CC BY 4.0 · Rev Bras Ginecol Obstet 2018; 40(09): 547-553
DOI: 10.1055/s-0038-1672163
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Quality Information about Uterine Fibroids on the Internet

Qualidade da informação presente na Internet sobre Leiomioma uterino
Daniela Gama de Melo
1   Department of Gynecology and Obstetrics, Faculty of medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Pedro Sérgio Soares Jallad
2   Department of Gynecology and Obstetrics, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Luiz Gustavo Oliveira Brito
1   Department of Gynecology and Obstetrics, Faculty of medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
2   Department of Gynecology and Obstetrics, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Publikationsverlauf

03. April 2018

13. Juni 2018

Publikationsdatum:
19. September 2018 (online)

Abstract

Objective There are no published studies analyzing the quality of the information for lay women on the Internet regarding uterine fibroids. The accuracy of the provided material is also unknown. Thus, we have performed a cross-sectional study with 381 websites in the English and Brazilian Portuguese languages between May and December 2017.

Methods Two investigators performed the analysis, and the Cohen kappa coefficient was calculated to analyze the agreement between them. Search terms (uterine fibroids and derivatives) in the English and Brazilian Portuguese languages were used. The accuracy was analyzed by a 10-item checklist created based on the American Society for Reproductive Medicine (ASRM), National Institutes of Health (NIH) and European Menopause and Andropause Society (EMAS) consensuses about uterine fibroids. The item–test correlation and the intraclass coefficient were performed in the 16 questions from the DISCERN instrument, which was designed to measure the quality of health information on the Internet. Analysis of variance (ANOVA) measurements were performed for the independent variables and the DISCERN/accuracy scores.

Results Google was the most used search engine, and uterine fibroid was the search term that generated most of the analyzed material. The median score for accuracy in all websites was 5 out of 10, and the median score of the DISCERN instrument was 38 out of 80. The top-scoring sites in the English language were derived from scientific organizations and federal governments, and they regarded the DISCERN score (The American College of Obstetricians and Gynecologists [ACOG], the Food and Drug Administration [FDA]) and the accuracy criteria (NIH, and FDA). On the other hand, in the Brazilian Portuguese language, the highest scores in both instruments were from magazines or physician's blogs. The Cronbach α test showed a higher correlation (0.77–0.79) between the sites and DISCERN; however, the item–test correlation varied from 0.39 to 0.56.

Conclusion There is a need to improve the quality of the information regarding uterine fibroids for lay women.

Resumo

Objetivos Não existem estudos publicados analisando a qualidade de informação para mulheres leigas na internet sobre o leiomioma uterino. A acurácia do material existente também não é conhecida. Portanto, realizamos um estudo transversal envolvendo 381 sites em língua inglesa e portuguesa de maio a dezembro de 2017.

Métodos Dois pesquisadores fizeram a análise, e o coeficiente kappa de Cohen foi calculado para analisar a concordância entre ambos. Termos de pesquisa (leiomioma uterino e derivados) em inglês e português foram usados. A acurácia foi analisada por meio de uma lista de 10 itens criados após a fusão de consensos da Sociedade Americana de Medicina da Reprodução (ASRM, na sigla em inglês), dos Institutos Nacionais de Saúde (NIH, na sigla em inglês) e da Sociedade Europeia de Menopausa e Andropausa (EMAS, na sigla em inglês) sobre leiomioma uterino. A correlação item–teste e o coeficiente intraclasse foram realizados nas 16 questões do questionário DISCERN, um instrumento desenvolvido para medir a qualidade da informação de saúde disponível na internet. O método de análise de variância (ANOVA, na sigla em inglês) foi utilizado para as variáveis independentes e as pontuações de acurácia e do DISCERN.

Resultados O Google foi a ferramenta mais utilizada, e o leiomioma uterino foi o termo de busca que gerou a maior parte do material analisado. A pontuação média para a acurácia dos websites foi 5/10, e do questionário DISCERN, 38/80. Os sites de língua inglesa com maior pontuação foram os de organizações científicas e de governos federais, tanto no questionário DISCERN (Faculdade Americana de Obstetrícia e Ginecologia [ACOG, na sigla em inglês], Administração de Alimentos e Medicamentos [FDA, na sigla em inglês]) quanto na acurácia (NIH e FDA). Entretanto, em língua portuguesa, os sites com as maiores pontuações em ambos os instrumentos foram de revistas ou blogs médicos. O teste α de Cronbach evidenciou maior correlação entre os sites e o DISCERN (0,77–0,79); contudo, a correlação item–teste variou de 0,39 a 0,56.

Conclusão Há necessidade de melhorar a qualidade da informação sobre o leiomioma uterino para mulheres leigas.

Contributions

Melo DG and Jallad PSS: data collection or management; manuscript writing.


Brito LGO: project development; data management; data analysis; manuscript writing/editing.


All of the authors critically revised the article for important intellectual content and approved the final version of the manuscript to be published.


 
  • References

  • 1 Moroni R, Vieira C, Ferriani R, Candido-Dos-Reis F, Brito L. Pharmacological treatment of uterine fibroids. Ann Med Health Sci Res 2014; 4 (Suppl. 03) S185-S192 . Doi: 10.4103/2141-9248.141955
  • 2 Brito LG, Panobianco MS, Sabino-de-Freitas MM. , et al. Uterine leiomyoma: understanding the impact of symptoms on womens' lives. Reprod Health 2014; 11 (01) 10 . Doi: 10.1186/1742-4755-11-10
  • 3 Lee DW, Ozminkowski RJ, Carls GS, Wang S, Gibson TB, Stewart EA. The direct and indirect cost burden of clinically significant and symptomatic uterine fibroids. J Occup Environ Med 2007; 49 (05) 493-506 . Doi: 10.1097/JOM.0b013e31805f6cf2
  • 4 Brito LG, Panobianco MS, de Azevedo GD, Sabino-de-Freitas MM, de Barbosa HF, Candido-dos-Reis FJ. Motivational factors for women undergoing hysterectomy for uterine leiomyoma. Acta Obstet Gynecol Scand 2013; 92 (11) 1337-1338 . Doi: 10.1111/aogs.12220
  • 5 McMullan M. Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. Patient Educ Couns 2006; 63 (1-2): 24-28 . Doi: 10.1016/j.pec.2005.10.006
  • 6 Brito LG, Ferriani RA, Candido-Dos-Reis FJ, Nogueira AA. Using a search-volume tool (Google Trends) to assess global interest for uterine fibroids. Arch Gynecol Obstet 2014; 289 (06) 1163-1164 . Doi: 10.1007/s00404-014-3207-7
  • 7 Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 1999; 53 (02) 105-111
  • 8 Catherino WH, Parrott E, Segars J. Proceedings from theNational Institute of Child Health and Human Development conference on the Uterine Fibroid Research Update Workshop. Fertil Steril 2011; 95 (01) 9-12 . Doi: 10.1016/j.fertnstert.2010.08.049
  • 9 Pérez-López FR, Ornat L, Ceausu I. , et al; EMAS. EMAS position statement: management of uterine fibroids. Maturitas 2014; 79 (01) 106-116 . Doi: 10.1016/j.maturitas.2014.06.002
  • 10 Brito LG, Rosa e Silva JC, Nogueira AA. [Reflections about the impact caused by the Food and Drug Administration (FDA) warning against uterine and/or fibroid power morcellation]. Rev Bras Ginecol Obstet 2015; 37 (07) 299-301 . Doi: 10.1590/S0100-720320150005428
  • 11 Kakos AB, Lovejoy DA, Whiteside JL. Quality of information on pelvic organ prolapse on the Internet. Int Urogynecol J 2015; 26 (04) 551-555 . Doi: 10.1007/s00192-014-2538-z
  • 12 Dueñas-Garcia OF, Kandadai P, Flynn MK, Patterson D, Saini J, O'Dell K. Patient-focused websites related to stress urinary incontinence and pelvic organ prolapse: a DISCERN quality analysis. Int Urogynecol J 2015; 26 (06) 875-880 . Doi: 10.1007/s00192-014-2615-3
  • 13 Griffiths KM, Christensen H. Website quality indicators for consumers. J Med Internet Res 2005; 7 (05) e55 . Doi: 10.2196/jmir.7.5.e55
  • 14 Winker MA, Flanagin A, Chi-Lum B. , et al; American Medical Association. Guidelines for medical and health information sites on the internet: principles governing AMA web sites. JAMA 2000; 283 (12) 1600-1606 . Doi: 10.1001/jama.283.12.1600
  • 15 Hirsch M, Aggarwal S, Barker C, Davis CJ, Duffy JMN. Googling endometriosis: a systematic review of information available on the Internet. Am J Obstet Gynecol 2017; 216 (05) 451-458.e1 . Doi: 10.1016/j.ajog.2016.11.1007