ABSTRACT
Purpose: To evaluate the quality and correlation of readability on actionability and understandability of shoulder arthroscopy-related patient education materials (PEMs) found via a routine Google search. Methods: Two independent authors performed an online Google search with the term "shoulder arthroscopy." The first 5 pages of search results were then screened for PEMs. Journal articles, news articles, nontext materials, and unrelated websites were excluded. The readability of included resources was calculated using objective metrics: Flesch-Kincaid Grade Score, Simple Measure of Gobbledygook index, Coleman-Liau Index, and the Gunning Fog Index. Patient Education Material Assessment Tool for Printed Materials assessed for understandability and actionability. Associations between readability and actionability and understandability were determined using Spearman correlation and linear regression. Results: The searches returned 53 websites related to shoulder arthroscopy. A total of 34 (64%) met inclusion criteria. A high school reading level or greater was required to read the average PEM according to all scales used. The average PEM received a Patient Education Material Assessment Tool for Printed Materials score of 61.33 in understandability (range 18.75-89.47) and 55.59 points in actionability (range 16.67-83.33). An easily understood or actionable article would score at least 70 points. A moderate correlation was observed between readability and actionability on three of the scales used (r = 0.5, r = 0.59, r = 0.61). Conclusions: Most shoulder arthroscopy PEMs identified on Google are not written at a level that the average patient can read, understand, or act on (actionability). Clinical Relevance: Orthopaedic surgeons should be aware of the resources that patients use to obtain medical information. More accessible PEMs should be developed for patients undergoing shoulder arthroscopy to enhance comprehension of their condition and improve shared decision-making.
ABSTRACT
Purpose: To obtain a quantifiable measure of the frequency with which a shoulder instability article is discussed online and the association with its corresponding bibliometric impact, based on the Scopus Cite Score (SCS) or Web of Science Impact Factor (WSIF). Methods: The top 100 most-mentioned articles on shoulder instability based on Altmetric Attention Score (AAS) were extracted from the Altmetric Database. Mentions within blogs, news articles and outlets, public policy, and social media platforms, such as Twitter and Facebook, were included. Study impact was assessed using SCS or WSIF. The degree of association between AAS and impact was determined using Spearman correlation, logarithmic regression, and multivariate regression. Results: The most common study designs were "Clinical Trial," with 52 articles (49.5%), "Systematic Review" with 16 articles (15.2%), and "Review" with 10 articles (9.5%). Twitter provided more online mentions than other platforms, with the average article being discussed 27.7 times (range 0-220 times). A significant positive effect (estimate = 2.616, P = .0075) was observed between the AAS and WSIF, based on the logarithmic regression. Multivariate regression revealed that blogs help raise both WSIF and SCS (estimate = 7.272, P < .05). Conclusions: Social media and other online platforms are a strong way to disseminate information to patients. A positive association was observed between overall online attention and the bibliometric impact of an article related to shoulder instability. Clinical trials related to shoulder instability that receive online mentions, especially discussion in blogs, are more likely to be cited in the future than their counterparts. Clinical Relevance: The results of our study can guide authors as they aim to disseminate their articles. Twitter may be used as a tool to reach patients who may not venture into academic journals with current peer-reviewed articles. Further, blogs may be used to reach academic audiences and raise bibliometric impact broadly.
ABSTRACT
Digital phenotyping-the moment-by-moment quantification of human phenotypes in situ using data related to activity, behavior, and communications, from personal digital devices, such as smart phones and wearables-has been gaining interest. Personalized health information captured within free-living settings using such technologies may better enable the application of patient-generated health data (PGHD) to provide patient-centered care. The primary objective of this scoping review is to characterize the application of digital phenotyping and digitally captured active and passive PGHD for outcome measurement in surgical care. Secondarily, we synthesize the body of evidence to define specific areas for further work. We performed a systematic search of four bibliographic databases using terms related to "digital phenotyping and PGHD," "outcome measurement," and "surgical care" with no date limits. We registered the study (Open Science Framework), followed strict inclusion/exclusion criteria, performed screening, extraction, and synthesis of results in line with the PRISMA Extension for Scoping Reviews. A total of 224 studies were included. Published studies have accelerated in the last 5 years, originating in 29 countries (mostly from the USA, n = 74, 33%), featuring original prospective work (n = 149, 66%). Studies spanned 14 specialties, most commonly orthopedic surgery (n = 129, 58%), and had a postoperative focus (n = 210, 94%). Most of the work involved research-grade wearables (n = 130, 58%), prioritizing the capture of activity (n = 165, 74%) and biometric data (n = 100, 45%), with a view to providing a tracking/monitoring function (n = 115, 51%) for the management of surgical patients. Opportunities exist for further work across surgical specialties involving smartphones, communications data, comparison with patient-reported outcome measures (PROMs), applications focusing on prediction of outcomes, monitoring, risk profiling, shared decision making, and surgical optimization. The rapidly evolving state of the art in digital phenotyping and capture of PGHD offers exciting prospects for outcome measurement in surgical care pending further work and consideration related to clinical care, technology, and implementation.
