Tracy Marguerite Clare, Shepherd Heather L, Patel Pinika, Trevena Lyndal Jane
Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, School of Public Health, The University of Sydney, NSW, Australia.
Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, NSW, Australia.
J Med Internet Res. 2020 May 29;22(5):e17002. doi: 10.2196/17002.
There is increasing interest in shared decision making (SDM) in Australia. Question prompt lists (QPLs) support question asking by patients, a key part of SDM. QPLs have been studied in a variety of settings, and increasingly the internet provides a source of suggested questions for patients. Environmental scans have been shown to be useful in assessing the availability and quality of online SDM tools.
This study aimed to assess the number and readability of QPLs available to users via Google.com.au.
Our environmental scan used search terms derived from literature and reputable websites to search for QPLs available via Google.com.au. Following removal of duplicates from the 4000 URLs and 22 reputable sites, inclusion and exclusion criteria were applied to create a list of unique QPLs. A sample of 20 QPLs was further assessed for list length, proxy measures of quality such as a date of review, and evidence of doctor endorsement. Readability of the sample QPL instructions and QPLs themselves was assessed using Flesch Reading Ease and Flesch-Kincaid Grade Level scores.
Our environmental scan identified 173 unique QPLs available to users. Lists ranged in length from 1 question to >200 questions. Of our sample, 50% (10/20) had a listed date of creation or update, and 60% (12/20) had evidence of authorship or source. Flesch-Kincaid Grade Level scores for instructions were higher than for the QPLs (grades 10.3 and 7.7, respectively). There was over a 1 grade difference between QPLs from reputable sites compared with other sites (grades 4.2 and 5.4, respectively).
People seeking questions to ask their doctor using Google.com.au encounter a vast number of question lists that they can use to prepare for consultations with their doctors. Markers of the quality or usefulness of various types of online QPLs, either surrogate or direct, have not yet been established, which makes it difficult to assess the value of the abundance of lists. Doctor endorsement of question asking has previously been shown to be an important factor in the effectiveness of QPLs, but information regarding this is not readily available online. Whether these diverse QPLs are endorsed by medical practitioners warrants further investigation.
在澳大利亚，人们对共同决策（SDM）的兴趣日益浓厚。问题提示列表（QPLs）有助于患者提问，这是共同决策的关键部分。QPLs已在多种环境中得到研究，并且互联网越来越成为患者建议问题的来源。环境扫描已被证明有助于评估在线SDM工具的可用性和质量。
本研究旨在评估通过Google.com.au可供用户使用的QPLs的数量和可读性。
我们的环境扫描使用从文献和知名网站中提取的搜索词，搜索通过Google.com.au可获得的QPLs。在从4000个网址和22个知名网站中删除重复项后，应用纳入和排除标准以创建唯一QPLs列表。进一步评估了20个QPLs的样本的列表长度、诸如审查日期等质量的替代指标以及医生认可的证据。使用弗莱什阅读简易度和弗莱什 - 金凯德年级水平分数评估样本QPL说明和QPLs本身的可读性。
我们的环境扫描确定了可供用户使用的173个唯一QPLs。列表长度从1个问题到超过200个问题不等。在我们的样本中，50%（10/20）有列出的创建或更新日期，60%（12/20）有作者身份或来源的证据。说明的弗莱什 - 金凯德年级水平分数高于QPLs（分别为10.3年级和7.7年级）。与其他网站相比，知名网站的QPLs之间存在超过1个年级的差异（分别为4.2年级和5.4年级）。
使用Google.com.au寻求向医生提问的人会遇到大量可用于准备与医生咨询的问题列表。尚未建立各种类型在线QPLs质量或有用性的替代或直接指标，这使得难以评估大量列表的价值。先前已表明医生对提问的认可在QPLs的有效性中是一个重要因素，但在线上不容易获得有关此的信息。这些不同的QPLs是否得到医学从业者的认可值得进一步调查。
