Scoliosis related information on the internet in China: can patients benefit from this information?

Psychological Impact of COVID-19 Lockdown and Its Evolution: A Case Study Based on Internet Searching Data during the Lockdown of Wuhan 2020 and Shanghai 2022

It has been three years since the initial outbreak of COVID-19 in Wuhan, China, which incurred huge damage both physically and psychologically on human's normal life. As a prevention measure, the lockdown was first adopted by Wuhan, then by a long list of Chinese cities and many other major cities around the world. Lockdown is the most restrictive social distancing strategy, turning out effective in mitigating the spreading of COVID-19 on the community level, which, however, cuts off all social interactions and isolates healthy people from each other. The isolated nature of the lockdown could induce severe mental health issues, forming one major source of depression and domestic violence. Given the potential side effect, a comprehensive investigation based on reliable data sources is needed to evaluate the real psychological impact of COVID-19 lockdown and its evolution over time, particularly in the time when the Omicron variant, known for its low death risk, dominates the pandemic. Based on the Baidu Searching Index data collected for Wuhan and Shanghai, two major cities in China that suffered from long-lasting (over two months) lockdowns in 2020 and 2022, respectively, it is found that the major psychological issue during the lockdown period is not induced by the spreading of COVID-19, but by the execution of lockdown. With the deepening of knowledge about COVID-19 and the decrease in the death risk, the psychological impact of lockdown keeps increasing, while the impact of virus spreading becomes less important and even irrelevant to depression and domestic violence issues. The findings reveal that from the psychological perspective, the negative effect of lockdown already overweighs the positive one, which is especially true for the Omicron variant provided its almost ignorable death risk. Therefore, it is necessary to re-evaluate the yield and cost of lockdown for those countries where the COVID-19 pandemic has not yet come to an end.

Kyphosis-Related Information On The Internet Is the Quality, Content and Readability Sufficient for the Patients?

STUDY DESIGN

A quality-control Internet-based study using recognized quality scoring systems.

OBJECTIVE

The aim of the study is to evaluate the quality, content and readability of online information on kyphosis.

METHODS

The 3 most frequently used search engines were identified and a search for "Kyphosis" was made in each. The 2 reviewers categorized their Web-sites by type, and the quality of each was assessed using well-known scoring systems, including the DISCERN score, JAMA benchmark, GQS, and the kyphosis specific content score. The Flesch-Kincaid grade level (FKGL) was used to assess the readability. The quality of the information was also evaluated according to the presence and absence of the HONcode.

RESULTS

Sixty unique Web sites were identified and analyzed. The distribution of the categories was 33 (55%) medical, 22 (36.7%) academic, 2 (3.3%) non-physician, 2 (3.3%) commercial and 1 (1.7%) physician. There wasn't statistically significant difference between the sources in terms of DISCERN, JAMA, GQS and KSC scores (P > 0.05). However, a review of the FKGL scores revealed that the academic-based websites' FKGL score was significantly higher than the medical-based websites (P: 0.007). Also there wasn't statistically significant difference among the DISCERN, JAMA, GQS, KSC, FKRS and FKGL scores of the web-sites according to the HON code's presence (P > 0.05).

CONCLUSION

Information about kyphosis on the Internet is of limited quality and low information value. The readability of the online information in our results showed a significantly higher reading level than the sixth grade level recommended by the AMA and NIH.

Readability of the Most Commonly Accessed Online Patient Education Materials Pertaining to Surgical Treatments of the Spine

OBJECTIVE

The American Medical Association and National Institutes of Health have recommended that patient education materials should be written at the sixth-grade reading level to maximize patient comprehension. The objective of the present study was to evaluate the readability of Internet information for the 9 most common spinal surgeries.

METHODS

We reviewed 90 online patient educational materials regarding the 9 most common spinal surgeries as reported by the North American Spine Society. A Google search was performed on March 23, 2019 for each surgery, and the top 10 most visited websites for each surgery were assessed for reading level using the Flesch-Kincaid formula.

RESULTS

Using the Flesch-Kincaid formula, the average grade reading level of the 90 websites included was 12.82, with a reading ease of 37.04 ("difficult college"). Only 6 websites relayed information to patients at or below the national average of an eighth-grade reading level. The websites for bone morphogenic protein had the highest average grade reading level at 15.88 ± 2.6. Lumbar microscopic discectomy had the lowest average grade reading level at 10.37 ± 2.89. All surgical options discussed had an average readability above the recommended sixth-grade reading level.

CONCLUSIONS

The most accessed online materials for common spinal surgeries, not only exceeded the readability limits recommended by both the American Medical Association and the National Institutes of Health, but they also exceeded the average reading ability of most adults in the United States. Patients, therefore, might not fully comprehend the information from commonly accessed websites regarding surgical spine treatment options.

Evaluation of the Liver Disease Information in Baidu Encyclopedia and Wikipedia: Longitudinal Study

Background

The internet has changed the way of people acquiring health information. Previous studies have shown that Wikipedia is a reasonably reliable medical resource, and it has been ranked higher than other general websites in various search engines. Baidu Encyclopedia is one of the most popular encyclopedia websites in China. However, no studies have shown the quality of the content provided in the Baidu Encyclopedia.

Objective

This study aimed to evaluate the quality of liver disease information provided by Wikipedia (in English) and Baidu Encyclopedia (in Chinese) and to perform a comparison of the quality and timeliness of the articles published in these two encyclopedias. Moreover, a 3-year follow-up study was conducted to compare if the information in both these websites was updated regularly over this period.

Methods

We searched for information on liver diseases by using the International Statistical Classification of Diseases and Related Health Problems 10th Revision Version 2016 codes on Wikipedia (in English) and Baidu Encyclopedia (in Chinese). The quality of the articles was assessed using the DISCERN instrument, which consists of 3 sections. We recorded the latest editing date of the webpages and calculated the date interval to evaluate the update timeliness of these websites.

Results

We found 22 entries on liver diseases in Baidu Encyclopedia and 15 articles in Wikipedia between September 15, 2016, and September 30, 2016, and we found 25 entries in Baidu Encyclopedia and 16 articles in Wikipedia between September 15, 2019, and September 30, 2019. In section 1 of the DISCERN instrument, the mean (SE) scores of Baidu Encyclopedia entries were significantly lower than those of Wikipedia articles. In section 2 and section 3 of the DISCERN instrument, the DISCERN scores of Baidu Encyclopedia entries were lower than those of Wikipedia articles, but the differences were not statistically significant. The total DISCERN scores of Baidu Encyclopedia entries were significantly lower than those of Wikipedia articles. The update interval of the entries in Baidu Encyclopedia was found to be significantly longer than that of the articles in Wikipedia.

Conclusions

This study shows that the quality of articles and the reliability of the research content on liver diseases in Wikipedia are better than those of the entries in Baidu Encyclopedia. However, the quality of the treatment choices provided in both Wikipedia and Baidu Encyclopedia is not satisfactory. Wikipedia is updated more frequently than Baidu Encyclopedia, thereby ensuring that the information presented has the most recent research findings. The findings of our study suggest that in order to find accurate health information, it is important to seek the help of medical professionals instead of looking for a prescription amid the confusing information provided on the internet.

More Depression-Related Public Concern After the Suicide of a Pop Star in China: Evidence From the Online Big Data Platform

Background: In China, we have seen dramatic increases in public concern over depression and mental health after the suicide of some famous persons. The objective of this study is to investigate the changes of search-engine query patterns to monitor this phenomenon based on the tragic suicide of a young Chinese pop star, Kimi Qiao. Methods: The daily search volume for depression was retrieved from both the Baidu Index (BDI) and the Sina MicroBlog Index (SMI). Besides, the daily BDI for suicide, schizophrenia, obsessive-compulsive disorder, common cold, stomach cancer, and liver cancer were collected for comparison. According to the time of Qiao's suicide, all data were divided into two periods (i.e., Period One from 1 September 2015 to 31 August 2016 while Period Two ranged from 1 October 2016 to 30 September 2017). The paired t-test was used to compare the differences in search volumes between two periods. The Pearson correlation analysis was used to estimate correlations between the BDI and SMI for depression. Results: The average BDI for depression, BDI for suicide, and SMI for depression in Period Two were significantly higher than in Period One (p < 0.05). There was a strong positive correlation between the BDI and SMI for depression (r = 0.97, p < 0.001). And no significant difference in BDI for other diseases between the two periods was found. Conclusions: The changes of search-engine query patterns indicated that the celebrity's suicide might be able to improve the netizens' concern about depression in China. The study suggests publishing more practical knowledge and advice on depression through the Internet and social media, to improve the public's mental health literacy and help people to cope with their depressive symptoms appropriately.

Patterns of Internet and smartphone use by parents of children with chronic kidney disease

BACKGROUND

Smartphones have become a part of universal technology by combining mobile and handheld functions, enabling expanded access to health information sources available on the Internet. The purpose of this study was to describe the pattern of smartphones and Internet use to search for health information by parents of children with chronic kidney disease (CKD).

METHODS

In a cross-sectional study, a questionnaire was applied to 111 parents of patients in a Brazilian pediatric nephrology center. Descriptive assessments were performed on Internet use patterns, and associative analyses were made of the influence of the smartphone use pattern on the search for health information.

RESULTS

Of the 111 participants, 91% (101/111) accessed the Internet, 88% (89/101) searched for health information, and 90% (80/89) searched for CKD information. Smartphones were the most commonly used devices to access the Internet. There was no significant difference between age groups, schooling levels, places of residence and smartphone use to search information about CKD. Physicians continue to be primary sources of information (87%, 88/101), but now they share space with the Internet, which surpassed traditional sources such as books and other health professionals. There seems to be some discomfort on the part of the parents in admitting their research habit to the physician, considering that 65% (52/80) said they did not discuss the fact that they had looked for information on the Internet with their doctor. Obtaining more information about the disease and gaining knowledge regarding its complications were the main reasons that led to performing a search on the Internet, whose results were considered useful by 93% (74/80).

CONCLUSION

Parents of children with CKD have been using the Internet largely through smartphones to research about CKD, irrespective of age, schooling and place of residence. Given its wide use, the Internet can be an important vehicle for health education and contribute to providing the support needed by parents and patients to cope with the disease.

YouTube is a poor source of patient information for knee arthroplasty and knee osteoarthritis

Background

The objective of this study was to assess the educational quality of YouTube videos pertaining to total knee arthroplasty and knee osteoarthritis.

Methods

A systematic search for the terms “knee replacement” and “knee arthritis” was performed using YouTube's search function. Data from the 60 most relevant videos were collected for each search term. Quality assessment checklists with a scale of 0 to 10 points were developed to evaluate the video content. Videos were grouped into poor quality (grade 0-3), acceptable quality (grade 4-7), and excellent quality (grade 8-10), respectively.

Results

Overall, 106 videos were categorized. For videos regarding total knee arthroplasty (n = 50), 64% of videos were of poor educational quality (32/50), 28% were of acceptable quality (14/50), and 8% were of good educational quality (4/50). Common missing information included discussion of surgical complications and implant duration. For videos regarding knee arthritis (n = 56), 66% of videos were of poor educational quality (37/56), 32% were of acceptable quality (18/56), and 2% were of good educational quality. Common missing information were causes and risk factors for knee arthritis and long-term prognosis.

Conclusions

The present study suggests that YouTube is a poor educational source for patients regarding knee arthroplasty and knee arthritis. Recognizing the limitations of YouTube as well as which topics are not commonly presented may better guide physicians to educate their patients.

Anterior Cervical Discectomy and Fusion YouTube Videos as a Source of Patient Education

Study Design

Cross sectional study.

Purpose

To assess the quality of anterior cervical discectomy and fusion (ACDF) videos available on YouTube and identify factors associated with video quality.

Overview of Literature

Patients commonly use the internet as a source of information regarding their surgeries. However, there is currently limited information regarding the quality of online videos about ACDF.

Methods

A search was performed on YouTube using the phrase ‘anterior cervical discectomy and fusion.’ The Journal of the American Medical Association (JAMA), DISCERN, and Health on the Net (HON) systems were used to rate the first 50 videos obtained. Information about each video was collected, including number of views, duration since the video was posted, percentage positivity (defined as number of likes the video received, divided by the total number of likes or dislikes of that video), number of comments, and the author of the video. Relationships between video quality and these factors were investigated.

Results

The average number of views for each video was 96,239. The most common videos were those published by surgeons and those containing patient testimonies. Overall, the video quality was poor, with mean scores of 1.78/5 using the DISCERN criteria, 1.63/4 using the JAMA criteria, and 1.96/8 using the HON criteria. Surgeon authors’ videos scored higher than patient testimony videos when reviewed using the HON or JAMA systems. However, no other factors were found to be associated with video quality.

Conclusions

The quality of ACDF videos on YouTube is low, with the majority of videos produced by unreliable sources. Therefore, these YouTube videos should not be recommended as patient education tools for ACDF.

Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors: A Randomized Controlled Trial

Background:

Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up.

Methods:

A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method.

Results:

Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) (P < 0.001); total economic cost in WFU group (RMB 90 Yuan) was much lower than that in TFU group (RMB 196 Yuan). Lost-to-follow-up rate in the WFU group was 7.02% (4/57) compared with TFU group, 9.80% (5/51), while no significance was observed (95% confidence interval [CI]: 0.176–2.740; P = 0.732). The overall satisfaction rate in WFU group was 94.34% (50/53) compared with 80.43% (37/46) in TFU group (95% CI: 0.057–0.067; P = 0.034).

Conclusions:

The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions.

Trial Registration:

Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613.

Online Curves: A Quality Analysis of Scoliosis Videos on YouTube

STUDY DESIGN

A cross-sectional study.

OBJECTIVE

The aim of this study was to evaluate the quality of online scoliosis information available on the video sharing site YouTube.

SUMMARY OF BACKGROUND DATA

The Internet is an increasingly utilized resource for accessing information about a variety of heath conditions. YouTube is a video sharing platform used to both seek and distribute information.

METHODS

A search for "scoliosis" was carried out using YouTube's search engine and data were collected on the first 50 videos returned. A JAMA score to determine currency, authorship, source and disclosure, and scoliosis-specific score that measures the amount of information on the diagnosis and treatment options (as devised by Mathur et al in 2005; scored 0-32) was recorded for each video to measure quality objectively. In addition, the number of views, number of comments, and feedback positivity was documented for each. Data analysis was conducted using R 3.1.4/R Studio 0.98 with control for the age of each video in analysis models.

RESULTS

The average number of views per video was 71,152 with an average length of 7 minutes 32  seconds. Thirty-six percent of the videos fell under the authorship category of personal experience. The average JAMA score was 1.32/4 and average scoliosis specific score was 5.38/32. There was a positive correlation between JAMA score and number of views (P = 0.003). However, in contrast, there was a negative correlation between scoliosis-specific score and number of views (P = 0.01).

CONCLUSIONS

Online health information has historically been poor and our study shows that in an environment like YouTube that lacks a peer review process, the quality of scoliosis information is low. Further work is needed to determine whether accessing information on YouTube can play a role in patient care other than simple education pertaining to the disease and its management.

LEVEL OF EVIDENCE

3.