Quality Assessment of Elective Abdominal Aortic Aneurysm Repair Patient Information on the Internet Using the Modified Ensuring Quality Information for Patients Tool.

OBJECTIVE: This study aimed to assess the quality of patient information material regarding elective abdominal aortic aneurysm (AAA) repair on the internet using the Modified Ensuring Quality Information for Patients (MEQIP) tool. METHODS: A qualitative assessment of internet based patient information was performed. The 12 most used search terms relating to AAA repair were identified using Google Trends, with the first 10 pages of websites retrieved for each term searched. Duplicates were removed, and information for patients undergoing elective AAA were selected. Further exclusion criteria were marketing material, academic journals, videos, and non-English language sites. The remaining websites were then MEQIP scored independently by two reviewers, producing a final score by consensus. RESULTS: A total of 1 297 websites were identified, with 235 (18.1%) eligible for analysis. The median MEQIP score was 18 (interquartile range [IQR] 14, 21) out of a possible 36. The highest score was 33. The 99th percentile MEQIP scoring websites scored > 27, with four of these six sites representing online copies of hospital patient information leaflets, however hospital sites overall had lower median MEQIP scores than most other institution types. MEQIP subdomain median scores were: content, 8 (IQR 6, 11); identification, 3 (IQR 1, 3); and structure, 7 (IQR 6, 9). Of the analysed websites, 77.9% originated from the USA (median score 17) and 12.8% originated in the UK (median score 22). Search engine ranking was related to website institution type but had no correlation with MEQIP. CONCLUSION: When assessed by the MEQIP tool, most websites regarding elective AAA repair are of questionable quality. This is in keeping with studies in other surgical and medical fields. Search engine ranking is not a reliable measure of quality of patient information material regarding elective AAA repair. Health practitioners should be aware of this issue as well as the whereabouts of high quality material to which patients can be directed.

Assessment of Internet Available Patient Information on Chronic Pancreatitis Using the Ensuring Quality Information for Patients Tool: A Systematic Search and Evaluation.

INTRODUCTION: Chronic pancreatitis (CP) is a relevant chronic medical problem whereby delayed presentation and poor patient understanding can cause adverse effects. Quality of patient information available on the internet about CP is not known. METHODS: A systematic review of the information about CP available online using the search term "chronic pancreatitis" in using the search engine Google has been conducted. The quality of the top 100 websites returned from this search term was analysed using the validated Ensuring Quality Information for Patients (EQIP) tool (maximum score 36). Additional items were included in the website analysis specific to CP. RESULTS: In total, 45 websites were eligible for analysis. The median EQIP score of the websites was 16 (interquartile range 12-19.5). The majority of websites originated from the USA and the United Kingdom with 31 and 11 websites, respectively. Provision of additional information was inconsistent, with most websites covering information regarding aetiology and advocating alcohol and tobacco cessation, but only few reporting on more complex issues. CONCLUSION: Internet available information about CP is of limited quality. There is an immediate need for high quality, patient targeted, and informative literature accessible on the internet about this topic.

A Systematic Quality Assessment of Online Resources on Eyelid Ptosis Using the Modified Ensuring Quality Information for Patients (mEQIP) Tool.

BACKGROUND: Eyelid ptosis is an underestimated pathology deeply affecting patients' quality of life. Internet has increasingly become the major source of information regarding health care, and patients often browse on websites to acquire an initial knowledge on the subject. However, there is lack of data concerning the quality of available information focusing on the eyelid ptosis and its treatment. We systematically evaluated online information quality on eyelid ptosis by using the "Ensuring Quality Information for Patients" (EQIP) scale. MATERIALS AND METHODS: Google, Yahoo and Bing have been searched for the keywords "Eyelid ptosis," "Eyelid ptosis surgery" and "Blepharoptosis." The first 50 hits were included, evaluating the quality of information with the expanded EQIP tool. Websites in English and intended for general non-medical public use were included. Irrelevant documents, videos, pictures, blogs and articles with no access were excluded. RESULTS: Out of 138 eligible websites, 79 (57,7%) addressed more than 20 EQIP items, with an overall median score of 20,2. Only 2% discussed procedure complication rates. The majority fail to disclose severe complications and quantifying risks, fewer than 18% clarified the potential need for additional treatments. Surgical procedure details were lacking, and there was insufficient information about pre-/postoperative precautions for patients. Currently, online quality information has not improved since COVID-19 pandemic. CONCLUSIONS: This study highlights the urgent requirement for improved patient-oriented websites adhering to international standards for plastic and oculoplastic surgery. Healthcare providers should effectively guide their patients in finding trustworthy and reliable eyelid ptosis correction information. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evaluating the quality and reliability of YouTube videos on myopia: a video content analysis.

PURPOSE: To evaluate the quality and reliability of YouTube videos as an educational resource about myopia. METHODS: The videos were identified by searching YouTube with the keywords 'myopia' and 'nearsightedness', using the website's default search settings. The number of views, likes, dislikes, view ratio, source of the upload, country of origin, video type, and described treatment techniques were assessed. Each video was evaluated using the DISCERN, Journal of the American Medical Association (JAMA), Ensuring Quality Information for Patients (EQIP), Health On the Net Code of Conduct Certification (HONcode), and the Global Quality Score (GQS) scales. RESULTS: A total of 112 videos were included. The classification of videos by source indicated that the top three contributors were health channels (30 videos [26.8%]), physicians (24 videos [21.4%]), and academic centers (19 videos [16.9%]). Most of these videos originated from the United States (74 videos [66.1%]) and focused on the pathophysiology (n = 89, 79.4%) and the treatment (n = 77, 68.7%) of myopia. Statistical comparisons among the groups of video sources showed no significant difference in the mean DISCERN score (p = 0.102). However, significant differences were noted in the JAMA (p = 0.011), GQS (p = 0.009), HONcode (p = 0.011), and EQIP (p = 0.002) scores. CONCLUSIONS: This study underscored the variability in the quality and reliability of YouTube videos related to myopia, with most content ranging from 'weak to moderate' quality based on the DISCERN and GQS scales, yet appearing to be 'excellent' according to the HONcode and EQIP scales. Videos uploaded by physicians generally exhibited higher standards, highlighting the importance of expert involvement in online health information dissemination. Given the potential risks of accessing incorrect medical data that can affect the decision-making processes of patients, caution should be exercised when using online content as a source of information.

Reliability of Medical Information Provided by ChatGPT: Assessment Against Clinical Guidelines and Patient Information Quality Instrument.

BACKGROUND: ChatGPT-4 is the latest release of a novel artificial intelligence (AI) chatbot able to answer freely formulated and complex questions. In the near future, ChatGPT could become the new standard for health care professionals and patients to access medical information. However, little is known about the quality of medical information provided by the AI. OBJECTIVE: We aimed to assess the reliability of medical information provided by ChatGPT. METHODS: Medical information provided by ChatGPT-4 on the 5 hepato-pancreatico-biliary (HPB) conditions with the highest global disease burden was measured with the Ensuring Quality Information for Patients (EQIP) tool. The EQIP tool is used to measure the quality of internet-available information and consists of 36 items that are divided into 3 subsections. In addition, 5 guideline recommendations per analyzed condition were rephrased as questions and input to ChatGPT, and agreement between the guidelines and the AI answer was measured by 2 authors independently. All queries were repeated 3 times to measure the internal consistency of ChatGPT. RESULTS: Five conditions were identified (gallstone disease, pancreatitis, liver cirrhosis, pancreatic cancer, and hepatocellular carcinoma). The median EQIP score across all conditions was 16 (IQR 14.5-18) for the total of 36 items. Divided by subsection, median scores for content, identification, and structure data were 10 (IQR 9.5-12.5), 1 (IQR 1-1), and 4 (IQR 4-5), respectively. Agreement between guideline recommendations and answers provided by ChatGPT was 60% (15/25). Interrater agreement as measured by the Fleiss κ was 0.78 (P<.001), indicating substantial agreement. Internal consistency of the answers provided by ChatGPT was 100%. CONCLUSIONS: ChatGPT provides medical information of comparable quality to available static internet information. Although currently of limited quality, large language models could become the future standard for patients and health care professionals to gather medical information.

Using the Ensuring Quality Information for Patients Tool to Assess Patient Information on Appendicitis Websites: Systematic Search and Evaluation.

BACKGROUND: Appendicitis is a common surgical problem among the young adult population, who are likely to use the internet to obtain medical information. This information may determine the health-seeking behavior of an individual and may delay medical attention. Little is known regarding the quality of patient information on appendicitis on the internet, as this has not been previously studied. OBJECTIVE: The aim of our study was to identify the quality of information regarding appendicitis on websites intended for the public. METHODS: We conducted a systematic review of information on appendicitis available online using the following 4 search terms in google: "appendicitis," "appendix," "appendectomy," and "appendicectomy". The top 100 websites of each search term were assessed using the validated Ensuring Quality Information for Patients (EQIP) tool (score 0-36). RESULTS: A total of 119 websites met the eligibility criteria for evaluation. The overall median EQIP score for all websites was 20 (IQR 18-22). More than half the websites originated from the USA (65/119, 54.6%), and 45.4% (54/119) of all websites originated from hospitals, although 43% (23/54) of these did not mention qualitative risks from surgery. Incidence rates were only provided for complications and mortality in 12.6% (15/119) and 3.3% (4/119) of all websites, respectively. CONCLUSIONS: The assessment of the quality and readability of websites concerning appendicitis by the EQIP tool indicates that most sites online were of poor credibility, with minimal information regarding complication rates and mortality. To improve education and awareness of appendicitis, there is an immediate need for more informative and patient-centered websites that are more compatible with international quality standards.

Written patient information materials used in general practices fail to meet acceptable quality standards.

BACKGROUND: Patient information materials and decision aids are essential tools for helping patients make informed decisions and share in decision-making. The aim of this study was to investigate the quality of the written patient information materials available at general practices in Styria, Austria. METHODS: We asked general practitioners to send in all patient information materials available in their practices and to answer a short questionnaire. We evaluated the materials using the Ensuring Quality Information for Patients (EQIP-36) instrument. RESULTS: A total of 387 different patient information materials were available for quality assessment. These materials achieved an average score of 39 out of 100. The score was below 50 for 78% of all materials. There was a significant lack of information on the evidence base of recommendations. Only 9 % of the materials provided full disclosure of their evidence sources. We also found that, despite the poor quality of the materials, 89% of general practitioners regularly make active use of them during consultations with patients. CONCLUSION: Based on international standards, the quality of patient information materials available at general practices in Styria is poor. The vast majority of the materials are not suitable as a basis for informed decisions by patients. However, most Styrian general practitioners use written patient information materials on a regular basis in their daily clinical practice. Thus, these materials not only fail to help raise the health literacy of the general population, but may actually undermine efforts to enable patients to make shared informed decisions. To increase health literacy, it is necessary to make high quality, evidence-based and easy-to-understand information material available to patients and the public. For this, it may be necessary to set up a centralized and independent clearinghouse.

Quality Assessment of Online Information on Body Contouring Surgery in Postbariatric Patient.

BACKGROUND: Nowadays, we have to face the fact that the Web represents one of the most important sources of information for patients. Postbariatric patients in particular are usually very motivated, and they are enthusiastic users of the Web as a source of information on the different types of surgery they could undergo after their weight loss in order to reshape and remodel their body thus regaining physical and functional wellness and dignity. The aim of the study was to assess information on the four most commonly performed postbariatric procedures worldwide, tummy tuck, breast, arm and thigh lift, with the same scale. METHODS: Google and Yahoo have been probed for the keywords "Post bariatric Mastopexy OR breast lift" and "Post bariatric abdominoplasty OR tummy tuck" and "Post bariatric brachioplasty OR arm lift" and "post bariatric thigh lift". The first 50 hits were included, and the quality of information was evaluated with the expanded EQIP scale. RESULTS: There was a critical lack of information about qualitative risks and side-effect description, treatment of potential complications, alert signs for the patient and precautions that the patient may take. Moreover, there was poor information about the sequence of the medical procedure, quantitative benefits and risks and quality of life issues after the procedure, and often, there were no other sources of information. CONCLUSIONS: Due to the poor and not reliable information offered by the Web, health professionals should seek for a good communication practice with their patients. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Evaluating the Quality of Online Patient Information for Prepectoral Breast Reconstruction Using Polyurethane-Coated Breast Implants.

Background: An increasing number of patients are using online information regarding medical issues; however, the Internet is not subject to content ratings or filters. Unreliable information found on the web can heavily influence patients to the extent that it can lead to wrong decisions in the choice of treatment. In our daily experience we meet more informed patients and given the increasing use of polyurethane-coated implants in breast reconstruction in Europe, we wondered about the level of information available online. Our study aims to assess the quality of information available online on breast reconstruction with polyurethane-coated implants. Materials and Methods: Assuming that the most used search engines are Google and Yahoo, we used a search strategy to identify online information regarding prepectoral breast reconstruction with polyurethane-coated implants. The selected websites were divided into 5 groups (practitioners, hospitals, healthcare portals, professional societies, and encyclopedias), and the quality of information was assessed by using an expanded version of the Ensuring Quality Information for Patients (EQIP) tool, which is a checklist applicable to all existing types of information. Results: Fifty-six websites were selected and were categorized into 5 groups: 17 practitioners, 9 hospitals, 13 healthcare portals, 7 professional societies, 10 encyclopedias. The average score was 17 points (range: 12 - 25). We found 13 reliable websites with a score higher than 20 using the expanded version of the EQIP tool, whereas 43 were deemed unreliable, as they scored lower. Conclusion: Proper communication between surgeon and patient is crucial in the therapeutic choice, as the available online information presently is scarce and can lead to wrong decisions if not properly verified.

Quality of the Information provided by ChatGPT for Patients in Breast Plastic Surgery: Are we already in the future?

Introduction: In recent years, artificial intelligence (AI) has gained popularity, even in the field of plastic surgery. It is increasingly common for patients to use the internet to gather information about plastic surgery, and AI-based chatbots, such as ChatGPT, could be employed to answer patients' questions.The aim of this study was to evaluate the quality of medical information provided by ChatGPT regarding three of the most common procedures in breast plastic surgery: breast reconstruction, breast reduction, and augmentation mammaplasty. Methods: The quality of information was evaluated through the expanded EQIP scale. Responses were collected from a pool made by ten resident doctors in plastic surgery and then processed by SPSS software ver. 28.0. Results: The analysis of the contents provided by ChatGPT revealed sufficient quality of information across all selected topics, with a high bias in terms of distribution of the score between the different items. There was a critical lack in the "Information data field" (0/6 score in all the 3 investigations) but a very high overall evaluation concerning the "Structure data" (>7/11 in all the 3 investigations). Conclusion: Currently, AI serves as a valuable tool for patients; however, engineers and developers must address certain critical issues. It is possible that models like ChatGPT will play an important role in improving patient's consciousness about medical procedures and surgical interventions in the future, but their role must be considered ancillary to that of surgeons.

Evaluating the impact of field-scale management strategies on sediment transport to the watershed outlet.

Non-point source pollution from agricultural lands is a significant contributor of sediment pollution in United States lakes and streams. Therefore, quantifying the impact of individual field management strategies at the watershed-scale provides valuable information to watershed managers and conservation agencies to enhance decision-making. In this study, four methods employing some of the most cited models in field and watershed scale analysis were compared to find a practical yet accurate method for evaluating field management strategies at the watershed outlet. The models used in this study including field-scale model (the Revised Universal Soil Loss Equation 2 - RUSLE2), spatially explicit overland sediment delivery models (SEDMOD), and a watershed-scale model (Soil and Water Assessment Tool - SWAT). These models were used to develop four modeling strategies (methods) for the River Raisin watershed: Method 1) predefined field-scale subbasin and reach layers were used in SWAT model; Method 2) subbasin-scale sediment delivery ratio was employed; Method 3) results obtained from the field-scale RUSLE2 model were incorporated as point source inputs to the SWAT watershed model; and Method 4) a hybrid solution combining analyses from the RUSLE2, SEDMOD, and SWAT models. Method 4 was selected as the most accurate among the studied methods. In addition, the effectiveness of six best management practices (BMPs) in terms of the water quality improvement and associated cost were assessed. Economic analysis was performed using Method 4, and producer requested prices for BMPs were compared with prices defined by the Environmental Quality Incentives Program (EQIP). On a per unit area basis, producers requested higher prices than EQIP in four out of six BMP categories. Meanwhile, the true cost of sediment reduction at the field and watershed scales was greater than EQIP in five of six BMP categories according to producer requested prices.

Robotic colorectal surgery: quality assessment of patient information available on the internet using webscraping.

The primary goal of this study is to assess current patient information available on the internet concerning robotic colorectal surgery. Acquiring this information will aid in patients understanding of robotic colorectal surgery. Data was acquired through a web-scraping algorithm. The algorithm used two Python packages: Beautiful Soup and Selenium. The long-chain keywords incorporated into Google, Bing and Yahoo search engines were 'Da Vinci Colon-Rectal Surgery', 'Colorectal Robotic Surgery' and 'Robotic Bowel Surgery'. 207 websites resulted, were sorted and evaluated according to the ensuring quality information for patients (EQIP) score. Of the 207 websites visited, 49 belonged to the subgroup of hospital websites (23.6%), 46 to medical centers (22.2%), 45 to practitioners (21.7%), 42 to health care systems (20,2%), 11 to news services (5.3%), 7 to web portals (3.3%), 5 to industry (2.4%), and 2 to patient groups (0.9%). Only 52 of the 207 websites received a high rating. The quality of available information on the internet concerning robotic colorectal surgery is low. The majority of information was inaccurate. Medical facilities involved in robotic colorectal surgery, robotic bowel surgery and related robotic procedures should develop websites with credible information to guide patient decisions.

Gender dysphoria: Quality of online information for gender reassignment surgery.

An ever-increasing number of patients are using the Internet to learn about medical conditions. This study aimed to evaluate the quality of Internet-based patient information on gender reassignment surgery for people who suffer from gender dysphoria. Twenty websites identified using Google and Yahoo search engines were selected and evaluated based on the modified Ensuring Quality Information for Patients (EQIP) instrument (36 items). The EQIP tool comprises 36 questions to which the answer can be "yes" or "no". The final score for each website can be between 0 and 36. An overall score of 26 or above was considered high, because it co-related to the 72nd percentile. The average of the scores turned out to be 22.5 points, lower than our target; 7 (35%) sites were rated higher than the average and 13 (65%) were rated lower. The assessment of the websites included in the study showed a lack of information about the sequence of the medical procedures, perioperative criticalities and qualitative risks and side-effects descriptions. The overall quality of published information on gender reassignment surgery is very low. We believe that the Internet should not be used as the main source of medical information, and physicians should maintain the leadership in guiding patients affected by gender dysphoria. Level of Evidence: Level IV, case study.

Quality of Web-Based Sickle Cell Disease Resources for Health Care Transition: Website Content Analysis.

Background: Adolescents and young adults with sickle cell disease (SCD) transitioning from pediatric to adult health care face a high-risk period associated with increased use of acute health care services and mortality. Although 59% of American citizens report using the internet for health care information, the quality of web-based, patient-facing resources regarding transition in SCD care has not been evaluated. Objective: This study aimed to evaluate the quality and readability of web-based health information on SCD, especially as it pertains to the transition to adulthood for inidividuals with SCD. The study also compared the readability and content scores of websites identified in 2018 to those from 2021 to assess any change in quality over time. Methods: Keywords representing phrases adolescents may use while searching for information on the internet regarding transition in SCD care, including "hydroxyurea" and "SCD transition," were identified. A web-based search using the keywords was conducted in July 2021 using Google, Yahoo, and Bing. The top 20 links from each search were collected. Duplicate websites, academic journals, and websites not related to SCD health care transition were excluded. Websites were categorized based on the source: health department, hospital or private clinician, professional society, and other websites. Websites were assessed using Health On the Net Foundation code of conduct (HONcode), Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FGL), Ensuring Quality Information for Patients (EQIP), and a novel SCD content checklist (SCDCC). EQIP and SCDCC scores range from 0- to 100. Each website was reviewed by 2 research assistants and assessed for interrater reliability. Descriptive statistics were calculated. Results: Of the 900 websites collected, 67 (7.4%) met the inclusion criteria: 13 health department, 7 hospital or private clinician, 33 professional society, and 14 other websites. A total of 15 (22%) out of 67 websites had HONcode certification. Websites with HONcode certification had higher FRE and EQIP scores and lower FGL scores than those without HONcode certification, reflecting greater readability. Websites without HONcode certification had higher SCDCC scores, reflecting greater clinical content. Only 7 (10%) websites met the National Institutes of Health recommendation of a seventh-grade or lower reading level. Based on EQIP scores, 6 (9%) websites were of high quality. The mean SCDCC score was 20.60 (SD 22.14) out of 100. The interrater reliability for EQIP and SCDCC ratings was good (intraclass correlation: 0.718 and 0.897, respectively). No source of website scored significantly higher mean EQIP, FRE, FGL, or SCDCC scores than the others (all P<.05). Conclusions: Although seeking health care information on the web is very common, the overall quality of information about transition in SCD care on the internet is poor. Changes to current web-based health care information regarding SCD care transitions would benefit transitioning youth by providing expectations, knowledge, skills, and tools to increase self-efficacy.

Quality of online information about migraine headache surgery.

Migraine headache is a debilitating disease that can lead to severe functional limitations and is the most common primary headache. In more than 30% of cases conservative therapies do not allow the control of symptoms or cause side effects. Peripheral nerve surgery should be considered in non-responsive chronic migraine or suspected peripheral origin. Nowadays Web has become one of the most important sources of knowledge for patients: the information available on the web is not subject to a control of the sources reliability but can influence the patient. The aim of the study is to evaluate the quality of information accessible on the Web about the surgical treatment of migraine headache. "Headache OR migraine treatment", "headache OR migraine surgery" were the keywords used on two main search engines (Google and Yahoo). Among the first 50 websites, 26 were suitable and we divided them into five groups (practitioners, hospitals, healthcare portals, professional societies, encyclopedias). We applied the expanded EQIP (Ensuring Quality Information for Patients) scale: the EQIP scale consists of 36 questions with three sections (content, identification data and structure). Although the overall average score was relatively high (22 out of 36), many lacks information were highlighted: overall, readability was not satisfactory in communicating information regarding migraine and its surgical treatment. Readability should be tested before medical online publication, in order to provide for its correct use by the patient and improving migraine knowledge.

A quality assessment of online patient information regarding tonsillitis using the EQIP tool.

BACKGROUND: Tonsillitis is a common paediatric condition. The decision to seek medical attention and consent to treatment is usually made by parents or guardians. With increased accessibility of the internet, online medical information plays an increasingly significant role in the decision-making process. Little is known regarding the quality of online patient information on tonsillitis, as this has not been previously studied. OBJECTIVE: The aim of our study was to identify the quality of information regarding tonsillitis on websites intended for the public. METHODS: We conducted a systematic review of online information on tonsillitis using the following search terms: "Tonsillectomy", "Tonsillitis", "Adenotonsillectomy" and "Tonsil". The first three pages of returned websites were captured and each website was examined using the validated Ensuring Quality Information for Patients (EQIP) tool (score 0-36). RESULTS: A total of 92 websites met the inclusion criteria for analysis. The overall median EQIP score was 19 with an interquartile range of 17-22 and a maximum of 32. More than half of all websites originated from the USA (61%) and hospitals were the most common source of information (29%). Most websites failed to describe the quantitative benefits or address the medical intervention costs and insurance issues. Half of the websites included both tonsillectomy and antibiotics as treatments for tonsillitis. Only 68% included complications of tonsillitis or tonsillectomy. CONCLUSIONS: The assessment of the quality of online patient information websites regarding tonsillitis by the EQIP tool indicates that most websites were of poor credibility, with minimal information regarding treatment choices and complications. To improve awareness of tonsillitis, there is a need for more informative and patient-centred websites that are compatible with the international quality standard for patient information.

Inguinal hernia repair: a systematic analysis of online patient information using the Modified Ensuring Quality Information for Patients tool.

BACKGROUND: Online resources are a fundamental source of healthcare information due to the increasing popularity of the internet. Ensuring accuracy and reliability of websites is crucial to improving patient education and enhancing patient outcomes. Inguinal hernia repair is the most commonly performed general surgical procedure worldwide. This study analyses the quality of online patient information about inguinal hernia repair using the Modified Ensuring Quality Information for Patients (EQIP) tool. METHODS: A systematic review of online information on inguinal hernia repair was conducted using four search terms: 'inguinal hernia', 'groin hernia', 'inguinal hernia repair' and 'inguinoscrotal hernia'. The top 100 websites for each term identified using Google were assessed using the modified EQIP tool (score 0-36). Websites for the paediatric population or intended for medical professional use were excluded from analysis. FINDINGS: A total of 142 websites were eligible for analysis, 52.8% originating from the UK. The median EQIP score for all websites was 17/36 (interquartile range 14-21). The median EQIP scores for content, identification and structure were 8/18, 2/8 and 8/12, respectively. Complications of inguinal hernia repair were included in 46.5% of websites, with only 9.2% providing complication rates and 14.1% providing information on how complications are handled. CONCLUSION: This study highlights that the current quality of online patient information on inguinal hernia repair is poor, with minimal information available on complications, hindering patients' ability to make informed decisions regarding their healthcare. To improve patient education, there is an immediate need for improved quality online resources to meet international standards.

Quality assessment of patient information on orthognathic surgery on the internet.

OBJECTIVE: The aim of this study was to assess the quality of online information for patients on orthognathic surgery. MATERIALS AND METHODS: A selection of search terms specific for orthognathic surgery was chosen and 150 websites were identified using the Internet search engines Google, Yahoo and Bing. Irrelevant websites were excluded. The remaining websites were assessed with a modified Ensuring Quality Information for Patients (EQIP) tool. EQIP evaluates the quality of medical patient information by measuring the three key aspects of content, structure, and identification data. RESULTS: 48 relevant websites were identified. EQIP values ranged between 2 and 28 (median 13.65). While 37 of the 48 websites described details of the surgical procedures, only 13 mentioned possible risks and complications of the surgery. No differences were found between the websites of private practices, dentists and public hospitals, universities, or others (p = 0.66). Websites found by Google had a significantly lower EQIP score compared with Yahoo and Bing (11.12 vs. 16.60 for Yahoo and 16.23 for Bing; p = 0.012). The better the rank of the website, the higher the EQIP score (r = -0.411, p = 0.004). CONCLUSIONS: The results of this study reflected a large variation of quality of information on orthognathic surgery on the Internet. Therefore, surgeons must be aware that they might be confronted with unrealistic expectations of patients, who may underestimate the potential risks and drawbacks of orthognathic surgery.

Assessment of Written Patient Information Pertaining to Cirrhosis and Its Complications: A Pilot Study.

BACKGROUND: Written patient information may play an important role in the compliance of the cirrhosis disease, but little is known on the quality and patients' understanding of them. OBJECTIVES: To assess the written patient information leaflet pertaining to cirrhosis and its complications. METHODS: The Baker Able Leaflet Design (BALD) criteria and the Ensuring Quality Information for Patients (EQIP) questionnaire were applied to assess design, layout characteristics, and information quality. Readability was calculated using the Læsbarhedsindex (LIX) and the Simple Measure of Gobbledygook (SMOG). A cross-sectional study with a mixed methods design was carried out, using a questionnaire consisting of closed- and open-ended questions. RESULTS: The BALD score was 24 and the EQIP score 70%. The LIX score was 46 and the SMOG score 15.8. Sixteen phrases from the leaflet were selected to explore patients' understanding. Four phrases were understood by 100% of the patients, 6 phrases by more than 50% of the patients, and 6 phrases were understood by less than 50% of the patients. The meaning condensation showed that knowledge and understanding of cirrhosis and its complications were not enhanced by the availability of the leaflet. CONCLUSION: The leaflet had a good design, layout, and information quality but was difficult to read. Patients appeared to relate poorly to the leaflet and demonstrated limited health literacy. These results suggest that an assessment of written patient information ought to be made in an effort to improve readability. Further studies on intervention to improve patients' health literacy are recommended.