Maciolek Kimberly A, Jarrard David F, Abel E Jason, Best Sara L
Department of Urology, University of Wisconsin School of Medicine School of Medicine and Public Health, Madison, WI.
Department of Urology, University of Wisconsin School of Medicine School of Medicine and Public Health, Madison, WI; Department of Urology, William S. Middleton Memorial Veterans Hospital, Madison, WI.
Urology. 2017 Nov;109:101-106. doi: 10.1016/j.urology.2017.07.037. Epub 2017 Aug 2.
To evaluate the accuracy, readability, understandability, and actionability of Internet patient education materials (PEM) about transrectal ultrasound-guided prostate biopsy.
A comprehensive Internet search was performed to find PEM with pre- or postbiopsy instructions. PEM that were duplicates, government affiliated, international, or video based were excluded. Biopsy instructions were evaluated for accuracy and presence of essential topics. Readability was assessed via word count and Flesch-Kincaid Grade Level. Understandability and actionability were measured using the Patient Education Materials Assessment Tool (PEMAT). Effects of authorship and geographical variation were determined using Fischer exact and Kruskal-Wallis tests.
We identified 148 unique PEM. Only 31 (21%) sites adhered to the recommended <8th grade reading level. Most PEM did not contain recommended graphics (14%), checklists (2%), or summaries (6%). The PEMAT understandability score for academic PEM was higher than private (P = .02) and unaffiliated PEM (P = .01). No websites had inaccurate content. Only 2 PEM sites (1%) included all essential content (stop anticoagulants, antibiotics, need for urinalysis, biopsy pain, when to resume activity, and bleeding complications). Few significant differences based on geographic region were observed for word count, readability, PEMAT scores, or content.
Transrectal ultrasound-guided prostate biopsy PEM adhere poorly to guidelines for easy-to-understand materials. Most PEM lack vital information and are written at a reading level that is too complex for patient comprehension. The urology community can construct better websites by consulting PEM advisory materials and providing nontechnical language, figures, and specific instructions.
评估关于经直肠超声引导下前列腺活检的互联网患者教育材料（PEM）的准确性、可读性、可理解性和可操作性。
进行全面的互联网搜索以查找包含活检前或活检后指导的PEM。排除重复的、政府附属的、国际性的或基于视频的PEM。对活检指导的准确性和基本主题的涵盖情况进行评估。通过单词计数和弗莱什-金凯德年级水平评估可读性。使用患者教育材料评估工具（PEMAT）测量可理解性和可操作性。使用费舍尔精确检验和克鲁斯卡尔-沃利斯检验确定作者身份和地理差异的影响。
我们识别出148份独特的PEM。只有31个（21%）网站符合推荐的八年级以下阅读水平。大多数PEM没有包含推荐的图表（14%）、清单（2%）或总结（6%）。学术性PEM的PEMAT可理解性得分高于私立（P = 0.02）和非附属PEM（P = 0.01）。没有网站内容不准确。只有2个PEM网站（1%）包含了所有基本内容（停用抗凝剂、抗生素、尿常规检查的必要性、活检疼痛、何时恢复活动以及出血并发症）。在单词计数、可读性、PEMAT得分或内容方面，基于地理区域观察到的显著差异很少。
经直肠超声引导下前列腺活检的PEM对易于理解材料的指南遵循情况较差。大多数PEM缺乏重要信息，并且写作的阅读水平对于患者理解来说过于复杂。泌尿外科界可以通过参考PEM咨询材料并提供非技术性语言、图表和具体指导来构建更好的网站。
