bims-librar 2023-11-19 papers

bims-librar

Biomed News

on Biomedical librarianship

Issue of 2023–11–19
23 papers selected by
Thomas Krichel, Open Library Society

Scholarship of Drug Information and Library Sciences Instruction in North American Pharmacy Education: A Systematic Review of English Language Research.
Complementary and Integrative Health Information in the literature: its lexicon and named entity recognition.
Examining how information presentation methods and a chatbot impact the use and effectiveness of electronic health record patient portals: An exploratory study.
A Readability Analysis of Online Spondylolisthesis and Spondylolysis Patient Resources Among Pediatric Hospital Web Pages: A US-Based Study.
Orthodontic patients and the information found on the web: a cross-sectional study.
Most Online Resources for Home Suture Removal are Poor in Quality.
Optimizing Ophthalmology Patient Education via ChatBot-Generated Materials: Readability Analysis of AI-Generated Patient Education Materials and The American Society of Ophthalmic Plastic and Reconstructive Surgery Patient Brochures.
Assessment of the Readability of the Online Patient Education Materials of Intensive and Critical Care Societies.
Hirschsprung Disease: A Literacy Analysis of Patient Information.
Assessment of Internet Available Patient Information on Chronic Pancreatitis Using the Ensuring Quality Information for Patients Tool: A Systematic Search and Evaluation.
Online Patient Education Materials on Iron Deficiency Anemia Are Too Difficult to Read and Low Quality: A Readability and Quality Analysis.
Assessing the Quality and Readability of Web-Based Information on Otoplasty.
Should I freeze my sperm?-readability and quality of health resources for sperm banking.
Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material.
The concern about the educational quality of online videos on laparoscopic myomectomy.
Evaluation of the reliability and educational quality of YouTube™ videos on sport nutrition topics.
YouTube™ as a source of parents' information for craniosynostosis.
Assessing the scientific quality and reliability of YouTube videos about chemotherapy.
Diet-Nutrition Information Seeking, Source Trustworthiness, and Eating Behavior Changes: An International Web-Based Survey.
An Analysis of Male Plastic Surgery Content on TikTok.
Digital Health for Patients Undergoing Spine Surgery: A Systematic Review.
Prejuvenation: What Social Media Tells Us about the Rising Trend.
Letter to the editor concerning "Large language models: Are artificial intelligence-based chatbots a reliable source of patient information for spinal surgery?" by R. Stroop et al. (Eur Spine J [2023]; doi:10.1007/s00586-023-07975-z).

Am J Pharm Educ. 2023 Nov 14. pii: S0002-9459(23)04581-3. [Epub ahead of print] 100626

Scholarship of Drug Information and Library Sciences Instruction in North American Pharmacy Education: A Systematic Review of English Language Research.

Kayce D Gill, Timothy C Hutcherson, Julie Kalabalik-Hoganson, Jason B Reed, Amy H Sheehan, Kaitlin J Montagano, Rebecca M Hoover, Kathryn A Mueller, Christopher S Wisniewski.

   OBJECTIVES: To characterize the scholarship of teaching and learning (SOTL) specific to drug information and library sciences (DILS) in pharmacy education and provide a comprehensive, evidence-based resource for faculty detailing published practices for content delivery and scholarly research gaps.
FINDINGS: Systematic searches of PubMed, Embase, International Pharmaceutical Abstracts, Educational Resources Information Center, Scopus, Library Literature & Information Science Full Text, and Library, Information Science & Technology Abstracts were conducted from January 1997 through early February 2022. Included studies were published in English, involved DILS content, were specific to pharmacy education, were original research, and were conducted in North America. The review excluded abstract-only records and studies that did not include learners (ie, students and residents) as participants. Duplicate records were removed. After screening and review, 166 articles met eligibility criteria, 60% (n=100/166) of which were published in the last 10 years. Most studies focused on literature evaluation (45/166, 27%), fundamentals of drug information (43/166, 25%), evidence-based medicine (21/166, 13%), and resource utilization (21/166, 13%). Studied learners were mainly pharmacy students (77%) and 82% of research included authors who were pharmacists, while 14% included librarians. Assessment techniques used primarily focused on student perception (61/166, 37%), followed by summative assessment (46/166, 28%), other (25/166, 15%), and formative assessment (18/166, 11%).
SUMMARY: This article presents a systematically identified collection of North American literature examining the education of DILS to pharmacy learners. Areas for continued research of DILS content include evaluating under-represented educational domains (i.e., systematic approach, response development and provision, literature searching, study design), using librarians more in SOTL research, and using formative and summative assessments as outcomes.

Keywords:  Drug Information; Evidence-Based Medicine; Librarians; Medical Literature Evaluation; Pharmacy Education

DOI:  https://doi.org/10.1016/j.ajpe.2023.100626
J Am Med Inform Assoc. 2023 Nov 10. pii: ocad216. [Epub ahead of print]

Complementary and Integrative Health Information in the literature: its lexicon and named entity recognition.

Huixue Zhou, Robin Austin, Sheng-Chieh Lu, Greg Marc Silverman, Yuqi Zhou, Halil Kilicoglu, Hua Xu, Rui Zhang.

   OBJECTIVE: To construct an exhaustive Complementary and Integrative Health (CIH) Lexicon (CIHLex) to help better represent the often underrepresented physical and psychological CIH approaches in standard terminologies, and to also apply state-of-the-art natural language processing (NLP) techniques to help recognize them in the biomedical literature.
MATERIALS AND METHODS: We constructed the CIHLex by integrating various resources, compiling and integrating data from biomedical literature and relevant sources of knowledge. The Lexicon encompasses 724 unique concepts with 885 corresponding unique terms. We matched these concepts to the Unified Medical Language System (UMLS), and we developed and utilized BERT models comparing their efficiency in CIH named entity recognition to well-established models including MetaMap and CLAMP, as well as the large language model GPT3.5-turbo.
RESULTS: Of the 724 unique concepts in CIHLex, 27.2% could be matched to at least one term in the UMLS. About 74.9% of the mapped UMLS Concept Unique Identifiers were categorized as "Therapeutic or Preventive Procedure." Among the models applied to CIH named entity recognition, BLUEBERT delivered the highest macro-average F1-score of 0.91, surpassing other models.
CONCLUSION: Our CIHLex significantly augments representation of CIH approaches in biomedical literature. Demonstrating the utility of advanced NLP models, BERT notably excelled in CIH entity recognition. These results highlight promising strategies for enhancing standardization and recognition of CIH terminology in biomedical contexts.

Keywords:  Complementary and Integrative Health; Unified Medical Language System; named entity recognition; terminology

DOI:  https://doi.org/10.1093/jamia/ocad216
Patient Educ Couns. 2023 Nov 05. pii: S0738-3991(23)00436-6. [Epub ahead of print]119 108055

Examining how information presentation methods and a chatbot impact the use and effectiveness of electronic health record patient portals: An exploratory study.

Rong Yin, David M Neyens.

   OBJECTIVES: Examining information presentation strategies that may facilitate patient education through patient portals is important for effective health education.
METHODS: A randomized exploratory study evaluated information presentation (text or videos) and a chatbot in patient education and examined several performance and outcome variables (e.g., search duration, Decisional Conflict Scale, and eye-tracking measures), along with a simple descriptive qualitative content analysis of the transcript of chatbot.
RESULTS: Of the 92 participants, those within the text conditions (n = 46, p < 0.001), had chatbot experiences (B =-74.85, p = 0.046), knew someone with IBD (B =-98.66, p = 0.039), and preferred to engage in medical decision-making (B =102.32, p = 0.006) were more efficient in information-searching. Participants with videos spent longer in information-searching (mean=666.5 (SD=171.6) VS 480.3 (SD=159.5) seconds, p < 0.001) but felt more informed (mean score=18.8 (SD=17.6) VS 27.4 (SD=18.9), p = 0.027). The participants' average eye fixation duration with videos was significantly higher (mean= 473.8 ms, SD=52.9, p < 0.001).
CONCLUSIONS: Participants in video conditions were less efficient but more effective in information seeking. Exploring the trade-offs between efficiency and effectiveness for user interface designs is important to appropriately deliver education within patient portals.
PRACTICE IMPLICATIONS: This study suggests that user interface designs and chatbots impact health information's efficiency and effectiveness.

Keywords:  Eye-tracking; Health-information seeking; Inflammatory Bowel Disease (IBD); Patient education; Usability

DOI:  https://doi.org/10.1016/j.pec.2023.108055
J Am Acad Orthop Surg Glob Res Rev. 2023 Nov 01. 7(11):

A Readability Analysis of Online Spondylolisthesis and Spondylolysis Patient Resources Among Pediatric Hospital Web Pages: A US-Based Study.

Emily K Vallee, Christopher Lucasti, Maxwell M Scott, Benjamin C Graham, Jeremy P Doak, Michael R Ferrick, Joseph M Kowalski.

INTRODUCTION: With the increasing use of the internet for health information, it is essential to prioritize resources that match the reading level of patients and parents. Limited health literacy is a notable issue in the United States, creating a financial burden and negatively affecting patient outcomes. This study aimed to assess the availability and readability of pediatric hospital web pages concerning two prevalent spine conditions in children, spondylolisthesis and spondylolysis, specifically examining whether the available resources meet the recommended sixth grade reading level.
METHODS: A total of 179 pediatric hospital web pages were assessed for their availability and readability of spondylolisthesis and spondylolysis patient information. The web pages' readability was assessed using five readability formulae. Descriptive statistics and Student t-tests were performed on the collected scores with significance set at P < 0.05.
RESULTS: Among the analyzed hospitals, 40.2% had no information on spondylolisthesis or spondylolysis, 20.1% mentioned treating these conditions, 7.8% had < 100 dedicated words, and only 31.8% had dedicated web pages with more than 100 words on these conditions. The average reading grade level for the evaluated web pages was 12.0, indicating a high school education level is required for comprehension. None of the web pages were written below the recommended sixth grade reading level.
DISCUSSION: The readability of the limited resources was markedly higher than the recommended reading level. In addition, this study emphasizes the need for enhanced accessibility and readability of online patient information from pediatric hospitals to improve parental comprehension and informed decision-making. Physicians should consider identifying online resources that they consider of high quality and acceptable readability to support better patient understanding and outcomes.

DOI: https://doi.org/e23.00177
BMC Oral Health. 2023 Nov 13. 23(1): 860

Orthodontic patients and the information found on the web: a cross-sectional study.

Roberta Crispino, Alice Mannocci, Irene Alfonsa Dilena, Jackson Sides, Federico Forchini, Wael Mohammad Asif Alherawi, Sylvia A Frazier-Bowers, Cristina Grippaudo.

   BACKGROUND: In recent years, the Web has become a source of medical information for patients, even though the information available online may be incorrect or qualitatively inadequate. Younger generations, immersed in a digital environment since a very tender age, are more likely to get informed online. This study aims to understand the relevance of online information for prospective orthodontic patients and to investigate the effects of digital research on patients' decision-making process, and it also aims to investigate potential generational differences between digital natives and digital immigrants.
MATERIALS AND METHODS: An anonymous questionnaire was developed to investigate patients' orthodontic-themed Web searches as well as the effects digital material had on their decision-making process. Before submitting the newly designed survey to patients, it was validated in a pilot study. Univariate analysis was applied to analyze the relationship between the demographic characteristics of respondents and their answers on the use of digital research for the decision-making process.
RESULTS: 64.6% of the study population searched the Web for orthodontic information prior to their visit. Google was the most used platform regardless of patients' age. The perceived reliability of online sources varied significantly with age. Men displayed more trusting behavior towards their doctor than women. Prospective patients' satisfaction with affected patients' decision-making processes, and the perceived reliability of online sources of information had repercussions on the doctor-patient relationship.
CONCLUSIONS: Orthodontists should be aware that the majority of patients use the Internet as a source for orthodontic information, and that patients who are digital immigrants are more prone to trust the information found online. Patients who perceive the information found on the Web as either useful or reliable don't easily discard it, even if it is inconsistent with the orthodontist's opinion.

Keywords:  Decision-making; Digital information; Digital natives; Generational differences; Orthodontics; Survey; e-health

DOI:  https://doi.org/10.1186/s12903-023-03609-4
Kans J Med. 2023 ;16 261-263

Most Online Resources for Home Suture Removal are Poor in Quality.

Emily H Fan, Bao Vincent K Ho, Edward W Seger, Spencer P McClure, Anand Rajpara.

   Introduction: At home suture or staple removal can be stressful for patients and may lead some to seek out additional instruction via online resources as an adjunct to what was explained to them by their provider. The purpose of this study was to examine the existing online resources available to patients who may be interested in or have been instructed to remove sutures at home after a simple procedure, such as a skin biopsy or excision.
Methods: A systematic search was conducted using internet search engines to identify videos and webpages targeting at home suture removal instruction. The DISCERN instrument was used to evaluate the information quality of each included resource.
Results: There was no statistically significant difference between average DISCERN scores for videos and webpage resources, and the majority were rated poor in quality.
Conclusions: The online resources for at home suture and staple removal were often not comprehensive and were below the standard quality for written information. Health care providers should consider referring their patients to validated online sources for suture removal to prevent misinformation and improve patient safety.

Keywords:  dermatologic surgery; dermatology; lacerations/surgery; patient education; suture removal

DOI:  https://doi.org/10.17161/kjm.vol16.19485
Ophthalmic Plast Reconstr Surg. 2023 Nov 16.

Optimizing Ophthalmology Patient Education via ChatBot-Generated Materials: Readability Analysis of AI-Generated Patient Education Materials and The American Society of Ophthalmic Plastic and Reconstructive Surgery Patient Brochures.

Kevin Eid, Alen Eid, Diane Wang, Rahul S Raiker, Stephen Chen, John Nguyen.

PURPOSE: This study aims to compare the readability of patient education materials (PEM) of the American Society of Ophthalmic Plastic and Reconstructive Surgery to that of PEMs generated by the AI-chat bots ChatGPT and Google Bard.
METHODS: PEMs on 16 common American Society of Ophthalmic Plastic and Reconstructive Surgery topics were generated by 2 AI models, ChatGPT 4.0 and Google Bard, with and without a 6th-grade reading level prompt modifier. The PEMs were analyzed using 7 readability metrics: Flesch Reading Ease Score, Gunning Fog Index, Flesch-Kincaid Grade Level, Coleman-Liau Index, Simple Measure of Gobbledygook Index Score, Automated Readability Index, and Linsear Write Readability Score. Each AI-generated PEM was compared with the equivalent American Society of Ophthalmic Plastic and Reconstructive Surgery PEM.
RESULTS: Across all readability indices, PEM generated by ChatGPT 4.0 consistently had the highest readability scores, indicating that the material generated by this AI chatbot may be most difficult to read in its unprompted form (Flesch Reading Ease Score: 36.5; Simple Measure of Gobbledygook: 14.7). Google's Bard was able to generate content that was easier to read than both the American Society of Ophthalmic Plastic and Reconstructive Surgery and ChatGPT 4.0 (Flesch Reading Ease Score: 52.3; Simple Measure of Gobbledygook: 12.7). When prompted to produce PEM at a 6th-grade reading level, both ChatGPT 4.0 and Bard were able to significantly improve in their readability scores, with prompted ChatGPT 4.0 being able to consistently generate content that was easier to read (Flesch Reading Ease Score: 67.9, Simple Measure of Gobbledygook: 10.2).
CONCLUSION: This study suggests that AI tools, when guided by appropriate prompts, can generate accessible and comprehensible PEMs in the field of ophthalmic plastic and reconstructive surgeries, balancing readability with the complexity of the necessary information.

DOI: https://doi.org/10.1097/IOP.0000000000002549
Crit Care Med. 2023 Nov 13.

Assessment of the Readability of the Online Patient Education Materials of Intensive and Critical Care Societies.

Volkan Hanci, Büşra Otlu, Ali Salih Biyikoğlu.

OBJECTIVES: This study aimed to evaluate the readability of patient education materials (PEMs) on websites of intensive and critical care societies.
DATA SOURCES: Websites of intensive and critical care societies, which are members of The World Federation of Intensive and Critical Care and The European Society of Intensive Care Medicine.
SETTING: Cross-sectional observational, internet-based, website, PEMs, readability study.
STUDY SELECTION: The readability of the PEMs available on societies' sites was evaluated.
DATA EXTRACTION: The readability formulas used were the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog (GFOG).
DATA SYNTHESIS: One hundred twenty-seven PEM from 11 different societies were included in our study. In the readability analysis of PEM, the FRES was 58.10 (48.85-63.77) (difficult), the mean FKGL and SMOG were 10.19 (8.93-11.72) and 11.10 (10.11-11.87) years, respectively, and the mean GFOG score was 12.73 (11.37-14.15) (very difficult). All readability formula results were significantly higher than the recommended sixth-grade level (p < 0.001). All PEMs were above the sixth-grade level when the societies were evaluated individually according to all readability results (p < 0.05).
CONCLUSIONS: Compared with the sixth-grade level recommended by the American Medical Association and the National Institutes of Health, the readability of PEMs in intensive and critical care societies is relatively high. PEMs in intensive and critical care societies should be prepared with attention to recommendations on readability.

DOI: https://doi.org/10.1097/CCM.0000000000006121
Cureus. 2023 Oct;15(10): e46806

Hirschsprung Disease: A Literacy Analysis of Patient Information.

April L Baum, Anh Nguyen, Michael J Valentine, Larissa Vollin, Caleb R Mcnab, Carol E Kirila.

   OBJECTIVE: Hirschsprung disease in newborns can be a potentially life-threatening condition, with risks for complications such as Hirschsprung-associated enterocolitis. Accessing health information in a readable format for complex diseases demonstrates an important outlet for families to address concerns. While it is important to seek out information from trusted providers, many individuals seek out ways to educate themselves further by using common search engines and turning to the internet. This article will evaluate the readability of relevant articles on Hirschsprung disease and information accessibility to the average health literacy individual.
METHODS: A readability analysis of the first 20 Google search results from the keywords "Hirschsprung disease" and "aganglionic megacolon" was performed. Results were documented and averaged using standardized scoring systems. Scoring systems included an Automated Readability Index, Coleman Liau index, SMOG index, Gunning Fog score, Flesch Kinkaid grade level, Flesch Kinkaid reading ease, and average readability across all scoring systems. The number of sentences, number of words, number of complex words, percent of complex words, average words per sentence, and average syllables per word were included as a sample of criteria within scoring systems.
RESULTS: The average readability score for the first 20 search results of keywords "Hirschsprung disease" and "aganglionic megacolon" was 9.4, indicating a reading level just above the ninth grade. Readability ease was scored separately due to its unique scoring system on a scale of 0-100. Flesch Kincaid Readability ease score was averaged and resulted in a score of 46.4, which is considered "college level" or "difficult."
CONCLUSIONS: The average health consumer will turn to Google to find information about their own health, as well as the health of their loved ones. Hirschsprung disease in newborns presents a complex disease process and can be potentially life-threatening. Current resources available to the average health consumer averaged at a grade level of 9.4 relative to search results from keywords "Hirschsprung disease" and "aganglionic megacolon." Depending on the target audience for online information, more work needs to be done to improve readability for the average health information consumer.

Keywords:  aganglionic megacolon; click-through rate; health literacy; hirschsprung disease; online information; readability

DOI:  https://doi.org/10.7759/cureus.46806
Dig Dis. 2023 Nov 13.

Assessment of Internet Available Patient Information on Chronic Pancreatitis Using the Ensuring Quality Information for Patients Tool: A Systematic Search and Evaluation.

Sebastian M Staubli, Shahi Ghani, Harriet Walker, Giuseppe K Fusai, Dimitri A Raptis.

INTRODUCTION: Chronic pancreatitis (CP) is a relevant chronic medical problem whereby delayed presentation and poor patient understanding can cause adverse effects. Quality of patient information available on the internet about CP is not known.
METHODS: A systematic review of the information about CP available online using the search term "chronic pancreatitis" in using the search engine Google has been conducted. The quality of the top 100 websites returned from this search term were analysed using the validated Ensuring Quality Information for Patients (EQIP) tool (maximum score 36). Additional items were included in the website analysis specific to CP.
RESULTS: In total, 45 websites were eligible for analysis. The median EQIP score of the websites was 16 (IQR 12-19.5). The majority of websites originated from the United States and the United Kingdom with 31 and 11 websites, respectively. Provision of additional information was inconsistent, with most websites covering information regarding aetiology and advocating alcohol and tobacco cessation, but only few reporting on more complex issues.
CONCLUSION: Internet available information about CP is of limited quality. There is an immediate need for high quality, patient targeted and informative literature accessible on the internet about this topic.

DOI: https://doi.org/10.1159/000535073
Cureus. 2023 Oct;15(10): e46902

Online Patient Education Materials on Iron Deficiency Anemia Are Too Difficult to Read and Low Quality: A Readability and Quality Analysis.

Sajal Kulhari, Aaron B Ahn, James Xu, Jasmine Rhee, Gregory Cooper.

  Introduction Patients increasingly rely on online health information to understand and manage their diseases. Concerns about the quality and readability of these materials have been reported in the literature. Poor quality and difficult-to-read information lead to delayed diagnoses and adverse outcomes. We assessed the quality and readability of online health information about iron deficiency anemia (IDA) on Google. Method We searched for online web pages using the term "iron deficiency anemia"on Google. One hundred and twelve out of 200 web pages were included. We assessed web page typology, readability, the Journal of the American Medical Association (JAMA) score, the DISCERN score, and the Health on the Net Foundation certification (HONcode). Statistical analysis was performed with R version 4.2.2. Result Non-profit and scientific journal web pages were the most common. Scientific journal web pages were of the highest quality. News web pages were the most readable. The first Google Page web pages did not have greater JAMA scores or lower Flesch-Kinkaid Reading Grade Level (FKGL) and Simple Measure of Gobbledygook (SMOG) scores. Forty-six percent of all web pages were high-quality. Web pages on the first Google page were more likely to have HONCode certification. Conclusion We highlight gaps in the readability and quality of online information about IDA. Online web pages exceeded the recommended reading level for patients. Most web pages were low quality; only a quarter were HONcode-certified; and the first Google page web pages were not higher in quality than the later web pages on search.

Keywords:  anemia; iron deficiency anemia (ida); online health information; patient education; preventative medicine; quality improvement; readability

DOI:  https://doi.org/10.7759/cureus.46902
Facial Plast Surg Aesthet Med. 2023 Nov 17.

Assessing the Quality and Readability of Web-Based Information on Otoplasty.

Henriette Wa Katolo, Jasmine Derex-Briggs, Nicky Seymour, Simon Watts, Phillipe Bowles.

Introduction: As health care-related internet use expands, parents and patients considering otoplasty frequently turn to online resources for further information to aid their decision making. Objective: In online resources related to otoplasty, what is the quality of the information and how readable is it based on standardized tests? Methods: A web search was performed on the three major search engines, using search terms related to otoplasty. The top 20 results from each search engine were selected. The DISCERN instrument was applied to assess the quality of health information, whereas the Flesch-Kincaid readability tests were used to assess readability. Results: The mean DISCERN score was 28.7 out of a possible score of 80 (poor quality) and commercial bias was common. The Flesch-Kincaid readability test results were significantly higher than the average reading level for adults in the United Kingdom. On the largest search engine, there was a correlation between search engine ranking and both readability and quality. Conclusion: Online patient information resources on otoplasty are generally of poor quality and difficult to read for the average patient.

DOI: https://doi.org/10.1089/fpsam.2023.0162
Transl Androl Urol. 2023 Oct 31. 12(10): 1561-1567

Should I freeze my sperm?-readability and quality of health resources for sperm banking.

Reza Kianian, Andre Belarmino, Ilana Finkelshtein, Jesse N Mills, Sriram V Eleswarapu, Nicholas M Donin.

   Background: Sperm banking refers to the collection and storage of sperm cells for future use. Despite the recommendations of major medical societies, sperm banking is not discussed sufficiently with patients at risk of future fertility. Majority of Americans utilize the internet regarding health information. The aim of this study is to assess the reading level and the quality of online health information on sperm banking.
Methods: The top 50 search results from Google, Bing, and Yahoo were selected after searching for the term "sperm banking". Duplicate pages, advertisements, news and magazines, blog posts, videos, paid subscriptions, articles intended for health professionals, and non-related pages were excluded. Four validated readability and two quality assessment tools were used to score the text. Websites were divided into five categories: academic, hospital-affiliated, commercial, non-profit health advocacy, and non-categorized. Descriptive statistics, one sample t-test, and Pearson's correlation coefficient were used to analyze the data.
Results: Forty-one webpages were included. The mean Flesch Reading Ease Score (FRES) for all pages was 46.9/100 and the mean reading level was 11th grade, compared to the recommended 6th grade level, across various assessment tools. Utilizing the DISCERN Instrument, quality of online health information was fair. Seven percent of pages received a "good" quality score and no pages received a score of "excellent". On average, 1.5 out of 4 criteria categorized by the JAMA Benchmark, a validated quality assessment tool, were met. The hospital-affiliated webpages received the best reading scores and commercial pages received the highest quality scores.
Conclusions: Online health information on sperm banking available in English is of poor quality based on several quality assessment tools and at a reading level significantly higher than what is recommended. Further efforts are needed by providers and healthcare institutions to improve the quality of information available to patients.

Keywords:  Cryopreservation; consumer health information; readability; sperm bank

DOI:  https://doi.org/10.21037/tau-23-120
JSES Int. 2023 Nov;7(6): 2344-2348

Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material.

Matthew T Gulbrandsen, Olivia C O'Reilly, Burke Gao, Damion Cannon, Jose Jesurajan, Trevor R Gulbrandsen, Wesley P Phipatanakul.

   Background: The American Medical Association and National Institutes of Health recommend online health information be written at a 6th grade or lower reading level for clear understanding. While syntax reading grade level has previously been utilized, those analyses do not determine whether readers are processing key information (understandability) or identifying available actions to take (actionability). The Patient Education Materials Assessment Tool (PEMAT-P) is a method to measure the understandability and actionability of online patient education materials. The purpose of this study was to evaluate online resources regarding rotator cuff repair utilizing measures of readability, understandability, and actionability.
Methods: The search term "rotator cuff surgery" was used in two independent online searches to obtain the top 50 search results. The readability of included resources was quantified using valid objective algorithms: Flesch-Kincaid Grade-Level, Simple Measure of Gobbledygook grade, Coleman-Liau Index, and Gunning Fog Index. The PEMAT-P form was used to assess actionability and understandability.
Results: A total of 49 unique websites were identified to meet our inclusion criteria and were included in our analysis. The mean Flesch-Kincaid Grade Level graded materials at a 10.6 (approximately a 10th grade reading level), with only two websites offering materials at a 6th grade reading level or below. The remaining readability studies graded the mean reading level at high school or greater, with the Gunning Fog Index scoring at a collegiate reading level. Mean understandability and actionability scores were 64.6% and 29.5%, respectively, falling below the 70% PEMAT score threshold for both scales. Fourteen (28.6%) websites were above the threshold for understandability, while no website (0%) scored above the 70% threshold for actionability. When comparing source categories, commercial health publishers provided websites that scored higher in understandability (P < .05), while private practice materials scored higher in actionability (P < .05). Resources published by academic institutions or organizations scored lower in both understandability and actionability than private practice and commercial health publishers (P < .05). No readability, understandability, or actionability score was significantly associated with search result rank.
Conclusion: Overall, online patient education materials related to rotator cuff surgery scored poorly with respect to readability, understandability, and actionability. Only two (4.1%) of the patient education websites scored at the American Medical Association and National Institutes of Health recommended reading level. Fourteen (28.6%) scored above the 70% PEMAT score for understandability; however, no website met the threshold for actionability.

Keywords:  Actionability; Online patient education; Patient education; Readability; Rotator cuff; Shoulder; Understandability

DOI:  https://doi.org/10.1016/j.jseint.2023.06.016
Rev Assoc Med Bras (1992). 2023 ;pii: S0104-42302023001200617. [Epub ahead of print]69(12): e20230736

The concern about the educational quality of online videos on laparoscopic myomectomy.

Oguzhan Kuru, Ipek Betul Ozcivit Erkan, Elifnur Bicer.

OBJECTIVE: The aim of this study was to analyze the surgical content of the 50 most-viewed laparoscopic myomectomy videos on YouTube while evaluating the educational quality and accuracy of the videos.
METHODS: In this cross-sectional study, the keyword "laparoscopic myomectomy" was searched in publicly available content on YouTube, and the videos were sorted by view count using YouTube's advanced search options. Out of the first 66 videos, only 50 were eligible according to our selection criteria. One associate professor of gynecology and one gynecology resident watched these videos independently and evaluated the quality and surgical aspects. Our primary outcome was the scores of the Quality Criteria for Consumer Health Information and Global Quality Score and the features of the surgical technique.
RESULTS: The 50 most-viewed laparoscopic myomectomy videos were uploaded between 2010 and 2021. They had a mean of 66636.6±103772.2 views. According to the Quality Criteria for Consumer Health Information criteria, 78% of the videos were categorized as "poor," 12% of them were "fair," and 10% of them were "very poor." The indication of the surgery was not specified in 27 (54%) of them. The surgeons in 39 (79.6%) of the videos did not use any containment system for the power morcellation, even though it was restricted by the United States Food and Drug Administration. The preoperative and perioperative precautions to minimize blood loss were underemphasized. There was no scientific evidence in 49 (98%) of the videos.
CONCLUSION: Laparoscopic myomectomy videos on YouTube are limited in terms of providing evidence-based and well-organized scientific knowledge.

DOI: https://doi.org/10.1590/1806-9282.20230736
J Int Soc Sports Nutr. 2023 Dec;20(1): 2278632

Evaluation of the reliability and educational quality of YouTube™ videos on sport nutrition topics.

Anna Kiss, Sándor Soós, Ágoston Temesi, Brigitta Unger-Plasek, Zoltán Lakner, Orsolya Tompa.

BACKGROUND: YouTube is one of the most widespread social media channels, which is of growing importance in science communication and health education. The validity of medical and health-related information available on YouTube cannot be assured, and videos often contain potentially misleading or inaccurate information. Communication on sport nutrition may have a profound effect on the change in nutrition behavior among athletes, so evidence-based nutrition information must reach athletes. The main goal of the research is to evaluate the quality, reliability, and applicability of sports nutrition YouTube videos as educational material for athletes.
METHODS: A descriptive cross-sectional design was applied, and a systematic search was performed on YouTube. The quality and reliability of the videos were evaluated by applying the most frequently used and highly reliable scoring systems in the literature (e.g., DISCERN, Global Quality Score, and JAMA criteria) and a sports nutrition-specific scoring system (SNSS). Descriptive statistical analyses, two-sample t-test, Spearman correlation, Kruskal - Wallis, and Mann - Whitney U test were used to evaluate the results. A total of 114 YouTube videos met the inclusion criteria.
RESULTS: In 25% of the videos, the sports nutrition information was presented by a dietitian, while in two-thirds, coaches and athletes and other professionals shared sports nutrition knowledge. In terms of video content, the three most common topics were nutrition and health (33%), special diets (21%), and the training diet (17%). For the majority of the videos that received low GQS, JAMAS, DISCERN, and SNSS scores, the accuracy and quality of the analyzed YouTube videos on sports nutrition were inadequate. Videos uploaded by dietitians achieved significantly higher DISCERN, JAMAS, GQS, and SNSS scores. The GQS, SNSS, and DISCERN scores of videos from sports organizations, nonprofit organizations, and independent user sources were lower compared to videos uploaded by academic and professional organizations. Popular sport nutrition videos among users that contain personal stories or the experiences of athletes were deemed less reliable by experts or showed lower educational quality. Henceforth, we found a negative correlation between video popularity and JAMAS, GQS, and SNSS scores.
CONCLUSION: This study revealed that sports nutrition videos on the YouTube video platform show low accuracy and reliability. Professionals working with athletes need to consider misconceptions from sports nutrition videos in their nutrition counseling practice. Due to the popularity of the videos, professionals and professional organizations could use YouTube as an online educational tool to increase the nutrition knowledge of athletes.

DOI: https://doi.org/10.1080/15502783.2023.2278632
Orthod Craniofac Res. 2023 Nov 16.

YouTube™ as a source of parents' information for craniosynostosis.

Sara Samur Erguven, Kubra Gulnur Topsakal, Merve Aksoy.

   OBJECTIVE: This study aimed to evaluate the content, reliability and quality levels of YouTube™ videos regarding craniosynostosis for parents' information.
METHODS: A keyword search for 'craniosynostosis' was conducted on YouTube, and the uniform resource locators of the first 160 videos were initially recorded and evaluated. Ninety-four videos that met the inclusion criteria were analysed. Each video received a score ranging from 0 to 9 points, classifying them as low-content (0-3), moderate-content (4-6) and high-content (7-9). The reliability scores adapted from DISCERN and Global Quality Scale (GQS) scores were recorded.
RESULTS: The median content score for the videos was 4. According to the content scores, 34% of included videos (n = 32) were classified as low-content, 60.6% (n = 57) as moderate-content, and 5.3% (n = 5) as high-content. The median reliability score for the videos was 3, and the median GQS score was 3. The reliability and quality levels of videos classified as high-content and moderate-content were significantly superior to low-content videos (P < .05). Laypersons were identified as the most frequent source of information in the videos. However, most of the videos lacked information about syndromic/non-syndromic forms and specific complications. The importance of early referral/timing of surgery and minimally invasive surgical treatment techniques was mentioned in all high-content videos.
CONCLUSION: The results of the present study suggest that YouTube™ in its current format, is not a fully trustable source for parents seeking information on craniosynostosis. Craniofacial units must increase the content, quality and reliability level of videos on craniosynostosis.

Keywords:  YouTube™; craniofacial; craniosynostosis; healthcare information; social media

DOI:  https://doi.org/10.1111/ocr.12732
Medicine (Baltimore). 2023 Nov 10. 102(45): e35916

Assessing the scientific quality and reliability of YouTube videos about chemotherapy.

Elif Sahin, Mustafa Seyyar.

No studies have evaluated the interaction, quality, and reliability of chemotherapy-related videos published on YouTube. The aim was to evaluate the content of YouTube videos about chemotherapy using 5 different scoring tools. In this cross-sectional register-based study, popular videos on YouTube about the following keywords were examined; "chemotherapy," "what is chemotherapy," "types of chemotherapy," "chemotherapy side effects" and "chemotherapy treatments." Quality and reliability of video content were measured using the modified DISCERN (mDISCERN), the Journal of the American Medical Association (JAMA), the Global Quality Score (GQS), the Video Information Quality Index (VIQI), and Health on the Net code (HONcode) scores. A total of 108 videos were analyzed in the study. The median duration was 200 (30-2020) seconds and the median total number of views was 17500 (61-8615000). Among the video publishers, private hospitals were the most (n = 36, 33%). The most (n = 71, 66%) populer category of videos were patient education videos. Half (n = 55, 51%) of the narrators in the videos were only oncology professionals. Mean DISCERN, JAMA, GQS, VIQI, and HONcode scores were 2.73 ± 1.18, 1.97 ± 1.05, 2.94 ± 1.08, 14.03 ± 3.73, and 4.68 ± 2.46, respectively. A positive correlation was found between the 5 scoring points (P < .001 for all pairwise comparisons). There was a significant difference between video quality scores according to video categories and video publishers (P < .001 for both). Although most YouTube videos about chemotherapy were helpful to patients, content quality and reliability were moderate-low. Cancer patients looking for information on chemotherapy may find YouTube videos beneficial, but clinicians must be cautious to clear up any misunderstandings.

DOI: https://doi.org/10.1097/MD.0000000000035916
Nutrients. 2023 Oct 25. pii: 4515. [Epub ahead of print]15(21):

Diet-Nutrition Information Seeking, Source Trustworthiness, and Eating Behavior Changes: An International Web-Based Survey.

Maria A Ruani, Michael J Reiss, Anastasia Z Kalea.

  To understand the extent to which different sources of diet and nutrition information are sought, trusted, and relied upon for making dietary changes, the present international web-based survey study gauged participants' (n = 3419) diet-nutrition information-seeking behaviors from 22 interpersonal and general sources with varying quality, trust levels in these sources, and reliance on each source for making dietary changes. Qualitative insights were also captured regarding trustworthiness formation. The results revealed a disconnect between source popularity and perceived trustworthiness. While nutrition-health websites, Google-Internet searches, and diet-health books were most commonly consulted, participants placed the highest level of trust in nutrition scientists, nutrition professionals, and scientific journals, suggesting that frequent information seeking from a subpar source may not be a reliable predictor of the level of trust assigned to it. Although the frequency of source-seeking behaviors and source trustworthiness both contributed to dietary changes, the latter appeared to have a more pronounced influence. When a source was less trusted, there was a reduced likelihood of relying on it for changing diet. Additionally, source seeking may not always translate into effective dietary change, as shown by the less strong correlation between the two. These associations significantly differed depending on the source.

Keywords:  communication; dietary change; eating behavior change; information-seeking behaviors; literacy; misinformed beliefs; nutrition misinformation; public health; social media; source trustworthiness; sources of information

DOI:  https://doi.org/10.3390/nu15214515
Aesthet Surg J. 2023 Nov 16. pii: sjad350. [Epub ahead of print]

An Analysis of Male Plastic Surgery Content on TikTok.

Evan Rothchild, Daniel Chernovolenko, Fei Wang, Joseph A Ricci.

BACKGROUND: TikTok (ByteDance, Culver City, CA) is a powerful and popular source of patient education. However, the lack of content regulation raises concerns about the spread of medical misinformation.
OBJECTIVES: We aim to analyze the source, content, quality, and reliability of TikTok posts focusing on surgical and non-surgical cosmetic treatments focused on men.
METHODS: A search was conducted on TikTok using 16 popular hashtags related to male cosmetic procedures. The top 25 male-focused videos from each hashtag were chosen for analysis. Videos were categorized by content creator, video type, and descriptive metrics. Educational videos were evaluated for quality using the validated modified DISCERN (mDISCERN) score and the Patient Education Materials Assessment Tool (PEMAT) scale. Statistical analysis was performed using univariate and linear regression models.
RESULTS: The 399 included videos totaled 389 million views, 16.4 million likes, 174,594 comments, and 586,743 shares. Most videos were uploaded by Plastic and Reconstructive Surgeons (38.3%). A significant number (38%) of videos by physicians were posted by international physicians, with videos by United States physicians receiving fewer views, comments, and shares than videos posted by international physicians. Patient experience was the most common video category (48.9%). Educational videos had low overall quality, with physician-created videos demonstrating higher DISCERN and PEMAT scores but lower engagement compared to non-physician videos.
CONCLUSIONS: The quality of TikTok videos on male cosmetic surgery was generally low, emphasizing the importance of accurate information dissemination by physicians on social media. The strong presence of international physicians highlights the potential implications of social media on medical tourism.

DOI: https://doi.org/10.1093/asj/sjad350
World Neurosurg. 2023 Nov 13. pii: S1878-8750(23)01597-8. [Epub ahead of print]

Digital Health for Patients Undergoing Spine Surgery: A Systematic Review.

Vishal Venkatraman, Helen Heo, Samantha Kaplan, Beth A Parente, Shivanand P Lad.

   INTRODUCTION: Digital health tools, including smartphone apps, websites, and online search engines, are increasingly being utilized for health data collection and patient education. Studies have shown that these tools can help disseminate information widely and even help guide patients through acute surgical episodes. We aimed to search the literature to summarize available studies on using digital health tools for patients undergoing spine surgery.
METHODS: We conducted a systematic review of PubMed MEDLINE, Elsevier EMBASE, and Elsevier Scopus databases, as well as ClinicalTrials.gov up to March 11, 2022.
RESULTS: Forty-four full-text articles were included and qualitatively analyzed. Studies were broadly grouped into those that analyzed the quality of web-based materials for patients, the quality of YouTube videos for spine surgery, the development, feasibility, & implementation of mobile apps for patients, and randomized controlled trials for integrating mobile apps into perioperative care.
CONCLUSIONS: We presented a systematic review analyzing the current landscape of digital health for patients undergoing spine surgery. Internet patient education materials in searchable websites and YouTube videos are of poor quality, lacking in readability to the average patient and robustness of information needed for patients to make informed decisions about pursuing spine surgery. However, there lies promise in digital apps developed to guide patients through surgery and collect postoperative outcomes.

Keywords:  Digital Health; Mobile Apps; Patient Education; Spine Surgery

DOI:  https://doi.org/10.1016/j.wneu.2023.11.035
Aesthet Surg J. 2023 Nov 14. pii: sjad347. [Epub ahead of print]

Prejuvenation: What Social Media Tells Us about the Rising Trend.

Evan Rothchild, Geena Jung, Fei Wang, Joseph A Ricci.

BACKGROUND: "Prejuvenation," a practice gaining enormous popularity amongst younger adults, can largely attribute its explosive growth to TikTok (ByteDance, Culver City, CA), the platform where many first encounter this trend. Despite the rising usage of prejuvenation, however, there is a lack of clarity regarding its clinical practice and efficacy.
OBJECTIVES: To investigate the understandability, reliability, and actionability of prejuvenation-related TikTok content.
METHODS: TikTok was queried using 13 hashtags consisting of popular colloquial terms associated with prejuvenation treatments, and the top 25 videos meeting inclusion criteria for each hashtag were analyzed. For each video, poster credentials and video type were determined. Videos considered "educational" was analyzed using the validated modified DISCERN (mDISCERN) score and the Patient Education Materials Assessment Tool (PEMAT) scales. Creator's prejuvenation recommendations were recorded. Univariate and linear regression models were utilized for analysis.
RESULTS: 303 videos amassed over 61,000,000 million views, 3,957,091 likes, 24,455 comments, and 71,697 shares. Non-physicians posted the most videos (n = 257, 84.8%) and had significantly higher median views, likes, comments, and engagement than physician videos. Analysis of "educational" videos showed that most videos (50, 67%) supported the use of prejuvenation treatments, 18 (24%) were neutral, and 6 (8%) were opposed.
CONCLUSIONS: Prejuvenation content on TikTok varies widely in terms of quality and recommendations, calling for more standardization regarding the practice. Physician-generated prejuvenation content was more reliable, but distinguishing it from non-physician content is challenging, underscoring the need for platform-specific verification tools.

DOI: https://doi.org/10.1093/asj/sjad347
Eur Spine J. 2023 Nov 16.

Letter to the editor concerning "Large language models: Are artificial intelligence-based chatbots a reliable source of patient information for spinal surgery?" by R. Stroop et al. (Eur Spine J [2023]; doi:10.1007/s00586-023-07975-z).

Hinpetch Daungsupawong, Viroj Wiwanitkit.

DOI: https://doi.org/10.1007/s00586-023-08035-2