DISCERN Instrument Research Articles

Otosclerosis online: a critical analysis of quality, reliability, readability and content of otosclerosis information.

Several therapeutic options are usually discussed for otosclerosis management. Patients seek medical advice from an ENT specialist but are also increasingly using the internet for medical issues. This study intends to assess readability and quality of websites with information on otosclerosis. This is a cross-sectional study performed in a tertiary care centre. The results of the first two pages of a Google search with the keyword "otosclerosis" were reviewed by two independent investigators. Readability was assessed with the Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES) and Gunning Fog Index. For quality and reliability assessment, the 16-item DISCERN instrument was used. Spearman's coefficient was used for correlations, and multivariate analyses of variance were used to assess differences. Inter-rater agreement was evaluated with concordance correlation coefficient. 18 websites were included. Two websites (11.0%) were authored by academic institutions, 5/18 (28%) by government agencies, 6/18 (33%) by professional organisations and 5/18 (28%) were medical information websites. The mean DISCERN score of the 18 websites was 40.8 ± 6.7/80 (range 28.7-51.7), corresponding to "fair" quality. The mean FRES score was 43.27 ± 10.6, and the mean FKGL was 11.43 ± 2.30, corresponding to "difficult to read". The mean Gunning Fog index was 12.90 ± 2.19 (range 9.81-18.20), corresponding to a "college freshman" level. This study shows that internet information on otosclerosis has an overall low readability, while the quality is heterogeneous and varies from "poor" to "good". Efforts should be made to improve the readability of otosclerosis websites.

Video-Based Information About Plantar Fasciitis Reflects Current Treatment Guidelines.

Online health-related information has become increasingly popular. Social media platforms have great potential to support and change patients' perspective. Plantar fasciitis (PF) is a common disease that is one of the most frequently researched subjects among foot problems. This study aimed to assess the content, quality, and reliability of YouTube videos related to PF and to evaluate whether they reflect current PF treatment guidelines. The descriptive cross-sectional study analyzed the most viewed 79 YouTube videos retrieved by using the keyword "plantar fasciitis." The quality, reliability, and content of the videos were analyzed using Global Quality Scale (GQS), the modified DISCERN instrument, the Journal of the American Medical Association instrument, and a content scoring system by two independent physiotherapists. The analyzed videos were divided into three groups according to their GQS score as high, intermediate, and low quality. Also, video parameters were compared between the useful and misleading groups. Of the 79 analyzed videos, 26 (32.9%) were of low quality, 29 (36.7%) were of intermediate quality, and 24 were of (30.3%) high quality. Most high-quality videos were uploaded by allied health professionals (39.4%). The view ratio and video power index scores were highest in patients. There were significant differences between useful and misleading videos in terms of DISCERN, GQS, and Journal of the American Medical Association scores (P = .000, P = .000, and P = .020, respectively). Almost all of the evaluated videos contain at least one treatment approach. This study demonstrates that the vast of majority of YouTube videos on PF are useful and comprehensive; also, our results may lead us to propose that the vast majority of the videos reflect current treatment guidelines. Video-based information about PF may provide valuable insight to patients, especially in the absence of direct access to health care by stakeholders.

Most Online Resources for Home Suture Removal are Poor in Quality

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 are often not comprehensive and are below the standard quality for written information. Healthcare providers should consider referring their patients to validated online sources for suture removal to prevent misinformation and improve patient safety.

Evaluation of the quality of thyroidectomy-related posts on a video-based social media platform.

To evaluate the quality of thyroidectomy-related posts on TikTok, the fastest-growing social media platform worldwide. Videos posted from April 2020 to September 2022 were queried on TikTok using the search terms "thyroidsurgery," "thyroidectomy," and "thyroidremoval." Two reviewers recorded thematic, demographic, and performance data of these posts. The DISCERN instrument was used to evaluate the quality and reliability of the information contained in the videos. Descriptive statistics were used to characterize post-submitter demographics and video content. Simple and multiple linear regression analyses were used to evaluate the association between DISCERN scores and video characteristics. Univariate analysis of variance was performed to compare DISCERN scores between author types. In this study, 228 TikTok videos were included which totaled over 23 million views. On average, each video accumulated more than 6000 "likes," 300 comments, and 70 shares. The average total DISCERN score was 27.46, which is deemed to be of poor overall quality. Upon multiple linear regression, video duration (β = 4.66, p < .001) and educational subject type (β = 3.97, p < .001) significantly positively predicted aggregate DISCERN scores, while journey subject type (β = -3.19, p = .006), and reassurance subject type (β = -2.52, p = .035) significantly negatively predicted aggregate DISCERN scores. Aggregate DISCERN scores varied significantly (p < .05) between author types. Social media posts on TikTok about thyroidectomy are mostly of poor quality and reliability but vary by authorship, subject type, and video characteristics. Given its widespread popularity, TikTok videos may have an increasing role in shaping patient perception of thyroidectomy and may represent an opportunity to provide education. TikTok posts about thyroidectomy are mostly of poor quality but vary by authorship, subject, and video characteristics. Given its popularity, TikTok videos may have a role in shaping the patient perception of thyroidectomy and may represent an opportunity to provide education. Level 4.

Is YouTube Propagating Concerns About Breast Implant Illness?

An increasing number of patients who underwent breast implant surgery are reporting a cluster of concerning physical and psychological symptoms-newly coined term breast implant illness (BII). YouTube is a popular educational tool for plastic surgery patients. The purposes of this study were to assess the quality and reliability of YouTube videos on BII, compare the quality and reliability of different video categories and publishers, and determine the frequencies of reported BII symptoms. On YouTube, videos were searched for the term breast implant illness , and the first 100 results were collected. Engagement parameters and symptoms of BII mentioned in each video were recorded. Video power index, a modified DISCERN instrument, and the Global Quality Scale (GQS) were used to assess popularity, reliability, and quality, respectively. Ninety videos met the inclusion criteria. More than half mentioned fatigue (66%), cognitive dysfunction (59%), or muscle and/or joint pain (57%). Videos with a plastic surgeon present had higher DISCERN ( P = 0.001) and GQS ( P = 0.002) scores than those without. Educational videos had higher DISCERN and GQS scores than patient experience ( P < 0.0001, P = 0.001) and entertainment and advertisement videos ( P = 0.014, P = 0.022). Videos published by plastic surgeons had higher Video power index ( P = 0.033), DISCERN ( P < 0.0001), and GQS scores ( P < 0.0001) than those by nonmedical publishers. The top YouTube videos for BII are generally of low reliability and low-to-moderate quality. Patients unaware of YouTube's limited quality control measures for health education videos are susceptible to misinformation. Additional social media content created by plastic surgeons can improve the quality and accuracy of videos viewed by patients.

Assessment of Arabic Web-Based Knowledge About Clear Aligners: An Infodemiologic Study.

Orthodontic treatments aim to enhance dental aesthetics, functionality, and long-term oral health. Clear aligners have gained popularity as an aesthetic and convenient option for patients seeking orthodontic correction. However, the quality and readability of online Arabic patient-centered information regarding clear aligners has not been studied yet. The aim of our study is to investigate the quality and readability of Arabic patient-centered information about clear aligners. We conducted an extensive evaluation of Arabic web-based content pertaining to clear aligners using three prominent search engines. Eligible websites were categorized based on specialization, organizational affiliation, material type, and presentation style. We assessed website quality and reliability using the DISCERN instrument, Journal of American Medical Association (JAMA)benchmarks, and Health on the Net (HON) code. In addition, we measured readability using the Flesch Reading Ease Score (FRES), Simplified Measure of Gobbledygook (SMOG), and Flesch-Kincaid Grade Level (FKGL). Out of 600 search results, 195 websites met the inclusion criteria. None of the websites were HON-code accredited. DISCERN assessments revealed low content quality, with none of the websites achieving high-quality status. The JAMA benchmarks showed limited compliance with the four items, with currency being the most frequently achieved. Readability assessments indicated generally high readability, with FKGL scores suggesting easy comprehension for the average readers. While Arabic web-based information on clear aligners is highly readable, its credibility and quality require significant improvement. Websites should adhere to medical information standards, subject content to rigorous assessments, and seek accreditation to ensure reliability. Enhancing the accessibility and comprehensibility of health-related content will empower individuals to make informed health decisions. Addressing limitations, such as social media and video content evaluation, and conducting comparisons with English websites in future research will provide a more comprehensive understanding of the landscape of online orthodontic information.

Assessing the quality of complementary, alternative, and integrative medicine website information for cancer: A cross-sectional survey and analysis

IntroductionPatients with cancer frequently utilize complementary, alternative, and integrative medicine (CAIM); prior to this, many seek information about these therapies online. Little is known about the quality of this web-based consumer health information. Our study aimed to address this paucity of research by evaluating the quality of CAIM consumer health information on websites discussing the treatment and/or management of cancer. MethodsSix search terms were entered into Google across four English-speaking countries (Canada, United States, United Kingdom and Australia) on January 4, 2023. The first 20 results of each search were assessed and included if they contained CAIM consumer health information for the treatment and/or management of cancer. Eligible websites were assessed using the 16-item DISCERN instrument, designed to evaluate information quality. ResultsOf 480 identified websites, 393 were duplicates, and 48 fit the eligibility criteria and were assessed using the DISCERN instrument. Mean summed DISCERN scores across all websites was 48.28 (SD = 14.26), and mean scores of the overall quality of each website was 3.11 (SD = 0.66). Several website quality issues were identified, including a lack of transparency surrounding sources of information, areas of uncertainty regarding treatment, consequences of foregoing treatment, and treatment impacts on quality of life. ConclusionHealthcare providers should be aware that patients may use these websites for CAIM information. To facilitate informed decision-making, healthcare providers are encouraged to ask about patients’ usage and interest in CAIM and direct them to credible and trustworthy resources.

Qualitative Assessment of Vulvovaginal Health Information on Social Media

Adolescents and young adults use vulvovaginal hygiene practices, products, and treatments. Access to social media platforms allows health information, including gynecologic care, to be easily disseminated and more accessible. Our objective was to characterize and assess vulvovaginal health information available on a popular video-sharing social media platform. In this cross-sectional analysis study, search terms related to vulvovaginal health were included to assess the top videos appearing on June 15, 2022. Descriptive statistics, uploader demographic characteristics, and content characteristics were recorded for each video. Information quality was evaluated using the DISCERN instrument. One hundred and sixty-four videos met the study criteria with a combined total of over 500 million views, over 1.5 million shares, and nearly 60 million likes. Over 90% of videos consisted of educational content or product advertisements, and nearly 70% of videos provided information on general vulvovaginal hygiene and health. Seventy-five percent of videos were uploaded by private companies and nonmedical individuals. The mean DISCERN score was 1.6 out of 5. Medical providers scored significantly better than other uploaders on 12 of 16 DISCERN items, and mean overall publication quality scores were significantly higher for videos created by medical providers than nonmedical individuals and private companies (P < .0001). Social media platforms are a popular medium for vulvovaginal health information, accumulating over half a billion views within a short timeframe. Although medical providers had fewer shortcomings in their videos, the overall quality of health information shared was low, with serious or extensive shortcomings.

A quality analysis of internet patient information for immediate, sequential, bilateral cataract surgery (ISBCS).

Due to surgical capacity pressures, induced by the COVID-19 pandemic, immediate bilateral simultaneous cataract surgery (ISBCS) has been utilised increasingly throughout the U.K. This surgical method comes with both novel risks and benefits, so the consent process must be modified. Prior randomised trials have demonstrated that appropriate online information may act as an adjunct to the surgical consent process. This study aims to assess the quality of available internet information for ISBCS. Terms searched were 'bilateral cataract surgery patient information', 'double cataract surgery patient information', and 'immediate sequential bilateral cataract surgery patient information'. The Google search engine was used. The DISCERN instrument and JAMA benchmarks were used to assess healthcare information for quality. The Flesch Reading Ease Score (FRE), Flesch Kincaid Grade (FKG) Level and Gunning Fog Score (GFS) were used to assess for readability. HONcode certification was used to assess transparency and quality. Forty-six websites were found. The average DISCERN score was 41.3, meaning a "fair" quality which is below what many patients would anticipate discovering when trying to find information. National Healthcare Service websites had higher DISCERN scores than private healthcare-provided websites (p < 0.01; 95% CI: 1.13-1.88.). Fair patient information for ISBCS has been demonstrated. Specific internet information sources with appropriate information should be further developed, with cited sources, and patients signposted to them if felt appropriate.

Dietary and herbal supplement consumer health information for pain: A cross-sectional survey and quality assessment of online content

BackgroundPatients are increasingly utilizing the internet to learn about dietary and herbal supplements (DHSs) for various diseases/conditions, including pain management. Online health information has been found to be inconsistent and of poor quality in prior studies, which may have detrimental effects on patient health. This study assessed the quality of online DHSs consumer health information for pain. MethodsSix search items related to DHSs and pain were used to generate the first 20 websites on Google across four English-speaking countries. The identified 480 webpages produced 68 eligible websites, which were then evaluated using the DISCERN tool. The mean scores and standard deviations (SD) of the reviewers’ ratings on each of the 15 DISCERN instrument items as well as the overall total score were calculated. ResultsThe mean summed score for the 68 eligible websites was 46.6 (SD = 10.1), and the mean overall rating was 3.3 (SD = 0.8). Websites lacked information regarding areas of uncertainty, the effects of no treatment being used, and how treatments affect the overall quality of life. These shortcomings were especially apparent across commercial websites, which frequently displayed bias, failed to report the risks of DHS products, and lacked support for shared decision-making regarding the use of DHSs. ConclusionVariability exists in the quality of online consumer health information regarding DHS use for pain. Healthcare providers should be aware of and provide guidance to patients regarding the identification of reliable online resources so that they can make informed decisions about DHS use for pain management.

Web-Based Information on the Treatment of Dental Hypomineralization.

To categorise and evaluate the quality and readability of the web-based information about the treatment of the variety of forms of dental hypomineralization. An internet search using two different search terms regarding treating dental hypomineralization was conducted using the Google search engine. The first 100 websites from each search were analysed. Data recorded included DISCERN instrument scores, the Journal of the American Medical Association (JAMA) benchmarks, and the Health on the Net seal (HON). Flesch Reading Ease Scores (FRES), Flesch-Kincaid Grade Level (FKGL), the Simplified Measure of Gobbledygook Index (SMOG), and the Coleman-Liau index were calculated to assess readability. A search for "Treatment of hypomineralized teeth" on Google yielded 48,500 results. After excluding irrelevant websites, only 25 were evaluated based on affiliation with universities/medical centers, non-profit organizations, commercial entities, or government agencies. The majority of the content was medical facts presented as text and visuals such as images and videos. The study found that the scores for questions about the benefits and risks of treatment were low, while alternative treatments had high scores. Only one website met the HON code criteria, and a minority of websites achieved JAMA benchmarks. The readability ratings varied across different tests used in the study. Most websites had university or medical center affiliation but only partially related to the specialty. Two-thirds of websites used images. The online information was inaccurate, poor quality, and hard to read for the average person. Dental professionals should be aware of this information's quality and work to improve it.

A cross-sectional quality assessment of TikTok content on benign prostatic hyperplasia.

With an increasing reliance on online sources for medical information, we studied the quality and completeness of health literacy videos on TikTok regarding BPH. A cross-sectional systematic evaluation of TikTok videos using the search term "Benign Prostatic Hyperplasia" was performed on 14th April 2023, and included 49 patient information and educational videos. The videos were then analysed by two reviewers and scored using two instruments: the DISCERN instrument and a completeness analysis. Of the 49 videos, 38 were created by healthcare professionals (HCPs). The average length of each video was 62.7 ± 59.3s, with a large average number of total views (24,990.1 ± 109,534.9 views). The DISCERN score trended higher in every category in videos published by HCPs compared to non-HCPs, with HCPs providing a statistically significant increase in reliability (19.0,14.6, p < 0.05) and total score (29.4,23, p < 0.05). Majority of videos were deemed as poor or worse (91.8%) in quality. The completeness of the videos' content was also evaluated across five categories with an average score of 2.53 ± 2.1 out of the maximum 12. The DISCERN scores did not correlate with the degree of completeness of the videos (r = 0.226). BPH videos on TikTok have a wide reach, but the videos are mostly of low quality and completeness. Future videos should be made with quality and completeness in mind given the large viewership and more can be done to evaluate the extent of BPH misinformation and its impact on patients.

Co-Design of a website for women with pelvic organ prolapse: A study protocol.

Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for premenopausal women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing.Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate.Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed.The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

TikTok and YouTube Videos on Overactive Bladder Exhibit Poor Quality and Diversity.

We sought to assess the quality, understandability, actionability, and diversity of speakers in videos on TikTok and YouTube regarding overactive bladder. Using Application Program Interface, the top 500 TikTok and 120 YouTube videos on overactive bladder were retrieved. Videos unrelated to overactive bladder, those not in English, longer than 10 minutes, or lacking both text and audio were excluded. Surgical technique videos for providers were also excluded. Videos were scored by trained raters using 2 validated instruments: PEMAT (Agency for Healthcare Research and Quality's Patient Education Materials Assessment Tool) for actionability and understandability, and the DISCERN instrument for quality of consumer health information. We also examined for evidence of misinformation and commercial bias. One hundred thirty-six TikTok videos and 75 YouTube videos met inclusion criteria. Eighty-eight percent of TikTok videos had poor PEMAT actionability scores (a score below 75%), as compared to 60% of YouTube videos. Both YouTube and TikTok videos scored low on PEMAT understandability. Ninety-eight percent of TikTok videos and 65% of YouTube videos were poor quality (DISCERN score <3). YouTube videos had higher actionability and quality than TikTok videos (P < .001) but did not differ on understandability (P = .769). Twenty-three percent of TikTok and 11% of YouTube videos had high misinformation (score >3). Commercial bias was present in 10% of TikTok and 19% of YouTube videos. Actionability, understandability, and quality for overactive bladder-related content is poor on YouTube and TikTok. With increasing access to social media, it is important that health care providers and organizations invest resources in patient education on health literacy.

BPPV Information on Google VersusAI (ChatGPT).

To quantitatively compare online patient education materials found using traditional search engines (Google) versus conversational Artificial Intelligence (AI) models (ChatGPT) for benign paroxysmal positional vertigo (BPPV). The top 30 Google search results for "benign paroxysmal positional vertigo" were compared to the OpenAI conversational AI language model, ChatGPT, responses for 5 common patient questions posed about BPPV in February 2023. Metrics included readability, quality, understandability, and actionability. Online information. Validated online information metrics including Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease (FRE), DISCERN instrument score, and Patient Education Materials Assessment Tool for Printed Materials were analyzed and scored by reviewers. Mean readability scores, FKGL and FRE, for the Google webpages were 10.7 ± 2.6 and 46.5 ± 14.3, respectively. ChatGPT responses had a higher FKGL score of 13.9 ± 2.5 (P < .001) and a lower FRE score of 34.9 ± 11.2 (P = .005), both corresponding to lower readability. The Google webpages had a DISCERN part 2 score of 25.4 ± 7.5 compared to the individual ChatGPT responses with a score of 17.5 ± 3.9 (P = .001), and the combined ChatGPT responses with a score of 25.0 ± 0.9 (P = .928). The average scores of the reviewers for all ChatGPT responses for accuracy were 4.19 ± 0.82 and 4.31 ± 0.67 for currency. The results of this study suggest that the information on ChatGPT is more difficult to read, of lower quality, and more difficult to comprehend compared to information on Google searches.

Quality and Readability of Spanish-Language Online Information for Aortic Aneurysm and Its Endovascular Treatment.

Aortic aneurysms represent a chronic degenerative disease with life-threatening implications. In order for patients to comprehend health related information, it must be written at a level that can be readily understood. In January 2023, we searched "aneurisma aorta" and "endoprótesis aorta" terms on Google, Yahoo and Microsoft/Bing. The 31th websites provided by each search engine were analyzed. Four readability measures were used to evaluate websites regarding aortic aneurysm and their endovascular treatment in Spanish language: Flesch Index, Flesch-Szigriszt Index, Fernández-Huerta Index and grading Inflesz scale. The quality on information was evaluated by the HONcode seal, the DISCERN instrument and the JAMA benchmark criteria. 180 websites containing the terms "aneurisma aorta" and "endoprótesis aorta" were analyzed. Among the websites retrieved, the mean Flesh index score (53.12 ± 6.09 and 47.48 ± 7.12, respectively; P = .019), the Flesch-Szigriszt index (56.39 ± 5.72 and 48.10 ± 8.33; P = .000), and the Fernández Huerta index (61.30 ± 5.59 and 53.19 ± 8.21; P = .000), corresponding to a "somewhat difficult" readability level. In addition, the Inflesz scale (2.62 ± .59 and 2.07 ± .61; P = .000) reported a "somewhat difficult" readability, higher for the websites regarding aortic aneurysm. The HONcode seal was only presented in websites regarding aortic aneurysm (16.7%), whereas none of the websites relating to aortic endoprostheses presented it (0%) (P = .000). Websites that presented the HONcode seal obtained higher DISCERN score (P = .000, 95% CI = 6.42-16.84) and JAMA score (P = .000, 95% CI = 3.44-11.32). Internet information on aortic aneurysms and aortic endoprostheses is too difficult to read for the general Spanish-speaking population and is lacking in quality.

Sickle Cell Disease Stories on YouTube: A Comparison of Nigeria, Ghana, Uganda, and Kenya

Sickle cell disease (SCD) is a group of blood disorders common across Sub-Saharan Africa. Countries such as Nigeria and Ghana have a high prevalence of the inherited condition, which causes, for most patients, severe pain during a crisis and can lead to serious complications, such as anaemia and stroke. This study examines messaging about SCD in Kenya, Nigeria, Ghana, and Uganda posted on YouTube. It used DISCERN and Global Quality Score instruments to analyse a total of 58 videos from the four countries. Most were from news organizations. The most common DISCERN and Global Quality Score was a 3, which means the basic background information provided was not extensive but still useful. There was an association between the type of message and video uploader (Fisher's exact, p = 0.0001). However, no significant associations were found between the type of message and country (Fisher's exact, p = 0.219), using overall DISCERN and video uploader (Fisher's exact, p = 0.485), or using global quality score and video uploader (Fisher's exact, p = 0.818). The videos analysed not only gave the public some medical information but also addressed some of the social issues associated with SCD and helped to increase public awareness of the disease

Audiovisual information of oral epithelial dysplasia: Quality, understandability and actionability.

Online information on oral epithelial dysplasia (OED) is insufficient and of low quality. While only written information has been previously assessed, this study aims to evaluate the content and quality of audiovisual (AV) online information about OED. One hundred and twenty-seven materials were initially considered using six key words across two search engines (YouTube and Google). Ultimately, 29 materials remained for the final assessment. These materials were then analysed for content, quality (DISCERN instrument, JAMA benchmarks), understandability and actionability. Most contents were scientific (n = 25), while three videos were educational, and one video was a personal experience with OED. On a scale of 1-5, the overall DISCERN score was (mean ± SD = 2.26 ± 0.79), suggesting poor quality of information. Regarding JAMA benchmarks, there was no single material that fulfilled or lacked all four benchmarks. The overall mean understandability score was 82% and the actionability mean score was significantly low at 29%. Although the vast majority of AV materials on OED were primarily produced for scientific purposes, these materials could be helpful as resources for patient education. Keeping in mind, however, that the desired quality and essential patient information about OED available online remains largely poor and missing.

Co-Design of a website for women with pelvic organ prolapse: A study protocol

Background: Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. Methods: A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing. Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate. Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed. The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. Conclusion: This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

YouTube as a source of information on ectopic pregnancy: A qualitative and quantitative analysis.

The aim of this study was to assess the quality and reliability of YouTube videos on ectopic pregnancies for the public. We searched for the key terms "ectopic pregnancy", "ectopic birth" and "extra uterine pregnancy" on YouTube. Each video that met the inclusion criteria was analyzed by two independent raters. Quantitative and qualitative metrics were recorded, and the videos were scored using the DISCERN instrument. A total of 37 videos met the inclusion criteria. The mean overall DISCERN score was 44.5 ± 15.6. Videos had significantly a higher DISCERN score if they contained explanations on anatomy (pvalue <0.01), physiopathology (p-value <0.01), diagnosis (p-value = <0.01), treatments (p-value <0.01), symptoms (p-value <0.01), clear information (p-value <0.01), animations (p-value <0.01) and if it was a physician speaking (p-value <0.01). YouTube videos on ectopic pregnancy have been assessed to be only fairly reliable. We identified the five best ones using the validated DISCERN instrument. While ectopic pregnancy is not uncommon, YouTube videos should be improved to provide more accurate information for the public.