1
|
Twohig P, Walsh E, Trujillo S, Manatsathit W, Peeraphatdit TB. Evaluating online patient education materials for liver cirrhosis. Ir J Med Sci 2024:10.1007/s11845-024-03645-1. [PMID: 38446347 DOI: 10.1007/s11845-024-03645-1] [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: 09/11/2023] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND & AIMS Liver cirrhosis affects 4.5 million adults in the United States (US). As more patients educate themselves online, we evaluated the accessibility, quality, understandability, accuracy, readability, and comprehensiveness (AQUA-RC) of online patient education materials for cirrhosis. METHODS Cross-sectional analysis using Google® and YouTube® on a cleared internet browser from 12 cities across the US. The authors independently reviewed the top 25 search results from each platform using search terms "liver cirrhosis" and "cirrhosis". Accessibility was evaluated from twelve cities in six regions across the US. We evaluated resource quality using the DISCERN score, understandability using the PEMAT score, readability using the Flesch-Kinkaid score, and accuracy/comprehensiveness using a list of author-generated criteria. AQUA-RC was compared between 1) academic websites (AW) vs. non-academic websites (NAW), and 2) websites vs. YouTube® videos. RESULTS 28 websites and 25 videos were included. Accessibility was equal across all regions. Websites had higher average quality scores than videos, although this was not statistically significant (p = 0.84). Websites were more understandable than videos (p < 0.00001). Both websites and videos were 100% accurate. Readability for websites was higher than recommended standards. Websites were more comprehensive than videos (p = 0.02). CONCLUSION Online patient education materials for cirrhosis in the US are equally accessible, but readability and understandability are too complex. Websites are of greater quality, accuracy, and comprehensiveness than YouTube videos, which are often narrowly focused and targeted at the medical community rather than patients. Further efforts should be made to improve online patient education and expand content across platforms.
Collapse
Affiliation(s)
- Patrick Twohig
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Erin Walsh
- Division of Gastroenterology & Hepatology, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA, 15212, USA
| | - Sophie Trujillo
- Division of Gastroenterology & Hepatology, University of California-Irvine, 3390 University Avenue, Riverside, CA, 92501, USA
| | - Wuttiporn Manatsathit
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Thoetchai Bee Peeraphatdit
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198, USA
| |
Collapse
|
2
|
Denniss E, Lindberg R, McNaughton SA. Quality and accuracy of online nutrition-related information: a systematic review of content analysis studies. Public Health Nutr 2023; 26:1345-1357. [PMID: 37138366 PMCID: PMC10346027 DOI: 10.1017/s1368980023000873] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 03/23/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE This systematic review aimed to summarise the level of quality and accuracy of nutrition-related information on websites and social media and determine if quality and accuracy varied between websites and social media or publishers of information. DESIGN This systematic review was registered with PROSPERO (CRD42021224277). CINAHL, MEDLINE, Embase, Global Health and Academic Search Complete were systematically searched on 15 January 2021 to identify content analysis studies, published in English after 1989, that evaluated the quality and/or accuracy of nutrition-related information published on websites or social media. A coding framework was used to classify studies' findings about information quality and/or accuracy as poor, good, moderate or varied. The Academy of Nutrition and Dietetics Quality Criteria Checklist was used to assess the risk of bias. SETTING N/A. PARTICIPANTS N/A. RESULTS From 10 482 articles retrieved, sixty-four were included. Most studies evaluated information from websites (n 53, 82·8 %). Similar numbers of studies assessed quality (n 41, 64·1 %) and accuracy (n 47, 73·4 %). Almost half of the studies reported that quality (n 20, 48·8 %) or accuracy (n 23, 48·9 %) was low. Quality and accuracy of information were similar on social media and websites, however, varied between information publishers. High risk of bias in sample selection and quality or accuracy evaluations was a common limitation. CONCLUSION Online nutrition-related information is often inaccurate and of low quality. Consumers seeking information online are at risk of being misinformed. More action is needed to improve the public's eHealth and media literacy and the reliability of online nutrition-related information.
Collapse
Affiliation(s)
- Emily Denniss
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC3125, Australia
| | - Rebecca Lindberg
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC3125, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC3125, Australia
| |
Collapse
|
3
|
Pérez-Pérez M, Ferreira T, Igrejas G, Fdez-Riverola F. A novel gluten knowledge base of potential biomedical and health-related interactions extracted from the literature: using machine learning and graph analysis methodologies to reconstruct the bibliome. J Biomed Inform 2023:104398. [PMID: 37230405 DOI: 10.1016/j.jbi.2023.104398] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND In return for their nutritional properties and broad availability, cereal crops have been associated with different alimentary disorders and symptoms, with the majority of the responsibility being attributed to gluten. Therefore, the research of gluten-related literature data continues to be produced at ever-growing rates, driven in part by the recent exploratory studies that link gluten to non-traditional diseases and the popularity of gluten-free diets, making it increasingly difficult to access and analyse practical and structured information. In this sense, the accelerated discovery of novel advances in diagnosis and treatment, as well as exploratory studies, produce a favourable scenario for disinformation and misinformation. OBJECTIVES Aligned with, the European Union strategy "Delivering on EU Food Safety and Nutrition in 2050" which emphasizes the inextricable links between imbalanced diets, the increased exposure to unreliable sources of information and misleading information, and the increased dependency on reliable sources of information; this paper presents GlutKNOIS, a public and interactive literature-based database that reconstructs and represents the experimental biomedical knowledge extracted from the gluten-related literature. The developed platform includes different external database knowledge, bibliometrics statistics and social media discussion to propose a novel and enhanced way to search, visualise and analyse potential biomedical and health-related interactions in relation to the gluten domain. METHODS For this purpose, the presented study applies a semi-supervised curation workflow that combines natural language processing techniques, machine learning algorithms, ontology-based normalization and integration approaches, named entity recognition methods, and graph knowledge reconstruction methodologies to process, classify, represent and analyse the experimental findings contained in the literature, which is also complemented by data from the social discussion. RESULTS and Conclusions: In this sense, 5,814 documents were manually annotated and 7,424 were fully automatically processed to reconstruct the first online gluten-related knowledge database of evidenced health-related interactions that produce health or metabolic changes based on the literature. In addition, the automatic processing of the literature combined with the knowledge representation methodologies proposed has the potential to assist in the revision and analysis of years of gluten research. The reconstructed knowledge base is public and accessible at https://sing-group.org/glutknois/.
Collapse
Affiliation(s)
- Martín Pérez-Pérez
- CINBIO, Universidade de Vigo, Department of Computer Science, ESEI - Escuela Superior de Ingeniería Informática, 32004 Ourense, España; SING Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain.
| | - Tânia Ferreira
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
| | - Gilberto Igrejas
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; LAQV-REQUIMTE, Faculty of Science and Technology, Nova University of Lisbon, Lisbon, Portugal.
| | - Florentino Fdez-Riverola
- CINBIO, Universidade de Vigo, Department of Computer Science, ESEI - Escuela Superior de Ingeniería Informática, 32004 Ourense, España; SING Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain.
| |
Collapse
|
4
|
Jaime C, Samuel L, Fera J, Basch CH. Discussing health while seeking community: A descriptive study of celiac disease on TikTok. Nutr Health 2023; 29:37-41. [PMID: 36148909 DOI: 10.1177/02601060221127505] [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: 11/15/2022]
Abstract
Background: For individuals suffering from chronic disease, more than being an information source for health information, social media serves as a dynamic forum for shared goals, emotional and practical support through the sharing of lived experiences. Aim: This study envisaged a content analysis of the 100 most widely-viewed English language videos related to celiac disease posted on TikTok. Methods: TikTok was searched using the hashtag #celiacdisease. This search term was chosen as it represented the broadest summation of the desired topic with the most views (80 million) of any related hashtag. The first 100 English language videos were selected. The video content was analyzed against predetermined descriptive categories, deductively derived content related to facts about celiac disease from a reliable source, and inductive content categories derived during the coding process. Results: The 100 videos included in this study received a total of 44,056,600 likes. The average number of likes across all videos was 440,566 with a standard deviation of 656,642.06. Two of the three categories were present in a majority (>50) of the videos. They were practical information on diet therapy management (n = 63) and challenges in managing celiac disease (n = 73). In both instances, videos featuring this content also garnered a majority of the likes, 74.18% and 82.9% respectively. Independent one-tailed t-tests (α = .05) returned significant results for the diagnosis-related information (p = .0390) and practical information in diet therapy management (p = .0358) categories. On average, videos that included diagnosis-related information received more likes than those that did not: 672,983.33 vs. 340,958.57. Similarly, the average number of likes was significantly higher for videos that included practical information on diet therapy management (518,715.87) vs. those that did not (307,500). Conclusions: This study further confirms the growing trend of people using social media to discuss health issues in a way that is free and easily accessible among communities with shared experiences. The long-term effects of using personal narratives as credible sources of behavioral change for health, medical, or professional resources can be further investigated.
Collapse
Affiliation(s)
- Christie Jaime
- Department of Public Health, 15665William Paterson University, Wayne, NJ, USA
| | - Lalitha Samuel
- Department of Health Promotion and Nutrition Sciences, 2008Lehman College, The City University of New York Bronx, NY, USA
| | - Joseph Fera
- Department of Mathematics, 2008Lehman College, The City University of New York Bronx, NY, USA
| | - Corey H Basch
- Department of Public Health, 15665William Paterson University, Wayne, NJ, USA
| |
Collapse
|
5
|
Aspasia S, Emmanuela-Kalliopi K, Nikolaos T, Eirini S, Ioannis S, Anastasia M. The gluten-free diet challenge in adults with coeliac disease: the Hellenic survey. PEC INNOVATION 2022; 1:100037. [PMID: 37213748 PMCID: PMC10194373 DOI: 10.1016/j.pecinn.2022.100037] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 05/23/2023]
Abstract
Objective The only available treatment for coeliac disease (CD) is a lifelong strict gluten-free diet (GFD), which can be extremely challenging. Τhe aim of the present study was to gain an insight into patients' perceptions regarding the GFD, in relation to difficulties experienced, disease-specific symptoms, adherence level, and information sources used. Methods Two hundred ninety CD patients (247 women and 43 men) aged 18-74 years, completed a self-administered questionnaire. Results Self-rated dietary adherence was high in 65.5%, moderate in 27.5% and poor in 6.9% of the patients. The main difficulties encountered were the high cost and limited availability of GF foods and meals in markets and restaurants. The main source of information concerning CD and GFD was the internet, and the most useful source was the Coeliac Society. Dietary adherence correlated positively with Coeliac Society membership and awareness of the monthly CD allowance. Conclusion Α substantial proportion of patients did not adhere to a strict GFD. Patients were not adequately followed-up. Innovation A self-administered questionnaire was used to explore the practical challenges of a GFD in an understudied population, Greek adult coeliac patients. The results highlighted the need for dietitians with expertise on CD.
Collapse
Affiliation(s)
- Spyridaki Aspasia
- Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University (HMU), Trypitos area, 723 00 Sitia, Greece
| | - Kotsoni Emmanuela-Kalliopi
- Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University (HMU), Trypitos area, 723 00 Sitia, Greece
| | - Thalassinos Nikolaos
- Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University (HMU), Trypitos area, 723 00 Sitia, Greece
| | - Sfakianaki Eirini
- Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University (HMU), Trypitos area, 723 00 Sitia, Greece
| | - Sfendourakis Ioannis
- Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University (HMU), Trypitos area, 723 00 Sitia, Greece
| | - Markaki Anastasia
- Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University (HMU), Trypitos area, 723 00 Sitia, Greece
| |
Collapse
|
6
|
Germone M, Wright CD, Kimmons R, Coburn SS. Twitter Trends for Celiac Disease and the Gluten-Free Diet: Cross-sectional Descriptive Analysis. JMIR INFODEMIOLOGY 2022; 2:e37924. [PMID: 37113453 PMCID: PMC9987182 DOI: 10.2196/37924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 04/29/2023]
Abstract
Background Few studies have systematically analyzed information regarding chronic medical conditions and available treatments on social media. Celiac disease (CD) is an exemplar of the need to investigate web-based educational sources. CD is an autoimmune condition wherein the ingestion of gluten causes intestinal damage and, if left untreated by a strict gluten-free diet (GFD), can result in significant nutritional deficiencies leading to cancer, bone disease, and death. Adherence to the GFD can be difficult owing to cost and negative stigma, including misinformation about what gluten is and who should avoid it. Given the significant impact that negative stigma and common misunderstandings have on the treatment of CD, this condition was chosen to systematically investigate the scope and nature of sources and information distributed through social media. Objective To address concerns related to educational social media sources, this study explored trends on the social media platform Twitter about CD and the GFD to identify primary influencers and the type of information disseminated by these influencers. Methods This cross-sectional study used data mining to collect tweets and users who used the hashtags #celiac and #glutenfree from an 8-month time frame. Tweets were then analyzed to describe who is disseminating information via this platform and the content, source, and frequency of such information. Results More content was posted for #glutenfree (1501.8 tweets per day) than for #celiac (69 tweets per day). A substantial proportion of the content was produced by a small percentage of contributors (ie, "Superuser"), who could be categorized as self-promotors (eg, bloggers, writers, authors; 13.9% of #glutenfree tweets and 22.7% of #celiac tweets), self-identified female family members (eg, mother; 4.3% of #glutenfree tweets and 8% of #celiac tweets), or commercial entities (eg, restaurants and bakeries). On the other hand, relatively few self-identified scientific, nonprofit, and medical provider users made substantial contributions on Twitter related to the GFD or CD (1% of #glutenfree tweets and 3.1% of #celiac tweets, respectively). Conclusions Most material on Twitter was provided by self-promoters, commercial entities, or self-identified female family members, which may not have been supported by current medical and scientific practices. Researchers and medical providers could potentially benefit from contributing more to this space to enhance the web-based resources for patients and families.
Collapse
Affiliation(s)
- Monique Germone
- Digestive Health Institute Colorado Center for Celiac Disease Children's Hospital Colorado Aurora, CO United States
- Department of Psychiatry University of Colorado Anschutz Medical Campus Aurora, CO United States
| | - Casey D Wright
- Department of Developmental Sciences School of Dentistry Marquette University Milwaukee, WI United States
| | - Royce Kimmons
- David O McKay School of Education, Instructional Psychology & Technology Brigham Young University Provo, UT United States
| | - Shayna Skelley Coburn
- Department of Psychology and Behavioral Health Children's National Hospital Washington, DC United States
- Department of Psychiatry and Behavioral Sciences The George Washington School of Medicine and Health Sciences Washington, DC United States
| |
Collapse
|
7
|
Nangia D, Saini A, Krishnan A, Sharma S, Kumar V, Chawla A, Logani A. Quality and accuracy of patient-oriented Web-based information regarding tooth avulsion. Dent Traumatol 2022; 38:299-308. [PMID: 35225429 DOI: 10.1111/edt.12741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND/AIM Tooth avulsion (TA) is a severe form of traumatic dental injury. The tooth's prognosis depends on the immediate measures taken. First responders are often laypeople, and the Internet is a favored platform to access health-related information. The aim of this descriptive study was to evaluate the accuracy, quality, readability, and popularity of patient-oriented web information regarding the emergency management of TA. METHODS Three search engines (Google, Bing, and Yahoo.com) were browsed with six VPNs using "knocked out tooth," "fallen out tooth," and "tooth avulsion" as keywords. The top 20 results for each were evaluated. Webpages were included if they had information oriented to caregivers. They were analyzed for accuracy (cutoff ≥95%). Quality of web pages was assessed using DISCERN and the Journal of the American Medical Association (JAMA) benchmark. Readability was evaluated using Flesch-Kincaid Grade Level (FKGL), Gunning Fog (FOG), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Popularity was assessed by Alexa Popularity Rank (APR). Accurate and inaccurate webpages were compared using chi-square analysis and the Mann-Whitney U test. Spearman's correlation between the studied metrics was established. A p < .05 was considered significant. RESULTS Seventy-two webpages were included, of which 23 (32%) were accurate. The median DISCERN ratings for accurate and inaccurate webpages were 3.0 [2.5-3.0] and 3.0 [2.0-3.0], respectively (p = .331). Ten (44%) accurate and 12 (24.5%) inaccurate webpages had high-quality JAMA (p = .089). The median readability scores for accurate webpages were FKGL (8 [6.75-9.2]), FOG (10.6 [9.55-12.3]), CLI (7 [6-7]), SMOG (6.7 [6.15-7.5]), while scores for the inaccurate webpages were FKGL (7.85 [6.275-8.525]), FOG (10.55 [8.875-11.425]), CLI (7 [7-8.25]), and SMOG (7 [6.2-7.925]), with a higher CLI score for inaccurate webpages (p = .0035). The median APRs for accurate and inaccurate webpages were 1,02,538 [26,852-14,43,755] and 7,63,190 [2,19,799-29,92,067], respectively (p = .163). Accuracy had a positive correlation with quality (DISCERN: rho = .293, p = .013; JAMA: rho = .249, p = .036), while popularity (APR) was negatively correlated with quality (DISCERN: rho = -.330, p = .013; JAMA: rho = -.287, p = .032). CONCLUSION Relevant webpages were limited and had low accuracy. This can impact the emergency management by laypeople and adversely affect the prognosis following avulsion.
Collapse
Affiliation(s)
- Divya Nangia
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Aakriti Saini
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Arunakshi Krishnan
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Sidhartha Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
8
|
Buseck A, Lebwohl B, Green PHR. Quality and Content of Online Patient Resources for Celiac Disease. Dig Dis Sci 2021; 66:2209-2215. [PMID: 32816213 DOI: 10.1007/s10620-020-06537-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Patient-directed information on celiac disease has been reported to be of variable quality. We assessed the quantity and quality of information on blogs and Web sites intended to inform the layperson of celiac disease information. METHODS We performed a cross-sectional study analyzing celiac disease blogs and Web sites intended for the layperson. We searched from 20 cities, resulting in 55 Web sites. These sites were analyzed for 38 criteria that considered relevant clinical information for people with celiac disease. Claims were classified as true, false, or not proven. The readability level of each Web site was determined. RESULTS The 55 Web sites were categorized as national organizations, personal blogs, recipe-based blogs, or commercial/marketing Web sites. Only 40% of Web sites contained more than 50% of criteria. Of 212 claims assessed, 97% were found to be accurate. National organizations included the most criteria, followed by recipe-based blogs, then personal blogs, and lastly commercial/marketing Web sites. Additionally, national organizations had the highest proportion of accurate claims, followed by personal blogs, then commercial/marketing Web sites, and recipe-based blogs with the most inaccurate information. The average readability level of overall was 9.7, above the recommended readability level for patient education materials. CONCLUSIONS A significant number of online claims regarding celiac disease were true, but the majority of patient-facing Web sites are missing large amounts of relevant information. This warrants efforts to improve the quality of medical information published online.
Collapse
Affiliation(s)
- Alison Buseck
- The Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, Suite 936, New York, NY, 10032, USA
| | - Benjamin Lebwohl
- The Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, Suite 936, New York, NY, 10032, USA
| | - Peter H R Green
- The Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, Suite 936, New York, NY, 10032, USA.
| |
Collapse
|
9
|
Barnoy S, Melnikov S, Bar-Tal Y. The effect of e-health information on nurse-patient encounters: Mutual feelings and perceptions. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-018-9845-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
10
|
Ethan D, Meleo-Erwin Z, Fera J, Garcia P, Basch CH. Readability of Online Information on Celiac Disease: A Brief Report. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2020. [DOI: 10.1080/15398285.2020.1752028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Danna Ethan
- Department of Health Sciences, Lehman College, The City University of New York, Bronx, New York, USA
| | - Zoe Meleo-Erwin
- Department of Public Health, William Paterson University, Wayne, New Jersey, USA
| | - Joseph Fera
- Department of Mathematics, Lehman College, The City University of New York, Bronx, New York, USA
| | - Phillip Garcia
- Department of Public Health, William Paterson University, Wayne, New Jersey, USA
| | - Corey H. Basch
- Department of Public Health, William Paterson University, Wayne, New Jersey, USA
| |
Collapse
|
11
|
Felipe L, Beukes EW, Fox BA, Manchaiah V. Quality and readability of English-language Internet information for vestibular disorders. J Vestib Res 2020; 30:63-72. [PMID: 32333571 PMCID: PMC9249283 DOI: 10.3233/ves-200698] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND: The Internet has become a powerful, accessible resource for many patients to use for their own medical management and knowledge. Vestibular disorders are prevalent, especially in the elderly. As the Internet is increasingly a major source of health-related information to the general public, it is often used to search for information regarding dizziness and vertigo. Ensuring that the information is accessible, unbiased, and appropriate can aid informed decision-making. OBJECTIVE: To evaluate the quality and readability of English-language Internet information related to vestibular disorders. METHODS: A cross-sectional website search using three keywords (nausea, dizziness, and vertigo) in five country-specific versions of the most commonly used Internet search engine was conducted in March 2018. The language was limited to English for all websites. Quality was assessed by presence of Health on the Net (HON) certification and DISCERN scores. Readability was assessed using the Flesch Reading Ease (FRE) score, Flesch-Kincaid Grade Level Formula (F-KGL), and Simple Measure of Gobbledygook (SMOG). RESULTS: In total, 112 websites were included and analyzed. The majority were commercial (61%) websites. A total of 42% had obtained HON certification. No association was found between the presence of HON certification and the resource of the website. The DISCERN scores had a mean of 2.52 (SD 1.1). Readability measures indicated that an average of 14–18 years of education was required to read and understand the Internet information provided regarding vestibular disorders. CONCLUSIONS: To ensure the accessible to the general population, it is necessary to improve the quality and readability of Internet-based information regarding vestibular disorders.
Collapse
Affiliation(s)
- Lilian Felipe
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.,Department of Speech and Hearing, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Eldré W Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.,Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Baylie A Fox
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.,Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| |
Collapse
|
12
|
Al Sarkhy A. Social media usage pattern and its influencing factors among celiac patients and their families. Saudi J Gastroenterol 2020; 26:99-104. [PMID: 32031161 PMCID: PMC7279077 DOI: 10.4103/sjg.sjg_495_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/04/2019] [Accepted: 12/01/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND/AIM The aim of this study was to investigate social media usage patterns among celiac patients and explore the potential factors that may influence the frequency of its usage. PATIENTS AND METHODS A cross-sectional survey was conducted, in which an online questionnaire was sent to celiac patients registered in the Saudi celiac patients' support group through email and its related social media accounts. Eligible participants included all patients with biopsy-confirmed celiac disease or their parents. RESULTS In total, 221 participants completed the survey. The majority (96%, n = 212/221) reported using social media networks for their disease management. We included only those participants in the analysis. The median age was 36 years (range; 18-60 years). The majority of respondents (59.4%) were female. Most participants (65.6%) were patients with celiac disease and 34.4% were parents of celiac patients. The median duration of the disease was three years (range; 1 month-26 years). The three most frequently visited social media platforms were WhatsApp by 175 (82.5%) participants, Instagram by 132 (62.3%), and Twitter by 124 (58.5%) participants. The median time spent on social media was 60 min per day (range; 10-720 min). Multivariate logistic regression showed that celiac disease patients used social media two times more than the parents of celiac patients (OR 2.37, 95% CI: 1.19 - 4.72; P = 0.014). CONCLUSIONS Celiac patients are highly involved in social media activities for purposes related to their disease. We encourage healthcare providers to be available online to provide trustable and high-quality educational materials.
Collapse
Affiliation(s)
- Ahmed Al Sarkhy
- Gastroenterology Unit, Pediatric Department, King Saud University, Riyadh, Saudi Arabia
- Prince Abdullah Bin Khalid Celiac Disease Research Chair, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
13
|
Quality, Trustworthiness, Readability, and Accuracy of Medical Information Regarding Common Pediatric Emergency Medicine-Related Complaints on the Web. J Emerg Med 2019; 57:469-477. [DOI: 10.1016/j.jemermed.2019.06.043] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/05/2019] [Accepted: 06/04/2019] [Indexed: 12/25/2022]
|
14
|
Sjöström AE, Hörnsten Å, Hajdarevic S, Emmoth A, Isaksson U. Primary Health Care Nurses' Experiences of Consultations With Internet-Informed Patients: Qualitative Study. JMIR Nurs 2019; 2:e14194. [PMID: 34345770 PMCID: PMC8279453 DOI: 10.2196/14194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/21/2019] [Accepted: 06/19/2019] [Indexed: 01/10/2023] Open
Abstract
Background Most people in modern societies now use the Internet to obtain health-related information. By giving patients knowledge, digital health information is considered to increase patient involvement and patient-centered interactions in health care. However, concerns are raised about the varying quality of health-related websites and low health literacy in the population. There is a gap in the current knowledge of nurses’ experiences with Internet-informed patients. Objective The objective of this study was to explore primary health care nurses’ experiences of consultations with patients who present health-related information from the Internet. Methods This is a qualitative study based on interviews with 9 primary health care nurses. Data were analyzed using qualitative content analysis. Results are reported according to the consolidated criteria for reporting qualitative research guidelines. Results The phenomenon of Internet-informed patients was considered to change the usual rules in health care, affecting attributes and actions of patients, patterns of interactions in consultations, and roles of nurses and patients. Three categories were identified: (1) Facing the downsides of Googling, (2) Patients as main actors, and (3) Nurse role challenged. Although the benefits of health-related Internet information were described, its negative consequences were emphasized overall. The problems were mainly ascribed to inaccurate Internet information and patients’ inability to effectively manage the information. Conclusions Our study suggests ambivalent attitudes among nurses toward health-related Internet information. In order to promote equitable care in the digital era, increased awareness in health care about useful strategies for overcoming the difficulties and embracing the benefits of conferring with Internet-informed patients seems to be a legitimate goal.
Collapse
Affiliation(s)
| | - Åsa Hörnsten
- Department of Nursing Umeå University Umeå Sweden
| | | | | | - Ulf Isaksson
- Department of Nursing Umeå University Umeå Sweden.,Arctic Research Centre Umeå University Umeå Sweden
| |
Collapse
|
15
|
Exploring the relationship of digital information sources and medication adherence. Comput Biol Med 2019; 109:303-310. [DOI: 10.1016/j.compbiomed.2019.04.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/15/2019] [Accepted: 04/20/2019] [Indexed: 12/28/2022]
|
16
|
Sample D, Turner J. Improving gluten free diet adherence by youth with celiac disease. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2019-0026/ijamh-2019-0026.xml. [PMID: 30875325 DOI: 10.1515/ijamh-2019-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 02/17/2019] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Celiac disease (CD) is a gluten-triggered autoimmune disorder of the small intestine, which can occur in genetically susceptible individuals at any age. A strict life-long gluten free diet (GFD) is the only medically approved treatment, and non-adherence is associated with significant morbidity. However, gluten use is widespread, complicating efforts to follow the diet. Youth with CD are especially challenged with dietary adherence, as they strive for peer acceptance and personal autonomy in the context of managing a chronic disease. METHODS A scoping review was conducted to identify mechanisms to assist youth with remaining gluten free. RESULTS There is a paucity of literature regarding best approaches to improve diet adherence by youth, however, lessons can also be learned by borrowing ideas from self-management approaches of other chronic diseases. Several mechanisms for improving GFD adherence among youth are identified, including regular engagement of the youth with CD and their family with an experienced multidisciplinary team, electronic tool utilization and awareness of accurate resources for self-guided education and resources. CONCLUSIONS Improvement in GFD adherence by youth is achievable and may influence long-term health outcomes.
Collapse
Affiliation(s)
- Dory Sample
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada, Phone: +780-248-5599
| | - Justine Turner
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
17
|
Hypervigilance to a Gluten-Free Diet and Decreased Quality of Life in Teenagers and Adults with Celiac Disease. Dig Dis Sci 2018; 63:1438-1448. [PMID: 29387990 DOI: 10.1007/s10620-018-4936-4] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 01/16/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Avoidance of gluten is critical for individuals with celiac disease (CD), but there is also concern that "extreme vigilance" to a strict gluten-free diet may increase symptoms such as anxiety and fatigue, and therefore, lower quality of life (QOL). We examined the associations of QOL with energy levels and adherence to, and knowledge about, a gluten-free diet. METHODS This is a cross-sectional prospective study of 80 teenagers and adults, all with biopsy-confirmed CD, living in a major metropolitan area. QOL was assessed with CD-specific measures. Dietary vigilance was based on 24-h recalls and an interview. Knowledge was based on a food label quiz. Open-ended questions described facilitators and barriers to maintaining a gluten-free diet. RESULTS The extremely vigilant adults in our sample had significantly lower QOL scores than their less vigilant counterparts [(mean (SD): 64.2 (16.0) vs 77.2 (12.2), p = 0.004]. Extreme vigilance was also associated with greater knowledge [5.7 (0.7) vs 5.1 (0.8), p = 0.035]. Adults with lower energy levels had significantly lower overall QOL scores than adults with higher energy levels [68.0 (13.6) vs 78.9 (13.0), p = 0.006]. Patterns were similar for teenagers. Cooking at home and using internet sites and apps were prevalent strategies used by the hypervigilant to maintain a strict gluten-free diet. Eating out was particularly problematic. CONCLUSION There are potential negative consequences of hypervigilance to a strict gluten-free diet. Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.
Collapse
|
18
|
Sivakumar G, Mares ML. The Doctor Versus the Internet: Effects of Low-, Medium-, and High-Quality Websites on Intentions to Follow the Doctor's Advice. HEALTH COMMUNICATION 2017; 32:1454-1462. [PMID: 27767346 DOI: 10.1080/10410236.2016.1228030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
How do patients respond when advice on health websites differs from advice given by a doctor? To test effects of advice concordance, 418 participants 25-80 years old were randomly assigned to read real websites that varied in quality of information about diabetes: high (medically accurate and complete), medium (accurate but incomplete), and low (inaccurate). The control group read travel sites. Participants then watched a video of a physician making treatment recommendations for a diabetic patient, and indicated how they would respond if they were the patient. There was no direct effect of condition on ratings of doctor credibility or intentions to adhere to the treatment plan, but there was an indirect effect: Those who read high-quality websites gave higher ratings of doctor-website concordance, which predicted greater confidence in the doctor's recommendations, which in turn predicted greater intention to comply.
Collapse
Affiliation(s)
- Gayathri Sivakumar
- a Department of Journalism and Media Communication , Colorado State University
| | | |
Collapse
|
19
|
[Gluten: Is the information available on the Internet valid?]. Arch Pediatr 2017; 24:977-985. [PMID: 28927776 DOI: 10.1016/j.arcped.2017.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/11/2017] [Accepted: 08/05/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Internet provides easy access to health information, but the quality and validity of this information vary. OBJECTIVES Evaluate the quality of website structures and the information provided on celiac disease (CD), gluten sensitivity (GS), and wheat allergy (WA). MATERIALS AND METHODS The websites addressing CD, GS, and WA appearing on the first two pages of Google, Yahoo, and Bing from seven selected queries were investigated. We initially assessed the website structures with one instrument (Netscoring) and the presence of certification (quality label Health On the Net (HON code)). Then we evaluated the content of each website concerning the information about CD, GS, and WA. Our repository was based on the most recent guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) and the World Gastroenterology Organization (WGO) published in 2012. The websites were classified into eight categories. RESULTS One hundred and five websites were included. Twenty-one websites obtained a sufficient score with the Netscoring instrument (average 113.6/312). There was a significant correlation between the referenced websites analyzed and the grades obtained with the Netscoring instrument (Pearson=0.39, P=0.2×10-5): websites of scientific societies (11.8/18), community websites (9.44/18), and website associations (9.4/18). There was a significant correlation between the results obtained for the websites on CD, GS, and WA and the results obtained for the websites with the Netscoring instruments (Pearson=0.41, P=2.6×10-6). Only three websites were consistent with the guidelines on CD, GS, and WA. CONCLUSION The websites were partially in agreement with the guidelines. To date, the pediatrician remains the main actor in parental guidance concerning gluten information.
Collapse
|
20
|
Registered Dietitians' Preferred Celiac Disease Resources and Twitter, Facebook, Smartphone App, or Internet Use for Celiac Disease Patient Education. TOP CLIN NUTR 2017. [DOI: 10.1097/tin.0000000000000108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Ben-Mussa A, Paget AM. Popular apps on the medical category targeting patients and the general public in the United Kingdom: Do they conform to the Health On the Net Foundation principles? Health Informatics J 2016; 24:259-276. [PMID: 27566750 DOI: 10.1177/1460458216664193] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Smartphones with their rising popularity and versatile software 'apps' have great potential for revolutionising healthcare services. However, this was soon overshadowed by concerns highlighted by many studies over quality. These were subject and/or discipline specific and mostly evaluated compliance with a limited number of information portrayal standards originally devised for health websites. Hence, this study aimed to take a broader approach by evaluating the most popular apps categorised as medical in the United Kingdom for compliance with all of those standards systematically using the Health On the Net (HON) Foundation principles. The study evaluated top 50 free and paid apps of the 'medical' category on both iTunes and Google stores for evidence of compliance with an app-adapted version of the HON Foundation code of conduct. The sample included 64 apps, 34/64 (53%) were on Google Play and 36/64 (56%) were free. None of the apps managed to comply with the entire eight principles. Compliance with seven principles was achieved by only one app (1.6%), and the rest were compliant with three, two, and one (14.7%, 27%, and 38%, respectively). In conclusion, this study demonstrated that most popular apps on the medical category that are available in the United Kingdom do not meet the standards for presenting health information to the public, and this is consistent with earlier studies. Improving the situation would require raising the public awareness, providing tools that would assist in quality evaluation, encouraging developers to use robust development process, and facilitating collaboration and engagement among the stakeholders.
Collapse
|
22
|
Conesa-Fuentes MC, Hernandez-Morante JJ. Prospective analysis of the quality of Spanish health information web sites after 3 years. Inform Health Soc Care 2016; 41:417-29. [PMID: 26809468 DOI: 10.3109/17538157.2015.1064426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Although the Internet has become an essential source of health information, our study conducted 3 years ago provided evidence of the low quality of Spanish health web sites. The objective of the present study was to evaluate the quality of Spanish health information web sites now, and to compare these results with those obtained 3 years ago. METHODS For the original study, the most visited health information web sites were selected through the PageRank® (Google®) system. The present study evaluated the quality of the same web sites from February to May 2013, using the method developed by Bermúdez-Tamayo et al. and HONCode® criteria. RESULTS The mean quality of the selected web sites was low and has deteriorated since the previous evaluation, especially in regional health services and institutions' web sites. The quality of private web sites remained broadly similar. Compliance with privacy and update criteria also improved in the intervening period. CONCLUSION The results indicate that, even in the case of health web sites, design or appearance is more relevant to developers than quality of information. It is recommended that responsible institutions should increase their efforts to eliminate low-quality health information that may further contribute to health problems.
Collapse
|
23
|
See JA, Kaukinen K, Makharia GK, Gibson PR, Murray JA. Practical insights into gluten-free diets. Nat Rev Gastroenterol Hepatol 2015; 12:580-91. [PMID: 26392070 DOI: 10.1038/nrgastro.2015.156] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Coeliac disease is a global disease, and the only currently available treatment is a gluten-free diet (GFD). Although conceptually simple, the diet changes are substantial and have a profound effect on a patient's life. Untreated coeliac disease is associated with complications, including excess mortality, most of which can be avoided with a strict GFD. However, there are many barriers, including availability, cost and safety of gluten-free foods, and gluten cross-contamination. The GFD can be restrictive in social situations, leading to poor quality of life and, ultimately, nonadherence. As the number of patients with coeliac disease increases worldwide, clinicians need to be aware of the challenges patients face. Heightened awareness by physicians, dietitians and other providers can help maximize successful treatment, improve outcomes, and reduce health-care costs and disease burden. Routine follow-up is necessary to reinforce the need for a GFD, provide social and emotional support, and achieve mucosal healing, leading to reduced risk of complications. Unfortunately, there is wide variation in follow-up practices. The objective of this Review is to increase awareness of the challenges, management and follow-up of patients with coeliac disease to help them achieve GFD adherence and prevent complications whilst preserving their quality of life.
Collapse
Affiliation(s)
- Jacalyn A See
- Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
| | - Katri Kaukinen
- Department of Medicine, Building Finn-Medi 3, University of Tampere, Tampere, FI-33014, Finland
| | - Govind K Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | - Peter R Gibson
- Department of Gastroenterology, Central Clinical School, Monash University, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia
| | - Joseph A Murray
- Division of Gastroenterology and Department of Immunology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
| |
Collapse
|
24
|
Oxentenko AS, Murray JA. Celiac Disease: Ten Things That Every Gastroenterologist Should Know. Clin Gastroenterol Hepatol 2015; 13:1396-404; quiz e127-9. [PMID: 25051511 DOI: 10.1016/j.cgh.2014.07.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 07/09/2014] [Accepted: 07/09/2014] [Indexed: 02/07/2023]
Abstract
There are 10 things that all gastroenterologists should know about celiac disease (CD). (1) The immunoglobulin A tissue transglutaminase is the single best serologic test to use for the detection of CD. (2) CD can be recognized endoscopically, and water immersion enhances villi detection, although a normal endoscopic appearance does not preclude the diagnosis. (3) It is recommended that 4 biopsies be taken from the second part of the duodenum and 2 bulb biopsies be taken at the 9 o'clock and 12 o'clock positions to maximize the sensitivity for histologic confirmation of CD. (4) Consider serologic testing of first-degree relatives, patients with type 1 diabetes mellitus, Down's, Turner's, and Williams' syndromes, as well as those with premature osteoporosis, iron deficiency, abnormal liver biochemistries, and other manifestations of CD. (5) Patients already on a prolonged gluten-free diet (GFD) should be tested for the presence of HLA DQ2 or DQ8, thereby avoiding the need for further evaluation of CD in non-allelic carriers. (6) The basic treatment of CD is a strict, lifelong GFD, enabled by an expert dietitian. (7) Newly diagnosed adults with CD should be assessed for micronutrient deficiencies (iron, B12, folate, zinc, copper), fat soluble vitamin deficiencies (vitamin D), and bone densitometry. (8) All patients diagnosed with CD should have clinical follow-up to ensure response and adherence to a GFD. (9) In those with persistent or relapsing symptoms, the robustness of the original diagnosis should be reviewed, gluten exposure sought, and a systematic evaluation for alternative and associated diseases performed. (10) Evaluate those with refractory disease for malignant transformation.
Collapse
Affiliation(s)
- Amy S Oxentenko
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Joseph A Murray
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
| |
Collapse
|
25
|
|
26
|
Ludvigsson JF, Card T, Ciclitira PJ, Swift GL, Nasr I, Sanders DS, Ciacci C. Support for patients with celiac disease: A literature review. United European Gastroenterol J 2015; 3:146-59. [PMID: 25922674 PMCID: PMC4406900 DOI: 10.1177/2050640614562599] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/01/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Celiac disease (CD) is a lifelong disorder. Patients are at increased risk of complications and comorbidity. OBJECTIVES We conducted a review of the literature on patient support and information in CD and aim to issue recommendations about patient information with regards to CD. METHODS DATA SOURCE We searched PubMed for English-language articles published between 1900 and June 2014, containing terms related to costs, economics of CD, or education and CD. STUDY SELECTION Papers deemed relevant by any of the participating authors were included in the study. DATA SYNTHESIS No quantitative synthesis of data was performed. Instead we formulated a consensus view of the information that should be offered to all patients with CD. RESULTS There are few randomized clinical trials examining the effect of patient support in CD. Patients and their families receive information from many sources. It is important that health care personnel guide the patient through the plethora of facts and comments on the Internet. An understanding of CD is likely to improve dietary adherence. Patients should be educated about current knowledge about risk factors for CD, as well as the increased risk of complications. Patients should also be advised to avoid other health hazards, such as smoking. Many patients are eager to learn about future non-dietary treatments of CD. This review also comments on novel therapies but it is important to stress that no such treatment is available at present. CONCLUSION Based on mostly observational data, we suggest that patient support and information should be an integral part of the management of CD, and is likely to affect the outcome of CD.
Collapse
Affiliation(s)
- Jonas F Ludvigsson
- Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tim Card
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| | - Paul J Ciclitira
- Division of Nutritional Sciences, King’s College London, The Rayne Institute London, London, UK
| | - Gillian L Swift
- Department of Gastroenterology, Cardiff and Vale University Health Board, Cardiff, UK
| | - Ikram Nasr
- Division of Nutritional Sciences, King’s College London, The Rayne Institute London, London, UK
| | - David S Sanders
- Regional GI and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK
| | - Carolina Ciacci
- Department of Medicine and Surgery, Gastroenterology, University of Salerno, Salerno, Italy
| |
Collapse
|
27
|
Ciacci C, Ciclitira P, Hadjivassiliou M, Kaukinen K, Ludvigsson JF, McGough N, Sanders DS, Woodward J, Leonard JN, Swift GL. The gluten-free diet and its current application in coeliac disease and dermatitis herpetiformis. United European Gastroenterol J 2015; 3:121-35. [PMID: 25922672 PMCID: PMC4406897 DOI: 10.1177/2050640614559263] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/17/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A gluten-free diet (GFD) is currently the only available therapy for coeliac disease (CD). OBJECTIVES We aim to review the literature on the GFD, the gluten content in naturally gluten-free (GF) and commercially available GF food, standards and legislation concerning the gluten content of foods, and the vitamins and mineral content of a GFD. METHODS We carried out a PubMed search for the following terms: Gluten, GFD and food, education, vitamins, minerals, calcium, Codex wheat starch and oats. Relevant papers were reviewed and for each topic a consensus among the authors was obtained. CONCLUSION Patients with CD should avoid gluten and maintain a balanced diet to ensure an adequate intake of nutrients, vitamins, fibre and calcium. A GFD improves symptoms in most patients with CD. The practicalities of this however, are difficult, as (i) many processed foods are contaminated with gluten, (ii) staple GF foods are not widely available, and (iii) the GF substitutes are often expensive. Furthermore, (iv) the restrictions of the diet may adversely affect social interactions and quality of life. The inclusion of oats and wheat starch in the diet remains controversial.
Collapse
Affiliation(s)
- Carolina Ciacci
- Department of Medicine and Surgery, Gastroenterology, University of Salerno, Italy
| | - Paul Ciclitira
- Department of Gastroenterology, Division of Diabetes and Nutritional Sciences, Kings College London; The Rayne Institute, St Thomas Hospital, London, UK
| | - Marios Hadjivassiliou
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Trust; Royal Hallamshire Hospital, Sheffield, UK
| | - Katri Kaukinen
- School of Medicine, University of Tampere and Department of Internal Medicine, Tampere University Hospital and Department of Internal Medicine, Seinäjoki Central Hospital, Finland
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet and Department of Pediatrics, Örebro University Hospital, Sweden
| | | | - David S Sanders
- Gastroenterology and Liver Unit, Royal Hallamshire Hospital & University of Sheffield, Sheffield, UK
| | - Jeremy Woodward
- Cambridge Intestinal Unit, Addenbrooke’s Hospital, Cambridge, UK
| | - Jonathan N Leonard
- Department of Dermatology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Gillian L Swift
- Department of Gastroenterology, University Hospital Llandough, Cardiff, UK
| |
Collapse
|
28
|
Sullivan TB, Anderson JT, Ahn UM, Ahn NU. Can Internet information on vertebroplasty be a reliable means of patient self-education? Clin Orthop Relat Res 2014; 472:1597-604. [PMID: 24338042 PMCID: PMC3971214 DOI: 10.1007/s11999-013-3425-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 12/05/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND Studies of the quality and accuracy of health and medical information available on the Internet have shown that many sources provide inadequate information. However, to our knowledge, there are no published studies analyzing the quality of information available online regarding vertebroplasty. Because this has been a high-volume procedure with highly debated efficacy, it is critical that patients receive complete, accurate, and well-balanced information before deciding a treatment course. Additionally, few studies have evaluated the merit of academic site authorship or site certification on information quality, but some studies have used measurements of quality that are based primarily on subjective criteria or information accuracy rather than information completeness. QUESTIONS/PURPOSES The purposes of our study were (1) to evaluate and analyze the information on vertebroplasty available to the general public through the Internet; (2) to see if sites sponsored by academic institutions offered a higher quality of information; and (3) to determine whether quality of information varied according to site approval by a certification body. METHODS Three search engines were used to identify 105 web sites (35 per engine) offering information regarding vertebroplasty. Sites were evaluated for authorship/sponsorship, content, and references cited. Information quality was rated as "excellent," "high," "moderate," "low," or "unacceptable." Sites also were evaluated for contact information to set up an appointment. Data were analyzed as a complete set, then compared between authorship types, and finally evaluated by certification status. Academic sites were compared with other authorship groups and certified sites were compared with noncertified sites using Student's t-test. RESULTS Appropriate indications were referenced in 74% of sites, whereas only 45% discussed a contraindication to the procedure. Benefits were expressed by 100% of sites, but risks were outlined in only 53% (p < 0.001). Ninety-nine percent of sites provided step-by-step descriptions of the procedure, and 44% of sites also included images. Alternative treatments were mentioned by 51% of sites. Twenty-seven percent of sites referenced peer-reviewed literature, 41% offered experiential or noncited data based on American populations, and 7% offered analogous data from international populations. Thirty percent of sites provided contact information for patient appointment scheduling. Seven percent of sites were classified as excellent quality, 6% as high quality, 11% as moderate quality, 19% as poor quality, and 57% as unacceptable. Sixteen percent of sites were sponsored by academic institutions, 62% by private groups, 8% by biomedical device companies, and 14% were sponsored otherwise. Academic sites reported fewer risks of the procedure than private sites or other sites (p = 0.05 and p = 0.04), but reported more risks than industry sites (p = 0.007). Academic sites were more likely than sites classified as other to offer contact information for patient appointment scheduling (p = 0.004). Nine percent of sites evaluated were Health on the Net Foundation (HONCode) certified. No association with improved information quality was observed in these sites relative to noncertified sites (all p > 0.05). CONCLUSIONS Internet information regarding vertebroplasty is not only inadequate for proper patient education, but also potentially misleading as sites are more likely to present benefits of the procedure than risks. Although academic sites might be expected to offer higher-quality information than private, industry, or other sites, our data would suggest that they do not. HONCode certification cannot be used reliably as a means of qualifying website information quality. Academic sites should be expected to set a high standard and alter their Internet presence with adequate information distribution. Certification bodies also should alter their standards to necessitate provision of complete information in addition to emphasizing accurate information. Treating physicians may want to counsel their patients regarding the limitations of information present on the Internet and the pitfalls of current certification systems. LEVEL OF EVIDENCE Level IV, economic and decision analyses. See the Instructions for Authors for a complete description of levels of evidence.
Collapse
Affiliation(s)
- T. Barrett Sullivan
- />Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106 USA
| | - Joshua T. Anderson
- />Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106 USA
| | - Uri M. Ahn
- />New Hampshire Spine Institute, Bedford, NH USA
| | - Nicholas U. Ahn
- />Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106 USA
| |
Collapse
|
29
|
Park K, Harris M, Khavari N, Khosla C. Rationale for Using Social Media to Collect Patient-Reported Outcomes in Patients with Celiac Disease. ACTA ACUST UNITED AC 2014; 4. [PMID: 25392743 PMCID: PMC4226063 DOI: 10.4172/2161-069x.1000166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patients with celiac disease (CD) are increasingly interconnected through social media, exchanging patient experiences and health-tracking information between individuals through various web-based platforms. Social media represents potentially unique communication interface between gastroenterologists and active social media users - especially young adults and adolescents with celiac disease-regarding adherence to the strict gluten-free diet, gastrointestinal symptoms, and meaningful discussion about disease management. Yet, various social media platforms may be underutilized for research purposes to collect patient-reported outcomes data. In this commentary, we summarize the scientific rationale and potential for future growth of social media in patient-reported outcomes research, focusing on college freshmen with celiac disease as a case study and provide overview of the methodological approach. Finally, we discuss how social media may impact patient care in the future through increasing mobile technology use.
Collapse
Affiliation(s)
- Kt Park
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA ; Center for Health Policy/Primary Care Outcomes Research, Stanford University, Stanford, CA, USA
| | - Merissa Harris
- School of Medicine, George Washington University, District of Columbia, USA
| | - Nasim Khavari
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Chaitan Khosla
- School of Medicine, George Washington University, District of Columbia, USA
| |
Collapse
|