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Online Patient Information for Hysterectomies: A Systematic Environmental Scan of Quality and Readability

Published:April 25, 2022DOI:https://doi.org/10.1016/j.jogc.2022.03.015

      Abstract

      Objective

      Hysterectomy is a common gynaecological procedure, and therefore online information is highly valuable to patients. Our objective was to evaluate the quality, readability, and comprehensiveness of online patient information on hysterectomy.

      Methods

      The first 25 patient-directed websites on hysterectomy, identified using 5 online search engines (Google, Yahoo, AOL, Bing, Ask.com) as well as clinical professional societies, were assessed using validated tools for quality (DISCERN, JAMA benchmark), readability (Flesch-Kincaid Grade Level [FKGL], Gunning Fog, Simple Measure of Gobbledygook [SMOG], Flesch Reading Ease Score [FRES]), and completeness of information.

      Results

      We identified 50 websites for inclusion. Overall, websites were of good quality (median DISCERN score 53/80 [interquartile range {IQR} 47–61]; median JAMA score 3/4 [IQR 1–4]). Most websites described surgical risks (39, 78%), benefits (45, 90%), and types of hysterectomy (48, 96%). Content readability corresponded to grade 11 using FKGL (median 11.1 [IQR 10.2–13.0]) and SMOG (median 10.9 [IQR 10.2–12.4]), or 15 years education using Gunning Fog (median 14.7 [IQR 13.8–16.4]). Websites were assessed as difficult to read using FRES (median 45.6/100 [IQR 37.9–50.9]). No differences were observed in readability scores when we compared websites from clinical professional societies, government, health care, or academic organizations with other websites (P > 0.05).

      Conclusion

      Online patient information on hysterectomy is of good quality and comprehensive. However, the content is above the American Medical Association’s recommended grade 6 reading level. Website authors should consider readability to make their content more accessible to patients.

      Résumé

      Objectif

      L’hystérectomie étant une intervention gynécologique courante, l’information en ligne s’avère très précieuse pour les patientes. Notre objectif était d’évaluer la qualité, la lisibilité et l’exhaustivité de l’information en ligne sur l’hystérectomie à l’intention des patientes.

      Méthodologie

      Les 25 premiers sites Web sur l’hystérectomie destinés aux patientes, répertoriés à l’aide de 5 moteurs de recherche en ligne (Google, Yahoo, AOL, Bing, Ask.com) et de sociétés cliniques professionnelles, ont été analysés au moyen d’outils validés pour évaluer la qualité (DISCERN, JAMA benchmark), la lisibilité (Flesch-Kincaid, Gunning Fog, SMOG, Flesch) et l’exhaustivité de l’information.

      Résultats

      Nous avons répertorié 50 sites Web répondant aux critères d’inclusion. Dans l’ensemble, les sites étaient de bonne qualité (score DISCERN médian de 53/80 [intervalle interquartile {IIQ} : 47–61]; score JAMA médian de 3/4 [IIQ : 1–4]). La plupart décrivaient les risques chirurgicaux (39, 78 %), les bénéfices (45, 90 %) et les types d’hystérectomie (48, 96 %). La lisibilité du contenu correspond à un niveau de lecture de 11e année selon le test de Flesch-Kincaid (indice médian de 11,1 [IIQ : 10,2–13,0]) et le test SMOG (score médian de 10,9 [IIQ : 10,2–12,4]) ou à 15 ans de scolarité selon la méthode de Gunning Fog (indice médian de 14,7 [IIQ : 13,8–16,4]). Selon le test de lisibilité de Flesch, les sites Web étaient difficiles à lire (indice médian de 45,6/100 [IIQ : 37,9–50,9]). Aucune différence n’a été relevée dans les scores de lisibilité lorsque nous avons comparé les sites Web de sociétés cliniques professionnelles, de gouvernements, de systèmes de santé ou d’organismes universitaires à d’autres sites Web (p > 0,05).

      Conclusion

      L’information en ligne sur l’hystérectomie destinée aux patientes est de bonne qualité et complète. Cependant, le contenu surpasse le niveau de lecture de 6e année que recommande l’American Medical Association. Les auteurs des sites Web devraient tenir compte de la lisibilité pour rendre leur contenu plus accessible aux patientes.

      Keywords

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      References

        • Langford A.T.
        • Roberts T.
        • Gupta J.
        • et al.
        Impact of the internet on patient-physician communication.
        Eur Urol Focus. 2020; 6: 440-444
        • Eysenbach G.
        How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews.
        BMJ. 2002; 324: 573-577
        • Fox S.
        • Duggan M.
        Health Online 2013. Pew Research Center.
        (Available at:) (Accessed on March 2020)
        • Tan S.S.-L.
        • Goonawardene N.
        Internet health information seeking and the patient-physician relationship: a systematic review.
        J Med Internet Res. 2017; 19: e9
        • Langford A.
        • Loeb S.
        Perceived patient-provider communication quality and sociodemographic factors associated with watching health-related videos on YouTube: a cross-sectional analysis.
        J Med Internet Res. 2019; 21e13512
        • Weiss B.D.
        Help patients understand. Manual for clinicians.
        (Available at:) (Accessed on March 2020)
        • National Work Group on Literacy and Health
        Communicating with patients who have limited literacy skills.
        J Fam Pract. 1998; 46: 168-176
        • Doak C.
        • Doak L.
        • Root J.
        Teaching patients with low literacy skills.
        (Available at:) (Accessed on April 2020)
        • Sobota A.
        • Ozakinci G.
        The quality and readability of online consumer information about gynecologic cancer.
        Int J Gynecol Cancer. 2015; 25: 537-541
        • Samuel D.
        • Vilardo N.
        • Isani S.S.
        • et al.
        Readability assessment of online gynecologic oncology patient education materials from major governmental, non-profit and pharmaceutical organizations.
        Gynecol Oncol. 2019; 154: 616-621
        • Hirsch M.
        • Aggarwal S.
        • Barker C.
        • et al.
        Googling endometriosis: a systematic review of information available on the Internet.
        Am J Obstet Gynecol. 2017; 216: 451-458.e1
        • Lange E.M.S.
        • Shah A.M.
        • Braithwaite B.A.
        • et al.
        Readability, content, and quality of online patient education materials on preeclampsia.
        Hypertens Pregnancy. 2015; 34: 383-390
        • NWHN
        • Hysterectomy
        The National Women’s Health Network.
        (Available at:) (Accessed on July 1, 2020)
        • Wright J.D.
        • Herzog T.J.
        • Tsui J.
        • et al.
        Nationwide trends in the performance of inpatient hysterectomy in the United States.
        Obstet Gynecol. 2013; 122: 233-241
        • Ramdhan R.C.
        • Loukas M.
        • Tubbs R.S.
        Anatomical complications of hysterectomy: a review.
        Clin Anat. 2017; 30: 946-952
        • Chris A.
        Top 10 search engines in the world. Reliable Soft.
        (Available at:) (Accessed on March 2020)
        • Ratcliff C.
        What are the top 10 most popular search engines? Search Engine Watch.
        (Available at:) (Accessed on March 2020)
        • Sterling G.
        Survey: 82 percent of smartphone shoppers conduct ‘near me’ searches. Search Engine Land.
        (Available at:) (Accessed on March 2020)
      1. Team HON. Health on the net. Available at: https://www.hon.ch/en/certification.html. Accessed on April 2020.

        • Cassidy J.T.
        • Baker J.F.
        Orthopaedic patient information on the world wide web.
        J Bone Jt Surg. 2016; 98: 325-338
        • Charnock D.
        The DISCERN Handbook. Radcliffe Medical Press, Oxford1998
        • Automatic Readability Checker
        Readability formulas.
        (Available at:) (Accessed on April 2020)
        • Evans K.G.
        Consent: A guide for Canadian Physicians. Canadian Medical Protective Association.
        (Available at:) (Accessed on May 2020)
        • Kandula S.
        • Zeng-Treitler Q.
        Creating a gold standard for the readability measurement of health texts.
        AMIA Annu Symp Proc. 2008; 2008: 353-357
        • Murray T.E.
        • Mansoor T.
        • Bowden D.J.
        • et al.
        Uterine artery embolization: an analysis of online patient information quality and readability with historical comparison.
        Acad Radiol. 2018; 25: 619-625
      2. Weiss BD. Health literacy and patient safety: help patients understand. Health literacy educational toolkit, 2nd ed. Available at: http://www.partnershiphp.org/Providers/HealthServices/Documents/Health Education/CandLToolKit/2 Manual for Clinicians.pdf. Accessed on May 2020.

        • Smith C.A.
        Consumer language, patient language, and thesauri: a review of the literature.
        J Med Libr Assoc. 2011; 99: 135-144