直接前入路与后入路全髋关节置换术的在线搜索特征和质量。
Characteristics and Quality of Online Searches for Direct Anterior Versus Posterior Approach for Total Hip Arthroplasty.
机构信息
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Institute for Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York.
出版信息
J Arthroplasty. 2024 Sep;39(9):2329-2335.e1. doi: 10.1016/j.arth.2024.03.048. Epub 2024 Apr 4.
BACKGROUND
Online resources are important for patient self-education and reflect public interest. We described commonly asked questions regarding the direct anterior versus posterior approach (DAA, PA) to total hip arthroplasty (THA) and the quality of associated websites.
METHODS
We extracted the top 200 questions and websites in Google's "People Also Ask" section for 8 queries on January 8, 2023, and grouped websites and questions into DAA, PA, or comparison. Questions were categorized using Rothwell's classification (fact, policy, value) and THA-relevant subtopics. Websites were evaluated by information source, Journal of the American Medical Association Benchmark Criteria (credibility), DISCERN survey (information quality), and readability.
RESULTS
We included 429 question/website combinations (questions: 52.2% DAA, 21.2% PA, 26.6% comparison; websites: 39.0% DAA, 11.0% PA, 9.6% comparison). Per Rothwell's classification, 56.2% of questions were fact, 31.7% value, 10.0% policy, and 2.1% unrelated. The THA-specific question subtopics differed between DAA and PA (P < .001), specifically for recovery timeline (DAA 20.5%, PA 37.4%), indications/management (DAA 13.4%, PA 1.1%), and technical details (DAA 13.8%, PA 5.5%). Information sources differed between DAA (61.7% medical practice/surgeon) and PA websites (44.7% government; P < .001). The median Journal of the American Medical Association Benchmark score was 1 (limited credibility, interquartile range 1 to 2), with the lowest scores for DAA websites (P < .001). The median DISCERN score was 55 ("good" quality, interquartile range 43 to 65), with the highest scores for comparison websites (P < .001). Median Flesch-Kincaid Grade Level scores were 12th grade level for both DAA and PA (P = .94).
CONCLUSIONS
Patients' informational interests can guide counseling. Internet searches that explicitly compare THA approaches yielded websites that provide higher-quality information. Providers may also advise patients that physician websites and websites only describing the DAA may have less balanced perspectives, and limited information regarding surgical approaches is available from social media resources.
背景
在线资源对于患者的自我教育很重要，并且反映了公众的兴趣。我们描述了关于直接前路（DAA）与后外侧入路（PA）全髋关节置换术（THA）的常见问题，以及相关网站的质量。
方法
我们于 2023 年 1 月 8 日提取了谷歌“人们也在问”（People Also Ask）版块中排名前 200 的 8 个查询的问题和网站，并将网站和问题分为 DAA、PA 或比较。问题采用 Rothwell 的分类（事实、政策、价值）和与 THA 相关的子主题进行分类。网站根据信息来源、美国医学会基准标准（可信度）、DISCERN 调查（信息质量）和可读性进行评估。
结果
我们共纳入 429 个问题/网站组合（问题：52.2%为 DAA，21.2%为 PA，26.6%为比较；网站：39.0%为 DAA，11.0%为 PA，9.6%为比较）。根据 Rothwell 的分类，56.2%的问题为事实，31.7%为价值，10.0%为政策，2.1%为无关。DAA 和 PA 之间的特定于 THA 的问题子主题不同（P<0.001），具体为恢复时间线（DAA 20.5%，PA 37.4%）、适应证/管理（DAA 13.4%，PA 1.1%）和技术细节（DAA 13.8%，PA 5.5%）。DAA 网站的信息来源为 61.7%为医疗实践/外科医生，PA 网站为 44.7%为政府（P<0.001）。美国医学会基准评分中位数为 1 分（可信度有限，四分位距 1 至 2），DAA 网站得分最低（P<0.001）。DISCERN 评分中位数为 55 分（“良好”质量，四分位距 43 至 65），比较网站得分最高（P<0.001）。DAA 和 PA 的 Flesch-Kincaid 年级分数中位数均为 12 年级（P=0.94）。
结论
患者的信息兴趣可以指导咨询。明确比较 THA 方法的互联网搜索产生了提供更高质量信息的网站。医生也可以建议患者，医生网站和仅描述 DAA 的网站可能具有不平衡的观点，并且社交媒体资源提供的有关手术方法的信息有限。
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