Consumer-oriented Web Sites Research Articles

Evaluation of consumer-oriented websites for menopause education

The author reports the findings of a study utilizing a systematic approach to review consumer-oriented websites on menopause to determine which are accurate and accessible and give nurse practitioners these resources to recommend to patients seeking more menopause information.

Readability, understandability and language accessibility of Swedish websites about the coronavirus disease 2019: a cross-sectional study

BackgroundThe COVID-19 pandemic has caused significant morbidity and mortality. To mitigate its spread, members in the general population were prompted to apply significant behavioral changes. This required an effective dissemination of understandable information accessible for people with a wide range of literacy backgrounds. The aim of this study was to investigate the readability, understandability and language accessibility of Swedish consumer-oriented websites containing information about COVID-19.MethodsWebsites were identified through systematic searches in Google.se (n = 76), and were collected in May 2020 when the pandemic spread started in Sweden. Readability and understandability were assessed with the Readability Index, the Ensuring Quality Information for Patients (EQIP) tool, and the Patient Education Materials Assessment Tool Understandability subscale (PEMAT-PU).ResultsThe median total sample score for Readability Index was 42.0, with the majority of scores being classified as moderate (n = 30, 39%) or difficult (n = 43, 57%). Median total sample scores were for EQIP 54.0% (IQR = 17.0, Range = 8–75) and for PEMAT-PU 60.0% (IQR = 14.75, Range = 12–87). The majority of the websites did not have any texts or links containing information in an alternative language (n = 58, 76%).ConclusionsSwedish websites contained information of difficult readability and understandability at the beginning of the coronavirus disease 2019 pandemic, with few providing information available in alternative languages. It is possible that these deficits contributed to the spread and impact of the virus. There is a need for studies investigating methods aiming to enhance the readability, understandability and language accessibility of web-based information at the beginning of an epidemic or pandemic.

Quality of web-based information at the beginning of a global pandemic: a cross-sectional infodemiology study investigating preventive measures and self care methods of the coronavirus disease 2019

Backgroundreducing the spread and impact epidemics and pandemics requires that members of the general population change their behaviors according to the recommendations, restrictions and laws provided by leading authorities. When a new epidemic or pandemic emerges, people are faced with the challenge of sorting through a great volume of varied information. Therefore, the dissemination of high-quality web-based information is essential during this time period. The overarching aim was to investigate the quality of web-based information about preventive measures and self care methods at the beginning of the COVID-19 pandemic.Methodsin May 2020, consumer-oriented websites written in Swedish were identified via systematic searches in Google (n = 76). Websites were assessed with inductive content analysis, the JAMA benchmarks, the QUEST tool and the DISCERN instrument.Resultsseven categories and 33 subcategories were identified concerning preventive measures (md = 6.0 subcategories), with few specifying a method for washing hands (n = 4), when to sanitize the hands (n = 4), and a method for sanitizing the hands (n = 1). Eight categories and 30 subcategories were identified concerning self care methods (md = 3.0 subcategories), with few referring to the national number for telephone-based counseling (n = 20) and an online symptom assessment tool (n = 16). Overall, the median total quality scores were low (JAMA = 0/4, QUEST =13/28, DISCERN = 29/80).Conclusionsat the beginning of the pandemic, substantial quality deficits of websites about COVID-19 may have counteracted the public recommendations for preventive measures. This illustrates a critical need for standardized and systematic routines on how to achieve dissemination of high-quality web-based information when new epidemics and pandemics emerge.

How hospitals can improve their public quality metrics: a decision-theoretic model.

The public reporting of hospitals' quality of care is providing additional motivation for hospitals to deliver high-quality patient care. Hospital Compare, a consumer-oriented website by the Centers for Medicare and Medicaid Services (CMS), provides patients with detailed quality of care data on most US hospitals. Given that many quality metrics are the aggregate result of physicians' individual clinical decisions, the question arises if and how hospitals could influence their physicians so that their decisions positively contribute to hospitals' quality goals. In this paper, we develop a decision-theoretic model to explore how three different hospital interventions-incentivization, training, and nudging-may affect physicians' decisions. We focus our analysis on Outpatient Measure 14 (OP-14), which is an imaging quality metric that reports the percentage of outpatients with a brain computed tomography (CT) scan, who also received a same-day sinus CT scan. In most cases, same-day brain and sinus CT scans are considered unnecessary, and high utilizing hospitals aim to reduce their OP-14 metric. Our model captures the physicians' imaging decision process accounting for medical and behavioral factors, in particular the uncertainty in clinical assessment and a physician's diagnostic ability. Our analysis shows how hospital interventions of incentivization, training, and nudging affect physician decisions and consequently OP-14. This decision-theoretic model provides a foundation to develop insights for policy makers on the multi-level effects of their policy decisions.

Quality of consumer-oriented websites containing information about the second trimester ultrasound examination during pregnancy

BackgroundProviding information about prenatal tests is a clinical challenge and the public frequently accesses the Web to read pregnancy-related information. The overarching aim of this study was to investigate the quality of consumer-oriented websites addressing obstetric ultrasound examination in the second trimester of pregnancy.MethodsSwedish websites were identified with Google, using 20 search strings and screening 400 hits (n = 71 included websites). Reliability and information about the examination were assessed with the DISCERN instrument, completeness was assessed according to national guidelines, and readability analyzed with the Readability Index. Popularity was determined with the ALEXA tool and search rank was determined according to Google hit lists.ResultsThe mean total DISCERN score was 29.7/80 (SD 11.4), with > 50% having low quality for 15 of the 16 questions. The mean completeness score was 6.8/24 (SD 4.5). The Readability Index ranged between 22 and 63, with a mean of 42.7 (SD 6.8), indicating difficult readability. Weak and non-significant correlations were observed between ALEXA/search rank and the investigated quality variables, except for search rank and reliability.ConclusionsThe quality of consumer-oriented websites addressing the second trimester ultrasound examination is low. Health professionals need to discuss this with expectant parents considering undergoing the examination. There is a need for efforts that aim to improve the poor quality of online sources in the field of prenatal examinations.

A systematic method for reviewing and analysing health information on consumer-oriented websites.

A discussion of a proposed method for analysing the quality of consumer-oriented websites that provide health-related information. The quality of health information available to consumers online varies widely in quality. In an effort to improve the quality of online information, experts have undertaken systematic reviews on selected health topics; however, no standardized comprehensive methodology currently exists for such review. An eight-step method is recommended embracing the following steps: (a) select topic; (b) determine the purpose of the analysis; (c) select search terms and engines; (d) develop and apply website inclusion and exclusion criteria; (e) develop processes and tools to manage search results; (f) specify measures of quality; (g) compute readability; (h) evaluate websites. Each of these steps is illustrated in relation to the health topic of gynaecomastia, a physical and mental health challenge for many adolescent males and young men. Although most extant analyses of consumer-oriented websites have focused on disease conditions and their treatment, website analysis methodology would encourage analyses that fall into the nursing care domain. The method outlined in this paper is intended to provide nurses and others who work with specific patient populations with the tools needed for website analytic studies. Such studies provide a foundation for making recommendations about quality websites, and identifying gaps in online information for health consumers.

Rate that journal.

Consumer-oriented websites allow researchers to compare the merits of scientific journals and review their publishing experiences.

Consumer information on fetal heart rate monitoring during labor: a content analysis: a content analysis.

Electronic fetal monitoring (EFM) is used for the majority of births that occur in the United States. While there are indications for use of EFM for women with high-risk pregnancies, its use in low-risk pregnancies is less evidence-based. In low-risk women, the use of EFM is associated with an increased risk for cesarean birth compared with the use of intermittent auscultation of the fetal heart rate. The purpose of this investigation was to evaluate the existence of evidence-based information on fetal heart rate monitoring in popular consumer-focused maternity books and Web sites. Content analysis of information in consumer-oriented Web sites and books was completed using the NVivo software (QRSinternational, Melbourne, Australia). Themes identified included lack of clear terminology when discussing fetal monitoring, use of broad categories such as low risk and high risk, limited presentation of information about intermittent auscultation, and presentation of EFM as the standard of care, particularly upon admission into the labor unit. More than one-third of the sources did not mention auscultation, and conflicting information about monitoring methods was presented. The availability of accurate, publically accessible information offers consumers the opportunity to translate knowledge into the power to seek evidence-based care practices during their maternity care experience.

Expanding Online Guidance: Creating a Consumer-oriented Website with Practical Solutions for Healthy Eating on a Budget

Expanding Online Guidance: Creating a Consumer-oriented Website with Practical Solutions for Healthy Eating on a Budget

Evaluating Consumer-Oriented Web Sites for Complementary and Alternative Medicine

Consumers and healthcare professionals need to exercise caution when seeking health care information of any type on the Web, but they need to exercise even greater caution when seeking nonstandard medical advice through complementary and alternative medical (CAM) web sites. The Health on the Net (HON) Foundation certifies web sites, but CAM information seekers need to engage in their own critical appraisals in addition to seeking out sites which enjoy HON certification. The web sites of the University of Maryland Medical Center, the National Center for Complementary and Alternative Medicine, and the Mayo Clinic are evaluated as sources of information about CAM.

Promoting Patient-Centered Preventive Care Using a Wellness Portal

Optimal delivery of preventive services requires appropriate information processing and patient involvement. However, information is limited in preventive service delivery that integrates health information technology (HIT). This study aimed to develop and pilot test an Internet-based wellness portal to facilitate patient-centered care. Guiding portal development, an advisory panel systematically identified portal elements/features and engaged in the Delphi technique to achieve consensus on portal structure. To pilot test the portal, 30 patients were randomly recruited from 2 practices to complete a questionnaire. Frequency statistics were compiled for structured questions, and content analyses were conducted to examine qualitative responses on portal utility. Participant age ranged from 23 to 83 years (mean, 41 years). About 78% were female, 22% were ethnic minorities, and 80% had some college education. The portal provides a personalized wellness plan for preventive services based on patient demographics, medical history, risk factors, medications, laboratory tests, and functions like symptoms tracking, access to education materials, and secure patient-practice communication. Patients rated the portal in ease of use, importance, and utility/value. Over 90% found the portal easy to use in terms of navigation, finding information, comprehension, and instructions. Patients regarded the portal as an important tool in achieving wellness, improving patient-practice interactions, and a valuable resource. Contents analyses showed that patients found the portal helpful, particularly its reminder and tracking functions. Patients with basic computer literacy may use a simple, consumer-oriented Web site to manage their preventive care. The portal exemplifies how HIT may encourage active patient participation in their care and potentially improve health outcomes.

Choosing The Best Hospital: The Limitations Of Public Quality Reporting

The call for accountability in health care quality has fueled the development of consumer-oriented Web sites that provide hospital ratings. Taking the consumer perspective, we compared five Web sites to assess the level of agreement in their rankings of local hospitals for four diagnoses. The sites assessed different measures of structure, process, and outcomes and did not use consistent patient definitions or reporting periods. Consequently, they failed to agree on hospital rankings within any diagnosis, even when using the same metric (such as mortality). In their current state, rating services appear likely to confuse, rather than inform, consumers.

Social Support Web-Based Resources for Patients with Chronic Pain

The authors performed an electronic search of websites that address psychosocial issues in pain management identified over 5 million sites. A search limited to pychosocial issue sin pain produced nearly 400,000. Nine scientific, professional and consumer-oriented websites were selected for review of social support information and opportunities using criteria focusing on patient information, referrals for counseling services and community-based assistance programs, self-help groups, specific pain syndromes, and readability and interpretability of consumer-oriented content. The internet can empower patients to self-manage their pain and seek out effective social support venues for improving their lives.

Safety and risk communication to patients

Comprehensive and accurate information about the medicines available to them is a key issue for patients to participate in the decision making process of their own healthcare. One aspect of this information is the patient information leaflet provided by the manufacturer, according to national and international guidelines. The comprehensibility and user-friendliness of these manufacturers’ leaflets has been tested and criticised. In addition to this information under the laws of national and international authorities, consumer-oriented websites of self-help groups are becoming a more and more relevant source of information. For most patients, the primary sources of information are healthcare professionals, such as the prescribing physicians and/or nurses or the dispensing pharmacist. The information provided for by healthcare professionals has to be tailored according to the patients’ needs, where law suits against physicians often address the comprehensiveness and a lack of documentation. Improvement of individualised drug information has been shown to increase patients’ satisfaction and treatment adherence, whereas the overall influence on outcome (i.e., reduction of adverse drug events) has still to be demonstrated. However, in order to achieve such a goal, striking changes in the whole system of pharmacovigilance have to be implemented with special emphasis on patients and consumers representation.

Advice from a Medical Expert through the Internet on Queries about AIDS and Hepatitis: Analysis of a Pilot Experiment

BackgroundAdvice from a medical expert on concerns and queries expressed anonymously through the Internet by patients and later posted on the Web, offers a new type of patient–doctor relationship. The aim of the current study was to perform a descriptive analysis of questions about AIDS and hepatitis made to an infectious disease expert and sent through the Internet to a consumer-oriented Web site in the Spanish language.Methods and FindingsQuestions were e-mailed and the questions and answers were posted anonymously in the “expert-advice” section of a Web site focused on AIDS and hepatitis. We performed a descriptive study and a temporal analysis of the questions received in the first 12 months after the launch of the site. A total of 899 questions were received from December 2003 to November 2004, with a marked linear growth pattern. Questions originated in Spain in 68% of cases and 32% came from Latin America (the Caribbean, Central America, and South America). Eighty percent of the senders were male. Most of the questions concerned HIV infection (79%) with many fewer on hepatitis (17%) . The highest numbers of questions were submitted just after the weekend (37% of questions were made on Mondays and Tuesdays). Risk factors for contracting HIV infection were the most frequent concern (69%), followed by the window period for detection (12.6%), laboratory results (5.9%), symptoms (4.7%), diagnosis (2.7%), and treatment (2.2%). ConclusionsOur results confirm a great demand for this type of “ask-the-expert” Internet service, at least for AIDS and hepatitis. Factors such as anonymity, free access, and immediate answers have been key factors in its success.

Endocrinology resources on the internet.

Endocrinologists and other medical subspecialists are increasingly turning to the Internet as a resource for use in clinical practice. The latest American Medical Association Study on Physicians’ Use of the World Wide Web reported that 37% of physicians have used the Internet, a substantial increase from the number identified on a similar survey completed 2 yr earlier (1). Market research surveys report that most practitioners use the Internet to search for information about specific diseases, to look up prescribing information, and to read online versions of medical journals (2). According to these sources, a significant number of practitioners also use e-mail to communicate with patients on a regular basis (3). Endocrinologists using the Internet in clinical practice face a number of challenges. The process of finding information involves sorting through an enormous quantity of content dispersed among an estimated 100,000 web sites containing health care information (4). The problem of identifying appropriate information is compounded by the fact that it is often difficult to distinguish physician-oriented resources from patient-oriented sites on summary review. Another formidable challenge lies in assessment of the quality of information available on the Internet. As an open-access resource, the Internet does not require any validation of information posted on individual web sites. The lack of enforced standards of documentation makes it difficult to determine whether specific content is reliable enough to be used as reference material. Among medical subspecialties, endocrinology is relatively well represented on the Internet, as evidenced by the number of topical pages retrieved with different search engine queries (Table 1). By way of demonstration, a search performed with a popular search engine using the general term “thyroid” returned a count of 465,000 indexed pages (5). A similar search performed using the specific term “diabetes mellitus” returned a count of 135,000 indexed pages (6). Common endocrine topics are highly visible on most of the major consumer-oriented web sites. A number of active online interest and support groups focus on discussion of specific endocrine disorders. This level of representation probably stems from the fact that clinical practice centers on the evaluation and treatment of chronic disorders incorporating specific knowledge, specialized diagnostic testing, and use of a wide variety of pharmacological agents and treatments. A selection of freely available, nonsubscription resources that may serve as useful starting points for exploration of the Internet are listed below. These include general and medical search engines, reference resources, and compilations of practice guidelines that have been selected based on their potential utility in real-time clinical practice. A home page address is provided for each site.

Design Quality of Websites for Electronic Commerce: Fortune 1000 Webmasters' Evaluations

This article presents a study of Fortune 1000 webmasters' perceptions of thirtyfive variables that support quality in the design of consumer-oriented web sites used for electronic commerce. The study combines consumer marketing constructs: Learning Capability, Playfulness, Service Quality with information systems constructs of Information Quality, System Quality, and System Use. The subjects have expert level knowledge related to quality issues in the design of web sites. Eighteen percent of the Webmasters responded to two formats of an electronic survey. The overall importance ratings correlated positively and significantly with the marketing and information systems research constructs, thus these constructs were shown as significant to well designed web sites for consumeroriented electronic commerce. Designers of web sites might apply these results.