Association Between Patient Education Videos and Knowledge of Radiation Treatment

Assessing the Quality and Reliability of ChatGPT's Responses to Radiotherapy-Related Patient Queries: Comparative Study With GPT-3.5 and GPT-4

Background

Patients frequently resort to the internet to access information about cancer. However, these websites often lack content accuracy and readability. Recently, ChatGPT, an artificial intelligence-powered chatbot, has signified a potential paradigm shift in how patients with cancer can access vast amounts of medical information, including insights into radiotherapy. However, the quality of the information provided by ChatGPT remains unclear. This is particularly significant given the general public's limited knowledge of this treatment and concerns about its possible side effects. Furthermore, evaluating the quality of responses is crucial, as misinformation can foster a false sense of knowledge and security, lead to noncompliance, and result in delays in receiving appropriate treatment.

Objective

This study aims to evaluate the quality and reliability of ChatGPT's responses to common patient queries about radiotherapy, comparing the performance of ChatGPT's two versions: GPT-3.5 and GPT-4.

Methods

We selected 40 commonly asked radiotherapy questions and entered the queries in both versions of ChatGPT. Response quality and reliability were evaluated by 16 radiotherapy experts using the General Quality Score (GQS), a 5-point Likert scale, with the median GQS determined based on the experts' ratings. Consistency and similarity of responses were assessed using the cosine similarity score, which ranges from 0 (complete dissimilarity) to 1 (complete similarity). Readability was analyzed using the Flesch Reading Ease Score, ranging from 0 to 100, and the Flesch-Kincaid Grade Level, reflecting the average number of years of education required for comprehension. Statistical analyses were performed using the Mann-Whitney test and effect size, with results deemed significant at a 5% level (P=.05). To assess agreement between experts, Krippendorff α and Fleiss κ were used.

Results

GPT-4 demonstrated superior performance, with a higher GQS and a lower number of scores of 1 and 2, compared to GPT-3.5. The Mann-Whitney test revealed statistically significant differences in some questions, with GPT-4 generally receiving higher ratings. The median (IQR) cosine similarity score indicated substantial similarity (0.81, IQR 0.05) and consistency in the responses of both versions (GPT-3.5: 0.85, IQR 0.04; GPT-4: 0.83, IQR 0.04). Readability scores for both versions were considered college level, with GPT-4 scoring slightly better in the Flesch Reading Ease Score (34.61) and Flesch-Kincaid Grade Level (12.32) compared to GPT-3.5 (32.98 and 13.32, respectively). Responses by both versions were deemed challenging for the general public.

Conclusions

Both GPT-3.5 and GPT-4 demonstrated having the capability to address radiotherapy concepts, with GPT-4 showing superior performance. However, both models present readability challenges for the general population. Although ChatGPT demonstrates potential as a valuable resource for addressing common patient queries related to radiotherapy, it is imperative to acknowledge its limitations, including the risks of misinformation and readability issues. In addition, its implementation should be supported by strategies to enhance accessibility and readability.

Development and Implementation of Digital Health Tools in Radiation Oncology: A Rapid Review

A rapid review of 21 studies into 20 unique digital health tools found significant benefits to utilizing the following 4 categories of tools: (1) educational videos increased patient knowledge of radiotherapy (RT) and reduced treatment-related anxiety; (2) extended reality tools improved patient understanding of RT and reduced anxiety, with virtual reality coaching enhancing tumor motion reproducibility during CT simulation; (3) digital patient engagement tools helped patients manage treatment symptoms, increased health literacy, and improved quality of life; (4) an electronic feedback form decreased patient anxiety and increased RT knowledge. Most interventions were single-use and implemented before the start of RT.

Key Insights and Implementation of a Patient-Centered Education Video For Managing Acute Radiation Dermatitis in Breast Cancer: A Single-Center Pilot Study

Purpose

This study aimed to develop an educational tool to improve breast cancer patients' understanding of radiation therapy (RT) and analyze its usage.

Methods and Materials

A single-arm trial was conducted at a tertiary hospital in Taiwan with newly diagnosed breast cancer patients scheduled for RT. Patients viewed a 4-minute educational video explaining RT mechanisms, self-care for irradiated skin, treatment precautions, and radiation dermatitis toxicity grading. A QR code provided video access. The Skindex-16 (traditional Chinese version) questionnaire assessed skin reactions before, during, and after RT. A satisfaction survey was also administered post-RT.

Results

Of the 57 enrolled patients, 51 completed the study. Most found the video satisfactory (90.2%) and easy to understand (86.3%). The video provided emotional support (90.2%) and reduced anxiety (84.3%). Nearly all patients (96.1%) found the QR code helpful. Skindex-16 outcomes indicated increasing discomfort throughout treatment, with a significant rise midway through RT. Patient characteristics, such as age, education, occupation, and social support, were not correlated with satisfaction, emotional support efficacy, or video-watching frequency. Subgroup analysis showed no significant differences in Skindex-16 scores between conventional and hypofractionated RT. Most patients (82.4%) watched the video most frequently during the first 2 weeks of RT, with 25.5% replaying it when dermatitis worsened.

Conclusions

The in-house educational video enhanced patients' understanding of RT and provided emotional support, with efficacy unaffected by patient characteristics or fractionation. Patients valued QR code access. The timing of watching the video was crucial. Continuous, accessible educational materials were important as symptoms worsened at the first follow-up. This study paved the way for future clinical trials and educational tools for breast cancer patients in radiation oncology departments.

Impact of Educational Videos on Patient Understanding of Interventional Radiology Procedures

RATIONALE AND OBJECTIVES

Under-awareness of Interventional Radiology (IR) care by the public has been reported. The aim of this study is to evaluate the impact of educational videos to facilitate better patient understanding during the informed consent process.

MATERIALS AND METHODS

Educational videos for six common IR procedures including chemoembolization, radioembolization, ablation, tunneled central venous catheter placement, port placement, and port removal were developed for educating patients in the pre-procedural setting. One hundred and eighty patients referred to a tertiary academic institution were randomly selected to participate, including 30 patients per procedure type. Anonymous seven question, five-point Likert-scale assessments were administered to the participants before and after engaging with the videos. The survey evaluated patients' perceived understanding of IR procedures and satisfaction with the videos as educational tools.

RESULTS

One hundred and eighty patients completed the survey. Comparing post-video to pre-video ratings, there was an increase in patients' understanding of the involved anatomy (4.5 vs 3.3; p < 0.01), understanding of procedure benefits (4.6 vs 3.7; p < 0.01), understanding of procedural risks (4.5 vs 3.3; p < 0.01), understanding of procedural alternatives (3.4 vs 2.7; p < 0.01), and overall procedural understanding (4.7 vs 3.4; p < 0.01). Additionally, patients had a positive impression of the videos with a mean overall satisfaction rating of the video-assisted explanation of 4.80.

CONCLUSIONS

A patient-centric video-assisted informed consent for IR procedures enhances patients' understanding and results in high patient satisfaction.

Virtual Reality in Cancer Care: Enhancing Knowledge and Reducing Anxiety about Chemotherapy among Patients and Caregivers

Virtual reality (VR) technology has evolved from entertainment to significant applications in healthcare and education. Despite its potential, there is limited research on the role of VR in cancer care. This study investigates VR's ability to simulate the chemotherapy process, aiming to enhance patients' knowledge and mitigate anxiety associated with chemotherapy. Utilizing a two-arm, mixed-methods pre/post-survey design, the study measured changes in patients' anxiety and knowledge before and after exposure to a VR simulation. Participants (n = 267) engaged with VR simulations or interactive 360-degree videos depicting the chemotherapy process. Data analyses revealed a significant median increase in chemotherapy knowledge post-exposure to the VR content (z = 12.511, p < 0.001). Demographic factSors significantly influenced perceptions of VR realism and usefulness (p < 0.05). Additionally, VR exposure was correlated with reduced anxiety levels and improved treatment expectations (p < 0.05). Participants with higher post-understanding chemotherapy scores considered VR a useful tool for managing anxiety about chemotherapy and recommended VR for other medical procedures (p < 0.001). These findings underscore VR technology's potential as a valuable tool in cancer treatment, suggesting it can enhance patient education and reduce anxiety, thereby improving patient outcomes during cancer therapy.

The immediate, intermediate, and long-term effectiveness of audiovisuals for providing pre-treatment information to patients with cancer: A systematic review

OBJECTIVE

To assess the effectiveness of audiovisuals in providing pre-treatment information to patients with cancer. Following the Six Function Model of Medical Communication, we distinguish between immediate, intermediate, and long-term outcomes.

METHODS

A systematic search was performed in five electronic databases for quantitative studies comparing the addition of audiovisuals with standard care or alternative interventions. Quality was assessed using Cochrane's Risk of Bias 2.

RESULTS

After abstract (n = 10,179) and full-text (n = 85) screening, 37 articles were included. Audiovisuals positively impacted patients' anxiety, knowledge, understanding, and physiological responses shortly after the consultation, particularly when video was compared with standard verbal care without audiovisual. Only five studies measured long-term outcomes, leaving the long-term effectiveness of audiovisuals unexplored. Majority of studies showed 'high risk of bias' (n = 34).

CONCLUSION

Although caution is warranted because of the variability in study design and quality, the results suggest potential benefits of using audiovisuals alongside interpersonal communication.

PRACTICAL IMPLICATIONS

More high-quality and longitudinal research is needed with emphasis on comparing counseling with and without usage of audiovisual tools. Healthcare providers can improve the short-term impact of information provision by using audiovisuals alongside standard care, but should carefully consider content, for whom, how, and timing.

Patient Education Practices and Preferences of Radiation Oncologists and Interprofessional Radiation Therapy Care Teams: A Mixed-Methods Study Exploring Strategies for Effective Patient Education Delivery

PURPOSE

Patients' understanding of radiation therapy (RT) and data regarding optimal approaches to patient education (PE) within radiation oncology (RO) are limited. We aimed to evaluate PE practices of radiation oncologists and interprofessional RT care team members to inform recommendations for delivering inclusive and accessible PE.

METHODS AND MATERIALS

An anonymous survey was administered to all Radiation Oncology Education Collaborative Study Group members (10/5/22-11/23/22). Respondent demographics, individual practices/preferences, and institutional practices were collected. Qualitative items explored strategies, challenges, and desired resources for PE. Descriptive statistics summarized survey responses. The Fisher exact test compared PE practices by respondent role and PE timing. Thematic analysis was used for qualitative responses.

RESULTS

One hundred thirteen Radiation Oncology Education Collaborative Study Group members completed the survey (28.2% response rate); RO attendings comprised 68.1% of respondents. Most practiced in an academic setting (85.8%) in North America (80.5%). Institution-specific materials were the most common PE resource used by radiation oncologists (67.6%). Almost half (40.2%) reported that their PE practices differed based on clinical encounter type, with paper handouts commonly used for in-person and multimedia for telehealth visits. Only 57.7% reported access to non-English PE materials. PE practices among radiation oncologists differed according to RT clinical workflow timing (consultation versus simulation versus first RT, respectively): one-on-one teaching: 88.5% versus 49.4% versus 56.3%, P < .01, and paper handouts: 69.0% versus 28.7% versus 16.1%, P < .01. Identified challenges for PE delivery included limited time, administrative barriers to the development or implementation of new materials or practices, and a lack of customized resources for tailored PE. Effective strategies for PE included utilization of visual diagrams, multimedia, and innovative education techniques to personalize PE delivery/resources for a diverse patient population, as well as fostering interprofessional collaboration to reinforce educational content.

CONCLUSIONS

Radiation oncologists and interprofessional RO team members engage in PE, with most using institution-specific materials often available only in English. PE practices differ according to clinical encounter type and RT workflow timing. Increased adoption of multimedia materials and partnerships with patients to tailor PE resources are needed to foster high-quality, patient-centered PE delivery.

Impact of patient information format on the experience of cancer patients treated with radiotherapy

Introduction

Radiotherapy (RT) stands as one of the main cancer treatments. The impact of RT and cancer treatment can have a physical and psychological impact on patients and their carers. To gain patient's trust, and ensure they feel valued, information should be provided before, during, and after RT. Patient and public involvement (PPI) has been lacking, and increased engagement with PPI groups could improve this. This rapid review aims to analyse the literature, and describe and report patient perception, experience, and satisfaction regarding the information received concerning their course of RT.

Methods

To allow the synthesis of results, a pragmatic decision was made to use a rapid review approach to analyse the literature, providing more timely information to inform future work. This rapid review utilised systematic review methods and was conducted according to a pre-defined protocol including clear inclusion criteria (PROSPERO registration: CRD42023415916).Electronic databases CINAHL, AMED, Pubmed/MEDLINE, EMBASE, and PsycINFO were searched using a comprehensive search for published studies from January 2012 to November 2023. Two independent reviewers applied the eligibility criteria. Evidence from literature was extracted and transcribed into qualitative data and Braun and Clarke's six-step thematic analysis (TA) was employed to determine themes by one reviewer and checked by a second [26]. Due to the heterogeneity of the included literature, the analysis of this review is presented primarily through narrative synthesis.

Results

Sixty eight articles met the inclusion criteria for this review. Emerging themes included; a desire for information based on patient characteristics, information format, patient preparedness, timing e.g. timing of information and changing priorities over time, health care professional (HCP) involvement, barriers to information, and motivators for better information delivery.

Conclusions

Several factors can influence a patient's desire for information, from whom and when they receive it, to what format they would prefer to receive it. There is benefit to be gained in employing PPI and patient advocacy to inform future studies that aim to further understand the themes that emerged from this review. Such studies can therefore inform HCPs in providing patient-specific information and support by utilising multiple teaching strategies available to them.

The Development and Evaluation of an Educational Video for Breast Cancer Patients Requiring Adjuvant Radiation Therapy

Patient education and informed consent are required prior to adjuvant radiation therapy (RT) for early breast cancer (EBC), and include the role, rationale, potential toxicities and practicalities of the treatment process. Current education of patients about RT is verbal, in the form of a consultation by a radiation oncologist, often supplemented with print or online materials. This approach is limited by its doctor-dependency and non-standardised nature. Video education is being recognised increasingly as an opportunity to remediate this and appeal to patients' preference for visual learning. The purpose of this study was to design and produce a video as an educational adjunct for EBC patients' viewing prior to adjuvant RT, and to evaluate its acceptability through content analysis of three online focus group discussions, among ten participants with EBC requiring RT. After qualitative content analysis of the focus group transcripts, data were summarised into three main categories: (1) understanding of RT, (2) ease of engagement with the video and (3) anxiety and preparedness for RT. The 18-min video was positively received by all participants, and discussion feedback was used to inform improvements to the video. This focus group study demonstrated that the video was well understood, informative and acceptable to EBC patients in preparing them for RT. The effectiveness of the video in improving knowledge and alleviating distress in preparation for therapy will be further evaluated in an ethics-approved biphasic quasi-experimental study.

"Current", "heated rods", and "hot vapour": why patients refuse radiotherapy as a treatment modality for cancer in northern Sri Lanka

PURPOSE

Significant proportions of patients either refuse or discontinue radiotherapy, even in the curative setting, leading to poor clinical outcomes. This study explores patient perceptions that underlie decisions to refuse/discontinue radiotherapy at a cancer care facility in northern Sri Lanka.

METHODS

An exploratory descriptive qualitative study was carried out among 14 purposively selected patients with cancer who refused/discontinued radiotherapy. In-depth semi-structured interviews were transcribed in Tamil, translated into English, coded, and thematically analyzed.

RESULTS

All participants referred to radiotherapy as "current" with several understanding the procedure to involve electricity, heat, or hot vapour. Many pointed to gaps in information provided by healthcare providers, who were perceived to focus on side effects without explaining the procedure. In the absence of these crucial details, patients relied on family members and acquaintances for information, often based on second or third-hand accounts of experiences with radiotherapy. Many felt pressured by family to refuse radiation, feared radiation, or felt ashamed to ask questions, while for others COVID-19 was an impediment. All but three participants regretted their decision, claiming they would recommend radiation to patients with cancer, especially when it is offered with curative intent.

CONCLUSION

Patients with cancer who refused/discontinued radiation therapy have significant information needs. While human resource deficits need to be addressed in low-resource settings like northern Sri Lanka, providing better supportive cancer care could improve clinical outcomes and save healthcare resources that would otherwise be wasted on patient preparation for radiotherapy.

Design and implementation of a prototype radiotherapy menu in a patient portal

PURPOSE

Radiotherapy patients often face undue anxiety due to misconceptions about radiation and their inability to visualize their upcoming treatments. Access to their personal treatment plans is one way in which pre-treatment anxiety may be reduced. But radiotherapy data are quite complex, requiring specialized software for display and necessitating personalized explanations for patients to understand them. Therefore, our goal was to design and implement a novel radiotherapy menu in a patient portal to improve patient access to and understanding of their radiotherapy treatment plans.

METHODS

A prototype radiotherapy menu was developed in our institution's patient portal following a participatory stakeholder co-design methodology. Customizable page templates were designed to render key radiotherapy data in the portal's patient-facing mobile phone app. DICOM-RT data were used to provide patients with relevant treatment parameters and generate pre-treatment 3D visualizations of planned treatment beams, while the mCODE data standard was used to provide post-treatment summaries of the delivered treatments. A focus group was conducted to gather initial patient feedback on the menu.

RESULTS

Pre-treatment: the radiotherapy menu provides patients with a personalized treatment plan overview, including a personalized explanation of their treatment, along with an interactive 3D rendering of their body, and treatment beams for visualization. Post-treatment: a summary of the delivered radiotherapy is provided, allowing patients to retain a concise personal record of their treatment that can easily be shared with future healthcare providers. Focus group feedback was overwhelmingly positive. Patients highlighted how the intuitive presentation of their complex radiotherapy data would better prepare them for their radiation treatments.

CONCLUSIONS

We successfully designed and implemented a prototype radiotherapy menu in our institution's patient portal that improves patient access to and understanding of their radiotherapy data. We used the mCODE data standard to generate post-treatment summaries in a way that is easily shareable and interoperable.

An Investigation of the Effect of Virtual Reality on Alleviating Anxiety in Patients With Breast Cancer Undergoing Radiation Therapy: A Randomized Controlled Trial

PURPOSE

The aim of this study was to evaluate the anxiety-reducing effects of virtual reality (VR) on patients with breast cancer undergoing adjuvant radiation therapy (RT).

METHODS AND MATERIALS

This randomized controlled trial was conducted among patients with breast cancer receiving RT at a single institution. Of 196 enrolled and randomized patients, 97 were assigned to a VR explanation group (intervention) and 99 were assigned to the standard-of-care group (control). Anxiety levels were measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) as the primary endpoint and the State-Trait Anxiety Inventory (STAI) and Linear Analogue Scale Assessment (LASA) as secondary endpoints. Knowledge of the RT procedure, patient satisfaction, and time spent for counseling were also assessed.

RESULTS

Intervention significantly reduced patient anxiety immediately, not only on the primary endpoint, APAIS, but also on the STAI and LASA anxiety scales. Specifically, in the intervention group, there were immediate reductions of 26.0%, 16.1%, and 55.8% for APAIS, STAI, and LASA, respectively, whereas in the control group, the respective reductions were 8.1%, 8.5%, and 13.7%. Among the 3 anxiety scales, long-term anxiety reduction was observed only when anxiety was measured by LASA. Subgroup analyses showed that the effect on anxiety did not differ based on the physician, baseline anxiety level, use of hormone therapy, or health literacy. The intervention also significantly improved knowledge of the RT procedure (81.9/100 vs 76.8/100; P = .006) and patient satisfaction with the explanation manner (6.56 vs 5.72; P < .001) compared with the control group.

CONCLUSIONS

Immersive VR applied to the current procedure reduces anxiety during RT planning for patients with breast cancer. Further research is necessary to investigate the long-term effects of VR on anxiety.

An Affordable Platform for Virtual Reality-Based Patient Education in Radiation Therapy

PURPOSE

The goal of this study was to develop and assess the effectiveness of an affordable smartphone-based virtual reality (VR) patient education platform with 360-degree videos produced depicting a first-person patient perspective during the radiation therapy (RT) care path to reduce patient anxiety.

METHODS AND MATERIALS

Three disease site-specific (breast, pelvis, head and neck) VR videos were filmed using a 360-degree camera to portray the first-person perspective of a patient's standard RT appointments, including a computed tomography simulation and the first RT treatment session. Instruction is given for possible clinical implementation. Patient participation was divided into 2 groups: (1) Group A (n = 28) included patients participating before simulation and later after the first treatment, and (2) Group B (n = 33) included patients participating only while undergoing treatment. Patients viewed their disease site-specific video using an inexpensive cardboard VR viewer and their smartphone, emulating an expensive VR-headset. Surveys were administered assessing patient anxiety, comfort, satisfaction, and knowledge of RT on a 5-point Likert-type scale.

RESULTS

Patients in Group A and Group B while undergoing treatment both indicated that their anxiety "decreased a little" in the survey, after watching the VR video (Group A, median on a 5-point Likert-type scale, 4 [IQR, 4-5]; Group B, 4 [IQR, 4-4]). The VR aspect of the videos was especially liked by patients while undergoing treatment, with 96.4% in Group A and 90.9% in Group B reporting that the VR aspect of the videos was helpful. All Group A participants believed that the VR videos would be beneficial to new patients.

CONCLUSIONS

Our affordable VR patient education platform effectively immerses a patient in their care path from simulation through initial treatment delivery, reducing anxiety and increasing familiarity with the treatment process.

The Effect of Video-Based Education on Anxiety of Patients Receiving Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

Patients receiving stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) may have an anxiety due to unknown aspects of the treatment. We aimed to reduce patient anxiety by using video-based education. Forty patients were divided into 2 groups, with one-to-one information session (n = 20) and one-to-one information session plus video-based education (n = 20). The patients completed the State-Trait Anxiety Inventory (STAI) and visual facial anxiety scale before and after information sessions and after treatment. The setup time and disruptions during treatment sessions were recorded for patients receiving treatment with Novalis® and Cyberknife®, respectively. The patient characteristics and STAI scores before education were similar between groups. The anxiety level was significantly lower in group 1 after treatment (median 38, interquartile range (IQR) 27-45) compared to before (median 43, IQR 36-47) (p = 0.003) and after information sessions (median 42, IQR 36-47) (p = 0.004); however, any difference was not observed in anxiety levels between before and after information sessions (p = 0.317). The anxiety level was significantly lower in group 2 after video-based education (median 25, IQR 22-33) and after treatment (median 25, IQR 20-30) compared to before video-based education (median 35, IQR 31-42) (p < 0.001 for both), while there was no significant difference in anxiety levels between after video-based education and after the treatment (p = 0.407). The interruptions during treatment were observed in 9 (60%) patients in group 1 and 6 (40%) patients in group 2 (p = 0.038). Video-based educations significantly reduce patient anxiety before SRS/SBRT and increase their compliance with the treatment.

[Improved Patients' Satisfaction Level of Radiation Therapy: The Effect of "Explainer Videos about Radiation Therapy", "Treatment of Breast Cancer Patients by Female Radiation Therapists" and "Treating Male Patients While Wearing Underwear in Pelvic Radiation Therapy"]

PURPOSE

The questionnaire survey investigated whether "Explainer videos about radiation therapy (RT-Video)", "Treatment of breast cancer patients by female radiation therapists (F-RTT)" and "Treating male patients while wearing underwear in pelvic radiation therapy (M-RTT)" can improve patient's satisfaction.

METHODS

The RT-Video survey included questions regarding the impression of radiation therapy, improving its understanding, and anxiety reduction (102 patients received radiation therapy). Fifty-one breast cancer patients were asked whether they preferred an F-RTT treatment. Subsequently, the patients treated with F-RTT (41 patients) and M-RTT (50 patients) were surveyed about their treatment satisfaction on a five-point scale.

RESULTS

RT-Video improved the understanding of radiation therapy for 86 out of 102 patients (84%). In all, 68 out of 102 patients (68%) had a negative impression of radiotherapy; among them, watching the RT-Video reduced anxiety in 63% of patients. A total of 14 out of 51 breast cancer patients (28%) preferred the F-RTT treatment. The percentage of patients who received treatment satisfaction by F-RTT and M-RTT was 95% and 84%, respectively.

CONCLUSION

RT-Video, F-RTT and M-RTT treatments improved patients' satisfaction.

Characteristics Assessment of Online YouTube Videos on Radiotherapy for Breast Cancer

BACKGROUND

Radiotherapy (RT) is an important component of breast cancer management but is underutilized due to barriers such as the lack of proper education. YouTube is commonly used for obtaining health information, yet the quality of information has been a previous concern. This study systematically evaluates the characteristics of educational YouTube videos on RT for breast cancer.

MATERIALS AND METHODS

A total of 200 YouTube videos were identified by recording the top 50 videos of 4 searches. Duplicates were removed, videos were rank ordered and screened against pre-determined inclusion criteria, then the first 50 videos were reviewed using a video assessment tool. Two independent reviewers were used. Positively skewed distributions were observed for most general parameters including views, likes, length and View Ratio.

RESULTS

The USA (66%) or UK (20%) were the most common locations of publication. Publishers were frequently affiliated with health care facilities (48%) or non-profits (30%). The interview using a physician (68%) or patient (26%) was the most common media type, and B-roll footage with narration (48%) was the second most common. Most videos were targeted towards patients (96%), had comments (56%) and subtitles available (96%). The most common themes identified were Explaining RT (54%), Acute Side Effects (40%) and Patient Care Experience (32%).

CONCLUSION

This review is useful to inform the future development of video resources for health education in this topic. Though parameters were variable and inconsistently followed best practice guidelines, YouTube remains as a potentially important tool for the dissemination of health information.

Knowledge and Understanding of Radiation Therapy Among Patients With Breast Cancer From Culturally Diverse Backgrounds at a Safety-Net Hospital

INTRODUCTION

Comprehensive understanding of oncologic treatment is essential for shared decision-making. However, comprehension of information in radiation oncology consults is poorly understood, particularly among Spanish-speaking patients at safetynet hospitals. The purpose of this pilot study was to examine post-consultation radiation oncology knowledge and health literacy among breast cancer patients from culturally diverse backgrounds.

METHODS

After consultation for curative post-operative breast radiotherapy (cT1-4N1-3M0), the Radiation Oncology Knowledge Assessment Survey (ROKAS) was administered to Spanish- and English-speaking patients ≥ 18 years old, from January 2021 to January 2022 at a safety-net hospital. Radiation knowledge was assessed using the ROKAS which included eight radiation-specific multiple-choice questions and two separate questions regarding short- and long-term side effects. Additional independent variables included validated questionnaires related to health literacy, health numeracy, acculturation, primary language, and sociodemographic factors. Bivariate Pearson correlations and T-test analyses were conducted to examine the relationship between the independent variables and post-consultation radiation knowledge.

RESULTS

Fifty ROKAS were obtained from 25 English- and 25 Spanish-speaking breast cancer patients (median age 57 [IQR 49.75-62.25]). When compared to Englishspeaking patients, Spanish-speaking patients had lower health literacy, health numeracy, and acculturation. There was no difference in the multiple-choice ROKAS score between English- and Spanish-speakers, or correlation with the other independent factors. Higher health numeracy correlated with a higher accuracy for identifying short-term side effects. Lower accuracy of identifying long-term side effects was seen in patients with lower education levels, health literacy, health numeracy, and acculturation, with the most missed long-term side effects being arm swelling, skin toxicity, and heart toxicity.

CONCLUSIONS

Patients with low health literacy, health numeracy, acculturation, and education levels as well as Spanish-speaking patients were associated with poor understanding of radiotherapy long-term side effects. Determining barriers to radiation knowledge is crucial to improve shared decision-making between patients and providers in a culturally diverse population.

Video tools in pediatric goals of care communication: A systematic review

•Goals of Care resources are primarily in written format and for adult patients.•Video tools can support families of pediatric patients facing prognostic uncertainty.•Videos represent an effective but underutilized Goals of Care communication tool.

Virtual integration of patient education in radiotherapy (VIPER)

•

Videoconferencing allows for face-to-face interactions and visual aids for patient education.

•

Patients were highly satisfied with videoconferencing for virtual patient education.

•

Radiation Therapists reported videoconferencing and in-person patient education were comparable.

Purpose

Pre-radiotherapy patient education led by Radiation Therapists (RTT) has been shown to improve patients’ distress and overall experiences. In an effort to offer a remote delivery method while allowing for visual learning and face-to-face communication, this pilot project evaluated the feasibility and acceptability of using virtual videoconferencing for patient education.

Methods

This prospective pilot study integrated virtual patient education into standard care. This workflow consisted of a one-on-one, 45-minute tele-education session with an RTT on the day prior to CT-simulation. For this study, patients were offered the option to complete the session using web-based videoconferencing if they had the capability for it. Feasibility was evaluated as the proportion of patients who agreed to and completed virtual education. To evaluate acceptability, patients and RTTs were then emailed post-intervention surveys evaluating their satisfaction with virtual patient education.

Results

Over three months 106 of 139 patients (76%) approached consented to virtual education. The median (range) age was 65 (27–93), 69% were male and most had genitourinary (38%) or head-and-neck (29%) cancers. Ninety patients (85%) completed virtual education as planned, with incompletions due to scheduling (8) or patient technical issues (7), or treatment cancellation (1). Sixty-eight patients completed surveys, with the vast majority agreeing virtual education was clear (94%) and helped them prepare (100%), they were comfortable with the technology (96%) and they were satisfied overall (99%). Twelve RTTs responded, suggesting overall that virtual education was higher quality though less feasible than tele-education, and comparable to in-person education.

Conclusion

Offering individual, RTT-led virtual education using videoconferencing to patients pre-radiotherapy was feasible and acceptable in this pilot study, and is therefore being recommended as an option for all our patients. Future work will directly compare the effectiveness of in-person versus virtual education, and incorporate individual patient needs and preferences.