Mitchell K Ng1, Michael A Mont2, Nicolas S Piuzzi1. 1. Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH. 2. Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY.
Abstract
BACKGROUND: An increasing number of patients use the Internet to obtain health information, although online information is unregulated and highly variable. We aimed to assess the readability, quality, and content of online information available for "stem cell" injections for knee osteoarthritis. METHODS: A cross-sectional analysis was performed on March 2019, inputting the search term "stem cells osteoarthritis" into the 3 most popular global search engines: Google, Bing, and Yahoo. The first 50 search results of each engine were evaluated/categorized. Readability was assessed using Flesch-Kincaid Ease/Grade Level. Quality/content was assessed through DISCERN score and a stem cell content score created for this study. RESULTS: Eighty-two websites were analyzed (18 academic websites, 21 commercial, 13 government/non-profit, 30 physician). Among all websites, mean Flesch-Kincaid readability was 35.9 with a grade level of 13.6. The average DISCERN score was 49.5/80 with statistically significant differences between academic vs physician websites (64.6 vs 38.1, P < .001), and commercial vs physician websites (52.3 vs 38.1, P = .001). Mean stem cell content score was 6.5/19 with a statistically significant difference between academic vs physician websites (8.5 vs 5.1, P = .007). CONCLUSION: Readability of online materials available for patients regarding "stem cell" treatment for knee osteoarthritis is significantly higher than the grade 6-8 recommended by the National Institutes of Health. The quality and content of websites is highly variable, with physician websites scoring especially low. Improving quality and readability of online materials that discuss risks/benefits of stem cell injections may potentially enhance the physician-patient therapeutic alliance and indirectly lead to better patient outcomes.
BACKGROUND: An increasing number of patients use the Internet to obtain health information, although online information is unregulated and highly variable. We aimed to assess the readability, quality, and content of online information available for "stem cell" injections for knee osteoarthritis. METHODS: A cross-sectional analysis was performed on March 2019, inputting the search term "stem cells osteoarthritis" into the 3 most popular global search engines: Google, Bing, and Yahoo. The first 50 search results of each engine were evaluated/categorized. Readability was assessed using Flesch-Kincaid Ease/Grade Level. Quality/content was assessed through DISCERN score and a stem cell content score created for this study. RESULTS: Eighty-two websites were analyzed (18 academic websites, 21 commercial, 13 government/non-profit, 30 physician). Among all websites, mean Flesch-Kincaid readability was 35.9 with a grade level of 13.6. The average DISCERN score was 49.5/80 with statistically significant differences between academic vs physician websites (64.6 vs 38.1, P < .001), and commercial vs physician websites (52.3 vs 38.1, P = .001). Mean stem cell content score was 6.5/19 with a statistically significant difference between academic vs physician websites (8.5 vs 5.1, P = .007). CONCLUSION: Readability of online materials available for patients regarding "stem cell" treatment for knee osteoarthritis is significantly higher than the grade 6-8 recommended by the National Institutes of Health. The quality and content of websites is highly variable, with physician websites scoring especially low. Improving quality and readability of online materials that discuss risks/benefits of stem cell injections may potentially enhance the physician-patient therapeutic alliance and indirectly lead to better patient outcomes.