Lee Kevin C, Berg Elizabeth T, Jazayeri Hossein E, Chuang Sung-Kiang, Eisig Sidney B
Resident, Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY.
DDS Candidate, College of Dental Medicine, Columbia University, New York, NY.
J Oral Maxillofac Surg. 2019 Jan;77(1):180.e1-180.e8. doi: 10.1016/j.joms.2018.08.033. Epub 2018 Sep 12.
The purpose of this study was to evaluate the readability and quality of online patient educational materials (PEMs) for orthognathic surgery.
Two internet searches were performed using the search terms orthognathic surgery and jaw surgery. The presence of content related to the risks, benefits, procedure, and postoperative care was recorded. Readability was measured using 4 validated scales: Flesch-Kincaid grade level, Gunning Fog index, Coleman-Liau index, and Simple Measure of Gobbledygook index. Materials were readable if they were written at or below an eighth-grade reading level as recommended by the American Medical Association (AMA) and the National Institutes of Health (NIH). Quality was assessed using 2 metrics: the DISCERN instrument and the Journal of the American Medical Association benchmark criteria. A DISCERN score of 50 was set as the lower limit of acceptable quality. Mann-Whitney U and Fisher exact tests were used to compare the readability, quality, and presence of content between private practice and non-private practice PEMs.
Fifty websites were included in the study after removing duplicates and applying exclusion criteria. On average, PEMs were written at a 13.4-grade level (range, 7.8 to 17.3). Nearly every website (n = 49; 98%) mentioned the benefits of surgery; however, very few websites discussed the surgical procedure (n = 12; 24%), postoperative care (n = 10; 20%), and risks or complications (n = 6; 12%). The mean DISCERN score was 25.5 of 80 (range, 18 to 63), and only 2 websites achieved DISCERN scores of acceptable quality. Private practice websites reported less content related to the surgical procedure (P = .03) and had lower DISCERN scores (P = .02).
As a whole, online PEMs for orthognathic surgery failed to meet AMA and NIH readability recommendations and yielded poor quality scores. Increasing the presence of content related to treatment risks and postoperative care will help improve the quality of PEMs.
本研究旨在评估正颌外科在线患者教育材料（PEMs）的可读性和质量。
使用搜索词“正颌外科”和“颌骨手术”进行了两次互联网搜索。记录与风险、益处、手术过程及术后护理相关内容的存在情况。使用4种经过验证的量表测量可读性：弗莱施-金凯德年级水平、冈宁雾度指数、科尔曼-廖指数和简式费解度指数。如果材料的写作水平达到或低于美国医学协会（AMA）和美国国立卫生研究院（NIH）推荐的八年级阅读水平，则认为其具有可读性。使用2种指标评估质量：DISCERN工具和美国医学会基准标准。将DISCERN分数50设定为可接受质量的下限。采用曼-惠特尼U检验和费舍尔精确检验比较私人执业和非私人执业PEMs之间的可读性、质量及内容的存在情况。
在去除重复项并应用排除标准后，共有50个网站纳入本研究。PEMs的平均写作水平为13.4年级（范围为7.8至17.3）。几乎每个网站（n = 49；98%）都提到了手术的益处；然而，很少有网站讨论手术过程（n = 12；24%）、术后护理（n = 10；20%）以及风险或并发症（n = 6；12%）。DISCERN平均得分为80分中的25.5分（范围为18至63），只有2个网站达到了可接受质量的DISCERN分数。私人执业网站报告的与手术过程相关的内容较少（P = 0.03），且DISCERN分数较低（P = 0.02）。
总体而言，正颌外科的在线PEMs未达到AMA和NIH的可读性建议，质量得分较低。增加与治疗风险和术后护理相关内容的呈现将有助于提高PEMs的质量。
