Journal Of The American Medical Association Benchmark Criteria Research Articles

Can ChatGPT answer patient questions regarding reverse shoulder arthroplasty?

IntroductionIn recent years, artificial intelligence (AI) has seen substantial progress in its utilization, with Chat Generated Pre-Trained Transformer (ChatGPT) is emerging as a popular language model. The purpose of this study was to test the accuracy and reliability of ChatGPT's responses to frequently asked questions (FAQ) pertaining to reverse shoulder arthroplasty (RSA). MethodsThe ten most common FAQs were queried from institution patient education websites. These ten questions were then input into the chatbot during a single session without additional contextual information. The responses were then critically analyzed by two orthopedic surgeons for clarity, accuracy, and the quality of evidence-based information using The Journal of the American Medical Association (JAMA) Benchmark criteria and the DISCERN score. The readability of the responses was analyzed using the Flesch-Kincaid Grade Level. ResultsIn response to the ten questions, the average DISCERN score was 44 (range 38–51). Seven responses were classified as fair and three were poor. The JAMA Benchmark criteria score was 0 for all responses. Furthermore, the average Flesch-Kincaid Grade Level was 14.35, which correlates to a college graduate reading level. ConclusionOverall, ChatGPT was able to provide fair responses to common patient questions. However, the responses were all written at a college graduate reading level and lacked reliable citations. The readability greatly limits its utility. Thus, adequate patient education should be done by orthopedic surgeons. This study underscores the need for patient education resources that are reliable, accessible, and comprehensible. Level of evidenceIV.

Is YouTube a Sufficient and Reliable Source to Inform Patients About Cardiac Rehabilitation?: A Cross-sectional Study.

There is a growing concern surrounding the utility of medical content on social media. In this study, the popularity metrics and content quality of cardiac rehabilitation (CR) videos on YouTube regarding patient education were examined. Using the search key word "cardiac rehabilitation," we analyzed the 50 most relevant videos. Our video popularity analytics encompassed viewing rate, such as ratio, number of comments, and the video power index (VPI). We assessed content quality using the Global Quality Scale (GQS), the modified DISCERN questionnaire, Journal of the American Medical Association ( JAMA ) benchmark criteria, Patient Education Materials Assessment Tool for Audio/Visual Materials (PEMAT-A/V), and a novel tool, the Cardiac Rehabilitation Specific Scale (CRSS). Notably, 78% of the videos were uploaded by medical organizations. The average viewing rate was 4.6 views per day. There were positive correlations between the scores from different content quality scales. Median scores for the GQS, the modified DISCERN questionnaire, JAMA benchmark criteria, and the CRSS were 3, 3.5, 2, and 5, respectively. Mean PEMAT-A/V scores were 60.4% for understandability and 38.3% for actionability. Videos published by entities other than medical centers predicted lower CRSS and GQS scores. High JAMA benchmark criteria scores were negative predictors of VPI, view rate, and number of comments. Our findings suggest that CR-related videos on YouTube are characterized by low popularity, average content quality and understandability, but a lack of reliability and actionability. To ensure individuals seek accurate CR information on social media platforms, we recommend directing them to videos uploaded by medical centers.

ChatGPT-3.5 Responses Require Advanced Readability for the General Population and May Not Effectively Supplement Patient-Related Information Provided by the Treating Surgeon Regarding Common Questions About Rotator Cuff Repair

The purpose of this study was to investigate the accuracy of ChatGPT's responses to frequently asked questions (FAQ) prior to rotator cuff repair surgery. The ten most common FAQs related to rotator cuff repair were compiled from four institution websites. Questions were then input into ChatGPT-3.5 in one session. The provided ChatGPT-3.5 responses were analyzed by two orthopedic surgeons for reliability, quality, and readability using The Journal of the American Medical Association (JAMA) Benchmark criteria, the DISCERN score, and the Flesch-Kincaid Grade Level. The JAMA Benchmark criteria score was 0, indicating the absence of reliable source material citations. The mean Flesch-Kincaid Grade Level was 13.4 (range, 11.2-15.0). The mean DISCERN score was 43.4 (range, 36-51) indicating that the quality of the responses overall was considered fair. All responses cited making final decision-making to be made with the treating physician. ChatGPT-3.5 provided substandard patient-related information in alignment with recommendations from the treating surgeon regarding common questions around rotator cuff repair surgery. Additionally, the responses lacked reliable source material citations and the readability of the responses was relatively advanced with a complex language style. The findings of this study suggest that ChatGPT-3.5 may not effectively supplement patient-related information in the context of recommendations provided by the treating surgeon prior to rotator cuff repair surgery.

Online Videos Regarding Relevant Postoperative Patient Information and Postoperative Rehabilitation After Arthroscopic Rotator Cuff Repair Provide Poor Information Quality, Accuracy, and Reliability

To evaluate the information quality, accuracy, and reliability of YouTube videos regarding relevant postoperative patient information and postoperative rehabilitation after arthroscopic rotator cuff repair. By use of The Onion Router (TOR) software and predefined search terms, 102 videos were assessed. Four scoring systems were used to evaluate included videos: (1) Journal of the American Medical Association (JAMA) benchmark criteria score; (2) Global Quality Score (GQS); (3) DISCERN score; and (4) a newly developed score, the Rotator Cuff Score (RCS). The RCS (0-30 points) was built based on the latest published evidence and guidelines from the American Academy of Orthopaedic Surgeons. Videos that scored up to 9 points were regarded as poor-quality videos. Most of the included videos provided poor information quality, accuracy, and reliability. Videos that were uploaded by medically trained professionals showed significantly better results for all scores compared with commercial or personal-testimony videos (JAMA benchmark criteria score, P < .001; GQS, P < .001; DISCERN score, P= .001; and RCS, P= .001). Multivariate linear regression showed that the involvement of medically trained professionals was a significant predictor of better results for all scores (JAMA benchmark criteria score, β= 1.496 [P < .001]; GQS, β= 1.105 [P < .001]; DISCERN score, β= 11.234 [P < .001]; and RCS, β= 5.017 [P < .001]). Surprisingly, the like ratio was significantly higher for videos that were uploaded by non-medically trained individuals (P= .041). The average information quality, accuracy, and reliability of YouTube videos regarding relevant postoperative patient information and postoperative rehabilitation after arthroscopic rotator cuff repair are poor. Videos from medically trained professionals provide significantly higher information quality; however, even these videos lack important information for a better understanding of arthroscopic rotator cuff repair. Because of the lack of a peer-review process, available videos on YouTube regarding relevant postoperative patient information and postoperative rehabilitation after arthroscopic rotator cuff repair are of low quality, accuracy, and reliability. However, patients increasingly visit YouTube to gather medical knowledge. Physicians should enlighten patients about these findings and should be able to provide alternative sources of high-quality information.

Proximal Humerus Fracture: An Evaluation of the Readability and Value of Web-Based Knowledge.

BackgroundIn today’s scientifically developed world, the majority of patients use different websites to explore sophisticated and varied health knowledge. Consequently, healthcare specialists remain concerned that patients may be betrayed. Currently, there is a scarcity of information on the importance and legibility of online health data on proximal humerus fractures. This study aimed to assess the readability and value of existing web-based evidence regarding fractures of the proximal humerus.MethodologyA search of three keywords, namely, broken shoulder, proximal humerus fracture, and broken humerus, was performed using the top three internet search engines. The first five pages of every search browser were analyzed. After discarding duplicate websites, 80 websites were found to be suitable for the analysis. Website quality was scored using the Journal of the American Medical Association (JAMA) benchmark criteria and the DISCERN criteria. The presence or absence of the Health on the Net Foundation Code of Conduct (HON code) certification and author characteristics were noted. The degree of readability was measured using six unique parameters, namely, the Automated Readability Index, Flesch Reading Ease Score, SMOG Index, Coleman-Liau index, Flesch-Kincaid Grade Level, and Gunning-Fog Index.ResultsIn total, 80 specific websites were fit for evaluation and analysis. On the DISCERN tool, six (7.5%) websites revealed a high score. Only 20 websites fulfilled all four JAMA benchmark criteria. Of the total 80, only 17 were HON code-certified websites. Readability was variable but the majority was at the college level.ConclusionsThe most important result of this study is the low value, readability, and clarity of online testimony regarding proximal humerus fractures.

Evaluation of the quality of information online for arthroscopic Bankart repair.

The purpose of this study was to evaluate the quality and readability of information online for patients searching terms related to arthroscopic Bankart repair (ABR). Google, Yahoo and Bing were searched with terms related to ABR. The quality of information was assessed using the Journal of the American Medical Association (JAMA) Benchmark criteria, DISCERN Score, and the Flesch-Kincaid Reading Ease & Grade Level. The presence of the HONcode marker was noted. Additionally, we used a scoring system specific to content relating to the ABR (AB score), a 1-20 Likert scale. Websites were also categorised according to the source: academic institution, physician, allied healthcare, commercial, media or social media. Statistical analysis was performed using GraphPad Prism. Ninety-six unique websites were evaluated, with the most common website category being physician websites (52) and academic institution websites (24). There were nine websites with the HONcode marker. The average JAMA Benchmark criteria score was 1.95 (1-4), the average DISCERN score was 48.8 (20-78), with an average Flesch-Kincaid reading ease of 50.9 (11-96) and grade level of 8 (1-18). The average AB score was 5.9 (0-18), and there was a strong correlation with a higher DISCERN score (r=0.57), but not JAMA score (r=0.18) or Flesch-Kincaid grade (r=0.16). Websites with the HONcode marker did not score higher in any criteria than those without it (p>0.05). The quality of information on physician websites was better than (statistically insignificant) non-physician websites; however, the readability of information in the former was poorer (statistically significant) than the latter. There was wide variability in the quality and readability online of the information on ABR, and the AB scoring system was shown to correlate strongly with increased quality.

An Investigation of Google Searches for Knee Osteoarthritis and Stem Cell Therapy: What are Patients Searching Online?

Stem cell therapies have emerged as a potential treatment for osteoarthritis (OA), but their role remains controversial. Their growing popularity may lead patients to search for information online, but search queries and sources are unknown. We sought to (1) identify the most frequently asked questions on Google related to knee OA and stem cell therapy, (2) assess the types of websites accessed through these searches, and (3) evaluate the transparency of these websites. The search terms "knee," "osteoarthritis," and "stem cell" were entered into Google. Frequently asked questions suggested by Google, and their corresponding websites were extracted. Questions and websites were classified by type. Journal of the American Medical Association (JAMA) benchmark criteria were used as a measure of website transparency (range: 0-4). Analysis of variance tests were performed to compare JAMA benchmark criteria between website types. Of the 145 questions and website extracted, the most common question subtype pertained to non-stem cell treatments (41.4%) for knee OA; the most common website types were medical publishers (24.8%) and nonacademic medical practices (22.8%). JAMA scores were highest for medical publishers (mean: 3.81) and lowest for nonacademic medical practices (mean: 1.55). Nonacademic medical practices had significantly worse JAMA scores compared with commercial, academic, and medical publishers. The most frequent questions pertained to non-stem cell treatments, although questions related to stem cell efficacy were most common among the 10 most frequent questions. Google searches on knee OA and stem cell therapies often directed the user to websites lacking transparency and verifiable information. Further research is warranted.

YouTube and the Achilles Tendon: An Analysis of Internet Information Reliability and Content Quality.

Purpose: To evaluate the educational content, quality, and reliability of YouTube videos regarding the Achilles tendon and Achilles tendon injuries.Methods: The first 50 videos found on YouTube after searching “Achilles tendon” were evaluated and classified by content type and uploader source. Reliability and accuracy were assessed using the Journal of the American Medical Association (JAMA) benchmark criteria, nonspecific educational content was assessed via the Global Quality Score (GQS), and specific educational content was assessed using the Achilles Tendon Specific Score (ATSS). ANOVA was performed to determine differences in video reliability and educational content quality by video content type and source. Multivariate stepwise regressions were used to evaluate the effects of specific video characteristics on JAMA benchmark criteria, GQS, and ATSS.Results: The 50 videos evaluated had a cumulative view total of 53,323,307, a mean of 1,066,466, and a range of 1,009 to 42,663,665 views per video. Most videos focused on disease-specific information (38%) and exercise training (22%). Most videos were uploaded by non-physicians (34%) or medical sources (health websites) (32%). A higher view ratio was an independent predictor of lower JAMA scores (lower reliability and accuracy) (standardized beta = −0.281, P = 0.048) and increased video duration was an independent predictor of greater GQS (standardized beta = 0.380, P = 0.007) and ATSS scores (standardized beta = 0.364, P = 0.009) (increased quality of nonspecific and specific educational content).Conclusion: Videos on YouTube regarding the Achilles tendon were viewed numerous times, but their educational content and reliability were poor. Providers treating patients for Achilles tendon-related pathologies should initiate a dialogue with patients about their use of internet sources and should educate them on their optimal usage. They should warn them of the low quality of YouTube-derived information and provide them with reliable sources that may better give them control over their own care.

A Systematic Evaluation of the Quality, Accuracy, and Reliability of Internet Websites about Pulmonary Arterial Hypertension.

Rationale: Patients with pulmonary arterial hypertension (PAH) or their caregivers may seek information about their disease online, but the accuracy and quality of websites on PAH is not known. Objectives: To assess the quality, reliability, and accuracy of information on websites about PAH. Methods: We searched Google, Yahoo, and Bing for "pulmonary arterial hypertension" and screened the first 200 sites from each search engine. Website quality was evaluated by two authors using the validated DISCERN tool (best score is 80) and the Journal of the American Medical Association (JAMA) benchmark criteria (best score is 4). Content accuracy was assessed according to 39 prespecified disease-relevant topics from international PAH guidelines. Linear regression models and generalized estimating equations were used to assess the association between website characteristics with JAMA benchmark criteria, DISCERN scores, and content scores. Results: One hundred seventeen eligible sites were included (50% scientific organizations, 20% foundation and/or advocacy organizations, 14% industry or for-profit, 12% personal commentary or blogs, and 4% news and media sites), with most sites hosted in North America. The median time since last website update was 1.2 years (interquartile range [IQR], 0.4-2.6). Website readability was at the high school or college education level (Flesh Reading Ease score 39.9 ± 15.2; reading grade, 11.9 ± 2.7), which is more challenging than the recommendation by the American Medical Association for patient medical information to be written at fifth- to sixth-grade levels. Only 23% had Health on the Net Code of Conduct certification for ethical presentation of healthcare information. The median DISCERN total score and JAMA benchmark score were 29.5 (IQR, 22.5-35.5) and 1.5 (IQR, 0.5-2.5), respectively, indicating poor transparency, reliability, and quality of information. Foundation/advocacy organization sites had higher DISCERN scores than personal commentary/blog sites and higher content scores than industry/for-profit sites. Websites with Health on the Net Code of Conduct certification were more reliable and had higher JAMA benchmark scores. A minority of websites addressed exercise/rehabilitation, palliative care, pregnancy, and financial concerns relevant to patients. Conclusions: Most internet websites on PAH were not easily readable, comprehensive, or transparent. Using a systematic appraisal approach, we identified the highest-quality internet websites with balanced and accurate coverage of relevant issues and treatment options for patients with PAH, which may be useful for patients, caregivers, and clinicians.

Evaluating the quality and readability of online information on keratoconus treatment

ObjectiveThis study aims to evaluate the quality and readability of online resources on keratoconus treatment. MethodsA Google.com search was conducted on August 9, 2020; 32 web sites were selected for analysis. Popularity was assessed by Google and Alexa rank. The quality of web sites was analyzed using the quality criteria for consumer health information (DISCERN) tool, the Journal of the American Medical Association (JAMA) benchmark, and the Health On the Net Code of Conduct Certification (HONcode). The readability of the web sites was assessed using the Fleschwebr hea Reading Ease, the Automated Readability Index, and the Fleschted Readability ResultsThe JAMA benchmark scores, unlike the DISCERN scores, were correlated with the Google and Alexa rank. One web site (3.1%) met all the JAMA benchmark criteria, and 3 (9.3%) others had HONcode certification. The median DISCERN score was 33 (range, 29.6–43.1; maximum possible, 80). Rnib.org.uk scored the highest at 57 (71.0%). The mean Flesch–Kincaid Reading Ease score (52.9 ± 7.1) corresponded to uk" n DIdifficult to read.” Thirty-one web sites (96.8%) had a Flesch–Kincaid Grade higher than the American Medical Association recommendation of sixth grade level. The median Automated Readability Index score was 7 (range, 6.2–7.3). ConclusionThe majority of online information currently available on keratoconus treatment is complex and highly variable. Rnib.org.uk is the best currently available source. Clinicians should inform patients on how to assess the credibility of online information and recommend suitable information sources.

The Quality, Reliability, and Popularity of YouTube Education Videos for Vestibular Rehabilitation: A Cross-sectional Study.

Vestibular rehabilitation (VR) education videos on YouTube are poor-quality and unreliable. YouTube has become a health information source. Recent studies have determined that videos on YouTube contain misleading and inappropriate information for different medical conditions. The aim of the present study was to assess the quality and reliability of VR education videos. A search was performed using the keywords vertigo, vertigo treatment, vertigo exercise, and vestibular rehabilitation, on YouTube. The first 50 videos for each keyword were analyzed. Videos were divided into four groups according to the video source: Group 1: universities/occupational organizations, Group 2: medical ad/profit-oriented companies, Group 3: independent users, and Group 4: others (news/media/state institution). The quality and reliability of videos were evaluated regarding the modified DISCERN criteria, the modified Journal of the American Medical Association (JAMA) benchmark criteria, and global quality scores (GQS). Among the 200 videos analyzed, 103 were included. The main video source was medical ad/profit-oriented companies (60.2%). The mean modified DISCERN criteria score, the mean modified JAMA benchmark criteria score, and the mean GQS value of the videos were found as low (2.46 ± 1.37, 2.09 ± 1.23, and 2.67 ± 1.38, respectively). Videos uploaded by universities/occupational organizations (25.2%) had statistically significant higher modified DISCERN criteria scores, modified JAMA benchmark criteria scores, and GQS values compared with the other groups (p < 0.001). Online information about VR education on YouTube was of poor quality and unreliable. Expert vestibular providers should be aware of these inappropriate sources and educate patients regarding the poor-quality of videos and also aim to provide more quality and reliable sources of information.

Glioblastoma: assessment of the readability and reliability of online information

Introduction Glioblastoma Multiforme (GBM) represents one of the most common and most aggressive forms of brain tumours with a poor prognosis. There is often uncertainty around diagnosis and prognosis amongst patients diagnosed with cancer. Most patients rely on internet to access health-related information. The aim of this study was to assess the readability and reliability of online information on GBM. Methods The terms ‘Glioblastoma’ and ‘GBM’ were used to search Google and the first 50 websites identified were screened. For each website, the quality of each website was assessed using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria and the Health on the Net Foundation code certification (HON-code). The readability was assessed using the Flesch Reading Ease Score (FRE), the Flesch-Kincaid grade level (FKGL) and the Gunning Fog Index (GFI). The relevant patient information by 4 International patient information websites were also assessed. Results Following screening, 31 websites met the inclusion criteria with only four websites displaying the HON-code (12.9%). The median DISCERN score was 43 (range: 17–70) corresponding to ‘fair’ quality, and the median JAMA benchmark criteria score was 1. Display of the HON-code certificate or the publication date was associated with higher quality websites. The median FRE score corresponded to ‘difficult’ to read (34.4). The median GFI score (15.9) and FKGL score (13.3) corresponded to a ‘college’ level of education reading ability. The Cancer Australia online information was the most readable website while Cancer Research UK had the highest quality information. Conclusion The readability and reliability of online information relating to GBM is inadequate. Health professionals need to provide or guide patients to information that is both readable and reliable.

Osteotomy around the knee: Assessment of quality, content and readability of online information

BackgroundAs knee osteotomy surgery becomes increasingly accessible, more patients may turn to the Internet for information. This study examined the source, quality, content and readability of online information regarding osteotomy around the knee. MethodsThe first 70 websites returned by the top four search engines were identified using the key words: “knee osteotomy” and “high tibial osteotomy.” The websites were categorised by type and assessed using the DISCERN score, Journal of the American Medical Association (JAMA) benchmark criteria and a novel Knee Osteotomy-Specific Score (KOSS). The presence of the Health On the Net (HON) code accreditation seal was noted. Readability of each website was assessed using eight readability formulae. The mean reading grade level (RGL) was compared to the 6th and 8th grade reading levels. The mean RGL of each category was also compared. ResultsOf the 45 unique websites analysed, the majority were Physician (33%) and Journal websites (31%). The mean DISCERN score was 36.7 (±8.9) which is classified as ‘poor.’ The mean JAMA benchmark criteria score was 2.04 (±1.5) and Physician websites were most likely to be scored zero. The mean KOSS was 15.4 (±5.7). The highest scoring website was a Commercial site but, overall, Journal category sites provided the best quality information. Websites that bore the HONcode seal obtained higher DISCERN, JAMA benchmark criteria and Knee Osteotomy - Specific Scores.The cumulative mean RGL was 13.2 (±2.2) which exceeded the 6th grade level by an average of 7.2 grade levels and the 8th grade level by an average of 5.2 grade levels. No website (0%) was written at or below either the 6th or the 8th grade reading levels. The mean Flesch Reading Ease Score of all websites was 41.13 (±14.7) which is classified as ‘difficult.’ Journal websites had the highest RGL. ConclusionThe information available online regarding osteotomy around the knee varies tremendously in quality and completeness. Physician sites predominate, but these were among the lowest scoring of all websites. Even where high quality information is available, it is set at too high a level to be easily understood. Level of evidenceSurvey of materials – Internet.

Evaluating YouTube as a Source of Patient Information for Functional Endoscopic Sinus Surgery.

To evaluate the quality of information presented on YouTube regarding functional endoscopic sinus surgery (FESS) for patients. YouTube was searched using FESS-specific keywords under the setting of "relevance." The first 50 videos from each keyword were reviewed and analyzed by 2 independent physician reviewers. Videos not related to FESS and duplicates were excluded. Outcome measures included the modified DISCERN score (range 0-5), the Journal of the American Medical Association (JAMA) benchmark criteria (range: 0-4), a novel scoring checklist for FESS assessing usefulness (range: 0-16), and the Video Power Index (VPI). Intraclass correlation coefficient (ICC) was calculated. Of the 200 videos identified, 95 videos were analyzed after exclusions. Videos had an average VPI of 40.8 and SD 133.2. Average scores from the 3 objective checklists among all videos were low: modified DISCERN: 1.91, SD: 1.15; JAMA benchmark: 1.91, SD: 0.76; and FESS score: 3.54, SD: 1.77. The ICC between the 2 independent reviewers was excellent for all 3 checklists. We noted significant positive Pearson correlation between all 3 checklist scores (P < .001). In between-group comparisons of mean scores, there was significantly higher DISCERN and JAMA scores for videos from university/professional organizations, as compared to videos from medical advertising/for-profit companies and independent users. There were no significant differences in FESS scores noted between the 3 groups. There were overall low scores across the modified DISCERN, JAMA benchmark criteria, and FESS scoring checklists, reflecting the poor quality of YouTube videos as a source of patient information for FESS.

A systematic review of internet-based information on dermatomyositis and polymyositis.

Patients with rheumatic diseases are increasingly using internet-based information to inform healthcare utilization and make treatment decisions. Our aim was to assess the readability and quality of internet-based information on dermatomyositis (DM) and polymyositis (PM). Key words "Dermatomyositis" and "Polymyositis" were searched on 3 commonly used search engines (Google, Yahoo and Bing). The first 3 pages (~30) of search results were examined from each search engine. Readability of information was assessed using 4 readability formulae (Flesch Reading Ease Score, Flesch-Kincaid Grade Level, the Simplified Measure of Gobbledygook index, the Coleman-Liau index). Quality of information was assessed using the DISCERN tool, Journal of The American Medical Association (JAMA) benchmark criteria and Health on The Net Code (HoN code). We also examined Google Trends® data to determine if there were obvious temporal search patterns. Thirty-two websites were included in the study after duplicates were removed and exclusion criteria were applied. The overall quality was low including DISCERN with a median overall score of 38/80 (interquartile range 12.25), only 4/32 (13%) websites fulfilled all 4 JAMA benchmark criteria, and 9/32 (28%) had HoN code. Readability of information was assessed using 4 readability formulae (Flesch Reading Ease Score, Flesch-Kincaid Grade Level, the Simplified Measure of Gobbledygook index, the Coleman-Liau index. There was no obvious temporal trend in searches on analysis of Google Trends® data. The overall quality and readability of internet-based information relating to DM and PM is poor. Patients require appropriate information of high quality and readability throughout the course of their disease in order to make informed decisions on their condition including treatment.

P126 An analysis of the quality and readability of online information for osteoarthritis

Abstract Background Osteoarthritis is the most common cause of disability in people over 65 years old. The readability of of online osteoarthritis information has never been assessed. A 2003 study found the quality of online osteoarthritis information to be poor. This study reviews the quality of online information regarding osteoarthritis in 2018 using three validated scoring systems. Readability is reviewed for the first time, again using three validated tools. Methods The term osteoarthritis was searched across the three most popular English language search engines. The first 25 pages from each search engine were analysed. Duplicate pages, websites featuring paid advertisements, inaccessible pages (behind a pay wall, not available for geographical reasons) and non-text pages were excluded. Readability was measured using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL) and Gunning-Fog Index (GFI). Website quality was scored using the the Journal of the American Medical Association (JAMA) benchmark criteria and DISCERN criteria. Presence or absence of HONcode certification, age of content, content producer and author characteristics were noted. Results 37 unique websites were suitable for analysis. Readability varied by assessment tool from 8th to 12th grade level. This compares with the recommended 7- 8th grade level. One (2.7%) website met all four JAMA Criteria. Mean DISCERN quality of information for OA websites was “fair”, comparing favourably with the “poor” grading of a 2003 study. HONCode endorsed websites (43.2%) were of a statistically significantly higher quality. Conclusion Quality of online health information for OA is “fair”. 2.7% of websites met JAMA benchmark criteria for quality. Readability was equal to or more difficult than recommendations. HONcode certification was indicative of higher quality, but not readability. Disclosures K. Murray None. T. Murray None. C. Low None. A. O'Rourke None. D.J. Veale None.

Evaluating the Quality, Content, and Readability of Online Resources for Failed Back Spinal Surgery.

An Internet-based assessment of websites using recognized score systems. To assess the quality, content, and readability of online information for failed back spinal surgery (FBSS). A significant amount of patients still suffer from chronic or recurrent back pain with or without radicular symptoms after spinal surgery. More and more patients use the Internet to find health-related information. Low-quality or inaccurate information may not only misleading patients but also have a negative impact on the trust between patients and physicians. The terms "chronic pain after spinal surgery," "chronic pain after back surgery," "failed back surgery syndrome," "post spinal surgery syndrome," and "post laminectomy syndrome" were entered into three search engines (Google, Yahoo!, and Bing). The first 25 websites from each search were reviewed. The quality, content, and readability of each website were evaluated using DISCERN score, FBSS-specific content score, and the Journal of the American Medical Association (JAMA) benchmark criteria, the first two score systems were assessed by three reviewers independently. The Flesch-Kincaid grade level (FKGL) was used to assess the readability. Each website with or without the Health on the Net Code (HONcode) was also recorded. Seventy-two websites were analyzed in our study. The average DISCERN score for all websites was 35.26 ± 11.45, indicating the quality of the websites was poor. The DISCERN score of physician websites was 31.25 ± 9.08, lower than that of media (36.50 ± 0.71, P = 0.017) and commercial websites (42.55 ± 10.93, P = 0.045). The mean FBSS-specific content score was 9.58 ± 3.90 out of maximum 25. We failed to find any difference of FBSS-specific content score among different type of website. Websites with HONcode certification were associated with higher DISCERN score, FBSS-specific content score, and JAMA benchmark criteria score than non-certified websites. The mean FKGL was 12.19 ± 2.20, and none of the websites' FKGL was lower than the six grade level. The quality and content of available online information for FBSS were poor. The readability of online information in our results showed a significantly higher reading level than the sixth-grade level recommended by the AMA and NIH. 4.

Comparison of the Source and Quality of Information on the Internet Between Anterolateral Ligament Reconstruction and Anterior Cruciate Ligament Reconstruction: An Australian Experience.

Background:The internet is a valuable tool, but concerns exist regarding the quality and accuracy of medical information available online.Purpose:To evaluate the source and quality of information on the internet relating to anterolateral ligament reconstruction (ALLR) compared with anterior cruciate ligament reconstruction (ACLR).Study Design:Cross-sectional study.Methods:A questionnaire was administered to 50 ACLR patients in Australia to determine their use of the internet to research their operation and their familiarity with the anterolateral ligament (ALL) of the knee. The most common search terms were determined, and the first 70 websites returned by the 5 most popular search engines were used to assess the quality of information about ACLR and ALLR. Each site was categorized by type and was assessed for quality and validity using the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria, and a novel specific content score for each procedure. The presence of the Health on the Net Code (HONcode) seal was also recorded.Results:The majority (84%) of ACLR patients used the internet to research their operation. The quality of information available for ALLR was significantly inferior to that for ACLR according to the DISCERN score (37.3 ± 3.4 vs 54.4 ± 4.6; P < .0001) and specific content score (5.3 ± 1.3 vs 11.0 ± 1.5; P < .0001). ACLR websites were predominantly physician produced, while the majority of ALLR websites were academic. In contrast to ACLR websites, the majority of ALLR websites did not provide information on the indication for treatment or potential complications. ALLR websites scored better on the JAMA benchmark criteria due to the predominance of academic websites. A greater proportion of ACLR websites (14.6%) versus ALLR websites (2.5%) provided an HONcode seal. Correlation was demonstrated between the DISCERN score and specific content scores for both ACLR and ALLR but not with JAMA benchmark criteria. The specific content score had high reliability for both ACLR and ALLR.Conclusion:The majority of patients undergoing ACLR in Australia used the internet to research the procedure. The quality of information on the internet relating to ALLR was significantly inferior to information about ACLR. Most ALLR websites failed to include crucial information about the indication or options for treatment, prognosis, and potential complications. Surgeons should be aware of the information to which their patients are exposed through the internet and should be proactive in directing patients to appropriate websites.

Surfing Behind a Boat: Quality and Reliability of Online Resources on Scaphoid Fractures.

Patients seeking information and advice on treatment of scaphoid fractures unknowingly confront longstanding medical controversies surrounding the management of this condition. However, there are no studies specifically looking into the quality and reliability of online information on scaphoid fractures. We identified 44 unique websites for evaluation using the term "scaphoid fractures". The websites were categorized by type and assessed using the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria and the Health on the net (HON) code. The majority of websites were commercial (n = 13) followed by academic (n = 12). Only seven of the websites were HON certified. The mean DISCERN score was 43.8. Only 4 websites scored 63 or above representing excellent quality with minimal shortcomings but 13 websites scored 38 or below representing poor or very poor quality. The mean JAMA benchmark criteria score was 2.2. The Governmental and Non-Profit Organizations category websites had the highest mean JAMA benchmark score. The websites that displayed the HON-code seal had higher mean DISCERN scores and higher mean JAMA benchmark scores compared to websites that did not display the seal. Good quality health information is certainly available on the Internet. However, it is not possible to predict with certainty which sites are of higher quality. We suggest clinicians should have a responsibility to educate their patients regarding the unregulated nature of medical information on the internet and proactively provide patients with educational resources and thus help them make smart and informed decisions.

Robotic Prostatectomy on the Web: A Cross-Sectional Qualitative Assessment

BackgroundMany patients diagnosed with prostate cancer search for information on robotic prostatectomy (RobP) on the Web. We aimed to evaluate the qualitative characteristics of the mostly frequented Web sites on RobP with a particular emphasis on provider-dependent issues. Materials and MethodsGoogle was searched for the term “robotic prostatectomy” in Europe and North America. The mostly frequented Web sites were selected and classified as physician-provided and publically-provided. Quality was measured using Journal of the American Medical Association (JAMA) benchmark criteria, DISCERN score, and addressing of Trifecta surgical outcomes. Popularity was analyzed using Google PageRank and Alexa tool. Accessibility, usability, and reliability were investigated using the LIDA tool and readability was assessed using readability indices. ResultsTwenty-eight Web sites were physician-provided and 15 publically-provided. For all Web sites, 88% of JAMA benchmark criteria were fulfilled, DISCERN quality score was high, and 81% of Trifecta outcome measurements were addressed. Popularity was average according to Google PageRank (mean 2.9 ± 1.5) and Alexa Traffic Rank (median, 49,109; minimum, 7; maximum, 8,582,295). Accessibility (85 ± 7%), usability (92 ± 3%), and reliability scores (88 ± 8%) were moderate to high. Automated Readability Index was 7.2 ± 2.1 and Flesch–Kincaid Grade Level was 9 ± 2, rating the Web sites as difficult to read. Physician-provided Web sites had higher quality scores and lower readability compared with publically-provided Web sites. ConclusionWebsites providing information on RobP obtained medium to high ratings in all domains of quality in the current assessment. In contrast, readability needs to be significantly improved so that this content can become available for the populace.