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Online Information for Treatment for Low-Risk Thyroid Cancer: Assessment of Timeliness, Content, Quality, and Readability

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Abstract

The Internet is a key source of health information, yet little is known about resources for low-risk thyroid cancer treatment. We examined the timeliness, content, quality, readability, and reference to the 2015 American Thyroid Association (ATA) guidelines in websites about thyroid cancer treatment. We identified the top 60 websites using Google, Bing, and Yahoo for “thyroid cancer.” Timeliness and content analysis identified updates in the ATA guidelines (n = 6) and engaged a group of stakeholders to develop essential items (n = 29) for making treatment decisions. Website quality and readability analysis used 4 validated measures: DISCERN; Journal of the American Medical Association (JAMA) benchmark criteria; Health on the Net Foundation certification (HONcode); and the Suitability Assessment of Materials (SAM) method. Of the 60 websites, 22 were unique and investigated. Content analysis revealed zero websites contained all updates from the ATA guidelines and rarely (18.2%) referenced them. Only 31.8% discussed all 3 treatment options: total thyroidectomy, lobectomy, and active surveillance. Websites discussed 28.2% of the 29 essential items for making treatment decisions. Quality analysis with DISCERN showed “fair” scores overall. Only 29.9% of the JAMA benchmarks were satisfied, and 40.9% were HONcode certified. Readability analysis with the SAM method found adequate readability, yet 90.9% scored unsuitable in literacy demand. The overall timeliness, content, quality, and readability of websites about low-risk thyroid cancer treatment is fair and needs improvement. Most websites lack updates from the 2015 ATA guidelines and information about treatment options that are necessary to make informed decisions.

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References

  1. Ward E et al (2019) Annual Report to the Nation on the Status of Cancer, 1999-2015, Featuring Cancer in men and women ages 20-49. J Natl Cancer Inst

  2. Cancer Stat Facts: Thyroid Cancer (2019) SEER: National Cancer Institute. [cited 2019 July]; Available from: https://seer.cancer.gov/statfacts/html/thyro.html

  3. Fitch K, Bazell C, Dehipawala S (2018) Preference-sensitive surgical procedures for preference-sensitive conditions: Is there opportunity to reduce variation in utilization? September, 2018

  4. Pitt SC, Lubitz CC (2017) Editorial: complex decision making in thyroid cancer: costs and consequences-is less more? Surgery 161(1):134–136

    Article  Google Scholar 

  5. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L (2016) 2015 American Thyroid Association management guidelines for adult Patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26(1):1–133

    Article  Google Scholar 

  6. Woolf SH, Chan EC, Harris R, Sheridan SL, Braddock CH 3rd, Kaplan RM, Krist A, O'Connor AM, Tunis S (2005) Promoting informed choice: transforming health care to dispense knowledge for decision making. Ann Intern Med 143(4):293–300

    Article  Google Scholar 

  7. Rowlands IJ, Loxton D, Dobson A, Mishra GD (2015) Seeking health information online: association with young Australian women's physical, mental, and reproductive health. J Med Internet Res 17(5):e120

    Article  Google Scholar 

  8. van Deursen AJAM, van Dijk JAGM (2009) Using the internet: skill related problems in users’ online behavior. Interact Comput 21(5–6):393–402

    Article  Google Scholar 

  9. Fahy E, Hardikar R, Fox A, Mackay S (2014) Quality of patient health information on the internet: reviewing a complex and evolving landscape. Australas Med J 7(1):24–28

    Article  Google Scholar 

  10. Fox S, D M (2013) Health Online 2013. [cited 2017 November]; Internet and Technology:[The Pew Internet & American Life Project]. Available from: https://www.pewinternet.org/2013/01/15/health-online-2013/

  11. McDow AD, Pitt S (2019) Extent of surgery for Low-risk differentiated thyroid Cancer. Surg Clin North Am 99(4):599–610

    Article  Google Scholar 

  12. Air M, Roman SA, Yeo H, Maser C, Trapasso T, Kinder B, Sosa JA (2007) Outdated and incomplete: a review of thyroid cancer on the world wide web. Thyroid 17(3):259–265

    Article  Google Scholar 

  13. Yeo H et al (2007) Filling a void: thyroid cancer surgery information on the internet. World J Surg 31(6):1185–1191 discussion 1192-3

    Article  Google Scholar 

  14. Chang KL, Grubbs EG, Ingledew PA (2019) An analysis of the quality of thyroid cancer websites. Endocr Pract

  15. Tan SS, Goonawardene N (2017) Internet health information seeking and the patient-physician relationship: a systematic review. J Med Internet Res 19(1):e9

    Article  Google Scholar 

  16. Bruce-Brand RA, Baker JF, Byrne DP, Hogan NA, McCarthy T (2013) Assessment of the quality and content of information on anterior cruciate ligament reconstruction on the internet. Arthroscopy 29(6):1095–1100

    Article  Google Scholar 

  17. Clancy AA, Hickling D, Didomizio L, Sanaee M, Shehata F, Zee R, Khalil H (2018) Patient-targeted websites on overactive bladder: what are our patients reading? Neurourol Urodyn 37(2):832–841

    Article  Google Scholar 

  18. De Groot L et al (2019) Quality of online resources for pancreatic Cancer Patients. J Cancer Educ 34(2):223–228

    Article  Google Scholar 

  19. Fast AM et al (2012) Partial nephrectomy online: a preliminary evaluation of the quality of health information on the Internet. BJU Int 110(11 Pt B):E765–E769

    Article  Google Scholar 

  20. Kobes K, Harris IB, Regehr G, Tekian A, Ingledew PA (2018) Malignant websites? Analyzing the quality of prostate cancer education web resources. Can Urol Assoc J 12(10):344–350

    Article  Google Scholar 

  21. Kuenzel U, Monga Sindeu T, Schroth S, Huebner J, Herth N (2018) Evaluation of the quality of online information for patients with rare cancers: thyroid Cancer. J Cancer Educ 33(5):960–966

    Article  Google Scholar 

  22. Purdy AC, Idriss A, Ahern S, Lin E, Elfenbein DM (2017) Dr Google: the readability and accuracy of patient education websites for Graves’ disease treatment. Surgery 162(5):1148–1154

    Article  Google Scholar 

  23. Rhee RL, von Feldt J, Schumacher HR, Merkel PA (2013) Readability and suitability assessment of patient education materials in rheumatic diseases. Arthritis Care Res (Hoboken) 65(10):1702–1706

    Google Scholar 

  24. Roughead T, Sewell D, Ryerson CJ, Fisher JH, Flexman AM (2016) Internet-based resources frequently provide inaccurate and out-of-date recommendations on preoperative fasting: a systematic review. Anesth Analg 123(6):1463–1468

    Article  Google Scholar 

  25. Storino A, Castillo-Angeles M, Watkins AA, Vargas C, Mancias JD, Bullock A, Demirjian A, Moser AJ, Kent TS (2016) Assessing the accuracy and readability of online health information for patients with pancreatic cancer. JAMA Surg 151(9):831–837

    Article  Google Scholar 

  26. Tian C, Champlin S, Mackert M, Lazard A, Agrawal D (2014) Readability, suitability, and health content assessment of web-based patient education materials on colorectal cancer screening. Gastrointest Endosc 80(2):284–290

    Article  Google Scholar 

  27. 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 Commun Health 53:105–111

    Article  CAS  Google Scholar 

  28. 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):1244–1245

    Article  CAS  Google Scholar 

  29. Foundation, H.o.t.N. (2017) HON code of conduct (HONcode) for medical and health. May 2, [cited 2017 November]; Available from: https://www.hon.ch/HONcode/Conduct.html

  30. Doak CC, Doak LG, Root JH (1996) Teaching Patients with Low Literacy Skills, 2nd edn. J. B. Lippincott Company, Philadelphia

    Google Scholar 

  31. Barnes JA, Davies L (2015) Reading grade level and completeness of freely available materials on thyroid nodules: there is work to be done. Thyroid 25(2):147–156

    Article  Google Scholar 

  32. Berdowski J, Schmohl A, Tijssen JG, Koster RW (2009) Time needed for a regional emergency medical system to implement resuscitation guidelines 2005--the Netherlands experience. Resuscitation 80(12):1336–1341

    Article  Google Scholar 

  33. Nielsen AM, Isbye DL, Lippert FK (2008) Have the 2005 Guidelines for resuscitation been implemented? Ugeskr Laeger 170(47):3843–3847

    PubMed  Google Scholar 

  34. Fischer F et al (2016) Barriers and strategies in guideline implementation-a Scoping review. Healthcare (Basel) 4(3)

  35. Starman JS, Gettys FK, Capo JA, Fleischli JE, Norton HJ, Karunakar MA (2010) Quality and content of internet-based information for ten common orthopaedic sports medicine diagnoses. J Bone Joint Surg Am 92(7):1612–1618

    Article  Google Scholar 

  36. Bruce JG, Tucholka JL, Steffens NM, Neuman HB (2015) Quality of online information to support patient decision-making in breast cancer surgery. J Surg Oncol 112(6):575–580

    Article  Google Scholar 

  37. Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, Ren J, Peel J (2002) Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. Am J Public Health 92(8):1278–1283

    Article  Google Scholar 

  38. Kutner M, Greenberg E, Jin Y, Paulsen C (2006) The health literacy of America's adults: results from the 2003 National Assessment of Adult Literacy

  39. Weiss B (2009) Health literacy and patient safety: help patients understand. A.M. Association, Editor. Chicago, IL

  40. Braddock CH 3rd et al (1999) Informed decision making in outpatient practice: time to get back to basics. JAMA 282(24):2313–2320

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Division of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA

    Amanda R. Doubleday, Sherwin Novin, Kristin L. Long, David F. Schneider, Rebecca S. Sippel & Susan C. Pitt

Authors
  1. Amanda R. Doubleday
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  2. Sherwin Novin
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  3. Kristin L. Long
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  4. David F. Schneider
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  5. Rebecca S. Sippel
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  6. Susan C. Pitt
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Correspondence to Amanda R. Doubleday.

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Websites Included in Analysis

Websites Included in Analysis

  1. 1.

    https://www.cancer.net/cancer-types/thyroid-cancer/treatment-options

  2. 2.

    https://www.webmd.com/cancer/tc/thyroid-cancer-topic-overview

  3. 3.

    https://www.cancer.org/cancer/thyroid-cancer/treating.html

  4. 4.

    https://www.endocrineweb.com/conditions/thyroid-cancer/thyroid-cancer

  5. 5.

    https://www.mayoclinic.org/diseases-conditions/thyroid-cancer/symptoms-causes/syc-20354161

  6. 6.

    https://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq

  7. 7.

    https://www.thyroid.org/thyroid-cancer/

  8. 8.

    https://www.medicinenet.com/thyroid_cancer/article.htm

  9. 9.

    https://www.medicinenet.com/thyroid_cancer/article.htm

  10. 10.

    http://www.thyca.org/about/types/

  11. 11.

    https://www.healthline.com/health/thyroid-cancer#overview1

  12. 12.

    https://www.mdanderson.org/cancer-types/thyroid-cancer.html

  13. 13.

    https://www.mcancer.org/thyroid-cancer/learn-about-thyroid-cancer/diagnosis

  14. 14.

    https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032552/#CDR0000258038__67

  15. 15.

    http://www.thyroidcancer.com/thyroid-cancer-surgery

  16. 16.

    https://www.mskcc.org/cancer-care/types/thyroid/treatment

  17. 17.

    https://www.cityofhope.org/clinical-program/thyroid-cancer

  18. 18.

    https://www.dukehealth.org/treatments/cancer/thyroid-cancer

  19. 19.

    https://labtestsonline.org/conditions/thyroid-cancer

  20. 20.

    http://www.activebeat.com/your-health/6-need-to-know-thyroid-cancer-facts/?utm_medium=cpc&utm_source=bing&utm_campaign=AB_BNG_US_DESK-SearchMarketing&utm_content=o_c_73804754542188&cus_widget=kwd-73804781951464:loc-190&utm_term=thyroid%20cancer&cus_teaser=&msclkid=779f0f4fbadc1606c5d855cc953a0936

  21. 21.

    https://www.emedicinehealth.com/thyroid_cancer_treatment/article_em.htm

  22. 22.

    https://my.clevelandclinic.org/health/diseases/12210-thyroid-cancer

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Doubleday, A.R., Novin, S., Long, K.L. et al. Online Information for Treatment for Low-Risk Thyroid Cancer: Assessment of Timeliness, Content, Quality, and Readability. J Canc Educ 36, 850–857 (2021). https://doi.org/10.1007/s13187-020-01713-5

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