Evaluating breast cancer websites targeting Arabic speakers: empirical investigation of popularity, availability, accessibility, readability, and quality

Assessing parental comprehension of online resources on childhood pain

We aimed to examine the patient education materials (PEMs) on the internet about "Child Pain" in terms of readability, reliability, quality and content. For our observational study, a search was made on February 28, 2024, using the keywords "Child Pain," "Pediatric Pain," and "Children Pain" in the Google search engine. The readability of PEMs was assessed using computer-based readability formulas (Flesch Reading Ease Score [FRES], Flesch-Kincaid Grade Level [FKGL], Automated readability index (ARI), Gunning Fog [GFOG], Coleman-Liau score [CL], Linsear Write [LW], Simple Measure of Gobbledygook [SMOG]). The reliability and quality of websites were determined using the Journal of American Medical Association (JAMA) score, Global Quality Score (GQS), and DISCERN score. 96 PEM websites included in our study. We determined that the FRES was 64 (32-84), the FKGL was 8.24 (4.01-15.19), ARI was 8.95 (4.67-17.38), GFOG was 11 (7.1-19.2), CL was 10.1 (6.95-15.64), LW was 8.08 (3.94-19.0) and SMOG was 8.1 (4.98-13.93). The scores of readability formulas showed that, the readability level of PEMs was statistically higher than sixth-grade level with all formulas (P = .011 for FRES, P < .001 for GFOG, P < .001 for ARI, P < .001 for FKGL, P < .001 for CL and P < .001 for SMOG), except LW formula (P = .112). The websites had moderate-to-low reliability and quality. Health-related websites had the highest quality with JAMA score. We found a weak negative correlation between Blexb score and JAMA score (P = .013). Compared to the sixth-grade level recommended by the American Medical Association and the National Institutes of Health, the readability grade level of child pain-related internet-based PEMs is quite high. On the other hand, the reliability and quality of PEMs were determined as moderate-to-low. The low readability and quality of PEMs could cause an anxious parent and unnecessary hospital admissions. PEMs on issues threatening public health should be prepared with attention to the recommendations on readability.

Customization options in consumer health information materials on type-2 diabetes mellitus-an analysis of modifiable features in different types of media

Introduction

The understanding of health-related information is essential for making informed decisions. However, providing health information in an understandable format for everyone is challenging due to differences in consumers' health status, disease knowledge, skills, and preferences. Tailoring health information to individual needs can improve comprehension and increase health literacy.

Objective

The aim of our research was to analyze the extent to which consumers can customize consumer health information materials (CHIMs) for type-2 diabetes mellitus through various media types.

Methods

We conducted a comprehensive search for various CHIMs across various media types, such as websites, apps, videos, and printed or printable forms. A representative sample of CHIMs was obtained for analysis through blocked randomization across the various media types. We conducted a quantitative content analysis to determine the frequency of user-centered customization options. Cross-comparisons were made to identify trends and variations in modifiable features among the media.

Results

In our representative sample of 114 CHIMs, we identified a total of 24 modifiable features, which we grouped into five main categories: (i) language, (ii) text, (iii) audiovisual, (iv) presentation, and (v) medical content. Videos offered the most customization opportunities (95%), while 47% of websites and 26% of apps did not allow users to tailor health information. None of the printed or printable materials provided the option to customize the information. Overall, 65% of analyzed CHIMs did not allow users to tailor health information according to their needs.

Conclusion

Our results show that CHIMs for type-2 diabetes mellitus could be significantly improved by providing more customization options for users. Further research is needed to investigate the effectiveness and usability of these options to enhance the development and appropriate provision of modifiable features in health information.

Arabic websites assessment of irritable bowel syndrome: How trustworthy are they? A cross-sectional study

Background and Aims

Irritable bowel syndrome (IBS) is a chronic GI disorder that affects people all over the world. Patients frequently look for information about their ailments online. Despite being widely and easily accessible, online information's quality and readability are under doubt. In this investigation, we assessed the effectiveness and usability of IBS Arabic websites found on significant search engines.

Methods

IBS-related search terms in Arabic were entered into two search engines (Google and YouTube), and the first 30 websites per word from Google, and the first 20 websites per word from YouTube were assessed for eligibility. Eligible Google websites were assessed for quality and readability, while YouTube websites were assessed for quality. Quality was assessed using the DISCERN score and the JAMA Benchmark. Readability was assessed using the automatic Arabic readability index (AARI). Associations between quality, readability, types of websites (medical/nonmedical), and video length were analyzed.

Results

For Google: A total of 48 websites were evaluated, mean DISCERN score was 40.4 (SD = 10.28) indicating fair quality. The mean JAMA score was 1.6 (SD = 0.69), with the readability being worse the higher the quality. Medical websites had higher quality scores than nonmedical ones. For YouTube: A total of 34 YouTube videos were evaluated, mean DISCERN score was 34.7 (SD = 7.35), indicating poor quality. The mean JAMA score was 1.4 (SD = 0.72). Medical websites had higher quality scores than nonmedical ones. There was no association between the quality of the videos and their length.

Conclusion

The majority of websites were of low to fair quality and required a high degree of readability. As a result, we advise (1) healthcare practitioners to offer helpful websites to their patients, and (2) the development of IBS-related websites under the guidance of experts, with the involvement of patients.

Assessing the Quality, Privacy, and Security of Breast Cancer Apps for Arabic Speakers: Systematic Search and Review of Smartphone Apps

BACKGROUND

Breast cancer is a widespread disease, and its incidence is rapidly increasing in the Middle East and North Africa region. With the increasing availability of smartphone apps for various health purposes, breast cancer apps have emerged as tools for raising awareness, providing support, and empowering women affected by this disease. These apps offer many features, including information on breast cancer risk factors, self-examination guides, appointment reminders, and community support groups or hotlines. Using apps raises the risk of privacy and security issues, and we hope that examining these features of the apps will contribute to the understanding of how technology can be used to improve these apps and provide insights for future development and improvement of breast cancer apps.

OBJECTIVE

This study aims to critically review the quality, privacy, and security of breast cancer apps available to Arabic speakers.

METHODS

Similar to several recent studies, we used a systematic search for apps available in Google Play and Apple App stores using both the web interface and the built-in native stores installed on smartphones. The search was conducted in mid-December 2022 in Arabic using the following keywords: سرطان الثدي - فحص سرطان الثدي - علاج سرطان الثدي - مرض سرطان الثدي - أعراض سرطان الثدي - فحص الثدي (breast cancer, breast cancer treatment, breast cancer disease, breast cancer symptoms, breast cancer screening, and breast test). These preidentified search terms are based on earlier work concerning the top searched breast cancer topics by Arabic speakers through Google's search engine. We excluded apps that did not have an Arabic interface, were developed for non-Arabic speakers, were paid, needed a subscription, or were directed toward health care workers. The Mobile App Rating Scale was used to evaluate the quality of the apps concerning their engagement, functionality, aesthetics, and information. A risk score was calculated for the apps to determine their security risk factors.

RESULTS

Only 9 apps were included, with most (6/9, 67%) being supported by advertisements and categorized as informational. Overall, the apps had low numbers of downloads (>10 to >1000). The majority of the included apps (8/9, 89%) requested dangerous access permissions, including access to storage, media files, and the camera. The average security score of the included apps was 3.22, while only 2 apps provided information about data security and privacy. The included apps achieved an overall average quality score of 3.27, with individual dimension scores of 4.75 for functionality, 3.04 for information, 3.00 for aesthetics, and 2.32 for engagement.

CONCLUSIONS

The limited availability of breast cancer apps available to Arabic speakers should be a call to action and prompt health care organizations and developers to join forces and collaboratively develop information-rich, usable, functional, engaging, and secure apps.

An evaluation of the quality of COVID-19 websites in terms of HON principles and using DISCERN tool

BACKGROUND

As many people relied on information from the Internet for official scientific or academically affiliated information during the COVID-19 pandemic, the quality of information on those websites should be good.

OBJECTIVE

The main purpose of this study was to evaluate a selection of COVID-19-related websites for the quality of health information provided.

METHOD

Using Google and Yahoo, 36 English language websites were selected, in accordance with the inclusion criteria. The two tools were selected for evaluation were the Health on the Net (HON) Code and the 16-item DISCERN tool.

RESULTS

Most websites (39%) were related to information for the public, and a small number of them (3%) concerned screening websites in which people could be informed of their possible condition by entering their symptoms. The result of the evaluation by the HON tool showed that most websites were reliable (53%), and 44% of them were very reliable. Based on the assessment results of the Likert-based 16-item DISCERN tool, the maximum and minimum values for the average scores of each website were calculated as 2.44 and 4.25, respectively.

CONCLUSION

Evaluation using two widely accepted tools shows that most websites related to COVID-19 are reliable and useful for physicians, researchers and the public.

An examination of the content of diabetes websites targeting Arabic speakers

BACKGROUND

There has been an increase in the numbers of people in the Middle East and North Africa (MENA) region seeking online information about diabetes, as the Internet is considered a helpful tool for finding information about disease prevention and treatment. It is important that the sources available are reliable, trustworthy and easily accessible. However, the quality and readability of such information is questionable. This study examines the content of Arabic diabetes websites and offers recommendations to improve engagement and access to health information.

METHODS

This study employed a cross-sectional analysis approach to assess diabetes websites targeting Arabic speakers in the MENA countries. Google trends was utilized to reveal the top searched topics across the MENA region, which were used as search terms to identify the websites in search engines, resulting in the examination of 26 websites. The analysis combined automated tools with expert evaluation methods and involved five dimensions: quality, readability, engagement, popularity, and availability.

RESULTS

Overall, the majority of the websites performed poorly in the five dimensions and thus require careful reassessment of their content, design, and readability; no website performed well in all dimensions. Only two websites (7.6%) were HONcode certified, and none of the websites achieved a high score in the DISCERN analysis. The readability scores indicated that most websites were above the recommended level of reading. The results also revealed that all websites had poor engagement. Half of the websites had good ranking, and 58% of the websites covered all of the target topics. Of the websites examined, the non-commercial and non-professional sites (classified as "others") seem to have greater readability, higher bounce rates and longer visit duration than the commercial sites.

CONCLUSIONS

The results from this study show a need for improving the content of diabetes information websites available to Arabic speakers. In order to develop websites that contain easy-to-read and understand high-quality information, collaboration between multiple stakeholders is necessary.

How readable and quality are online patient education materials about Helicobacter pylori?: Assessment of the readability, quality and reliability

This study aimed to examine the readability, reliability, quality, and content of patient education materials (PEM) on the Internet about "Helicobacter pylori (H pylori)." A search was conducted on March 14, 2023, using the keyword "H pylori" in the Google search engine. The readability of PEMs was assessed using the Flesch reading ease score, FKGL, simple measure of gobbledygook, and gunning fog readability formulas. The reliability and quality of the websites were determined using the Journal of American Medical Association score, health on the net foundation code of conduct, global quality score, and DISCERN score. A total of 93 patient education websites were included in the study. In the readability analysis of PEMs, we determined that the Flesch reading ease score was 49,73 (47,46-52,00) (difficult), the mean Flesch-Kincaid grade level and simple measure of gobbledygook were 9,69 (9,26-10,12) and 9,28 (8,96-9,61) years, respectively, and the mean gunning fog score was 12,47 (12,03-12,91) (very difficult). Most of the evaluated patient educational materials were commercial websites (n = 50, 53.8%). It was found that 16.1% of the websites were of high quality according to global quality score, 30.1% were HON code certified, and 23.7% of the websites were highly reliable according to Journal of American Medical Association scores. There was no statistically significant difference between website typologies and readability (P > .05). However, there was a statistically significant difference between website typologies and quality and reliability scores (P < .005). Compared to the sixth grade level recommended by the American Medical Association and National Institutes of Health, the readability of H pylori-related internet-based PEMs is quite high. On the other hand, the reliability and quality of the PEMs were determined as moderate to poor. PEMs for issues threatening public health should be prepared with attention to recommendations on readability.

Quality evaluation of health information about breast cancer treatment found on WeChat public accounts

BACKGROUND

With growing cases of breast cancer, WeChat public account, an important information publishing platform of WeChat, has become a breast cancer treatment health information provider to a huge audience. It is essential for health information to possess high-level accuracy and reliability. This work evaluates the quality of health information on breast cancer treatment in WeChat public accounts (WPAs), to benefit the patients while making treatment decisions and provide WPA authors with suggestions on publishing high-quality treatment health information.

METHODS

With "breast cancer" as keywords, searches were implemented on weixin.sogou.com and the WeChat app. The WPAs oriented to patients with breast cancer were selected, and the four latest articles of each WPA were included in a set to be evaluated with DISCERN.

RESULTS

A total of 37 WPAs and 136 articles published by them were included. The accounts operated by individual users were 54%. The median of overall quality of 136 articles was 44 (interquartile range = 10.75) and ranked as "fair", of which only 28 (21%) were of "good" or higher quality. Among these articles, 74 (54%) were related to medical treatments, and 13 of them mentioned clinical trials; 36 (27%) dealt with surgery. 101 (74.26%) omitted additional sources of information; 102 (75%) did not explicitly suggest shared decision-making. A significant difference was not found in the dimensions "reliability of the articles" and "specific details of information on treatment choices" between the distinct categories of account subjects and various treatment options (P > 0.05).

CONCLUSIONS

The quality of the articles on breast cancer treatment health information in WPAs was moderate. WPA producers should focus on improving the reliability of information and providing more details on treatment options, to assist patients in making optimal decisions during treatment.

Evaluating the readability, quality and reliability of online patient education materials on transcutaneuous electrical nerve stimulation (TENS)

Increasing digitization also raises concerns regarding the reliability and comprehensibility of online health information. In this study, we aimed to examine the readability, reliability, and quality of internet-based patient education materials on "transcutaneous electrical nerve stimulation." On September 15, 2022, we used Google search engine to search the keyword "Transcutaneous Electrical Nerve Stimulation" and obtained information from 200 websites. The readability of the websites was evaluated using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, and Gunning Fog. The Journal of American Medical Association score and Health on the Net Foundation code of conduct were used to determine the reliability of the websites, whereas the DISCERN score and Global Quality Score were used to evaluate the quality of the websites. In the readability analysis of 102 websites that met the inclusion criteria of this study, we found that the Flesch Reading Ease Score was 47.91 ± 13.79 (difficult), average Flesch-Kincaid Grade Level and Simple Measure of Gobbledygook were 11.20 ± 2.85 and 10.53 ± 2.11 years, respectively, and average Gunning Fog score was 14.04 ± 2.74 (very difficult). Commercial websites constituted the highest proportion of websites (n = 36, 35.5%). Overall, 16.7% of the websites were found to be of high quality according to the Global Quality Score, 16 (15.7%) websites had Health on the Net Foundation code of conduct certification, and 8.8% of the websites were found to be highly reliable according to the Journal of American Medical Association scores. There was a statistically significant difference between website typologies and quality and reliability scores (P < .001). Compared with the sixth-grade level recommended by the American Medical Association and the National Institute of Health, the readability of transcutaneous electrical nerve stimulation-related internet-based patient education materials was considerably high, but they showed low reliability and moderate-to-poor quality. Thus, the quality, reliability, and readability of websites developed by health professionals play a major role in conveying accurate and easily understandable information.

Evaluating online health information quality using machine learning and deep learning: A systematic literature review

Background

Due to the large volume of online health information, while quality remains dubious, understanding the usage of artificial intelligence to evaluate health information and surpass human-level performance is crucial. However, the existing studies still need a comprehensive review highlighting the vital machine, and Deep learning techniques for the automatic health information evaluation process.

Objective

Therefore, this study outlines the most recent developments and the current state of the art regarding evaluating the quality of online health information on web pages and specifies the direction of future research.

Methods

In this article, a systematic literature is conducted according to the PRISMA statement in eight online databases PubMed, Science Direct, Scopus, ACM, Springer Link, Wiley Online Library, Emerald Insight, and Web of Science to identify all empirical studies that use machine and deep learning models for evaluating the online health information quality. Furthermore, the selected techniques are compared based on their characteristics, such as health quality criteria, quality measurement tools, algorithm type, and achieved performance.

Results

The included papers evaluate health information on web pages using over 100 quality criteria. The results show no universal quality dimensions used by health professionals and machine or deep learning practitioners while evaluating health information quality. In addition, the metrics used to assess the model performance are not the same as those used to evaluate human performance.

Conclusions

This systemic review offers a novel perspective in approaching the health information quality in web pages that can be used by machine and deep learning practitioners to tackle the problem more effectively.