Online Ratings of Urologists: Comprehensive Analysis

Online ratings and narrative comments of American Head and Neck Society surgeons

BACKGROUND

We analyzed online rating scores and comments of head and neck surgeons to understand factors that contribute to higher ratings.

METHODS

Numerical ratings and comments for American Head and Neck Society physicians were extracted from Healthgrades, Vitals, RateMDs, and Yelp, with narrative comments categorized based on content. Physician practice location, education, and residency training were also compiled.

RESULTS

Patient ratings were significantly higher with supportive staff and affable physician demeanor but showed significant drops with longer wait times and difficulties scheduling appointments or follow-ups. Physician education and postgraduate training did not significantly affect ratings.

CONCLUSION

Online ratings and comments correlated to modifiable factors in clinical practice and may be informative in understanding patient needs.

The Credibility of Physician Rating Websites: A Systematic Literature Review

OBJECTIVES

Increasingly, the credibility of online reviews is drawing critical attention due to the lack of control mechanisms, the constant debate about fake reviews and, last but not least, current developments in the field of artificial intelligence. For this reason, the aim of this study was to examine the extent to which assessments recorded on physician rating websites (PRWs) are credible, based on a comparison to other evaluation criteria.

METHODS

Referring to the PRISMA guidelines, a comprehensive literature search was conducted across different scientific databases. Data were synthesized by comparing individual statistical outcomes, objectives and conclusions.

RESULTS

The chosen search strategy led to a database of 36,755 studies of which 28 were ultimately included in the systematic review. The literature review yielded mixed results regarding the credibility of PRWs. While seven publications supported the credibility of PRWs, six publications found no correlation between PRWs and alternative datasets. 15 studies reported mixed results.

CONCLUSIONS

This study has shown that ratings on PRWs seem to be credible when relying primarily on patients' perception. However, these portals seem inadequate to represent alternative comparative values such as the medical quality of physicians. For health policy makers our results show that decisions based on patients' perceptions may be well supported by data from PRWs. For all other decisions, however, PRWs do not seem to contain sufficiently useful data.

Patient-Centered Insights and Biases Regarding Cardiologists Via Online Review Platform Analysis

Background Online cardiologist reviews, such as those on the Yelp website, are a frequently used method for patients to find a cardiologist. It remains unknown how bias may influence such reviews. Our objectives for this study were to (1) determine which cardiologist- or practice-related factors influence the overall rating of cardiologists and patient satisfaction and (2) discover any associations between sex and race with the overall rating of cardiologists or with cardiologist- or practice-related factors. Methods and Results Cardiologist Yelp reviews from practices in the United States from 2007 to 2020 were analyzed. A total of 563 reviews were coded for positive and negative themes. Binary logistic regression was used to determine whether certain factors increased the likelihood of high ratings. Chi-squared tests were used to determine associations between sex and race with certain factors and overall cardiologist ratings. Cardiologists were more likely to receive higher ratings when reviewers noted the characteristics of competency/knowledge base and thoroughness, positive interactions with staff, and when the cardiologist's name was mentioned in the review. Negative interactions with staff were associated with lower ratings. Female cardiologists received lower ratings and more negative mentions of cardiologist-patient communication than expected. White and Black cardiologists received lower ratings than expected compared with other racial groups. Conclusions Patient-perceived cardiologist competency, thoroughness, and positive staff interactions were associated with positive reviews in online assessments. Sex and racial differences were also found. Further research must be done to confirm these findings and to understand the association of online reviews with clinical care and patient outcomes.

Quantifying the relationship between specialisation and reputation in an online platform

Online platforms implement digital reputation systems in order to steer individual user behaviour towards outcomes that are deemed desirable on a collective level. At the same time, most online platforms are highly decentralised environments, leaving their users plenty of room to pursue different strategies and diversify behaviour. We provide a statistical characterisation of the user behaviour emerging from the interplay of such competing forces in Stack Overflow, a long-standing knowledge sharing platform. Over the 11 years covered by our analysis, we represent the interactions between users and topics as bipartite networks. We find such networks to display nested structures akin to those observed in ecological systems, demonstrating that the platform's user base consistently self-organises into specialists and generalists, i.e., users who focus on narrow and broad sets of topics, respectively. We relate the emergence of these behaviours to the platform's reputation system with a series of data-driven models, and find specialisation to be statistically associated with a higher ability to post the best answers to a question. We contrast our findings with observations made in top-down environments-such as firms and corporations-where generalist skills are consistently found to be more successful.

Experiences and Challenges of Emerging Online Health Services Combating COVID-19 in China: A Retrospective, Cross-sectional Study of Internet Hospitals

Background

Internet-based online virtual health services were originally an important way for the Chinese government to resolve unmet medical service needs due to inadequate medical institutions. Its initial development was not well received. Then, the unexpected COVID-19 pandemic produced a tremendous demand for telehealth in a short time, which stimulated the explosive development of internet hospitals. The Second Affiliated Hospital of Zhejiang University (SAHZU) has taken a leading role in the construction of internet hospitals in China. The pandemic triggered the hospital to develop unique research on health service capacity under strict quarantine policies and to predict long-term trends.

Objective

This study aims to provide policy enlightenment for the construction of internet-based health services to better fight against COVID-19 and to elucidate future directions through an in-depth analysis of 2 years of online health service data gleaned from SAHZU’s experiences and lessons learned.

Methods

We collected data from SAHZU Internet Hospital from November 1, 2019, to September 16, 2021. Data from over 900,000 users were analyzed with respect to demographic characteristics, demands placed on departments by user needs, new registrations, and consultation behaviors. Interrupted time series (ITS) analysis was adopted to evaluate the impact of this momentous emergency event and its long-term trends. With theme analysis and a defined 2D model, 3 investigations were conducted synchronously to determine users’ authentic demands on online hospitals.

Results

The general profile of internet hospital users is young or middle-aged women who live in Zhejiang and surrounding provinces. The ITS model indicated that, after the intervention (the strict quarantine policies) was implemented during the outbreak, the number of internet hospital users significantly increased (β_2=105.736, P<.001). Further, long-term waves of COVID-19 led to an increasing number of users following the outbreak (β_3=0.167, P<.001). In theme analysis, we summarized 8 major demands by users of the SAHZU internet hospital during the national shutdown period and afterwards. Online consultations and information services were persistent and universal demands, followed by concerns about medical safety and quality, time, and cost. Users’ medical behavior patterns changed from onsite to online as internet hospital demands increased.

Conclusions

The pandemic has spawned the explosive growth of telehealth; as a public tertiary internet hospital, the SAHZU internet hospital is partially and irreversibly integrated into the traditional medical system. As we shared the practical examples of 1 public internet hospital in China, we put forward suggestions about the future direction of telehealth. Vital experience in the construction of internet hospitals was provided in the normalization of COVID-19 prevention and control, which can be demonstrated as a model of internet hospital management practice for other medical institutions.

One Decade of Online Patient Feedback: Longitudinal Analysis of Data From a German Physician Rating Website

Background

Feedback from patients is an essential element of a patient-oriented health care system. Physician rating websites (PRWs) are a key way patients can provide feedback online. This study analyzes an entire decade of online ratings for all medical specialties on a German PRW.

Objective

The aim of this study was to examine how ratings posted on a German PRW have developed over the past decade. In particular, it aimed to explore (1) the distribution of ratings according to time-related aspects (year, month, day of the week, and hour of the day) between 2010 and 2019, (2) the number of physicians with ratings, (3) the average number of ratings per physician, (4) the average rating, (5) whether differences exist between medical specialties, and (6) the characteristics of the patients rating physicians.

Methods

All scaled-survey online ratings that were posted on the German PRW jameda between 2010 and 2019 were obtained.

Results

In total, 1,906,146 ratings were posted on jameda between 2010 and 2019 for 127,921 physicians. The number of rated physicians increased constantly from 19,305 in 2010 to 82,511 in 2018. The average number of ratings per rated physicians increased from 1.65 (SD 1.56) in 2010 to 3.19 (SD 4.69) in 2019. Overall, 75.2% (1,432,624/1,906,146) of all ratings were in the best rating category of “very good,” and 5.7% (107,912/1,906,146) of the ratings were in the lowest category of “insufficient.” However, the mean of all ratings was 1.76 (SD 1.53) on the German school grade 6-point rating scale (1 being the best) with a relatively constant distribution over time. General practitioners, internists, and gynecologists received the highest number of ratings (343,242, 266,899, and 232,914, respectively). Male patients, those of higher age, and those covered by private health insurance gave significantly (P<.001) more favorable evaluations compared to their counterparts. Physicians with a lower number of ratings tended to receive ratings across the rating scale, while physicians with a higher number of ratings tended to have better ratings. Physicians with between 21 and 50 online ratings received the lowest ratings (mean 1.95, SD 0.84), while physicians with >100 ratings received the best ratings (mean 1.34, SD 0.47).

Conclusions

This study is one of the most comprehensive analyses of PRW ratings to date. More than half of all German physicians have been rated on jameda each year since 2016, and the overall average number of ratings per rated physicians nearly doubled over the decade. Nevertheless, we could also observe a decline in the number of ratings over the last 2 years. Future studies should investigate the most recent development in the number of ratings on both other German and international PRWs as well as reasons for the heterogeneity in online ratings by medical specialty.

Online Reputations: Comparing Hospital- and Patient-Generated Ratings in Academic Otolaryngology

OBJECTIVES

This study compares hospital-generated online ratings to patient-generated online ratings in academic otolaryngology and evaluates physician factors influencing these results.

METHODS

Websites of academic otolaryngologists were assessed for inclusion of hospital-generated Press Ganey surveys. Corresponding scores on Healthgrades and Vitals.com were identified via internet search. Hospital ratings were compared with patient-generated ratings, including score, demographics, and number of ratings. All data was collected between July 15th 2019 and August 22nd 2019.

RESULTS

742 academic otolaryngologists with hospital-generated ratings were identified. Mean hospital-generated rating was significantly higher ((4.70, 95% CI 4.69-4.72) than patient-generated rating (Vitals:4.26, 95% CI 4.18-4.34, and Healthgrades:4.02, 95% CI 3.87-4.18; P < .001). In patient-generated rating, an increased number of rating scores (>20) was associated with male gender, professor ranking, and >30 years in practice (P < .005). Physician demographics did not impact number of ratings in hospital-generated setting. With patient-generated, lower aggregate score was associated with professor ranking (P = .001). In hospital-generated, lower score was associated with >30+ years in practice (P = .023). Across all platforms, comprehensive otolaryngologists and neurotologists/otologists were rated lower in comparison to other specialties (PGS:P < .001,Vitals:P = .027,Healthgrades:P = .016).

CONCLUSION

Hospital-generated ratings yield higher mean scores than patient-generated platforms. Between sources, Healthgrades.com scores were lower than those of Vitals.com. Professors with >30 years of practice generated more reviews in patient-generated ratings, and these physicians were generally rated lower. Access to patient-generated ratings is universal and physicians should be aware of variability between online rating platforms as scores may affect referrals and practice patterns.

Digital Footprint of Academic Vascular Surgeons in the Southern United States on Physician Rating Websites: Cross-sectional Evaluation Study

Background

The internet has become a popular platform for patients to obtain information and to review the health care providers they interact with. However, little is known about the digital footprint of vascular surgeons and their interactions with patients on social media.

Objective

This study aims to understand the activity of academic vascular surgeons on physician rating websites.

Methods

Information on attending vascular surgeons affiliated with vascular residency or with fellowships in the Southern Association for Vascular Surgery (SAVS) was collected from public sources. A listing of websites containing physician ratings was obtained via literature reviews and Google search. Open access websites with either qualitative or quantitative evaluations of vascular surgeons were included. Closed access websites were excluded. Ranking scores from each website were converted to a standard 5-point scale for comparison.

Results

A total of 6238 quantitative and 967 qualitative reviews were written for 287 physicians (236 males, 82.2%) across 16 websites that met the inclusion criteria out of the 62 websites screened. The surgeons affiliated with the integrated vascular residency and vascular fellowship programs in SAVS had a median of 8 (IQR 7-10) profiles across 16 websites, with only 1 surgeon having no web presence in any of the websites. The median number of quantitative ratings for each physician was 17 (IQR 6-34, range 1-137) and the median number of narrative reviews was 3 (IQR 2-6, range 1-28). Vitals, WebMD, and Healthgrades were the only 3 websites where over a quarter of the physicians were rated, and those rated had more than 5 ratings on average. The median score for the quantitative reviews was 4.4 (IQR 4.0-4.9). Most narrative reviews (758/967, 78.4%) were positive, but 20.2% (195/967) were considered negative; only 1.4% (14/967) were considered equivocal. No statistical difference was found in the number of quantitative reviews or in the overall average score in the physician ratings between physicians with social media profiles and those without social media profiles (departmental social media profile: median 23 vs 15, respectively, P=.22; personal social media profile: median 19 vs 14, respectively, P=.08).

Conclusions

The representation of vascular surgeons on physician rating websites is varied, with the majority of the vascular surgeons represented only in half of the physician rating websites The number of quantitative and qualitative reviews for academic vascular surgeons is low. No vascular surgeon responded to any of the reviews. The activity of vascular surgeons in this area of social media is low and reflects only a small digital footprint that patients can reach and review.

Data Quality Issues With Physician-Rating Websites: Systematic Review

BACKGROUND

In recent years, online physician-rating websites have become prominent and exert considerable influence on patients' decisions. However, the quality of these decisions depends on the quality of data that these systems collect. Thus, there is a need to examine the various data quality issues with physician-rating websites.

OBJECTIVE

This study's objective was to identify and categorize the data quality issues afflicting physician-rating websites by reviewing the literature on online patient-reported physician ratings and reviews.

METHODS

We performed a systematic literature search in ACM Digital Library, EBSCO, Springer, PubMed, and Google Scholar. The search was limited to quantitative, qualitative, and mixed-method papers published in the English language from 2001 to 2020.

RESULTS

A total of 423 articles were screened. From these, 49 papers describing 18 unique data quality issues afflicting physician-rating websites were included. Using a data quality framework, we classified these issues into the following four categories: intrinsic, contextual, representational, and accessible. Among the papers, 53% (26/49) reported intrinsic data quality errors, 61% (30/49) highlighted contextual data quality issues, 8% (4/49) discussed representational data quality issues, and 27% (13/49) emphasized accessibility data quality. More than half the papers discussed multiple categories of data quality issues.

CONCLUSIONS

The results from this review demonstrate the presence of a range of data quality issues. While intrinsic and contextual factors have been well-researched, accessibility and representational issues warrant more attention from researchers, as well as practitioners. In particular, representational factors, such as the impact of inline advertisements and the positioning of positive reviews on the first few pages, are usually deliberate and result from the business model of physician-rating websites. The impact of these factors on data quality has not been addressed adequately and requires further investigation.

Factors Associated With the Actual Behavior and Intention of Rating Physicians on Physician Rating Websites: Cross-Sectional Study

BACKGROUND

Although online physician rating information is popular among Chinese health consumers, the limited number of reviews greatly hampers the effective usage of this information. To date, little has been discussed on the variables that influence online physician rating from the users' perspective.

OBJECTIVE

This study aims to investigate the factors associated with the actual behavior and intention of generating online physician rating information in urban China.

METHODS

A web-based cross-sectional survey was conducted, and the valid responses of 1371 Chinese health consumers were recorded. Using a pilot interview, we analyzed the effects of demographics, health variables, cognitive variables, and technology-related variables on online physician rating information generation. Binary multivariate logistic regression, multiple linear regression, one-way analysis of variance analyses, and independent samples t test were performed to analyze the rating behavior and the intentions of the health consumers. The survey instrument was designed based on the existing literature and the pilot interview.

RESULTS

In this survey, 56.7% (778/1371) of the responders used online physician rating information, and 20.9% (287/1371) of the responders rated the physicians on the physician rating website at least once (posters). The actual physician rating behavior was mainly predicted by health-related factors and was significantly associated with seeking web-based physician information (odds ratio [OR] 5.548, 95% CI 3.072-10.017; P<.001), usage of web-based physician service (OR 2.771, 95% CI 1.979-3.879; P<.001), health information-seeking ability (OR 1.138, 95% CI 0.993-1.304; P=.04), serious disease development (OR 2.699, 95% CI 1.889-3.856; P<.001), good medical experience (OR 2.149, 95% CI 1.473-3.135; P<.001), altruism (OR 0.612, 95% CI 0.483-0.774; P<.001), self-efficacy (OR 1.453, 95% CI 1.182-1.787; P<.001), and trust in online physician rating information (OR 1.315, 95% CI 1.089-1.586; P=.004). Some factors influencing the intentions of the posters and nonposters rating the physicians were different, and the rating intention was mainly determined by cognitive and health-related factors. For posters, seeking web-based physician information (β=.486; P=.007), using web-based medical service (β=.420; P=.002), ability to seek health information (β=.193; P=.002), rating habits (β=.105; P=.02), altruism (β=.414; P<.001), self-efficacy (β=.102; P=.06), trust (β=.351; P<.001), and perceived ease of use (β=.275; P<.001) served as significant predictors of the rating intention. For nonposters, ability to seek health information (β=.077; P=.003), chronic disease development (β=.092; P=.06), bad medical experience (β=.047; P=.02), rating habits (β=.085; P<.001), altruism (β=.411; P<.001), self-efficacy (β=.171; P<.001), trust (β=.252; P<.001), and perceived usefulness of rating physicians (β=.109; P<.001) were significantly associated with the rating intention.

CONCLUSIONS

We showed that different factors affected the physician rating behavior and rating intention. Health-related variables influenced the physician rating behavior, while cognitive variables were critical in the rating intentions. We have proposed some practical implications for physician rating websites and physicians to promote online physician rating information generation.