bims-librar Biomed News
on Biomedical librarianship
Issue of 2021–01–03
twenty-six papers selected by
Thomas Krichel, Open Library Society



  1. J Clin Epidemiol. 2020 Dec 23. pii: S0895-4356(20)31226-9. [Epub ahead of print]
       OBJECTIVE: Medline/PubMed is often first choice for health science researchers when doing literature searches. However, Medline/PubMed does not cover the health science research literature equally well across specialties. Embase is often considered an important supplement to Medline/PubMed in health sciences. The present study analyses the coverage of Embase as a supplement to PubMed, and the aim of the study is to investigate if searching Embase can compensate for low PubMed retrieval.
    STUDY DESIGN AND SETTING: The population in this study is all the included studies in all Cochrane reviews from 2012 to 2016 across the 53 Cochrane groups. The analyses were performed using two units of analysis (study and publication). We are examining the coverage in Embase of publications and studies not covered by PubMed (25,119 publications and 9,420 studies).
    RESULTS: The results showed that using Embase as a supplement to PubMed resulted in a coverage of 66,994 publications out of 86,167 and a coverage rate of 77.7, 95% CI [75.05, 80.45] of all the included publications. Embase combined with PubMed covered 48,326 out of 54,901 studies and thus had a coverage rate of 88.0%, 95% CI [86.2, 89.9] of studies. The results also showed that supplementing PubMed with Embase increased coverage of included publications by 6.8 percentage points and the coverage of studies increased by 5.5 percentage points. Substantial differences were found across and within review groups over time.
    CONCLUSION: The included publications and studies in some groups are covered considerably better by supplementing with Embase whereas in other groups the difference in coverage is negligible. However, due to the variation over time one should be careful predicting the benefit from supplementing PubMed with Embase in order to retrieve relevant publications to include in a review.
    DOI:  https://doi.org/10.1016/j.jclinepi.2020.12.022
  2. Eur J Orthod. 2020 Dec 26. pii: cjaa078. [Epub ahead of print]
       BACKGROUND: This study aimed to assess the reporting of the methodological quality of search strategies undertaken in orthodontic quantitative systematic reviews (SRs) and hence their reproducibility.
    MATERIALS AND METHODS: A search of a single electronic database (Medline via PubMed) was undertaken to identify interventional orthodontic SRs with meta-analysis published within a 10-year period. The Cochrane Library of Systematic Reviews was also sourced. Full articles were reviewed by two assessors against the eligibility criteria. The reporting quality of each search strategy was assessed using a previously validated checklist with a score of 1 or 2 given for each of the eight items. Cumulative totals were calculated. Guided by previous research, the authors agreed the following cut-offs to categorize the overall level of quality: 8-10 (poor), 10-12 (fair), and greater than 13 (good).
    RESULTS: A total of 127 SRs were analysed. The overall median quality score for the reporting of the search strategy was 14 [interquartile range (IQR): 13-15]. Cochrane SRs and those originating in Europe received higher aggregate scores, whereas no difference was evident based on Prospero registration. The continent of the corresponding author predicated the overall score. Non-Cochrane reviews achieved lower overall scores compared to Cochrane reviews (-1.0, 95% confidence interval: -1.65, -0.34, P = 0.003). The most frequently searched database was EMBASE (N = 93) and the median number of authors was 5 (IQR 4-6). Authors of 26.8% of SRs searched the grey literature. Language restrictions were applied to the search strategies of 88 (69.3%) SRs.
    CONCLUSIONS: The reporting quality of search strategies undertaken in orthodontic SRs is at a good level but differences between Cochrane and non-Cochrane reviews currently exist. The reporting of searching of the grey literature and application of no language restrictions can be improved.
    DOI:  https://doi.org/10.1093/ejo/cjaa078
  3. Medwave. 2020 Dec 23. 20(11): e8092
      This is the second article from a collaborative methodological series of biostatistics and clinical epidemiology narrative reviews. This review aims to describe living systematic reviews relevance, the considerations that should be taken when producing one, and the challenges proper of this type of review. The living systematic review is a continuous update that maintains a systematic reviews rigor and methodological quality. The living format is appropriate when the review aims to answer a priority question in terms of health decision-making, the existent certainty of the evidence for this question is low or very low, and new evidence will likely appear soon. To carry out a successful living systematic review, researchers should consider different things, such as: having a continuous and automated search, having update criteria, evaluating how to update the meta-analysis and how to perform the editorial process, and publishing in a friendly format, among others. As living systematic reviews are a new proposal, they will likely change in the future to improve their performance, so we will have to keep an eye on its future updates.
    Keywords:   Review Literature as Topic; Systematic Reviews as Topic
    DOI:  https://doi.org/10.5867/medwave.2020.11.8092
  4. Scientometrics. 2020 Dec 17. 1-25
      Forecasting is one of the methods applied in many studies in the library and information science (LIS) field for numerous purposes, from making predictions of the next Nobel laureates to potential technological developments. This study sought to draw a picture for the future of the LIS field and its sub-fields by analysing 97 years of publication and citation patterns. The core Web of Science indexes were used as the data source, and 123,742 articles were examined in-depth for time series analysis. The social network analysis method was used for sub-field classification. The field was divided into four sub-fields: (1) librarianship and law librarianship, (2) health information in LIS, (3) scientometrics and information retrieval and (4) management and information systems. The results of the study show that the LIS sub-fields are completely different from each other in terms of their publication and citation patterns, and all the sub-fields have different dynamics. Furthermore, the number of publications, references and citations will increase significantly in the future. It is expected that more scholars will work together. The future subjects of the LIS field show astonishing diversity from fake news to predatory journals, open government, e-learning and electronic health records. However, the findings prove that publish or perish culture will shape the field. Therefore, it is important to go beyond numbers. It can only be achieved by understanding publication and citation patterns of the field and developing research policies accordingly.
    Keywords:  Disciplinary differences; Forecasting; Library and information science; Sub-field analysis; Time series analysis
    DOI:  https://doi.org/10.1007/s11192-020-03800-2
  5. Health Info Libr J. 2020 Dec;37(4): 251-253
      Does sports science librarianship differ from other aspects of health librarianship? Or are sports science librarians more likely to identify as generalist librarians? This editorial introduces the salutogenic approach to sport, factors that support human health and well-being, and highlights the challenge of resourcing the diversity of subjects covered by sports sciences. Highlighting key parallels with medicine and public health, it concludes by advocating for closer alignment between sports and health science librarianship.
    Keywords:  Europe; careers; health science; librarianship; northern; sports
    DOI:  https://doi.org/10.1111/hir.12350
  6. Health Info Libr J. 2020 Dec;37(4): 343-347
      In 2019 Health Education England supported health care library knowledge service staff in the Northern region to organise a two-day event to share knowledge and expertise, and to develop their networks. The article describes how the event was organised, emphasising the advance planning and development opportunities provided for participants, such as webinars, and randomised coffee trial meetings between participants. Of the 100 participants, 60 delivered a poster, workshop or presentation. Reflective evaluation of the event by the organising committee indicated that networking was actively encouraged, and that a higher proportion of library assistants participated than usual. Concludes that the virtual aspects of the event worked well, and that future events could include a mix of face to face and virtual sessions. D.I.
    Keywords:  continuing professional development; health care; knowledge management; learning; libraries; library and information professionals; library assistants
    DOI:  https://doi.org/10.1111/hir.12331
  7. J Am Med Inform Assoc. 2020 Dec 22. pii: ocaa314. [Epub ahead of print]
      This letter discusses the limitations of the use of filters to enhance the accuracy of the extraction of parenthetic abbreviations from scholarly publications and proposes the usage of the parentheses level count algorithm to efficiently extract entities between parentheses from raw texts as well as of machine learning-based supervised classification techniques for the identification of biomedical abbreviations to significantly reduce the removal of acronyms including disallowed punctuations.
    Keywords:  acronym extraction; data mining; information retrieval; parenthetic acronym
    DOI:  https://doi.org/10.1093/jamia/ocaa314
  8. Perspect Behav Sci. 2020 Dec;43(4): 725-760
      Literature reviews allow professionals to identify effective interventions and assess developments in research and practice. As in other forms of scientific inquiry, the transparency of literature searches enhances the credibility of findings, particularly in regards to intervention research. The current review evaluated the characteristics of search methods employed in literature reviews appearing in publications concerning behavior analysis (n = 28) from 1997 to 2017. Specific aims included determining the frequency of narrative, systematic, and meta-analytic reviews over time; examining the publication of reviews in specific journals; and evaluating author reports of literature search and selection procedures. Narrative reviews (51.30%; n = 630) represented the majority of the total sample (n = 1,228), followed by systematic (31.51%; n = 387) and meta-analytic (17.18%; n = 211) reviews. In contrast to trends in related fields (e.g., special education), narrative reviews continued to represent a large portion of published reviews each year. The evaluated reviews exhibited multiple strengths; nonetheless, issues involving the reporting and execution of searches may limit the validity and replicability of literature reviews. A discussion of implications for research follows an overview of findings.
    Keywords:  Literature review; Quality indicators; Systematic review
    DOI:  https://doi.org/10.1007/s40614-020-00265-9
  9. Hum Behav Emerg Technol. 2020 Nov 23.
      Cyberchondria is an excessive or repeated online health information seeking that is associated with increasing levels of health anxiety or distress. This article presents a model of cyberchondria during public health crises such as the COVID-19 pandemic. The factors that contribute to cyberchondria at this time include (a) a heightened perception of threat and fear of a newly identified and poorly understood disease; (b) difficulty in coping with uncertainty associated with the pandemic; (c) lack of authoritative and trustworthy sources of relevant health information; (d) difficulty in coping with abundance of information that is often confusing, conflicting, unverified and constantly updated, along with a decreased ability to filter out unnecessary information; and (e) inability of excessive online health information seeking to provide the necessary information and deliver reassurance. These factors amplify fear and distress, which increases the perception of threat and uncertainty and perpetuates further online health searches. Cyberchondria has significant public health implications because of the associated distress or functional impairment and effects on health behaviors. Cyberchondria should be addressed by targeting a heightened perception of threat, improving management of uncertainty and online health information and promoting an ability to critically appraise the results of online health searches. This should contribute to a better online health information literacy. The model of cyberchondria during the COVID-19 pandemic explains the hypothesized rise in cyberchondria during public health emergencies and helps to formulate a framework for prevention of cyberchondria and its effective management.
    Keywords:  COVID‐19; cyberchondria; information overload; intolerance of uncertainty; online health information; online health information literacy; online health searching; public health; reassurance seeking; uncertainty
    DOI:  https://doi.org/10.1002/hbe2.233
  10. Health Info Libr J. 2020 Dec 29.
      This article summarises Shane Godbolt's international Collaborations. It includes her associations with the European Association of Health Information & Libraries (EAHIL), International Congress on Medical Librarianship (ICML) and the Irish Health Sciences Libraries (HSLG).
    Keywords:  professional associations; professional development
    DOI:  https://doi.org/10.1111/hir.12337
  11. Health Info Libr J. 2020 Dec 29.
      
    Keywords:  Africa, east; Africa, north; Africa, south; Africa, west; collaboration; critical appraisal; health professionals; professional associations
    DOI:  https://doi.org/10.1111/hir.12341
  12. Front Psychol. 2020 ;11 572744
      Many urgent problems that societies currently face-from climate change to a global pandemic-require citizens to engage with scientific information as members of democratic societies as well as to solve problems in their personal lives. Most often, to solve their epistemic aims (aims directed at achieving knowledge and understanding) regarding such socio-scientific issues, individuals search for information online, where there exists a multitude of possibly relevant and highly interconnected sources of different perspectives, sometimes providing conflicting information. The paper provides a review of the literature aimed at identifying (a) constraints and affordances that scientific knowledge and the online information environment entail and (b) individuals' cognitive and motivational processes that have been found to hinder, or conversely, support practices of engagement (such as critical information evaluation or two-sided dialogue). Doing this, a conceptual framework for understanding and fostering what we call online engagement with scientific information is introduced, which is conceived as consisting of individual engagement (engaging on one's own in the search, selection, evaluation, and integration of information) and dialogic engagement (engaging in discourse with others to interpret, articulate and critically examine scientific information). In turn, this paper identifies individual and contextual conditions for individuals' goal-directed and effortful online engagement with scientific information.
    Keywords:  argumentation; digital literacy; epistemic cognition; multiple documents literacy; online engagement with scientific information; scientific literacy
    DOI:  https://doi.org/10.3389/fpsyg.2020.572744
  13. PLoS Comput Biol. 2020 Dec;16(12): e1008469
      The distribution of scholarly content today happens in the context of an immense deluge of information found on the internet. As a result, researchers face serious challenges when archiving and finding information that relates to their work. Library science principles provide a framework for navigating information ecosystems in order to help researchers improve findability of their professional output. Here, we describe the information ecosystem which consists of users, context, and content, all 3 of which must be addressed to make information findable and usable. We provide a set of tips that can help researchers evaluate who their users are, how to archive their research outputs to encourage findability, and how to leverage structural elements of software to make it easier to find information within and beyond their publications. As scholars evaluate their research communication strategies, they can use these steps to improve how their research is discovered and reused.
    DOI:  https://doi.org/10.1371/journal.pcbi.1008469
  14. J Biomed Inform. 2020 Dec 24. pii: S1532-0464(20)30297-5. [Epub ahead of print] 103669
      Over the last decades clinical research has been driven by informatics changes nourished by distinct research endeavors. Inherent to this evolution, several issues have been the focus of a variety of studies: multi-location patient data access, interoperability between terminological and classification systems and clinical practice and records harmonization. Having these problems in mind, the Data Safe Haven paradigm emerged to promote a newborn architecture, better reasoning and safe and easy access to distinct Clinical Data Repositories. This study aim is to present a novel solution for clinical search harmonization within a safe environment, making use of a hybrid coding taxonomy that enables researchers to collect information from multiple repositories based on a clinical domain query definition. Results show that is possible to query multiple repositories using a single query definition based on clinical domains and the capabilities of the Unified Medical Language System, although it leads to deterioration of the framework response times. Participants of a Focus Group and a System Usability Scale questionnaire rated the framework with a median value of 72.5, indicating the hybrid coding taxonomy could be enriched with additional metadata to further improve the refinement of the results and enable the possibility of using this system as data quality tagging mechanism.
    Keywords:  Clinical research; Clinical search harmonization; Data Safe Havens
    DOI:  https://doi.org/10.1016/j.jbi.2020.103669
  15. Prof Inferm. 2020 Jun-Sep;73(3):73(3): 171-180
       INTRODUCTION: Web and social networks play a crucial role in health information seeking and health literacy levels. In the last ten years people are able to access a wide range of health information from a plethora of sources. People who live in the city experience an increased stimulus level related to the density of people and the overload of information inputs.
    METHODS: We undertook a census analysis of groups on a social network to identify the importance of health information for the all population and with the aim to evaluate the intersection between digital health information seeking, social networks, and social capital.
    RESULTS: This study shows that there is a relevant growing number of groups health-related, especially connected to chronic disease and another aspect relevant to the daily health of the population. The study identifies two aspect in all groups: one aspect is connected to share information about treatment and medication and other aspect connected to the relationship in terms of sharing experiences and emotional support.
    CONCLUSION: Social networks have a relevant impact on health and allow millions of users fast, easy, and concise access to the most important and useful medical information. More research should be conducted to enhance the understanding of the correct pathway to follow to align and measures outcomes of understanding health information and health literacy, use of social networks and the key role of the environment, infrastructure, algorithms and construction in building social capital of individuals and society. It's necessary avoid to think that people live in many separate islands, instead in the same interconnected arena with health professionals that have to work for a better understanding of digital and social networks.
    DOI:  https://doi.org/10.7429/pi.2020.733171
  16. Facial Plast Surg. 2020 Dec;36(6): 773-777
      YouTube is a common source of medical information for patients. This is the first study to assess the reliability and educational value of YouTube videos on neurotoxin procedures. YouTube.com was searched on June 15, 2020 using the keyword "Botox" or "neurotoxin." A total of 100 videos were reviewed. Sixty-one videos met the inclusion criteria and were included in the final analysis. Video characteristics were noted, and a score was assigned to each video using the Journal of the American Medical Association (JAMA) benchmark criteria and the Global Quality Score (GQS) to measure source reliability and educational value, respectively. A total of 61 videos that met the inclusion criteria had an average length of 589 seconds (9 minutes and 49 seconds), 210,673 views, 5,295 likes, 318 dislikes, and 478 comments. A total of 30 videos (49%) were posted with an intention to educate patients while 31 videos (51%) were posted with the intention to detail a personal experience with neurotoxin. Patient education videos were significantly more reliable (P JAMA< 0.001) and had more educational value (P GQS < 0.001) but were less popular than "personal experience videos." Personal-experience videos posted by patients had higher popularity, more likes and comments, yet lower scores on reliability and education. Patients will continue to seek educational material online, and clinicians should utilize this information to help primarily educate patients with standardized and accurate information about their treatment. KEY POINTS: · Question: Are YouTube videos pertaining to neurotoxin reliable and contain useful information to educate patients to make informed decisions about their neurotoxin treatment?. · Findings: Roughly half of videos reviewed were vlogs (video logs), which were of low quality and educational value, but were more popular compared with videos that were intended to educate patients on neurotoxin treatment.. · Meaning: Patients who use YouTube as a source of information about neurotoxin treatment may be misled with inaccurate and unreliable information. Physicians must be aware of these findings to properly educate patients with standardized and accurate information about their treatment..
    DOI:  https://doi.org/10.1055/s-0040-1719100
  17. J Med Internet Res. 2020 Dec 30. 22(12): e18816
       BACKGROUND: Digitalization and the increasing availability of online information have changed the way in which information is searched for and retrieved by the public and by health professionals. The technical developments in the last two decades have transformed the methods of information retrieval. Although systematic evidence exists on the general information needs of specialists, and in particular, family physicians (FPs), there have been no recent systematic reviews to specifically address the needs of FPs and any barriers that may exist to accessing online health information.
    OBJECTIVE: This review aims to provide an up-to-date perspective on the needs of FPs in searching, retrieving, and using online information.
    METHODS: This systematic review of qualitative and quantitative studies searched a multitude of databases spanning the years 2000 to 2020 (search date January 2020). Studies that analyzed the online information needs of FPs, any barriers to the accessibility of information, and their information-seeking behaviors were included. Two researchers independently scrutinized titles and abstracts, analyzing full-text papers for their eligibility, the studies therein, and the data obtained from them.
    RESULTS: The initial search yielded 4541 studies for initial title and abstract screening. Of the 144 studies that were found to be eligible for full-text screening, 41 were finally included. A total of 20 themes were developed and summarized into 5 main categories: individual needs of FPs before the search; access needs, including factors that would facilitate or hinder information retrieval; quality needs of the information to hand; utilization needs of the information available; and implication needs for everyday practice.
    CONCLUSIONS: This review suggests that searching, accessing, and using online information, as well as any pre-existing needs, barriers, or demands, should not be perceived as separate entities but rather be regarded as a sequential process. Apart from accessing information and evaluating its quality, FPs expressed concerns regarding the applicability of this information to their everyday practice and its subsequent relevance to patient care. Future online information resources should cater to the needs of the primary care setting and seek to address the way in which such resources may be adapted to these specific requirements.
    Keywords:  barriers; family physicians; general practitioners; health information; health resources; information-seeking behaviors; internet; mobile phone; needs; online information; primary care
    DOI:  https://doi.org/10.2196/18816
  18. Int J Rheum Dis. 2020 Dec 23.
       AIM: The internet has gained popularity as a health information source for patients. YouTube is one of the biggest platforms used worldwide. Several studies showed that quality of the information on YouTube videos for patient information is poor. This study aimed to evaluate the content and quality of YouTube videos, as a source of patient information for fibromyalgia (FM).
    METHODS: In this cross-sectional study, a YouTube search with the keyword "fibromyalgia" was performed, and the first 200 videos were listed according to relevancy. Advertisements, duplicate videos, videos in languages other than English, and videos without audio were excluded. Video features (number of "likes", "dislikes", views, length of video), and source of upload were recorded. DISCERN and Journal of the American Medical Association (JAMA) benchmark criteria were used for quality analysis. Video quality was assessed according to the source of upload and video features. The correlation analysis was performed between video features, JAMA, and DISCERN scores.
    RESULTS: A total number of 102 videos were analyzed. The most common source of upload was physicians and majority of the content (55.8%) was about symptoms and treatment. Mean DISCERN and JAMA scores were 35.7 and 2.2, respectively. These scores were highest in videos uploaded by physicians (52.7 and 2.6, respectively). There is a positive correlation between the duration of the video, DISCERN, and JAMA scores.
    CONCLUSION: The majority of YouTube content has poor quality. Health professionals should be aware of the importance of health-related information on YouTube and provide high-quality accurate and up-to-date content.
    Keywords:  DISCERN; YouTube; fibromyalgia; internet; quality
    DOI:  https://doi.org/10.1111/1756-185X.14043
  19. Data Brief. 2021 Feb;34 106624
      Supplementary data for the article Osteotomy around the Knee: Assessment of Quality, Content and Readability of Online Information is provided. 45 unique websites were evaluated. The DISCERN score, JAMA (Journal of the American Medical Association) benchmark criteria and HONcode (Health On the Net) criteria are provided for reference. Readability of online information was analysed with Readability Studio Professional Edition, Version 2019 (Oleander Software Ltd.). The software assessed readability using eight different instruments: Flesch-Kincaid Reading Grade Level (FKGL), Flesch Reading Ease Score (FRES), Raygor Estimate, SMOG, Coleman- Liau, Fry, FORCAST and Gunning Fog. Data is also provided on the percentage of complex words, long words, Dale-Chall unfamiliar words, Fog words, as well as the number of 'wordy' items, overly long sentences and longest sentence length.
    Keywords:  Internet; Knee osteotomy; Patient education; Quality of information; Readability
    DOI:  https://doi.org/10.1016/j.dib.2020.106624
  20. Angle Orthod. 2020 May 01. 90(3): 419-424
       OBJECTIVES: To evaluate the content, reliability, and quality of videos about orthodontic clear aligners on YouTube.
    MATERIALS AND METHODS: Researchers used the Google Trends website to determine that the most frequently used search term for orthodontic clear aligners on the Internet was: "Invisalign." A search was then conducted on YouTube using the key word "Invisalign." From the first 140 results, 100 videos were selected for analysis. A 13-point content score was used to classify poor-content and rich-content videos, and the global quality scale (GQS) was used to examine quality of the videos. To evaluate reliability of the information, a five-question scale was used. The Mann-Whitney U-test, χ2 test, and Pearson correlation coefficients were used for statistical evaluations.
    RESULTS: Of the YouTube videos, 33 were classified as rich content and 67 as poor content. Most videos (73%) were uploaded by laypeople, and most uploaders (71%) were women. The most commonly discussed content was instructions (65%), followed by procedure (57%) and pain (52%). Regarding the GQS, most of the videos were evaluated as moderate quality (51%). Compared with the poor-content video group, the rich-content video group had a significantly higher GQS score (P = .004). There was no significant difference between the poor-content and rich-content groups regarding information reliability (P > .05).
    CONCLUSIONS: Video content on YouTube relating to aligner orthodontics was generally insufficient. The quality of videos was moderate, but the reliability of information was generally poor. Specialists should refer patients to reliable sources of information.
    Keywords:  Clear aligners; Invisalign; Social media; YouTube
    DOI:  https://doi.org/10.2319/072419-491.1
  21. Knee. 2020 Dec 22. pii: S0968-0160(20)30375-6. [Epub ahead of print]28 139-150
       BACKGROUND: As knee osteotomy surgery becomes increasingly accessible, more patients may turn to the Internet for information. This study examined the source, quality, content and readability of online information regarding osteotomy around the knee.
    METHODS: The first 70 websites returned by the top four search engines were identified using the key words: "knee osteotomy" and "high tibial osteotomy." The websites were categorised by type and assessed using the DISCERN score, Journal of the American Medical Association (JAMA) benchmark criteria and a novel Knee Osteotomy-Specific Score (KOSS). The presence of the Health On the Net (HON) code accreditation seal was noted. Readability of each website was assessed using eight readability formulae. The mean reading grade level (RGL) was compared to the 6th and 8th grade reading levels. The mean RGL of each category was also compared.
    RESULTS: Of the 45 unique websites analysed, the majority were Physician (33%) and Journal websites (31%). The mean DISCERN score was 36.7 (±8.9) which is classified as 'poor.' The mean JAMA benchmark criteria score was 2.04 (±1.5) and Physician websites were most likely to be scored zero. The mean KOSS was 15.4 (±5.7). The highest scoring website was a Commercial site but, overall, Journal category sites provided the best quality information. Websites that bore the HONcode seal obtained higher DISCERN, JAMA benchmark criteria and Knee Osteotomy - Specific Scores. The cumulative mean RGL was 13.2 (±2.2) which exceeded the 6th grade level by an average of 7.2 grade levels and the 8th grade level by an average of 5.2 grade levels. No website (0%) was written at or below either the 6th or the 8th grade reading levels. The mean Flesch Reading Ease Score of all websites was 41.13 (±14.7) which is classified as 'difficult.' Journal websites had the highest RGL.
    CONCLUSION: The information available online regarding osteotomy around the knee varies tremendously in quality and completeness. Physician sites predominate, but these were among the lowest scoring of all websites. Even where high quality information is available, it is set at too high a level to be easily understood.
    LEVEL OF EVIDENCE: Survey of materials - Internet.
    Keywords:  Internet; Knee osteotomy; Patient education; Quality of information; Readability
    DOI:  https://doi.org/10.1016/j.knee.2020.11.010
  22. J Clin Nurs. 2020 Dec 29.
       AIMS AND OBJECTIVES: The aim of this study was to identify the needs and expectations of persons with dementia regarding dementia-related information on the internet concerning content, presentation, navigation, language and design.
    BACKGROUND: Research on internet-related needs of persons with dementia is lacking. However, the importance of the internet as a source of health information is increasing. To improve health literacy and to ensure participation in therapy decisions, target group-specific health information is necessary, especially for persons with chronic conditions like dementia.
    DESIGN: We conducted a qualitative interview study between April 2019 and April 2020 in the German speaking part of Switzerland. To report the study, we used the COREQ checklist.
    METHODS: We analysed the interview data using content analysis according to Mayring.
    RESULTS: Four interviews with five persons with dementia took place We identified two main themes: (1) "use of media and changing needs" and (2) "information about dementia on the internet". The first theme is related to changing user habits due to progressing dementia. The second theme is focussed on requirements concerning design and content. Critical reception and assessment of internet-based information are also addressed.
    CONCLUSIONS: Information should be adapted to the course of disease. Opportunities and positive aspects should also be mentioned. The presentation should be well-structured. Health professionals might support persons with dementia in searching and interpreting internet-based information.
    RELEVANCE TO CLINICAL PRACTICE: Website operators should consider specific needs of persons with dementia regarding design and content. Involving persons with dementia in the development of website content and design could be an opportunity for better meeting their needs.
    Keywords:  Alzheimer’s Disease; Dementia; Education; Internet
    DOI:  https://doi.org/10.1111/jocn.15629
  23. J Multidiscip Healthc. 2020 ;13 1957-1964
       Background: During the pandemic, information is inevitable and important, and having knowledge on pertinent information is very crucial for health-care professionals in order to deliver sustainable and quality health services to their clients, and to combat the virus. Therefore, the aim of this study was to assess the health-care providers' information seeking behavior on COVID-19 pandemic.
    Methods: A descriptive cross-sectional study had conducted among 291 respondents. The participant's characteristics were presented using frequency and percentage. The association between the independent and dependent variables was explained using chi-squared test.
    Results: Out of the 291 respondents, 207 (71.1%) of them had sought information on COVID-19 pandemic. The association between the gender and educational status with the outcome variable was found insignificant. Age (χ2=10.6, P=0.011), respondent's working unit (χ2=33.7, P<0.001), profession (χ2=12.7, P=0.013), taking computer training (χ2=17.44, P=0.000), computer access at work place (χ2=7.28, P=0.007), internet access at work place (χ2=22.2, P<0.001), and frequency of internet use (χ2=17.63, P<0.001) were found significant with COVID-19 information seeking.
    Conclusion: Information seeking behavior was positively associated with computer access, computer training, internet access and frequency of use. Therefore, comprehensive package is required to build the capacity of care providers on computer-related skills. Besides, institutions need to have internet and computer access.
    Keywords:  COVID-19; Ethiopia; information seeking; pandemic
    DOI:  https://doi.org/10.2147/JMDH.S283563
  24. Patient Educ Couns. 2020 Nov 21. pii: S0738-3991(20)30640-6. [Epub ahead of print]
       OBJECTIVES: This systematic review assessed the influence of online health information (OHI) search behaviour on health and medical decisions.
    METHODS: Eligible studies were identified by searching electronic databases PubMed, Scopus, and CINAHL in February 2020 for studies reporting OHI search behaviour and its influence on health decisions. Information was extracted pertaining to either consumers' (self-reported) perceptions of the influence of OHI on decision-making or the association between online search behaviour and health decision-making.
    RESULTS: A total of 3995 articles were screened, with 48 included in the final analysis. The reviewed studies indicated that OHI assisted in making subsequent health related decisions such as asking questions during a consultation, increased professional visits, improved adherence to the advice of a physician, being more compliant with taking medication, and improved self-care.
    CONCLUSION: Consumers largely used OHI to support information provided by their physicians. The strength of the patient-provider relationship was considered important in moderating the potential negative outcomes of OHI.
    PRACTICE IMPLICATIONS: Health care systems have a unique opportunity to direct OHI search behaviours towards empowering consumers to engage as an informed, active and joint decision-maker in their own health care.
    Keywords:  Consumers; Decisions; Health care; Online health information; Systematic review
    DOI:  https://doi.org/10.1016/j.pec.2020.11.016