Lim Brandon, Sen Suddhajit
Trinity College Dublin, School of Medicine, Dublin, Ireland.
Department of Trauma and Orthopaedic Surgery, Raigmore Hospital, Inverness, UK.
J Hand Microsurg. 2024 Jun 26;16(4):100119. doi: 10.1016/j.jham.2024.100119. eCollection 2024 Oct.
Thumb carpometacarpal (CMC) joint osteoarthritis is a common degenerative condition that affects up to 15 % of the population older than 30 years. Poor readability of online health resources has been associated with misinformation, inappropriate care, incorrect self-treatment, worse health outcomes, and increased healthcare resource waste. This study aims to assess the readability and quality of online information regarding thumb carpometacarpal (CMC) joint replacement surgery.
The terms "thumb joint replacement surgery", "thumb carpometacarpal joint replacement surgery", "thumb cmc joint replacement surgery", "thumb arthroplasty", "thumb carpometacarpal arthroplasty", and "thumb cmc arthroplasty" were searched in Google and Bing. Readability was determined using the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Reading Grade Level (FKGL). FRES >65 or a grade level score of sixth grade and under was considered acceptable. Quality was assessed using the Patient Education Materials Assessment Tool (PEMAT) and a modified DISCERN tool. PEMAT scores below 70 were considered poorly understandable and poorly actionable.
A total of 34 websites underwent qualitative analysis. The average FRES was 54.60 ± 7.91 (range 30.30-67.80). Only 3 (8.82 %) websites had a FRES score >65. The average FKGL score was 8.19 ± 1.80 (range 5.60-12.90). Only 3 (8.82 %) websites were written at or below a sixth-grade level. The average PEMAT percentage score for understandability and actionability was 76.82 ± 9.43 (range 61.54-93.75) and 36.18 ± 24.12 (range 0.00-60.00) respectively. Although 22 (64.71 %) of websites met the acceptable standard of 70 % for understandability, none of the websites met the acceptable standard of 70 % for actionability. The average total DISCERN score was 32.00 ± 4.29 (range 24.00-42.00).
Most websites reviewed were written above recommended reading levels. Most showed acceptable understandability but none showed acceptable actionability. To avoid the negative outcomes of poor patient understanding of online resources, providers of these resources should optimise accessibility to the average reader by using simple words, avoiding jargon, and analysing texts with readability software before publishing the materials online. Websites should also utilise visual aids and provide clearer pre-operative and post-operative instructions.
拇指腕掌关节（CMC）骨关节炎是一种常见的退行性疾病，在30岁以上人群中的发病率高达15%。在线健康资源可读性差与错误信息、不恰当的护理、不正确的自我治疗、更差的健康结果以及医疗资源浪费增加有关。本研究旨在评估关于拇指腕掌关节（CMC）置换手术的在线信息的可读性和质量。
在谷歌和必应上搜索“拇指关节置换手术”“拇指腕掌关节置换手术”“拇指CMC关节置换手术”“拇指关节成形术”“拇指腕掌关节成形术”和“拇指CMC关节成形术”等术语。使用弗莱什易读性评分（FRES）和弗莱什 - 金凯德阅读年级水平（FKGL）来确定可读性。FRES>65或六年级及以下的年级水平得分被认为是可接受的。使用患者教育材料评估工具（PEMAT）和改良的DISCERN工具评估质量。PEMAT得分低于70被认为难以理解且难以付诸行动。
总共对34个网站进行了定性分析。平均FRES为54.60±7.91（范围30.30 - 67.80）。只有3个（8.82%）网站的FRES得分>65。平均FKGL得分为8.19±1.80（范围5.60 - 12.90）。只有3个（8.82%）网站的写作水平在六年级及以下。可理解性和可操作性的平均PEMAT百分比得分分别为76.82±9.43（范围61.54 - 93.75）和36.18±24.12（范围0.00 - 60.00）。虽然22个（64.71%）网站达到了70%的可接受理解标准，但没有一个网站达到70%的可接受行动标准。平均总DISCERN得分为32.00±4.29（范围24.00 - 42.00）。
大多数被审查的网站写作水平高于推荐阅读水平。大多数显示出可接受的可理解性，但没有一个显示出可接受的可操作性。为避免患者对在线资源理解不佳的负面结果，这些资源的提供者应通过使用简单词汇、避免行话以及在将材料在线发布之前使用可读性软件分析文本，来优化普通读者的可及性。网站还应使用视觉辅助工具并提供更清晰的术前和术后指导。
