Abstract
PurposeTransjugular intrahepatic portosystemic shunt (TIPS) procedure is an established procedure carried out by interventional radiologists to achieve portal decompression and to manage the complications of portal hypertension. The aim of this study was to evaluate the quality and readability of information available online for TIPS procedure.MethodsWebsites were identified using the search terms “TIPS procedure”, “TIPSS procedure”, “transjugular intrahepatic portosystemic shunt procedure”, with the first 25 pages from the three most popular search engines (Google, Bing and Yahoo) being selected for evaluation with a total of 225. Each Website was grouped by authorship into one of five categories: (1) Physician, (2) Academic, (3) For-profit, (4) Non-profit (including government and public health), or (5) Other (discussion/social media). Readability of each Website was assessed using the Flesch-Reading Ease score, Flesch–Kincaid grade level, Gunning-Fog Index, Coleman–Liau and SMOG index. Quality was calculated using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria and the presence of Health on the Net (HON) code certification.ResultsAfter disregarding duplicate and non-accessible Websites a total of 81 were included. The mean DISCERN score assessing the quality of information provided by Websites was “good” (59.3 ± 10.2) with adherence to the JAMA Benchmark being 54.3%. Websites with HON-code certification were statistically significantly higher in terms of DISCERN (p = 0.034) and JAMA scores (p = 0.003) compared to HON-code negative sites. The readability scores of Websites ranged from 10 to 12th grade across calculators. Thirty-two out of the 81 Websites were targeted towards patients (39.5%), 46 towards medical professionals (56.8%) and 3 were aimed at neither (3.7%). The medical professional aimed Websites were statistically significantly more difficulty to read across all readability formulas (all p < 0.001).ConclusionWhile quality of online information available to patients is “good”, the average readability for information on the internet for TIPS is set far above the recommended 7th-grade level. Academic Websites were of the highest quality, yet most challenging for the general public to read. These findings call for the production of high-quality and comprehensible content around TIPS procedure, where physicians can reliably direct their patients for information.
Highlights
Transjugular intrahepatic portosystemic shunt (TIPS) procedure is an established procedure carried out by interventional radiologists, and is preformed to achieveLim et al BMC Med Inform Decis Mak (2021) 21:149 portal decompression and to manage the complications of portal hypertension
The Shapiro–Wilk test was performed in order to analyse the distribution of the variables, and the results revealed the non-normal distribution of the values for Journal of the American Medical Association (JAMA) and Discern testing
The medical professional aimed Websites were statistically significantly more difficulty to read across all readability formulas
Summary
Transjugular intrahepatic portosystemic shunt (TIPS) procedure is an established procedure carried out by interventional radiologists, and is preformed to achieveLim et al BMC Med Inform Decis Mak (2021) 21:149 portal decompression and to manage the complications of portal hypertension. While TIPS procedure is usually well tolerated by patients, it is associated with numerous complications ranging from minor to life-threatening. For patients with hepatic encephalopathy refractory to medical therapy, further intervention to reduce the shut diameter or reversing the procedure by occluding the shunt may be necessary, but is associated with further risk [3,4,5]. With the chances of life-threatening complications and possible need for procedural reintervention, it is important for the patient to be well informed on the benefits and adverse outcomes associated with the procedure. Patients often use the internet as a source of information to research about their conditions and treatments available [8]. This information is unregulated and varies in quality. The popularity of health information on the internet is reflected by the increasing number of studies being published evaluating the quality of health-related information available online [9,10,11]
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