bims-librar Biomed News
on Biomedical librarianship
Issue of 2020–11–08
seventeen papers selected by
Thomas Krichel, Open Library Society
  1. Public Libraries as health literate multi-purpose workspaces for improving health literacy.
  2. Publications search optimization: Comparison of a homegrown-API approach versus manual publication searches at an NCI designated cancer center.
  3. PubChem in 2021: new data content and improved web interfaces.
  4. Guidance for overviews of reviews continues to accumulate, but important challenges remain: a scoping review.
  5. Basics of meta-analysis.
  6. COVID-19 Information Sources and the Relationship with Attitudes in Battling the Pandemic: A Cross-Sectional Survey Among the Malaysian Public.
  7. Estimating Information Seeking-Behaviour of Public in Malaysia During COVID-19 by Using Google Trends.
  8. Evaluating the Readability of Online Patient Education Materials Related to Orthopedic Oncology.
  9. Predictors of Internet Health Information-Seeking Behaviors Among Young Adults Living With HIV Across the United States: Longitudinal Observational Study.
  10. Readability of Online Patient Education Materials for Interventional Pain Procedures.
  11. Health Information Seeking Behaviors and Source Preferences between Chinese and U.S. Populations.
  12. Trochanteric bursitis information on the internet; can we trust the information presented?
  13. U.S. College Students' Marijuana Information Sources, Confidence in Knowledge, and Objective Knowledge.
  14. YouTube as a Source of Medical Information About Spinal Cord Stimulation.
  15. Features of patient-education websites for patients with chronic kidney disease: an analysis of recommended websites.
  16. Search Trends and Quality of Online Resources Regarding Thyroidectomy.
  17. Carotid Endarterectomy Versus Carotid Artery Stenting: Survey of the Quality, Readability, and Treatment Preference of Carotid Artery Disease Websites.
  1. Health Promot J Austr. 2020 Nov 02.
    Public Libraries as health literate multi-purpose workspaces for improving health literacy.
    Lucio Naccarella, Jacqui Horwood.
      Now more than ever, in this COVID-19 pandemic, our individual and collective ability to access, understand and apply information to inform our health care and broader lifestyle decisions, that is, to be health literate - has life or death consequences.1 Health literacy is recognised as key to supporting people to better manage their own health and has the potential to improve health-related outcomes of disadvantaged populations.
    Keywords:  Health Literacy; Libraries; Organisations; Workforce; Workplace
    DOI:  https://doi.org/10.1002/hpja.437
  2. Health Informatics J. 2020 Nov 05. 1460458220966816
    Publications search optimization: Comparison of a homegrown-API approach versus manual publication searches at an NCI designated cancer center.
    Colin Cernik, John Fife, Jeffrey Thompson, Lisa Harlan-Williams, Dinesh Pal Mudaranthakam.
      One measure of research productivity within the University of Kansas Cancer Center (KU Cancer Center) is peer-reviewed publications. Considerable effort goes into searching, capturing, reviewing, storing, and reporting cancer-relevant publications. Traditionally, the method of gathering relevant information to the publications is done manually. This manuscript describes the efforts to transition KU Cancer Center's publication gathering process from a heavily manual to a more automated and efficient process. To achieve this transition in the most customized and cost-effective manner, a homegrown, automated system was developed using open source API among other software. When comparing the automated and the manual processes over several years of data, publication search and retrieval time dropped from an average of 59 h to 35 min, which would amount to a cost savings of several thousand dollars per year. The development and adoption of an automated publications search process can offer research centers great potential for less-error prone results with a savings in time and cost.
    Keywords:  IT healthcare evaluation; data mining; databases and data mining; health information on the Web; text mining
    DOI:  https://doi.org/10.1177/1460458220966816
  3. Nucleic Acids Res. 2020 Nov 05. pii: gkaa971. [Epub ahead of print]
    PubChem in 2021: new data content and improved web interfaces.
    Sunghwan Kim, Jie Chen, Tiejun Cheng, Asta Gindulyte, Jia He, Siqian He, Qingliang Li, Benjamin A Shoemaker, Paul A Thiessen, Bo Yu, Leonid Zaslavsky, Jian Zhang, Evan E Bolton.
      PubChem (https://pubchem.ncbi.nlm.nih.gov) is a popular chemical information resource that serves the scientific community as well as the general public, with millions of unique users per month. In the past two years, PubChem made substantial improvements. Data from more than 100 new data sources were added to PubChem, including chemical-literature links from Thieme Chemistry, chemical and physical property links from SpringerMaterials, and patent links from the World Intellectual Properties Organization (WIPO). PubChem's homepage and individual record pages were updated to help users find desired information faster. This update involved a data model change for the data objects used by these pages as well as by programmatic users. Several new services were introduced, including the PubChem Periodic Table and Element pages, Pathway pages, and Knowledge panels. Additionally, in response to the coronavirus disease 2019 (COVID-19) outbreak, PubChem created a special data collection that contains PubChem data related to COVID-19 and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
    DOI:  https://doi.org/10.1093/nar/gkaa971
  4. Syst Rev. 2020 11 04. 9(1): 254
    Guidance for overviews of reviews continues to accumulate, but important challenges remain: a scoping review.
    Michelle Gates, Allison Gates, Samantha Guitard, Michelle Pollock, Lisa Hartling.
       BACKGROUND: Overviews of reviews (overviews) provide an invaluable resource for healthcare decision-making by combining large volumes of systematic review (SR) data into a single synthesis. The production of high-quality overviews hinges on the availability of practical evidence-based guidance for conduct and reporting.
    OBJECTIVES: Within the broad purpose of informing the development of a reporting guideline for overviews, we aimed to provide an up-to-date map of existing guidance related to the conduct of overviews, and to identify common challenges that authors face when undertaking overviews.
    METHODS: We updated a scoping review published in 2016 using the search methods that had produced the highest yield: ongoing reference tracking (2014 to March 2020 in PubMed, Scopus, and Google Scholar), hand-searching conference proceedings and websites, and contacting authors of published overviews. Using a qualitative meta-summary approach, one reviewer extracted, organized, and summarized the guidance and challenges presented within the included documents. A second reviewer verified the data and synthesis.
    RESULTS: We located 28 new guidance documents, for a total of 77 documents produced by 34 research groups. The new guidance helps to resolve some earlier identified challenges in the production of overviews. Important developments include strengthened guidance on handling primary study overlap at the study selection and analysis stages. Despite marked progress, several areas continue to be hampered by inconsistent or lacking guidance. There is ongoing debate about whether, when, and how supplemental primary studies should be included in overviews. Guidance remains scant on how to extract and use appraisals of quality of the primary studies within the included SRs and how to adapt GRADE methodology to overviews. The challenges that overview authors face are often related to the above-described steps in the process where evidence-based guidance is lacking or conflicting.
    CONCLUSION: The rising popularity of overviews has been accompanied by a steady accumulation of new, and sometimes conflicting, guidance. While recent guidance has helped to address some of the challenges that overview authors face, areas of uncertainty remain. Practical tools supported by empirical evidence are needed to assist authors with the many methodological decision points that are encountered in the production of overviews.
    Keywords:  Evidence synthesis; Evidence-based medicine; Knowledge synthesis; Metareview; Metasummary; Overview of reviews; Scoping review; Systematic reviews; Umbrella review
    DOI:  https://doi.org/10.1186/s13643-020-01509-0
  5. Indian J Gastroenterol. 2020 Nov 04.
    Basics of meta-analysis.
    Ayesha Shah, Michael P Jones, Gerald J Holtmann.
      Meta-analysis is an approach to formally, systematically and quantitatively analyze multiple existing research studies and to synthesize new research findings based upon the existing data. Until the late 1970s, meta-analyses were not regularly reported in the medical literature, but since then there has been an exponential growth of meta-analyses and they are now among the most frequently cited form of research. A properly performed systematic review and meta-analysis is a very important tool in evidence-based medicine and a good understanding of the steps involved in doing a systematic review and meta-analysis is important to yield meaningful results. The purpose of this review article is to provide a brief overview about systematic reviews and meta-analyses and the underlying principles for conducting this type of research. Methodological approaches for conducting a meticulous meta-analysis are described and the important steps involved in the interpretation and presentation of meta-analysis are outlined and discussed. The key objective of this paper is to outline a step-by-step approach that is useful to all researchers, who would like to conduct their first meta-analysis. This paper also provides clinicians and researchers with the information to interpret systematic reviews and meta-analyses.
    Keywords:  Bias; Evidence-based medicine; Meta-analysis; Systematic review
    DOI:  https://doi.org/10.1007/s12664-020-01107-x
  6. J Med Internet Res. 2020 Oct 30.
    COVID-19 Information Sources and the Relationship with Attitudes in Battling the Pandemic: A Cross-Sectional Survey Among the Malaysian Public.
    Emma Mohamad, Jen Sern Tham, Suffian Hadi Ayub, Mohammad Rezal Hamzah, Hasrul Hashim, Arina Anis Azlan.
       BACKGROUND: There are multiple media platforms and various resources available on COVID-19. Identifying people's preferences is key to building public confidence and planning for successful national health intervention strategies.
    OBJECTIVE: This study examines the sources of information for COVID-19 used by the Malaysian public and identifies those that are associated with building public confidence as well as positive perceptions toward the Malaysian government.
    METHODS: A cross-sectional online survey of 4,850 Malaysian residents was conducted. Participant demographics, media use, information source, and attitudes surrounding COVID-19 were assessed. Descriptive statistics and multiple logistic regression analyses were conducted to gauge the relationship between demographics, information source and attitudes toward COVID-19.
    RESULTS: Malaysians primarily utilized television and Internet news portals for information on COVID-19. The Malaysian Ministry of Health was the most preferred source of COVID-19 information. Respondents who referred to the Ministry of Health, television and the Malaysian National Security Council had greater odds in believing that the country could win the battle against COVID-19 and that the government was handling the health crisis well. Those who used the World Health Organization, friends, YouTube, family and radio as sources of information were less likely to harbor confidence and positive belief toward combating COVID-19.
    CONCLUSIONS: Managing information and sustaining public confidence is important in a pandemic. Health authorities should pay considerable attention to the use of appropriate media channels and sources to allow for more effective dissemination of critical information to the public.
    CLINICALTRIAL:
    DOI:  https://doi.org/10.2196/23922
  7. Malays J Med Sci. 2020 Oct;27(5): 202-204
    Estimating Information Seeking-Behaviour of Public in Malaysia During COVID-19 by Using Google Trends.
    Jin Lee Lim, Chong Yau Ong, Beiqi Xie, Lian Leng Low.
      The public was reported to be anxious and concerned during the pandemic. It is unknown whether these reactions had a relationship with the statistics of coronavirus disease 2019 (COVID-19) in Malaysia. We used Google Trends (GT) to understand whether the publics' inquisitiveness towards COVID-19 and its recommended precautionary measures had increased during the initial duration of the pandemic in Malaysia.
    Keywords:  Malaysia; behaviour; coronavirus; internet
    DOI:  https://doi.org/10.21315/mjms2020.27.5.16
  8. Orthopedics. 2020 Nov 03. 1-5
    Evaluating the Readability of Online Patient Education Materials Related to Orthopedic Oncology.
    Ashok Para, Franklin Thelmo, Nicole D Rynecki, Brandon Zelman, Raghav Gupta, Daniel Coban, Varun Ayyaswami, Arpan V Prabhu, Joseph A Ippolito, Nitin Agarwal, Justin M Moore, Kathleen S Beebe.
      The internet is increasingly used to access patient education materials. The average American reading level has been found to be that of a 7th- to 8th-grade student, prompting the National Institutes of Health (NIH) and the American Medical Association (AMA) to advise that patient education materials be written between the 4th- to 6th-grade reading level. The purpose of this study was to evaluate the reading level of current patient education materials for the most common musculoskeletal oncological tumors. A Google search was performed with all location filters off to account for geographic variability for patient education materials related to 28 orthopedic primary or secondary tumors. All patient education articles from the first 10 website hits for each tumor type were analyzed. Patient education materials from these websites were evaluated using 8 validated readability scales. Patient resources were found to be written at an average grade level nearly double the NIH and AMA recommendation. Patient education materials for soft tissue chondromas were written at the highest level (14.8±1.9), whereas education materials for chordomas (10.1±1.0) most closely approached national recommendations, despite still being written at a readability level nearly 4 grade levels higher than has been recommended. The Flesch Reading Ease assessment provided a mean score of 46.5±7.7, corresponding with a "difficult to read" result. Current patient education materials regarding oncological musculoskeletal-related patient education materials are written significantly above the recommended reading level. Further modification of these resources is warranted to ensure adequate comprehension and informed decision making in the clinical setting. [Orthopedics. 2021;44(x):xx-xx.].
    DOI:  https://doi.org/10.3928/01477447-20201012-04
  9. J Med Internet Res. 2020 11 02. 22(11): e18309
    Predictors of Internet Health Information-Seeking Behaviors Among Young Adults Living With HIV Across the United States: Longitudinal Observational Study.
    Special Projects Of National Significance Social Media Initiative Study Group
       BACKGROUND: Consistent with young adults' penchant for digital communication, young adults living with HIV use digital communication media to seek out health information. Understanding the types of health information sought online and the characteristics of these information-seeking young adults is vital when designing digital health interventions for them.
    OBJECTIVE: This study aims to describe characteristics of young adults living with HIV who seek health information through the internet. Results will be relevant to digital health interventions and patient education.
    METHODS: Young adults with HIV (aged 18-34 years) self-reported internet use during an evaluation of digital HIV care interventions across 10 demonstration projects in the United States (N=716). Lasso (least absolute shrinkage and selection operator) models were used to select characteristics that predicted whether participants reported seeking general health and sexual and reproductive health (SRH) information on the internet during the past 6 months.
    RESULTS: Almost a third (211/716, 29.5%) and a fifth (155/716, 21.6%) of participants reported searching for general health and SRH information, respectively; 26.7% (36/135) of transgender young adults with HIV searched for gender-affirming care topics. Areas under the curve (>0.70) indicated success in building models to predict internet health information seeking. Consistent with prior studies, higher education and income predicted health information seeking. Higher self-reported antiretroviral therapy adherence, substance use, and not reporting transgender gender identity also predicted health information seeking. Reporting a sexual orientation other than gay, lesbian, bisexual, or straight predicted SRH information seeking.
    CONCLUSIONS: Young adults living with HIV commonly seek both general health and SRH information online, particularly those exploring their sexual identity. Providers should discuss the most commonly sought SRH topics and the use of digital technology and be open to discussing information found online to better assist young adults with HIV in finding accurate information. Characteristics associated with health information-seeking behavior may also be used to develop and tailor digital health interventions for these young adults.
    Keywords:  HIV stigma; HIV/AIDS; digital technology; general health; health information seeking; sexual and reproductive health; young adults; youth
    DOI:  https://doi.org/10.2196/18309
  10. Cureus. 2020 Sep 27. 12(9): e10684
    Readability of Online Patient Education Materials for Interventional Pain Procedures.
    Dilip Kamath, Sean Mcintyre, Evan Peskin, Scott Stratman, Nitin Agarwal, Preetha D Kamath, Raghav Gupta, Ruben Schwartz, Alaa Abd-Elsayed, Ivan Urits, Omar Viswanath, Alan D Kaye, Danielle B Horn.
      Background The internet has had an enormous influence on the field of medicine. In this regard, Statista, a market and consumer data company, estimated in 2019 that more than half the world's population (>four billion people) were active internet users. Accessing the World Wide Web has become the second nature for most. In the medical field, many patients look to the internet for information regarding certain procedures. The purpose of this study, therefore, was to assess the readability level of more than 492 online sources with information on a wide array of interventional pain procedures. Objective The aim is to determine the readability of online patient educational materials for interventional pain procedures. Study design This is a retrospective review. Methods We downloaded and reformatted to plain text 492 internet-based patient educational materials for 17 different interventional pain procedures. Plain text was processed using Readability Studio (Oleander Software Ltd., Vandalia, Ohio, USA), which employs 10 quantitative readability scales that are widely used and accepted in the medical literature. Results The software determined the average reading level (or grade level) of the 492 online sources we examined to be 12.1, with a range of 10.9 to 13. Limitations Google is not the only online search engine patients utilize for information, and the top links for each search could change over time. Also, some patients prefer videos rather than text to learn about their disease and treatment options. Finally, depending on their provider, the links that patients are directed to may be significantly more or less readable. Conclusions The average American adult reads at the eighth grade level. The National Institutes of Health and the American Medical Association have recommended education materials be made available at the third to seventh grade level. Our analysis shows patient educational materials found online for interventional pain procedures to be overly technical, with an average reading level (or grade level) of 12.1.
    Keywords:  readability
    DOI:  https://doi.org/10.7759/cureus.10684
  11. J Health Commun. 2020 Jun 02. 25(6): 490-500
    Health Information Seeking Behaviors and Source Preferences between Chinese and U.S. Populations.
    Linqi Lu, Jiawei Liu, Y Connie Yuan.
      This study examined similarities and differences in health information-seeking behaviors between American and Chinese people using data from the 2017 U.S. Health Information National Trends Survey (HINTS) and the 2017 China HINTS. It is one of the first studies that use comparable samples and survey instruments to make direct comparisons of the two populations' health information-seeking behaviors. Results showed that Americans (including different racial/ethnic groups in the U.S.) were more likely to actively seek health information than Chinese people. Americans were also more likely to use mediated communication as their primary sources of health information while Chinese people favored interpersonal sources. Chinese people reported lower quality of doctor-patient communication than their American counterparts. These differences between the two countries highlight the importance of using different information sources to reach specific populations, and the need to develop tailored public health intervention programs in different cultures.
    DOI:  https://doi.org/10.1080/10810730.2020.1806414
  12. World J Orthop. 2020 Oct 18. 11(10): 473-474
    Trochanteric bursitis information on the internet; can we trust the information presented?
    Richard Tyrrell, Martin Kelly, Cian Kennedy.
      Trochanteric bursitis is one of the most common causes of lateral hip pain in adults. The prevalence of unilateral trochanteric bursitis is 15.0% in women and 8.5% in men. Access to internet based information has increased dramatically and health related information is now one of the most popular searches in online activity, despite this the quality of information can vary. The objective of this paper is to examine the quality and readability of internet based information of trochanteric bursitis. Overall, we have found a high variability among not only the quality but also the readability of information published. Websites that appeared first on each search engine for trochanteric bursitis did not necessarily score better, demonstrating the importance of providing patients with high quality resources. Future articles should use more critical appraisal tools in order to provide the reader with more high quality and readable information.
    Keywords:  DISCERN; Flesh Reading Ease; Internet; Journal of American Medical Association; Quality; Readability
    DOI:  https://doi.org/10.5312/wjo.v11.i10.473
  13. J Health Commun. 2020 Nov 05. 1-11
    U.S. College Students' Marijuana Information Sources, Confidence in Knowledge, and Objective Knowledge.
    Sung-Yeon Park, Nora Constantino, Gi Woong Yun, Lea Moser, Daniela Cortes-Arriola.
      In recent years, marijuana use on U.S. college campuses reached the highest point while the perceptions of risk and social disapproval registered the lowest since the early 1980s. However, little attention has been paid to the sources of the marijuana-related messages and their relationships with marijuana knowledge and confidence in knowledge, proximate protective/risk factors. To fill this gap, a convenience sample of students (N = 249) on a campus located in a U.S. recreational marijuana legal state were surveyed to identify their marijuana information sources and explore the relationships among the sources, confidence in marijuana knowledge, and objective knowledge. Peers/media were the most important sources and they were used more than other sources. Use of peers/media sources was related to lower health knowledge and higher confidence in knowledge. Although students named parents and education/science sources as important, these were less frequently used than siblings, the sources they named as the least important. This study advanced our understanding of the various sources of marijuana information used by U.S. college students and the relationships between the information sources and confidence in knowledge and objective knowledge, two emerging risk/protective factors in the era of marijuana deregulation.
    DOI:  https://doi.org/10.1080/10810730.2020.1840677
  14. Neuromodulation. 2020 Nov 02.
    YouTube as a Source of Medical Information About Spinal Cord Stimulation.
    Brendan Langford, William Michael Hooten, Shawn D'Souza, Susan Moeschler, Ryan S D'Souza.
       BACKGROUND: Social media platforms may play an important role in the dissemination of medical information on interventional pain procedures. This cross-sectional study quantitatively assessed the reliability and quality of information from YouTube regarding spinal cord stimulation.
    MATERIALS AND METHODS: YouTube was queried on May 20, 2020 using keywords "spinal cord stimulator," "spinal cord stimulation experience," and "spinal cord stimulation risks." The top 50 viewed videos from each search were analyzed. The primary outcome was video quality, which was analyzed using the modified DISCERN (mDISCERN) criteria.
    RESULTS: Seventy-nine of 103 (77%) videos were classified as useful. Fifteen of 103 (14%) videos were classified as misleading and contained nonfactual information on spinal cord stimulation. Hospitals, group practices, or physicians produced a greater proportion of useful videos compared to misleading videos (63.3% vs. 26.7%, p = 0.008). Nonmedical independent users produced a greater proportion of misleading videos compared to useful videos (73.3% vs. 16.4%, p < 0.001). Useful videos had significantly higher mDISCERN scores compared to misleading videos (2.6 vs. 1.9, p = 0.009). Nonmedical independent users produced a greater proportion of low-quality videos (mDISCERN score < 3) than high-quality videos (mDISCERN score ≥ 3; 50.8% vs. 2.4%, respectively, p < 0.001). Educational videos from professional pain medicine societies were not captured.
    CONCLUSION: YouTube is an accessible platform for medical information on spinal cord stimulation, yet a significant amount of nonfactual information is present. As social media platforms continue to gain prominence in health care, future efforts to appraise the quality of medical content delivered to the public are warranted. In addition, reputable sources including professional pain medicine societies should consider collaborating with producers to disseminate high-quality video content that reaches a wider audience.
    Keywords:  Communication; Internet; information dissemination; social media; spinal cord stimulation
    DOI:  https://doi.org/10.1111/ner.13303
  15. BMC Nephrol. 2020 Nov 03. 21(1): 457
    Features of patient-education websites for patients with chronic kidney disease: an analysis of recommended websites.
    Rohanit Singh, Lawrence J Appel, Gibran Kazi, Bernard G Jaar.
       BACKGROUND: Chronic kidney disease (CKD) requires lifelong self-management. With the rise in access to the Internet, many CKD patients and their caregivers increasingly use the internet for information on CKD self-management. A recent environmental scan by Smekal et al. identified 11 CKD-related websites that covered the greatest number of content areas. This paper aims to evaluate these 11 selected websites in order to identify those that most effectively address content areas relevant to patients with CKD.
    METHODS: Each website was assessed for information to 6 content areas: diet, physical activity, financial information, emotional support, general CKD information, and medication adherence. A three-tiered scoring metric was used in which a 0 was given if a content area was completely unaddressed, a (+) was given for a category that was generally addressed, and a (++) was given for a category that was addressed with actionable guidance.
    RESULTS: While CKD information and diet were very comprehensively covered with scores of 11 (++) and 8 (++), respectively; physical activity, emotional support and medication adherence received the fewest (++) scores (3 for physical activity and five for both emotional support and medication adherence). For each content area, recommendations are made for websites that are particularly useful. Common themes for these highlighted websites include specific instructions, multiple modalities of information, downloadable and printable resources, and contact references for personal inquiries.
    CONCLUSION: The recommended websites can help CKD patients and caregivers utilize the most applicable information for their specific self-management needs. Website improvements related to physical activity, emotional support, and financial information for persons with CKD are warranted.
    Keywords:  Chronic kidney disease; Internet; Website
    DOI:  https://doi.org/10.1186/s12882-020-02128-6
  16. Otolaryngol Head Neck Surg. 2020 Nov 03. 194599820969154
    Search Trends and Quality of Online Resources Regarding Thyroidectomy.
    Lena W Chen, Vandra Chatrice Harris, Justin Lee Jia, Deborah Xingchun Xie, Ralph Patrick Tufano, Jonathon Owen Russell.
       OBJECTIVE: Thyroidectomy is one of the most common procedures performed in head and neck surgery. The quality of online resources for thyroidectomy is unknown. We aim to evaluate search trends and online resource quality regarding thyroidectomy.
    STUDY DESIGN: Cross-sectional analysis.
    SETTING: Websites appearing on Google search.
    METHODS: The first 30 Google websites for thyroidectomy were reviewed, excluding research, video, and restricted sites. Search patterns were obtained with Google Trends. Quality was measured by readability (Flesch Reading Ease and Flesch-Kinkaid Grade Level), understandability and actionability (Patient Education Materials Assessment Tool), and clinical practice guideline (CPG) compatibility. Fleiss kappa interrater reliability analysis was performed for 2 raters.
    RESULTS: Twenty-one sites were evaluated. Search popularity for thyroidectomy has increased since 2004. Median reading ease was 42.2 (range, 15.4-62.7) on a scale from 1 to 100, with 100 indicating maximum readability. Median reading grade level was 12 (range, 7-16). Thyroidectomy resources were poorly understandable (median, 66%; range, 21%-88%) and actionable (median, 10%; range, 0%-60%). Median CPG compatibility was 4 out of 5 (range, 0-5). Interrater reliability ranged from substantial to moderate for understandability (0.78), actionability (0.57), and CPG compatibility (0.58), with P < .05 for all results.
    CONCLUSION: Online resources about thyroidectomy vary in quality and reliability and are written at grade levels above the average reading level of the public. Providers should be aware of existing resources and work to create education resources that meet universal health literacy guidelines. The framework provided in this article may also serve as a guide and provide tangible steps that providers can take to help patients access care.
    Keywords:  PEMAT; google search results; otolaryngology; patient education materials; readability; thyroid surgery; thyroidectomy
    DOI:  https://doi.org/10.1177/0194599820969154
  17. Interact J Med Res. 2020 Nov 03. 9(4): e23519
    Carotid Endarterectomy Versus Carotid Artery Stenting: Survey of the Quality, Readability, and Treatment Preference of Carotid Artery Disease Websites.
    Shira Strauss, Michael Yacob, Apoorva Bhandari, Prasad Jetty.
       BACKGROUND: The internet is becoming increasingly more important in the new era of patient self-education. Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are recognized interventions to treat patients with carotid artery stenosis. Using the Google search platform, patients encounter many websites with conflicting information, which are sometimes difficult to understand. This lack of accessibility creates uncertainty or bias toward interventions for carotid artery disease. The quality, readability, and treatment preference of carotid artery disease (CAD) websites have not yet been evaluated.
    OBJECTIVE: This study aimed to explore the quality, readability, and treatment preference of CAD websites.
    METHODS: We searched Google Canada for 10 CAD-related keywords. Returned links were assessed for publication date, medical specialty and industry affiliation, presence of randomized controlled trial data, differentiation by symptomatic status, and favored treatment. Website quality and readability were rated by the DISCERN instrument and Gunning Fog Index.
    RESULTS: We identified 54 unique sites: 18 (33.3%) by medical societies or individual physicians, 11 (20.4%) by government organizations, 9 (16.7%) by laypersons, and 1 (1.9%) that was industry-sponsored. Of these sites, 26 (48.1%) distinguished symptomatic from asymptomatic CAD. A majority of sites overall (57.4%) and vascular-affiliated (72.7%) favored CEA. In contrast, radiology- and cardiology-affiliated sites demonstrated the highest proportion of sites favoring CAS, though they were equally likely to favor CEA. A large proportion (21/54, 38.9%) of sites received poor quality ratings (total DISCERN score <48), and the majority (41/54, 75.9%) required a reading level greater than a high school senior.
    CONCLUSIONS: CAD websites are often produced by government organizations, medical societies, or physicians, especially vascular surgeons. Sites ranged in quality, readability, and differentiation by symptomatic status. Google searches of CAD-related terms are more likely to yield sites favoring CEA. Future research should determine the extent of website influence on CAD patients' treatment decisions.
    Keywords:  Google; carotid artery disease; carotid endarterectomy; carotid stenosis; carotid stenting; carotid surgery; online health information; patient information; preference; quality; readability; treatment
    DOI:  https://doi.org/10.2196/23519
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