The Medical School, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK.
Department of General Surgery, Sheffield Teaching Hospitals, Sheffield, UK.
Tech Coloproctol. 2017 Nov;21(11):853-862. doi: 10.1007/s10151-017-1708-7. Epub 2017 Nov 3.
The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery.
This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0).
Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8).
Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.
互联网正成为一种越来越受欢迎的资源，可在临床就诊之外为患者的决策提供支持。网络健康信息的质量参差不齐，且在很大程度上不受监管。本研究旨在评估支持全层直肠脱垂手术患者决策的在线资源的质量。
本系统评价已在 PROSPERO 数据库（CRD42017058319）中注册。使用预先设定的搜索策略在 Google 和专业决策辅助资源库中进行搜索。根据以下三个标准对来源进行分析：（1）使用弗莱什-金凯德阅读舒适度评分评估其可读性；（2）DISCERN 评分；（3）国际患者决策辅助标准（IPDAS）最低标准标准评分（IPDASi，v4.0）。
总体而言，有 95 个来源来自 Google 和专业决策辅助资源库。剔除了 53 个重复项，18 个来源不符合预先设定的合格标准，最终有 24 个来源纳入全文分析。平均弗莱什-金凯德阅读舒适度评分高于患者教育材料的推荐值（48.8±15.6，范围 25.2-85.3）。支持全层直肠脱垂手术患者决策的来源的整体质量较差（中位数 DISCERN 评分为 1/5±1.18，范围 1-5）。没有来源符合最低决策标准（中位数 IPDASi 评分为 5/12±2.01，范围 1-8）。
目前，可用于支持直肠手术患者决策的易于访问的在线健康信息质量较差，难以阅读，且不支持共同决策。建议专业机构和医务人员寻求开发决策辅助工具，以支持全层直肠脱垂手术的决策。
