Yermilov Irina, Chow Warren, Devgan Lara, Makary Martin A, Ko Clifford Y
Department of Surgery, Greater West Los Angeles VA Healthcare System, Los Angeles, CA, USA.
J Am Coll Surg. 2008 Oct;207(4):580-6. doi: 10.1016/j.jamcollsurg.2008.04.034. Epub 2008 Jun 30.
Although there is high-quality information on the Internet, it is difficult for patients to identify high-quality Web sites from those with inaccurate or misleading information. Our goal was to determine specific characteristics of Web search results that yield high-quality information and can be discerned easily by patients.
A validated rating system was used to evaluate surgical Web sites for appropriateness and adequacy. Web sites were identified using three search term types (technical, descriptive, and layperson) for 10 common surgical procedures. The top three sponsored (paid) and unsponsored (unpaid) Web site matches were identified. The search and analysis were repeated 1 month later.
One hundred forty-five Web sites were retrieved: 90 unsponsored and 55 sponsored. Unsponsored sites had higher mean composite scores than sponsored Web sites (50.6% versus 25%, p < 0.0001). Searches using layperson terms had lower mean composite scores compared with those using technical terms (36.9% versus 47.5%, p < 0.02). Professional Web sites had the highest mean composite scores (66.3%); legal Web sites had the lowest (6.3%). On regression analysis, unsponsored Web sites were associated with higher composite scores (p < 0.0001); number 1 match results (p < 0.02) and using layperson search terms (p < 0.052) were associated with lower mean composite scores. Repeat search results demonstrated no significant differences, except number 3 match results were no longer significant.
To optimize patients' Web searches, surgeons should recommend unsponsored sites; suggest professional society sites, if available; and provide technical search terms. But information on some topics, such as risks of not undergoing surgery, remains poor and requires discussion between the surgeon and patient.
尽管互联网上有高质量的信息，但患者很难从那些提供不准确或误导性信息的网站中识别出高质量的网站。我们的目标是确定网络搜索结果的具体特征，这些特征能够产生高质量的信息并且患者能够轻松辨别。
使用一个经过验证的评分系统来评估外科手术相关网站的适宜性和充分性。通过三种搜索词类型（专业术语、描述性术语和外行术语）来识别10种常见外科手术的网站。确定排名前三的付费和免费网站匹配结果。1个月后重复进行搜索和分析。
共检索到145个网站：90个免费网站和55个付费网站。免费网站的平均综合得分高于付费网站（50.6%对25%，p<0.0001）。与使用专业术语的搜索相比，使用外行术语的搜索平均综合得分更低（36.9%对47.5%，p<0.02）。专业网站的平均综合得分最高（66.3%）；法律网站的得分最低（6.3%）。回归分析显示，免费网站与更高的综合得分相关（p<0.0001）；排名第一的匹配结果（p<0.02）和使用外行搜索词（p<0.052）与更低的平均综合得分相关。重复搜索结果显示无显著差异，除了排名第三的匹配结果不再显著。
为了优化患者的网络搜索，外科医生应推荐免费网站；如果有专业学会网站，建议患者访问；并提供专业搜索词。但是关于某些主题的信息，如不进行手术的风险，仍然很少，需要外科医生和患者之间进行讨论。
