Oral Presentation NZ Association of Plastic Surgeons & NZ Society for Surgery of the Hand

How good is online patient information on skin grafts?  A validated multi-dimensional analysis of a common outpatient plastic surgery procedure. (1520)

Chelsea L Heaven 1 , Cheerag B Patel 2 , Omid Ahmadi 3 4 , Jon A Mathy 4 5
  1. Department of Otorhinolaryngology, Head and Neck Surgery, Te Whatu Ora – Te Toka Tumai, Auckland, New Zealand
  2. Department of Otorhinolaryngology, Head and Neck Surgery, Te Whatu Ora – Te Tai Tokerau, Whangarei, New Zealand
  3. Department of Otorhinolaryngology, Head and Neck Surgery, Te Whatu Ora – Waikato, Hamilton, New Zealand
  4. Faculty of Medical and Health Sciences, Surgery, Waipapa Taumata Rau – The University of Auckland, Auckland, New Zealand
  5. Auckland Regional Plastic & Reconstructive Unit, Te Whatu Ora - Counties Manukau, Auckland, New Zealand

Background

Plastic surgeons frequently perform skin grafts for traumatic and ablative wounds, and patient education is critical for managing expectations and optimizing outcomes in the outpatient setting.  There are no existing studies of quality of online health information regarding skin grafts.

Methods

Google, Microsoft Bing, and Yahoo! search engines were queried using ‘skin graft,’ and the first 25 results from each were analysed using a variety of validated instruments. Readability was assessed using the Flesch-Kincaid Grade score (FKG), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG) and the New Dale-Chall Readability Index (NDC). Reliability was assessed using the DISCERN instrument and credibility with the Journal of the American Medical Association Benchmark Criteria (JAMA). Transparency was identified by presence of the Health on the Net Foundation Code certification (HON-code).

Results

Forty-three unique websites were analysed with average FKG, GFI and SMOG scores of 7.8, 10.1 and 10.7 respectively. The average NDC was 5.9. The average reliability with a DISCERN score based on the first 15 questions of the instrument was 42.6.  The mean JAMA score was 2, and 9 websites displayed the HON-code certificate. 

Discussion

We rank and contextually compare existing online material using validated tools.  Overall, mean readability scores were above the level of a sixth-grade reading level, mean reliability scores revealed a ‘fair’ quality, and mean benchmark credibility was average.  These results show that existing online patient health information is targeted towards a more highly educated population overall and reliability is adequate but can be improved.

Conclusion

Health care providers can utilize this critical assessment of information to inform targeted online patient information recommendations based on audience and circumstance.  We also highlight a role for development of alternative material to help guide optimal health literacy and perioperative advice for patients undergoing this common outpatient plastic surgery procedure.