The Value of Web-Based Patient Education Materials on Transarterial Chemoembolization: Systematic Review

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Abstract

Background

Thousands of web searches are performed related to transarterial chemoembolization (TACE), given its palliative role in the treatment of liver cancer.

Objective

This study aims to assess the reliability, quality, completeness, readability, understandability, and actionability of websites that provide information on TACE for patients.

Methods

The five most popular keywords pertaining to TACE were searched on Google, Yahoo, and Bing. General website characteristics and the presence of Health On the Net Foundation code certification were documented. Website assessment was performed using the following scores: DISCERN, Journal of the American Medical Association, Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Patient Education Materials Assessment Tool. A novel TACE content score was generated to evaluate website completeness.

Results

The search yielded 3750 websites. In total, 81 website entities belonging to 78 website domains met the inclusion criteria. A medical disclaimer was not provided on 28% (22/78) of website domains. Health On the Net code certification was present on 12% (9/78) of website domains. Authorship was absent on 88% (71/81) of websites, and sources were absent on 83% (67/81) of websites. The date of publication or of the last update was not listed on 58% (47/81) of websites. The median DISCERN score was 47.0 (IQR 40.5-54.0). The median TACE content score was 35 (IQR 27-43). The median readability grade level was in the 11th grade. Overall, 61% (49/81) and 16% (13/81) of websites were deemed understandable and actionable, respectively. Not-for-profit websites fared significantly better on the Journal of the American Medical Association, DISCERN, and TACE content scores.

Conclusions

The content referring to TACE that is currently available on the web is unreliable, incomplete, difficult to read, understandable but not actionable, and characterized by low overall quality. Websites need to revise their content to optimally educate consumers and support shared decision-making.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews CRD42020202747; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020202747

Related collections

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Author and article information

Contributors

Georgios Antonios Sideris:

ORCID: https://orcid.org/0000-0001-7927-3690

Department of RadiologyBaystate Medical CenterUniversity of Massachusetts Medical School759 Chestnut StreetSpringfield, MA, 01199United States1 4133029024siderismd@gmail.com

Journal

Journal ID (nlm-ta): JMIR Cancer

Journal ID (iso-abbrev): JMIR Cancer

Journal ID (publisher-id): JC

Title: JMIR Cancer

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2369-1999

Publication date Collection: Apr-Jun 2021

Publication date (Electronic): 7 May 2021

Volume: 7

Issue: 2

Electronic Location Identifier: e25357

Affiliations

[1 ] Department of Radiology Baystate Medical Center University of Massachusetts Medical School Springfield, MA United States

[2 ] School of Life Sciences Technical University of Munich Munich Germany

[3 ] Department of Medicine Tufts Medical Center Boston, MA United States

Author notes

Corresponding Author: Georgios Antonios Sideris siderismd@ 123456gmail.com

Author information

Georgios Antonios Sideris https://orcid.org/0000-0001-7927-3690

Aikaterini-Themis Vyllioti https://orcid.org/0000-0003-2355-2791

Danai Dima https://orcid.org/0000-0002-3587-7975

Michael Chill https://orcid.org/0000-0001-6412-8204

Njogu Njuguna https://orcid.org/0000-0001-6817-1664

Article

Publisher ID: v7i2e25357

DOI: 10.2196/25357

PMC ID: 8140383

PubMed ID: 33960948

SO-VID: f23686ac-5b90-49c9-97b4-df9a590f0299

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on https://cancer.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 28 October 2020

Date revision requested : 14 March 2021

Date revision received : 21 March 2021

Date accepted : 29 March 2021

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