The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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The quality of non-alcoholic fatty liver disease information resources for patients on the internet in Korea

  • So, In Tae (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Lee, Yoo Jin (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Jung, Hye In (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Hwang, Jae Seok (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Jang, Byoung Kuk (Department of Internal Medicine, Keimyung University School of Medicine)
  • Received : 2018.10.08
  • Accepted : 2019.04.01
  • Published : 2021.01.01
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Abstract

Background/Aims: Many patients uses the internet to obtain information about their diseases. However, there is increasing concern regarding the quality of internet information. Thus, we aimed to systematically evaluate the quality of websites containing educational information about non-alcoholic fatty liver disease (NAFLD) in Korea. Methods: Naver, Daum, and Google search engines were searched using the term "non-alcoholic fatty liver disease" in Korean. Two reviewers independently evaluated website quality using the quality evaluation instrument (QEI), which awarded websites scores for specific information on various aspects of NAFLD, as well as a five-point Likert scale (1-5), the DISCERN instrument, and a global quality scale (GQS). Results: Forty-seven websites met the inclusion criteria. We found that the quality of the internet information about NAFLD is generally poor. The mean QEI score with standard deviation was 10.31 ± 5.09 (range, 4 to 22), with only 17% of websites scoring higher than 10 points. The median GQS of the websites was 2.0, with no website achieving a score of 4 or 5. The QEI score was highly associated with the GQS score (r = 0.74, p < 0.01). For each DISCERN question from question 1 to question 15, the mean score was less than 3. Conclusions: Overall, the internet health information for patients regarding NA-FLD is poor and in need of much improvement. There is a need for institutional support, qualitative regulation of internet information, and development of an accreditation system to provide patients with internet health information of appropriate quality.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korea Government (MSIP) (No. 2014R1A5A2010008).

References

  1. Ofosu A, Ramai D, Reddy M. Non-alcoholic fatty liver disease: controlling an emerging epidemic, challenges, and future directions. Ann Gastroenterol 2018;31:288-295.
  2. Hwang YC, Ahn HY, Park SW, Park CY. Nonalcoholic fatty liver disease associates with increased overall mortality and death from cancer, cardiovascular disease, and liver disease in women but not men. Clin Gastroenterol Hepatol 2018;16:1131-1137. https://doi.org/10.1016/j.cgh.2017.11.026
  3. Hamaguchi M, Kojima T, Takeda N, et al. The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med 2005;143:722-728. https://doi.org/10.7326/0003-4819-143-10-200511150-00009
  4. Lee JW, Cho YK, Ryan M, et al. Serum uric acid as a predictor for the development of nonalcoholic fatty liver disease in apparently healthy subjects: a 5-year retrospective cohort study. Gut Liver 2010;4:378-383. https://doi.org/10.5009/gnl.2010.4.3.378
  5. Whalley S, Puvanachandra P, Desai A, Kennedy H. Hepatology outpatient service provision in secondary care: a study of liver disease incidence and resource costs. Clin Med (Lond) 2007;7:119-124.
  6. Korean Association for the Study of the Liver. KASL clinical practice guidelines: management of hepatitis C. Clin Mol Hepatol 2016;22:76-139. https://doi.org/10.3350/cmh.2016.22.1.76
  7. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease: meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016;64:73-84. https://doi.org/10.1002/hep.28431
  8. Park SH, Jeon WK, Kim SH, et al. Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol 2006;21:138-143. https://doi.org/10.1111/j.1440-1746.2005.04086.x
  9. Yoon CH, Jin YJ, Lee JW. Nonalcoholic fatty liver disease-associated hepatocellular carcinoma in a hepatitis B virus-endemic area. Eur J Gastroenterol Hepatol 2018;30:1090-1096. https://doi.org/10.1097/MEG.0000000000001174
  10. Zelber-Sagi S, Ratziu V, Oren R. Nutrition and physical activity in NAFLD: an overview of the epidemiological evidence. World J Gastroenterol 2011;17:3377-3389. https://doi.org/10.3748/wjg.v17.i29.3377
  11. Wieland AC, Mettler P, McDermott MT, Crane LA, Cicutto LC, Bambha KM. Low awareness of nonalcoholic fatty liver disease among patients at high metabolic risk. J Clin Gastroenterol 2015;49:e6-e10. https://doi.org/10.1097/MCG.0000000000000075
  12. Internet World Stats. Internet users in the world by regions [Internet]. Statistics and World Population Stats. Bhopal (IN): Miniwatts Marketing Group, c2019 [cited 2019 Jun 11]. Available from: https://www.internetworldstats.com/stats.htm.
  13. Ryu SW, Ha YJ.Usage of Health Information on the Internet. Sejong (KR): Korea Institute for Health and Social Affairs, 2004:71-87.
  14. Basch EM, Thaler HT, Shi W, Yakren S, Schrag D. Use of information resources by patients with cancer and their companions. Cancer 2004;100:2476-2483. https://doi.org/10.1002/cncr.20261
  15. Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW. Patients' use of the Internet for medical information. J Gen Intern Med 2002;17:180-185. https://doi.org/10.1046/j.1525-1497.2002.10603.x
  16. O'Connor JB, Johanson JF. Use of the web for medical information by a gastroenterology clinic population. JAMA 2000;284:1962-1964. https://doi.org/10.1001/jama.284.15.1962
  17. Crocco AG, Villasis-Keever M, Jadad AR. Analysis of cases of harm associated with use of health information on the internet. JAMA 2002;287:2869-2871. https://doi.org/10.1001/jama.287.21.2869
  18. Jorgensen KJ, Gotzsche PC. Presentation on websites of possible benefits and harms from screening for breast cancer: cross sectional study. BMJ 2004;328:148. https://doi.org/10.1136/bmj.328.7432.148
  19. McClung HJ, Murray RD, Heitlinger LA. The Internet as a source for current patient information. Pediatrics 1998;101:E2.
  20. Bernard A, Langille M, Hughes S, Rose C, Leddin D, Veldhuyzen van Zanten S. A systematic review of patient inflammatory bowel disease information resources on the World Wide Web. Am J Gastroenterol 2007;102:2070-2077. https://doi.org/10.1111/j.1572-0241.2007.01325.x
  21. Langille M, Bernard A, Rodgers C, Hughes S, Leddin D, van Zanten SV. Systematic review of the quality of patient information on the internet regarding inflammatory bowel disease treatments. Clin Gastroenterol Hepatol 2010;8:322-328. https://doi.org/10.1016/j.cgh.2009.12.024
  22. van Deursen AJ. Internet skill-related problems in accessing online health information. Int J Med Inform 2012;81:61-72. https://doi.org/10.1016/j.ijmedinf.2011.10.005
  23. Internet trend Korea. Search Engine [Internet]. Seoul (KR): BizSpring, c2019 [cited 2019 Jun 11]. Available from: http://trend.logger.co.kr/trendForward.tsp.
  24. iProspect. Search engine user behavior study [Internet]. Seoul (KR): iProspect, c2019 [cited 2019 Jun 11]. Available from: http://www.iprospect.com.
  25. Charnock D. The DISCERN Handbook: Quality Criteria for Consumer Health Information on Treatment Choices. Abingdon (UK): Radcliffe Medical Press, 1998.
  26. 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;53:105-111. https://doi.org/10.1136/jech.53.2.105
  27. Buck D, Jacoby A, Baker GA, Graham-Jones S, Chadwick DW. Patients' experiences of and satisfaction with care for their epilepsy. Epilepsia 1996;37:841-849. https://doi.org/10.1111/j.1528-1157.1996.tb00036.x
  28. Azer SA, AlOlayan TI, AlGhamdi MA, AlSanea MA. Inflammatory bowel disease: an evaluation of health information on the internet. World J Gastroenterol 2017;23:1676-1696. https://doi.org/10.3748/wjg.v23.i9.1676
  29. Chang MY, Kim JW, Rhee CS. The quality of health information on allergic rhinitis, rhinitis, and sinusitis available on the internet. Allergy Asthma Immunol Res 2015;7:141-147. https://doi.org/10.4168/aair.2015.7.2.141
  30. van der Marel S, Duijvestein M, Hardwick JC, et al. Quality of web-based information on inflammatory bowel diseases. Inflamm Bowel Dis 2009;15:1891-1896. https://doi.org/10.1002/ibd.20976
  31. Halmos T, Suba I. Non-alcoholic fatty liver disease, as a component of the metabolic syndrome, and its causal correlations with other extrahepatic diseases. Orv Hetil 2017;158:2051-2061. https://doi.org/10.1556/650.2017.30936
  32. Griffiths KM, Christensen H. Website quality indicators for consumers. J Med Internet Res 2005;7:e55. https://doi.org/10.2196/jmir.7.5.e55
  33. Tian C, Champlin S, Mackert M, Lazard A, Agrawal D. Readability, suitability, and health content assessment of web-based patient education materials on colorectal cancer screening. Gastrointest Endosc 2014;80:284-290. https://doi.org/10.1016/j.gie.2014.01.034
  34. Lee S, Shin JJ, Haro MS, Song SH, Nho SJ. Evaluating the quality of Internet information for femoroacetabular impingement. Arthroscopy 2014;30:1372-1379. https://doi.org/10.1016/j.arthro.2014.04.102
  35. Silberg WM, Lundberg GD, Musacchio RA. Assessing, controlling, and assuring the quality of medical information on the Internet: caveant lector et viewor. Let the reader and viewer beware. JAMA 1997;277:1244-1245. https://doi.org/10.1001/jama.1997.03540390074039
  36. Cotugna N, Vickery CE, Carpenter-Haefele KM. Evaluation of literacy level of patient education pages in health-related journals. J Community Health 2005;30:213-219. https://doi.org/10.1007/s10900-004-1959-x
  37. Shedlosky-Shoemaker R, Sturm AC, Saleem M, Kelly KM. Tools for assessing readability and quality of health-related web sites. J Genet Couns 2009;18:49-59. https://doi.org/10.1007/s10897-008-9181-0