Sideris Georgios Antonios, Vyllioti Aikaterini-Themis, Dima Danai, Chill Michael, Njuguna Njogu
Department of Radiology, Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, United States.
School of Life Sciences, Technical University of Munich, Munich, Germany.
JMIR Cancer. 2021 May 7;7(2):e25357. doi: 10.2196/25357.
Thousands of web searches are performed related to transarterial chemoembolization (TACE), given its palliative role in the treatment of liver cancer.
This study aims to assess the reliability, quality, completeness, readability, understandability, and actionability of websites that provide information on TACE for patients.
The five most popular keywords pertaining to TACE were searched on Google, Yahoo, and Bing. General website characteristics and the presence of Health On the Net Foundation code certification were documented. Website assessment was performed using the following scores: DISCERN, Journal of the American Medical Association, Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Patient Education Materials Assessment Tool. A novel TACE content score was generated to evaluate website completeness.
The search yielded 3750 websites. In total, 81 website entities belonging to 78 website domains met the inclusion criteria. A medical disclaimer was not provided on 28% (22/78) of website domains. Health On the Net code certification was present on 12% (9/78) of website domains. Authorship was absent on 88% (71/81) of websites, and sources were absent on 83% (67/81) of websites. The date of publication or of the last update was not listed on 58% (47/81) of websites. The median DISCERN score was 47.0 (IQR 40.5-54.0). The median TACE content score was 35 (IQR 27-43). The median readability grade level was in the 11th grade. Overall, 61% (49/81) and 16% (13/81) of websites were deemed understandable and actionable, respectively. Not-for-profit websites fared significantly better on the Journal of the American Medical Association, DISCERN, and TACE content scores.
The content referring to TACE that is currently available on the web is unreliable, incomplete, difficult to read, understandable but not actionable, and characterized by low overall quality. Websites need to revise their content to optimally educate consumers and support shared decision-making.
PROSPERO International Prospective Register of Systematic Reviews CRD42020202747; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020202747.
鉴于经动脉化疗栓塞术（TACE）在肝癌治疗中的姑息作用，人们进行了数千次与之相关的网络搜索。
本研究旨在评估为患者提供TACE信息的网站的可靠性、质量、完整性、可读性、易懂性和可操作性。
在谷歌、雅虎和必应上搜索与TACE相关的五个最热门关键词。记录网站的一般特征以及是否存在健康网基金会代码认证。使用以下评分进行网站评估：DISCERN评分、美国医学会杂志评分、弗莱什-金凯德年级水平评分、弗莱什阅读简易度评分以及患者教育材料评估工具。生成一个新的TACE内容评分以评估网站的完整性。
搜索共得到3750个网站。总共有属于78个网站域名的81个网站实体符合纳入标准。28%（22/78）的网站域名未提供医学免责声明。12%（9/78）的网站域名有健康网代码认证。88%（71/81）的网站没有作者信息，83%（67/81）的网站没有来源信息。58%（47/81）的网站未列出发布日期或最后更新日期。DISCERN评分的中位数为47.0（四分位间距40.5 - 54.0）。TACE内容评分的中位数为35（四分位间距27 - 43）。可读性年级水平的中位数为11年级。总体而言，分别有61%（49/81）和16%（13/81）的网站被认为是易懂的和可操作的。非营利性网站在美国医学会杂志评分、DISCERN评分和TACE内容评分方面表现明显更好。
目前网络上关于TACE的内容不可靠、不完整、难以阅读、易懂但不可操作，且总体质量较低。网站需要修订其内容，以更好地教育消费者并支持共同决策。
国际系统评价前瞻性注册库PROSPERO CRD42020202747；https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020202747 。
