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Websites on Bladder Cancer: an Appropriate Source of Patient Information?

Abstract

A growing number of patients search for health information online. An early investigation of websites about bladder cancer (BCa) revealed mostly incomplete and particularly inaccurate information. We analyzed the quality, readability, and popularity of the most frequented websites on BCa. An Internet search on www.google.com was performed for the term “bladder cancer.” After selecting the most frequented websites for patient information, HONcode quality certification, Alexa popularity rank, and readability scores (according to US grade levels) were investigated. A 36-point checklist was used to assess the content according to the EAU guidelines on BCa, which was categorized into seven topics. The popularity of the 49 websites analyzed was average, with a median Alexa popularity rank of 41,698 (interquartile range [IQR] 7–4,671,246). The readability was rated difficult with 11 years of school education needed to understand the information. Thirteen (27%) websites were HONcode certified. Out of 343 topics (seven EAU guideline topics each on 49 websites), 79% were mentioned on the websites. Of these, 10% contained incorrect information, mostly outdated or biased, and 34% contained incomplete information. Publically provided websites mentioned more topics per website (median [IQR] 7 [5.5–7] vs. 5.5 [3.3–7]; p = 0.022) and showed less incorrect information (median [IQR] 0 [0–1] vs. 1 [0–1]; p = 0.039) than physician-provided websites. Our study revealed mostly correct but partially incomplete information on BCa websites for patients. Physicians and public organizations should strive to keep their website information up-to-date and unbiased to optimize patients’ health literacy.

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Fig. 1

Abbreviations

BCa:

Bladder cancer

EAU:

European Association of Urology

IQR:

Interquartile rage

References

  1. Pew Research Center (2013) Health Online 2013. http://www.pewinternet.org/files/old-media//Files/Reports/PIP_HealthOnline.pdf. Accessed 30 May 2017

  2. De Oliveira GS, Jr., Jung M, McCaffery KJ, McCarthy RJ, Wolf MS (2015) Readability evaluation of Internet-based patient education materials related to the anesthesiology field. J Clin Anesth 27 (5):401–405. doi:https://doi.org/10.1016/j.jclinane.2015.02.005

  3. Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J (2007) Health literacy and mortality among elderly persons. Arch Intern Med 167(14):1503–1509. https://doi.org/10.1001/archinte.167.14.1503

    Article  PubMed  Google Scholar 

  4. Hale TM, Pathipati AS, Zan S, Jethwani K (2014) Representation of health conditions on Facebook: content analysis and evaluation of user engagement. J Med Internet Res 16(8):e182. https://doi.org/10.2196/jmir.3275

    Article  PubMed  PubMed Central  Google Scholar 

  5. Borgmann H, Wolm JH, Vallo S, Mager R, Huber J, Breyer J, Salem J, Loeb S, Haferkamp A, Tsaur I (2017) Prostate cancer on the web-expedient tool for patients’ decision-making? J Cancer Educ 32(1):135–140. https://doi.org/10.1007/s13187-015-0891-3

    Article  PubMed  Google Scholar 

  6. Paffenholz P, Salem J, Borgmann H, Nestler T, Pfister D, Ruf C, Tsaur I, Haferkamp A, Heidenreich A (2017) Testicular cancer on the web-an appropriate source of patient information in concordance with the European Association of Urology guidelines? J Cancer Educ. Aug 4 [Epub ahead of print] doi:https://doi.org/10.1007/s13187-017-1249-9

  7. Brever J, Rothbauer C, Ludwig B, Dotzler B, Wolff C, Reimann S, Borgmann H, Burger M (2016) 359 quality of online health information on prostate cancer—adherence to EAU guidelines? Eur Urol Suppl 15(3):e359. https://doi.org/10.1016/S1569-9056(16)60361-5

    Article  Google Scholar 

  8. Abdul-Muhsin H, Tyson M, Raghu S, Humphreys M (2015) The informed patient: an analysis of information seeking behavior and surgical outcomes among men with benign prostatic hyperplasia. Am J Mens Health. Nov 26 [Epub ahead of print] doi:https://doi.org/10.1177/1557988315617527

  9. Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin 66(1):7–30. https://doi.org/10.3322/caac.21332

    Article  Google Scholar 

  10. Lee CT, Smith CA, Hall JM, Waters WB, Biermann JS (2003) Bladder cancer facts: accuracy of information on the Internet. J Urol 170(5):1756–1760. https://doi.org/10.1097/01.ju.0000092696.20128.9b

    Article  PubMed  Google Scholar 

  11. Alfred Witjes J, Lebret T, Comperat EM, Cowan NC, De Santis M, Bruins HM, Hernandez V, Espinos EL, Dunn J, Rouanne M, Neuzillet Y, Veskimae E, van der Heijden AG, Gakis G, Ribal MJ (2017) Updated 2016 EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol 71(3):462–475. https://doi.org/10.1016/j.eururo.2016.06.020

    Article  CAS  Google Scholar 

  12. Babjuk M, Bohle A, Burger M, Capoun O, Cohen D, Comperat EM, Hernandez V, Kaasinen E, Palou J, Roupret M, van Rhijn BW, Shariat SF, Soukup V, Sylvester RJ, Zigeuner R (2017) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol 71(3):447–461. https://doi.org/10.1016/j.eururo.2016.05.041

    Article  PubMed  Google Scholar 

  13. Statista (2016) Worldwide desktop market share of leading search engines from January 2010 to January 2016 http://www.statista.com/statistics/216573/worldwide-market-share-of-search-engines/. Accessed 20 June 2017

  14. Health On the Net Foundation (2016) The HON code of conduct for medical and health web sites (HONcode). http://www.hon.ch. Accessed 24 June 2017

  15. Alexa (2017) Alexa what’s going on with my Alexa Rank? https://support.alexa.com/hc/en-us/articles/200449614. Accessed 24 June 2017

  16. Prestin A, Vieux SN, Chou WY (2015) Is online health activity alive and well or flatlining? Findings from 10 years of the Health Information National Trends Survey. J Health Commun 20(7):790–798. https://doi.org/10.1080/10810730.2015.1018590

    Article  PubMed  Google Scholar 

  17. Hussein AA, Hashmi Z, Dibaj S, Altartir T, Fiorica T, Wing J, Durrani M, Binkowski J, Boateng L, Wilding G, Guru KA (2016) Reoperations following robot-assisted radical cystectomy: a decade of experience. J Urol 195(5):1368–1376. https://doi.org/10.1016/j.juro.2015.10.171

    Article  PubMed  Google Scholar 

  18. Miller ME, Siegler M, Angelos P (2014) Ethical issues in surgical innovation. World J Surg 38(7):1638–1643. https://doi.org/10.1007/s00268-014-2568-1

    Article  PubMed  Google Scholar 

  19. Breyer J, Rothbauer C, Ludwig B, Dotzler B, Wolff C, Reimann S, Borgmann H, Burger M (2016) 359: quality of online health information on prostate cancer—adherence to EAU guidelines? Paper presented at the EAU congress 2016, Munic, 13 March 2016

  20. Colaco M, Svider PF, Agarwal N, Eloy JA, Jackson IM (2013) Readability assessment of online urology patient education materials. J Urol 189(3):1048–1052. https://doi.org/10.1016/j.juro.2012.08.255

    Article  PubMed  Google Scholar 

  21. Walsh TM, Volsko TA (2008) Readability assessment of internet-based consumer health information. Respir Care 53(10):1310–1315

    PubMed  Google Scholar 

  22. Dalziel KLM, Steele SS, Izard JP (2016) An analysis of the readability of patient information materials for common urological conditions. Can Urol Assoc J 10(5–6):167–170. https://doi.org/10.5489/cuaj.3578

    Article  PubMed  PubMed Central  Google Scholar 

  23. Heffernan V (2011) A prescription for fear. New York Times. http://www.nytimes.com/2011/02/06/magazine/06FOB-Medium-t.html. Accessed 5 August 2016

  24. Quora (2016) How do I stop .messages.webmd.com spam? https://www.quora.com/How-do-I-stop-messages-webmd-com-spam. Accessed 5 August 2016

  25. Bosco J, Iorio R, Barber T, Barron C, Caplan A (2016) Ethics of the physician’s role in health-care cost control: AOA critical issues. J Bone Joint Surg Am 98(14):e58. https://doi.org/10.2106/JBJS.15.00889

    Article  PubMed  Google Scholar 

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Correspondence to Johannes Salem.

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The authors declare that they have no conflict of interest.

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Keypoints

1. Online health information on bladder cancer is mostly mentioned correctly, and selected websites can serve as an appropriate source of patient information.

2. Improvement of readability and completeness of the given information is needed.

3. Physicians and public organizations should strive to keep their website information up-to-date and unbiased.

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Salem, J., Paffenholz, P., Bolenz, C. et al. Websites on Bladder Cancer: an Appropriate Source of Patient Information?. J Canc Educ 34, 381–387 (2019). https://doi.org/10.1007/s13187-017-1316-2

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  • DOI: https://doi.org/10.1007/s13187-017-1316-2

Keywords

  • Internet information
  • Guidelines
  • Patient information
  • Bladder cancer
  • New media
  • Websites
  • Patient education
  • Health literacy