Quality and readability of websites for patient information on tonsillectomy and sleep apnea
Introduction
Sleep apnea exists on the spectrum of sleep-disordered breathing and is defined by pauses in breathing, apneas, and periods of decreased airflow, or hypopneas. In obstructive sleep apnea (OSA), respiratory effort is present, but decreased or absent airflow results from upper airway collapse [1]. OSA occurs in up to 3% of pediatric patients and is most commonly caused by adenotonsillar hypertrophy [2]. Tonsillectomy is one of the mostly commonly performed procedures on children and may often been offered to OSA patients with enlarged tonsils [3]. Patients and their parents may elect to proceed with tonsillectomy, pursue medical management, or forgo treatment entirely.
The advent of the Internet has changed the way patients evaluate treatment options. The Internet allows patients to access medical information directly without having to consult a medical professional. As a result, by the time patients reach a medical provider, they may already have decided on a treatment plan or may have more sophisticated management questions [4]. Since information on the Internet is largely unregulated, the quality of the information is variable. Review of websites with accurate medical information can aid patients in making decisions. However, websites with false, misleading, or biased data can compromise patients' ability to make sound medical decisions [5].
Furthermore, website readability is a concern; Internet sources must be at a level that can be easily understood by the patients consuming them. The American Medical Association [6] and the National Institution of Health [7] recommend that medical information be equal or less than 6th grade reading level.
The readability and quality of medical information available on the Internet related to the topics of glue ear, aural atresia, tympanostomy tubes, and vascular anomalies has been assessed [8], [9], [10], [11], but no similar review has been conducted for the topic of tonsillectomy and sleep. The purpose of this study is to evaluate the quality and readability of the most popular websites presenting information on sleep apnea and tonsillectomy.
Section snippets
Selection of sources
The three most popular search engines (Google, Bing, Yahoo) were queried with the phrase “sleep apnea and tonsillectomy” on June 25, 2016 from Pittsburgh, PA. Articles were culled from only the first page of results for each search engine to amass a pool of 30 websites to evaluate. Websites duplicated between the various search engines were reviewed only once, and non-text sources were excluded.
The article text was separated from any identifying website features and from the address link. Two
Website characteristics
Of the 30 websites generated with the search term “sleep apnea AND tonsillectomy,” 15 met inclusion criteria. 13 were duplicates, and 2 were non-text sources. 9 of these websites were geared to a discussion of pediatric sleep apnea, 3 were targeted at adult sleep apnea, and 3 were undifferentiated with respect to age.
DISCERN instrument
Out of the maximum of 80, the average DISCERN score for the websites was 55.1 (SD- 12.3, Median- 60.5). 5 (33%) websites scored at least 65 and 3 (20%) scored less than 40.
Discussion
In recent years, the Internet has been increasingly used as a source of medical information by patients. Information on the Internet is quick, convenient, and free of charge. If patients are going to use information obtained from the Internet to guide their medical decision-making, this information must be reliable and easy to comprehend. Patients should be aware that this is not always the case.
There were a wide range of DISCERN scores recorded for sleep apnea and tonsillectomy. This wide
Conclusion
The Internet is a valuable source for medical information due to ease of access. However, patients should be aware that the information is unregulated and varies in reliability. Physicians should be aware that patients use information on the Internet to inform their medical decisions. By being aware of what information their patients are reading online, they can better explain treatments and address misunderstandings. Physicians may even consider creating their own website to strike a balance
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