Division of Vascular and Endovascular Surgery, Department of Surgery, Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Tex; South Texas Center for Vascular Care, South Texas Medical Center, San Antonio, Tex.
Shanghai Medical College, Fudan University, Shanghai, China.
J Vasc Surg Venous Lymphat Disord. 2021 Jul;9(4):1017-1024.e7. doi: 10.1016/j.jvsv.2020.12.072. Epub 2020 Dec 17.
Patients increasingly seek information on their medical conditions from the internet. The present study evaluated the quality and readability of readily available online patient resources for varicose veins.
An internet search for "varicose veins" was conducted using the meta-search engines Yippy and Dogpile and the general search engines Google, Yahoo, and Bing with a cleared-cache web browser in July 2019. Two trained raters scored the websites separately on the dimensions of accessibility, accountability, interactivity, structure, and content. Any discrepancies were discussed, and a consensus was reached. Readability was calculated using four readability metric systems. Rater consistency was evaluated using kappa, weighted kappa, and interrater correlation coefficient, as indicated.
A total of 189 websites met the inclusion criteria. The total median quality score was 15.6 (interquartile range [IQR], 13.1-20.5; range, 7.4-31.3) of 38. The websites scored a median of 4 (IQR, 1-8) of 15 for accountability, 2 (IQR, 2-2) of 5 for interactivity, 4 (IQR, 2-4) of 4 for organization, and 6.4 (IQR, 3.9-7.9) of 14 for weighted content. Most websites (81.5%) were accessible. However, the overall readability was poor. The median Flesch-Kincaid reading ease score was 55.1 (IQR, 49.4-6.7), indicating that the text was fairly difficult to read. The median grade level was 10th grade using both the Flesch-Kincaid grade level and simple measure of the Gobbledygook index and 11th to 12th grade using the new Dale-Chall readability formula. Government websites were the most accountable, featured the best content, and were the most readable. The website traffic had a positive, nonlinear correlation with the total score and a negative, nonlinear correlation with the website rank (or position on the search result page). Website rank correlated negatively with the total score, although the correlation was weak.
The quality of the online patient resources on varicose veins varies greatly, and the readability for most sites is poor. Government-sponsored websites had the highest quality and were the most readable. Physicians are advised to consider providing a list of appropriate websites to their patients to better inform them, avoid confusion, and ensure appropriate delivery of accurate and readable information.
患者越来越多地从互联网上获取有关其病情的信息。本研究评估了可用于静脉曲张的现成在线患者资源的质量和可读性。
2019 年 7 月，使用元搜索引擎 Yippy 和 Dogpile 以及通用搜索引擎 Google、Yahoo 和 Bing 进行了“静脉曲张”的互联网搜索，并使用清除缓存的网络浏览器进行搜索。两名经过培训的评审员分别根据可访问性、问责制、交互性、结构和内容对网站进行评分。对任何差异进行讨论并达成共识。使用四个可读性度量系统计算可读性。使用kappa、加权 kappa 和组内相关系数评估评分者一致性，具体取决于情况。
共有 189 个网站符合纳入标准。总体质量评分中位数为 15.6（四分位距[IQR]，13.1-20.5；范围，7.4-31.3），满分 38 分。网站在问责制方面的评分为中位数 4（IQR，1-8），满分 15 分；交互性为 2（IQR，2-2），满分 5 分；组织性为 4（IQR，2-4），满分 4 分；加权内容为 6.4（IQR，3.9-7.9），满分 14 分。大多数网站（81.5%）具有可访问性。但是，整体可读性较差。Flesch-Kincaid 阅读舒适度得分中位数为 55.1（IQR，49.4-6.7），表明文本阅读难度相当大。Flesch-Kincaid 年级水平和简单的 Gobbledygook 指数中位数为 10 年级，而新的 Dale-Chall 可读性公式则为 11 年级至 12 年级。政府网站最具问责制，提供最佳内容，可读性最强。网站流量与总分呈正相关，与网站排名（或搜索结果页面上的位置）呈负相关。网站排名与总分呈负相关，但相关性较弱。
静脉曲张在线患者资源的质量差异很大，大多数网站的可读性较差。政府赞助的网站质量最高，可读性最强。建议医生考虑为患者提供合适的网站列表，以便更好地为他们提供信息，避免混淆，并确保提供准确且易读的信息。
