Surgical informatics on the internet: any improvement?

Assessing Vasectomy-Related Information on YouTube: An Analysis of the Quality, Understandability, and Actionability of Information

This study aims to critically appraise the quality of vasectomy-related health information currently available on YouTube to better address patient information needs moving forward. A YouTube search was performed using the keyword “vasectomy.” The first 100 videos were assessed, with irrelevant and duplicate videos excluded. Two independent reviewers evaluated the remaining videos using the DISCERN instrument for evaluating the quality of information and the Patient Education Materials Assessment Tool for Audiovisual materials (PEMAT-A/V) for assessing the understandability and actionability of materials. Source characteristics and markers of bias and misinformation were also collected. Seventy-eight videos were included in the study, with a mean duration of 6.6 minutes and mean of 216,672 views. The median DISCERN score was poor at 28 (IQR 22–33) out of a possible 80 with mean PEMAT-AV Understandability and Actionability scores of 67.6% (±16.7%) and 33.8% (±36.2%), respectively. A medical doctor was present in 61 (78.2%) of the videos, of which 53 (86.9%) were urologists and 38 (62.2%) promoted their personal practice or institution. False statements regarding vasectomy were made in 14 (17.9%) videos. Notably, no significant difference was noted in quality, understandability, or actionability of videos created by those with personal promotion to those without. The quality of information regarding vasectomy on YouTube is poor and reaches a wide audience. Continued appraisal and creation of YouTube videos that contain quality, understandable and actionable information by urologists is necessary to ensure patients are well-informed.

Quality and reliability evaluation of current Internet information regarding mesh use in inguinal hernia surgery using HONcode and the DISCERN instrument

INTRODUCTION

Mesh-related complications following pelvic prolapse surgery has potentiated societal fear and led to increased investigation into mesh use in inguinal hernia repair (IHR) surgery online. However concern exists regarding the quality of Internet health informatics. The DISCERN Instrument and HONcode  tool can be used to assess the quality and reliability of online health information. The aim of this study is to investigate the reliability and quality of online information pertaining to mesh use in IHR surgery using the DISCERN instrument and HONcode tool.

METHODS

An Internet search using the keywords: 'mesh', 'inguinal hernia' and 'surgery' was carried out via Google, Yahoo, Bing, Facebook and Twitter. The HONcode and DISCERN scores were generated for each of the first ten search engine result pages (SERPs).

RESULTS

Google provided the most reliable [Median HONcode score 77% (IQR 25.5%)] and highest quality information [Median DISCERN score; 61.5 (IQR 18.25)]. Social media yielded both the most unreliable and lowest quality information. Facebook was the most unreliable [Median HONcode score 21% (IQR 14.25%)], while Twitter imparted the lowest quality information [Median DISCERN score of 18.5 (IQR 25.25)].

DISCUSSION

A 2018 Cochrane review concluded the use of mesh in IHR to be safe and associated with superior outcomes. However, numerous SERPs present results contradicting this, based solely upon Level 5 evidence. Commercialisation of the Internet has resulted in search engine optimisation, which can permit lesser quality sites to obtain higher SERP ranking. Alarmingly  if only a limited search is carried out by patients [4], lower quality, sensationalist evidence may be the only information they are exposed to. As such this may negatively influence the patient decision-making process detrimentally. However utilisation of social media by healthcare professionals may offer a solution to bridge the gap between the public and high quality medical information.

CONCLUSIONS

Online information regarding mesh repair of inguinal herniae is of variable quality and reliability. Enhanced quality assurance of online health information is necessary. However, increased presence by hernia societies on social media may help to disseminate high quality information to patients, thus enabling pre-hospital education to set the scene prior to formal hospital consultation.

Capturing intra-operative safety information using surgical wikis

BACKGROUND

Expert surgeons use a mass of intra-operative information, as well as pre- and post-operative information to complete operations safely. Trainees acquired this intra-operative knowledge at the operating table, now largely diminished by the working time directive. Wikis offer unexplored approaches to capturing and disseminating expert knowledge to further promote safer surgery for the trainee.

METHODS

Grafting an abdominal aortic aneurysm represents a potentially high-risk operation demanding extreme safety measures. Operative details, presented on a surgical wiki in the form of a script and content analysed to classify types of safety information.

RESULTS

The intra-operative part of the script contained 2,743 items of essential surgical information, comprising 21 sections, 405 steps and 2,317 items of back-up information; 155 (5.7%) of them were also specific intra-operative safety checks. Best case scenarios consisted of 1,077 items of intra-operative information, 69 of which were safety checks. Worse case and rare scenarios required a further 1,666 items of information, including 86 safety checks.

CONCLUSIONS

Wikis are relevant to surgical practice specifically as a platform for knowledge sharing and optimising the available operating time of trainees, as a very large amount of minutely detailed information essential for a safe major operation can be captured.

Surgical education and Internet‐based simulation: The World Virtual University

The new means and modalities of communication and information technologies have significantly revolutionized access to surgical education. The introduction of the Internet information highway into mainstream clinical practice as an information sharing medium offers a wide range of opportunities to healthcare professionals. High-speed Internet broadcasting allows the display of high-quality full-screen videos. Access to surgical procedures through the Internet already plays a major role in continuing medical education nowadays and will undoubtedly be gaining grounds in the future. WebSurg.com, the World Virtual University, a web-based surgical university, is dedicated to minimally invasive laparoscopic surgery. Using brand-new multimedia data, the electronic university provides thorough descriptions of over 150 procedures in minimal access surgery and 265 videos of surgical interventions. Such a teaching tool recreates all the prerequisites and requirements of a traditional School of Medicine, incorporating the manifold standpoints of world-renowned experts about specific topics and hands-on hints in various surgical specialities. Following the evolution of technologies, recent advances have made it possible to display items of Websurg.com on handheld devices (personal data/digital assistance also known as PDAs, Pocket PCs, and smart phones). Integrating all these elements into a unique World Virtual University, Websurg.com epitomizes the concept of a unified academic center providing teaching and tutorials administered by international experts. The Internet assuredly contributes to the worldwide diffusion of scientific information in an easy and user-friendly way.