Online Resources For Patients With Peripheral Artery Disease: Failing To Make The Distance!

The internet remains the leading resource for patients to learn about their medical conditions. The burden of peripheral artery disease is significant for public health, but the readily available information on the disease is poorly studied. This study seeks to evaluate the quality and readability of patient resources that appear in the top search results for peripheral artery disease. Internet searches were performed for “PAD” and “Peripheral Artery Disease” and “PVD” on three search engines and two metasearch engines. The top 30 websites from each search engine were then compiled, screened for relevance, and evaluated by two reviewers across four categories of information to assess overall quality: accountability, interactivity, structure, and content. Scoring discrepancies among reviewers were then resolved. Four indices were used to evaluate readability. Statistical analysis was performed using Rstudio with analysis of variance. Sixty-three websites met inclusion criteria. Types of websites included 25 open access (34.9%), 30 hospital/health care organization (47.6%), 5 government agency (7.9%), 4 industry-sponsored (6.3%), and 2 professional medical society (3.2%) websites (Table). Median total score was 19 of 47 (interquartile range [IQR], 15-30), accountability was 5 of 17 (IQR, 2-10), interactivity was 2 of 5 (IQR, 2-2), structure was 3 of 4 (IQR, 2.5-3), and content was 11 of 21 (IQR, 7-13.75). Accountability was low, with only 31.7% of sites disclosing authorship, 33.3% citing sources, and 30.2% being written or modified within the past 2 years. Angioplasty (80.2%) was the most discussed intervention, although only 60.5% of these sites described the procedure in three or more sentences. Total score varied significantly by organization type (P = .007) (Table II). Open access (median, 30; IQR, 17-33.5) and government agency (median, 30; IQR, 29-30.5) websites scored the highest, whereas hospital/health care organization (median, 16; IQR, 14-21) websites scored the lowest. Overall readability was low, with a median Flesch-Kincaid Grade Level Score of 10.7 (IQR, 9.7-12). Using this index, 81% of websites were written above the universally accepted 8th grade reading level. Freely available online patient education materials for peripheral artery disease are poor, have varying quality, and are largely written at a grade level higher than that of an average adult in the United States, thus depriving the patient from understanding the existing information. Although organization type predicted overall website quality, assessing information found online about their health condition can be difficult for patients. We recommend that the vascular societies reexamine the current offering and provide high-quality readable websites to patients to facilitate patient education.Table IOverview of online resources for peripheral artery diseaseValueType of organizationWebsite type, % Open access34.9 Hospital/health care organization47.6 Government agency7.9 Professional medical society3.2 Industry-sponsored6.3Quality scores (potential points)Median (IQR) Total (47)19 (15-30) Accountability (17)5 (2-10) Interactivity (5)2 (2-2) Structure and organization (4)3 (2.5-3) Content (21)11 (7-13.75)Readability indexMedian (IQR) Flesch Reading Ease50.7 (43-56) Flesch-Kincaid10.7 (9.7-12) SMOG10.4 (9.2-11.2) Dale-Chall8.1 (7.7-8.7)IQR, Interquartile range. Open table in a new tab Table IIDetails of online resources for peripheral artery disease by type of websiteWebsite typeTotalAccountabilityInteractivityStructure and organizationContentFlesch reading EaseFlesch- KincaidSMOGDale-ChallOpen access30 (17-33.5)11 (3.5-13.8)2 (2-2)2.75 (2.12-3)11.5 (7.88-14.9)53.3 (43.2-59.8)9.9 (8.52-11.6)9.62 (8.46-10.9)7.85 (7.56-8.7)Hospital/health care organization16.5 (14-21)2 (2-5.75)2 (2-2)3 (2.12-3)8.25 (6.62-11.5)46.5 (42.6-54.4)11.4 (10.2-12.2)10.8 (9.76-11.4)8.22(7.93-8.72)Government agency30 (29-30.5)9 (7-11)2 (2-2)4 (3-4)13 (11.5-18)56.8 (55-59.9)10 (8.95-10)9.35 (8.75-9.4)7.7 (7.6-8)Professional medical society24 (23.5-24.58 (7-9)2.5 (2.2.5-2.75)3.5 (3.25-3.75)10 (10-10)50.7 (50-51.4)11.2 (10.5-11.9)10.4 (10-10.8)8.18 (8.06-8.29)Industry-sponsored24.8 (18.5-32.6)6.5 (3.5-10.8)2.5 (2-3.25)4 (3.75-4)12.8 (10.4-14.5)45.7 (37-52)11.8 (10.8-13.1)10.7 (9.99-11.5)8.35 (8-8.99)P value for Kruskal-Wallis analysis of variance.007.0004.425.01.189.117.05.06.335IQR, Interquartile range.Data are presented as median (IQR). Open table in a new tab