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World Journal of Urology

, Volume 36, Issue 6, pp 985–992 | Cite as

Assessment of readability, quality and popularity of online information on ureteral stents

  • Sarah Mozafarpour
  • Briony Norris
  • James Borin
  • Brian H. Eisner
Original Article

Abstract

Objective

To evaluate the quality and readability of online information on ureteral stents.

Methods

Google.com was queried using the search terms “ureteric stent”, “ureteral stent”, “double J stent” and, “Kidney stent” derived from Google AdWords. Website popularity was determined using Google Rank and the Alexa tool. Website quality assessment was performed using the following criteria: Journal of the American Medical Association (JAMA) benchmarks, Health on the Net (HON) criteria, and a customized DISCERN questionnaire. The customized DISCERN questionnaire was developed by combining the short validated DISCERN questionnaire with additional stent-specific items including definition, placement, complications, limitations, removal and “when to seek help”. Scores related to stent items were considered as the “stent score” (SS). Readability was evaluated using five readability tests.

Results

Thirty-two websites were included. The mean customized DISCERN score and “stent score” were 27.1 ± 7.1 (maximum possible score = 59) and 14.6 ± 3.8 (maximum possible score = 24), respectively. A minority of websites adequately addressed “stent removal” and “when to seek medical attention”. Only two websites (6.3%) had HON certification (drugs.com, radiologyinfo.org) and only one website (3.3%) met all JAMA criteria (bradyurology.blogspot.com). Readability level was higher than the American Medical Association recommendation of sixth-grade level for more than 75% of the websites. There was no correlation between Google rank, Alexa rank, and the quality scores (P > 0.05).

Discussion

Among the 32 most popular websites on the topic of ureteral stents, online information was highly variable. The readability of many of the websites was far higher than standard recommendations and the online information was questionable in many cases. These findings suggest a need for improved online resources in order to better educate patients about ureteral stents and also should inform physicians that popular websites may have incomplete information.

Keywords

Ureter Stent Internet Quality Readability 

Notes

Author contributions

Sarah Mozafarpour—protocol/project development, data collection and management, data analysis, manuscript writing. Briony Norris—protocol/project development, data collection and management, data analysis, manuscript writing. James Borin—protocol/project development, data analysis, manuscript writing/editing. Brian Eisner—protocol/project development, data analysis, manuscript writing/editing.

Compliance with ethical standards

This study evaluated the readability of internet websites. No humans subjects or animal subjects were involved. Therefore, there is no risk of non-compliance with ethical standards for human or animal subjects and there was no informed consent needed for the study.

Conflict of interest

Sarah Mozafarpour—no conflicts. Briony Norris—no conflicts. James Borin—no conflicts. Brian Eisner—consultant for Boston Scientific, Olympus, Kalera Medical and Sonomotion.

References

  1. 1.
    Gibbons RP, Correa RJ Jr, Cummings KB, Mason JT (1976) Experience with indwelling ureteral stent catheters. J Urol 115(1):22–26CrossRefPubMedGoogle Scholar
  2. 2.
    Chew BH, Knudsen BE, Denstedt JD (2004) The use of stents in contemporary urology. Curr Opin Urol 14(2):111–115CrossRefPubMedGoogle Scholar
  3. 3.
    Agency for healthcare research and quality R M. HCUP Nationwide Inpatient Sample (NIS) (2014) Healthcare cost and utilization project (HCUP). Available from: https://www.hcup-us.ahrq.gov/nisoverview.jsp
  4. 4.
    Leibovici D, Cooper A, Lindner A, Ostrowsky R, Kleinmann J, Velikanov S et al (2005) Ureteral stents: morbidity and impact on quality of life. Isr Med Assoc J 7(8):491–494PubMedGoogle Scholar
  5. 5.
    Jlala HA, French JL, Foxall GL, Hardman JG, Bedforth NM (2010) Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia. Br J Anaesth 104(3):369–374CrossRefPubMedGoogle Scholar
  6. 6.
    Sjoling M, Nordahl G, Olofsson N, Asplund K (2003) The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management. Patient Educ Couns 51(2):169–176CrossRefPubMedGoogle Scholar
  7. 7.
    Susan F: Pew Internet Health Update. Pew Internet & American Life Project. Pew Internet Health Update, http://www.pewinternet.org/2012/03/09/main-findings-11
  8. 8.
    Silberg WM, Lundberg GD, Musacchio RA (1997) Assessing, controlling, and assuring the quality of medical information on the internet: caveant lector et viewor—let the reader and viewer beware. JAMA 277(15):1244–1245CrossRefPubMedGoogle Scholar
  9. 9.
    Boyer C, Selby M, Scherrer JR, Appel RD (1998) The health on the net code of conduct for medical and health Websites. Comput Biol Med 28(5):603–610CrossRefPubMedGoogle Scholar
  10. 10.
    Health on the Net Foundation, the HON code of conduct for medical and health websites (HONcode). Available from: https://www.healthonnet.org/honcode/conduct.html)
  11. 11.
    Charnock D, Shepperd S, Needham G, Gann R (1999) DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 53(2):105–111CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Fast AM, Deibert CM, Boyer C, Hruby GW, McKiernan JM (2012) Partial nephrectomy online: a preliminary evaluation of the quality of health information on the Internet. BJU Int 110(11 Pt B):E765–E769CrossRefPubMedGoogle Scholar
  13. 13.
    Joury AU, Alshathri M, Alkhunaizi M, Jaleesah N, Pines JM (2016) Internet websites for chest pain symptoms demonstrate highly variable content and quality. Acad Emerg Med 23(10):1146–1152CrossRefPubMedGoogle Scholar
  14. 14.
    Crozier-Shaw G, Queally JM, Quinlan JF (2016) Metal-on-metal total hip arthroplasty: quality of online patient information. Orthopedics 40(2):1–7Google Scholar
  15. 15.
    Sadowski DJ, Ellimoottil CS, Tejwani A, Gorbonos A (2013) Proton therapy for prostate cancer online: patient education or marketing? Can J Urol 20(6):7015–7020PubMedGoogle Scholar
  16. 16.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMedGoogle Scholar
  17. 17.
    Flesch R (1948) A new readability yardstick. J Appl Psychol 32(3):221–233CrossRefPubMedGoogle Scholar
  18. 18.
    Smith EA, and Senter RJ (1967) United States. Air Force. Automated Readability Index. Dayton: Wright-Patterson AFB, Aerospace Medical Division. PrintGoogle Scholar
  19. 19.
    Raygor AL (1977) The Raygor Readability Estimate: a quick and easy way to determine difficulty. In: Pearson PD, ed. Reading: Theory, Research, and Practice—The 26th Yearbook of the National Reading Conference. Clemson, SC: National Reading Conference, 259–263Google Scholar
  20. 20.
    Blanchett KD (2011) Transforming the medical information landscape: think tank explores new media applications. BJU Int 107(8):2–5Google Scholar
  21. 21.
    Eysenbach G (2003) The impact of the internet on cancer outcomes. CA Cancer J Clin 53(6):356–371CrossRefPubMedGoogle Scholar
  22. 22.
    Borgmann H, Wolm JH, Vallo S, Mager R, Huber J, Breyer J et al (2015) Prostate cancer on the web-expedient tool for patients’ decision-making? J Cancer Educ 32(1):135–140CrossRefGoogle Scholar
  23. 23.
    Redmond CE, Nason GJ, Kelly ME, McMahon C, Cantwell CP, Quinlan DM (2015) Transrectal ultrasound guided biopsy of the prostate: is the information accessible, usable, reliable and readable? Curr Urol 8(1):32–37CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Sahin C, Tuncer M, Yazici O, Kafkasli A, Can U, Eryildirim B et al (2014) The importance of internet usage for urologic patients. Archivio italiano di urologia, andrologia 86(4):261–265CrossRefPubMedGoogle Scholar
  25. 25.
    Lawrentschuk N, Abouassaly R, Hackett N, Groll R, Fleshner NE (2009) Health information quality on the internet in urological oncology: a multilingual longitudinal evaluation. Urology 74(5):1058–1063CrossRefPubMedGoogle Scholar
  26. 26.
    Agricola E, Gesualdo F, Pandolfi E, Gonfiantini MV, Carloni E, Mastroiacovo P et al (2013) Does googling for preconception care result in information consistent with international guidelines: a comparison of information found by Italian women of childbearing age and health professionals. BMC Med Inform Decis Mak 13:14CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    BD W (2007) Health literacy: a manual for clinicians. 2edGoogle Scholar
  28. 28.
    Sobota A, Ozakinci G (2015) The quality and readability of online consumer information about gynecologic cancer. Int J Gynecol Cancer 25(3):537–541CrossRefPubMedGoogle Scholar
  29. 29.
    Fast AM, Deibert CM, Hruby GW, Glassberg KI (2013) Evaluating the quality of Internet health resources in pediatric urology. J Pediatr Urol 9(2):151–156CrossRefPubMedGoogle Scholar
  30. 30.
    Schreuders EH, Grobbee EJ, Kuipers EJ, Spaander MC, Veldhuyzen van Zanten SJ (2016) Variable quality and readability of patient-oriented websites on colorectal cancer screening. Clin Gastroenterol Hepatol.  https://doi.org/10.1016/j.cgh.2016.06.029 Google Scholar
  31. 31.
    Cheng C, Dunn M (2015) Health literacy and the internet: a study on the readability of Australian online health information. Aust N Z J Public Health 39(4):309–314CrossRefPubMedGoogle Scholar
  32. 32.
    Sharma N, Tridimas A, Fitzsimmons PR (2014) A readability assessment of online stroke information. J Stroke Cerebrovasc Dis 23(6):1362–1367CrossRefPubMedGoogle Scholar
  33. 33.
    Borgmann H, Mager R, Salem J, Brundl J, Kunath F, Thomas C et al (2015) Robotic prostatectomy on the web: a cross-sectional qualitative assessment. Clin Genitourin Cancer 14(4):e355–e362CrossRefPubMedGoogle Scholar
  34. 34.
    Colaco M, Svider PF, Agarwal N, Eloy JA, Jackson IM (2013) Readability assessment of online urology patient education materials. J Urol 189(3):1048–1052CrossRefPubMedGoogle Scholar
  35. 35.
    Abt D, Warzinek E, Schmid HP, Haile SR, Engeler DS (2015) Influence of patient education on morbidity caused by ureteral stents. Int J Urol 22(7):679–683CrossRefPubMedGoogle Scholar
  36. 36.
    Horner SD, Surratt D, Juliusson S (2000) Improving readability of patient education materials. J Community Health Nurs 17(1):15–23CrossRefPubMedGoogle Scholar
  37. 37.
    Sheppard ED, Hyde Z, Florence MN, McGwin G, Kirchner JS, Ponce BA (2014) Improving the readability of online foot and ankle patient education materials. Foot Ankle Int 35(12):1282–1286CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology, Harvard Medical School, GRB 1102Massachusetts General HospitalBostonUSA
  2. 2.Department of UrologyNew York University School of MedicineNew YorkUSA

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