The average age of the evaluators was 30 years (range, 23-63). Half of the evaluators (n=5) were women. Seven volunteers had completed 4 years of college, and 1 had completed 2 years of college.
Dr Storino explained that patients with pancreatic cancer might participate more actively in online searches, but she cautioned against the vulnerabilities that patients with a recent diagnosis can experience: “Patients often search online right after diagnosis, a time of uncertainty and distress, thereby making them more vulnerable to misleading information. Vulnerable populations face at least the same obstacles as healthy volunteers.”
Though clinical trial websites were ranked overall the most accurate, they and alternative therapy websites shared the same low suitability score despite the striking difference in accuracy.
Surgery and radiotherapy websites were rated more suitable than clinical trial or alternative therapy websites. Chemotherapy websites were less suitable than surgery websites. Radiotherapy websites were the second most accurate, with chemotherapy and surgery websites close behind, though radiotherapy websites were the most difficult to read.
By ownership, government websites were easiest to read. Nonprofit websites were easier to read than media websites. Government, nonprofit, and academic websites were among the most accurate. Suitability scores were not significantly different among most affiliations; this includes privately owned websites, which were lower in accuracy but relatively high in suitability.
Although readability was not enhanced by visual content, suitability scores increased by 11% for sites that included pictures and 13% for sites that included videos. Less accurate websites, however, were significantly more likely to contain visual content.
Neither readability nor accuracy correlated with suitability of content for this pool of participants with above-average educational levels. The volunteer audience judged websites from all study categories to be sufficiently suitable, in contrast to expectations based on assessments of prior researchers.
Limitations, Considerations, and Conclusions
The study authors suggested evaluations of lay readers should be considered when professionals judge content suitability.
In addition to ensuring accuracy and readability, content creators and healthcare providers must recognize that many patients are drawn to materials emphasizing visual content. These patients may also want patient education materials that address their immediate concerns.
“Moreover, our data suggest that more accurate websites were less likely to present pictures,” the authors wrote. The visual appeal of a website could affect patients’ engagement with the presented material. “Audiences for online PEM [patient education material] on pancreatic cancer may be drawn to low-quality websites using attractive displays, while high-quality websites become potentially unproductive if they do not implement successful engagement methods,” the authors wrote.
Patients engage with online health information at the highest rate immediately following a cancer diagnosis, according to the researchers, who stated that what these patients need is high quality online patient educational content that is simple but meaningful and encourages them to seek professional care.
“Most of the research on online education materials has focused on improving text readability (to ensure that most patients are able to understand the content) and accuracy (to ensure that content is unbiased and factual),” said Dr Storino. She concluded, “Our study highlights the importance of suitability, which focuses on appropriately targeting readable and accurate content to the needs of the audience. This is important because suitable materials are more likely to be preferred and chosen by intended audiences over nonsuitable materials.”
Megan Garlapow is a medical writer based in Tempe, Arizona.
1. Fox S, Duggan M. Health Online 2013. Pew Research Center website. http://www.pewinternet.org/2013/01/15/health-online-2013/. Published January 15, 2013. Accessed August 1, 2018.
2. Storino A, Guetter C, Castillo-Angeles M, et al. What patients look for when browsing online for pancreatic cancer: the bait behind the byte [published online ahead of print July 3, 2018]. World J Surg. doi: 10.1007/s00268-018-4719-2.
3. Storino A, Castillo-Angeles M, Watkins AA, et al. Assessing the accuracy and readability of online health information for patients with pancreatic cancer. JAMA Surgery. 2016;151(9):831-837.