Comparing quality and readability of online English language information to patient use and perspectives for common rheumatologic conditions.

Evaluate quality and readability of online information for common rheumatologic diseases. Compare rheumatology patients' internet use and preferences to an objective evaluation of internet quality and readability. Five common rheumatologic diseases were searched on the web browser Google using English language. The first twenty websites from each of the five searches were evaluated for internet quality (e.g. content that is current, balanced, has specific aims, and is appropriately cited) using the DISCERN criteria and readability using the Flesch-Kincaid Grade Level (FKGL). The results were contrasted with a survey sent to patients with rheumatic disease. The survey measured patient likeliness to use and trust identified websites. Internet quality was similar (good) for all five diseases searched while readability was poor. There was an inverse relationship between internet quality and readability. Internet quality significantly differed across website sponsor, and readability significantly differed across disease and website sponsor. Common medical website sponsors with the highest combined quality and readability scores were Mayo Clinic and Web MD. Eight hundred and fifty-eight patients were sent a survey, of which 147 (17%) completed. Patients indicated they were most likely to use and trust a Mayo Clinic-sponsored website when compared to other common sponsored websites from our evaluation, followed by the American College of Rheumatology. Although we found good-quality information, all websites evaluated had readability levels above the recommended sixth-grade reading level. The website sponsor with the highest combined readability and quality score was also the most used and trusted by patients. Patients would like more information about credible and trusted websites from their medical providers.

Pembrolizumab-Associated Seronegative Myasthenia Gravis in a Patient With Metastatic Renal Cell Carcinoma.

Seronegative myasthenia gravis is a rare, but potential adverse effect of immune checkpoint inhibition. There have been few but increasing number of cases reported in recent years, and early recognition is important for prompt diagnosis and management. Here, we describe the case of a 65-year-old male with metastatic renal cell carcinoma on pembrolizumab diagnosed with new-onset seronegative myasthenia gravis and review literature on its management.