scholarly journals Quality Assessment of Online Patient Information for Cosmetic Botulinum Toxin

2020 ◽  
Vol 40 (11) ◽  
pp. NP636-NP642 ◽  
Author(s):  
Eric Barbarite ◽  
David Shaye ◽  
Samuel Oyer ◽  
Linda N Lee

Abstract Background In an era of widespread Internet access, patients increasingly look online for health information. Given the frequency with which cosmetic botulinum toxin injection is performed, there is a need to provide patients with high-quality information about this procedure. Objectives The aim of this study was to examine the quality of printed online education materials (POEMs) about cosmetic botulinum toxin. Methods An Internet search was performed to identify 32 websites of various authorship types. Materials were evaluated for accuracy and inclusion of key content points. Readability was measured by Flesch Reading Ease and Flesch-Kincaid Grade Level. Understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Printed Materials. The effect of authorship was measured by undertaking analysis of variance between groups. Results The mean [standard deviation] accuracy score among all POEMs was 4.2 [0.7], which represents an accuracy of 76% to 99%. Mean comprehensiveness was 47.0% [16.4%]. Mean Flesch-Kincaid Grade Level and Flesch Reading Ease scores were 10.7 [2.1] and 47.9 [10.0], respectively. Mean understandability and actionability were 62.8% [18.8%] and 36.2% [26.5%], respectively. There were no significant differences between accuracy (P > 0.2), comprehensiveness (P > 0.5), readability (P > 0.1), understandability (P > 0.3), or actionability (P > 0.2) by authorship. Conclusions There is wide variability in the quality of cosmetic botulinum toxin POEMs regardless of authorship type. The majority of materials are written above the recommended reading level and fail to include important content points. It is critical that providers take an active role in the evaluation and endorsement of online patient education materials.

2020 ◽  
pp. 019459982096915
Author(s):  
Lena W. Chen ◽  
Vandra Chatrice Harris ◽  
Justin Lee Jia ◽  
Deborah Xingchun Xie ◽  
Ralph Patrick Tufano ◽  
...  

Objective Thyroidectomy is one of the most common procedures performed in head and neck surgery. The quality of online resources for thyroidectomy is unknown. We aim to evaluate search trends and online resource quality regarding thyroidectomy. Study Design Cross-sectional analysis. Setting Websites appearing on Google search. Methods The first 30 Google websites for thyroidectomy were reviewed, excluding research, video, and restricted sites. Search patterns were obtained with Google Trends. Quality was measured by readability (Flesch Reading Ease and Flesch-Kinkaid Grade Level), understandability and actionability (Patient Education Materials Assessment Tool), and clinical practice guideline (CPG) compatibility. Fleiss kappa interrater reliability analysis was performed for 2 raters. Results Twenty-one sites were evaluated. Search popularity for thyroidectomy has increased since 2004. Median reading ease was 42.2 (range, 15.4-62.7) on a scale from 1 to 100, with 100 indicating maximum readability. Median reading grade level was 12 (range, 7-16). Thyroidectomy resources were poorly understandable (median, 66%; range, 21%-88%) and actionable (median, 10%; range, 0%-60%). Median CPG compatibility was 4 out of 5 (range, 0-5). Interrater reliability ranged from substantial to moderate for understandability (0.78), actionability (0.57), and CPG compatibility (0.58), with P < .05 for all results. Conclusion Online resources about thyroidectomy vary in quality and reliability and are written at grade levels above the average reading level of the public. Providers should be aware of existing resources and work to create education resources that meet universal health literacy guidelines. The framework provided in this article may also serve as a guide and provide tangible steps that providers can take to help patients access care.


Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Kieran Murray ◽  
Timothy Murray ◽  
Candice Low ◽  
Anna O'Rourke ◽  
Douglas J Veale

Abstract Background Osteoarthritis is the most common cause of disability in people over 65 years old. The readability of of online osteoarthritis information has never been assessed. A 2003 study found the quality of online osteoarthritis information to be poor. This study reviews the quality of online information regarding osteoarthritis in 2018 using three validated scoring systems. Readability is reviewed for the first time, again using three validated tools. Methods The term osteoarthritis was searched across the three most popular English language search engines. The first 25 pages from each search engine were analysed. Duplicate pages, websites featuring paid advertisements, inaccessible pages (behind a pay wall, not available for geographical reasons) and non-text pages were excluded. Readability was measured using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL) and Gunning-Fog Index (GFI). Website quality was scored using the the Journal of the American Medical Association (JAMA) benchmark criteria and DISCERN criteria. Presence or absence of HONcode certification, age of content, content producer and author characteristics were noted. Results 37 unique websites were suitable for analysis. Readability varied by assessment tool from 8th to 12th grade level. This compares with the recommended 7- 8th grade level. One (2.7%) website met all four JAMA Criteria. Mean DISCERN quality of information for OA websites was “fair”, comparing favourably with the “poor” grading of a 2003 study. HONCode endorsed websites (43.2%) were of a statistically significantly higher quality. Conclusion Quality of online health information for OA is “fair”. 2.7% of websites met JAMA benchmark criteria for quality. Readability was equal to or more difficult than recommendations. HONcode certification was indicative of higher quality, but not readability. Disclosures K. Murray None. T. Murray None. C. Low None. A. O'Rourke None. D.J. Veale None.


Author(s):  
Naudia Falconer ◽  
E. Reicherter ◽  
Barbara Billek-Sawhney ◽  
Steven Chesbro

The readability level of many patient education materials is too high for patients to comprehend, placing the patient’s health at risk. Since health professionals often recommend Internet-based patient education resources, they must ensure that the readability of information provided to consumers is at an appropriate level. Purpose: The purpose of this study was to determine the readability of educational brochures found on the American Physical Therapy Association (APTA) consumer website. Methods: Fourteen educational brochures on the APTA website in March 2008 were analyzed using the following assessments: Flesch-Kincaid Grade Level, Flesch Reading Ease, Fry Readability Formula, Simple Measure of Gobbledygook (SMOG), Checklist for Patient Education Materials, and Consumer Health Web Site Evaluation Checklist. Results: According to the Flesch-Kincaid and Flesch Reading Ease, over 90% of the brochures were written at greater than a sixth grade level. The mean reading level was grade 10.2 (range = 3.1 to 12) with a Reading Ease score between 31.5 to 79.9. Using the SMOG formula, the brochures had a mean reading level of grade 11.5 (range = 9 to 13). The Fry Readability showed that 85% of the brochures were written higher than a sixth grade level, with a mean reading level of grade 9.5 (range = 6 to 14). Conclusion: Findings suggest that most of the consumer education information available on the website of this health professional organization had readability scores that were too high for average consumers to read.


2011 ◽  
Vol 125 (7) ◽  
pp. 714-718 ◽  
Author(s):  
S Morzaria ◽  
E J Damrose

AbstractBackground:Botulinum toxin injection under electromyographic guidance is the ‘gold standard’ for adductor spasmodic dysphonia treatment. The point-touch technique, an alternative injection method which relies on anatomical landmarks, is cheaper, quicker and more accessible, but has not yet gained widespread acceptance due to concerns about patient satisfaction.Objective:To assess swallowing and voice-related quality of life following point-touch botulinum toxin injection in adductor spasmodic dysphonia patients.Setting:Stanford University Voice and Swallowing Center.Design:Prospective case series (evidence level four).Methods:Consecutive adductor spasmodic dysphonia patients with a stable botulinum toxin dose–response relationship were recruited prospectively. The Eating Assessment Tool and Voice-Related Quality of Life questionnaires were completed pre-treatment and at 10 and 30 per cent completion of the injection cycle, respectively.Results:Thirty-seven patients completed follow up. The mean total botulinum toxin dose was 0.88 units. Pre-treatment Voice-Related Quality of Life questionnaire results reflected the burden of disease. Post-treatment Eating Assessment Tool and Voice-Related Quality of Life questionnaire results were collected at 2.53 and 7.84 weeks, respectively; the former showed an increase in dysphagia, albeit statistically insignificant, while the latter showed significantly improved scores (both domain and total).Conclusion:The point-touch technique is a viable alternative for botulinum toxin injection in the treatment of adductor spasmodic dysphonia.


2018 ◽  
Author(s):  
Kieran Edward Murray ◽  
Timothy Eanna Murray ◽  
Anna Caroline O'Rourke ◽  
Candice Low ◽  
Douglas James Veale

BACKGROUND Osteoarthritis (OA) is the most common cause of disability in people older than 65 years. Readability of online OA information has never been assessed. A 2003 study found the quality of online OA information to be poor. OBJECTIVE The aim of this study was to review the readability and quality of current online information regarding OA. METHODS The term osteoarthritis was searched across the three most popular English language search engines. The first 25 pages from each search engine were analyzed. Duplicate pages, websites featuring paid advertisements, inaccessible pages (behind a pay wall, not available for geographical reasons), and nontext pages were excluded. Readability was measured using Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Gunning-Fog Index. Website quality was scored using the Journal of the American Medical Association (JAMA) benchmark criteria and the DISCERN criteria. Presence or absence of the Health On the Net Foundation Code of Conduct (HONcode) certification, age of content, content producer, and author characteristics were noted. RESULTS A total of 37 unique websites were found suitable for analysis. Readability varied by assessment tool from 8th to 12th grade level. This compares with the recommended 7th to 8th grade level. Of the 37, 1 (2.7%) website met all 4 JAMA criteria. Mean DISCERN quality of information for OA websites was “fair,” compared with the “poor” grading of a 2003 study. HONcode-endorsed websites (43%, 16/37) were of a statistically significant higher quality. CONCLUSIONS Readability of online health information for OA was either equal to or more difficult than the recommended level.


Author(s):  
Elysia M. Grose ◽  
Connor P. Holmes ◽  
Kaishan A. Aravinthan ◽  
Vincent Wu ◽  
John M. Lee

Abstract Background Given that nasal septoplasty is a common procedure in otolaryngology – head and neck surgery, the objective of this study was to evaluate the quality and readability of online patient education materials on septoplasty. Methods A Google search was performed using eight different search terms related to septoplasty. Six different tools were used to assess the readability of included patient education materials. These included the Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning-Fog Index, Simple Measure of Gobbledygook Index, Coleman-Liau Index, and Automated Readability Index. The DISCERN tool was used to assess quality and reliability. Results Eighty-five online patient education materials were included. The average Flesch-Reading Ease score for all patient education materials was 54.9 ± 11.5, indicating they were fairly difficult to read. The average reading grade level was 10.5 ± 2.0, which is higher than the recommended reading level for patient education materials. The mean DISCERN score was 42.9 ± 10.5 and 42% (36/85) of articles had DISCERN scores less than 39, corresponding to poor or very poor quality. Conclusion The majority of online patient education materials on septoplasty are written above the recommended reading levels and have significant deficiencies in terms of their quality and reliability. Clinicians and patients should be aware of the shortcomings of these resources and consider the impact they may have on patients’ decision making.


OTO Open ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 2473974X2110326
Author(s):  
Matthew Shneyderman ◽  
Grace E. Snow ◽  
Ruth Davis ◽  
Simon Best ◽  
Lee M. Akst

Objectives To assess readability and understandability of online materials for vocal cord leukoplakia. Study Design Review of online materials. Setting Academic medical center. Methods A Google search of “vocal cord leukoplakia” was performed, and the first 50 websites were considered for analysis. Readability was measured by the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). Understandability and actionability were assessed by 2 independent reviewers with the PEMAT-P (Patient Education Materials Assessment Tool for Printable Materials). Unpaired t tests compared scores between sites aimed at physicians and those at patients, and a Cohen’s kappa was calculated to measure interrater reliability. Results Twenty-two websites (17 patient oriented, 5 physician oriented) met inclusion criteria. For the entire cohort, FRES, FKGL, and SMOG scores (mean ± SD) were 36.90 ± 20.65, 12.96 ± 3.28, and 15.65 ± 3.57, respectively, indicating that materials were difficult to read at a >12th-grade level. PEMAT-P understandability and actionability scores were 73.65% ± 7.05% and 13.63% ± 22.47%. Statistically, patient-oriented sites were more easily read than physician-oriented sites ( P < .02 for each of the FRES, FKGL, and SMOG comparisons); there were no differences in understandability or actionability scores between these categories of sites. Conclusion Online materials for vocal cord leukoplakia are written at a level more advanced than what is recommended for patient education materials. Awareness of the current ways that these online materials are failing our patients may lead to improved education materials in the future.


2016 ◽  
Vol 27 (04) ◽  
pp. 354-359 ◽  
Author(s):  
John Joseph ◽  
Peter F. Svider ◽  
Kevin Shaigany ◽  
Jean Anderson Eloy ◽  
Paulette G. McDonald ◽  
...  

Purpose: The purpose of this study was to analyze and compare the readability of patient education materials (PEMs) from leading manufacturers of behind-the-ear style hearing aids and popular hearing aid information Web sites to determine if they meet guidelines recommended by public health agencies. Research Design: Analysis of hearing aid PEMs. Methods: Printed user guides from six of the leading manufacturers of BTE hearing aids and 15 of the most popular hearing aid–information Web sites were accessed online and analyzed for readability using the Gunning-Fog Index, New Fog Count, Raygor Estimate Graph, Simple Measure of Gobbledygook, and Flesch Reading Ease score. Results: Overall average grade–level readability for all six printed manufacturer user manuals was calculated to be written at a 10th grade reading level. Overall average grade-level readabilities for all 15 popular online hearing aid–information Web sites representing professional organizations, suppliers, and health information services were calculated to be written at 10th, 10th, and 11th grade reading levels, respectively. Average Flesch Reading Ease scores for all printed guides and online patient information Web sites were calculated to fall within the fairly difficult category for readability. Conclusions: PEMs provided by top hearing aid manufactures and popular hearing aid Web sites are written well above the reading level recommended by the National Institutes of Health. Consideration should be given toward simplifying these materials in order to enhance user experience and increase compliance among behind-the-ear hearing aid users.


10.2196/12855 ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. e12855 ◽  
Author(s):  
Kieran Edward Murray ◽  
Timothy Eanna Murray ◽  
Anna Caroline O'Rourke ◽  
Candice Low ◽  
Douglas James Veale

Background Osteoarthritis (OA) is the most common cause of disability in people older than 65 years. Readability of online OA information has never been assessed. A 2003 study found the quality of online OA information to be poor. Objective The aim of this study was to review the readability and quality of current online information regarding OA. Methods The term osteoarthritis was searched across the three most popular English language search engines. The first 25 pages from each search engine were analyzed. Duplicate pages, websites featuring paid advertisements, inaccessible pages (behind a pay wall, not available for geographical reasons), and nontext pages were excluded. Readability was measured using Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Gunning-Fog Index. Website quality was scored using the Journal of the American Medical Association (JAMA) benchmark criteria and the DISCERN criteria. Presence or absence of the Health On the Net Foundation Code of Conduct (HONcode) certification, age of content, content producer, and author characteristics were noted. Results A total of 37 unique websites were found suitable for analysis. Readability varied by assessment tool from 8th to 12th grade level. This compares with the recommended 7th to 8th grade level. Of the 37, 1 (2.7%) website met all 4 JAMA criteria. Mean DISCERN quality of information for OA websites was “fair,” compared with the “poor” grading of a 2003 study. HONcode-endorsed websites (43%, 16/37) were of a statistically significant higher quality. Conclusions Readability of online health information for OA was either equal to or more difficult than the recommended level.


2020 ◽  
Author(s):  
Trevor Gulbrandsen ◽  
Mary Kate Skalitzky ◽  
Alan Gregory Shamrock ◽  
Burke Gao ◽  
Obada Hasan ◽  
...  

BACKGROUND Patients often turn to online resources following the diagnosis of osteosarcoma. To be fully understood by the average American adult, the American Medical Association (AMA) and National Institutes of Health (NIH) recommend online health information to be written at a 6th grade level or lower. Previous analyses of osteosarcoma resources have not measured whether text is written such that readers can process key information (understandability) or identify available actions to take (actionability). The Patient Education Materials Assessment Tool (PEMAT) is a validated measurement of understandability and actionability. OBJECTIVE The purpose of this study was to evaluate osteosarcoma online resources utilizing measures of readability, understandability, and actionability. METHODS Using the search term “osteosarcoma”, two independent searches (Google.com) were performed and the top 50 results were collected. Websites were included if directed at providing patient education on osteosarcoma. Readability was quantified using validated algorithms: Flesh-Kincaid Grade Ease (FKGE), Flesch-Kincaid Grade-Level (FKGL). A higher FKGE score represents the material is easier to read. All other readability scores represent the US school grade level. Two independent PEMAT assessments were performed with independent scores assigned for both understandability and actionability. A PEMAT score of 70% or below is considered poorly understandable and/or poorly actionable. Statistical significance was defined as p≤0.05. RESULTS Of 53 unique websites, 37 websites (69.8%) met inclusion criteria. The mean FKGE was 40.8±13.6. The mean FKGL grade level was 12.0±2.4. No (0%) websites scored within the acceptable NIH/AHA recommended reading level. Overall, only 10.8% (n=4) and 2.7% (n=1) met the acceptable understandability and actionability threshold. CONCLUSIONS Overall, osteosarcoma online patient educational materials scored poorly with respect to readability, understandability, and actionability. None of the online resources scored at the recommended reading level. Only four met the appropriate score to considered understandable by the general public. Future efforts should be made to improve online resources in order to support patient understanding.


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