THE USE OF THE INTERNET BY ORTHOPAEDIC OUTPATIENTS

Subject matter predicts where top pediatric spine articles are shared: citations vs. social media

STUDY DESIGN

Systematic review. The purpose of this study was to compare the top 25 articles on pediatric spine surgery by number of citations and Altmetric score. All published articles pertaining to pediatric spine surgery from 2010 to 2021 were assessed for: Altmetric scores, Altmetric score breakdown (e.g. Twitter, News), citation counts, and article topics. The top 25 Altmetric articles and top 25 cited articles were identified. Out of the 50 total articles, only 3 (6.0%) overlapped between the two groups. The top Altmetric articles had averages (mean ± SD) of 167 ± 130 Altmetric score and 66 ± 135 citations, while the top citation articles had averages of 22 ± 45 Altmetric score and 196 ± 114 citations. When evaluating article topics, articles on 'back pain' (36% vs. 4%; P = 0.003) and 'backpacks' (16% vs. 0%; P = 0.030) were published significantly more in the top Altmetric group, while articles on 'scoliosis' (93% vs. 36%; P < 0.001) and 'growth friendly surgery' (24% vs. 4%; P = 0.041) were published significantly more in the top citation group. The total number of citations and online mentions for both groups are presented in Table 2. The biggest differences were the top Altmetric score articles receiving greater percentages of Twitter mentions relative to overall mentions (87% vs. 57%). The most socially popular articles focused on back pain and backpacks, and the most cited articles focused on scoliosis and growth-friendly surgery. Twitter had the most mentions of all social media for both the top cited articles and the top Altmetric articles.

YouTube-Friend or Foe? A Closer Look at Videos on Inguinal Hernia Surgery as a Source for Patient Education

INTRODUCTION

The Internet is an extensively used source of medical education by the public. In particular, YouTube is a valuable source of information which can be used to improve patient education. However, there is no quality assurance regime for YouTube videos pertaining to medical education. In this study, we aimed to evaluate the quality and accuracy of videos regarding inguinal hernia repair.

METHODS

Two hundred videos were searched for and viewed on YouTube from the phrases: 'inguinal hernia repair,' 'patient information for inguinal hernia repair,' and 'hernia operation.' After the application of predefined exclusion criteria, 23 videos were selected and the following data were collected: number of views, duration since video was posted, and the number of likes, dislikes, and comments. The educational quality was rated using three scoring systems: Health on the Net code, Journal of the American Medical Association, and DISCERN scoring systems. All three scoring systems have been previously used to evaluate online videos; however, they have not been formally validated.

RESULTS

The videos were of low quality when using the Health on the Net code, Journal of the American Medical Association, and DISCERN scoring systems. There was no association between video quality as measured by any of the scoring systems and the number of views. The number of days online was independently predictive of the number of views (P = 0.044) and explained 18% of the variance in views. Likewise, there was no significant association between video quality and video length.

CONCLUSIONS

YouTube videos on inguinal hernia repair are of low quality and accuracy. However, the potential of using YouTube to educate patients cannot be ignored.

Evaluating the Accuracy and Quality of the Information in Kyphosis Videos Shared on YouTube

STUDY DESIGN

A quality-control YouTube-based study using the recognized quality scoring systems.

OBJECTIVE

In this study, our aim was to confirm the accuracy and quality of the information in kyphosis videos shared on YouTube.

SUMMARY OF BACKGROUND DATA

The Internet is a widely and increasingly used source for obtaining medical information both by patients and clinicians. YouTube, in particular, manifests itself as a leading source with its ease of access to information and visual advantage for Internet users.

METHODS

The first 50 videos returned by the YouTube search engine in response to "kyphosis" keyword query were included in the study and categorized under seven and six groups, based on their source and content. The popularity of the videos was evaluated with a new index called the video power index (VPI). The quality, educational quality, and accuracy of the source of information were measured using the Journal of American Medical Association (JAMA) score, Global Quality Score (GQS), and Kyphosis-Specific Score (KSS).

RESULTS

Videos had a mean duration of 397 seconds and a mean number of 131,644 views, with a total viewing number of 6,582,221. The source (uploader) in 36% of the videos was a trainer and the content in 46% of the videos was exercise training. Seventy-two percent of the videos were about postural kyphosis. Videos had a mean JAMA score of 1.36 (range: 1-4), GQS of 1.68 (range: 1-5), and KSS of 3.02 (range: 0-32). The academic group had the highest scores and the lowest VPIs.

CONCLUSION

Online information on kyphosis is low quality and its contents are of unknown source and accuracy. In order to keep the balance in sharing the right information with the patient, clinicians should possess knowledge about the online information related to their field and should contribute to the development of optimal medical videos.

LEVEL OF EVIDENCE

3.

Is the Digital Divide for Orthopaedic Trauma Patients a Myth? Prospective Cohort Study on Use of a Custom Internet Site

OBJECTIVES

Some have proposed that a so-called digital divide exists for orthopaedic trauma patients and that the clinical usefulness of the Internet for these patients is limited. No studies to date have confirmed this or whether patients would use a provided web resource. The hypotheses of this study were (1) a larger than expected percentage of trauma patients have access to the Internet and (2) if given access to a custom site, patients will use it.

DESIGN

Prospective cohort.

SETTING

Level 1 regional trauma center.

PATIENTS

Patients who were 18 years or older with acute operative fractures participated in this study. Enrollment was initiated either before discharge or at initial outpatient follow-up.

INTERVENTION

We conducted a survey of demographics, Internet usage, device type, eHealth Literacy, and intent to use the web site. Participants received a keychain containing the web address and a unique access code to our custom orthopaedic trauma web site.

MAIN OUTCOME MEASUREMENTS

Percentage of patients with Internet access and percentage of patients who visited the web site.

RESULTS

One hundred twelve patients were enrolled. Ninety-three percent (104/112) reported having Internet access (P < 0.0001). Only increasing age predicted lack of access (P < 0.015; odds ratio, 0.95). Most (95%, 106/112) planned to visit our site; however, only 11% (P < 0.001) accessed it.

CONCLUSIONS

The digital divide is a myth in orthopaedic trauma. Despite widespread access and enthusiasm for our web site, few patients visited. This cautions against the allocation of resources for patient-specific web sites for orthopaedic trauma until a rationale for use can be better delineated.

LEVEL OF EVIDENCE

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Does a Directive to an Internet Site Enhance the Doctor-Patient Interaction? A Prospective Randomized Study for Patients with Carpal Tunnel Syndrome

BACKGROUND

Sixty-two percent of patients would like their doctor to recommend a specific web site to find health information, but only 3% of patients receive such recommendations. We investigated whether providing patients with an Internet web-site link recommended by their physician would improve patient knowledge and satisfaction. Our hypothesis was that directing patients to a reliable web site would improve both.

METHODS

Sixty patients with a new diagnosis of carpal tunnel syndrome were prospectively randomized into two groups. Twenty-three patients in the control group had a traditional physician office visit and received standard care for carpal tunnel syndrome. Thirty-seven patients in the treatment group received a handout that directed them to the American Society for Surgery of the Hand (ASSH) web page on carpal tunnel syndrome in addition to the standard care provided in the office visit. Patients later completed a ten-question true-or-false knowledge questionnaire and a six-item satisfaction survey. Differences in scores were analyzed using two-sample t tests.

RESULTS

Less than half (48%) of the patients who were given the Internet directive reported that they had visited the recommended web site. The mean scores on the knowledge assessment (6.84 of 10 for the treatment group and 6.96 of 10 for the control group) and the satisfaction survey (4.49 of 5 for the treatment group and 4.43 of 5 for the control group) were similar for both groups. The mean score for knowledge was similar for the patients who had used the ASSH web site and for those who had not (6.89 and 6.97 respectively). Moreover, compared with patients who had not used the Internet at all to learn about carpal tunnel syndrome, patients who used the Internet scored 6.6% better (mean score, 7.14 for those who used the Internet compared with 6.70 for those who had not; p > 0.05). Regardless of Internet usage, most patients scored well on the knowledge assessment and reported a high level of satisfaction.

CONCLUSIONS

Whether the patient was given a handout or had visited the ASSH or other Internet web sites, the knowledge and satisfaction scores for all patients were similar. Since the physician was the common denominator in both groups, the results indicate that the patient-physician relationship may be more valuable than the Internet in providing patient education.

CLINICAL RELEVANCE

Effective communication between patients and practitioners is at the cornerstone of delivering excellent care and building trusting relationships. This study examines whether reliable Internet information should be embraced as a tool to enhance patient-surgeon communication in a clinical context.