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What Information Are Patients Receiving from the Internet about the Operative and Nonoperative Management of Acute Appendicitis?
Digestive Surgery ( IF 2.7 ) Pub Date : 2020-01-01 , DOI: 10.1159/000510383
Luke Conlon 1 , Zarrukh Baig 2 , Michael A J Moser 3
Affiliation  

Introduction: Recent studies suggest that nonoperative management of appendicitis (NOMA) may be a reasonable option for managing uncomplicated acute appendicitis. We examined the Internet to see if patients are likely to find the information they need to make an informed decision between the 2 options. Methods: A list of 29 search terms was established by a focus group and then entered into Google, resulting in 49 unique webpages, each reviewed by 3 reviewers. Consensus was obtained for bias (surgery, NOMA, or balanced), webpage type, JAMA score, reading grade, and DISCERN score, a measure of quality of written information for patients. Results: Thirty of the 49 websites (61%) favored surgery, while 13 (27%) favored NOMA, and 6 sites (12%) provided balanced information. Twelve of 49 sites (24%) did not list NOMA as an option. The majority of patient-directed (11/12 = 92%) and physician-directed (7/9 = 78%) webpages favored surgery, whereas academic webpages presented a more balanced distribution. Academic and physician-directed webpages ranked higher than commercial and news webpages (median ranks 3 and 4 vs. 7.5 and 8). Only 8/49 sites (16%) mentioned that the presence of a fecalith predicts the failure of NOMA. Reading grades were almost all well above the recommended grade 8 level. Conclusion: Most of the webpages available on the Internet do not provide enough information, nor are they sufficiently understandable to allow most patients to make an informed decision about the current options for the management of acute appendicitis.

中文翻译:

患者从互联网上收到哪些关于急性阑尾炎手术和非手术治疗的信息?

简介:最近的研究表明,非手术治疗阑尾炎 (NOMA) 可能是治疗无并发症急性阑尾炎的合理选择。我们检查了互联网,看看患者是否有可能找到他们在两种选择之间做出明智决定所需的信息。方法:由焦点小组建立29个搜索词列表,然后输入谷歌,产生49个独特的网页,每个网页由3个审稿人审阅。就偏见(手术、NOMA 或平衡)、网页类型、JAMA 评分、阅读等级和 DISCERN 评分(衡量患者书面信息的质量)达成了共识。结果:49 个网站中有 30 个 (61%) 支持手术,13 个 (27%) 支持 NOMA,6 个站点 (12%) 提供平衡信息。49 个站点中有 12 个 (24%) 没有将 NOMA 列为选项。大多数面向患者 (11/12 = 92%) 和面向医生 (7/9 = 78%) 的网页支持手术,而学术网页的分布更为均衡。学术和医生导向的网页排名高于商业和新闻网页(中位数排名 3 和 4,对比 7.5 和 8)。只有 8/49 站点 (16%) 提到粪便的存在预示着 NOMA 的失败。阅读成绩几乎都远高于推荐的 8 年级水平。结论:互联网上的大多数网页都没有提供足够的信息,也没有足够的可理解性,无法让大多数患者对当前的急性阑尾炎治疗方案做出明智的决定。而学术网页则呈现出更均衡的分布。学术和医生导向的网页排名高于商业和新闻网页(中位数排名 3 和 4,对比 7.5 和 8)。只有 8/49 站点 (16%) 提到粪便的存在预示着 NOMA 的失败。阅读成绩几乎都远高于推荐的 8 年级水平。结论:互联网上的大多数网页都没有提供足够的信息,也没有足够的可理解性,无法让大多数患者对当前的急性阑尾炎治疗方案做出明智的决定。而学术网页则呈现出更均衡的分布。学术和医生导向的网页排名高于商业和新闻网页(中位数排名 3 和 4,对比 7.5 和 8)。只有 8/49 站点 (16%) 提到粪便的存在预示着 NOMA 的失败。阅读成绩几乎都远高于推荐的 8 年级水平。结论:互联网上的大多数网页都没有提供足够的信息,也没有足够的可理解性,无法让大多数患者对当前的急性阑尾炎治疗方案做出明智的决定。阅读成绩几乎都远高于推荐的 8 年级水平。结论:互联网上的大多数网页都没有提供足够的信息,也没有足够的可理解性,无法让大多数患者对当前的急性阑尾炎治疗方案做出明智的决定。阅读成绩几乎都远高于推荐的 8 年级水平。结论:互联网上的大多数网页都没有提供足够的信息,也没有足够的可理解性,无法让大多数患者对当前的急性阑尾炎治疗方案做出明智的决定。
更新日期:2020-01-01
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