sophey Y. Ho
- Albert Einstein College of MedicineThe BronxNew YorkUSA
| | - Alexis Boro
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineThe BronxNew YorkUSA
| | - Daniel J. Correa
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineThe BronxNew YorkUSA
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16
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Williams MT. Patient education about breathlessness. Curr Opin Support Palliat Care 2023; 17:255-262. [PMID: 37812384 DOI: 10.1097/spc.0000000000000678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
PURPOSE OF THE REVIEW Effective education enables people to modify the distress and impact of breathlessness by integrating evidence-informed breathlessness-related behaviours (knowledge, skill, attitude) into everyday life. This review considers recent studies of educational approaches focussed on chronic breathlessness as a modifiable, noxious and debilitating multidimensional experience. RECENT FINDINGS Systematic assessments of text-based patient education materials and mobile phone applications specific to breathlessness indicate that while these resources are readily available, issues continue to persist with quality, readability, usefulness and availability of non-English language versions. Various forms of educational interventions for breathlessness have proven feasible and valued by people living with breathlessness and their significant others (uptake/completion, personal benefit, ripple effect on health professionals). Health professional knowledge about the impact of chronic breathlessness and effective management can be altered through structured, educational interventions. SUMMARY Empiric studies of patient education for breathlessness are scarce despite persistent calls for better breathlessness education for people living with or providing care for someone living with this noxious symptom. In clinical practice, it is highly likely that there are effective and ineffective educational practices, both of which, if publicly disseminated, would inform future educational strategies to advance breathlessness self-management.
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Affiliation(s)
- Marie T Williams
- Allied Health and Human Performance and Innovation, IMPlementation And Clinical Translation in Health (IIMPACT), University of South Australia, North Terrace, Adelaide, South Australia, Australia
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17
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Tan DJY, Ko TK, Fan KS. The Readability and Quality of Web-Based Patient Information on Nasopharyngeal Carcinoma: Quantitative Content Analysis. JMIR Form Res 2023; 7:e47762. [PMID: 38010802 DOI: 10.2196/47762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/25/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is a rare disease that is strongly associated with exposure to the Epstein-Barr virus and is characterized by the formation of malignant cells in nasopharynx tissues. Early diagnosis of NPC is often difficult owing to the location of initial tumor sites and the nonspecificity of initial symptoms, resulting in a higher frequency of advanced-stage diagnoses and a poorer prognosis. Access to high-quality, readable information could improve the early detection of the disease and provide support to patients during disease management. OBJECTIVE This study aims to assess the quality and readability of publicly available web-based information in the English language about NPC, using the most popular search engines. METHODS Key terms relevant to NPC were searched across 3 of the most popular internet search engines: Google, Yahoo, and Bing. The top 25 results from each search engine were included in the analysis. Websites that contained text written in languages other than English, required paywall access, targeted medical professionals, or included nontext content were excluded. Readability for each website was assessed using the Flesch Reading Ease score and the Flesch-Kincaid grade level. Website quality was assessed using the Journal of the American Medical Association (JAMA) and DISCERN tools as well as the presence of a Health on the Net Foundation seal. RESULTS Overall, 57 suitable websites were included in this study; 26% (15/57) of the websites were academic. The mean JAMA and DISCERN scores of all websites were 2.80 (IQR 3) and 57.60 (IQR 19), respectively, with a median of 3 (IQR 2-4) and 61 (IQR 49-68), respectively. Health care industry websites (n=3) had the highest mean JAMA score of 4 (SD 0). Academic websites (15/57, 26%) had the highest mean DISCERN score of 77.5. The Health on the Net Foundation seal was present on only 1 website, which also achieved a JAMA score of 3 and a DISCERN score of 50. Significant differences were observed between the JAMA score of hospital websites and the scores of industry websites (P=.04), news service websites (P<.048), charity and nongovernmental organization websites (P=.03). Despite being a vital source for patients, general practitioner websites were found to have significantly lower JAMA scores compared with charity websites (P=.05). The overall mean readability scores reflected an average reading age of 14.3 (SD 1.1) years. CONCLUSIONS The results of this study suggest an inconsistent and suboptimal quality of information related to NPC on the internet. On average, websites presented readability challenges, as written information about NPC was above the recommended reading level of sixth grade. As such, web-based information requires improvement in both quality and accessibility, and healthcare providers should be selective about information recommended to patients, ensuring they are reliable and readable.
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Affiliation(s)
- Denise Jia Yun Tan
- Department of Surgery, Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - Tsz Ki Ko
- Department of Surgery, Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - Ka Siu Fan
- Department of Surgery, Royal Surrey County Hospital, Guildford, Surrey, United Kingdom
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18
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Lazaro G. When Positive is Negative: Health Literacy Barriers to Patient Access to Clinical Laboratory Test Results. J Appl Lab Med 2023; 8:1133-1147. [PMID: 37681277 PMCID: PMC10756206 DOI: 10.1093/jalm/jfad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/09/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Health literacy is a multidimensional set of skills (e.g., narrative, numeracy, digital, medication) that patients need to access and understand health information timely and accurately to make evidence-based informed decisions. CONTENT Multiple barriers prevent patients from effectively interacting with health information. The most salient barriers are poor overall health literacy skills and linguistic proficiency in English. As patients prefer direct access to laboratory test results, especially those of routine tests, contextualization and provider-directed interpretation of results are required to foster shared decision-making to address their healthcare issues and improve health outcomes. SUMMARY The use of systematic approaches that account for poor health literacy skills and include culturally and linguistically appropriate planning and availability of resources is warranted at individual and population health levels (e.g., human-centered design of patient portals).
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Affiliation(s)
- Gerardo Lazaro
- Division of Laboratory Systems, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Singh SP, Ramprasad A, Qureshi FM, Baig FA, Qureshi F. A Cross-Sectional Study of Graduate Medical Education in Radiological Fellowships using Accessible Content. Curr Probl Diagn Radiol 2023; 52:528-533. [PMID: 37246039 DOI: 10.1067/j.cpradiol.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/16/2023] [Accepted: 05/08/2023] [Indexed: 05/30/2023]
Abstract
Graduate medical education in radiology serves an imperative role in training the next generation of specialists. Given the regularity of virtual interviews, the website of a fellowship programs remains a critical first-line source of information of applicants. The aim of this study is to systematically evaluate 7 radiology fellowship programs utilizing a systematic process. A cross-sectional descriptive 286 graduate medical education fellowship programs in radiology were screened from the Fellowship and Residency Electronic Interactive Database (FREIDA). Extracted data was evaluated for comprehensiveness using 20 content criteria, and a readability score is calculated. The mean comprehensiveness among all fellowship program websites was 55.8% (n = 286), and the average FRE among the program overview sections was 11.9 (n = 214). ANOVA revealed no statistical significance in program website comprehensiveness between radiology fellowships (P = 0.33). The quality of a program's website data continues to serve an important role in an applicant's decision-making. Fellowship programs have improved in their content availability overtime, but content reevaluation needs to be continued for tangible improvement.
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Affiliation(s)
- Som P Singh
- University of Missouri Kansas City School of Medicine, Kansas City, MO..
| | - Aarya Ramprasad
- University of Missouri Kansas City School of Medicine, Kansas City, MO
| | - Fahad M Qureshi
- University of Missouri Kansas City School of Medicine, Kansas City, MO
| | - Farhan A Baig
- University of Missouri Kansas City School of Medicine, Kansas City, MO
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20
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Goodrum E, Johal A. The quality and reliability of the Internet as a source of information for hypodontia patients. J Orthod 2023; 50:268-275. [PMID: 36628988 DOI: 10.1177/14653125221145705] [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] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this study was to determine the quality, reliability and usability of information on the Internet regarding hypodontia. METHOD A survey of patients with hypodontia revealed seven key search terms favoured by patients: Hypodontia; Congenitally missing teeth; Missing teeth; Gaps in teeth; Cure of missing teeth; Information on missing teeth; and Treatment of missing teeth. These were entered into four search engines: Google; Ask; Wikipedia; and NHS Choices. Relevant websites were assessed for their overall demographics, author type, country of origin and rank within the search engine. They were then analysed using five validated assessment tools. Intra-examiner reliability was assessed, and statistical analysis of the data was undertaken. RESULTS Good intra-examiner reliability was observed. A total of 48 websites were included for analysis from an initial 1718. There was no relationship between the ranking of a website on a search engine and the quality of information it contained. When medical search terminology was used, it resulted in websites of better quality than layperson search terms. Most websites were produced by general dental or specialist dental practices but the quality of these was poorer than those developed by private companies and medical organisations. The country of origin was primarily the USA and UK; however, this had no relationship to website quality. Overall, the majority of websites scored poorly for the validated tools and none scored well across multiple tools. A statistical analysis showed a positive relationship between the LIDA and DISCERN instruments but no other correlation between other validated tools was found. CONCLUSION The quality and reliability of information on the Internet regarding hypodontia is generally poor. There is a need for a reliable online hypodontia resource that can be recommended for patient use.
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Affiliation(s)
- Emma Goodrum
- Oral Growth & Development (Orthodontics), Institute of Dentistry, Bart's and The London School of Medicine & Dentistry, Queen Mary College, London, UK
| | - Ama Johal
- Oral Growth & Development (Orthodontics), Institute of Dentistry, Bart's and The London School of Medicine & Dentistry, Queen Mary College, London, UK
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21
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Mehra M, Brody PA, Kollapaneni SS, Sakhalkar O, Rahimi S. Evaluating the Quality, Readability, and Activity of Online Information on Brain Arteriovenous Malformations. Cureus 2023; 15:e45984. [PMID: 37900528 PMCID: PMC10601510 DOI: 10.7759/cureus.45984] [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] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Brain arteriovenous malformations (AVMs) are vascular deformities created by improper connections between arteries and veins, most commonly in the brain and spinal cord. The management is complex and patient-dependent; further understanding of patient education activities is imperative. Internet access has become more ubiquitous, allowing patients to utilize a large database of medical information online. Using Google Trends (GT) (Google LLC, Mountain View, CA, USA), one can see the public interest in a particular topic over time. Further, when presented with numerous search results, patients may not be able to identify the highest-yielding resources, making objective measures of information quality and readability imperative. Methods A GT analysis was conducted for "hereditary hemorrhagic telangiectasia," "cerebral aneurysm," and "arteriovenous malformation". These relative search volumes (RSV) were compared with the 2017 to 2019 annual USA AVM diagnosis quantity for correlation. These RSVs were also compared with the 2017 to 2019 annual USA deaths due to cerebral hemorrhagic conditions. One search was conducted for "brain arteriovenous malformation". Since most users looking for health information online use only the first page of sources, the quality and readability analyses were limited to the first page of results on Google search. Five quality tools and six readability formulas were used. Results Pearson's correlation coefficients showed positive correlations between USA AVM RSVs and annual AVM deaths per capita from 2017 to 2019 (R2=0.932). The AVM annual diagnosis quantity and AVM RSVs showed a strong positive correlation as well (R2=0.998). Hereditary hemorrhagic telangiectasia and cerebral aneurysms had strong positive correlations between their RSVs and their corresponding annual diagnoses in the 2017 to 2019 time period (R2=0.982, R2=0.709). One-way ANOVA, for USA's 2004 to 2021 AVM RSVs and 2004 to 2019 deaths per capita, displayed no month-specific statistically significant repeating pattern (all p>0.483). The DISCERN tool had four websites that qualified as "poor" and five as "good." The average score for the tool was "good." The Journal of the American Medical Association (JAMA) benchmark scores were very low on average, as four websites achieved zero points. There was a wide variance in the currency, relevance, authority, accuracy, and purpose (CRAAP) scores, indicating an inconsistent level of webpage reliability across results. The patient education materials assessment tool (PEMAT) understandability (86.6%) showed much higher scores than the PEMAT actionability (54.6%). No readability score averaged at or below the American Medical Association (AMA)-recommended sixth-grade reading level. Conclusion These GT correlations may be due to patients and families with new diagnoses researching those same conditions online. The seasonality results reflect that no prior research has detected seasonality for AVM diagnosis or presentation. The quality study showed a wide variance in website ethics, treatment information quality, website/author qualifications, and actionable next steps regarding AVMs. Overall, this study showed that patients are routinely attempting to access information regarding these intracranial conditions, but the information available, specifically regarding AVMs, is not routinely reliable and the reading level required to understand them is too high.
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Affiliation(s)
- Mehul Mehra
- Neurological Surgery, Medical College of Georgia, Augusta University, Augusta, USA
| | - Pierce A Brody
- Neurological Surgery, Medical College of Georgia, Augusta University, Augusta, USA
| | | | - Om Sakhalkar
- Neurological Surgery, Medical College of Georgia, Augusta University, Augusta, USA
| | - Scott Rahimi
- Neurological Surgery, Medical College of Georgia, Augusta University, Augusta, USA
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Taylor F, Turner-Moore R, Pacey A, Jones G. Accessing publicly funded donor insemination treatment in the UK: is funding information available on fertility clinic websites? HUM FERTIL 2023; 26:512-518. [PMID: 37161825 DOI: 10.1080/14647273.2023.2202830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/24/2023] [Indexed: 05/11/2023]
Abstract
We sought to find out if information about public funding for regulated donor insemination (DI) was available on UK fertility clinic websites, and if so, what information was provided for same-sex couples and single women; and if the available information was easily readable. The 'Choose a fertility clinic' pages of the Human Fertilisation and Embryology Authority (HFEA) website were used to identify all licensed fertility clinics in the UK, and any available text on public funding for DI treatment was extracted. The Flesch reading ease scores were calculated to determine the readability of the extracted text. Of the 52 clinics included in the synthesis, 23 mentioned public funding, and for 16 of these, it was unclear whether public funding was available. Six of the 23 clinics mentioned public funding for same-sex couples, and two mentioned public funding for single women. The Flesch reading ease scores indicated that none of the text about funding for DI treatment on any of the clinic websites met the NHS-advised level of readability for health information. Fertility clinic websites should specify whether they offer publicly funded treatment, and to whom, as well as clearly stating the eligibility criteria, using suitably readable language to communicate this.
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Affiliation(s)
- Francesca Taylor
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - Rhys Turner-Moore
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - Allan Pacey
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Georgina Jones
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK
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23
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Boutemen L, Miller AN. Readability of publicly available mental health information: A systematic review. PATIENT EDUCATION AND COUNSELING 2023; 111:107682. [PMID: 36944285 DOI: 10.1016/j.pec.2023.107682] [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: 08/09/2022] [Revised: 02/06/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Relatively little research has examined the health literacy demand of public communication (e.g. websites, pamphlets, and posters) about mental disorders. This study describes characteristics of existing research and summarizes what is known about the readability of such information. METHODS A search of eight data bases yielded 33 studies that met inclusion criteria. Studies were screened for relevance at each stage and then coded for key characteristics and appraised for quality by both authors working independently. RESULTS Grade-level readability scores as measured by the Flesch-Kincaid, SMOG, and other indices ranged from 6th to 17th grade. Most Flesch Reading Ease scores fell within the 30-50 range. Results of accessibility measures were inconsistent. CONCLUSION With the recommended readability level for health communication set at sixth grade, most publicly available information about mental disorders uses vocabulary and sentence structure that is too complex for the general public. Mixed evidence indicated that accessibility issues are also problematic. PRACTICE IMPLICATIONS Developers of health information need to decrease health literacy demand in written mental health information to ensure patients and their families may benefit from this information.
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Affiliation(s)
- Laura Boutemen
- Nicholson School of Communication and Media, University of Central Florida, Orlando, FL, USA
| | - Ann Neville Miller
- Nicholson School of Communication and Media, University of Central Florida, Orlando, FL, USA.
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Dahm MR, Bull R, Sadow L, Tran D, Zurynski Y, Amin J, Hadley F, Harrison LJ, Waniganayake M, Wong S, Degotardi S. Readability and beyond - Health literacy and numeracy and COVID-19 communications in early childhood education: Are we communicating effectively? PATIENT EDUCATION AND COUNSELING 2023; 114:107823. [PMID: 37270932 PMCID: PMC10210820 DOI: 10.1016/j.pec.2023.107823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Analyse the linguistic and numerical complexity of COVID-19-related health information communicated from Australian national and state governments and health agencies to national and local early childhood education (ECE) settings. METHODS Publicly available health information (n = 630) was collected from Australian national and state governments and health agencies, and ECE agencies and service providers. A purposive sample of documents (n = 33) from 2020 to 2021 was analysed inductively and deductively combining readability, health numeracy and linguistic analyses and focusing on the most frequent actionable health advice topics. RESULTS COVID-19 health advice most frequently related to hygiene, distancing and exclusion. Readability scores in 79% (n = 23) of documents were above the recommended grade 6 reading level for the public. Advice was delivered using direct linguistic strategies (n = 288), indirect strategies (n = 73), and frequent mitigating hedges (n = 142). Most numerical concepts were relatively simple, but lacked elaborative features (e.g., analogies) and/or required subjective interpretation. CONCLUSION COVID-19 health advice available to the ECE sector included linguistic and numerical information open to mis/interpretation making it difficult to understand and implement. PRACTICE IMPLICATIONS Combining readability scores with measures of linguistic and numerical complexity offers a more holistic approach to assessing accessibility of health advice and improving health literacy among its recipients.
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Affiliation(s)
- Maria R Dahm
- Institute for Communication in Health Care, College of Arts and Social Science, Australian National University, Canberra, Australia.
| | - Rebecca Bull
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Lauren Sadow
- Institute for Communication in Health Care, College of Arts and Social Science, Australian National University, Canberra, Australia; Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Dung Tran
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Yvonne Zurynski
- Australian Institute of Health Innovation and the NHMRC Partnership Centre for Health System Sustainability, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Janaki Amin
- Department of Health Sciences, Macquarie University, Sydney, Australia
| | - Fay Hadley
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Linda J Harrison
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | | | - Sandie Wong
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Sheila Degotardi
- Macquarie School of Education, Macquarie University, Sydney, Australia
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25
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Bourdache LR, Ould Brahim L, Wasserman S, Nicolas-Joseph M, Frati FYE, Belzile E, Lambert SD. Evaluation of quality, readability, suitability, and usefulness of online resources available to cancer survivors. J Cancer Surviv 2023; 17:544-555. [PMID: 36626094 DOI: 10.1007/s11764-022-01318-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/08/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE The aim of this study was to evaluate the quality, readability, suitability, and usefulness of resources publicly available to adult cancer survivors (aged 18 +) who have completed primary treatment. METHODS Resources were identified in July 2021 through Google. Search completeness was verified using Yahoo, Bing, and MedlinePlus. Retrieved resources were assessed for quality using the DISCERN, readability, suitability using the Suitability Assessment Measure (SAM), and usefulness based on a list of unmet needs and self-management skills derived from the literature. Descriptive analyses were conducted, and a cluster analysis identified the highest-scoring resources. RESULTS Forty-five resources were included. The mean DISCERN score was fair at 63.3% (SD 13.7%) with low-rated items being sources, publication date, and risks and mechanisms of treatment. The mean reading grade level was 11.19 (SD 1.61, range 8-16) with only one resource scoring an 8. The mean SAM score was in the adequate range at 48.2% (SD 10.6%), with graphics being the lowest-rated section. On average, included resources addressed 57.7% (SD 27.3%) of the unmet needs and 48.4% (SD 20.9%) of the self-management skills, the least addressed being problem-solving. CONCLUSION Quality and suitability were fair, whereas readability exceeded recommended levels. Only one resource had a superior score in both quality and suitability. IMPLICATIONS FOR CANCER SURVIVORS The most pressing need is to develop resources for cancer survivors that address their unmet needs and are accessible in terms of literacy. Study findings outline the highest-scoring resources currently available to survivors, families, and clinicians.
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Affiliation(s)
- Lydia Rosa Bourdache
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de La Montagne, Montreal, QC, H3G 2M1, Canada
| | - Lydia Ould Brahim
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, QC, H3A 2M7, Canada
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Sydney Wasserman
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, QC, H3A 2M7, Canada
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Marrah Nicolas-Joseph
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, QC, H3A 2M7, Canada
| | - Francesca Y E Frati
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, 809 Sherbrooke West, QC, H3A 0C1, Montreal, Canada
| | - Eric Belzile
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, QC, H3A 2M7, Canada.
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada.
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Rouhi AD, Muhammad HA, Lee B, Eng OS. Improving online resources for cytoreductive surgery and HIPEC by engaging patients. J Surg Oncol 2023. [DOI: 10.1002/jso.27259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023]
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27
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Eckert C, Sanders M, Bharadwaj R, Fiscella KA. Accessibility of State and Territory Public Health Department Website Information on COVID-19 Outpatient Treatments in the US. JAMA Netw Open 2023; 6:e230186. [PMID: 36809472 PMCID: PMC9945065 DOI: 10.1001/jamanetworkopen.2023.0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/04/2023] [Indexed: 02/23/2023] Open
Abstract
This cross-sectional study assesses the reading level and accessibility of information on COVID-19 treatments posted on US public health websites for states, territories, and Washington, DC.
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Affiliation(s)
- Cody Eckert
- University of Rochester Medical Center, Rochester, New York
| | | | - Rhea Bharadwaj
- University of Rochester Medical Center, Rochester, New York
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28
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İzci EK, Keskin F. Evaluation of accuracy, reliability, quality, and readability of online patient information materials on coccyx injury. Medicine (Baltimore) 2023; 102:e32685. [PMID: 36701705 PMCID: PMC9857249 DOI: 10.1097/md.0000000000032685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The aim of this research is to evaluate the websites containing "coccydynia, coccyx trauma or fracture" in terms of readability, reliability, accuracy, and quality. Searches for "coccydynia, coccyx trauma, coccyx fracture" were carried out in the 3 most used search engines in the USA: Google, Yahoo, and Bing in February 2022. A total of 141 websites were rated by 2 different neurosurgeons for the "Global Quality Score" and "Alexa Popularity Rank." 97.2% of the sites examined include the definition of the disease, 66% include the importance of the disease, 92.9% include the symptoms of the disease, 88.7% include the treatment of the disease, 78% include the signs of the disease, 77.3% include the mechanism of the disease It has been determined that the websites examined within the scope of the research have high global quality score (GQS) and APR and are enriched with images to a large extent.
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Affiliation(s)
- Emir Kaan İzci
- Neurosurgery Department, Konya City Hospital, Konya, Turkey
- *Correspondence: Emir Kaan Izci, Neurosurgery Department, Konya City Hospital, Akabe District, Adana Str, No:135/1, 42020 Karatay/Konya, Turkey (e-mail: )
| | - Fatih Keskin
- Neurosurgery Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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Barrett DR, Boone JD, Butch JO, Cavender JA, Sole G, Wassinger CA. A critical appraisal of web-based information on shoulder pain comparing biomedical vs. psychosocial information. J Shoulder Elbow Surg 2023; 32:e23-e32. [PMID: 36108880 DOI: 10.1016/j.jse.2022.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/12/2022] [Accepted: 07/17/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Websites have become a primary way for patients to access health-related information, which allows patients to not only understand their condition better but also to engage in better decision making with their health care provider. However, this can be a double-edged sword, as information patients access may not be of high quality, easily readable, or could be biased based on website authorship. This study examines the readability and content quality of common websites about shoulder pain, with a specific focus on biomedical vs. psychosocial information. METHODS The Flesch reading-ease score (FRES) and Flesch-Kincaid grade level (FKGL) instruments were used to assess website readability. Health on the net code of conduct (HONcode) certification and the DISCERN tool were used to evaluate the reliability and quality of information. Lastly, shoulder-specific content quality and focus was gauged using a Shoulder-specific Website Appraisal Tool (SWAT) created for this study. A systematic search protocol was used to identify popular shoulder injury websites. The websites were identified using 5 search terms (shoulder pain, shoulder muscle pain, shoulder impingement, shoulder rotator cuff pain, and shoulder pain diagnosis) across 5 English-speaking regions (United States, Canada, United Kingdom, Australia, and New Zealand) using the Google search engine. The top 10 websites for each term and region combination were included and combined, yielding 41 original websites for appraisal; several (6) websites were omitted as duplicates, behind paywalls, or nontext (video) for a total of 35 websites appraised. RESULTS On average, the FRES shoulder pain websites readability was 55.37, which is categorized as "fairly difficult" to read, and a seventh- or eighth-grade reading level based on the FKGL. For trustworthiness and bias, 57% (20 of 35) of the websites were HONcode certified. The quality of health care information using the DISCERN score averaged 50.92%. Examining shoulder-specific content quality, the average SWAT score was 10.54 out of 14 possible points, with only 1 website reporting information on psychosocial aspects of shoulder pain. CONCLUSIONS This study suggests that shoulder pain websites present information that is at too high of a reading level for public consumption, has a strong bias toward biomedical causes of shoulder pain, and would benefit from implementation of website screening tools to improve evidence-based content.
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Affiliation(s)
- Dustin R Barrett
- Emory and Henry College Physical Therapy Department, Emory, VA, USA
| | - James D Boone
- East Tennessee State University Physical Therapy Department, Johnson City, TN, USA
| | - Jacqueline O Butch
- East Tennessee State University Physical Therapy Department, Johnson City, TN, USA
| | - Jeanie A Cavender
- East Tennessee State University Physical Therapy Department, Johnson City, TN, USA
| | - Gisela Sole
- University of Otago School of Physiotherapy, Dunedin North, Dunedin, New Zealand
| | - Craig A Wassinger
- Tufts University School of Medicine Physical Therapy Department, Boston, MA, USA.
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Płaciszewski K, Wierzba W, Ostrowski J, Pinkas J, Jankowski M. Use of the Internet for Health Purposes-A National Web-Based Cross-Sectional Survey among Adults in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16315. [PMID: 36498389 PMCID: PMC9736358 DOI: 10.3390/ijerph192316315] [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: 10/29/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
The Internet is one of the most popular information sources. This study aimed to assess the public attitudes towards the use of the Internet for health purposes as well as to identify factors associated with the use of the Internet for health purposes among adults in Poland. A web-based cross-sectional survey was carried out between 9 and 12 September 2022 on a nationwide random-quota sample of 1092 adults in Poland. The study questionnaire included 10 questions on Internet use for health purposes. The most common reason for the use of the Internet for health purposes was searching for information on drugs and their effects (69.9%). Almost two-thirds of participants used the Internet for searching for health information (64.9%), for doctors/medical services (63.4%), or for medical facilities (65.3%). Over half of the participants used the Internet for checking online reviews of doctors (55.2%) and 43.5% of the participants ordered drugs or dietary supplements online. Out of 9 different socioeconomic factors analyzed in this study, having higher education, being female, as well as living in cities from 100,000 to 499,999 residents were the most important factors (p < 0.05) associated with the use of the Internet for health purposes. This study confirmed a high level of adoption of medical Internet in Poland.
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Affiliation(s)
- Krzysztof Płaciszewski
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland
| | - Waldemar Wierzba
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland
| | - Janusz Ostrowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
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Agbonlahor O, Vincent K, Wood L, Tomlinson M, Kerstiens S, Clarke J, McLeish A, Walker K, Hart J. Readability of online information on nature and mental
health. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/156429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Sheldon EM, Lillington G, Simpson K, Gibson K, Chambers L, D'Afflitto M, Greig N, Stearn T, Hind D, Ainley R, Winsor G, Ridsdale K, Totton N, Lobo A. Development of an inflammatory bowel disease (IBD) Patient-Reported Experience Measure (PREM): A patient-led consensus work and 'think aloud' study for a quality improvement programme. Health Expect 2022; 26:213-225. [PMID: 36335578 PMCID: PMC9854292 DOI: 10.1111/hex.13647] [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: 05/26/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Patient-Reported Experience Measures (PREMs) are key in improving healthcare quality, but no PREM exists for inflammatory bowel disease (IBD). This study aimed to co-produce a PREM with IBD service users for IBD service evaluation and quality improvement programme. METHODS A pool of 75 items was drawn from published survey instruments covering interactions with services and aspects of living with IBD. In Stage 1, during two workshops, eight expert service users reduced candidate items through a ranked-choice voting exercise and suggested further items. During Stage 2, 18 previously uninvolved people with IBD assessed the face and content validity of the candidate items in 'Think Aloud' interviews. During two final workshops (Stage 3), the expert service users removed, modified and added items based on the interview findings to produce a final version of the PREM. RESULTS Stage 1 generated a draft working PREM mapped to the following four domains: Patient-Centred Care; Quality; Accessibility; Communication and Involvement. The PREM included a set of nine items created by the expert group which shifted the emphasis from 'self-management' to 'living with IBD'. Stage 2 interviews showed that comprehension of the PREM was very good, although there were concerns about the wording, IBD-relevance and ambiguity of some items. During the final two workshops in Stage 3, the expert service users removed 7 items, modified 15 items and added seven new ones based on the interview findings, resulting in a 38-item PREM. CONCLUSIONS This study demonstrates how extensive service user involvement can inform PREM development. PATIENT OR PUBLIC CONTRIBUTION Patients were involved as active members of the research team and as research participants to co-produce and validate a PREM for IBD services. In Stage 1, eight expert service users ('the expert group') reduced candidate items for the PREM through a voting exercise and suggested new items. During Stage 2, 18 previously uninvolved people with IBD (the 'think aloud' participants) assessed the validity of the candidate items in 'Think Aloud' interviews as research participants. In Stage 3, the expert group removed, changed and added items based on the interview findings to produce a final version of the 38-item PREM. This study shows how service user involvement can meaningfully inform PREM development.
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Affiliation(s)
- Elena M. Sheldon
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - George Lillington
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Kati Simpson
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Kirsty Gibson
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Lucy Chambers
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | | | - Nancy Greig
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Theresa Stearn
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Daniel Hind
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | | | | | - Katie Ridsdale
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Nikki Totton
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Alan Lobo
- Gastroenterology and Liver Unit, Royal Hallamshire HospitalSheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
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Hemaya M, Hemaya M, Habeeb A. The Risks Associated With Computed Tomography Scans: An Assessment of the Readability and Reliability of Online Text Available for Patient Information and Guidance. Cureus 2022; 14:e30758. [DOI: 10.7759/cureus.30758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/07/2022] Open
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Alghanemi L, Sanad SA, Alzahrani FS, Hussien EA, Safi AA, Kokandi AA. The Evaluation of the Informational Content, Readability, and Quality of Online Information Related to Vitiligo in the Arabic Language. Cureus 2022; 14:e30497. [DOI: 10.7759/cureus.30497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
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Atherton K, Forshaw MJ, Kidd TM. Readability of online health information pertaining to migraine and headache in the UK. Br J Pain 2022; 17:117-125. [PMID: 37057254 PMCID: PMC10088424 DOI: 10.1177/20494637221134461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
An estimated 46% of the worldwide adult population live with an active headache disorder, and it is thought that there is a proportion of headache and migraine sufferers who do not attend for medical care, instead choosing to manage their symptoms at home. The internet continues to act as a source of online health information for self-management, however, it is important that this information can be understood by the user. Research indicates that most health information online is written at a level too difficult for much of the UK population to understand. The aim of this study was to investigate the readability of online health information pertaining to headache and migraine for a UK-based internet user accessing the top four search engines. Searches for ‘headache’ and ‘migraine’ were performed on each search engine and results from the first page were selected for analysis. Five validated readability tests were used to analyse readability; Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning Fog Index, Coleman-Liau Index and Simple Measure of Gobbledygook Index. We found that the majority of online health information about migraine and headache is too difficult for the UK adult population to read. Findings highlight work is required to ensure that information from a wider variety of sources is easier to comprehend for much of the population in order for individuals to make informed decisions about health seeking and self-management of headache and migraine. Health information providers should weave readability analysis into their content design process, incorporating shorter sentences and simpler words in their description of conditions and treatment.
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Affiliation(s)
- Kate Atherton
- School of Psychology, Liverpool John Moores University, UK
| | | | - Tara M. Kidd
- School of Psychology, Liverpool John Moores University, UK
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Stern J, Georgsson S, Carlsson T. Quality of web-based information about the coronavirus disease 2019: a rapid systematic review of infodemiology studies published during the first year of the pandemic. BMC Public Health 2022; 22:1734. [PMID: 36096783 PMCID: PMC9467667 DOI: 10.1186/s12889-022-14086-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Following the outbreak of the coronavirus disease 2019, adequate public information was of outmost importance. The public used the Web extensively to read information about the pandemic, which placed significant responsibility in, for many, an unfamiliar situation as the disease spread across the globe. The aim of this review was to synthesize the quality of web-based information concerning the coronavirus disease 2019 published during the first year of the pandemic. MATERIALS AND METHODS A rapid systematic review was undertaken by searching five electronic databases (CINAHL, Communication & Mass Media Complete, PsycINFO, PubMed, Scopus). Empirical infodemiology reports assessing quality of information were included (n = 22). Methodological quality and risk of bias was appraised with tools modified from previous research, while quality assessment scores were synthesized with descriptive statistics. Topics illustrating comprehensiveness were categorized with content analysis. RESULTS The included reports assessed text-based content (n = 13) and videos (n = 9). Most were rated good overall methodological quality (n = 17). In total, the reports evaluated 2,654 websites or videos and utilized 46 assessors. The majority of the reports concluded that websites and videos had poor quality (n = 20). Collectively, readability levels exceeded the recommended sixth grade level. There were large variations in ranges of the reported mean or median quality scores, with 13 of 15 total sample scores being classified as poor or moderate quality. Four studies reported that ≥ 28% of websites contained inaccurate statements. There were large variations in prevalence for the six categories illustrating comprehensiveness. CONCLUSION The results highlight quality deficits of web-based information about COVID-19 published during the first year of the pandemic, suggesting a high probability that this hindered the general population from being adequately informed when faced with the new and unfamiliar situation. Future research should address the highlighted quality deficits, identify methods that aid citizens in their information retrieval, and identify interventions that aim to improve the quality of information in the online landscape.
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Affiliation(s)
- Jenny Stern
- Department of Women's and Children's Health, Uppsala University, MTC-huset, Dag Hammarskjölds väg 14B, 1 tr, SE-75237, Uppsala, Sweden
- Sophiahemmet University, Stockholm, Sweden
| | - Susanne Georgsson
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
- The Swedish Red Cross University, Huddinge, Sweden
| | - Tommy Carlsson
- Department of Women's and Children's Health, Uppsala University, MTC-huset, Dag Hammarskjölds väg 14B, 1 tr, SE-75237, Uppsala, Sweden.
- The Swedish Red Cross University, Huddinge, Sweden.
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Özduran E, Hanci V. Evaluating the readability, quality and reliability of online information on Behçet’s disease. Reumatismo 2022; 74. [DOI: 10.4081/reumatismo.2022.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
There are concerns over the reliability and comprehensibility of health-related information on the internet. The goal of our research was to analyze the readability, reliability, and quality of information obtained from websites associated with Behçet’s disease (BD). On September 20, 2021, the term BD was used to perform a search on Google, and 100 eligible websites were identified. The Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog (GFOG) were used to evaluate the readability of the website. The JAMA score was used to assess the websites’ reliability, the DISCERN score and the Health on the Net Foundation code of conduct (HONcode) were used to assess quality, and Alexa was used to analyze their popularity. Sections of the text were evaluated, and the results revealed that the mean FRES was 35.49±14.42 (difficult) and the mean GFOG was 14.93±3.13 years (very difficult). According to the JAMA scores, 36% of the websites had a high reliability rating and 20% adhered to the HONcode. The readability was found to significantly differ from the reliability of the websites (p<0.05). Moreover, websites with scientific content were found to have higher readability and reliability (p<0.05). The readability of BD-related information on the Internet was found to be considerably higher than that recommended by the National Health Institute’s Grade 6, with moderate reliability and good quality. We believe that online information should have some level of readability and must have reliable content that is appropriate to educate the public, particularly for websites that provide with patient education material.
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Ozduran E, Büyükçoban S. Evaluating the readability, quality and reliability of online patient education materials on post-covid pain. PeerJ 2022; 10:e13686. [PMID: 35880220 PMCID: PMC9308460 DOI: 10.7717/peerj.13686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/15/2022] [Indexed: 01/17/2023] Open
Abstract
Background The use of the Internet to access healthcare-related information is increasing day by day. However, there are concerns regarding the reliability and comprehensibility of this information. This study aimed to investigate the readability, reliability, and quality of Internet-based patient educational materials (PEM) related to "post-COVID-19 pain." Methods One-hundred websites that fit the purposes of the study were identified by searching for the terms "post-COVID-19 pain" and "pain after COVID-19" using the Google search engine on February 24, 2022. The website readability was assessed using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning FOG (GFOG). The reliability, quality, and popularity of the websites were assessed using the JAMA score, DISCERN score/Health on the Net Foundation code of conduct, and Alexa, respectively. Results Upon investigation of the textual contents, the mean FRES was 51.40 ± 10.65 (difficult), the mean FKGL and SMOG were 10.93 ± 2.17 and 9.83 ± 1.66 years, respectively, and the mean GFOG was 13.14 ± 2.16 (very difficult). Furthermore, 24.5% of the websites were highly reliable according to JAMA scores, 8% were of high quality according to GQS values, and 10% were HONcode-compliant. There was a statistically significant difference between the website types and reliability (p = 0.003) and quality scores (p = 0.002). Conclusion The readability level of PEM on post-COVID-19 pain was considerably higher than grade 6 educational level, as recommended by the National Institutes of Health, and had low reliability and poor quality. We suggest that Internet-based PEM should have a certain degree of readability that is in accordance with the educational level of the general public and feature reliable content.
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Affiliation(s)
- Erkan Ozduran
- Department of Physical Medicine and Rehabilitation, Algology, Dokuz Eylül University, Izmir, Turkey
| | - Sibel Büyükçoban
- Department of Anesthesiology and Reanimation, Dokuz Eylül University, Izmir, Turkey
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Wood LA, Agbonlahor O, Tomlinson MM, Kerstiens S, Vincent K, McLeish AC, Walker KL, Hart JL. Readability of online e-cigarette cessation information. Tob Induc Dis 2022; 20:53. [PMID: 35795399 PMCID: PMC9175538 DOI: 10.18332/tid/149906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/08/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Given the growing awareness of the health risks associated with e-cigarettes, many users will access information about how to effectively quit using e-cigarettes, and the internet likely will be a popular source of information. However, little is known about the readability of online e-cigarette cessation information. Therefore, the goal of the current study was to assess the readability of webpage information about e-cigarette cessation. METHODS A search of webpages was conducted using the following search terms: vaping addiction, quit vaping, quit Juul, stop vaping, stop Juul, and vaping cessation. The 464 webpages identified were coded for target audience, message valence, and source, and then assessed for reading level with the Flesch-Kincaid Grade Level assessment. RESULTS On average, webpage content was written at a 7th grade reading level (Flesch-Kincaid Grade Level Mean=7.34, SD=2.22) and less than 25% of webpages met readability guidelines (i.e. ≤6th grade reading level). There were no differences in readability by target audience, message valence, or webpage source. CONCLUSIONS The results suggest that most online content related to e-cigarette cessation is not written at a level that is easily understood by general audiences. Thus, tobacco control advocates should assess the reading level of their messaging to ensure wide accessibility of information.
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Affiliation(s)
- Lindsey A Wood
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Osayande Agbonlahor
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Madeline M Tomlinson
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Savanna Kerstiens
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Kolbie Vincent
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Alison C McLeish
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,Department of Psychological and Brain Sciences, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
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Leroy G, Kauchak D, Haeger D, Spegman D. Evaluation of an online text simplification editor using manual and automated metrics for perceived and actual text difficulty. JAMIA Open 2022; 5:ooac044. [PMID: 35663117 PMCID: PMC9155254 DOI: 10.1093/jamiaopen/ooac044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/22/2022] [Accepted: 05/23/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Simplifying healthcare text to improve understanding is difficult but critical to improve health literacy. Unfortunately, few tools exist that have been shown objectively to improve text and understanding. We developed an online editor that integrates simplification algorithms that suggest concrete simplifications, all of which have been shown individually to affect text difficulty. Materials and Methods The editor was used by a health educator at a local community health center to simplify 4 texts. A controlled experiment was conducted with community center members to measure perceived and actual difficulty of the original and simplified texts. Perceived difficulty was measured using a Likert scale; actual difficulty with multiple-choice questions and with free recall of information evaluated by the educator and 2 sets of automated metrics. Results The results show that perceived difficulty improved with simplification. Several multiple-choice questions, measuring actual difficulty, were answered more correctly with the simplified text. Free recall of information showed no improvement based on the educator evaluation but was better for simplified texts when measured with automated metrics. Two follow-up analyses showed that self-reported education level and the amount of English spoken at home positively correlated with question accuracy for original texts and the effect disappears with simplified text. Discussion Simplifying text is difficult and the results are subtle. However, using a variety of different metrics helps quantify the effects of changes. Conclusion Text simplification can be supported by algorithmic tools. Without requiring tool training or linguistic knowledge, our simplification editor helped simplify healthcare related texts.
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Affiliation(s)
- Gondy Leroy
- Management Information Systems, Eller College of Management, University of Arizona, Tucson, Arizona, USA
| | - David Kauchak
- Computer Science, Pomona College, Claremont, California, USA
| | - Diane Haeger
- El Rio Community Health Center, Tucson, Arizona, USA
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Jawad D, Cheng H, Wen LM, Rissel C, Baur L, Mihrshahi S, Taki S. Interactivity, Quality, and Content of Websites Promoting Health Behaviours during Infancy: A six-year update of the Systematic Assessment (Preprint). J Med Internet Res 2022; 24:e38641. [DOI: 10.2196/38641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/03/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
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Dowdle TS, Nguyen JM, Steadman JN, Layher H, Sturgeon ALE, Akin R. Online Readability Analysis: Mohs Micrographic Surgery Postsurgical Wound Care. Adv Skin Wound Care 2022; 35:213-218. [PMID: 35026774 DOI: 10.1097/01.asw.0000816960.79821.e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although various treatment modalities exist for skin cancer care, Mohs micrographic surgery (MMS) is one of the most effective and cosmetically sensitive surgical techniques. The readability of online informational materials specifically related to MMS postsurgical wound care is extremely relevant for patients given the high rates of skin cancer in the US and the number of patients utilizing the internet for information. METHODS Investigators conducted Google searches to evaluate the current state of readability on MMS postsurgical wound care using the specific keywords "healing after Mohs surgery" and "wound care Mohs surgery." The readabilities of individual websites were analyzed using the WebFX online software. Health-specific click-through rate was used to select the number of samples assessed. RESULTS Based on the 33 unique websites evaluated, the aggregate readability of online MMS postsurgical wound care materials was 11.3, corresponding to an 11th-grade reading level by US standards. CONCLUSIONS Although this level of readability is an improvement in online MMS postsurgical wound care information relative to prior literature, there is still considerable work to be done by the dermatologic community in improving the readability of online patient materials regarding MMS.
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Affiliation(s)
- Travis S Dowdle
- Travis S. Dowdle, BS, is Medical Student, Texas Tech University Health Sciences Center, School of Medicine, Lubbock, Texas, United States. Jeannie M. Nguyen, MD, is Dermatology Resident, Texas Tech University Health Sciences Center. Jesse N. Steadman, BS, is Medical Student, University of Utah, School of Medicine, Salt Lake City. At the Texas Tech University Health Sciences Center, Heather Layher, DO, is Mohs Fellow; Ashley L. E. Sturgeon, MD, is Mohs Fellow and Professor; and Russell Akin, MD, is Mohs Fellow and Professor
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Man A, van Ballegooie C. Assessment of the Readability of Web-Based Patient Education Material From Major Canadian Pediatric Associations: Cross-sectional Study. JMIR Pediatr Parent 2022; 5:e31820. [PMID: 35293875 PMCID: PMC8968558 DOI: 10.2196/31820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Web-based patient education materials (PEMs) are frequently written above the recommended reading level in North America. Poor PEM readability limits the accessibility of medical information for individuals with average literacy levels or lower. Pediatric hospital and association websites have not only been shown to be a preferred source of information among caregivers but have also become a necessity during the COVID-19 pandemic. The readability of Canadian pediatric association websites has not yet been assessed. OBJECTIVE The aim of this study is to determine if the content of PEMs from Canadian pediatric associations is written at a reading level that the majority of Canadians can understand. METHODS A total of 258 PEMs were extracted from 10 Canadian pediatric associations and evaluated for their reading level using 10 validated readability scales. The PEMs underwent a difficult word analysis and comparisons between PEMs from different associations were conducted. RESULTS Web-based PEMs were identified from 3 pediatric association websites, where the reading level (calculated as a grade level) was found to be an average of 8.8 (SD 1.8) for the Caring for Kids website, 9.5 (SD 2.2) for the Pediatric Endocrine Group website, and 13.1 (SD 2.1) for the Atlantic Pediatric Society website. The difficult word analysis identified that 19.9% (SD 6.6%) of words were unfamiliar, with 13.3% (SD 5.3%) and 31.9% (SD 6.1%) of words being considered complex (≥3 syllables) and long (≥6 letters), respectively. CONCLUSIONS The web-based PEMs were found to be written above the recommended seventh-grade reading level for Canadians. Consideration should be made to create PEMs at an appropriate reading level for both patients and their caregivers to encourage health literacy and ultimately promote preventative health behaviors and improve child health outcomes.
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Affiliation(s)
- Alice Man
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Courtney van Ballegooie
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Experimental Therapeutics, British Columbia Cancer Research Institute, Vancouver, BC, Canada
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Martin CA, Khan S, Lee R, Do A, Sridhar J, Crowell E, Bowden E. Readability and Suitability of Online Glaucoma Patient Education Materials. Ophthalmol Glaucoma 2022; 5:525-530. [PMID: 35301989 DOI: 10.1016/j.ogla.2022.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the quality, content, readability, and accountability of information found online for glaucoma. DESIGN Cross-sectional study. PARTICIPANTS 13 websites containing glaucoma patient education materials were analyzed for this study. METHODS An online Google search was conducted using the keyword glaucoma. 13 medical website results were selected for analysis. Each website was assessed by three independent reviewers for suitability, readability, and accountability. The standardized Suitability Assessment of Materials (SAM) tool was used to evaluate the quality and content of information on each website. The Flesch reading ease (FRE), Flesch-Kincaid Grade Level (FKGL), Coleman-Liau Index (CLI), Simple Measure of Gobbledygook Index (SMOG), Automated Readability Index (ARI), and Linsear Write Formula (LWF) scores were used to assess readability of the websites. The Journal of the American Medical Association (JAMA) Accountability Benchmarks were used to evaluate each website's accountability. MAIN OUTCOME MEASURES SAM score, FRE, FKGL, CLI, SMOG, ARI, LWF scores, and JAMA Accountability Benchmarks. RESULTS The average SAM score for all the websites included in this study was 18 points out of a possible 34 points. Eyewiki.org was the lowest scoring website (11.7 ± 0.6 points), while aao.org and nei.nih.gov were the highest scoring websites (26.0 ± 1.0 points and 26.0 ± 2.6 points, respectively). Three content graders in this study were in moderate agreement (kappa statistic = 0.59). The average Flesch Reading Ease (FRE) scores among all websites was 47.0 (95% confidence interval (CI), 39.3 - 54.7). The average reading grade score among all websites was 11.2 (95% CI, 10.0 - 12.4). Two of the thirteen websites (15.4%) satisfied all 4 JAMA accountability criteria. CONCLUSIONS There is significant variation in the content and quality of freely available online glaucoma education material. The material is generally either not suitable or only adequate for use. Most websites reviewed are written at a reading grade level higher than that recommended for patient education materials.
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Affiliation(s)
- Cole A Martin
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Saima Khan
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Rachel Lee
- New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Anna Do
- Eye Care of San Diego, San Diego, CA, USA
| | - Jayanth Sridhar
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eric Crowell
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | - Eileen Bowden
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin, Austin, TX, USA.
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Moon H, Lee GH, Cho YJ. Readability of Korean-Language COVID-19 Information from the South Korean National COVID-19 Portal Intended for the General Public: Cross-sectional Infodemiology Study. JMIR Form Res 2022; 6:e30085. [PMID: 35072633 PMCID: PMC8896563 DOI: 10.2196/30085] [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: 04/30/2021] [Revised: 06/01/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The coronavirus pandemic has increased reliance on the internet as a tool for disseminating information; however, information is useful only when it can be understood. Prior research has shown that web-based health information is not always easy to understand. It is not yet known whether the Korean-language COVID-19 information from the internet is easy for the general public to understand. OBJECTIVE We aimed to evaluate the readability of Korean-language COVID-19 information intended for the general public from the national COVID-19 portal of South Korea. METHODS A total of 122 publicly available COVID-19 information documents written in Korean were obtained from the South Korean national COVID-19 portal. We determined the level of readability (at or below ninth grade, 10th to 12th grade, college, or professional) of each document using a readability tool for Korean-language text. We measured the reading time, character count, word count, sentence count, and paragraph count for each document. We also evaluated the characteristics of difficult-to-read documents to modify the readability from difficult to easy. RESULTS The median readability level was at a professional level; 90.2% (110/122) of the information was difficult to read. In all 4 topics, few documents were easy to read (overview: 5/12, 41.7%; prevention: 6/97, 6.2%; test: 0/5, 0%; treatment: 1/8, 12.5%; P=.006), with a median 11th-grade readability level for overview, a median professional readability level for prevention, and median college readability levels for test and treatment. Difficult-to-read information had the following characteristics in common: literacy style, medical jargon, and unnecessary detail. CONCLUSIONS In all 4 topics, most of the Korean-language COVID-19 web-based information intended for the general public provided by the national COVID-19 portal of South Korea was difficult to read; the median readability levels exceeded the recommended ninth-grade level. Readability should be a key consideration in developing public health documents, which play an important role in disease prevention and health promotion.
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Affiliation(s)
- Hana Moon
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Geon Ho Lee
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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Bachu VS, Mahjoub H, Holler AE, Crihalmeanu T, Bachu DM, Ayyaswami V, Parker PD, Prabhu AV. Assessing COVID-19 Health Information on Google Using the Quality Evaluation Scoring Tool (QUEST): Cross-sectional and Readability Analysis. JMIR Form Res 2022; 6:e32443. [PMID: 34995206 PMCID: PMC8843082 DOI: 10.2196/32443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/31/2021] [Accepted: 01/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic spurred an increase in online information regarding disease spread and symptomatology. OBJECTIVE Our purpose is to systematically assess the quality and readability of articles resulting from frequently Google-searched COVID-19 terms in the United States. METHODS We used Google Trends to determine the 25 most commonly searched health-related phrases between February 29 and April 30, 2020. The first 30 search results for each term were collected, and articles were analyzed using the Quality Evaluation Scoring Tool (QUEST). Three raters scored each article in authorship, attribution, conflict of interest, currency, complementarity, and tone. A readability analysis was conducted. RESULTS Exactly 709 articles were screened, and 195 fulfilled inclusion criteria. The mean article score was 18.4 (SD 2.6) of 28, with 7% (14/189) scoring in the top quartile. National news outlets published the largest share (70/189, 36%) of articles. Peer-reviewed journals attained the highest average QUEST score compared to national/regional news outlets, national/state government sites, and global health organizations (all P<.05). The average reading level was 11.7 (SD 1.9, range 5.4-16.9). Only 3 (1.6%) articles were written at the recommended sixth grade level. CONCLUSIONS COVID-19-related articles are vastly varied in their attributes and levels of bias, and would benefit from revisions for increased readability.
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Affiliation(s)
- Vismaya S Bachu
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Heba Mahjoub
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Albert E Holler
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Tudor Crihalmeanu
- School of Medicine, West Virginia University, Morgantown, WV, United States
| | - Dheevena M Bachu
- Department of Neuroscience, University of Colorado, Boulder, CO, United States
| | - Varun Ayyaswami
- Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Pearman D Parker
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Arpan V Prabhu
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Winthrop P Rockefeller Cancer Institute, Little Rock, AR, United States
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D'Souza RS, Daraz L, Hooten WM, Guyatt G, Murad MH. Users' Guides to the Medical Literature series on social media (part 1): how to interpret healthcare information available on platforms. BMJ Evid Based Med 2022; 27:11-14. [PMID: 34933925 DOI: 10.1136/bmjebm-2021-111817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 01/21/2023]
Affiliation(s)
- Ryan S D'Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, Minnesota, USA
| | - Lubna Daraz
- School of Library and Information Science, University of Montreal, Montreal, Quebec, Canada
| | - W Michael Hooten
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, Minnesota, USA
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| | - Mohammad Hassan Murad
- Kern Center for the Science of Healthcare Delivery, Mayo Clinic Hospital, Rochester, Minnesota, USA
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Xu Z, Lin CA, Laffidy M, Fowks L. Perpetuating Health Disparities of Minority Groups: The Role of U.S. Newspapers in the COVID-19 Pandemic. RACE AND SOCIAL PROBLEMS 2022; 14:357-368. [PMID: 35079295 PMCID: PMC8777407 DOI: 10.1007/s12552-021-09354-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 06/13/2023]
Abstract
During the COVID-19 pandemic, news media are expected to play a critical role in reducing health disparities. However, we know little about whether and how disparities in COVID-19 have been covered in national and local U.S. newspapers. This study examined whether minority health gained news attention and whether partisan bias affected related coverage in the early stages of the pandemic. Results indicate that minority groups have been underrepresented in COVID-19 news articles. Left-leaning newspapers were more likely to discuss minorities in COVID-19 news than least biased media. Left-leaning and right-leaning newspapers did not differ in the number of articles mentioning racial/ethnic minorities. COVID-19 news exceeded the average U.S. reading comprehension level and require some college education to understand but did not differ in readability levels among partisan newspapers. Left-leaning newspapers used significantly more medical terms and affiliated scientific facts to describe COVID-19 than right-leaning newspapers. Implications include avoiding potential failures in informing the public (especially the racial/ethnic minorities) essential scientific facts about disease prevention and increasing public trust in health news coverage.
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Affiliation(s)
- Zhan Xu
- School of Communication, Northern Arizona University, 700 S. Knoles Dr, Flagstaff, AZ 86011 USA
| | | | - Mary Laffidy
- University of Illinois at Urbana-Champaign, Champaign, IL USA
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49
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Wang X, Chao F, Yu G, Zhang K. Factors influencing fake news rebuttal acceptance during the COVID-19 pandemic and the moderating effect of cognitive ability. COMPUTERS IN HUMAN BEHAVIOR 2022; 130:107174. [PMID: 35002055 PMCID: PMC8719053 DOI: 10.1016/j.chb.2021.107174] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 12/23/2021] [Accepted: 12/29/2021] [Indexed: 11/30/2022]
Abstract
Fake news is spreading rapidly on social media and poses a serious threat to the COVID-19 outbreak response. This study thus aims to reveal the factors influencing the acceptance of fake news rebuttals on Sina Weibo. Drawing on the elaboration likelihood model (ELM), we used text mining and the econometrics method to investigate the relationships among the central route (rebuttal's information readability and argument quality), peripheral route (rebuttal's source credibility, including authority and influence), and rebuttal acceptance, as well as the moderating effect of receiver's cognitive ability on these relationships. Our findings suggest that source authority had a negative effect on rebuttal acceptance, while source influence had a positive effect. Second, both information readability and argument quality had positive effects on rebuttal acceptance. In addition, individuals with low cognitive abilities relied more on source credibility and argument quality to accept rebuttals, while individuals with high cognitive abilities relied more on information readability. This study can provide decision support for practitioners to establish more effective fake news rebuttal strategies; it is especially valuable to reduce the negative impact of fake news related to major public health emergencies and safeguard the implementation of anti-epidemic strategies.
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Affiliation(s)
- Xin Wang
- School of Management, Harbin Institute of Technology, Harbin, China
| | - Fan Chao
- School of Management, Harbin Institute of Technology, Harbin, China
| | - Guang Yu
- School of Management, Harbin Institute of Technology, Harbin, China
| | - Kaihang Zhang
- School of Management, Harbin Institute of Technology, Harbin, China
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50
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Ozduran E, Hanci V. Evaluating the readability, quality, and reliability of online information on sjogren's syndrome. INDIAN JOURNAL OF RHEUMATOLOGY 2022. [DOI: 10.4103/injr.injr_56_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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