bims-librar Biomed News
on Biomedical librarianship
Issue of 2020–01–19
sixteen papers selected by
Thomas Krichel, Open Library Society
  1. Sensitive Versus Specific Search Strategy to Answer Clinical Questions.
  2. You Get What You Pay for on Health Care Question and Answer Platforms: Nonparticipant Observational Study.
  3. Using the MINT Database to Search Protein Interactions.
  4. Software tools to support title and abstract screening for systematic reviews in healthcare: an evaluation.
  5. Using Natural Language Processing to Examine the Uptake, Content, and Readability of Media Coverage of a Pan-Canadian Drug Safety Research Project: Cross-Sectional Observational Study.
  6. Tools to Assess the Trustworthiness of Evidence-Based Point-of-Care Information for Health Care Professionals: Systematic Review.
  7. Medicines information: dwindling support in the age of information overload.
  8. Patient-oriented online resources in pediatric surgery: Are we failing the readability test?
  9. Recent trends in diabetes-related consumer health information technology research.
  10. Quality of Information About Bariatric Surgery on the Internet: A Two-Continent Comparison of Website Content.
  11. The informative value and design of orthodontic practice websites in The Netherlands.
  12. Systematic Analysis of Readability of Patient Information on Internet Pages from Departments for Trauma Surgery of German University Hospitals.
  13. A Qualitative Study Assessing Information on the Internet Compared With AAOS Guidelines for the Treatment of Distal Radius Fractures.
  14. QUALITY AND RELIABILITY OF PUBLICLY ACCESSIBLE INFORMATION ON LASER TREATMENTS FOR URINARY INCONTINENCE: WHAT IS AVAILABLE TO OUR PATIENTS?
  15. Use of online information in diabetes.
  16. Disappearing libraries.
  1. J Nurs Educ. 2020 Jan 01. 59(1): 22-25
    Sensitive Versus Specific Search Strategy to Answer Clinical Questions.
    Susan B Stillwell, Jane Greer Scott.
       BACKGROUND: Students and clinicians are challenged to locate evidence to answer clinical questions. Searching experiences include frustration with words to query databases, lack of searching skills, lack of confidence in nursing databases, and questioning how many databases to search. To implement practice change based on best available evidence, search strategies need to be efficient and effective.
    METHOD: We replicated the systematic review by Stillwell, Vermeesch, and Scott, which used a specific search, with a sensitive search to compare search strategies to answer the clinical question.
    RESULTS: The specific search produced 5,108 articles, with eight being relevant; whereas the sensitive search produced 11,362 articles with nine being relevant.
    CONCLUSION: The sensitive search located the same eight studies and one additional study. If PubMed instead of MEDLINE had been used in the specific search, the results would have been identical. [J Nurs Educ. 2020;59(1):22-25.].
    DOI:  https://doi.org/10.3928/01484834-20191223-05
  2. J Med Internet Res. 2020 Jan 15. 22(1): e13534
    You Get What You Pay for on Health Care Question and Answer Platforms: Nonparticipant Observational Study.
    Fatemeh Ameri, Kathleen Keeling, Reza Salehnejad.
       BACKGROUND: Seeking health information on the internet is very popular despite the debatable ability of lay users to evaluate the quality of health information and uneven quality of information available on the Web. Consulting the internet for health information is pervasive, particularly when other sources are inaccessible because of time, distance, and money constraints or when sensitive or embarrassing questions are to be explored. Question and answer (Q&A) platforms are Web-based services that provide personalized health advice upon the information seekers' request. However, it is not clear how the quality of health advices is ensured on these platforms.
    OBJECTIVE: The objective of this study was to identify how platform design impacts the quality of Web-based health advices and equal access to health information on the internet.
    METHODS: A total of 900 Q&As were collected from 9 Q&A platforms with different design features. Data on the design features for each platform were generated. Paid physicians evaluated the data to quantify the quality of health advices. Guided by the literature, the design features that affected information quality were identified and recorded for each Q&A platform. The least absolute shrinkage and selection operator and unbiased regression tree methods were used for the analysis.
    RESULTS: Q&A platform design and health advice quality were related. Expertise of information providers (beta=.48; P=.001), financial incentive (beta=.4; P=.001), external reputation (beta=.28; P=.002), and question quality (beta=.12; P=.001) best predicted health advice quality. Virtual incentive, Web 2.0 mechanisms, and reputation systems were not associated with health advice quality.
    CONCLUSIONS: Access to high-quality health advices on the internet is unequal and skewed toward high-income and high-literacy groups. However, there are possibilities to generate high-quality health advices for free.
    Keywords:  eHealth; health care access; health information; health literacy; information literacy; internet health information
    DOI:  https://doi.org/10.2196/13534
  3. Curr Protoc Bioinformatics. 2020 Mar;69(1): e93
    Using the MINT Database to Search Protein Interactions.
    Alberto Calderone, Marta Iannuccelli, Daniele Peluso, Luana Licata.
      The Molecular INTeractions Database (MINT) is a public database designed to store information about protein interactions. Protein interactions are extracted from scientific literature and annotated in the database by expert curators. Currently (October 2019), MINT contains information on more than 26,000 proteins and more than 131,600 interactions in over 30 model organisms. This article provides protocols for searching MINT over the Internet, using the new MINT Web Page. © 2020 by John Wiley & Sons, Inc. Basic Protocol 1: Searching MINT over the internet Alternate Protocol: MINT visualizer Basic Protocol 2: Submitting interaction data.
    Keywords:  MINT; database; protein-protein interaction
    DOI:  https://doi.org/10.1002/cpbi.93
  4. BMC Med Res Methodol. 2020 Jan 13. 20(1): 7
    Software tools to support title and abstract screening for systematic reviews in healthcare: an evaluation.
    Hannah Harrison, Simon J Griffin, Isla Kuhn, Juliet A Usher-Smith.
       BACKGROUND: Systematic reviews are vital to the pursuit of evidence-based medicine within healthcare. Screening titles and abstracts (T&Ab) for inclusion in a systematic review is an intensive, and often collaborative, step. The use of appropriate tools is therefore important. In this study, we identified and evaluated the usability of software tools that support T&Ab screening for systematic reviews within healthcare research.
    METHODS: We identified software tools using three search methods: a web-based search; a search of the online "systematic review toolbox"; and screening of references in existing literature. We included tools that were accessible and available for testing at the time of the study (December 2018), do not require specific computing infrastructure and provide basic screening functionality for systematic reviews. Key properties of each software tool were identified using a feature analysis adapted for this purpose. This analysis included a weighting developed by a group of medical researchers, therefore prioritising the most relevant features. The highest scoring tools from the feature analysis were then included in a user survey, in which we further investigated the suitability of the tools for supporting T&Ab screening amongst systematic reviewers working in medical research.
    RESULTS: Fifteen tools met our inclusion criteria. They vary significantly in relation to cost, scope and intended user community. Six of the identified tools (Abstrackr, Colandr, Covidence, DRAGON, EPPI-Reviewer and Rayyan) scored higher than 75% in the feature analysis and were included in the user survey. Of these, Covidence and Rayyan were the most popular with the survey respondents. Their usability scored highly across a range of metrics, with all surveyed researchers (n = 6) stating that they would be likely (or very likely) to use these tools in the future.
    CONCLUSIONS: Based on this study, we would recommend Covidence and Rayyan to systematic reviewers looking for suitable and easy to use tools to support T&Ab screening within healthcare research. These two tools consistently demonstrated good alignment with user requirements. We acknowledge, however, the role of some of the other tools we considered in providing more specialist features that may be of great importance to many researchers.
    Keywords:  Feature analysis; Screening; Software tools; Systematic reviews; Title and abstract
    DOI:  https://doi.org/10.1186/s12874-020-0897-3
  5. JMIR Form Res. 2020 Jan 14. 4(1): e13296
    Using Natural Language Processing to Examine the Uptake, Content, and Readability of Media Coverage of a Pan-Canadian Drug Safety Research Project: Cross-Sectional Observational Study.
    Hossein Mohammadhassanzadeh, Ingrid Sketris, Robyn Traynor, Susan Alexander, Brandace Winquist, Samuel Alan Stewart.
       BACKGROUND: Isotretinoin, for treating cystic acne, increases the risk of miscarriage and fetal abnormalities when taken during pregnancy. The Health Canada-approved product monograph for isotretinoin includes pregnancy prevention guidelines. A recent study by the Canadian Network for Observational Drug Effect Studies (CNODES) on the occurrence of pregnancy and pregnancy outcomes during isotretinoin therapy estimated poor adherence to these guidelines. Media uptake of this study was unknown; awareness of this uptake could help improve drug safety communication.
    OBJECTIVE: The aim of this study was to understand how the media present pharmacoepidemiological research using the CNODES isotretinoin study as a case study.
    METHODS: Google News was searched (April 25-May 6, 2016), using a predefined set of terms, for mention of the CNODES study. In total, 26 articles and 3 CNODES publications (original article, press release, and podcast) were identified. The article texts were cleaned (eg, advertisements and links removed), and the podcast was transcribed. A dictionary of 1295 unique words was created using natural language processing (NLP) techniques (term frequency-inverse document frequency, Porter stemming, and stop-word filtering) to identify common words and phrases. Similarity between the articles and reference publications was calculated using Euclidian distance; articles were grouped using hierarchical agglomerative clustering. Nine readability scales were applied to measure text readability based on factors such as number of words, difficult words, syllables, sentence counts, and other textual metrics.
    RESULTS: The top 5 dictionary words were pregnancy (250 appearances), isotretinoin (220), study (209), drug (201), and women (185). Three distinct clusters were identified: Clusters 2 (5 articles) and 3 (4 articles) were from health-related websites and media, respectively; Cluster 1 (18 articles) contained largely media sources; 2 articles fell outside these clusters. Use of the term isotretinoin versus Accutane (a brand name of isotretinoin), discussion of pregnancy complications, and assignment of responsibility for guideline adherence varied between clusters. For example, the term pregnanc appeared most often in Clusters 1 (14.6 average times per article) and 2 (11.4) and relatively infrequently in Cluster 3 (1.8). Average readability for all articles was high (eg, Flesch-Kincaid, 13; Gunning Fog, 15; SMOG Index, 10; Coleman Liau Index, 15; Linsear Write Index, 13; and Text Standard, 13). Readability increased from Cluster 2 (Gunning Fog of 16.9) to 3 (12.2). It varied between clusters (average 13th-15th grade) but exceeded the recommended health information reading level (grade 6th to 8th), overall.
    CONCLUSIONS: Media interpretation of the CNODES study varied, with differences in synonym usage and areas of focus. All articles were written above the recommended health information reading level. Analyzing media using NLP techniques can help determine drug safety communication effectiveness. This project is important for understanding how drug safety studies are taken up and redistributed in the media.
    Keywords:  knowledge translation; mass media; natural language processing; pharmacoepidemiology; readability
    DOI:  https://doi.org/10.2196/13296
  6. J Med Internet Res. 2020 Jan 17. 22(1): e15415
    Tools to Assess the Trustworthiness of Evidence-Based Point-of-Care Information for Health Care Professionals: Systematic Review.
    Gerlinde Lenaerts, Geertruida E Bekkering, Martine Goossens, Leen De Coninck, Nicolas Delvaux, Sam Cordyn, Jef Adriaenssens, Patrick Vankrunkelsven.
       BACKGROUND: User-friendly information at the point of care should be well structured, rapidly accessible, and comprehensive. Also, this information should be trustworthy, as it will be used by health care practitioners to practice evidence-based medicine. Therefore, a standard, validated tool to evaluate the trustworthiness of such point-of-care information resources is needed.
    OBJECTIVE: This systematic review sought to search for tools to assess the trustworthiness of point-of-care resources and to describe and analyze the content of these tools.
    METHODS: A systematic search was performed on three sources: (1) we searched online for initiatives that worked off of the trustworthiness of medical information; (2) we searched Medline (PubMed) until June 2019 for relevant literature; and (3) we scanned reference lists and lists of citing papers via Web of Science for each retrieved paper. We included all studies, reports, websites, or methodologies that reported on tools that assessed the trustworthiness of medical information for professionals. From the selected studies, we extracted information on the general characteristics of the tools. As no standard, risk-of-bias assessment instruments are available for these types of studies, we described how each tool was developed, including any assessments on reliability and validity. We analyzed the criteria used in the different tools and divided them into five categories: (1) author-related information; (2) evidence-based methodology; (3) website quality; (4) website design and usability; and (5) website interactivity. The percentage of tools in compliance with these categories and the different criteria were calculated.
    RESULTS: Included in this review was a total of 17 tools, all published between 1997 and 2018. The tools were developed for different purposes, from a general quality assessment of medical information to very detailed analyses, all specifically for point-of-care resources. However, the development process of the tools was poorly described. Overall, seven tools had a scoring system implemented, two were assessed for reliability only, and two other tools were assessed for both validity and reliability. The content analysis showed that all the tools assessed criteria related to an evidence-based methodology: 82% of the tools assessed author-related information, 71% assessed criteria related to website quality, 71% assessed criteria related to website design and usability, and 47% of the tools assessed criteria related to website interactivity. There was significant variability in criteria used, as some were very detailed while others were more broadly defined.
    CONCLUSIONS: The 17 included tools encompass a variety of items important for the assessment of the trustworthiness of point-of-care information. Overall, two tools were assessed for both reliability and validity, but they lacked some essential criteria for the assessment of the trustworthiness of medical information for use at the point-of-care. Currently, a standard, validated tool does not exist. The results of this review may contribute to the development of such an instrument, which may enhance the quality of point-of-care information in the long term.
    TRIAL REGISTRATION: PROSPERO CRD42019122565; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=122565.
    Keywords:  evidence-based medicine; evidence-based practice; health care quality; information science; internet information; point-of-care systems; systematic review
    DOI:  https://doi.org/10.2196/15415
  7. Aust Prescr. 2019 Dec;42(6): 178-179
    Medicines information: dwindling support in the age of information overload.
    Felicity Prior.
      
    Keywords:  drug information; pharmacists
    DOI:  https://doi.org/10.18773/austprescr.2019.068
  8. J Pediatr Surg. 2019 Dec 27. pii: S0022-3468(19)30881-4. [Epub ahead of print]
    Patient-oriented online resources in pediatric surgery: Are we failing the readability test?
    James M Prieto, Cassidy West-Santos, Agnes S Montgomery, Utsav Patwardhan, David A Lazar, Hariharan Thangarajah, Stephen W Bickler, Eunice Y Huang, Timothy J Fairbanks, Romeo C Ignacio.
       BACKGROUND: The study aim was to evaluate the readability of patient-oriented resources in pediatric surgery from children's hospitals in the US.
    METHODS: The websites of 30 children's hospitals were evaluated for information on 10 common pediatric surgical procedures. Hospitals of varying characteristics including bed number, geographic location and ACS Children's Surgery Verification (CSV) were selected for the study. Readability scores were calculated using validated algorithms, and text was assigned an overall grade level.
    RESULTS: Of 195 patient-oriented resources identified, only three (2%) were written at or below the recommended sixth grade level. Larger hospitals provided patient information at a higher grade level than medium and smaller sized centers (10.7 vs 9.3 vs 9.0 respectively, p < 0.001). Hospital size also correlated with availability of information, with large and medium sized hospitals having information more often. Hospitals with ACS CSV had information available more often, and written at a lower grade level, compared to nonverified centers (78% vs 62%, p = 0.023; 9.0 vs 10.0, p = 0.013).
    CONCLUSION: Most hospital provided patient-oriented resources in pediatric surgery are written at a grade level well above the national guidelines. Centers with ACS CSV status have improved availability and readability of this material, while larger hospitals have improved availability, but decreased readability.
    TYPE OF STUDY: Modeling study.
    LEVEL OF EVIDENCE: III.
    Keywords:  Educational material; Online information; Patient education; Patient information; Readability
    DOI:  https://doi.org/10.1016/j.jpedsurg.2019.11.018
  9. Conf Proc IEEE Eng Med Biol Soc. 2019 Jul;2019 4283-4288
    Recent trends in diabetes-related consumer health information technology research.
    John Preston Claiborne, Claire Wellbeloved-Stone, Rupa S Valdez.
      Diabetes-related consumer health information technology (CHIT) has been designed to facilitate self-management practices, and its use has improved health outcomes for many consumers. This analysis sought to identify tendencies in diabetes-related CHIT research from 2010-2015 to help researchers find novel research topics, periodicals, collaborators, and funding agencies and experts and lay consumers to find scholarly information. Six search engines encompassing computer science, engineering, and medicine yielded potential diabetes-related CHIT publications. Abstracts and full texts were screened based on inclusion and exclusion criteria. Information on year, periodical, periodical domain, keywords, author location, author institutions, authors, and funding agencies were collected from included publications. The screening process yielded 1551 publications. Studies were published in a core of twenty periodicals, commonly comprising medicine or technology domains. "Telemedicine" was the most frequently used keyword. Harvard University, Dr. Eirik Årsand, and the National Institute of Diabetes and Digestive Kidney Diseases were the most frequent author institution, author, and funding agency, respectively, associated with publications. This analysis revealed potential for novel research on the sociology and economics of diabetes-related CHIT, among other topics. A lack of collaboration between top authors in the field indicates potential for new, impactful collaborations. Ongoing bibliometric research will be necessary to assess changes in this field. The opportunity exists to inform lay consumers and researchers through bibliometric analyses of other consumer health informatics topics.
    DOI:  https://doi.org/10.1109/EMBC.2019.8857052
  10. Obes Surg. 2020 Jan 16.
    Quality of Information About Bariatric Surgery on the Internet: A Two-Continent Comparison of Website Content.
    Juan S Barajas-Gamboa, Michael Klingler, Joshua Landreneau, Andrew Strong, Ahmed Al Zubaidi, Hala Sharadgah, Gabriel Diaz Del Gobbo, Carlos Abril, Matthew Kroh, Ricard Corcelles.
       BACKGROUND: Many patients considering bariatric surgery will obtain medical information through the Internet. The type and quality of information patients access may vary significantly by geographic region.
    METHODS: Searches were performed using commercial search engines in both the United States of America (USA) and United Arab Emirates (UAE) using search terms "bariatric surgery" and "weight loss surgery." Quality was assessed using the scoring systems previously published by DISCERN (United Kingdom (UK)), the Journal of the American Medical Association Benchmark (JAMA; USA), and Expanded Ensuring Quality Information for Patients (EQIP) (UK).
    RESULTS: Website types were more evenly distributed in UAE, though physician websites were also the most common (n = 25, 25%). Within the USA, most websites analyzed were from physicians (n = 32, 32%), followed by academic sources (n = 26, 26%). Academic websites were the highest average quality in the USA (p < .00001). The overall mean DISCERN scores for all websites in the UAE group and US group had no statistically significance differences (p = .950). The overall mean JAMA Benchmark for all websites in the UAE group and USA had no statistically significance differences (p = 0.202). There were no major differences between the USA and UAE in Expanded EQIP scores.
    CONCLUSIONS: The overall quality of information regarding bariatric surgery is poor to fair in both the USA and UAE. Additionally, there are differences in the types of sites retrieved by the most commonly used search engines in each region. The lack of high-quality, evidence-based, information regarding bariatric surgery online is a potential target to improve public education.
    Keywords:  Bariatric surgery; Information; Internet; Quality; Website; Weight loss surgery
    DOI:  https://doi.org/10.1007/s11695-019-04375-5
  11. Prog Orthod. 2020 Jan 13. 21(1): 2
    The informative value and design of orthodontic practice websites in The Netherlands.
    Cesar Guy Oey, Christos Livas.
       BACKGROUND: The aims of this cross-sectional study were to investigate the regulatory compliance of Dutch practice websites offering orthodontic services, readability of the available treatment information, website design as well as possible relationship with practice location and professional qualification of practitioners.
    METHODS: A comprehensive Internet search was performed using the Google search engine and five relevant terms in Dutch. Eligibility screening of the first 50 results of each search led to the final inclusion of 111 websites. The content of the selected websites was evaluated in terms of compliance to international regulations on ethical advertising guidelines (CED), treatment information text readability using Flesch Reading Ease Score (FRES), and website design using the BDC assessment tool.
    RESULTS: Reporting of websites according to CED guidelines covered on average 85% of the mandatory items. No significant differences were observed between dental and orthodontic practices, and between practices located in densely and sparsely populated regions (P > 0.05). The mean FRES of the displayed information indicated difficult-to-understand text. BDC scores of multi-location practices were significantly higher than the rest (P < 0.006).
    CONCLUSIONS: The websites of orthodontic practices in The Netherlands do not fully comply with CED guidelines on ethical advertising. Readability of the displayed information and website technical performance needs to be further optimized.
    Keywords:  Ethics; Patient education; Practice management; Websites
    DOI:  https://doi.org/10.1186/s40510-019-0302-0
  12. Z Orthop Unfall. 2020 Jan 13.
    Systematic Analysis of Readability of Patient Information on Internet Pages from Departments for Trauma Surgery of German University Hospitals.
    Simon Paul, Marc-Daniel Ahrend, Jan-Christoffer Lüers, Kersten Sven Roth, Peter P Grimmiger, Florian Bopp, Babak Janghorban Esfahani.
       INTRODUCTION: The need-based information transfer in education as well as for the recruitment of patients becomes more and more relevant. Here, the internet has emerged as an increasingly important factor in recent years and therefore information pages on hospital homepages can be very helpful. However, it is known that basic text comprehension skills are lacking among large populations.
    METHOD: The aim of the present study was to evaluate the readability of the patient information available on the websites of trauma departments of German university hospitals. For this purpose, a search for information material on 10 different diagnoses was carried out. Out of 360 texts possible, 185 were found and assigned to 2 superordinate thematic areas (emergency vs. elective operations), subjected to a systematic text analysis via software "Text-Lab" and rated using 5 known readability indices (Amstad, G-SMOG, LIX, HIX, WSTF).
    RESULTS: The indices used for both thematic complexes consistently showed poor readability, so that the texts only seem sufficiently comprehensible to readers with higher education. (Amstad: 21.4 ± 20.8; G-SMOG: 11.6 ± 2.0; WSTF 13.3 ± 2.1; LIX: 60.9 ± 7.6; HIX: 4.1 ± 3.2).
    CONCLUSION: For the medical information provided by university hospitals, there is a clear need for improvement in order to make the adequate acquisition of knowledge accessible to a broader spectrum of patients.
    DOI:  https://doi.org/10.1055/a-1059-9779
  13. Orthopedics. 2020 Jan 13. 1-8
    A Qualitative Study Assessing Information on the Internet Compared With AAOS Guidelines for the Treatment of Distal Radius Fractures.
    Sarah M Lamont, Andrew M Steffensmeier, Timothy W Harman, David W Martineau.
      The goal of this study was to compare information available on the Internet about the treatment of distal radius fractures with the guidelines established by the American Academy of Orthopaedic Surgeons (AAOS) in a qualitative observational study. A scoring system was used to compare the top 20 websites, excluding advertisements, from Google, Bing, and Yahoo with the AAOS guidelines. In addition, the results of the advertising content and the social media content were discussed. Of the 32 unique websites included in the study, 22 (68.75%) suggested operative fixation for fractures with unacceptable postreduction alignment (radial shortening >3 mm, dorsal tilt >10°, or intra-articular displacement or step-off >2 mm) as opposed to cast fixation. Of the 32 sites, 26 (81.25%) were unable to recommend for or against any 1 specific operative method for fixation of distal radius fractures. Only 2 of 32 (6.25%) sites mentioned age-specific recommendations, and 6 of 32 (18.75%) mentioned accurate activity protocols. Because the AAOS cannot recommend for or against immobilization of the elbow in patients treated with cast immobilization, it is reasonable that 7 of 32 (21.88%) sites discussed these options. The websites common to all 3 search engines also scored very well, with 84.89% of their recommendations being consistent with the AAOS recommendations. Most websites contain appropriate recommendations for the treatment of distal radius fractures. However, there is a significant amount of misinformation as well. The available information may be difficult for patients to interpret and may affect their expectations about care. [Orthopedics. 2020;43(x):xx-xx.].
    DOI:  https://doi.org/10.3928/01477447-20200107-01
  14. J Minim Invasive Gynecol. 2020 Jan 09. pii: S1553-4650(20)30034-0. [Epub ahead of print]
    QUALITY AND RELIABILITY OF PUBLICLY ACCESSIBLE INFORMATION ON LASER TREATMENTS FOR URINARY INCONTINENCE: WHAT IS AVAILABLE TO OUR PATIENTS?
    Darian Perruzza, Courtney Jolliffe, Andrew Butti, Carmen McCaffrey, Rose Kung, Louise Gagnon, Patricia Lee.
       STUDY OBJECTIVE: To determine the quality and reliability of the top 20 internet search results for laser treatment of SUI.
    DESIGN: review of 20 websites SETTING: n/a PATIENTS: none INTERVENTIONS: An internet search with the most popular search engine, Google, was undertaken to identify the top 20 websites for laser treatment of stress urinary incontinence (SUI). Standardized, validated tools for the analysis of website quality, credibility and transparency were used independently by 7 health care workers: DISCERN instrument, JAMA benchmarks and HONcode certification. Readability of the information was assessed by a single reviewer using the Flesch-Kincaid Grade Level and Automated Readability Index (ARI). The intraclass correlation coefficient (ICC) was calculated to document reliability between website assessors.
    MEASUREMENTS AND MAIN RESULTS: 15/20 websites reviewed were created by private clinics, 2/20 by online newspaper/newsletters, and 3 by laser medical device manufacturers. 0/20 websites met all of the JAMA criteria: 1/20 websites had attained authorship, 1/20 had clear attribution, 0/20 had adequate disclosure and 2/20 achieved currency. None of the websites took part in the HONcode certification program. The mean DISCERN score (to determine quality of websites) was 40 (out of 80) with the lowest average scores within the DISCERN tool primarily associated with clarity around sources of information, website bias, posting dates, risks of treatment and shared treatment decision making. The intraclass correlation coefficient (ICC) was calculated for the DISCERN tool (0.72, 95%CI 0.48-0.87) and JAMA benchmarks (0.85, 95%CI 0.73-0.93). The mean Flesch-Kincaid grade level was 13.2 (±3.1) and the ARI scores ranged from 7.6 to 22.8 (mean 13.5±3.5).
    CONCLUSION: There is a lack of good quality, reliable and unbiased information available to patients on laser treatment of SUI in the most commonly searched websites. Information is presented at a reading level that is above that of the average reader and may indicate that patients will have trouble comprehending the information.
    Keywords:  laser vaginal treatment; stress urinary incontinence; website review
    DOI:  https://doi.org/10.1016/j.jmig.2020.01.001
  15. J Diabetes. 2020 Jan 14.
    Use of online information in diabetes.
    Zachary T Bloomgarden.
      
    DOI:  https://doi.org/10.1111/1753-0407.13022
  16. Natl Med J India. 2019 Mar-Apr;32(2):32(2): 125
    Disappearing libraries.
    B C Rao.
      
    DOI:  https://doi.org/10.4103/0970-258X.275361
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