Patient-Directed Online Education for Carpal Tunnel Syndrome and Release: Analysis of What Patients Ask and Quality of Resources

Abstract

This study classifies common questions searched by patients from the Google search engine and categorizes the types and quality of online education resources used by patients regarding carpal tunnel syndrome (CTS) and carpal tunnel release (CTR). Google's results were extracted and compiled using the "People also ask" function for frequent questions and associated web pages for CTS and CTR. Questions were categorized using Rothwell's classification with further topic subcategorization. Web pages were evaluated by using Journal of the American Medical Association Benchmark Criteria for source quality. Of the 600 questions evaluated, "How do I know if I have carpal tunnel or tendonitis?" and "What causes carpal tunnel to flare up?" were the most commonly investigated questions for CTS. For CTR, frequent questions investigated included "How long after hand surgery can I drive" and "How do you wipe after carpal tunnel surgery." The most common questions for CTS by Rothwell classification were policy (51%), fact (41%), and value (8%) with the highest subcategories being indications/management (46%) and technical details (27%). For CTR, the most common questions entailed fact (54%), policy (34%), and value (11%) with the highest subcategories as technical details (31%) and indications/management (26%). The most common web pages were academic and medical practice. The mean Journal of the American Medical Association score for all 600 web pages was 1.43, with journals (mean= 3.91) having the highest score and legal (mean = 0.52) and single surgeon practice websites (mean= 0.28) having the lowest scores. Patients frequently inquire online about etiology, precipitating factors, diagnostic criteria, and activity restrictions regarding CTS/CTR. Overall, the quality of online resources for this topic was poor, especially from single surgeon practices and legal websites. Understanding the type and quality of information patients are accessing assists physicians in tailoring counseling to patient concerns and facilitates informed decision-making regarding CTS/CTR as well as guiding patients to high-quality online searches.