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Kidney Stones in Pregnancy: Misinformation for Patients on the Internet
Elizabeth B. Johnson, MD, Lawrence Dagrosa, MD, Vernon M. Pais, Jr., MD. Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Introduction: The management of symptomatic urolithiasis during pregnancy may present significant management dilemmas to even the most seasoned urologist, despite a growing body of contemporary, peer-reviewed medical literature on the subject. Unlike the physician -- well versed in navigating health care literature via US National Library of Medicine and its search engines including PubMed, patients increasingly turn to general internet search engines. Information from these searches may affect their decision whether to seek treatment and their treatment expectations. However, the quality and accuracy of this information regarding stones during pregnancy is undefined. As it behooves the treating physician to be aware of patient pre- and misconceptions, we sought to evaluate the information available via a popular search engine. Materials and methods: We queried the Google search engine regarding key words “kidney”, “stone”, and “pregnancy”. Paid advertisements were excluded. The top 100 resultant sites were reviewed. These were categorized as medical websites, user-driven blogs, or other. These were evaluated for medical misinformation, either regarding diet, dissolution, or surgical interventions. Results: Thirteen of these top 100 sites were provided by medical practitioners. Seventy-three of the sites were user-driven discussion forums. Medical misinformation was present in 2/13 (15%) of sites authored in part by a health care professional. In sites with no visible health care professional involvement, 58/87 (66.7%) contained misinformation. The most common misinformation included dietary recommendations for prevention, dissolution or passage of stones. Sites from medical practitioners were least likely to contain the above noted errors. Conclusions: Internet search engine-derived information regarding management of urolithiasis during pregnancy is prone to error, with frequently noted perpetuation of misconceptions and misinformation in user driven sites and discussion forums. Recognition of these specific misconceptions is important for the physician to allow appropriate intervention and to better inform patient counseling and decision making.
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