Medical Information Websites Research Articles

An Update from the Benchmark Survey of phactMI™ Member Companies on Providing Medical Information in the Digital Space

ObjectiveThe Pharma Collaboration for Transparent Medical Information (phactMI™) benchmarking survey of 32 pharmaceutical companies describes the use of technology by Medical Information Departments.MethodsA survey was distributed to phactMI™ member companies in June 2022 and included 79 closed and open-ended questions. The survey’s six sections included demographics, chatbot, social media, instant messaging applications, websites, and technology.ResultsMost Medical Information Departments have implemented innovative technology since 2019 with the main driver of remaining up-to-date. A total of 94% have a Medical Information website. Of those with a Medical Information website for healthcare professionals (HCPs), 97% allow for self-authentication. Most HCP-based websites have webforms for inquiries and 1–800 numbers, while only few offer video chat, chatbot, and the ability to identify local representatives. These websites also link to clinicaltrials.gov, publications, posters, and congress materials. Only 30% have a website for patients/caregivers. Most websites are discoverable by Google™. Awareness of Medical Information Websites occurs in a variety of ways, with most using multiple strategies to reach HCPs. There is wide variation in the technology platform used for the core functions of Medical Information.ConclusionAs technology continues to advance and omnichannel content remains a key objective, Medical Information needs to remain agile and transformative in their strategic and tactical planning and execution. Based on this benchmarking survey, the authors recommend that Medical Information Departments focus on expanding services for patients/caregivers, leverage digital innovations, expanding awareness, building efficiencies in workflow through technology, and continually improving website functionalities with innovative technologies.

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.

Rotator cuff repair: what questions are patients asking online and where are they getting their answers?

This study analyzed questions searched by rotator cuff patients and determined types and quality of websites providing information. Three strings related to rotator cuff repair were explored by Google Search. Result pages were collected under the "People also ask" function for frequent questions and associated webpages. Questions were categorized using Rothwell classification and topical subcategorization. Webpages were evaluated by Journal of the American Medical Association (JAMA) benchmark criteria for source quality. One hundred twenty "People also ask" questions were collected with associated webpages. Using the Rothwell classification of questions, queries were organized into fact (41.7%), value (31.7%), and policy (26.7%). The most common webpage categories were academic (28.3%) and medical practice (27.5%). The most common question subcategories were timeline of recovery (21.7%), indications/ management (21.7%), and pain (18.3%). Average JAMA score for all 120 webpages was 1.50. Journal articles had the highest average JAMA score (3.77), while commercial websites had the lowest JAMA score (0.91). The most commonly suggested question for rotator cuff repair/ surgery was, "Is rotator cuff surgery worth having?," while the most commonly suggested question for rotator cuff repair pain was, "What happens if a rotator cuff is not repaired?" The most commonly asked questions pertaining to rotator cuff repair evaluate management options and relate to timeline of recovery and pain management. Most information is provided by medical practice, academic, and medical information websites, which have highly variable reliability. By understanding questions their patients search online, surgeons can tailor preoperative education to patient concerns and improve postoperative outcomes.

Chronic Vulvovaginal Pain in Patients of Color: Benefits of Partner Supportiveness in Relation to Sexual Dissatisfaction and Distress.

Within the social support literature, individuals who experience chronic pain have shown many positive outcomes and benefits when receiving the appropriate level of emotional support. In the current study, individuals who experience chronic vulvovaginal pain (CVVP) were asked about their partner’s supportiveness, other sources of emotional support, and their satisfaction and stress surrounding sexual activity. The participants (n = 333) also identified as people of color, with a majority identifying as African American or Black (n = 227). The participants indicated that their partners were overall supportive of their diagnoses and found other emotional support sources through medical professionals, vulvar/vaginal pain-specific medical information websites, and family or friends. After conducting linear regressions, results showed the partner supportiveness was associated with less distress and less dissatisfaction surrounding sexual activity. Future research is suggested to further examine social support’s role for minority patients who experience chronic vulvovaginal pain.

COVID-19 vaccination intention in the Western Pacific Region - insights from Japan.

COVID-19 vaccination intention in the Western Pacific Region - insights from Japan.

A Clinical Tool (CUE-tool) for Health Care Professionals to Assess the Usability and Quality of the Content of Medical Information Websites: Electronic Delphi Study.

BackgroundAs patients are increasingly searching for information about their medical condition on the internet, there is a need for health professionals to be able to guide patients toward reliable and suitable information sources on the internet.ObjectiveThe aim of the study was to develop a clinical tool for health care professionals to assess the usability and quality of the content of websites containing medical information that could be recommended to patients.MethodsA 3-round modified electronic Delphi (eDelphi) study was conducted with 20 health care professionals.ResultsIn round one of the eDelphi study, of the 68 items initially created, 41 items (29 on usability and 12 on content) were rated as important or very important by more than half of the panel and thus selected for further evaluation in round two. In round two, of the 41 items chosen from round 1, 19 were selected (9 on usability and 10 on content) as important or very important by more than half of the panel for further evaluation. As a result of round three, 2 items were combined as a single item, leaving the instrument with 18 items in total (8 on usability and 10 on content). The tool is freely accessible online.ConclusionsThe CUE-tool can be used to (1) evaluate the usability and reliability of the content of websites before recommending them to patients as a good information source; (2) identify websites that do not have reliable content or may be difficult for patients to use; (3) develop quality websites by using the criteria in the CUE-tool; and (4) identify different qualities between different websites.

Where are We Now in Providing Medical Information in the Digital Space? A Benchmark Survey of PhactMI™ Member Companies.

The Pharma Collaboration for Transparent Medical Information (phactMI™) benchmarking survey was conducted to evaluate the use of technology and websites associated with the medical information (MI) departments of 27 biopharmaceutical companies in the United States. The e-survey was administered to phactMI™ members between December 2017 and February 2018 and included closed and open-ended questions with 7 distinct categories: existence of a MI website, content type available following a search query, website functions, search engine optimization (SEO), website traffic, internal communications/analytics, and additional technology capabilities. Survey findings noted that 20 companies own a MI-specific website through which MI services are provided to healthcare providers (HCPs). When asked about the dissemination of MI content through varying formats, survey results indicated Portable Document Format (PDF) to be the most common (18/27), followed by videos (8/27), presentations (5/27), infographics (3/27), and Hypertext Markup Language (3/27). Many companies have a responsive design website (19/25), webform (24/25), and a 1-800 number (22/25) for MI services. Few companies have a live chat (10/25) or a chatbot (1/25) and 9 of 25 said that content is searchable on Google™. Although website traffic varied among companies, a significant driver of this appeared to be whether the site is indexed. While most of the member companies have a MI website, there is significant room for improvement in content formats available as part of a search. Traditional website features, such as search functionality and webform, are commonly available on websites; however, newer technologies, such as chatbot and live chat, are less featured. Across most member companies, there is also a need for improvement in increasing website traffic, Google™ indexing, and SEO.

Googling Musculoskeletal-Related Pain and Ranking of Medical Associations' Patient Information Pages: Google Ads Keyword Planner Analysis.

BackgroundMost people currently use the internet to obtain information about many subjects, including health information. Thus, medical associations need to provide accurate medical information websites. Although medical associations have their own patient education pages, it is not clear if these websites actually show up in search results.ObjectiveThe aim of this study was to evaluate how well medical associations function as online information providers by searching for information about musculoskeletal-related pain online and determining the ranking of the websites of medical associations.MethodsWe conducted a Google search for frequently searched keywords. Keywords were extracted using Google Ads Keyword Planner associated with “pain” relevant to the musculoskeletal system from June 2016 to December 2019. The top 20 search queries were extracted and searched using the Google search engine in Japan and the United States.ResultsThe number of suggested queries for “pain” provided by Google Ads Keyword Planner was 930 in the United States and 2400 in Japan. Among the top 20 musculoskeletal-related pain queries chosen, the probability that the medical associations’ websites would appear in the top 10 results was 30% in the United States and 45% in Japan. In five queries each, the associations’ websites did not appear among the top 100 results. No significant difference was found in the rank of the associations’ website search results (P=.28).ConclusionsTo provide accurate medical information to patients, it is essential to undertake effective measures for search engine optimization. For orthopedic associations, it is necessary that their websites should appear among the top search results.

Analysis of user behavior on the website of a university eye hospital in Germany.

Medical information websites are usually targeted toward patients, physicians, and medical students. Most of the latest studies researched the usability of such websites. However, reports on user numbers and behavior are rare.The goal of our study is to analyze the utility of a website of a large tertiary referral center in ophthalmology in terms of various target audiences (patients, applicants, medical students, referring ophthalmologists).The web access data from our institutional website was assessed with Google Analytics. Data collection started in 2016.From 2016 to 2018, we counted a total of 763,942 page views. The overall number of users dropped from 81,572 to 67,740. This drop's onset correlates with a change in the website structure. All target audience pages received constant traffic from 2016 to 2019, with the patients’ and doctors’ sites attracting the most traffic. The pages for medical students and job applicants, although not viewed often, revealed a long session duration.Our website is used by all our target audiences. The behavior and the user numbers of each target group differ. Changes to a website's structure can influence the number of users and their behavior. It is not possible to make a direct comparison to other institutions’ websites as there are so few similar reports available. By adding more parameters to the analytics profile in a prospective setting, more detailed analyses of user behavior may be possible in the future.

Learning an expandable EMR-based medical knowledge network to enhance clinical diagnosis.

Electronic medical records (EMRs) contain a wealth of knowledge that can be used to assist doctors in making clinical decisions like disease diagnosis. Constructing a medical knowledge network (MKN) to link medical concepts in EMRs is an effective way to manage this knowledge. The quality of the diagnostic result made by MKN-based clinical decision support system depends on the accuracy of medical knowledge and the completeness of the network. However, collecting knowledge is a long-lasting and cumulative process, which means it's hard to construct a complete MKN with limited data. This study was conducted with the objective of developing an expandable EMR-based MKN to enhance capabilities in making an initial clinical diagnosis. A network of symptom-indicate-disease knowledge in 992 Chinese EMRs (CEMRs) was manually constructed as Original-MKN, and an incremental expansion framework was applied to it to obtain an expandable MKN based on new CEMRs. The framework was composed by: (1) integrating external knowledge extracted from the medical information websites and (2) mining potential knowledge with new EMRs. The framework also adopts a diagnosis-driven learning method to estimate the effectiveness of each knowledge in clinical practice. Experimental results indicate that our expanded MKN achieves a precision of 0.837 for a recall of 0.719 in clinical diagnosis, which outperforms Original-MKN and four classical machine learning methods. Furthermore, both external medical knowledge and potential medical knowledge benefit MKN expansion and disease diagnosis. The proposed incremental expansion framework sustains the MKN learning new knowledge.

The Quality of Web Sites' Health Information on Minimal Invasive Repair of Pectus Excavatum Using the DISCERN Instrument.

The Internet is a frequently used tool for patients with pectus excavatum (PE) to get information about symptoms and treatment options. In addition, it is used by both health care providers as a marketing tool and support group systems. The Internet health information varies in precision, quality, and reliability. The study purpose was to determine the quality of information on the PE Web sites using the DISCERN instrument, including information about operation and potential complications after a Nuss bar procedure. Four search engines, Google, Yahoo, Ask, and Bing, were used to explore seven key terms concerning PE. Search language was English. The DISCERN quality instrument was used to evaluate the Web sites. Also, information on possible complications was scored per Web site. A total of 560 Web sites were assessed in March 2019. Excluded were 139 Web sites. There were 333 duplicates, leaving 88 unique Web sites. Of these, 58.1% were hospital-related information Web sites, 28.4% medical information Web sites, and 3.4% patient forum sites. Interactive multimedia was used on 21.6% of the sites. Pain postoperatively was mentioned on 64.8% of the sites, while only 9.1% mentioned the mortality risk of the surgical correction of PE for Nuss bar placement. The quality of the unique Web sites showed a mean DISCERN score of 42.5 (standard deviation 12.2). Medical information Web sites, encyclopedia, and government-sponsored sites had higher DISCERN scores. Hospital-related information sites, medical companies, and lay persons' sites, had lower total scores. The overall quality of PE Web sites is low to moderate, with serious shortcomings.

Google Medical Update: Why Is the Search Engine Decreasing Visibility of Health and Medical Information Websites?

The Google search engine answers many health and medical information queries every day. People have become used to searching for this type of information. This paper presents a study which examined the visibility of health and medical information websites. The purpose of this study was to find out why Google is decreasing the visibility of such websites and how to measure this decrease. Since August 2018, Google has been more rigorously rating these websites, since they can potentially impact people’s health. The method of the study was to collect data about the visibility of health and medical information websites in sequential time snapshots. Visibility consists of combined data of unique keywords, positions, and URL results. The sample under study was made up of 21 websites selected from 10 European countries. The findings reveal that in sequential time snapshots, search visibility decreased. The decrease was not dependent on the country or the language. The main reason why Google is decreasing the visibility of such websites is that they do not meet high ranking criteria.

A Critical Analysis of the Information Available Online for Ménière's Disease.

Patients increasingly rely on online resources for medical information; however, the Internet is unregulated and prone to misinformation. This study analyzes the reliability, quality, and readability of websites for Ménière's disease. A Google search was performed using keywords Ménière's disease. The first 5 pages (50 results) were reviewed. Websites were sorted into 5 categories: academic institutions, government agencies, professional organizations, medical information websites, and miscellaneous. The reliability, quality, and readability of each website were evaluated using the DISCERN instrument and Flesch-Kincaid Grade Level (FKGL). DISCERN assesses reliability and quality by scoring 15 questions on a scale from 1 (low) to 3 (high). The reliability score emphasizes clear objectives and sources, as well as lack of bias, whereas the quality score emphasizes information on treatment options. The FKGL of each website was calculated using a formula to determine the equivalent US grade reading level. Ambulatory. None. Forty-two websites were analyzed. Academic institutions were the most common (n = 13, 31%) but scored the lowest using DISCERN at 1.75 ± 0.13. Medical information websites scored highest at 2.24 ± 0.09 (P = .024 compared to academic institutions). The average FKGL of all websites was 10.12 ± 0.57 with medical information websites being the easiest to read at 8.84 ± 0.83. Only 5 (13%) of websites scored below the eighth-grade reading level. Most top online search results for Ménière's disease are deficient in quality and readability. Medical information websites are generally the most reliable and easy to read.

Knee arthroscopy prospective observational study of patient information.

Arthroscopy is especially well suited to outpatient implementation, as procedures are less heavy for the patient. Few studies, however, have focused on patient information and understanding in arthroscopic and outpatient surgery. The aim of the present study was to perform a prospective assessment of the information received by the patient concerning outpatient arthroscopic surgery. The study hypothesis was that there is room for improvement in information. A prospective descriptive observational cohort study was made of the means of information available to patients, their understanding of arthroscopic surgery and their satisfaction with the information delivered. Inclusion criteria consisted in scheduled outpatient arthroscopic surgery in whatever joint. Fifty consecutive patients responded to the study questionnaire. Forty-eight (96%) considered that the surgeon had provided sufficient oral information. Twenty-nine (58%) considered that they had received sufficient written information. Forty-four (88%) reported searching on the Internet. Twelve (24%) had sought testimony and advice from someone who had undergone similar surgery. Eighteen (36%) had sought information from their community physician. Four (8%) had called back or taken a new appointment with the surgeon to get more information. Five (10%) attributed lack of information to lack of time in the preoperative consultation. Three (6%) considered the information to have been too technical for good understanding of the procedure. The present study showed that this cohort, which was relatively young compared to patients undergoing implantation, was notably autonomous in their search for information. They mainly sought information in general-public medical information websites, rather than from their community physician or specialist. It is important to improve patient information, and specific tools should be implemented ahead of outpatient arthroscopic surgery. Four observational studies.

US Medical Information Websites Benchmarking: How Is the Industry Fairing in Usability?

This study of 23 US-based biopharmaceutical medical information (MI) websites was conducted to assess usability and identify best practices and areas of potential improvement. In this systematic review, websites were evaluated from June 22-November 1, 2016, and awarded points based on content, functionality, and navigation (maximum score of 42). Low-, mid-, and high-range usability scores were ≤13, 14-27, ≥28, respectively. Mean scores were 7 of 17, 4 of 10, and only 5 of 15 criteria for content, functionality, and navigation. The mean usability score across all websites was 15 of 42 criteria. Larger companies generally had a higher mean usability score. A minor trend was also observed with regard to usability score and industry size (r2 = 0.3). Only 2 websites scored high, whereas 13 scored in the mid- and 8 in the lower range of usability. Overall, websites scored low when pertaining to presence of novel content type, search engine optimization, presence of social media, and MI services offered. Overall site architecture, presence of self-certification, and mobile compatibility scored fairly well across the industry. The majority of websites scored in the low to midrange, which suggests an industry-wide opportunity for improvement. In order to meet the evolving needs of health care professionals, MI websites need to be optimized for content, navigation, and functionality. Ensuring MI websites are discoverable through search engines and improving the level of MI services offered was also deemed to be important features to incorporate into a given MI website optimization strategy.

Determinants of adherence to diabetes treatment.

Understanding and improving medication adherence is crucial in diabetes management. Adherence to a diabetes regimen can improve glucose control and limit the development of complications. The aim of the present study was to evaluate the extent to which a variety of factors influence diabetes medication adherence. A medication adherence survey was made available on WebMD, a medical information website for patients and/or consumers. Respondents were residents of the US, ≥18 years old, and diagnosed with either type 1 or type 2 diabetes mellitus (self-reported). Behavioral adherence (self-reported doses missed per week) correlated with perceived adherence (patients' self-report of their overall impression of medication adherence, ranked 0-5; P < 0.001). Adherent patients (very few [0%-10%] issues with adherence) were more likely to report having received information from their physician. Mostly adherent patients (few [11%-26%] issues with adherence) were less likely to obtain information from their physician, but reported more medication self-titration. Somewhat non-adherent patients (some [27%-46%] adherence issues) reported more "self-consciousness factors" and hypoglycemia. Non-adherent patients (many [47%-88%] adherence issues) were more likely to report worries about medication side effects. Receiving information from a healthcare provider is associated with greater diabetes medication adherence, suggesting the importance of clinicians making time to provide patient education.

A Method for the Design and Development of Medical or Health Care Information Websites to Optimize Search Engine Results Page Rankings on Google

BackgroundThe Internet is a widely used source of information for patients searching for medical/health care information. While many studies have assessed existing medical/health care information on the Internet, relatively few have examined methods for design and delivery of such websites, particularly those aimed at the general public.ObjectiveThis study describes a method of evaluating material for new medical/health care websites, or for assessing those already in existence, which is correlated with higher rankings on Google's Search Engine Results Pages (SERPs).MethodsA website quality assessment (WQA) tool was developed using criteria related to the quality of the information to be contained in the website in addition to an assessment of the readability of the text. This was retrospectively applied to assess existing websites that provide information about generic medicines. The reproducibility of the WQA tool and its predictive validity were assessed in this study.ResultsThe WQA tool demonstrated very high reproducibility (intraclass correlation coefficient=0.95) between 2 independent users. A moderate to strong correlation was found between WQA scores and rankings on Google SERPs. Analogous correlations were seen between rankings and readability of websites as determined by Flesch Reading Ease and Flesch-Kincaid Grade Level scores.ConclusionsThe use of the WQA tool developed in this study is recommended as part of the design phase of a medical or health care information provision website, along with assessment of readability of the material to be used. This may ensure that the website performs better on Google searches. The tool can also be used retrospectively to make improvements to existing websites, thus, potentially enabling better Google search result positions without incurring the costs associated with Search Engine Optimization (SEO) professionals or paid promotion.

Abstract P5-11-02: Breast Cancer Radiation Therapy and the Risk of Developing Bronchiolitis Obliterans Organizing Pneumonia (BOOP): Communication of BOOP Risk by Breast Cancer Information Websites and General Medical Information Websites

Abstract Background: BOOP is an inflammatory pulmonary disorder consisting of organized polypoid granulation tissue in the distal airways extending into the alveolar ducts and alveoli. Clinical manifestations of BOOP include fever, cough, dyspnea on exertion, and fatigue. Patients with severe BOOP require hospitalization. The mainstay of BOOP treatment is high dose corticosteroids. Many patients relapse and require long term corticosteroids, often in combination with another immunosuppressant. Significant morbidity and disability may be associated with both the diagnosis of BOOP and the toxicities of treatment. The mortality rate of BOOP has been estimated to be about 5%. Radiation Therapy (RT) is an important component in the treatment of breast cancer (Breast Ca). Beginning in 1995, reports of BOOP occurring in Breast Ca RT patients began to appear in the medical literature. From 1995 to the present, 43 case study reports described 121 Breast Ca RT patients who developed BOOP within one year of their RT. From 1999 to 2011, seven epidemiological studies were published that suggested that the incidence of BOOP in Breast Ca RT patients was in the range of 2% to 3%. Objectives: The primary objective of this study was to determine if internet sources of Breast Ca information targeted to Breast Ca patients include BOOP information in their description of RT risks. The secondary objective was to determine if general medical websites conveyed BOOP/Breast Ca RT risk information. Methods: Eight websites specifically targeted to Breast Ca patients were reviewed. Sponsors of these websites included the US government, Breast Ca advocacy groups, and medical organizations. Seven general medical websites that contained BOOP/Breast Ca RT information were also reviewed. Results: There was no mention of BOOP in any of the websites targeted to Breast Ca patients. The websites included those from the National Cancer Institute, American Cancer Society, American Society of Therapeutic Radiology and Oncology, Susan G. Komen, and BreastCancer.org. The internet search identified seven general medical websites that did include information about the risk of BOOP from Breast Ca RT. Discussion: It is perplexing that none of the eight website sources for Breast Ca patients included any mention of the risk of BOOP associated with Breast Ca RT, whereas seven general medical internet sources did disclose this information. This disparity raises important issues and questions. The majority of BOOP/Breast Ca RT reports were published in pulmonology journals. Is this information being disseminated to providers of Breast Ca treatment? Many of the Breast Ca information websites stated that their information was up to date and was reviewed by leading Breast Ca physicians, so it remains an enigma that the BOOP/RT association was not disclosed. The lack of any information about BOOP and Breast Ca RT may indicate Breast Ca physician unawareness. An alternative explanation for this finding may be that these physicans are aware of the BOOP/RT association, but they believe that the rarity of BOOP diagnoses justifies omitting this information in internet-based information sources. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-11-02.

Assessment of pharmaceutical industry-based medical information websites

Assessment of pharmaceutical industry-based medical information websites

Utilization of Web-Based Resources for Medical Research and Education by Health Professionals at the College of Medicine, Ibadan Nigeria

A survey was conducted to determine the use of web-based information resources for medical research and education by the health professionals in University College Hospital, Ibadan. Questionnaires were administered to the health professionals in various departments in the Hospital. The results showed a low level of use in spite of high awareness level. This was due inter-alia, to lack of information technology skills, fluctuation of electricity, non-access to useful medical information internet addresses. The study recommends compulsory intensive training for the health professionals. The medical librarian should organize massive awareness workshops on useful medical information websites and constantly circulate.