Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

Online resources for information on shoulder arthroplasty: an assessment of quality and readability

  • Mohamad Y. Fares (Division of Shoulder and Elbow Surgery, Rothman Orthopedic Institute) ;
  • Jaspal Singh (Division of Shoulder and Elbow Surgery, Rothman Orthopedic Institute) ;
  • Amar S. Vadhera (Division of Shoulder and Elbow Surgery, Rothman Orthopedic Institute) ;
  • Jonathan Koa (Division of Shoulder and Elbow Surgery, Rothman Orthopedic Institute) ;
  • Peter Boufadel (Division of Shoulder and Elbow Surgery, Rothman Orthopedic Institute) ;
  • Joseph A. Abboud (Division of Shoulder and Elbow Surgery, Rothman Orthopedic Institute)
  • Received : 2023.04.19
  • Accepted : 2023.06.17
  • Published : 2023.09.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty. Methods: An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES). Results: Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages. Conclusions: Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information. Level of evidence: IV.

Keywords

References

  1. Allahabadi S, Cheung EC, Hodax JD, Feeley BT, Ma CB, Lansdown DA. Outpatient shoulder arthroplasty: a systematic review. J Shoulder Elb Arthroplast 2021;5:24715492211028025. 
  2. Day JS, Lau E, Ong KL, Williams GR, Ramsey ML, Kurtz SM. Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Shoulder Elbow Surg 2010;19:1115-20.  https://doi.org/10.1016/j.jse.2010.02.009
  3. Best MJ, Aziz KT, Wilckens JH, McFarland EG, Srikumaran U. Increasing incidence of primary reverse and anatomic total shoulder arthroplasty in the United States. J Shoulder Elbow Surg 2021;30:1159-66.  https://doi.org/10.1016/j.jse.2020.08.010
  4. Schairer WW, Nwachukwu BU, Lyman S, Craig EV, Gulotta LV. National utilization of reverse total shoulder arthroplasty in the United States. J Shoulder Elbow Surg 2015;24:91-7.  https://doi.org/10.1016/j.jse.2014.08.026
  5. Wagner ER, Farley KX, Higgins I, Wilson JM, Daly CA, Gottschalk MB. The incidence of shoulder arthroplasty: rise and future projections compared with hip and knee arthroplasty. J Shoulder Elbow Surg 2020;29:2601-9.  https://doi.org/10.1016/j.jse.2020.03.049
  6. Wiater JM, Fabing MH. Shoulder arthroplasty: prosthetic options and indications. J Am Acad Orthop Surg 2009;17:415-25.  https://doi.org/10.5435/00124635-200907000-00002
  7. Stiggelbout AM, Van der Weijden T, De Wit MP, et al. Shared decision making: really putting patients at the centre of healthcare. BMJ 2012;344:e256. 
  8. File T, Ryan C. Computer and internet use in the United States: 2013 [Internet]. United States Census Bureau; 2014 [cited 2023 Jun 1]. Available from: https://www.census.gov/library/publications/2014/acs/acs-28.html 
  9. Shoukat S. Cell phone addiction and psychological and physiological health in adolescents. EXCLI J 2019;18:47-50. 
  10. Statista. Number of internet users in the United States from 2015 to 2023 [Internet]. Statista; 2023 [cited 2023 Jun 1]. Available from: https://www.statista.com/statistics/276445/number-of-internet-users-in-the-united-states/
  11. Thayer SE, Ray S. Online communication preferences across age, gender, and duration of Internet use. Cyberpsychol Behav 2006;9:432-40.  https://doi.org/10.1089/cpb.2006.9.432
  12. Murray E, Lo B, Pollack L, et al. The impact of health information on the Internet on health care and the physician-patient relationship: national U.S. survey among 1.050 U.S. physicians. J Med Internet Res 2003;5:e17.
  13. Shah NS, Kuechly HA, Ng MK, et al. YouTube videos on shoulder arthroplasty are of low quality, reliability, and content regardless of source. Semin Arthroplasty 2023;33:233-9.  https://doi.org/10.1053/j.sart.2022.10.008
  14. Abbas MJ, Evans H, et al. YouTube is a poor-quality source for patient information on the rehabilitation following total shoulder arthroplasty. Semin Arthroplasty 2022;32:800-6.  https://doi.org/10.1053/j.sart.2022.05.009
  15. Martinez VH, Ojo D, Gutierrez-Naranjo JM, Proffitt M, Hartzler RU. The most popular YouTube videos about shoulder replacement are of poor quality for patient education. Arthrosc Sports Med Rehabil 2023;5:e623-8. 
  16. Fares MY, Koa J, Boufadel P, Singh J, Vadhera AS, Abboud JA. Evaluation of online video content related to reverse shoulder arthroplasty: a YouTube-based study. Clin Shoulder Elb 2023;26:162-8.  https://doi.org/10.5397/cise.2022.01452
  17. Al-Ubaydli M. Using search engines to find online medical information. PLoS Med 2005;2:e228. 
  18. Corcelles R, Daigle CR, Talamas HR, Brethauer SA, Schauer PR. Assessment of the quality of Internet information on sleeve gastrectomy. Surg Obes Relat Dis 2015;11:539-44.  https://doi.org/10.1016/j.soard.2014.08.014
  19. Eysenbach G, Kohler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. BMJ 2002;324:573-7.  https://doi.org/10.1136/bmj.324.7337.573
  20. Khachfe HH, Chahrour MA, Habib JR, Yu J, Jamali FR. A quality assessment of the information accessible to patients on the internet about the whipple procedure. World J Surg 2021;45:1853-9.  https://doi.org/10.1007/s00268-021-05989-6
  21. Silberg WM, Lundberg GD, Musacchio RA. Assessing, controlling, and assuring the quality of medical information on the Internet: caveant lector et viewor. Let the reader and viewer beware. JAMA 1997;277:1244-5.  https://doi.org/10.1001/jama.1997.03540390074039
  22. Health on the Net website [Internet]. Health on the Net; 2023 [cited 2023 Jun 1]. Available from: https://www.hon.ch/en/
  23. Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 1999;53:105-11.  https://doi.org/10.1136/jech.53.2.105
  24. England GW, Thomas M, Paterson DG. Reliability of the original and the simplified Flesch reading ease formulas. J Appl Psychol 1953;37:111-3.  https://doi.org/10.1037/h0055346
  25. Nassiri M, Bruce-Brand RA, O'Neill F, Chenouri S, Curtin PT. Surfing for hip replacements: has the "internet tidal wave" led to better quality information. J Arthroplasty 2014;29:1339-44.  https://doi.org/10.1016/j.arth.2014.01.009
  26. Sheridan GA, O'Brien C, Masri BA, Duncan CP, Garbuz DS. Revision total hip arthroplasty: an analysis of the quality and readability of information on the internet. World J Orthop 2020;11:82-9.  https://doi.org/10.5312/wjo.v11.i2.82
  27. Barrett DR, Boone JD, Butch JO, Cavender JA, Sole G, Wassinger CA. A critical appraisal of web-based information on shoulder pain comparing biomedical vs. psychosocial information. J Shoulder Elbow Surg 2023;32:e23-32.  https://doi.org/10.1016/j.jse.2022.07.023
  28. Hammond JW, Queale WS, Kim TK, McFarland EG. Surgeon experience and clinical and economic outcomes for shoulder arthroplasty. J Bone Joint Surg Am 2003;85:2318-24.  https://doi.org/10.2106/00004623-200312000-00008
  29. Kuye IO, Jain NB, Warner L, Herndon JH, Warner JJ. Economic evaluations in shoulder pathologies: a systematic review of the literature. J Shoulder Elbow Surg 2012;21:367-75.  https://doi.org/10.1016/j.jse.2011.05.019
  30. Gartsman GM, Morris BJ, Unger RZ, Laughlin MS, Elkousy HA, Edwards TB. Characteristics of clinical shoulder research over the last decade: a review of shoulder articles in The Journal of Bone & Joint Surgery from 2004 to 2014. J Bone Joint Surg Am 2015;97:e26. 
  31. Stelzer JW, Wellington IJ, Trudeau MT, et al. Readability assessment of patient educational materials for shoulder arthroplasty from top academic orthopedic institutions. JSES Int 2021;6:44-8.  https://doi.org/10.1016/j.jseint.2021.08.004
  32. Wagner ER, Farley KX, Higgins I, Wilson JM, Daly CA, Gottschalk MB. The incidence of shoulder arthroplasty: rise and future projections compared with hip and knee arthroplasty. J Shoulder Elbow Surg 2020;29:2601-9.  https://doi.org/10.1016/j.jse.2020.03.049
  33. Purdy E, Thoma B, Bednarczyk J, Migneault D, Sherbino J. The use of free online educational resources by Canadian emergency medicine residents and program directors. CJEM 2015;17:101-6.  https://doi.org/10.1017/cem.2014.73
  34. Volaski H, Sharfman ZT, Levy IM. The value of 2 orthopaedic learning platforms from the learners' and educators' point of view. JB JS Open Access 2022;7:e21.00161. 
  35. Elshohna M, Hidayat Y, Karkuri A. Proximal humerus fracture: an evaluation of the readability and value of web-based knowledge. Cureus 2022;14:e27957. 
  36. Dalton DM, Kelly EG, Molony DC. Availability of accessible and high-quality information on the Internet for patients regarding the diagnosis and management of rotator cuff tears. J Shoulder Elbow Surg 2015;24:e135-40.  https://doi.org/10.1016/j.jse.2014.09.036
  37. Health literacy: report of the Council on Scientific Affairs. Ad hoc committee on health literacy for the Council on Scientific Affairs, American Medical Association. JAMA 1999;281:552-7. https://doi.org/10.1001/jama.281.6.552