bims-librar Biomed News
on Biomedical librarianship
Issue of 2021–10–24
sixteen papers selected by
Thomas Krichel, Open Library Society
  1. People mistake the internet's knowledge for their own.
  2. When in doubt, Google it: distress-related information seeking in Italy during the COVID-19 pandemic.
  3. Disabilities and the Digital Divide: Assessing Web Accessibility, Readability, and Mobility of Popular Health Websites.
  4. Identifying and classifying goals for scientific knowledge.
  5. Resource use during systematic review production varies widely: a scoping review: authors' reply.
  6. Quality and readability of online information on idiopathic subglottic stenosis.
  7. High tibial osteotomy: A review of the readability and quality of patient information on the internet.
  8. Evaluating the quality and readability of online information on keratoconus treatment.
  9. An Update on the Accessibility and Quality of Online Information for Pediatric Orthopaedic Surgery Fellowships.
  10. Quality and Reliability of Halitosis Videos on YouTube as a Source of Information.
  11. Evaluation of quality and educational effect of microsurgery videos on YouTube: a randomized controlled trial.
  12. Readability Assessment of HPV Vaccination and Cervical Cancer Information: A Systematic Scoping Review.
  13. The Content and Quality of Publicly Available Information About Congenital Diaphragmatic Hernia: Descriptive Study.
  14. Fertility health information seeking among sexual minority women.
  15. Examining the Trends in Online Health Information-Seeking Behavior About Chronic Obstructive Pulmonary Disease in Singapore: Analysis of Data From Google Trends and the Global Burden of Disease Study.
  16. Readability of patient education materials related to radiation safety: What are the implications for patient-centred radiology care?
  1. Proc Natl Acad Sci U S A. 2021 Oct 26. pii: e2105061118. [Epub ahead of print]118(43):
    People mistake the internet's knowledge for their own.
    Adrian F Ward.
      People frequently search the internet for information. Eight experiments (n = 1,917) provide evidence that when people "Google" for online information, they fail to accurately distinguish between knowledge stored internally-in their own memories-and knowledge stored externally-on the internet. Relative to those using only their own knowledge, people who use Google to answer general knowledge questions are not only more confident in their ability to access external information; they are also more confident in their own ability to think and remember. Moreover, those who use Google predict that they will know more in the future without the help of the internet, an erroneous belief that both indicates misattribution of prior knowledge and highlights a practically important consequence of this misattribution: overconfidence when the internet is no longer available. Although humans have long relied on external knowledge, the misattribution of online knowledge to the self may be facilitated by the swift and seamless interface between internal thought and external information that characterizes online search. Online search is often faster than internal memory search, preventing people from fully recognizing the limitations of their own knowledge. The internet delivers information seamlessly, dovetailing with internal cognitive processes and offering minimal physical cues that might draw attention to its contributions. As a result, people may lose sight of where their own knowledge ends and where the internet's knowledge begins. Thinking with Google may cause people to mistake the internet's knowledge for their own.
    Keywords:  attribution; cognition; knowledge; memory
    DOI:  https://doi.org/10.1073/pnas.2105061118
  2. BMC Public Health. 2021 Oct 20. 21(1): 1902
    When in doubt, Google it: distress-related information seeking in Italy during the COVID-19 pandemic.
    Dario Monzani, Laura Vergani, Giulia Marton, Silvia F M Pizzoli, Gabriella Pravettoni.
       BACKGROUND: Psychological health has been one of the aspects affected by the recent COVID-19 pandemic. We aim to evaluate the patterns of Google search for mental distress symptoms of Italian citizens during the various phases of the COVID-19 pandemic.
    METHODS: We assessed Google searches for psychological-health related words. We gathered and analyzed data on daily search queries on depression, anxiety, and insomnia from Google Trends, in a time ranging from the Pre-COVID phase (beginning 25th January 2020) up to the second wave phase (ending 17th October 2020). We performed three general linear models on search trends of the three words and tested whether and to what extent official data about new cases of COVID-19, information searching on new cases, and the government health measures impacted on these trends.
    RESULTS: Average daily search queries were higher for anxiety, followed by depression and insomnia. General linear models performed to assess differences in daily search queries for anxiety, depression and insomnia were significant, respectively [F(13, 253) = 6.80, P < .001]; [F(13, 253) = 10.25, P < .001]; [F(13, 253) = 6.61, P < .001]. Specifically, daily search queries differed among different phases of managing the COVID-19 outbreak: anxiety [F(5, 253) = 10.35, P < .001, [Formula: see text] = .17]; depression [F(5, 253) = 13.59, P < .001, [Formula: see text] = .21]; insomnia [F(5, 253) = 3.52, P = .004, [Formula: see text] = .07].
    CONCLUSIONS: Our study contributed to the investigation of online information-seeking behaviors of Italians regarding mental health throughout the entire phase of the pandemic and provides insights on the possible future trends of mental distress during upcoming pandemic phases.
    Keywords:  Anxiety; COVID-19; Depression; Google; Infodemiology; Insomnia; Psychological distress
    DOI:  https://doi.org/10.1186/s12889-021-11887-2
  3. J Health Commun. 2021 Oct 18. 1-8
    Disabilities and the Digital Divide: Assessing Web Accessibility, Readability, and Mobility of Popular Health Websites.
    Alicia M Mason, Josh Compton, Sakshi Bhati.
      With recognition of (1) unmet health information needs of persons with disabilities; and (2) anticipated growth of the persons with disabilities population, we seek to better understand the relative general accessibility of health information on popular, highly ranked health websites. That is, instead of examining the efficacy and impact of specific types of health message appeals, the present investigation assesses the functional performance of specific content platforms of health websites. We examine the components of accessing and understanding health information through the lens of web and language accessibility, readability, and mobility. A total of 139 health-focused websites were randomly sampled from the Alexa® "Top Sites" global ranking system which uses web traffic data to rank the most popular websites. The sample was processed using computer aided software (e.g., WEB AIM, Web FX & Google Test My Site.) We found 91.3% of sampled home pages had detectable accessibility failures. The most common accessibility failures were low contrast, empty links, missing ALT text, empty buttons, and missing form labels. Most websites offered neither an accessibility policy statement nor an option for automated language translation service, likely impacting those with limited English proficiency (LEP). The implications for these findings are reviewed with discussion and limitations provided.
    DOI:  https://doi.org/10.1080/10810730.2021.1987591
  4. Bioinform Adv. 2021 ;1(1): vbab012
    Identifying and classifying goals for scientific knowledge.
    Mayla R Boguslav, Nourah M Salem, Elizabeth K White, Sonia M Leach, Lawrence E Hunter.
       Motivation: Science progresses by posing good questions, yet work in biomedical text mining has not focused on them much. We propose a novel idea for biomedical natural language processing: identifying and characterizing the questions stated in the biomedical literature. Formally, the task is to identify and characterize statements of ignorance, statements where scientific knowledge is missing or incomplete. The creation of such technology could have many significant impacts, from the training of PhD students to ranking publications and prioritizing funding based on particular questions of interest. The work presented here is intended as the first step towards these goals.
    Results: We present a novel ignorance taxonomy driven by the role statements of ignorance play in research, identifying specific goals for future scientific knowledge. Using this taxonomy and reliable annotation guidelines (inter-annotator agreement above 80%), we created a gold standard ignorance corpus of 60 full-text documents from the prenatal nutrition literature with over 10 000 annotations and used it to train classifiers that achieved over 0.80 F1 scores.
    Availability and implementation: Corpus and source code freely available for download at https://github.com/UCDenver-ccp/Ignorance-Question-Work. The source code is implemented in Python.
    DOI:  https://doi.org/10.1093/bioadv/vbab012
  5. J Clin Epidemiol. 2021 Oct 16. pii: S0895-4356(21)00328-0. [Epub ahead of print]
    Resource use during systematic review production varies widely: a scoping review: authors' reply.
    Nussbaumer-Streit B, Ziganshina LE, Mahmić-Kaknjo M, Gartlehner G, Sfetcu R, Lund H.
      
    Keywords:  Collaboration; Evidence syntheses; LMIC; Low- and middle income countries; Open science
    DOI:  https://doi.org/10.1016/j.jclinepi.2021.10.007
  6. Laryngoscope Investig Otolaryngol. 2021 Oct;6(5): 1068-1076
    Quality and readability of online information on idiopathic subglottic stenosis.
    Austin Heffernan, Amanda Hu.
       Objective: Idiopathic subglottic stenosis (ISS) is a chronic condition characterized by disease recurrence and multiple surgeries. These frustrated patients may utilize the internet to research their condition. The aim of this study was to determine the quality and readability of online ISS information.
    Methods: "Idiopathic subglottic stenosis" was entered into Google. The first 50 websites that met inclusion criteria were extracted. The DISCERN instrument, Flesch Reading Ease Score (FRES), and Flesch-Kincaid Grade Level (FKGL) assessed the quality and readability, respectively. Means, SDs, Pearson correlation coefficients, and two-tailed Student's t-test were calculated.
    Results: The 50 websites consisted of 17 patient-targeted and 33 professional-targeted websites, plus 30 major and 20 minor websites. The overall DISCERN, FRES, and FKGL scores were 2.81 ± 0.99, 27.75 ± 15.27, and 13.65 ± 2.79, respectively (mean ± SD). Patient-targeted websites had significantly lower quality (DISCERN [P < .00]) but were easier to read (lower FKGL [P < .00], higher FRES [P < .00]) than professional-targeted websites. Minor websites had a significantly lower quality (DISCERN [P < 0.00]) but were easier to read (lower FKGL [P < .00], higher FRES [P < .00]) than major websites. There was a positive correlation between overall quality and difficulty in readability.
    Conclusion: The quality of online ISS information was suboptimal. Resources were too difficult to comprehend and readability scores were above AMA and NIH recommendations. Improved online information is required to properly educate this patient population.
    Level of Evidence: Level 4.
    Keywords:  consumer health information; idiopathic subglottic stenosis; otolaryngology; quality; readability
    DOI:  https://doi.org/10.1002/lio2.629
  7. Health Promot Perspect. 2021 ;11(3): 323-328
    High tibial osteotomy: A review of the readability and quality of patient information on the internet.
    Matthew Clark, Ian Colin Baxter, Matthew Hampton, Robert D Sandler, Andrew Legg.
      Background: High tibial osteotomy (HTO) is a common procedure performed for unicompartmental knee osteoarthritis (OA). Patients are increasingly using the internet to research surgical procedures to help aid decision making. Our aim was to assess the readability and quality of information available to patients online relating to HTO. Methods: A systematic review of three search engines Google®, Bing®, and Yahoo® using the search terms "high tibial osteotomy" and "tibial osteotomy" separately was performed. The first three pages of results for each search engine were analyzed. Readability was assessed using the Flesch Reading Ease Scale (FRES), Flesch-Kincaid Grade level (FKGL) and the Simple Measure of Gobbledygook formula (SMOG). Quality was assessed with the DISCERN questionnaire, JAMAbenchmarks and the presence of Health on the Net Foundation Code of Conduct (HONCode). Results: Twenty-four webpages were included after duplicates (n=42) and exclusions (n=24).The overall readability was low, with a mean FRES of 53.2 (SD: 9.1), FKGL 10.7 (SD: 1.8),SMOG 10.4 (SD: 1.5). Quality was also low with a mean DISCERN score of 42 (SD: 12.3).None of the webpages fulfilled all of the JAMA benchmarking criteria and only 2/24 (8.3%)webpages possessed HONCode certification. Conclusion: The overall online information available to patient's considering HTO is of lowreadability and quality. Improving the quality and readability of patient information online willbenefit informed patient decision making before HTO surgery.
    Keywords:  Comprehension; Health literacy; Internet Based intervention; Osteoarthritis; Osteotomy
    DOI:  https://doi.org/10.34172/hpp.2021.41
  8. Can J Ophthalmol. 2021 Oct 19. pii: S0008-4182(21)00351-3. [Epub ahead of print]
    Evaluating the quality and readability of online information on keratoconus treatment.
    Jesse Panthagani, Hisham Hamze, Afrah Riaz, George Moussa.
       OBJECTIVE: This study aims to evaluate the quality and readability of online resources on keratoconus treatment.
    METHODS: A Google.com search was conducted on August 9, 2020; 32 web sites were selected for analysis. Popularity was assessed by Google and Alexa rank. The quality of web sites was analyzed using the quality criteria for consumer health information (DISCERN) tool, the Journal of the American Medical Association (JAMA) benchmark, and the Health On the Net Code of Conduct Certification (HONcode). The readability of the web sites was assessed using the Fleschwebr hea Reading Ease, the Automated Readability Index, and the Fleschted Readability RESULTS: The JAMA benchmark scores, unlike the DISCERN scores, were correlated with the Google and Alexa rank. One web site (3.1%) met all the JAMA benchmark criteria, and 3 (9.3%) others had HONcode certification. The median DISCERN score was 33 (range, 29.6-43.1; maximum possible, 80). Rnib.org.uk scored the highest at 57 (71.0%). The mean Flesch-Kincaid Reading Ease score (52.9 ± 7.1) corresponded to uk" n DIdifficult to read." Thirty-one web sites (96.8%) had a Flesch-Kincaid Grade higher than the American Medical Association recommendation of sixth grade level. The median Automated Readability Index score was 7 (range, 6.2-7.3).
    CONCLUSION: The majority of online information currently available on keratoconus treatment is complex and highly variable. Rnib.org.uk is the best currently available source. Clinicians should inform patients on how to assess the credibility of online information and recommend suitable information sources.
    DOI:  https://doi.org/10.1016/j.jcjo.2021.09.006
  9. Cureus. 2021 Sep;13(9): e17802
    An Update on the Accessibility and Quality of Online Information for Pediatric Orthopaedic Surgery Fellowships.
    Samuel A Cohen, Kevin Shea, Meghan Imrie.
      Introduction The internet is an important tool for applicants seeking information on pediatric orthopaedic surgery fellowship programs. Previous analysis of pediatric orthopaedic surgery fellowship websites demonstrated they were often inaccessible and incomplete. As such, the purpose of this study was to (1) perform an updated assessment of the accessibility and content of pediatric orthopaedic fellowship program websites and (2) compare the results to the previous study to discern temporal trends in website accessibility and quality.  Methods A list of pediatric orthopaedic fellowship programs was compiled from the San Francisco Match (SF Match) and the Pediatric Orthopaedic Society of North America (POSNA) online databases. All identified websites were evaluated for (1) accessibility and (2) the presence of 12 education and 12 recruitment criteria. These criteria were determined by prior fellowship website analyses and the needs of current fellowship applicants. Website accessibility and quality were compared with previously reported metrics. Results Approximately 91% of pediatric orthopaedic surgery fellowship programs had a functioning website. While the SF Match and POSNA databases listed nearly identical programs, there were discrepancies in the information provided by the two databases, and individual program website links provided on both databases were often nonfunctional. Fellowship program websites contained an average of 15.1 ± 3.9 total education and recruitment criteria (range: 3 - 21). The most common education criteria featured on program websites included information about research, affiliated hospital information, and rotations. The most common recruitment criteria featured on program websites included program descriptions, contact information, and social media links. There was an increased frequency in nearly all education and recruitment criteria evaluated when compared with 2014 metrics.  Discussion Although website accessibility and content have improved since 2014, information on pediatric orthopaedic fellowship program websites remains incomplete, with many websites failing to provide information on criteria deemed important by fellowship applicants. In addition, many discrepancies exist between the SF Match and POSNA databases, the two primary sources of information for pediatric orthopaedic fellowship applicants. Increased consistency on pediatric orthopaedic fellowship websites and both the SF Match and POSNA databases may help applicants to better assess which programs to apply to and which programs to rank highly on their match list.
    Keywords:  accessibility; fellowship; online; orthopaedics; pediatric orthopaedics; quality; website
    DOI:  https://doi.org/10.7759/cureus.17802
  10. Dent J (Basel). 2021 Oct 15. pii: 120. [Epub ahead of print]9(10):
    Quality and Reliability of Halitosis Videos on YouTube as a Source of Information.
    Atik Ramadhani, Zenobia Zettira, Yuanita Lely Rachmawati, Ninuk Hariyani, Diah Ayu Maharani.
      Halitosis is a common condition that adversely affects quality of life. Through YouTube, people access oral health information. This study aimed to analyze the quality and comprehensiveness of the content, and reliability of halitosis videos hosted on YouTube. In total, 300 videos were collected based on three search keywords, and the number of likes, dislikes, views, duration, interaction index, viewing rate, and source category. Subsequently, the video score, which represents the content quality and comprehensiveness was used to categorize videos as poor, good, and excellent. DISCERN score was used to assess video reliability. Of the 105 videos analyzed, 68 (64.8%) were uploaded by personal users. In general, videos were categorized as poor and have low reliability. Videos sourced from healthcare professionals showed the highest quality, comprehensiveness of the content, and reliability (p < 0.05). There was no difference in the number of viewers for video duration less than or more than 4 min (p > 0.05). YouTube users prefer low-quality videos over high-quality ones, indicating that viewers cannot differentiate between reliable and potentially biased content. It is critical to enable viewers to critically assimilate information hosted on YouTube to make effective oral healthcare decisions.
    Keywords:  YouTube; halitosis; videos
    DOI:  https://doi.org/10.3390/dj9100120
  11. J Plast Surg Hand Surg. 2021 Oct 17. 1-7
    Evaluation of quality and educational effect of microsurgery videos on YouTube: a randomized controlled trial.
    Jong Yun Choi, Jeeyoon Kim, Jongweon Shin.
      Widespread use of smartphones and wireless internet have made YouTube an easily accessible educational modality. Many residents use YouTube to acquire knowledge regarding microsurgical techniques; however, its quality and effect has not been verified. We included 22 residents working in the Department of Plastic and Reconstructive Surgery at our institute. Using block randomization, seven were allocated to a textbook group (TG), eight to a free-searching group (FSG), and seven to a designated-video group (DVG). After reviewing textbooks, YouTube videos, or designated videos, respectively, each group performed microsurgical anastomosis using artificial vessels. The total procedure time, Objective Structured Assessment of Technical Skills (OSATS), operative errors, and degree of leakage were assessed by blinded evaluators. Self-confidence rates were also compared. The YouTube groups (FSG and DVG) performed better than the TG. Although procedure time was significantly longer in the DVG (p = .006), the performance of DVG was better than that of TG in all assessments (OSATS: p = .012; operative errors: p = .002; leakage: p = .010). FSG showed more operative errors (p = .004) and leakage (p = .007) compared to DVG, but had higher OSATS (p = .008) and fewer operative errors (p = .002) than TG. The post-intervention confidence rates were significantly higher in FSG and DVG compared to TG (p = .002 and p = .001, respectively). Although there are concerns regarding the reliability of YouTube videos, microsurgery videos on YouTube had positive effects on microsurgery practice. Therefore, YouTube may help to improve the microsurgical skills of residents. If a quality control system is introduced for YouTube videos, their educational effects may be enhanced.
    Keywords:  YouTube; anastomosis; education; microsurgery
    DOI:  https://doi.org/10.1080/2000656X.2021.1990936
  12. Healthcare (Basel). 2021 Sep 22. pii: 1246. [Epub ahead of print]9(10):
    Readability Assessment of HPV Vaccination and Cervical Cancer Information: A Systematic Scoping Review.
    Tsuyoshi Okuhara, Hiroko Okada, Eiko Goto, Takahiro Kiuchi.
      It is important to provide information on HPV vaccination and on early detection and early treatment for cervical cancer. Readability is a key aspect in the success of cancer communication using written health information. We reviewed studies assessing the readability of information on HPV vaccination and cervical cancer. We conducted a systematic literature search in June 2021 using four online databases (Medline, CINAHL, PsycArticles, and PsycINFO). Studies that assessed the readability level of online and offline information regarding HPV vaccination and cervical cancer were included in the review. Twelve articles were deemed fit for study inclusion. Our results showed that most of the materials assessed were difficult to read and higher than eighth-grade reading level. Few of the materials assessed were at the recommended grade 5-6 level or below. Readability assessments of HPV vaccination and cervical cancer information are scarce. Additional studies on the readability of information regarding HPV vaccination and cervical cancer are recommended. Health professionals should develop health information on HPV vaccination and cervical cancer that is easy to read.
    Keywords:  HPV vaccination; cervical cancer; health communication; health literacy; patient education; readability; written health information
    DOI:  https://doi.org/10.3390/healthcare9101246
  13. JMIR Pediatr Parent. 2021 Oct 19. 4(4): e30695
    The Content and Quality of Publicly Available Information About Congenital Diaphragmatic Hernia: Descriptive Study.
    Frank Coyle Soltys, Kimi Spilo, Mary C Politi.
       BACKGROUND: Congenital diaphragmatic hernia (CDH) diagnosis in an infant is distressing for parents. Parents often feel unable to absorb the complexities of CDH during prenatal consultations and use the internet to supplement their knowledge and decision making.
    OBJECTIVE: We aimed to examine the content and quality of publicly available, internet-based CDH information.
    METHODS: We conducted internet searches across 2 popular search engines (Google and Bing). Websites were included if they contained CDH information and were publicly available. We developed a coding instrument to evaluate websites. Two coders (FS and KS) were trained, achieved interrater reliability, and rated remaining websites independently. Descriptive statistics were performed.
    RESULTS: Searches yielded 520 websites; 91 met inclusion criteria and were analyzed. Most websites provided basic CDH information including describing the defect (86/91, 95%), need for neonatal intensive care (77/91, 85%), and surgical correction (79/91, 87%). Few mentioned palliative care, decisions about pregnancy termination (13/91, 14%), or support resources (21/91, 23%).
    CONCLUSIONS: Findings highlight the variability of information about CDH on the internet. Clinicians should work to develop or identify reliable, comprehensive information about CDH to support parents.
    Keywords:  congenital diaphragmatic hernia; fetal care; online information; parental decision making; prenatal counseling
    DOI:  https://doi.org/10.2196/30695
  14. Fertil Steril. 2021 Oct 18. pii: S0015-0282(21)02069-0. [Epub ahead of print]
    Fertility health information seeking among sexual minority women.
    Patrina Sexton Topper, José A Bauermeister, Jesse Golinkoff.
       OBJECTIVE: To qualitatively explore and describe fertility information-seeking experiences of sexual minority women (SMW) couples using assisted reproduction.
    DESIGN: Qualitative thematic analysis of 30 semistructured, in-depth individual and dyadic interviews with SMW couples.
    SETTING: Video conferencing.
    PATIENT(S): Twenty self-identified lesbian, bisexual, and queer women comprising 10 same-sex cisfemale couples (10 gestational and 10 nongestational partners) using assisted reproduction technology in the United States.
    INTERVENTION(S): Not applicable.
    MAIN OUTCOME MEASURE(S): We describe how SMW came to learn about ways to achieve pregnancy through information seeking, acquisition, appraisal, and use.
    RESULT(S): Analysis revealed three primary themes. First, uncertainty and information scarcity: SMW have basic knowledge about how to conceive but uncertainty persists due to information scarcity regarding how same-sex couples navigate assisted reproduction. Second, women attempt to collect fragmented information from disparate sources. The participants discussed a mixture of formal and informal, online, textual (books), and in-person seeking, finding, and synthesizing information that ranged from reliable to unreliable and from accurate to inaccurate. Finally, persistent heteronormative communication focused on the needs and conditions of male-female couples who experienced subfertility or infertility, rather than barriers related to social constraints and the absence of gametes that SMW sought to overcome.
    CONCLUSION(S): These findings support and extend existing evidence that has focused primarily on online fertility information seeking. Our findings suggest that shifts in fundamental assumptions about who seeks assisted reproductive support and why, together with improvements in fertility-related health communication, may result in more inclusive care for this population.
    Keywords:  Health information seeking; qualitative research; sexual minority women
    DOI:  https://doi.org/10.1016/j.fertnstert.2021.09.023
  15. J Med Internet Res. 2021 Oct 18. 23(10): e19307
    Examining the Trends in Online Health Information-Seeking Behavior About Chronic Obstructive Pulmonary Disease in Singapore: Analysis of Data From Google Trends and the Global Burden of Disease Study.
    Yang Fang, Thomas A Shepherd, Helen E Smith.
       BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally, and timely health care seeking is imperative for its prevention, early detection, and management. While online health information-seeking behavior (OHISB) is increasingly popular due to widespread internet connectivity, little is known about how OHISB for COPD has changed in comparison with the COPD disease burden, particularly at a country-specific level.
    OBJECTIVE: This study aimed to examine the trends in OHISB for COPD and how that compared with the estimates of COPD disease burden in Singapore, a highly wired country with a steadily increasing COPD disease burden.
    METHODS: To examine the trends in OHISB for COPD, we performed Prais-Winsten regression analyses on monthly search volume data for COPD from January 2004 to June 2020 downloaded from Google Trends. We then conducted cross-correlational analyses to examine the relationship between annualized search volume on COPD topics and estimates of COPD morbidity and mortality reported in the Global Burden of Disease study from 2004 to 2017.
    RESULTS: From 2004 to 2020, the trend in COPD search volume was curvilinear (β=1.69, t194=6.64, P<.001), with a slope change around the end of 2006. There was a negative linear trend (β=-0.53, t33=-3.57, P=.001) from 2004 to 2006 and a positive linear trend (β=0.51, t159=7.43, P<.001) from 2007 to 2020. Cross-correlation analyses revealed positive associations between COPD search volume and COPD disease burden indicators: positive correlations between search volume and prevalence, incidence, years living with disability (YLD) at lag 0, and positive correlations between search volume and prevalence, YLD at lag 1.
    CONCLUSIONS: Google search volume on COPD increased from 2007 to 2020; this trend correlated with the upward trajectory of several COPD morbidity estimates, suggesting increasing engagement in OHISB for COPD in Singapore. These findings underscore the importance of making high-quality, web-based information accessible to the public, particularly COPD patients and their carers.
    Keywords:  Global Burden of Disease study; Google Trends; chronic obstructive pulmonary disease; infodemiology; online health information seeking; respiratory health
    DOI:  https://doi.org/10.2196/19307
  16. Insights Imaging. 2021 Oct 21. 12(1): 148
    Readability of patient education materials related to radiation safety: What are the implications for patient-centred radiology care?
    Francis T Delaney, Tiarnán Ó Doinn, James M Broderick, Emma Stanley.
       BACKGROUND: Increasing numbers of patients and carers rely on online resources for healthcare information. Radiation safety can be misunderstood by patients and clinicians and lead to patient anxiety. We aimed to assess the readability of online patient educational materials (PEMs) related to radiation safety.
    METHODS: A total of 84 articles pertaining to radiation safety from 14 well-known online resources were identified. PEMs were then analysed using Readability Studio Professional Edition Version 2019. Readability was assessed using eight different instruments: the Flesch-Kincaid Reading Grade Level, Raygor Estimate, SMOG, Coleman-Liau, Fry, FORCAST, Gunning Fog, and Flesch Reading Ease Score formula. The mean reading grade level (RGL) of each article was compared to the 6th and 8th grade reading level using 1-sample t-tests.
    RESULTS: The cumulative mean RGL for all 84 articles was 13.3 (range = 8.6-17.4), and none were written at or below the 6th or 8th grade level. The cumulative mean RGL exceeded the 6th grade reading level by an average of 7.3 levels (95% CI, 6.8-7.8; p < 0.001) and the 8th grade level by an average of 5.3 grade levels (95% CI, 4.8-5.8; p < 0.001). The mean Flesch Reading Ease Score was 39/100 ('difficult').
    CONCLUSION: Currently available online PEMs related to radiation safety are still written at higher than recommended reading levels. Radiation safety is a topic in which the specialist training of radiologists is crucial in providing guidance to patients. Addressing the readability of online PEMs can improve radiology-patient communication and support the shift to a patient-centred model of practice.
    Keywords:  Health literacy; Patient education; Patient-centred care; Radiation dosage; Readability
    DOI:  https://doi.org/10.1186/s13244-021-01094-3
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