Tan Denise Jia Yun, Ko Tsz Ki, Fan Ka Siu
Department of Surgery, Royal Stoke University Hospital, Stoke on Trent, United Kingdom.
Department of Surgery, Royal Surrey County Hospital, Guildford, Surrey, United Kingdom.
JMIR Form Res. 2023 Nov 27;7:e47762. doi: 10.2196/47762.
Nasopharyngeal carcinoma (NPC) is a rare disease that is strongly associated with exposure to the Epstein-Barr virus and is characterized by the formation of malignant cells in nasopharynx tissues. Early diagnosis of NPC is often difficult owing to the location of initial tumor sites and the nonspecificity of initial symptoms, resulting in a higher frequency of advanced-stage diagnoses and a poorer prognosis. Access to high-quality, readable information could improve the early detection of the disease and provide support to patients during disease management.
This study aims to assess the quality and readability of publicly available web-based information in the English language about NPC, using the most popular search engines.
Key terms relevant to NPC were searched across 3 of the most popular internet search engines: Google, Yahoo, and Bing. The top 25 results from each search engine were included in the analysis. Websites that contained text written in languages other than English, required paywall access, targeted medical professionals, or included nontext content were excluded. Readability for each website was assessed using the Flesch Reading Ease score and the Flesch-Kincaid grade level. Website quality was assessed using the Journal of the American Medical Association (JAMA) and DISCERN tools as well as the presence of a Health on the Net Foundation seal.
Overall, 57 suitable websites were included in this study; 26% (15/57) of the websites were academic. The mean JAMA and DISCERN scores of all websites were 2.80 (IQR 3) and 57.60 (IQR 19), respectively, with a median of 3 (IQR 2-4) and 61 (IQR 49-68), respectively. Health care industry websites (n=3) had the highest mean JAMA score of 4 (SD 0). Academic websites (15/57, 26%) had the highest mean DISCERN score of 77.5. The Health on the Net Foundation seal was present on only 1 website, which also achieved a JAMA score of 3 and a DISCERN score of 50. Significant differences were observed between the JAMA score of hospital websites and the scores of industry websites (P=.04), news service websites (P<.048), charity and nongovernmental organization websites (P=.03). Despite being a vital source for patients, general practitioner websites were found to have significantly lower JAMA scores compared with charity websites (P=.05). The overall mean readability scores reflected an average reading age of 14.3 (SD 1.1) years.
The results of this study suggest an inconsistent and suboptimal quality of information related to NPC on the internet. On average, websites presented readability challenges, as written information about NPC was above the recommended reading level of sixth grade. As such, web-based information requires improvement in both quality and accessibility, and healthcare providers should be selective about information recommended to patients, ensuring they are reliable and readable.
鼻咽癌（NPC）是一种罕见疾病，与感染爱泼斯坦-巴尔病毒密切相关，其特征是鼻咽组织中形成恶性细胞。由于初始肿瘤部位的位置以及初始症状的非特异性，鼻咽癌的早期诊断往往很困难，导致晚期诊断的频率较高且预后较差。获取高质量、易读的信息可以改善该疾病的早期检测，并在疾病管理期间为患者提供支持。
本研究旨在使用最流行的搜索引擎评估互联网上公开可用的英文鼻咽癌相关信息的质量和可读性。
在3个最流行的互联网搜索引擎（谷歌、雅虎和必应）中搜索与鼻咽癌相关的关键词。每个搜索引擎的前25个结果纳入分析。排除包含非英语文本、需要付费访问、针对医学专业人员或包含非文本内容的网站。使用弗莱什易读性分数和弗莱什-金凯德年级水平评估每个网站的可读性。使用美国医学会杂志（JAMA）和DISCERN工具以及网络健康基金会认证标志评估网站质量。
总体而言，本研究纳入了57个合适的网站；其中26%（15/57）的网站是学术性的。所有网站的JAMA和DISCERN平均得分分别为2.80（四分位距3）和57.60（四分位距19），中位数分别为3（四分位距2 - 4）和61（四分位距49 - 68）。医疗保健行业网站（n = 3）的JAMA平均得分最高，为4（标准差0）。学术网站（15/57，26%）的DISCERN平均得分最高，为77.5。只有1个网站有网络健康基金会认证标志，该网站的JAMA得分为3，DISCERN得分为50。医院网站的JAMA得分与行业网站（P = 0.04）、新闻服务网站（P < 0.048）、慈善和非政府组织网站（P = 0.03）的得分之间存在显著差异。尽管全科医生网站是患者的重要信息来源，但发现其JAMA得分与慈善网站相比显著较低（P = 0.05）。总体平均可读性分数反映平均阅读年龄为14.3（标准差1.1）岁。
本研究结果表明互联网上与鼻咽癌相关的信息质量参差不齐且不理想。平均而言，网站存在可读性挑战，因为关于鼻咽癌的书面信息高于六年级的推荐阅读水平。因此，基于网络的信息在质量和可及性方面都需要改进，医疗保健提供者应谨慎选择向患者推荐的信息，确保其可靠且易读。
