Joury Abdulaziz U, Alshathri Mashhoor, Alkhunaizi Mohammad, Jaleesah Najlaa, Pines Jesse M
Medical Research Fellowship Program, The George Washington University School of Medicine and Health Sciences, Washington, DC.
King Salman Heart Center, King Fahd Medical City, Riyadh, Saudi Arabia.
Acad Emerg Med. 2016 Oct;23(10):1146-1152. doi: 10.1111/acem.13039. Epub 2016 Sep 27.
Chest pain is a common symptom with causes that range from benign to serious. We assess the content and quality of websites about chest pain symptoms that describe its causes and when to seek care.
We used five search engines (Google, Bing, Yahoo, Ask, AOL) using the term "chest pain" and assessed the first 30 websites that resulted from each search. We excluded websites that were diagnosis-driven, intended for physicians, patient blogs, advertisements, news, or videos. For included websites, we assessed for the presence of content potentially useful to patients with chest pain symptoms; website quality with three instruments (DISCERN, HONcode, and JAMA benchmark criteria); readability using four validated scores, accessibility, usability, and reliability using the LIDA instrument; and popularity using the Alexa tool.
In 27 included websites, 96 and 81% mentioned cardiac and noncardiac causes of chest pain, respectively, while 85% described when to seek emergency care. Only 51% of websites mentioned potential tests that might be used to diagnose symptoms, 22% described potential treatments, and 11% mentioned consequences if treatment is delayed or avoided. The median website DISCERN score was 23 (interquartile range [IQR] = 18-32) out of a possible 45 points, which can be interpreted as low to medium quality. A total of 44% of websites had HONcode certification, and only 11% fulfilled all four JAMA benchmark criteria. Average reading scores demonstrated that half of websites were above the eighth to ninth grade reading level. With LIDA, the average scores were "medium" for accessibility at 83% and usability at 59% and "low" for reliability at 43%.
Many websites that provide health information for patients about chest pain symptoms are not reliable. There is highly variable content and quality, and the average website is difficult to read for patients with low health literacy.
胸痛是一种常见症状，其病因范围从良性到严重不等。我们评估了有关胸痛症状的网站内容和质量，这些网站描述了胸痛的病因以及何时应寻求治疗。
我们使用了五个搜索引擎（谷歌、必应、雅虎、Ask、美国在线），搜索词为“胸痛”，并评估了每次搜索结果中的前30个网站。我们排除了以诊断为导向的网站、面向医生的网站、患者博客、广告、新闻或视频。对于纳入的网站，我们评估了是否存在对有胸痛症状的患者可能有用的内容；使用三种工具（DISCERN、健康在线认证（HONcode）和《美国医学会杂志》基准标准）评估网站质量；使用四种经过验证的分数评估可读性、可及性、可用性，并使用LIDA工具评估可靠性；使用Alexa工具评估受欢迎程度。
在27个纳入的网站中，分别有96%和81%提到了胸痛的心脏和非心脏病因，而85%描述了何时应寻求紧急治疗。只有51%的网站提到了可能用于诊断症状的潜在检查，22%描述了潜在治疗方法，11%提到了如果延迟或不进行治疗的后果。网站DISCERN评分的中位数为23分（四分位间距[IQR]=18 - 32），满分45分，可解释为低到中等质量。共有44%的网站获得了HONcode认证，只有11%符合所有四项《美国医学会杂志》基准标准。平均阅读分数表明，一半的网站高于八年级到九年级的阅读水平。使用LIDA工具，可及性平均得分为“中等”，为83%，可用性为59%，可靠性为“低”，为43%。
许多为患者提供有关胸痛症状健康信息的网站不可靠。内容和质量差异很大，对于健康素养较低的患者来说，一般的网站难以读懂。
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