bims-librar Biomed News
on Biomedical librarianship
Issue of 2023–07–23
25 papers selected by
Thomas Krichel, Open Library Society



  1. Vet Rec. 2023 Jul 22. 193(2): 58-59
      Georgina Mills discusses the use of artificial intelligence tools in scientific research and literature.
    DOI:  https://doi.org/10.1002/vetr.3276
  2. Med Ref Serv Q. 2023 Jul-Sep;42(3):42(3): 273-293
      Spurred by the National Institute of Health mandating a data management and sharing plan as a requirement of grant funding, research data management has exploded in importance for librarians supporting researchers and research institutions. This editorial examines the role and direction of libraries in this process from several viewpoints. Key markers of success include collaboration, establishing new relationships, leveraging existing relationships, accessing multiple avenues of communication, and building niche expertise and cachè as a valued and trustworthy partner.
    Keywords:  Academic libraries; R1 institutions; RDM; Research data management; grant funding requirements; health sciences libraries; medical libraries; research libraries; role of libraries
    DOI:  https://doi.org/10.1080/02763869.2023.2218776
  3. Health Info Libr J. 2023 Jul 15.
      The professional identity of librarians is established with regard to the current understanding of their knowledge practices. The global phenomenon of false and untrustworthy information circulating on social media platforms paints a new issue that librarians must conquer. Messages, content, news, and information on the web make it challenging for librarians to educate users as to where the sources come from and the need to evaluate for credibility and trustworthiness. During the pandemic, and with a surge of information disorders on social media, the World Health Organization recommended building resilience to misinform-ation and engaging and empowering communities to take positive action. This research seeks to explore the relationship between professional identities and the participation of librarians in an infodiverse environment, specifically by exploring how Filipino librarians applied aspects of their knowledge practices to the evaluation of social media health information during the pandemic.
    Keywords:  Asia, southeast; health literacy; infodemiology; library and information professionals; public health
    DOI:  https://doi.org/10.1111/hir.12498
  4. Med Ref Serv Q. 2023 Jul-Sep;42(3):42(3): 260-272
      Virtual reference services have become a staple in many libraries, but these services reached a new level of importance when in-person reference shut down in response to COVID-19. This descriptive study aims to discover how health sciences librarians utilized virtual reference services in response to the pandemic. A survey was developed and distributed to health sciences librarians. The survey addressed the status of virtual reference services before and during the COVID-19 pandemic as well as any changes that are seen as libraries reopen. Virtual reference shifted heavily to video conferencing during the pandemic both for librarians at home and those remaining onsite.
    Keywords:  COVID-19; health science; librarians; libraries; virtual reference
    DOI:  https://doi.org/10.1080/02763869.2023.2220604
  5. BMJ Evid Based Med. 2023 Jul 18. pii: bmjebm-2022-111921. [Epub ahead of print]
      The incorporation of publications that have been retracted is a risk in reliable evidence synthesis. Retraction is an important mechanism for correcting the literature and protecting its integrity. Within the medical literature, the continued citation of retracted publications occurs for a variety of reasons. Recent evidence suggests that systematic reviews and meta-analyses often unwittingly cite retracted publications which, at least in some cases, may significantly impact quantitative effect estimates in meta-analyses. There is strong evidence that authors of systematic reviews and meta-analyses may be unaware of the retracted status of publications and treat them as if they are not retracted. These problems are difficult to address for several reasons: identifying retracted publications is important but logistically challenging; publications may be retracted while a review is in preparation or in press and problems with a publication may also be discovered after the evidence synthesis is published. We propose a set of concrete actions that stakeholders (eg, scientists, peer-reviewers, journal editors) might take in the near-term, and that research funders, citation management systems, and databases and search engines might take in the longer term to limit the impact of retracted primary studies on evidence syntheses.
    Keywords:  Evidence-Based Practice; Information Storage and Retrieval; Publishing; Retraction of Publication as Topic; Systematic Reviews as Topic
    DOI:  https://doi.org/10.1136/bmjebm-2022-111921
  6. Med Ref Serv Q. 2023 Jul-Sep;42(3):42(3): 211-227
      This study examines the frequency of misspellings in health sciences literature and explores how they affect citation retrieval in multiple databases. Searches for commonly misspelled medical words were conducted in PubMed, CINAHL Complete, APA PsycArticles (ProQuest), APA PsycInfo, and ProQuest Psychology databases. Citations that would be retrieved using a word's correct spelling were removed from the search results. Remaining results were citations that could only be retrieved if the word was misspelled in the search. Articles with clinical significance were targeted. The top five most commonly misspelled words were occurrence, ophthalmology, pruritus, sagittal, and resistance. Ophthalmology had the highest number of citations that contained at least one misspelling, with 57% of those citations "missing" when searched with the correct spelling of the word. The word with the highest percentage (82%) of missed citations was arrhythmia. The results of this study indicate that misspellings in scholarly literature are more prevalent than searchers might realize. The ability to retrieve citations is adversely affected by misspellings, which has the potential to affect patient care. Many opportunities exist in the editorial process to identify and correct misspellings before publication. This is less so once a journal is published. The implications for database searching and manuscript evaluation are discussed.
    Keywords:  Citation recall; citation retrieval; database searching; misspellings; spelling errors
    DOI:  https://doi.org/10.1080/02763869.2023.2214038
  7. Med Ref Serv Q. 2023 Jul-Sep;42(3):42(3): 240-259
      Increased requests for assistance with literature searches on educational topics within the health professions motivated two health science librarians to analyze search function and results in eleven bibliographic databases on questions representing three allied health instructional target populations (patient, caregiver, and future health professionals). Results overlap and relevance were estimated and useful functions and subject headings were examined, as evidence for future search and database recommendations. This research confirmed the authors' hypothesis that PubMed and CINAHL overlapped significantly yet yielded sufficient unique citations to recommend searching both, plus at least one education-specific database. For the six questions researched, psychology and sports medicine databases were less productive.
    Keywords:  Bibliographic database comparison; complex evidence syntheses; database search functions; database selection; health professions
    DOI:  https://doi.org/10.1080/02763869.2023.2215105
  8. Med Ref Serv Q. 2023 Jul-Sep;42(3):42(3): 228-239
      Previous investigations into trends in Library and Information Science literature have revealed changes in the topics librarians publish on over time, with older studies highlighting classification and indexing, and information retrieval and more recent studies highlighting keywords such as Internet, information technology, digital libraries, and again, information retrieval. No similar investigation has been conducted on current publication trends by health sciences librarians. This study analyzes the top themes on which health sciences librarians published from 2016 to 2020 by examining the frequency of keywords. Keywords and subject headings were analyzed from The Journal of the Medical Library Association, Medical References Services Quarterly, The Journal of Hospital Librarianship, and The Journal of Electronic Resources in Medical Libraries. A total of 8,806 keywords were downloaded for analysis and organized into 292 categories during taxonomy creation. The ten most frequent themes were: libraries, information, education, humans, demography, librarian, geographical locations, research, electronic resources, and technology. The study also found that data, psychiatry and psychology, informatics, and publishing were other key themes, indicating that health sciences librarians are publishing on a wide range of topics. Some keywords that appeared only once, such as telecommuting and flexible staffing, suggest emerging areas of research for librarians.
    Keywords:  Health sciences librarians; keyword analysis; publication themes; scholarship
    DOI:  https://doi.org/10.1080/02763869.2023.2225351
  9. Int J Technol Assess Health Care. 2023 Jul 19. 39(1): e43
       OBJECTIVES: Though there have been longstanding discussions on the value of ethics in health technology assessment (HTA), less awareness exists on ethics information retrieval methods. This study aimed to scope available evidence and determine current practices for ethics information retrieval in HTA.
    METHODS: Literature searches were conducted in Ovid MEDLINE, LISTA, Scopus, and Google Scholar. Once a list of relevant articles was determined, citation tracking was conducted via Scopus. HTA agency websites were searched for published guidance on ethics searching, and for reports which included ethical analyses. Methods sections of each report were analyzed to determine the databases, subject headings, and keywords used in search strategies. The team also reached out to information specialists for insight into current search practices.
    RESULTS: Findings from this study indicate that there is still little published guidance from HTA agencies, few HTAs that contain substantial ethical analysis, and even less information on the methodology for ethics information retrieval. The researchers identified twenty-five relevant HTAs. Ten of these reports did not utilize subject-specific databases outside health sciences. Eight reports published ethics searches, with significant overlap in subject headings and text words.
    CONCLUSIONS: This scoping study of current practice in HTA ethics information retrieval highlights findings of previous studies-while ethics analysis plays a crucial role in HTA, methods for literature searching remain relatively unclear. These findings provide insight into the current state of ethics searching, and will inform continued work on filter development, database selection, and grey literature searching.
    Keywords:  Information storage and retrieval; bibliographic; bioethics; biomedical; databases; technology assessment
    DOI:  https://doi.org/10.1017/S0266462323000247
  10. J Med Internet Res. 2023 07 18. 25 e45059
       BACKGROUND: Co-creation is an approach that aims to democratize research and bridge the gap between research and practice, but the potential fragmentation of knowledge about co-creation has hindered progress. A comprehensive database of published literature from multidisciplinary sources can address this fragmentation through the integration of diverse perspectives, identification and dissemination of best practices, and increase clarity about co-creation. However, two considerable challenges exist. First, there is uncertainty about co-creation terminology, making it difficult to identify relevant literature. Second, the exponential growth of scientific publications has led to an overwhelming amount of literature that surpasses the human capacity for a comprehensive review. These challenges hinder progress in co-creation research and underscore the need for a novel methodology to consolidate and investigate the literature.
    OBJECTIVE: This study aimed to synthesize knowledge about co-creation across various fields through the development and application of an artificial intelligence (AI)-assisted selection process. The ultimate goal of this database was to provide stakeholders interested in co-creation with relevant literature.
    METHODS: We created a novel methodology for establishing a curated database. To accommodate the variation in terminology, we used a broad definition of co-creation that encompassed the essence of existing definitions. To filter out irrelevant information, an AI-assisted selection process was used. In addition, we conducted bibliometric analyses and quality control procedures to assess content and accuracy. Overall, this approach allowed us to develop a robust and reliable database that serves as a valuable resource for stakeholders interested in co-creation.
    RESULTS: The final version of the database included 13,501 papers, which are indexed in Zenodo and accessible in an open-access downloadable format. The quality assessment revealed that 20.3% (140/688) of the database likely contained irrelevant material, whereas the methodology captured 91% (58/64) of the relevant literature. Participatory and variations of the term co-creation were the most frequent terms in the title and abstracts of included literature. The predominant source journals included health sciences, sustainability, environmental sciences, medical research, and health services research.
    CONCLUSIONS: This study produced a high-quality, open-access database about co-creation. The study demonstrates that it is possible to perform a systematic review selection process on a fragmented concept using human-AI collaboration. Our unified concept of co-creation includes the co-approaches (co-creation, co-design, and co-production), forms of participatory research, and user involvement. Our analysis of authorship, citations, and source landscape highlights the potential lack of collaboration among co-creation researchers and underscores the need for future investigation into the different research methodologies. The database provides a resource for relevant literature and can support rapid literature reviews about co-creation. It also offers clarity about the current co-creation landscape and helps to address barriers that researchers may face when seeking evidence about co-creation.
    Keywords:  artificial intelligence; co-creation; co-design; co-production; database; methodology; participatory
    DOI:  https://doi.org/10.2196/45059
  11. ACS Med Chem Lett. 2023 Jul 13. 14(7): 879-883
      A targeted bibliographic search exposed the deficiencies within existing PROTAC preclinical pipelines, including missing, poor-quality data and technical limitations in the experimental assays. Several recommendations are proposed to improve the efficiency of preclinical platforms for PROTACs.
    DOI:  https://doi.org/10.1021/acsmedchemlett.3c00231
  12. Med Ref Serv Q. 2023 Jul-Sep;42(3):42(3): 294-300
      This column provides an overview of the Virtual Health Library (VHL) Regional Portal, a resource provided by Pan American Health Organization and others with the purpose of communicating and exchanging health experiences and information for Latin American and Caribbean countries. The content is organized in four sub-portals: the VHL Model, which describes health information and knowledge management to structures and guides; LILACS, the Latin American and Caribbean Index Health Science Literature; DeCS, Descriptors Health Sciences, a controlled vocabulary; and Training, which gathers and organizes information for librarians, developers, and users who are interested in construction and use of VHL methodologies. An overview of the resource and sample search is discussed.
    Keywords:  Online database; Spanish-language; World Health Organization; research resource; review
    DOI:  https://doi.org/10.1080/02763869.2023.2220607
  13. Am J Pharm Educ. 2023 Jul 14. pii: S0002-9459(23)04351-6. [Epub ahead of print] 100575
      Evaluation of clinical faculty involves an assessment of the quality of their publications in addition to quantity (number) of publications. In contrast to assessing quantity, assessing quality is difficult. The purpose of this paper is to discuss practical considerations and provide recommendations related to quality of publications that clinical faculty members should bear in mind as part of their overall scholarship activity. College and schools of pharmacy may not provide written criteria for assessing quality of publications, so it is important that clinical faculty members seek guidance from their department chair or direct supervisor, experienced colleagues, and formal or informal mentors or advisors. One criterion for assessing quality is whether a publication was evaluated through a peer-review process although there are other considerations including dissemination of the paper via search engines such as PubMed. Clinical faculty also need to consider authorship order on their papers and potential journals for submission.
    Keywords:  academia; assessment; clinical faculty; journal publishing; publication; quality
    DOI:  https://doi.org/10.1016/j.ajpe.2023.100575
  14. JMIR Pediatr Parent. 2023 Jul 18. 6 e41806
       BACKGROUND: Adolescents and young adults are disproportionately affected by HIV, suggesting that HIV prevention methods such as pre-exposure prophylaxis (PrEP) should focus on this group as a priority. As digital natives, youth likely turn to internet resources regarding health topics they may not feel comfortable discussing with their medical providers. To optimize informed decision-making by adolescents and young adults most impacted by HIV, the information from internet searches should be educational, accurate, and readable.
    OBJECTIVE: The aims of this study were to compare the accuracy of web-based PrEP information found using web search engines and virtual assistants, and to assess the readability of the resulting information.
    METHODS: Adolescent HIV prevention clinical experts developed a list of 23 prevention-related questions that were posed to search engines (Ask.com, Bing, Google, and Yahoo) and virtual assistants (Amazon Alexa, Microsoft Cortana, Google Assistant, and Apple Siri). The first three results from search engines and virtual assistant web references, as well as virtual assistant verbal responses, were recorded and coded using a six-tier scale to assess the quality of information produced. The results were also entered in a web-based tool determining readability using the Flesch-Kincaid Grade Level scale.
    RESULTS: Google web search engine and Google Assistant more frequently produced PrEP information of higher quality than the other search engines and virtual assistants with scores ranging from 3.4 to 3.7 and 2.8 to 3.3, respectively. Additionally, the resulting information generally was presented in language at a seventh and 10th grade reading level according to the Flesch-Kincaid Grade Level scale.
    CONCLUSIONS: Adolescents and young adults are large consumers of technology and may experience discomfort discussing their sexual health with providers. It is important that efforts are made to ensure the information they receive about HIV prevention methods, and PrEP in particular, is comprehensive, comprehensible, and widely available.
    Keywords:  HIV; PrEP; accuracy; adolescence; adolescent; comprehensible; comprehension; credibility; health information; human immunodeficiency virus; information quality; internet use; online information; patient education; pediatric; pre-exposure prophylaxis; prophylaxis; readability; reading level; search engine; sexual health; virtual assistant; web-based; young adult; youth
    DOI:  https://doi.org/10.2196/41806
  15. Phlebology. 2023 Jul 16. 2683555231190454
       BACKGROUND: Professional vascular societies and forums have disseminated patient information on education materials about chronic venous disease (CVD) via their official websites. While online patient education material is readily available with an Internet connection, its practical utility may be limited for patients with low health literacy.
    METHODS: Six readability measures were used to evaluate the patient education materials regarding CVD published by 12 professional medical societies.
    RESULTS: Patient education materials on CVD vary considerably in length among medical societies, and their comprehensibility points toward a difficult level. The mean readability score was 11.20, prominently above the National Institutes of Health (NIH) and American Medical Association (AMA) recommendations.
    CONCLUSION: Our analysis of patient education materials produced by 12 professional vascular societies and forums found that all materials exceeded the recommended readability levels. The innovative section "Information for patients'' in the ESVS CVD guidelines also exceeded these levels. Improving the readability of patient education materials is essential to meet patient health literacy standards and might improve patient outcomes in managing CVD.
    Keywords:  Readability; chronic venous disease; patient education; vascular
    DOI:  https://doi.org/10.1177/02683555231190454
  16. Eur Spine J. 2023 Jul 19.
       PURPOSE: Orthopaedic patient education materials (PEMs) have repeatedly been shown to be well above the recommended reading level by the National Institute of Health and American Medical Association. The purpose of this study is to create a standardized method to improve the readability of PEMs describing spine-related conditions and injuries. It is hypothesized that reducing the usage of complex words (≥ 3 syllables) and reducing sentence length to < 15 words per sentence improves readability of PEMs as measured by all seven readability formulas used.
    METHODS: OrthoInfo.org was queried for spine-related PEMs. The objective readability of PEMs was evaluated using seven unique readability formulas before and after applying a standardized method to improve readability while preserving critical content. This method involved reducing the use of > 3 syllable words and ensuring sentence length is < 15 words. Paired samples t-tests were conducted to assess relationships with the cut-off for statistical significance set at p < 0.05.
    RESULTS: A total of 20 spine-related PEM articles were used in this study. When comparing original PEMs to edited PEMs, significant differences were seen among all seven readability scores and all six numerical descriptive statistics used. Per the Flesch Kincaid Grade level readability formula, one original PEM (5%) versus 15 edited PEMs (75%) met recommendations of a sixth-grade reading level.
    CONCLUSION: The current study shows that using this standardized method significantly improves the readability of spine-related PEMs and significantly increased the likelihood that PEMs will meet recommendations for being at or below the sixth-grade reading level.
    Keywords:  Health literacy; Patient education materials; Readability; Spine
    DOI:  https://doi.org/10.1007/s00586-023-07856-5
  17. J Am Podiatr Med Assoc. 2023 May-Jun;113(3):pii: 22-187. [Epub ahead of print]113(3):
       BACKGROUND: Patients frequently use YouTube to learn about their illness. For this reason, the educational and quality of YouTube videos about various diseases has been investigated. In this study, we aimed to evaluate the accuracy and quality of YouTube videos.
    METHODS: A standard query was performed on the YouTube database using the following search terms: Plantar fasciitis, heel spur, and calcaneal spur. For each search term, the top 50 videos determined by YouTube's "relevance" according to its algorithm were evaluated (150 videos in total). After exclusion, 140 videos were included in the study. These videos were watched by 2 observers and the videos were evaluated and scored according to the Global Quality Score (GQS), DISCERN, Journal of the American Medical Association (JAMA), and Plantar Fasciitis and Calcaneal Spurs Specific Score (PFSS) scoring systems.
    RESULTS: According to the JAMA criteria, 76.42% of the videos and 43.57% of the videos according to the GQS scored 2 points or less. According to DISCERN criteria, 67.15% of the videos were evaluated as very poor/poor. According to the PFSS, 83.5% of the videos were rated as poor or very poor.
    CONCLUSIONS: These findings can be interpreted as the general information content of the videos about plantar fasciitis is insufficient and their reliability and quality are low. As a result, it can be concluded that the quality and reliability of YouTube videos regarding plantar fasciitis are insufficient for patients. Universities/associations prepare videos that provide information about plantar fasciitis to patients, and that these videos are presented on certain platforms can be a solution.
    DOI:  https://doi.org/10.7547/22-187
  18. J Vasc Access. 2023 Jul 18. 11297298231187168
       BACKGROUND: The European Society of Anaesthesiology (ESA) published a guideline regarding continuous ultrasound guidance for central venous catheters in 2020. YouTube has been a popular educational platform since its inception. The purpose of the present study was to evaluate the adequacy of videos on ultrasound-guided subclavian vein catheterization posted on YouTube based on this guideline.
    METHOD: YouTube was scanned using the keywords associated with ultrasound-guided subclavian vein catheterization and 46 of the 106 most-watched videos were included in the study. The videos were divided into three groups, as individual, manufacturer, and academic according to their sources, and were evaluated as poor, satisfactory, and good in terms of the overall content. The videos were then evaluated based on ESA's six-title guide for more specific informational content.
    RESULTS: A total of 46 videos were reviewed and 52.2% (n = 24) were found to be prepared by individuals. Among the videos, the rate of videos describing only venipuncture (poor) was 23.9% (n = 11), 73.9% (n = 34) of videos described the verification of the guidewire location with venipuncture, and 2.2% of videos described all the recommendations suggested by the guide (n = 1). At the end of the catheterization procedure, 4.3% (n = 2) stated that the catheter location should be confirmed by using ultrasound, 15.2% (n = 7) recommended chest-X-ray, and 80.4% (n = 37) did not suggest any.
    CONCLUSION: Manufacturer and academic videos can be watched due to their high-quality scores, but it may be practical to prepare training videos with guidelines both for educators and students to have global access to the renewed guideline information.
    Keywords:  YouTube; subclavian vein catheterization; ultrasound
    DOI:  https://doi.org/10.1177/11297298231187168
  19. Int Urogynecol J. 2023 Jul 20.
       INTRODUCTION AND HYPOTHESIS: The objective of the study is to evaluate the reliability and quality of the most-viewed female urinary incontinence-related TikTok and YouTube posts. Our second goal is to analyze the differences in the quality and content of videos between these platforms.
    METHODS: We searched for the keyword "female urinary incontinence" on TikTok and YouTube on 1 March 2023. We sorted the videos that appeared out of searches for this keyword by "top" results on TikTok and by "relevance" on YouTube. We excluded the videos that were not in English, whose narrator was unclear, unrelated videos, advertising videos, and duplicate videos. In this study, we included the top 50 videos on both platforms that were directly related to female urinary incontinence. The characteristics of the videos, such as likes, video duration, views, and type of narrator (patient, physician, nonphysician practitioner, and health care company), and DISCERN scores were analyzed.
    RESULTS: We observed that the median view count (p<0.001) and the median video duration (p<0.001) were higher and longer respectively on YouTube than on TikTok. In addition, the median DISCERN score of these videos was higher on YouTube than on TikTok (p<0.001). Similarly, the overall quality of videos was higher on YouTube than on TikTok (p=0.002). Only in two TikTok and two YouTube videos have the narrators cited a reference.
    CONCLUSIONS: Our findings emphasize the present lack of high-quality content available on TikTok and YouTube from both health care and nonhealth care experts. To address this lack of information, health care providers, especially urologists, should take an active role in creating video content.
    Keywords:  Female urinary incontinence; Social media platforms; TikTok; Video content; YouTube
    DOI:  https://doi.org/10.1007/s00192-023-05607-0
  20. Helicobacter. 2023 Jul 15. e13007
       BACKGROUND: Helicobacter pylori (H. pylori) is closely associated with gastric diseases and has a high prevalence in China. Public platforms are considered common and important tools to publicize H. pylori-related information. This study aimed to assess and compare the content and quality of H. pylori-related videos on TikTok and Bilibili.
    MATERIALS AND METHODS: A search was performed on the TikTok and Bilibili platforms using the keyword "H. pylori". The source of upload was categorized as for-profit organizations, general users, health professionals, news agencies, nonprofit organizations, and science communicators. The Journal of American Medical Association (JAMA), Global Quality Scale (GQS), and modified DISCERN scores were used to evaluate the quality of the included videos.
    RESULTS: A total of 93 TikTok videos and 79 Bilibili videos were included and analyzed. TikTok videos had a significantly shorter duration than Bilibili videos (64 vs. 149 s, respectively; p < 0.001). The duration of the video showed a positive correlation with the modified DISCERN and GQS scores (p < 0.001, r = 0.388 and r = 0.437, respectively). The JAMA and modified DISCERN scores of the TikTok video were significantly higher in health professionals and nonprofit organizations than in other sources (p < 0.05). For Bilibili, science communicators had a significantly higher JAMA score than the other video sources (p < 0.001). The videos uploaded by news agencies received more views, comments, shares, and favorites than any other organization or individual (p < 0.001).
    CONCLUSIONS: In China, H. pylori-related videos from TikTok and Bilibili tended to provide the information regarding the transmission and eradication of H. pylori. However, many videos scored an average rating in content and quality and need to be improved. We recommend that the public obtain H. pylori-related information through videos uploaded by health professionals, nonprofit organizations, and science communicators.
    Keywords:   Helicobacter pylori ; Bilibili; TikTok; quality; video
    DOI:  https://doi.org/10.1111/hel.13007
  21. J Plast Reconstr Aesthet Surg. 2023 Jun 29. pii: S1748-6815(23)00384-4. [Epub ahead of print]85 55-58
       PURPOSE: Patients considering gender-affirming surgery often utilize online health materials to obtain information about procedures. However, the distribution of patient concerns and content of online resources for gender-affirming surgery have not been examined. We aimed to quantify and comprehensively analyze the most searched questions of patients seeking gender-affirming surgery and to examine the quality and readability of associated websites providing the answers.
    METHODS: Questions were extracted from Google using the search phrases "gender-affirming surgery," "transgender surgery," "top surgery," and "bottom surgery." Questions were categorized by topic and average search volume per month was determined. Websites linked to questions were categorized by type, and quality of the health information was evaluated utilizing the DISCERN instrument (16-80). Readability was assessed with the Flesch Reading Ease Score and Flesch-Kincaid Grade Level.
    RESULTS: Ninety questions and associated websites were analyzed. Common questions were most frequently answered by academic websites (30%). Topics included cost (27%), technical details of surgery (23%), and preoperative considerations (11%). Median (interquartile range) DISCERN score across all website categories was 42 (18). The mean readability was of a 12th-grade level, well above the grade six reading level recommended by the American Medical Association.
    CONCLUSIONS: Online gender-affirming surgery materials are difficult to comprehend and of poor quality. To enhance patient knowledge, informed consent, and shared decision-making, there is a substantial need to create understandable and high-quality online health information for those seeking gender-affirming surgery.
    Keywords:  Bottom surgery; Gender-affirming surgery; Google analytics; Top surgery; Transgender surgery; Trends analysis
    DOI:  https://doi.org/10.1016/j.bjps.2023.06.060