scholarly journals Online Information About Periviable Birth: Quality Assessment (Preprint)

2018 ◽  
Author(s):  
Adriane F Haragan ◽  
Carly A Zuwiala ◽  
Katherine P Himes

BACKGROUND Over 20,000 parents in the United States face the challenge of participating in decisions about whether to use life support for their infants born on the cusp of viability every year. Clinicians must help families grasp complex medical information about their baby’s immediate prognosis as well as the risk for significant long-term morbidity. Patients faced with this decision want supplemental information and frequently seek medical information on the Internet. Empirical evidence about the quality of websites is lacking. OBJECTIVE We sought to evaluate the quality of online information available about periviable birth and treatment options for infants born at the cusp of viability. METHODS We read a counseling script to 20 pregnant participants that included information typically provided by perinatal and neonatal providers when periviable birth is imminent. The women were then asked to list terms they would use to search the Internet if they wanted additional information. Using these search terms, two reviewers evaluated the content of websites obtained via a Google search. We used two metrics to assess the quality of websites. The first was the DISCERN instrument, a validated questionnaire designed to assess the quality of patient-targeted health information for treatment choices. The second metric was the Essential Content Tool (ECT), a tool designed to address key components of counseling around periviable birth as outlined by professional organizations. DISCERN scores were classified as low quality if scores were 2, fair quality if scores were 3, and high quality if scores were 4 or higher. Scores of 6 or higher on the ECT were considered high quality. Interreviewer agreement was assessed by calculated kappa statistic. RESULTS A total of 97 websites were reviewed. Over half (57/97, 59%) were for-profit sites, news stories, or personal blogs; 28% (27/97) were government or medical sites; and 13% (13/97) were nonprofit or advocacy sites. The majority of sites scored poorly in DISCERN questions designed to assess the reliability of information presented as well as data regarding treatment choices. Only 7% (7/97) of the websites were high quality as defined by the DISCERN tool. The majority of sites did not address the essential content defined by the ECT. Importantly, only 18% of websites (17/97) indicated that there are often a number of reasonable approaches to newborn care when faced with periviable birth. Agreement was strong, with kappa ranging from .72 to .91. CONCLUSIONS Most information about periviable birth found on the Internet using common search strategies is of low quality. News stories highlighting positive outcomes are disproportionately represented. Few websites discuss comfort care or how treatment decisions impact quality of life.

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
B R O’Connor ◽  
E Doherty ◽  
F Friedmacher ◽  
L Vernon ◽  
T S Paran

Abstract Introduction Increasingly in pediatric surgical practice, patients, their parents, and surgeons alike use the Internet as an easily and quickly accessible source of information about conditions and their treatment. The quality and reliability of this information may often be unregulated. We aim to objectively assess the online information available relating to esophageal atresia and its management. Methods We performed searches for ‘oesophageal atresia’ and ‘esophageal atresia’ using the Google, Yahoo, and Bing engines to encompass both European and American spellings. We assessed the first 20 results of each search and excluded duplicates or unrelated pages. The DISCERN score and the Health on the Net Foundation Code (HONcode) toolbar were utilized to assess the quality of information on each website. We evaluated readability with the Flesch reading ease (FRE) and the Flesch–Kincaid grade (FKG). Results Of the original 120 hits, 61 were excluded (51 duplicates, 10 unrelated). Out of 59 individual sites reviewed, only 13 sites were HONcode approved. The mean overall DISCERN score was 52.55 (range: 22–78). The mean DISCERN score for the search term ‘oesphageal atresia’ was 57 (range: 22–78) in comparison to 59.03 for ‘esophageal atresia’ (range: 27–78). Google search had the lowest overall mean DISCERN score at 54.83 (range: 35–78), followed by Yahoo at 58.03 (range: 22–78), and Bing with the highest overall mean score of 61.2 (range: 27–78). The majority of websites were graded excellent (≥63) or good (51–62), 43% and 27%, respectively; 20% were scored as fair (39–50), with 10% being either poor (27–38) or very poor (≤26). In terms of readability, the overall Flesch Reading Ease score was 33.02, and the overall Flesch–Kincaid grade level was 10.3. Conclusions The quality of freely available online information relating to esophageal atresia is generally good but may not be accessible to everyone due to being relatively difficult to read. We should direct parents towards comprehensive, high-quality, and easily readable information sources should they wish to supplement their knowledge about esophageal atresia and its management.


2019 ◽  
Author(s):  
Jingchun Fan ◽  
Jean Craig ◽  
Na Zhao ◽  
Fujian Song

BACKGROUND Increasingly people seek health information from the Internet, in particular, health information on diseases that require intensive self-management, such as diabetes. However, the Internet is largely unregulated and the quality of online health information may not be credible. OBJECTIVE To assess the quality of online information on diabetes identified from the Internet. METHODS We used the single term “diabetes” or equivalent Chinese characters to search Google and Baidu respectively. The first 50 websites retrieved from each of the two search engines were screened for eligibility using pre-determined inclusion and exclusion criteria. Included websites were assessed on four domains: accessibility, content coverage, validity and readability. RESULTS We included 26 websites from Google search engine and 34 from Baidu search engine. There were significant differences in website provider (P<0.0001), but not in targeted population (P=0.832) and publication types (P=0.378), between the two search engines. The website accessibility was not statistically significantly different between the two search engines, although there were significant differences in items regarding website content coverage. There was no statistically significant difference in website validity between the Google and Baidu search engines (mean Discern score 3.3 vs 2.9, p=0.156). The results to appraise readability for English website showed that that Flesch Reading Ease scores ranged from 23.1 to 73.0 and the mean score of Flesch-Kincaid Grade Level ranged range from 5.7 to 19.6. CONCLUSIONS The content coverage of the health information for patients with diabetes in English search engine tended to be more comprehensive than that from Chinese search engine. There was a lack of websites provided by health organisations in China. The quality of online health information for people with diabetes needs to be improved to bridge the knowledge gap between website service and public demand.


2021 ◽  
Author(s):  
Jing Ma ◽  
Lisha Jiang ◽  
Jianchen Luo ◽  
Linli Zheng ◽  
Meiou Wang ◽  
...  

BACKGROUND The Internet has evolved the approaches of medical information spread. Demands of online information searching on mental disease expanded. The Wikipedia and Baidu Encyclopedia are popular information source. Websites with information on mental disease have not been systematically evaluated. OBJECTIVE The research aimed to estimate the quality of mental disease information on the internet and to evaluate all aspects including timeliness to value the information quality from Baidu Encyclopedia and Wikipedia to help users to make better choice. Besides, establishing a perfect relevant online health information examine and supervision system, in order to satisfy public self-help mental medical information service needs. METHODS We retrieved the entries on mental disease from the International Statistical Classification of Diseases and Related Health Problems 10th Revision Version 2016 codes on Wikipedia (in English) and Baidu Encyclopedia (in Chinese) in 2018 and 2021. Subject sites were accessed by DISCERN. The comparison between 2 engines as well as 3 years follow-up and timeliness were calculated. RESULTS The number of entries on mental disease we found in 2018 is 34 on Baidu Encyclopedia and 36 on Wikipedia and 37 entries on both Baidu Encyclopedia and Wikipedia in 2021. In 2018, the DISCERN score of Baidu Encyclopedia entries in section 1 and section 3 were lower than those of Wikipedia articles (11.21±4.57 vs 26.25±3.21, p<.001; 2.06±.74 vs 2.53±.94, p<.05). Significantly differences can also be found in total score and all sections in 2021 between 2 engines (total score, 26.29±11.03 vs 44.31±9.77, all 3 sections, p<.001). The DISCERN score of Wikipedia articles during 3 years showed significant increase (all 3 sections, p<.001; total, p<.001). The mean update interval varies greatly from Baidu Encyclopedia (824.79 days in 2018; 945.73 days in 2021) to Wikipedia (34.17 days in 2018;50.46 days in 2021) (p<.001). CONCLUSIONS Despite the general poor quality of mental disease entries in both two engines, Wikipedia expressed to be a better source of online mental disease information compared to Baidu Encyclopedia, with higher reliability, better treatment advice and shorter update interval. Our findings reflected the existing deficit of general website mental health information, suggested a reference for further and better medical network information order. Based on this foundation, it is essential to encourage people to seek professional help rather than believe the ambiguous source information from Internet. The quality of these entries has been improved during 3 years. This positive trend is encouraging that we can expect better online information service in the coming future.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S428-S429
Author(s):  
M Velasco Rodríguez-Belvís ◽  
L M Palomino Pérez ◽  
C Sánchez Fernández-Bravo ◽  
A Sanchiz Perea ◽  
L F Jose Luis ◽  
...  

Abstract Background Patients with paediatric Inflammatory Bowel Diseases (p-IBD) and their families widely use the Internet as a resource and tend to read the first page of 10 results. However, online content may be of questionable quality, and valuable information may be hard to find. This study aimed to (i) determine the average quality of online information on p-IBD and (ii) analyze whether it depends on the source of information. Methods A google search was performed on the 28 October 2019 using the keywords: ‘Crohn’s disease’, ‘ulcerative colitis’, ‘Inflammatory Bowel Disease’, ‘colonoscopy’, ‘endoscopy’, all of them combined with the terms ‘paediatric’ and ‘children’. We recorded the first 10 results for each search and excluded scientific papers, advertisements, videos and sites requiring subscription. Websites were classified according to their origin as hospital, professional society, government agency, health press or patient organisations. The quality of the information was assessed with the DISCERN instrument, a validated 16-point questionnaire (total score 16–80) to evaluate the quality of written information. DISCERN scores were graded as excellent (68–80), good (55–67), fair (42–54), poor (29–41) or very poor (16–28). In order to minimise subjectivity, four evaluators assessed the quality, and the mean total score was calculated for every selected website. The proportion of websites with excellent or good grading in each category was compared using the Fisher test. Results We identified 100 websites and 65 met the inclusion criteria. The type of authorship and DISCERN scores are shown in Table 1. The overall median DISCERN score was 40.8 [interquartile range, IQR 10.5]. Only 5 websites had an excellent or good score. The proportion of websites with excellent or good grading was significantly higher in those from government agencies and professional societies (33.3% and 30% vs. 2% and 0%, p &lt; 0.05). None of the health press websites showed excellent or good grading. Surprisingly, no websites from patient organisations were identified. Conclusion The quality of online information on p-IBD is highly variable. Most of the easily found websites are from hospitals, but professional societies and government agencies provide a higher quality of information. Improvement of online information on p-IBD is still needed.


10.2196/12278 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e12278 ◽  
Author(s):  
Joyce Kwakernaak ◽  
Just A H Eekhof ◽  
Margot W M De Waal ◽  
Elisabeth A M Barenbrug ◽  
Niels H Chavannes

Background Little is known about the exact process of how patients search for medical information on the internet and what they retrieve. There is especially a paucity of literature on browsing for information on minor ailments, a term used for harmless diseases that are very common in the general population and thus have a significant impact on health care. Objective This vignette-based experimental study aimed to explore what kind of Web-based search strategies are applied and how search strategies, demographic characteristics, and the quality of the visited websites relate to finding the right diagnosis. Additional goals were to describe how searching on the Web influences one’s perception of the severity of the potential diagnosis and whether or not the participants would discuss the information they found on the internet with their doctors. Methods Out of 1372 survey participants, 355 were randomly sampled, and 155 of them were recruited and assigned to one of four clinical scenarios. Each search term they used was classified as one of three search strategies: (1) hypothesis testing, (2) narrowing within the general hypothesis area, and (3) symptom exploration. The quality of the websites used was determined by using the DISCERN instrument. To compare the diagnostic accuracy of the participants before and after the internet search, a McNemar test was used. Chi-square tests were used to describe which factors are related to the chosen search strategy. A multivariate binary logistic regression model was constructed to predict which factors are related to finding a sound diagnosis after searching the internet for health information. Results Most participants (65.8%, 102/155) used the symptom exploration strategy. However, this depends on the assigned scenario (P<.001) and the self-estimated severity score of the symptoms before the internet search (P=.001). A significant relation was found between choosing an accurate diagnosis and age (odds ratio [OR] 0.94, 95% CI 0.90 to 0.98) and the clinical scenario, as well as the use of high-quality websites (OR 7.49, 95% CI 1.85 to 30.26). Browsing the internet did not lead to a statistically significant change in participants’ beliefs about the severity of the condition (McNemar test, P=.85). Most participants (65%) shared their retrieved information with their physician and most of them (75%) received a positive response. Conclusions Our findings suggest that most patients use a symptom-based approach; however, if patients expect the potential diagnosis to be severe, they tend to use a hypothesis verification strategy more often and are therefore prone to certain forms of bias. In addition, self-diagnosing accuracy is related to younger age, the symptom scenario, and the use of high-quality websites. We should find ways to guide patients toward search strategies and websites that may more likely lead to accurate decision making.


JMIR Cancer ◽  
10.2196/13240 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e13240 ◽  
Author(s):  
Rei Kobayashi ◽  
Masato Ishizaki

Background Online information seeking on medical topics by patients can have beneficial effects by helping them decide on treatment options and fostering better relationships with doctors. The quality of websites and processes of seeking information online have mostly been studied, with a focus on the accuracy and reliability of websites; however, few studies have examined the relationship between other aspects of quality and the processes of seeking medical information online. Objective This exploratory study aimed to shed light on the quality of websites used for information seeking from the perspective of understanding medical information in combination with seeking it online. Methods The study participants were 15 Japanese university students with no problem using the internet. A questionnaire survey about health literacy (47 items on a 4-point Likert scale) and information navigation skills on the internet (8 items on a 5-point Likert scale) was conducted before participants engaged in online information seeking and qualitative interviews. The students searched for information on a disease and its treatment. The websites viewed were gathered from search behavior recorded by software and browser logs. Follow-up interviews were conducted to elicit explanations from the participants about the assignments and their views of online information seeking. The explanations were evaluated by 55 health care professionals on a 3-point Likert scale and then assessed based on their comments and the participant interviews. Results The mean age of the participants was 20.6 years (median 21; SD 1.06). All participants were able to access reliable websites with information relevant to the assignments. The mean ratings of the students’ explanations were 108.6 (median 109; range=83-134) for the disease and 105.6 (median 104; range=87-117) for its treatment. The inter-rater reliability were 0.84 (95% CI 0.77-0.90) and 0.95 (95% CI 0.93-0.97), indicating good and excellent, respectively. The mean of the sum of the health literacy skills was 115.1 (median 115; range=80-166) and the mean for information navigation skills was 25.9 (median 26; range=17-36), respectively. Health literacy and information navigation skills were moderately correlated (r=0.54; 95% CI 0.033-0.822; P=.04). Among the four stages of health literacy, understanding and appraising (r=0.53; 95% CI 0.025-0.820; P=.04) were moderately correlated with information navigation skills (r=0.52; 95% CI 0.013-0.816; P=.046). The participants had no difficulties operating and browsing the internet and considered medical and public institution websites to be reliable; however, due to unfamiliarity with medical terms, they had difficulties choosing a site from the results obtained and comparing and synthesizing information provided by different sites. They also looked for sites providing orderly information in plain language but provided explanations from sites that gave inadequate interpretations of information. Conclusions This study revealed interactions between searching the internet for, and understanding, medical information by analyzing the processes of information seeking online, physicians’ evaluations and comments about the participants’ explanations, and the participants’ perceptions.


2018 ◽  
Author(s):  
Joyce Kwakernaak ◽  
Just AH Eekhof ◽  
Margot WM De Waal ◽  
Elisabeth AM Barenbrug ◽  
Niels H Chavannes

BACKGROUND Little is known about the exact process of how patients search for medical information on the internet and what they retrieve. There is especially a paucity of literature on browsing for information on minor ailments, a term used for harmless diseases that are very common in the general population and thus have a significant impact on health care. OBJECTIVE This vignette-based experimental study aimed to explore what kind of Web-based search strategies are applied and how search strategies, demographic characteristics, and the quality of the visited websites relate to finding the right diagnosis. Additional goals were to describe how searching on the Web influences one’s perception of the severity of the potential diagnosis and whether or not the participants would discuss the information they found on the internet with their doctors. METHODS Out of 1372 survey participants, 355 were randomly sampled, and 155 of them were recruited and assigned to one of four clinical scenarios. Each search term they used was classified as one of three search strategies: (1) hypothesis testing, (2) narrowing within the general hypothesis area, and (3) symptom exploration. The quality of the websites used was determined by using the DISCERN instrument. To compare the diagnostic accuracy of the participants before and after the internet search, a McNemar test was used. Chi-square tests were used to describe which factors are related to the chosen search strategy. A multivariate binary logistic regression model was constructed to predict which factors are related to finding a sound diagnosis after searching the internet for health information. RESULTS Most participants (65.8%, 102/155) used the symptom exploration strategy. However, this depends on the assigned scenario (<italic>P</italic>&lt;.001) and the self-estimated severity score of the symptoms before the internet search (<italic>P</italic>=.001). A significant relation was found between choosing an accurate diagnosis and age (odds ratio [OR] 0.94, 95% CI 0.90 to 0.98) and the clinical scenario, as well as the use of high-quality websites (OR 7.49, 95% CI 1.85 to 30.26). Browsing the internet did not lead to a statistically significant change in participants’ beliefs about the severity of the condition (McNemar test, <italic>P</italic>=.85). Most participants (65%) shared their retrieved information with their physician and most of them (75%) received a positive response. CONCLUSIONS Our findings suggest that most patients use a symptom-based approach; however, if patients expect the potential diagnosis to be severe, they tend to use a hypothesis verification strategy more often and are therefore prone to certain forms of bias. In addition, self-diagnosing accuracy is related to younger age, the symptom scenario, and the use of high-quality websites. We should find ways to guide patients toward search strategies and websites that may more likely lead to accurate decision making.


2018 ◽  
Author(s):  
Rei Kobayashi ◽  
Masato Ishizaki

BACKGROUND Online information seeking on medical topics by patients can have beneficial effects by helping them decide on treatment options and fostering better relationships with doctors. The quality of websites and processes of seeking information online have mostly been studied, with a focus on the accuracy and reliability of websites; however, few studies have examined the relationship between other aspects of quality and the processes of seeking medical information online. OBJECTIVE This exploratory study aimed to shed light on the quality of websites used for information seeking from the perspective of understanding medical information in combination with seeking it online. METHODS The study participants were 15 Japanese university students with no problem using the internet. A questionnaire survey about health literacy (47 items on a 4-point Likert scale) and information navigation skills on the internet (8 items on a 5-point Likert scale) was conducted before participants engaged in online information seeking and qualitative interviews. The students searched for information on a disease and its treatment. The websites viewed were gathered from search behavior recorded by software and browser logs. Follow-up interviews were conducted to elicit explanations from the participants about the assignments and their views of online information seeking. The explanations were evaluated by 55 health care professionals on a 3-point Likert scale and then assessed based on their comments and the participant interviews. RESULTS The mean age of the participants was 20.6 years (median 21; SD 1.06). All participants were able to access reliable websites with information relevant to the assignments. The mean ratings of the students’ explanations were 108.6 (median 109; range=83-134) for the disease and 105.6 (median 104; range=87-117) for its treatment. The inter-rater reliability were 0.84 (95% CI 0.77-0.90) and 0.95 (95% CI 0.93-0.97), indicating good and excellent, respectively. The mean of the sum of the health literacy skills was 115.1 (median 115; range=80-166) and the mean for information navigation skills was 25.9 (median 26; range=17-36), respectively. Health literacy and information navigation skills were moderately correlated (<italic>r</italic>=0.54; 95% CI 0.033-0.822; <italic>P</italic>=.04). Among the four stages of health literacy, understanding and appraising (<italic>r</italic>=0.53; 95% CI 0.025-0.820; <italic>P</italic>=.04) were moderately correlated with information navigation skills (<italic>r</italic>=0.52; 95% CI 0.013-0.816; <italic>P</italic>=.046). The participants had no difficulties operating and browsing the internet and considered medical and public institution websites to be reliable; however, due to unfamiliarity with medical terms, they had difficulties choosing a site from the results obtained and comparing and synthesizing information provided by different sites. They also looked for sites providing orderly information in plain language but provided explanations from sites that gave inadequate interpretations of information. CONCLUSIONS This study revealed interactions between searching the internet for, and understanding, medical information by analyzing the processes of information seeking online, physicians’ evaluations and comments about the participants’ explanations, and the participants’ perceptions.


10.2196/18684 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18684
Author(s):  
Yoichiro Yamaguchi ◽  
Deokcheol Lee ◽  
Takuya Nagai ◽  
Taro Funamoto ◽  
Takuya Tajima ◽  
...  

Background Most people currently use the internet to obtain information about many subjects, including health information. Thus, medical associations need to provide accurate medical information websites. Although medical associations have their own patient education pages, it is not clear if these websites actually show up in search results. Objective The aim of this study was to evaluate how well medical associations function as online information providers by searching for information about musculoskeletal-related pain online and determining the ranking of the websites of medical associations. Methods We conducted a Google search for frequently searched keywords. Keywords were extracted using Google Ads Keyword Planner associated with “pain” relevant to the musculoskeletal system from June 2016 to December 2019. The top 20 search queries were extracted and searched using the Google search engine in Japan and the United States. Results The number of suggested queries for “pain” provided by Google Ads Keyword Planner was 930 in the United States and 2400 in Japan. Among the top 20 musculoskeletal-related pain queries chosen, the probability that the medical associations’ websites would appear in the top 10 results was 30% in the United States and 45% in Japan. In five queries each, the associations’ websites did not appear among the top 100 results. No significant difference was found in the rank of the associations’ website search results (P=.28). Conclusions To provide accurate medical information to patients, it is essential to undertake effective measures for search engine optimization. For orthopedic associations, it is necessary that their websites should appear among the top search results.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0240664
Author(s):  
Elizabeth Pleasants ◽  
Sylvia Guendelman ◽  
Karen Weidert ◽  
Ndola Prata

Background In the United States, the internet is widely used to seek health information. Despite an estimated 18 million Google searches on abortion per year and the demonstrated importance of the abortion pill as an option for pregnancy termination, the top webpage search results for abortion pill searches, as well as the content and quality of those webpages, are not well understood. Methods We used Google’s Custom Search Application Programming Interface (API) to identify the top 10 webpages presented for “abortion pill” searches on August 06, 2018. We developed a comprehensive, evidence-based Family Planning Webpage Quality Assessment Tool (FPWQAT), which was used to assess webpage quality for the five top webpages presenting text-based educational content. Results Of the top webpages for “abortion pill” searches, a plannedparenthood.com page was the top result and scored highest on our assessment (81%), providing high-quality and useable information. The other four webpages, a Wikipedia.com page and three anti-abortion information webpages, scored much lower on our assessment (14%-43%). These four webpages had lower quality of information in less useable formats. The anti-abortion pages also presented a variety of disinformation about the abortion pill. Conclusions Both the lack of accurate clinical content on the majority of top webpages and the concerning disinformation they contained raise concerns about the quality of online abortion pill information, while underlining challenges posed by Google search results to informed choice for consumers. Healthcare providers and consumers must be informed of online abortion pill content that is not based in current clinical evidence, while advocates and policymakers should push for online information that is credible and useable. These changes are imperative given the importance of sound abortion pill information for reproductive decision-making at a time when in-person abortion services are further challenged in the US.


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