Concussion information online: evaluation of information quality, content and readability of concussion-related websites.

BACKGROUND: The internet plays an important role in the dissemination of health information to the general public. Information on orthopaedic sports medicine websites has been shown to be of a varying standard, and to date there has been no evaluation of the overall quality of concussion-related websites. METHODS: A four-stage methodological sampling technique was used to identify concussion-related websites. Websites were assessed for the presence of a quality standard (the HONcode), their adherence to current expert concussion knowledge using a custom-developed concussion checklist ('CONcheck'), and their readability using the established Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL). RESULTS: 43 Websites were identified from the search strategy with the majority (70%) not HONcode certified. A wide distribution of scores was seen for the CONcheck (0-22), FRE (16.3-77.4) and FKGL (6-17.8). Statistical analysis using independent t tests between websites with the HONcode and websites without the HONcode showed no significant differences between the two groups for CONcheck (t(41)=0.571, p=0.571), FRE (t(41)=0.808, p=0.424) and FKGL(t(41)=-0.964, p=0.341) scores. CONCLUSIONS: The variability in the standard of concussion-related websites highlights the need for sports medicine website providers to consider the delivery, content and readability of information to the public.

'What's happening?' A content analysis of concussion-related traffic on Twitter.

BACKGROUND: Twitter is a rapidly growing social networking site (SNS) with approximately 124 million users worldwide. Twitter allows users to post brief messages ('tweets') online, on a range of everyday topics including those dealing with health and wellbeing. Currently, little is known about how tweets are used to convey information relating to specific injuries, such as concussion, that commonly occur in youth sports. OBJECTIVE: The purpose of this study was to analyse the online content of concussion-related tweets on the SNS Twitter, to determine the concept and context of mild traumatic brain injury as it relates to an online population. STUDY DESIGN: A prospective observational study using content analysis. METHODS: Twitter traffic was investigated over a 7-day period in July 2010, using eight concussion-related search terms. From the 3488 tweets identified, 1000 were randomly selected and independently analysed using a customised coding scheme to determine major content themes. RESULTS: The most frequent theme was 'news' (33%) followed by 'sharing personal information/situation' (27%) and 'inferred management' (13%). Demographic data were available for 60% of the sample, with the majority of tweets (82%) originating from the USA, followed by Asia (5%) and the UK (4.5%). CONCLUSION: This study highlights the capacity of Twitter to serve as a powerful broadcast medium for sports concussion information and education.

Not Just for Dancing? A Content Analysis of Concussion and Head Injury Videos on TikTok.

Social media platforms are an accessible and increasingly used way for the public to gather healthcare-related information, including on sports injuries. "TikTok" is currently one of the fastest-growing social media platforms worldwide, and it is especially popular amongst adolescents and young adults. The widespread use and popularity of TikTok suggests that this platform has potential to be a source for healthcare information for younger individuals. The aim of this study was to gain a preliminary understanding of the concussion/head injury-related information on TikTok, and to gauge if TikTok could serve as a platform for concussion education. This exploratory study used a systematic search strategy to understand more about how concussion is being portrayed through TikTok videos. Using the keywords "concussion" and "head injury," 200 videos were downloaded from TikTok and 43 videos were excluded. Of the 92 videos retrieved using the keyword "concussion," 95% (n = 88) had more than 100,000 views and 6% (n = 10) had been viewed more than 10 million times. Over half, 54% (n = 50) of the "concussion" videos depicted individuals "playing around" and getting hit in the head, whilst only 1% (n = 1) of the TikTok videos were categorized as "explaining concussion facts." The large numbers of views of concussion-related TikTok videos demonstrates the popularity of this platform and indicates that healthcare organizations should consider TikTok as a potential means for concussion education amongst younger individuals.

Smartphone apps for total hip replacement and total knee replacement surgery patients: a systematic review.

Purpose: The aim of this study was to critically examine the content of smartphone apps produced for patients undergoing total hip replacement and total knee replacement surgery.Materials and methods: A systematic search was conducted across the five most popular smartphone app stores: iTunes; Google Play; Windows Mobile; Blackberry App World; and Nokia Ovi. Apps were identified for screening if they: targeted total hip replacement or total knee replacement patients; were free of charge; and were in English. App quality assessment was conducted independently by three reviewers using the Mobile App Rating Scale.Results: 15 apps met the inclusion criteria. On the 5-point Mobile App Rating Scale, the mean overall app quality score was 3.1. Within the Mobile App Rating Scale, the "Aesthetics" subscale had the most inconsistency across all apps, generating the highest and lowest mean scores (4.7 and 1, respectively). The "functionality" subscale had the highest mean score (3.8) among the four subscales, and the "information" subscale had the lowest mean score (2.7).Conclusion: This study highlights that despite a wide range of apps currently available to total hip replacement and total knee replacement patients, there is significant variability in their quality. Future efforts should be made to develop apps in partnership with patients, to improve the content, interactivity and relevance of apps.Implications for RehabilitationClinicians and rehabilitation professionals should consider that patients are using Smartphone apps to supplement their rehabilitation and be aware of currently available apps.Although some apps show promise, at present there is no one openly available app which is clinically recommended for rehabilitation use following total hip replacement and total knee replacement.Rehabilitation professionals tailor recovery programmes to individual patient needs following total hip replacement and total knee replacement, and future apps should also consider personal needs.We recommend that patients are involved in all stages of designing and testing future total hip replacement and total knee replacement rehabilitation apps.

Readability of Information on Smartphone Apps for Total Hip Replacement and Total Knee Replacement Surgery Patients.

BACKGROUND: Readability is a vital component of health information and providing this material at an appropriate literacy level may positively influence patient experience. OBJECTIVE: To assess the readability of the information provided within total hip replacement and total knee replacement apps to understand more about the impact this could have on patients. METHOD: A systematic search was conducted across the 5 most popular smartphone app stores: iTunes, Google Play, Windows Mobile, Blackberry App World, and Nokia Ovi. Apps were identified for screening if they: targeted total hip replacement or total knee replacement patients; were free of charge; and were in English. App readability assessment was conducted independently by 3 reviewers using the Gunning Fog Index, the Flesch Reading Ease Score, and the Flesch-Kincaid Grade Level. RESULTS: Fifteen apps met the inclusion criteria. Only one app was found "easy to read" (My THR). CONCLUSION: Findings suggest that the overall readability of information provided is written at a level which is difficult for patients to comprehend. App developers should engage patients in the design process of their apps, in order to enhance patient experience and for the potential impact of these innovative health technologies to be truly realized.

Moving concussion care to the next level: The emergence and role of concussion clinics in the UK.

Concussion is a worldwide issue in sports medicine at present, and in recent years has evolved into a major consideration for sports in the United Kingdom (UK). Governing bodies, sports clinicians, and indeed athletes themselves are dealing with the implications that this injury brings. In parallel with this, innovative means of managing this condition are emerging. The creation of specialized concussion clinics (which mirror those present in the United States and Canada) is one means of enhancing concussion care in the UK. In this chapter, the emergence of concussion clinics in the UK will be discussed. The specific roles of the multidisciplinary teams working in these clinics will be outlined (including the disciplines of sports medicine, radiology, neurology, physiotherapy, and psychology/psychiatry), and the approaches used in the management of concussion in this setting will be explored. Future recommendations for the growth and development of clinic-based concussion care in the UK will also be discussed.

A picture tells a thousand words: A content analysis of concussion-related images online.

BACKGROUND AND AIM: Recently image-sharing social media platforms have become a popular medium for sharing health-related images and associated information. However within the field of sports medicine, and more specifically sports related concussion, the content of images and meta-data shared through these popular platforms have not been investigated. The aim of this study was to analyse the content of concussion-related images and its accompanying meta-data on image-sharing social media platforms. METHODS: We retrieved 300 images from Pinterest, Instagram and Flickr by using a standardised search strategy. All images were screened and duplicate images were removed. We excluded images if they were: non-static images; illustrations; animations; or screenshots. The content and characteristics of each image was evaluated using a customised coding scheme to determine major content themes, and images were referenced to the current international concussion management guidelines. RESULTS: From 300 potentially relevant images, 176 images were included for analysis; 70 from Pinterest, 63 from Flickr, and 43 from Instagram. Most images were of another person or a scene (64%), with the primary content depicting injured individuals (39%). The primary purposes of the images were to share a concussion-related incident (33%) and to dispense education (19%). For those images where it could be evaluated, the majority (91%) were found to reflect the Sports Concussion Assessment Tool 3 (SCAT3) guidelines. CONCLUSIONS: The ability to rapidly disseminate rich information though photos, images, and infographics to a wide-reaching audience suggests that image-sharing social media platforms could be used as an effective communication tool for sports concussion. Public health strategies could direct educative content to targeted populations via the use of image-sharing platforms. Further research is required to understand how image-sharing platforms can be used to effectively relay evidence-based information to patients and sports medicine clinicians.

Smartphone apps for the self-management of low back pain: A systematic review.

Guidelines for low back pain (LBP) often recommend the use of self-management such as unsupervised exercise, booklets, and online education. Another potentially useful way for patients to self-manage LBP is by using smartphone applications (apps). However, to date, there has been no rigorous evaluation of LBP apps and no guidance for consumers on how to select high-quality, evidence-based apps. This chapter reviews smartphone apps for the self-management of LBP and evaluates their content quality and whether they recommend evidence-based interventions. This chapter shows that generally app developers are selecting interventions that are endorsed by guidelines, although their quality is low. There are many apps available for the self-management of LBP, but their effectiveness in improving patient outcomes has not been rigorously assessed. App developers need to work closely with healthcare professionals, researchers, and patients to ensure app content is accurate, evidence based, and engaging.

Acute low back pain information online: an evaluation of quality, content accuracy and readability of related websites.

The internet is increasingly being used as a source of health information by the general public. Numerous websites exist that provide advice and information on the diagnosis and management of acute low back pain (ALBP), however, the accuracy and utility of this information has yet to be established. The aim of this study was to establish the quality, content and readability of online information relating to the treatment and management of ALBP. The internet was systematically searched using Google search engines from six major English-speaking countries. In addition, relevant national and international low back pain-related professional organisations were also searched. A total of 22 relevant websites was identified. The accuracy of the content of the ALBP information was established using a 13 point guide developed from international guidelines. Website quality was evaluated using the HONcode, and the Flesch-Kincaid Grade level (FKGL) was used to establish readability. The majority of websites lacked accurate information, resulting in an overall mean content accuracy score of 6.3/17. Only 3 websites had a high content accuracy score (>14/17) along with an acceptable readability score (FKGL 6-8) with the majority of websites providing information which exceeded the recommended level for the average person to comprehend. The most accurately reported category was, "Education and reassurance" (98%) while information regarding "manipulation" (50%), "massage" (9%) and "exercise" (0%) were amongst the lowest scoring categories. These results demonstrate the need for more accurate and readable internet-based ALBP information specifically centred on evidence-based guidelines.