Strauss Shira, Yacob Michael, Bhandari Apoorva, Jetty Prasad
Division of Vascular Surgery, University of Ottawa, Ottawa, ON, Canada.
Division of Vascular Surgery, Queen's University, Kingston, ON, Canada.
Interact J Med Res. 2020 Nov 3;9(4):e23519. doi: 10.2196/23519.
The internet is becoming increasingly more important in the new era of patient self-education. Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are recognized interventions to treat patients with carotid artery stenosis. Using the Google search platform, patients encounter many websites with conflicting information, which are sometimes difficult to understand. This lack of accessibility creates uncertainty or bias toward interventions for carotid artery disease. The quality, readability, and treatment preference of carotid artery disease (CAD) websites have not yet been evaluated.
This study aimed to explore the quality, readability, and treatment preference of CAD websites.
We searched Google Canada for 10 CAD-related keywords. Returned links were assessed for publication date, medical specialty and industry affiliation, presence of randomized controlled trial data, differentiation by symptomatic status, and favored treatment. Website quality and readability were rated by the DISCERN instrument and Gunning Fog Index.
We identified 54 unique sites: 18 (33.3%) by medical societies or individual physicians, 11 (20.4%) by government organizations, 9 (16.7%) by laypersons, and 1 (1.9%) that was industry-sponsored. Of these sites, 26 (48.1%) distinguished symptomatic from asymptomatic CAD. A majority of sites overall (57.4%) and vascular-affiliated (72.7%) favored CEA. In contrast, radiology- and cardiology-affiliated sites demonstrated the highest proportion of sites favoring CAS, though they were equally likely to favor CEA. A large proportion (21/54, 38.9%) of sites received poor quality ratings (total DISCERN score <48), and the majority (41/54, 75.9%) required a reading level greater than a high school senior.
CAD websites are often produced by government organizations, medical societies, or physicians, especially vascular surgeons. Sites ranged in quality, readability, and differentiation by symptomatic status. Google searches of CAD-related terms are more likely to yield sites favoring CEA. Future research should determine the extent of website influence on CAD patients' treatment decisions.
在患者自我教育的新时代，互联网正变得越来越重要。颈动脉内膜切除术（CEA）和颈动脉支架置入术（CAS）是公认的治疗颈动脉狭窄患者的干预措施。通过谷歌搜索平台，患者会遇到许多信息相互矛盾且有时难以理解的网站。这种信息获取的不足会导致对颈动脉疾病干预措施的不确定性或偏见。颈动脉疾病（CAD）网站的质量、可读性和治疗偏好尚未得到评估。
本研究旨在探讨CAD网站的质量、可读性和治疗偏好。
我们在谷歌加拿大上搜索了10个与CAD相关的关键词。对返回的链接评估其发布日期、医学专业和行业归属、随机对照试验数据的存在情况、症状状态的区分以及偏好的治疗方法。网站质量和可读性由DISCERN工具和冈宁雾度指数进行评级。
我们识别出54个独特的网站：18个（33.3%）由医学协会或个体医生制作，11个（20.4%）由政府组织制作，9个（16.7%）由非专业人士制作，1个（1.9%）由行业赞助。在这些网站中，26个（48.1%）区分了有症状和无症状的CAD。总体而言，大多数网站（57.4%）和血管相关网站（72.7%）更倾向于CEA。相比之下，放射科和心脏病科相关网站中倾向于CAS的网站比例最高，不过它们同样有可能倾向于CEA。很大一部分网站（21/54，38.9%）质量评级较差（DISCERN总分<48），大多数网站（41/54，75.9%）要求的阅读水平高于高中毕业生。
CAD网站通常由政府组织、医学协会或医生制作，尤其是血管外科医生。网站在质量、可读性和症状状态区分方面存在差异。在谷歌上搜索与CAD相关的术语更有可能得到倾向于CEA的网站。未来的研究应确定网站对CAD患者治疗决策的影响程度。
