Quality and Accuracy of Cervical Radiculopathy-specific Information on the Internet: A Cross-sectional Analysis.

STUDY DESIGN: Cross-sectional analysis. OBJECTIVE: This study aimed to evaluate the quality and accuracy of the content surrounding cervical radiculopathy available on the internet. SUMMARY OF BACKGROUND DATA: Those experiencing cervical radiculopathy and their families are increasingly browsing the worldwide web for medical information. As the information offered is likely to influence their health care choices, spine care providers must understand the quality and accuracy of that information. METHODS: Independent searches were conducted on the three most commonly accessed search engines (Google, Yahoo, and Bing) using the keyword "cervical radiculopathy." The searches were performed on June 28th, 2019. The top 50 sites from each search engines were reviewed. The websites were evaluated using quality, accuracy and usability markers. RESULTS: Seventy-seven unique websites were analyzed; 54.5% were physician or medical group professional sites, 20.8% as non-physician, 10.4% as unidentified, 7.8% as academics, and 6.5% were commercial. Accuracy ranged from <25% to >75% were recorded with a mean accuracy of 3.5 signifying 50% to 75% agreement. Overall, website categories had a significant effect on Journal of American Medical Association (JAMA) score, content quality, accuracy, total summary scores, distraction index, reading ease, and grade level (P  < 0.05). Academic sites had the highest mean quality content, accuracy and total summary scores. Four of the top five websites with the highest total summary scores were physician driven. On average, Health on the Net code (HONcode) certified websites had lower grade level readability with greater reading ease and higher DISCERN and JAMA scores than uncertified sites (P < 0.05). CONCLUSION: Despite the wide number of sources available, the quality, accuracy, pertinence, and intelligibility of the information remains highly variable. Clinicians treating patients with cervical radiculopathy should direct them to verifiable sites with regulated information and, where possible, contribute high- quality information to those sites.Level of Evidence: 4.

Social media as a new source of medical information and support: analysis of scoliosis-specific information.

BACKGROUND CONTEXT: It has never been easier for patients to obtain information about and to connect with others with a given health issue. Frequently, patients turn to social media. There, more information and emotional support from individuals with similar experiences should empower patients, contributing to a better functional and overall outcome. Unfortunately, social media often contains biased reports and misinformation. PURPOSE: This study aimed to assess the footprint of AIS (adolescent idiopathic scoliosis) on the top four social media platforms. STUDY DESIGN: Cross-sectional analysis. METHODS: Independent searches were conducted across four major social media platforms (Facebook, Instagram, YouTube, and LinkedIn) using the keywords "scoliosis" and "#scoliosis" for Instagram. The top 50 posts from each platform were evaluated based on the overall tone of the post (positive, negative, neutral); who made the post (business, patient, family/friend, hospital/physician); the intent of the postcy (advertisement, educate the viewer about scoliosis/disease process/treatments, raise awareness, provide support to patients and their family/friends, promote research); the credentials of the poster [MD, clinician (non-MD), non-clinician, unknown]; the type of media used in the post (text only, picture, video, multiple) and if the post had an external link and what content the link provided (academic, hospital/physician, health news outlet, alternative treatment, personal blog, business, other). RESULTS: 196 unique postings were analyzed for the various content criteria. Across all four platforms, the majority of posts were made by a non-clinician (42.8%) representing a business (49.3%), with the intent to educate (32.3%) using a neutral tone (52.5%). Pictures (61%) were the most common media, and 56.3% of all posts contained external links. Often, those links lead to sites promoting alternative treatments (28.8%). In comparison to the overall analysis, Instagram deviated from the patterns the most. Instagram was the only platform with a predominantly positive tone (62%). Here, 71% of the postings came from an actual patient with the intent to describe their experience or daily life with scoliosis (36%). Instagram had the lowest rate of external links (39%) and most of those lead to another person's Instagram account or a personal blog (47%). Hospital and physician groups had the highest presence on YouTube (35%), but the highest MD authorship was on Facebook (28%). CONCLUSION: Social media can be a powerful tool to disseminate information and create supportive communities for patients with chronic conditions. Healthcare providers and educators are underutilizing these outlets to reach our patients and help provide them the information and support networks they need.

Cross sectional analysis of scoliosis-specific information on the internet: potential for patient confusion and misinformation.

BACKGROUND CONTEXT: Patients and their families are increasingly turning to the internet for medical information. Most of these patients believe the information to be accurate and reliable. However, the quality and accuracy of that information on the internet is variable and unregulated. Accurate and applicable information may align patients' expectations and improve satisfaction and overall outcomes. PURPOSE: This study aimed to evaluate the quality and accuracy of scoliosis-related information available on the internet. STUDY DESIGN: Cross-sectional analysis. METHODS: Independent searches were conducted on the three most commonly accessed search engines (Google, Yahoo and Bing) using the keyword "scoliosis". The top 30 sites from each search engine were reviewed. Each website was categorized as per its authorship and sourcing. Each site was then evaluated for accuracy, readability and with quality-assurance markers such as Health on the Net code (HONcode), DISCERN, Journal of American Medical Association (JAMA) systems. The accuracy of the website was assessed by two fellowship-trained spine specialists. Website accuracy was rated on a scale of 1-4 based on the level of agreement with the information presented. Websites with greater than 75% agreement were rated 4. Finally, the sites were evaluated with a validated website distraction index and assessed for mobile friendliness. RESULTS: 42 unique websites were analyzed. 31% of the sites were categorized as academic (13 academic, 9 healthcare system, 12 health news outlets and 8 unspecified) and had the highest rate of physician authorship (54%). Accuracy ranged from less than 25% to more than 75% were recorded with a mean accuracy of 3 signifying 50-75% agreement. Academic sites had the highest scoliosis specific accuracy score (P < 0.05). Overall, average readability was at a 12th grade reading level. More than 90% of the sites were mobile friendly. Approximately 71% of the websites did not have HONcode certification, although health news outlets had the highest rate of certification (67%). There was a significant effect of HONcode certification on DISCERN, JAMA, grade level and reading ease. On average, HONcode certified websites had lower grade level readability with greater reading ease and higher DISCERN and JAMA scores than un-certified sites (p < 0.05). On average, health news outlets had the highest DISCERN, JAMA, and reading ease scores and were written at the lowest grade reading level but had the highest level of distraction (p < 0.05). CONCLUSION: For the iGeneration and their care-givers, the internet remains the most popular source of health-related and medical information. Despite the wide number of sources available, the quality, accuracy, pertinence and intelligibility of the information remains highly variable. As clinicians, we should direct patients to verifiable sites with regulated information and, where possible, contribute high quality information to those sites.