Garcia Grant H, Taylor Samuel A, Dy Christopher J, Christ Alexander, Patel Ronak M, Dines Joshua S
Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address for G.H. Garcia:
University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555.
J Bone Joint Surg Am. 2014 Oct 15;96(20):e177. doi: 10.2106/JBJS.M.01228.
Evaluations of the medical literature suggest that many online sites provide poor-quality information. The purpose of our study was to investigate the value of online resources for patient education about shoulder instability.
Three search terms ("shoulder instability," "loose shoulder," and "shoulder dislocation") were entered into three Internet search engines. Three orthopaedic residents independently gauged the quality and accuracy of the information with use of a set of predetermined scoring criteria, in addition to noting whether or not four potential surgery options were mentioned. The readability of the web sites was evaluated with use of the Flesch-Kincaid score.
Eighty-two unique web sites were evaluated. Quality and accuracy were significantly higher with use of the term "shoulder instability" compared with the term "loose shoulder" (quality, p < 0.001; accuracy, p = 0.001). However, the reading level was significantly more advanced for the "shoulder instability" web sites (p < 0.001). Quality was significantly higher on web sites with reading levels above the eighth grade level (p = 0.001) (88% of web sites). Only twenty-three sites (28%) mentioned surgical options for shoulder instability, and of these, only eight mentioned thermal capsulorrhaphy as a primary treatment.
Online information regarding shoulder instability is often inaccurate and/or at an inappropriately high reading level. The quality of information is highly dependent on the specific search term used. Clinicians need to be aware of the information that is available online and should help direct patients to proper sites and guide Internet search terms.
对医学文献的评估表明，许多在线网站提供的信息质量较差。我们研究的目的是调查在线资源对患者进行肩部不稳定教育的价值。
在三个互联网搜索引擎中输入三个搜索词（“肩部不稳定”、“肩部松弛”和“肩关节脱位”）。三名骨科住院医师除了记录是否提及四种潜在的手术选择外，还使用一组预先确定的评分标准独立评估信息的质量和准确性。使用弗莱什-金凯德分数评估网站的可读性。
共评估了82个独特的网站。与“肩部松弛”一词相比，使用“肩部不稳定”一词时，质量和准确性显著更高（质量，p < 0.001；准确性，p = 0.001）。然而，“肩部不稳定”网站的阅读水平明显更高（p < 0.001）。阅读水平高于八年级的网站质量显著更高（p = 0.001）（占网站的88%）。只有23个网站（28%）提到了肩部不稳定的手术选择，其中只有8个提到热囊缩术作为主要治疗方法。
关于肩部不稳定的在线信息往往不准确和/或阅读水平过高。信息质量高度依赖于所使用的特定搜索词。临床医生需要了解在线可用的信息，并应帮助引导患者访问合适的网站并指导互联网搜索词。
