QUALITY OF INFORMATION ON THEINTERNET RELATED TO OVERACTIVE BLADDER: AN ANALYSIS OF QUALITY ANDREADABILITY OF PATIENT-TARGETED WEBSITES.
A. CLANCY1, D.HICKLING 2, L. DIDOMIZIO 3, M. SANAEE 4,F. SHEHATA 1, R. ZEE 1, H. KHALIL 1;
1Obstetrics and Gynecology, Univ. of Ottawa, Ottawa,Canada, 2Surgery, Univ. of Ottawa, Ottawa, Canada,3Obstetrics and Gynecology, McMaster Univ., Hamilton,Canada, 4Obstetrics and Gynecology, Univ. of BritishColumbia, Vancouver, Canada.
Introduction: Overactive bladder(OAB) affects 15% of men and women1, many of whom look tothe internet for diagnostic and treatment information. Studies showthat patients commonly use internet search engines to research healthinformation2, and many patients trust information on theinternet more than even friends and family3. Althoughthere is a plethora of websites available, the quality of widelyaccessible information relating to OAB has not been previouslyevaluated.
Objective: We aimed to objectively assess thequality and readability of websites relating to OAB treatments thatare available to patients through commonly used searchengines.
Methods: Forty-two patients attending appointmentsat a urogynecology clinic completed a brief survey regarding internetusage to obtain commonly used search engine terms. Google, Bing andYahoo search engines were used to identify the first 20 OAB relatedwebsites. After exclusion of duplicates, 35 final websites remainedfor evaluation. Each website was assessed by 6 reviewers whocompleted a standardized form regarding website content, andevaluated each website using the DISCERN instrument and JAMAbenchmark criteria. Health on the Net (HON) certification andreadability scores including Simplified Measure of Gobbledygook(SMOG) were determined for each website.
Results: Inpatient survey results 93% of patients (39/42) agreed orstrongly agreed that it would be helpful to have websites recommendedby their physician. 19/42 (45%) respondents described urinaryurgency, overactive bladder or urge incontinence as a bothersomeconcern. When asked to write down potential search terms they woulduse to find information about their most bothersome concern,“Overactive bladder” with “treatment” or “management” wasthe most commonly listed search term (11 of 19 patients, 58%).Interrater reliability showed substantial agreement (fleiss’ kappa0.65, 95% CI 0.60-0.70 p<0.001) for website classification andgood agreement for DISCERN instrument rating of overall quality ofwebsite (intraclass correlation coefficient (ICC 2,1) was 0.67, 95%CI 0.54-0.79)). For categorical data, if fewer than 5/6 reviewersagreed on the final category, an expert reviewer resolved anydiscrepancies and this was required in only 8.75% of cases. Websiteswere classified as advertisement or commercial (31%), health portal(29%), professional (26%), patient group (6%) or other (9%).Treatments described for OAB included behavioural modifications(83%), timed voiding or bladder drills (66%), pelvic floorphysiotherapy (69%), various medications (57%), a single medicationoption only (6%), onobotullinum toxinA (60%), sacroneuromodulation(46%) and posterior tibial nerve stimulation (26%). Overall DISCERNscores were poor with a mean score of 44 out of 80 (SD 18). For JAMAbenchmark criteria, 43% of websites provided date of update or datethat information was posted, 54% provided disclosure information, 31%provided references and sources for all content and only 14% providedcomplete information about authors and contributors. The median SMOGindex was 9.9 (IQR 9.3-11.2) and only 9 websites (26%) were HONcertified. There was no statistical difference between DISCERN orJAMA criteria scores for HON certified websites versus non-HONcertified websites (p<0.01). Websites classified as advertisementshad lower DISCERN scores (31 vs 51, p<0.001) than otherwebsites.
Conclusions: Websites providing information onOAB have low quality scores and often lack key information. Patientsshould be cautioned regarding incomplete information and a highproportion of advertisement/commercial material available throughcommonly used internet search engines when seeking information forOAB.
References: 1. European urology.2006;50:1306-1314 2. Female Pelvic Med Reconstr Surg.2015;21:269-272. 3. Current oncology 2014;21:165-173.