An Evaluation Of The Quality Of Patient-Oriented Online Resources For Hemodialysis Access (Preprint)

2021 ◽  
Author(s):  
Mark Davies
Keyword(s):  
Patient Education ◽  
Vascular Surgery ◽  
Search Engines ◽  
Reading Level ◽  
Online Resources ◽  
Hemodialysis Access ◽  
Patient Resources ◽  
Meta Search ◽  
Grade Reading Level

BACKGROUND Patients and families increasingly turn to the internet for information and resources regarding their medical conditions. These searches are conducted in an independent and unsupervised manner, often without guidance from providers. Multiple reports in the medical oncology literature have cast significant doubt on the accuracy and currency of the data found on patient-focused websites OBJECTIVE To critically appraise the quality of patient-focused online resources concerning hemodialysis access procedures. METHODS A recently validated search strategy using the meta-search engines Google, Dogpile, and Yippy with the query “hemodialysis access” was performed on a cleared-cache web browser during January 2020. Inclusion criteria for the study were websites intended for patient education in English. Exclusions criteria consisted of online monographs, academic journals, and sites requiring paid subscription. Three independent reviewers evaluated the websites using a validated, structured rating tool that scored the Affiliation, Accountability, Interactivity, Structure and Organization, Readability, and Content of the websites. Inter-rater reliability was quantified by calculated kappa coefficients for each element of the instrument. RESULTS Out of more than 27 million collective search results using the three meta-search engines, the first 269 hits were considered for analysis. Only 63 unique patient-oriented sites were acceptable for analysis. 46% were sponsored by commercial entities. Accountability and interactivity were weak across sites. Readability as determined by Flesch-Kincaid and SMOG indices ranged from 6th grade to post-graduate level. 19% were written at a college reading level or higher, however these sites had content quality comparable to those utilizing more elementary prose. 85% of non-commercial domain sites were free of inaccuracies compared to 59% of commercial sites (P=.02). Non-commercial domain sites trended toward more comprehensive content as well as superior readability (average 10th grade reading level compared to average 11th grade reading level, P=.08). The average composite score of all the websites was 2.8 out of a maximum possible weighted score of 7.8, indicating poor global quality of websites. Kappa coefficients were 0.7 or greater for a random sample of 10 websites. CONCLUSIONS This is the first report on the quality of online patient resources in vascular surgery. The study demonstrates that online patient education resources regarding hemodialysis access are poor and require input from the vascular surgery community. Providers need to be aware and understand this issue and seek to inform and mitigate misinformation and potential misguidance. The vascular surgery community should invest in more readable and comprehensive web resources. CLINICALTRIAL n.a

Depression in cancer: An evaluation of patient education resources.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24194-e24194
Author(s):  
Jim (Zhang Hao) Li ◽  
Mingyang Wang ◽  
Paris-Ann Ingledew
Keyword(s):  
Health Care ◽  
Patient Education ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Search Engines ◽  
Online Resources ◽  
Future Research ◽  
Care Providers ◽  
Patient Comprehension

e24194 Background: In recent years, there has been increasing awareness surrounding mental health and depression among cancer patients. Concurrently, the internet has cemented its role as a mainstay source of health information for the general public. However, little is known about the quality of online resources addressing depression specifically in cancer patients. Therefore, we aim to systematically evaluate the quality of such information. Methods: The term "depression in cancer patients" was searched online using the search engine Google and the meta-search engines Dogpile and Yippy. A set of predetermined inclusion and exclusion criteria was applied to all search results, which yielded 48 websites for inclusion. An evidence-based rating tool was then used to score the websites based on the six domains of Affiliation, Accountability, Interactivity, Structure & Organization, Readability, and Content Quality. The results were analyzed using descriptive statistics. Results: Of the 48 websites evaluated, 50% were commercial. In terms of accountability measures, 63% of websites disclosed authorship, 54% cited one or more reliable sources, and 38% were updated within the last two years. Although in-site search engines and video support were found in 94% and 52% of websites respectively, the presence of other interactive features were considerably lower. The average readability was at a grade 12.3 level using the Flesch-Kincaid scale and 11.3 using the SMOG Index, both of which were significantly higher than the traditionally recommended grade-six level ( p < 0.0001 for both). The most commonly covered topics were symptoms and treatment – found on 87% and 83% of websites respectively. Prevention and prognosis were not covered by any of the websites. Content accuracy was generally high among covered topics. Conclusions: Many websites addressing depression in cancer have poor authorship disclosure, attribution, and currency. Additional interactive features should be encouraged to facilitate user-friendliness. Poor readability may pose a barrier for patient comprehension, indicating a need for health care providers to proactively guide patients to suitable resources. Despite high content accuracy in other topics, prevention and prognosis are seldom covered. Our results could help guide the development of new patient education materials and better inform health care providers about the limitations of available online resources. Future research should aim to elucidate reasons contributing to difficult readability levels and identify topics that patients need additional information in.

scholarly journals Bladder Cancer Health Literacy: Assessing Readability of Online Patient Education Materials

2020 ◽  
pp. 1-8
Author(s):  
Lauren E. Powell ◽  
Theodore I. Cisu ◽  
Adam P. Klausner
Keyword(s):  
Bladder Cancer ◽  
Health Literacy ◽  
Patient Education ◽  
Search Engine ◽  
Reading Ability ◽  
Health Care Expenditure ◽  
Reading Level ◽  
T Test ◽  
Grade Levels ◽  
Grade Reading Level

BACKGROUND: Understanding of health-related materials, termed health literacy, affects decision makings and outcomes in the treatment of bladder cancer. The National Institutes of Health recommend writing education materials at a sixth-seventh grade reading level [6]. The goal of this study is to assess readability of bladder cancer materials available online. OBJECTIVE: The goal of this study is to characterize available information about bladder cancer online and evaluate readability. METHODS: Materials on bladder cancer were collected from the American Urological Association’s Urology Care Foundation (AUA-UCF) and compared to top 50 websites by search engine results. Resources were analyzed using four different validated readability assessment scales. The mean and standard deviation of the materials was calculated, and a two-tailed t test for used to assess for significance between the two sets of patient education materials. RESULTS: The average readability of AUA materials was 8.5 (8th–9th grade reading level). For the top 50 websites, average readability was 11.7 (11–12th grade reading level). A two-tailed t test between the AUA and top 50 websites demonstrated statistical significance between the readability of the two sets of resources (P = 0.0001), with the top search engine results being several grade levels higher than the recommended 6–7th grade reading level. CONCLUSIONS: Most health information provided by the AUA on bladder cancer is written at a reading ability that aligns with most US adults, with top websites for search engine results exceeding the average reading level by several grade levels. By focusing on health literacy, urologists may contribute lowering barriers to health literacy, improving health care expenditure and perioperative complications.

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
Keyword(s):  
Botulinum Toxin ◽  
Patient Education ◽  
Online Education ◽  
Grade Level ◽  
Assessment Tool ◽  
Botulinum Toxin Injection ◽  
Reading Level ◽  
Accuracy Score ◽  
Flesch Reading Ease

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 &gt; 0.2), comprehensiveness (P &gt; 0.5), readability (P &gt; 0.1), understandability (P &gt; 0.3), or actionability (P &gt; 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.

Readability Assessment of Patient Education Materials on Major Otolaryngology Association Websites

2012 ◽  
Vol 147 (5) ◽  
pp. 848-854 ◽  
Author(s):  
Jean Anderson Eloy ◽  
Shawn Li ◽  
Khushabu Kasabwala ◽  
Nitin Agarwal ◽  
David R. Hansberry ◽  
...  
Keyword(s):  
Patient Education ◽  
Sixth Grade ◽  
Reading Level ◽  
Flesch Reading Ease ◽  
Education Material ◽  
Individual Assessment ◽  
Honestly Significant Difference ◽  
Significant Difference ◽  
Grade Reading Level ◽  
Post Hoc

Objective Various otolaryngology associations provide Internet-based patient education material (IPEM) to the general public. However, this information may be written above the fourth- to sixth-grade reading level recommended by the American Medical Association (AMA) and National Institutes of Health (NIH). The purpose of this study was to assess the readability of otolaryngology-related IPEMs on various otolaryngology association websites and to determine whether they are above the recommended reading level for patient education materials. Study Design and Setting Analysis of patient education materials from 9 major otolaryngology association websites. Methods The readability of 262 otolaryngology-related IPEMs was assessed with 8 numerical and 2 graphical readability tools. Averages were evaluated against national recommendations and between each source using analysis of variance (ANOVA) with post hoc Tukey’s honestly significant difference (HSD) analysis. Mean readability scores for each otolaryngology association website were compared. Results Mean website readability scores using Flesch Reading Ease test, Flesch-Kincaid Grade Level, Coleman-Liau Index, SMOG grading, Gunning Fog Index, New Dale-Chall Readability Formula, FORCAST Formula, New Fog Count Test, Raygor Readability Estimate, and the Fry Readability Graph ranged from 20.0 to 57.8, 9.7 to 17.1, 10.7 to 15.9, 11.6 to 18.2, 10.9 to 15.0, 8.6 to 16.0, 10.4 to 12.1, 8.5 to 11.8, 10.5 to 17.0, and 10.0 to 17.0, respectively. ANOVA results indicate a significant difference ( P < .05) between the websites for each individual assessment. Conclusion The IPEMs found on all otolaryngology association websites exceed the recommended fourth- to sixth-grade reading level.

scholarly journals Meta search engine

2021 ◽  
Author(s):  
Kwok-Pun Chan
Keyword(s):  
Foreign Language ◽  
Search Engine ◽  
Waiting Time ◽  
Search Engines ◽  
Time Frame ◽  
Search Result ◽  
Meta Search Engine ◽  
Meta Search ◽  
Biased Information

Meta search engines allow multiple engine searches to minimize biased information and improve the quality of the results it generates. However, existing meta engine applications contain many foreign language results, and only run on Windows platform. The meta search engine we develop will resolve these problems. Our search engine will run on both Windows and Linus platforms, and has some desirable properties: 1) users can shorten the search waiting time if one of the search engines is down 2) users can sort the result titles in an alphabetic or relevancy order. Current meta search websites only allow users to sort results by relevancy. Our search engine allows users to do an alphabetical search from the previous relevancy search result, so that the users can identify the required title within a shorter time frame.

scholarly journals Achilles Tendon Repair: Can Patients Read, Understand, and Act on Online Educational Resources?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0022
Author(s):  
Burke Gao ◽  
Alan G. Shamrock ◽  
Trevor Gulbrandsen ◽  
John E. Femino ◽  
Cesar de Cesar Netto ◽  
...  
Keyword(s):  
Patient Education ◽  
Achilles Tendon ◽  
Grade Level ◽  
Elective Surgery ◽  
Tendon Repair ◽  
Reading Level ◽  
Achilles Tendon Repair ◽  
Grade Reading Level ◽  
Google Search ◽  
Online Patient Education

Category: Sports; Trauma Introduction/Purpose: Patients often access online resources to learn about orthopedic procedures prior to undergoing elective surgery. In order to be fully understood by the average English-speaking adult, online health information must be written at an elementary school reading level. To be helpful to patients, educational resources should also be generally understandable and have actionable direction that positively affects healthcare interactions. There are several previously validated indices for accessing the reading level of written materials. The Patient Education Materials Assessment Tool (PEMAT) provides a reliable and validated method to measure the understandability and actionability of education materials. The purpose of this study was to utilize PEMAT and readability algorithms to quantify readability, understandability and actionability of online patient education materials related to Achilles tendon repair. Methods: Online patient education materials were identified using two independently conducted Google engine searches with the term ‘Achilles tendon repair’. Using the top 50 search results, articles were included if they specifically served to educate patients regarding TAA. Exclusion criteria included news articles, non-text materials (video), research manuscripts, industry websites, and articles not related to Achilles tendon repair. The readability of included articles was quantified using the validated Flesch-Kincaid Grade Level index. The PEMAT form for printed materials was used to assess understandability and actionability using a 0-100 scale for both measures of interest. Spearman’s correlation coefficient was utilized to examine the relationship between a website’s average rank on Google (from first to last) and its readability, understandability, and actionability. P-values of less than 0.05 were considered significant. Results: Thirty-one websites met inclusion criteria. The mean Flesch Kincaid reading grade level was 10.8+-2.9, with only one website written below the 6th grade reading level. Higher Flesch-Kincaid grade was associated with later Google seach rank (rho: 0.488, p=0.010). Mean understandability and actionability scores were 67.1+-16.4% and 38.3+-28.4%, respectively. Among understandability criteria, only 12.9% (n=4) of articles included summaries and just 38.7% (n=12) included visual aids. Among actionability categories, 74% (n=23) of websites identified at least one action for readers, while only 60.8% (n=14) of these studies broke down actions into explicit, easy to understand steps. Actionability scores were not correlated with Google search rank (rho: -0.02, p=0.888), while higher understandability scores were associated with later Google search rank (rho: 0.45, p=0.017). Conclusion: Only one website describing Achilles tendon repair was written at or below the nationally recommended 6th grade reading level. Overall, Achilles tendon repair online educational materials scored poorly with respect to readability, understandability, and actionability. Articles that appeared earlier in the Google search had lower readability and understandability scores. In the era of shared decision making, it is vital that patients understand procedures, as well as the risks and benefits prior to undergoing elective surgery. These results suggest that current publicly available resources for Achilles tendon repair remain inadequate for patient education.

Assessment of the Readability of Online Patient Education Material from Major Canadian Pediatric Associations (Preprint)

2021 ◽  
Author(s):  
Alice Man ◽  
Courtney van Ballegooie
Keyword(s):  
Patient Education ◽  
Medical Information ◽  
Health Behaviours ◽  
Reading Level ◽  
Pediatric Society ◽  
Word Analysis ◽  
Education Material ◽  
Preventative Health ◽  
Grade Reading Level ◽  
Online Patient Education

BACKGROUND Online patient education materials (PEMs) are frequently written above the recommended reading level in North America. Poor PEM readability limits the accessibility of medical information to individuals with average to lower literacy levels. Pediatric hospital and association websites have not only been shown to be a preferred source of information among caregivers but have also become a necessity in the COVID-19 pandemic. The readability of Canadian pediatric association websites has not yet been assessed quantitatively. OBJECTIVE To assess the readability of online Canadian pediatric association PEMs to determine if the content of the material is written at a reading level that the majority of Canadians can understand. METHODS PEMs were extracted from ten Canadian pediatric associations and evaluated for their reading level using ten validated readability scales. Associations underwent a difficult word analysis and cross association comparisons were assessed. RESULTS Online PEMs were identified from three pediatric association websites, where the grade reading level was found to be 8.8 +/- 1.8 for the Caring for Kids website, 9.5 +/- 2.2 for the Pediatric Endocrine Group website and 13.1 +/- 2.1 for the Atlantic Pediatric Society website. The difficulty word analysis identified that 19.9% of words were unfamiliar overall. CONCLUSIONS The online PEMs were found to be written above the recommended seventh grade reading level for Canadians. Consideration should be made to create PEMs at an appropriate grade reading level for both patients and their caregivers to encourage health literacy and ultimately promote preventative health behaviours and child health outcomes.

scholarly journals Assessment of the Readability, Adequacy, and Suitability of Online Patient Education Resources for Benign Vascular Tumours Using the DISCERN Instrument

2019 ◽  
Vol 27 (4) ◽  
pp. 325-333
Author(s):  
Minh N.Q. Huynh ◽  
Katie E. Hicks ◽  
Claudia Malic
Keyword(s):  
Patient Education ◽  
Web Search ◽  
Final Analysis ◽  
Online Resources ◽  
College Level ◽  
Flesch Reading Ease ◽  
Ovid Medline ◽  
Patient Resources ◽  
Average Reader ◽  
Language Of Publication

Objective: This study aims to assess the quality and readability of Internet-based patient resources for vascular tumours in order to understand which areas require improvement. Methods: A World Wide Web search was performed, in addition to a literature review using PubMed, Ovid MEDLINE, and EMBASE. Any material that contained information on vascular tumours pertaining to patient education was included. We evaluated resources with DISCERN and Flesch Reading Ease scores when applicable. The language of publication was restricted to English and French. This review was registered with PROSPERO (CRD42018087885). Results: A total of 117 online resources were screened, with 73 resources included in the final analysis. The overall DISCERN rating for the patient resources was 1.8 (0.8). The majority of online resources failed to depict the entire spectrum of benign vascular tumours. The mean Flesch score was 36 (19), which translates to a college-level readability. Conclusion: The majority of resources were not adequate or comprehensive and were written at a much higher level than the average reader would be expected to comprehend.

scholarly journals Health Services: A Mixed Methods Assessment of Canadian Cancer Patient Education Materials Related to the 2019 Novel Coronavirus

2021 ◽  
Vol 28 ◽  
pp. 107327482198970
Author(s):  
Courtney van Ballegooie ◽  
Peter Hoang
Keyword(s):  
Patient Education ◽  
Cancer Patients ◽  
Cancer Care ◽  
Reading Level ◽  
Eastern Health ◽  
Cancer Society ◽  
Education Material ◽  
Novel Coronavirus ◽  
Grade Reading Level ◽  
Complex Words

The 2019 novel coronavirus (COVID-19) pandemic has prompted the reorganization in the scheduling and method of care for many patients, including patients diagnosed with cancer. Cancer patients, who have an immunocompromised status, may be at a higher risk of severe symptoms from infection with COVID-19. While information is rapidly evolving regarding COVID-19, Canada, both nationally and provincially, has been conveying new information to patients online. We assessed the content and readability of COVID-19-related online Canadian patient education material (PEM) for cancer patients to determine if the content of the material was written at a grade reading level that the majority of Canadians can understand. PEMs were extracted from provincial cancer agencies and the national Canadian Cancer Society, evaluated using 10 readability scales, qualitatively analyzed to identify their themes and difficult word content. Thirty-eight PEMs from both national and provincial cancers associations were, on average, written above the recommended 7th grade level. Each of the associations’ average grade levels were: BC Cancer (11.00 95% confidence interval [CI] 8.27-13.38), CancerControl Alberta (10.46 95% CI 8.29-12.62), Saskatchewan Cancer Agency (11.08 95% CI 9.37-12.80), Cancer Care Manitoba (9.55 95% CI 6.02-13.01), Cancer Care Ontario (9.35 95% CI 6.80-11.90), Cancer Care Nova Scotia (10.95 95% CI 9.86-12.04), Cancer Care Eastern Health Newfoundland and Labrador (10.14 95% CI 6.87-13.41), and the Canadian Cancer Society (10.06 95% CI 8.07-12.05). Thematic analysis identified 4 themes: public health strategy, information about COVID-19, patient instructions during COVID-19, and resources. Fifty-three percent of the complex words identified were medical jargon. This represents an opportunity to improve PEM readability, to allow for greater comprehension amongst a wider target audience.

scholarly journals P-BN24 Quality assessment of online patient information on upper gastrointestinal endoscopy using the Modified Ensuring Quality Information for Patients (EQIP) tool

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Gillian Miller ◽  
Siobhan Chien ◽  
Ivory Huang ◽  
Danielle Cunningham ◽  
Daniel Carson ◽  
...  
Keyword(s):  
Patient Education ◽  
Patient Information ◽  
Online Resources ◽  
Upper Gastrointestinal Endoscopy ◽  
Quality Information ◽  
Complication Rates ◽  
High Quality ◽  
Google Search ◽  
Upper Gastrointestinal

Abstract Background Online resources are rapidly becoming patients’ primary source of healthcare information due to the Internet’s ease of access. The availability of high-quality online information is paramount to improving patient education and clinical outcomes. Upper gastrointestinal (UGI) endoscopy is the gold standard investigation for UGI symptoms, yet little is known regarding the quality of patient oriented websites. This study aims to analyse the quality of online patient information on UGI endoscopy using the modified Ensuring Quality Information for Patients (EQIP) tool. Methods A systematic review was conducted using 10 search terms. The top 100 websites for each term identified using Google search were assessed using the modified EQIP tool (score 0-36). Sub-analysis was performed on high-scoring websites. Websites for medical professional use or containing video and marketing content were excluded. Results 378 websites were eligible for analysis. The median modified EQIP score for UGI endoscopy was 18/36 (IQR 14-21). Median EQIP scores for the content, identification and structure domains were 8/18, 1/6 and 9/12, respectively. Websites produced by government health departments and NHS hospitals had a higher modified EQIP score (p = 0.007). Complication rates were included in only 20.4% of websites. High-scoring websites were significantly more likely to provide balanced information on risks and benefits (94.6% vs. 34.4%; p &lt; 0.001). Conclusions The current quality of online patient information on UGI endoscopy is limited, with minimal information available on risks of the procedure, potentially hindering patients’ ability to make informed healthcare decisions. There is an immediate need for high-quality online resources to improve patient education.

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