Deng Jie, Savjani Ricky R, Lee Percy
Department of Radiation Oncology, University of California Los Angeles, Los Angeles, USA.
Cureus. 2019 Oct 7;11(10):e5857. doi: 10.7759/cureus.5857.
Cancer patients are faced with increasing options for cancer care, especially with the introduction of cancer immunotherapy with immune checkpoint inhibitors (ICIs). Though many patients turn to online resources to supplement their decision-making, it is unknown whether online resources in cancer immunotherapy with ICIs are written at an appropriate level of readability according to national medical organizations. We performed a cross-sectional analysis of internet search behavior for cancer immunotherapy by ICIs and clinical trial availability per ClinicalTrials.gov in the United States (US) from 2004 - 2018 with subsequent quantitation of readability by four readability formulas of top 50 online resources. Internet search behavior for "cancer immunotherapy" has steadily increased since 2013 and coincides with the year of the US Food and Drug Administration (FDA) approval for individual ICIs. Furthermore, internet search behavior was significantly correlated with clinical trial availability in the US (R = 0.97, p < 0.0001). None of the top 50 resources available to patients were found to be within the recommended level of sixth-grade readability or less with only one (2%) written at the middle school level, 21 (42%) at the high school level, 23 (46%) at the university level, and five (8%) at a graduate level. Population-level internet search patterns may reflect patient behavior in seeking relevant online health information and may be influenced by new options for cancer therapy, including via clinical trials. However, low readability of available online resources may impede patient comprehension and negatively affect medical decision-making.
癌症患者在癌症治疗方面面临着越来越多的选择，尤其是随着免疫检查点抑制剂（ICIs）癌症免疫疗法的引入。尽管许多患者会借助网络资源来辅助他们做决策，但根据国家医学组织的标准，尚不清楚关于ICIs癌症免疫疗法的网络资源是否具有适宜的可读性水平。我们对2004年至2018年美国通过ICIs进行癌症免疫疗法的互联网搜索行为以及ClinicalTrials.gov上的临床试验可用性进行了横断面分析，随后使用前50个网络资源的四种可读性公式对可读性进行了量化。自2013年以来，“癌症免疫疗法”的互联网搜索行为稳步增加，这与美国食品药品监督管理局（FDA）批准个别ICIs的年份相吻合。此外，美国的互联网搜索行为与临床试验可用性显著相关（R = 0.97，p < 0.0001）。在提供给患者的前50个资源中，没有一个的可读性水平达到或低于推荐的六年级水平，只有一个（2%）为初中水平，21个（42%）为高中水平，23个（46%）为大学水平，5个（8%）为研究生水平。人群层面的互联网搜索模式可能反映了患者寻求相关在线健康信息的行为，并且可能受到癌症治疗新选择的影响，包括通过临床试验。然而，现有网络资源的低可读性可能会妨碍患者理解，并对医疗决策产生负面影响。
