Beurteilung von im Internet verfügbaren deutschsprachigen Patienteninformationen zum Hörsturz

Zusammenfassung

Hintergrund Durch die Digitalisierung hat sich das Internet zu einem wesentlichen Informationsmedium für Patienten entwickelt. Patienten mit Hörsturz haben aufgrund unsicherer wissenschaftlicher Erkenntnisse einen besonders großen Informationsbedarf. In der vorliegenden Arbeit wurden daher die Ergebnisse einer Internetsuche zum Thema Hörsturz untersucht.

Material und Methoden Die ersten 30 Treffer einer Google-Suche mit dem Begriff „Hörsturz“ wurden kategorisiert, eine Lesbarkeitsstatistik anhand verschiedener Formeln (Flesch-Reading-Ease-Score; 0=schwer, 100=leicht lesbar) berechnet und falsche Informationen dokumentiert. Eine strukturierte inhaltliche Bewertung erfolgte mit dem DISCERN-Fragebogen (1=niedrige, 5=hohe Qualität) getrennt durch 2 verblindete Untersucher. Die Einhaltung empfohlener Standards wurde anhand einer Health-On-The-Net-Zertifizierung erfasst.

Ergebnisse 18 Internetseiten (60,0%) waren Informationsportale, 7 (23,3%) von Medizinprodukteunternehmen (davon 3 Hörgerätehersteller), 2 (6,7%) von öffentlichen Einrichtungen und je 1 (3,3%) von einem Ärzteverband und einer Selbsthilfeorganisation sowie ein wissenschaftlicher Artikel. Im Mittel lag die Wortanzahl bei 1307,0±840,2 Wörtern, die letzte Aktualisierung war vor 17,1±32,5 Monaten und der Flesch-Reading-Ease-Score lag bei 36,1±13,9. Am schwierigsten lesbar war der wissenschaftliche Artikel (13,7). Insgesamt lag der DISCERN bei 2,2±0,7 mit schlechtester Bewertung von Medizinprodukteunternehmen (1,6±0,5). Zwei Internetseiten (6,7%) hatten ein Health-On-The-Net-Zertifikat, 14 (46,7%) zeigten falsche Informationen.

Schlussfolgerung Patienteninformationen im Internet sind aufgrund geringer Lesbarkeit, potenzieller Interessenkonflikte, niedriger Qualität oder falscher Informationen kritisch zu bewerten. Eine mögliche Konsequenz wäre eine Bereitstellung verlässlicher Gesundheitsinformationen im Internet durch medizinische Leistungserbringer und Fachgesellschaften.

Abstracts

Objectives As a result of digitalization, the internet embodies the essential information medium. Especially, patients with sudden sensorineural hearing loss (SSNHL) require profound education due to unclear scientific evidence. Thus, our study investigated a German-language internet search about SSNHL.

Design The first 30 Google-search results with the term “Hörsturz” (SSNHL in German) were categorized, readability-statistic with different readability-scores (FRES: 0=complex, 100=easy; FKL; SMOG; GFI) calculated, and misinformation documented. A structured content-analysis was performed with the DISCERN-questionnaire (1=low, 5=high quality). Certification of the Health-On-The-Net-Foundation (HON) assessed the abidance of recommended standards.

Results 18 websites (60.0%) accounted for digital media, 7 (23.3%) manufacturers of medical devices, 2 (6.7%) government institutions, and respectively 1 (3.3%) healthcare provider, support-group, and scientific article. Mean word count was 1307.0±840.2, last update 17.1±32.5 months ago, and FRES 36.1±13.9, with the most difficult text by the scientific article (13.7). Mean of DISCERN was 2.2±0.7 with worst rating of manufacturers of medical devices (1.6±0.5). 2 websites (6.7%) were HON-certified, and 14 (46.7%) contained misinformation.

Conclusion Internet-based patient-information should be assessed cautiously due to poor readability, potential conflict of interests, low quality, or wrong information. Hence, healthcare providers and professional associations are urged to provide high-quality patient-information in the internet.

Schlüsselwörter

Gesundheitsbildung (health education) - Internet - Doktor Google - Dr. Google - Hörsturz

Keywords

health education - internet - Doctor Google - Dr. Google - sudden sensorineural hearing loss - SSNHL

Publication History

Received: 15 March 2020

Accepted after revision: 29 March 2021

Article published online:
02 June 2021

• Literatur

• 1 Mokhtar SB, Boutet A, Felber P. et al. X-search. In: Proceedings of the 18th ACM/IFIP/USENIX Middleware Conference on – Middleware ’17. New York, New York, USA: ACM Press; 2017: 198-208
• 2 Eysenbach G. The Impact of the Internet on Cancer Outcomes. CA Cancer J Clin 2003; 53: 356-371
• 3 McCray AT. Promoting Health Literacy. J Am Med Informatics Assoc 2004; 12: 152-163
• 4 Andreassen HK, Bujnowska-Fedak MM, Chronaki CE. et al. European citizens’ use of E-health services: A study of seven countries. BMC Public Health 2007; 7: 53
• 5 Kuehn BM. More than one-third of us individuals use the internet to self-diagnose. JAMA – J Am Med Assoc 2013; 309: 756-757
• 6 Dumitru RC, Bürkle T, Potapov S. et al. Use and perception of Internet for health related purposes in Germany: results of a national survey. Int J Public Health 2007; 52: 275-285
• 7 Toms EG, Latter C. How consumers search for health information. Health Informatics J 2007; 13: 223-235
• 8 Gurr A, Schwaab M, Hansen S. et al. Informationsverhalten von HNO-Patienten im Internet. HNO 2009; 57: 473-479
• 9 Purcell GP, Wilson P, Delamothe T. The quality of health information on the internet. BMJ 2002; 324: 557-558
• 10 Anderson JG, Rainey MR, Eysenbach G. The impact of Cyber Healthcare on the physician-patient relationship. J Med Syst 2003; 27: 67-84
• 11 Stone JH. Communication between physicians and patients in the era of E-medicine. N Engl J Med 2007; 356: 2451-2454
• 12 Tan S-L, Goonawardene N. Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review. J Med Internet Res 2017; 19: e9
• 13 Sorensen JA, Pusz MD, Brietzke SE. YouTube as an information source for pediatric adenotonsillectomy and ear tube surgery. Int J Pediatr Otorhinolaryngol 2014; 78: 65-70
• 14 Norman CD, Skinner HA. eHealth Literacy: Essential Skills for Consumer Health in a Networked World. J Med Internet Res 2006; 8: e9
• 15 Hodgetts D, Bolam B, Stephens C. Mediation and the Construction of Contemporary Understandings of Health and Lifestyle. J Health Psychol 2005; 10: 123-136
• 16 Levin-Zamir D, Bertschi I. Media Health Literacy, eHealth Literacy, and the Role of the Social Environment in Context. Int J Environ Res Public Health 2018; 15: 1643
• 17 Berkman ND, Sheridan SL, Donahue KE. et al. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Ann Intern Med 2011; 155: 97
• 18 Sheridan SL, Halpern DJ, Viera AJ. et al. Interventions for individuals with low health literacy: A systematic review. J Health Commun 2011; 16: 30-54
• 19 Murray E, Lo B, Pollack L. et al. The impact of health information on the Internet on health care and the physician-patient relationship: National U.S. survey among 1.050 U.S. Physicians. J Med Internet Res 2003; 5: 38-53
• 20 Ihler F, Canis M. Die Rolle des Internets für Gesundheitsinformationen in der Hals-Nasen-Ohrenheilkunde. Laryngo-Rhino-Otol 2019; 98: S1-S23
• 21 Acar B, Acar M, Ocak E. et al. Accuracy of Internet guidance on pediatric otolaryngology procedures. Int J Pediatr Otorhinolaryngol 2014; 78: 2190-2192
• 22 Irwin JY, Thyvalikakath T, Spallek H. et al. English and Spanish oral cancer information on the internet: A pilot surface quality and content evaluation of oral cancer Web sites. J Public Health Dent 2011; 71: 106-116
• 23 Meyer MF, Bacher R, Roth KS. et al. Systematische Analyse der Lesbarkeit von Patienteninformationstexten auf Internetseiten deutscher nichtuniversitärer HNO-Kliniken. HNO 2014; 62: 186-195
• 24 Luers J-C, Gostian A-O, Roth KS. et al. Lesbarkeit von medizinischen Texten im Internetangebot deutscher HNO-Universitätskliniken. HNO 2013; 61: 648-654
• 25 Stachler R, Chandrasekhar S, Archer S. et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012; 146: S1-S35
• 26 Marx M, Younes E, Chandrasekhar S. et al. International consensus (ICON) on treatment of sudden sensorineural hearing loss. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135: S23-S28
• 27 Arslan F, Aydemir E, Kaya Y. et al. Anxiety and depression in patients with sudden one-sided hearing loss. Ear Nose Throat J 2018; 97: E7-E10
• 28 Sano H, Okamoto M, Ohhashi K. et al. Quality of life reported by patients with idiopathic sudden sensorineural hearing loss. Otol Neurotol 2013; 34: 36-40
• 29 Carlsson P, Hall M, Lind K. et al. Quality of life, psychosocial consequences, and audiological rehabilitation after sudden sensorineural hearing loss. Int J Audiol 2011; 50: 139-144
• 30 Eysenbach G, Köhler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. BMJ 2002; 324: 573-577
• 31 Boyer C, Selby M, Appel RD. et al. The Health On the Net Code of Conduct for medical and health Websites. Comput Biol Med 1998; 28: 603-610
• 32 Walsh TM, Volsko TA. Readability assessment of internet-based consumer health information. Respir Care 2008; 53: 1310-1315
• 33 McLaughlin GH. SMOG grading: A new readability formula. J Read 1969; 12: 639-646
• 34 Flesch R. A new readability yardstick. J Appl Psychol 1948; 32: 221-233
• 35 Kincaid J, Fishburne J, Robert P. et al. Derivation of New Readability Formulas (Automated Readability Index, Fog Count and Flesch Reading Ease Formula) for Navy Enlisted Personnel.
• 36 Charnock D. The Discern Handbook. Oxford: Radcliffe Medical Press Ltd; 1998
• 37 Charnock D, Shepperd S, Needham G. et al. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Heal 1999; 53: 105-111
• 38 Allam A, Schulz PJ, Krauthammer M. Toward automated assessment of health Web page quality using the DISCERN instrument. J Am Med Informatics Assoc 2016; 24: ocw140
• 39 San Giorgi MRM, de Groot OSD, Dikkers FG. Quality and readability assessment of websites related to recurrent respiratory papillomatosis. Laryngoscope 2017; 127: 2293-2297
• 40 Alnafea S, Fedele S, Porter S. et al. Online Information on the Treatment of Burning Mouth Syndrome: Quality and Readability. J Oral Facial Pain Headache 2017; 31: 147-151
• 41 Narwani V, Nalamada K, Lee M. et al. Readability and quality assessment of internet-based patient education materials related to laryngeal cancer. Head Neck 2016; 38: 601-605
• 42 Nissan ME, Gupta A, Rayess H. et al. Otoplasty Online Information: A Comprehensive Analysis of the Websites and Videos that Patients View Regarding Cosmetic Ear Surgery. Facial Plast Surg 2018; 34: 82-87
• 43 Alamoudi U, Hong P. Readability and quality assessment of websites related to microtia and aural atresia. Int J Pediatr Otorhinolaryngol 2015; 79: 151-156
• 44 Davis KS, McCormick AA, Jabbour N. What might parents read: Sorting webs of online information on vascular anomalies. Int J Pediatr Otorhinolaryngol 2017; 93: 63-67
• 45 Wozney L, Chorney J, Huguet A. et al. Online Tonsillectomy Resources: Are Parents Getting Consistent and Readable Recommendations?. Otolaryngol – Head Neck Surg 2017; 156: 844-852
• 46 Varela-Centelles P, Ledesma-Ludi Y, Seoane-Romero JM. et al. Information about oral cancer on the Internet: Our patient scannot understand it. Br J Oral Maxillofac Surg 2015; 53: 393-395
• 47 Ting K, Hu A. Evaluating the quality and readability of thyroplasty information on the internet. J Voice 2014; 28: 378-381
• 48 Charnock D, Shepperd S. Learning to DISCERN online: applying an appraisal tool to health websites in a workshop setting. Health Educ Res 2004; 19: 440-446
• 49 Rees CE, Ford JE, Sheard CE. Evaluating the reliability of DISCERN: a tool for assessing the quality of written patient information on treatment choices. Patient Educ Couns 2002; 47: 273-275
• 50 Sommerhalder K, Abraham A, Zufferey MC. et al. Internet information and medical consultations: Experiences from patients’ and physicians’ perspectives. Patient Educ Couns 2009; 77: 266-271
• 51 Steehler KR, Steehler MK, Pierce ML. et al. Social media’s role in otolaryngology-head and neck surgery: informing clinicians, empowering patients. Otolaryngol Head Neck Surg 2013; 149: 521-524