Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Dana-Farber Cancer Institute, Boston, Massachusetts.
Dana-Farber Cancer Institute, Boston, Massachusetts.
Int J Radiat Oncol Biol Phys. 2020 May 1;107(1):33-38. doi: 10.1016/j.ijrobp.2019.12.043. Epub 2020 Jan 24.
Many patients weighing cancer treatment options may consider relatively novel options including proton radiation therapy (PRT) and turn to the Internet for online health resources (OHR). However, quality and readability of OHR for radiation oncology therapies has been shown to need improvement. Because the OHR that patients access can influence their treatment decisions, our study sought to understand the patterns of use, quality, and readability of OHR on PRT.
To validate the need to assess OHR on PRT, we assessed search patterns in the United States for the search phrase "proton therapy" using Google Trends. The Google search engine was then queried for websites with PRT information using 10 search phrases. The subsequent websites were analyzed for readability by the Flesch-Kincaid Grade Level and a Composite Grade Level (CGL) metric comprised of 5 readability metrics. Quality was analyzed using the DISCERN instrument.
Search volume index for "proton therapy" increased by an average of 2.0% each year for the last 15 years (January 1, 2005 to June 1, 2019, P < .001). States that had a greater number of proton centers tended to have a greater relative search volume in Google (P < .001). Of the 45 unique websites identified, the mean Flesch-Kincaid Grade Level was 12.0 (range, 7.3-18.6) and the mean CGL was 12.4 (range, 7-18). In addition, 80% of PRT pages required greater than 11th grade CGL. The mean DISCERN score of all websites was 39.8 out of 75, which corresponds to "fair" quality OHR.
Despite increasing interest in PRT OHR, in general, PRT websites require reading levels much higher than currently recommended, making PRT OHR less accessible to the average patient. Provision of high-quality PRT OHR at the appropriate reading level may increase comprehension of PRT, improve patient autonomy, and facilitate informed decision-making among radiation oncology patients.
许多权衡癌症治疗方案的患者可能会考虑包括质子放射治疗（PRT）在内的相对新颖的选择，并转向互联网获取在线健康资源（OHR）。然而，放射肿瘤治疗的 OHR 的质量和可读性已经被证明需要改进。由于患者获取的 OHR 会影响他们的治疗决策，我们的研究旨在了解 PRT 中 OHR 的使用、质量和可读性模式。
为了验证评估 PRT 上 OHR 的必要性，我们使用 Google Trends 评估了美国对搜索短语“质子治疗”的搜索模式。然后，使用 10 个搜索短语在谷歌搜索引擎上查询了包含 PRT 信息的网站。随后，使用 Flesch-Kincaid 年级水平和由 5 个可读性指标组成的综合年级水平（CGL）度量标准来分析网站的可读性。使用 DISCERN 工具分析质量。
在过去的 15 年中（2005 年 1 月 1 日至 2019 年 6 月 1 日），“质子治疗”的搜索量指数平均每年增长 2.0%（P<0.001）。质子中心数量较多的州在谷歌中的相对搜索量也较大（P<0.001）。在确定的 45 个独特网站中，平均 Flesch-Kincaid 年级水平为 12.0（范围为 7.3-18.6），平均 CGL 为 12.4（范围为 7-18）。此外，80%的 PRT 网页需要高于 11 年级 CGL 的阅读水平。所有网站的平均 DISCERN 得分为 75 分中的 39.8 分，对应于“中等”质量的 OHR。
尽管人们对 PRT OHR 的兴趣日益增加，但总的来说，PRT 网站的阅读水平要求远高于目前建议的水平，使得平均患者难以获得 PRT OHR。提供高质量的 PRT OHR 和适当的阅读水平可能会提高对 PRT 的理解，增强患者的自主性，并促进放射肿瘤学患者做出知情决策。
