Assessing the quality and content of online information about benign prostatic hyperplasia
Tremearne Hotz, BS1, Molly E. Reissmann, MD2, Shaun E.L. Wason, MD2, David S. Wang, MD2.
1Boston University School of Medicine, Boston, MA, USA, 2Boston University Medical Center, Boston, MA, USA.
Background: Benign Prostatic Hyperplasia (BPH) is a common disease, affecting around half of men over the age of 50 worldwide. While urologists specialize in treatment of BPH, general practitioners are often the first physicians to diagnose and start medical treatment for BPH. Consequently, it is common for patients to search the Internet before and after urologic consultation to better understand their diagnosis and treatment options. However, online health information is not well regulated and may be unreliable or difficult for patients to access or comprehend. This study aims to evaluate the readability and quality of available websites describing BPH treatment options.
Methods: Three search engines, Google, Bing, and DuckDuckGo, were used to search the terms “BPH,” “BPH surgery,” and “BPH treatment” to replicate a patient seeking self-education about BPH. 62 websites were identified, 23 of which were designated advertisements. Three readability formulas (Flesch-Kincaid Grade Level, Flesch-Kincaid Reading Ease, SMOG) were used to generate readability scores. The DISCERN standardized questionnaire was used to evaluate website quality.
Results: According to two out of three readability formulas, mean readability scores for the websites analyzed were in line with the American Medical Association-recommended 7th grade reading level. The mean DISCERN score for all websites was 68, equating to “Excellent” quality. However, the DISCERN scores for advertisements were significantly lower than non-advertisements (48.8 vs. 74.2, t = -23.3, p <0.05), being rated of “Fair” quality versus the “Excellent” quality of non-advertisements.Additionally,
we noted that of the sites advertised in search results 58.3% were selling herbal supplements.
Conclusion: Overall, websites about BPH treatment are written at the recommended 7th grade reading level. However, it is also clear that advertised websites, which hold the most optimal search result positions, have lower quality, reliability, and are largely selling unproven herbal supplements. We postulate that this gives supplement companies, who largely have unproven products and heavy bias, an outsized influence on the online education of patients with BPH.
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