Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA, 02114, USA.
Clin Orthop Relat Res. 2014 Apr;472(4):1246-50. doi: 10.1007/s11999-014-3461-9. Epub 2014 Jan 18.
Several websites allow people to post health questions and get answers from doctors. Knowing more about what patients seek from these websites might help in-office educational efforts, but little is known about what occurs on these sites.
QUESTIONS/PURPOSES: This study addressed whether patients seeking advice online already have seen a physician, the type of questions asked, if they are dissatisfied with their doctor, the characteristics of the physicians who respond, and the content of their answers. This study documents the circumstances and content of questions asked about hand illness, the characteristics of the physician responders, and their responses.
One hundred thirty-one hand surgery-related questions from an online health consultation website were reviewed retrospectively. The timing of and reason for the consultation, the content of the questions, the specialty of physician responder, and the content of the responses were recorded.
Sixty patients (46%) were seeking information before seeing a doctor, 21 (16%) after a medical encounter, and 19 (15%) after hand surgery. With increasing contact with providers, patient queries transitioned from diagnosis, to treatment, to prognosis, and potential complications. Patients who had seen a doctor often expressed dissatisfaction (16 of 37 patients [43%]) as did those who had hand surgery (seven of 26 patients [27%]). Between one and eight doctors (average, two) answered each query. Most of the answering physicians were hand surgeons. The information they provided predominantly addressed diagnosis.
Online consultations are most common among patients who have not seen a doctor, but also reflect uncertainty and dissatisfaction after seeing a doctor. Although online health consultations might support patients' quest for information and understanding, and the potential for multiple answers from different doctors creates the possibility for increased balance and breadth of opinions, the quality of the information and cost-effectiveness of this approach are uncertain and need to be evaluated carefully in future studies.
有几个网站允许人们发布健康问题，并从医生那里获得答案。了解患者从这些网站中寻求什么可能有助于改善门诊教育，但人们对这些网站上发生的情况知之甚少。
问题/目的：本研究旨在探讨在线寻求建议的患者是否已经看过医生、他们提出的问题类型、是否对医生不满意、回答问题的医生的特征以及他们回答的内容。本研究记录了在线咨询手部疾病的情况和内容、回答问题的医生特征及其回答。
回顾性分析了一个在线健康咨询网站上的 131 个手部手术相关问题。记录咨询的时间和原因、问题的内容、回答问题的医生的专业以及回答的内容。
60 名患者（46%）在看医生之前寻求信息，21 名（16%）在看医生后寻求信息，19 名（15%）在手手术后寻求信息。随着与提供者的接触增加，患者的询问从诊断、治疗、预后和潜在并发症转移。看过医生的患者经常表达不满（37 名患者中有 16 名[43%]），接受过手部手术的患者也表达不满（26 名患者中有 7 名[27%]）。每个问题平均有 1 到 8 位医生（平均两位）回答。大多数回答问题的医生都是手外科医生。他们提供的信息主要涉及诊断。
在线咨询最常见于未看过医生的患者，但也反映了看过医生后仍存在的不确定性和不满。尽管在线健康咨询可能支持患者寻求信息和理解的需求，并且来自不同医生的多个回答有可能增加意见的平衡和广度，但这种方法的信息质量和成本效益仍不确定，需要在未来的研究中仔细评估。
