Die Rolle des Internets für Gesundheitsinformationen in der Hals-Nasen-Ohrenheilkunde

Zusammenfassung

Durch die Verbreitung des Internets kam es in den letzten Jahrzehnten zu einer Revolution des menschlichen Informations- und Kommunikationsverhaltens. Informationen sind durch das Internet leicht zugänglich und partizipative Anwendungen ermöglichen neue Formen der Interaktion. Das Gesundheitswesen ist unmittelbar davon betroffen, weil es wesentlich durch Information und Kommunikation geprägt ist. Der vorliegende Beitrag soll diese Entwicklung und ihre Auswirkungen in der Hals-Nasen-Ohrenheilkunde darstellen.

Die Nutzung des Internets für die Suche nach Gesundheitsinformationen nimmt seit Jahren kontinuierlich zu und hat inzwischen eine erhebliche Bedeutung erreicht. Im klinischen Kontext haben derzeit noch andere Informationsquellen einen höheren Stellenwert. Für eine von Laien durchgeführte gesundheitsbezogene Recherche wird hauptsächlich die Suchmaschine Google verwendet. Obwohl die Beurteilung der Vertrauenswürdigkeit der dort dargebotenen Informationen schwer ist, haben sich alternative Angebote, die auf valide Gesundheitsinformationen spezialisiert sind, bisher nicht durchgesetzt. Anekdotische oder falsche Informationen treten regelmäßig auf.

Zahlreiche Studien haben die Qualität von Gesundheitsinformationen auf Internetseiten untersucht. Das methodische Spektrum dafür reicht von formelgebundenen Lesbarkeitsanalysen über strukturierte Beurteilungsinstrumente bis hin zu digitalen Zertifikaten. Im Ergebnis zeigt sich, dass Gesundheitsinformationen auf Internetseiten für die Allgemeinbevölkerung häufig schwer zu verstehen sind. Auch nahezu alle sozialen Medien enthalten Gesundheitsinformationen und ihre Bedeutung steigt. Dennoch gibt es zu Eigenschaften und Effekt von Gesundheitsinformationen in sozialen Medien bisher kaum wissenschaftliche Erkenntnisse.

Die Verfügbarkeit von Gesundheitsinformationen im Internet macht ein neues Verständnis von Gesundheitskompetenz (health literacy) erforderlich. Das Konzept der digitalen Gesundheitskompetenz (eHealth literacy) beinhaltet u. a. Lesefähigkeit, Medienkompetenz, EDV-Kenntnisse und naturwissenschaftliche Grundbildung. Die Verwirklichung dieser Fähigkeiten wird durch individuelle und soziale Faktoren wie Bildung, sozioökonomischer Status und Alter beeinflusst. Bisherige Untersuchungen zeigten bei einem großen Teil der Patienten eine niedrige Gesundheitskompetenz.

Die Verbreitung des Internets verändert auch das Arzt-Patienten-Verhältnis. Gut informierte Patienten fordern eine stärkere Beteiligung an medizinischen Entscheidungen ein. Ärzte haben eine besondere Verantwortung bei der Beratung medizinischer Laien durch Gewichtung und Verifizierung von Informationen. Ärzte sollten durch aktive Beteiligung dazu beitragen, dass die Digitalisierung der Medizin insgesamt den Patienten zugutekommt. Medizinische Fachgesellschaften sind in besonderer Weise dazu aufgerufen, diesen Prozess mit zu gestalten.

Schlüsselwörter

Internet - Patients - Physician-Patient Relations - Health literacy - Health education

• Literatur

• 1 Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009; 339: b2700 Im Internet: http://www.ncbi.nlm.nih.gov/pubmed/19622552
• 2 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535 Im Internet: http://www.ncbi.nlm.nih.gov/pubmed/19622551
• 3 Leiner BM, Cerf VG, Clark DD, Kahn RE, Kleinrock L, Lynch DC, Postel J, Roberts LG, Wolff S. A brief history of the internet. ACM SIGCOMM. Comput Commun Rev.2009: 39: 22 Im Internet http://portal.acm.org/citation.cfm?doid=1629607.1629613
• 4 Höflich JR. Internet und E-Mail – neue Wege schriftlicher Kommunikation?. In: Der Mensch und seine Medien. Wiesbaden: Springer Fachmedien Wiesbaden; 2016: 115-131 Im Internet: http://link.springer.com/10.1007/978-3-531-18683-2_7
• 5 Rosenzweig R. Wizards, Bureaucrats, Warriors, and Hackers: Writing the History of the Internet. Am Hist Rev 1998; 103: 1530 Im Internet http://www.jstor.org.prox.lib.ncsu.edu/sici?sici=0002-8762(1998)103:5%3C1530:WBWAHW%3E2.0.CO;2-U&origin=serialsolutions&
• 6 Cerf V, Kahn R. A Protocol for Packet Network Intercommunication. IEEE Trans Commun 1974; 22: 637-648 Im Internet http://ieeexplore.ieee.org/document/1092259/
• 7 Berners-Lee T, Cailliau R, Groff J, Pollermann B. World-Wide Web: The Information Universe. Internet Res 1992; 2: 52-58 Im Internet: http://www.emeraldinsight.com/doi/10.1108/eb047254
• 8 Ben Mokhtar S, Boutet A, Felber P, Pasin M, Pires R, Schiavoni V.X-search. In: Proceedings of the 18th ACM/IFIP/USENIX Middleware Conference on – Middleware ’17. New York, New York, USA: ACM Press, 2017: 198–208 Im Internet: http://dl.acm.org/citation.cfm?doid=3135974.3135987
• 9 Kobayashi M, Takeda K. Information retrieval on the web. ACM Comput Surv 2000; 32: 144-173 Im Internet http://portal.acm.org/citation.cfm?doid=358923.358934
• 10 Brin S, Page L. The anatomy of a large-scale hypertextual Web search engine. Comput Networks ISDN Syst 1998; 30: 107-117 Im Internet https://www.sciencedirect.com/science/article/pii/S016975529800110X?via%3Dihub
• 11 O’Reilly T.What Is Web 2.0 - Design Patterns and Business Models for the Next Generation of Software. 2005; Im Internet: https://www.oreilly.com/pub/a/web2/archive/what-is-web-20.html
• 12 DiNucci D. Fragmented Future. Print 1999; 32: 221-222 Im Internet http://darcyd.com/fragmented_future.pdf
• 13 Kamel Boulos MN, Wheeler S. The emerging Web 2.0 social software: an enabling suite of sociable technologies in health and health care education 1. Heal Inf Libr J.2007: 24: 2–23 Im Internet: http://doi.wiley.com/10.1111/j.1471-1842.2007.00701.x
• 14 Zhao WX, Jiang J, Weng J, He J, Lim E, Yan H, Li X. Comparing Twitter and Traditional Media using Topic Models. Proc 33rd Eur Conf Adv Inf Retr 2011; 338-349
• 15 Stein K, Hess C. Viele Autoren, gute Autoren? Eine Untersuchung ausgezeichneter Artikel in der deutschen Wikipedia. In: Web 2.0 — Eine empirische Bestandsaufnahme. Wiesbaden: Vieweg+Teubner; 107-129 Im Internet: http://www.springerlink.com/index/10.1007/978-3-8348-9498-4_6
• 16 Grajales FJ, Sheps S, Ho K, Novak-Lauscher H, Eysenbach G. Social media: a review and tutorial of applications in medicine and health care. J Med Internet Res 2014; 16: e13 Im Internet: http://www.jmir.org/2014/2/e13/
• 17 Giles J. Internet encyclopaedias go head to head. Nature 2005; 438: 900-901 Im Internet http://www.nature.com/articles/438900a
• 18 Kong Q, Rizoiu M-A, Wu S, Xie L.Will This Video Go Viral? Explaining and Predicting the Popularity of Youtube Videos. In: Companion of the The Web Conference 2018 on The Web Conference 2018 – WWW ’18. New York, New York, USA: ACM Press, 2018: 175–178 Im Internet http://dl.acm.org/citation.cfm?doid=3184558.3186972
• 19 Goes PB, Lin M, Au Yeung C. “Popularity Effect” in User-Generated Content: Evidence from Online Product Reviews. Inf Syst Res 2014; 25: 222-238 Im Internet: http://pubsonline.informs.org/doi/abs/10.1287/isre.2013.0512
• 20 Meng M, Agarwal R. Through a glass darkly: Information technology design, identity verification, and knowledge contribution in online communities. Inf Syst Res 2007; 18: 42-67 Im Internet: http://pubsonline.informs.org/doi/abs/10.1287/isre.1070.0113
• 21 Hodgetts D, Bolam B, Stephens C. Mediation and the Construction of Contemporary Understandings of Health and Lifestyle. J Health Psychol 2005; 10: 123-136 Im Internet: http://journals.sagepub.com/doi/10.1177/1359105305048559
• 22 Ziebland S, Wyke S. Health and illness in a connected world: how might sharing experiences on the internet affect people’s health?. Milbank Q 2012; 90: 219-249 Im Internet: http://doi.wiley.com/10.1111/j.1468-0009.2012.00662.x
• 23 O’Malley AS. Tapping the Unmet Potential of Health Information Technology. N Engl J Med 2011; 364: 1090-1091 Im Internet: http://www.nejm.org/doi/abs/10.1056/NEJMp1011227
• 24 Anderson JG, Rainey MR, Eysenbach G. The impact of CyberHealthcare on the physician-patient relationship. J Med Syst 2003; 27: 67-84 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/12617199
• 25 Prestin A, Vieux SN, Chou W-YS. Is Online Health Activity Alive and Well or Flatlining? Findings From 10 Years of the Health Information National Trends Survey. J Health Commun 2015; 20: 790-798 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/26042588
• 26 Stone JH. Communication between physicians and patients in the era of E-medicine. N Engl J Med 2007; 356: 2451-2454 Im Internet: http://www.nejm.org/doi/abs/10.1056/NEJMp068198
• 27 Eysenbach G. What is e-health?. J Med Internet Res 2001; 3: e20 Im Internet: http://www.jmir.org/2001/2/e20/
• 28 Eysenbach G, Jadad AR. Evidence-based patient choice and consumer health informatics in the Internet age. J Med Internet Res 2001; 3: E19 Im Internet http://www.jmir.org/2001/2/e19/
• 29 Capurro R. Skepsis gegenüber Hypes. Dtsch Arztebl 2018; 115: A 1425-A 1428
• 30 Al-Ubaydli M. Using Search Engines to Find Online Medical Information. PLoS Med 2005; 2: e228 Im Internet: http://dx.plos.org/10.1371/journal.pmed.0020228
• 31 Schoenherr GP, White RW.Interactions between health searchers and search engines. In: Proceedings of the 37^th international ACM SIGIR conference on Research & development in information retrieval - SIGIR ’14. New York, New York, USA: ACM Press, 2014: 143–152 Im Internet http://arxiv.org/abs/1712.03622
• 32 Wong MKY, Sivasegaran D, Choo CSC, Nah SA. Parental Internet Use and Health Information Seeking Behavior Comparing Elective and Emergency Pediatric Surgical Situations. Eur J Pediatr Surg 2018; 28: 89-95
• 33 Dumitru RC, Bürkle T, Potapov S, Lausen B, Wiese B, Prokosch H. Use and perception of Internet for health related purposes in Germany: results of a national survey. Int J Public Health 2007; 52: 275-285 Im Internet: http://link.springer.com/10.1007/s00038-007-6067-0
• 34 Andreassen HK, Bujnowska-Fedak MM, Chronaki CE, Dumitru RC, Pudule I, Santana S, Voss H, Wynn R. European citizens’ use of E-health services: A study of seven countries. BMC Public Health 2007; 7: 53 Im Internet: http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-7-53
• 35 Kuehn BM. More than one-third of us individuals use the internet to self-diagnose. JAMA – J Am Med Assoc 2013; 309: 756-757
• 36 Kummervold PE, Chronaki CE, Lausen B, Prokosch H-U, Rasmussen J, Santana S, Staniszewski A, Wangberg SC. eHealth Trends in Europe 2005-2007: A Population-Based Survey. J Med Internet Res 2008; 10: e42 Im Internet: http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-7-53
• 37 Roehr B. Trend for US patients to seek health information from media and internet is stalling. BMJ 2011; 343: d7738 Im Internet: http://www.bmj.com/cgi/doi/10.1136/bmj.d7738
• 38 Jacobs W, Amuta AO, Jeon KC. Health information seeking in the digital age: An analysis of health information seeking behavior among US adults. Cogent Soc Sci 2017; 3: Im Internet: https://www.cogentoa.com/article/10.1080/23311886.2017.1302785
• 39 Nelson DE, Kreps GL, Hesse BW, Croyle RT, Willis G, Arora NK, Rimer BK, Viswanath KV, Weinstein N, Alden S. The Health Information National Trends Survey (HINTS): development, design, and dissemination. J Health Commun 2004; 9: 443-460 discussion 81-4 Im Internet: http://www.tandfonline.com/doi/abs/10.1080/10810730490504233
• 40 O’Connor JB. Use of the Web for Medical Information by a Gastroenterology Clinic Population. JAMA 2000; 284: 1962 Im Internet: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.284.15.1962
• 41 Rokade A, Kapoor PKD, Rao S, Rokade V, Reddy KTV, Kumar BN. Has the internet overtaken other traditional sources of health information? Questionnaire survey of patients attending ENT outpatient clinics. Clin Otolaryngol Allied Sci 2002; 27: 526-528 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/12472525
• 42 Pagedar NA, Schularick NM, Lee PC, Karnell LH. Health-Related Internet Use Among Otolaryngology Patients. Ann Otol Rhinol Laryngol 2018; 127: 551-557 Im Internet: http://journals.sagepub.com/doi/10.1177/0003489418779414
• 43 Trotter MI, Morgan DW. Patients’ use of the Internet for health related matters: a study of Internet usage in 2000 and 2006. Health Informatics J 2008; 14: 175-181 Im Internet: http://journals.sagepub.com/doi/10.1177/1081180X08092828
• 44 Gurr A, Schwaab M, Hansen S, Noack V, Dazert S. Informationsverhalten von HNO-Patienten im Internet. HNO 2009; 57: 473-479 Im Internet: http://link.springer.com/10.1007/s00106-009-1897-0
• 45 Nogueira JF, Rodrigo Hermann D, Solferini Silva ML, Pires Santos F, Nagata Pignatari SS, Cassol Stamm A. Is the information available on the Web influencing the way parents see ENT surgical procedures?. Braz J Otorhinolaryngol 2009; 75: 517-523 Im Internet http://www.jmir.org/2001/2/e20/
• 46 Shaw B, Farboud A, Trinidade A, Kothari P. Internet and e-mail use in ENT: a survey of patient usage and satisfaction. Eur Arch Oto-Rhino-Laryngology 2012; 269: 1051-1054 Im Internet http://link.springer.com/10.1007/s00405-011-1773-x
• 47 Boston M, Ruwe E, Duggins A, Willging JP. Internet Use by Parents of Children Undergoing Outpatient Otolaryngology Procedures. Arch Otolaryngol Neck Surg 2005; 131: 719 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/16103305
• 48 Glynn RW, O’Duffy F, O’Dwyer TP, Colreavy MP, Rowley HM, O’Duffy F, O’Dwyer TP, Colreavy MP, Rowley HM. Patterns of Internet and smartphone use by parents of children attending a pediatric otolaryngology service. Int J Pediatr Otorhinolaryngol 2013; 77: 699-702 Im Internet: http://dx.doi.org/10.1016/j.ijporl.2013.01.021
• 49 Thorén ES, Öberg M, Wänström G, Andersson G, Lunner T. Internet access and use in adults with hearing loss. J Med Internet Res 2013; 15: e91 Im Internet: http://www.jmir.org/2013/5/e91/
• 50 Tassone P, Georgalas C, Patel NN, Appleby E, Kotecha B. Do otolaryngology out-patients use the internet prior to attending their appointment?. J Laryngol Otol 2004; 118: 34-38 Im Internet http://www.journals.cambridge.org/abstract_S002221510400009X
• 51 Tuffrey C, Finlay F. Use of the internet by parents of paediatric outpatients. Arch Dis Child 2002; 87: 534-536 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/12456558
• 52 Eysenbach G, Köhler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. BMJ 2002; 324: 573-577 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/11884321
• 53 Morahan-Martin JM. How internet users find, evaluate, and use online health information: a cross-cultural review. Cyberpsychol Behav 2004; 7: 497-510 Im Internet: http://www.liebertonline.com/doi/abs/10.1089/cpb.2004.7.497
• 54 Toms EG, Latter C. How consumers search for health information. Health Informatics J 2007; 13: 223-235
• 55 Boyer C, Gaudinat A, Hanbury A, Appel RD, Ball MJ. Accessing Reliable Health Information on the Web : A Review of the HON Approach. 2017; 1004-1008
• 56 Pletneva N, Ruiz de Castaneda R, Baroz F, Boyer C. General vs health specialized search engine: a blind comparative evaluation of top search results. Stud Health Technol Inform 2014; 205: 201-205 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/25160174
• 57 Muse K, McManus F, Leung C, Meghreblian B, Williams JMG. Cyberchondriasis: Fact or fiction? A preliminary examination of the relationship between health anxiety and searching for health information on the Internet. J Anxiety Disord 2012; 26: 189-196 Im Internet: http://dx.doi.org/10.1016/j.janxdis.2011.11.005
• 58 Bessiere K, Pressman S, Kiesler S, Kraut R. Effects of Internet use on health and depression: A longitudinal study. J Med Internet Res 2010; 12: 6-7
• 59 White RW, Horvitz E. Cyberchondria: studies of the escalation of medical concerns in web search. ACM Trans. Inf Syst 2009; 27: 1-37 Im Internet http://dl.acm.org/citation.cfm?id=1629096.1629101
• 60 Mathieu E. The Internet and Medical Decision Making: Can It Replace the Role of Health Care Providers?. Med Decis Mak 2010; 30: 14-16 Im Internet: http://journals.sagepub.com/doi/10.1177/0272989X10381228
• 61 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 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/12038937
• 62 Farmer SEJ, Bernardotto M, Singh V. How good is Internet self-diagnosis of ENT symptoms using Boots WebMD symptom checker?. Clin Otolaryngol 2011; 36: 517-518 Im Internet: http://doi.wiley.com/10.1111/j.1749-4486.2011.02375.x
• 63 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 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/9103351
• 64 Purcell GP, Wilson P, Delamothe T. The quality of health information on the internet. BMJ 2002; 324: 557-558 Im Internet http://www.bmj.com.kuleuven.ezproxy.kuleuven.be/content/bmj/324/7337/557.full.pdf
• 65 Kim H, Xie B. Health literacy in the eHealth era: A systematic review of the literature. Patient Educ Couns 2017; 100: 1073-1082 Im Internet: http://dx.doi.org/10.1016/j.pec.2017.01.015
• 66 Eysenbach G, Powell J, Kuss O, Sa E-R. Empirical Studies Assessing the Quality of Health Information for Consumers A Systematic Review. JAMA 2002; 287: 2691-2700 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/12020305
• 67 Sun GH. The digital divide in Internet-based patient education materials. Otolaryngol Head Neck Surg 2012; 147: 855-857 Im Internet: http://journals.sagepub.com/doi/10.1177/0194599812456153
• 68 Volsky PG, Baldassari CM, Mushti S, Derkay CS. Quality of Internet information in pediatric otolaryngology: A comparison of three most referenced websites. Int J Pediatr Otorhinolaryngol 2012; 76: 1312-1316 Im Internet: http://dx.doi.org/10.1016/j.ijporl.2012.05.026
• 69 Koh HK, Brach C, Harris LM, Parchman ML. A proposed „health literate care model“ would constitute a systems approach to improving patients’ engagement in care. Health Aff (Millwood) 2013; 32: 357-367 Im Internet: http://www.healthaffairs.org/doi/10.1377/hlthaff.2012.1205
• 70 McCray AT. Promoting Health Literacy. J Am Med Informatics Assoc 2004; 12: 152-163 Im Internet http://171.67.114.118/content/12/2/152.abstract
• 71 Walsh TM, Volsko TA. Readability assessment of internet-based consumer health information. Respir Care 2008; 53: 1310-1315 Im Internet http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18811992%5Cnhttp://rc.rcjournal.com/content/53/10/1310.full.pdf
• 72 Ley P, Florio T. The use of readability formulas in health care. Psychol Heal Med 1996; 1: 7-28
• 73 Friedman DB, Hoffman-Goetz L. A systematic review of readability and comprehension instruments used for print and web-based cancer information. Heal Educ Behav 2006; 33: 352-373
• 74 Wang L-W, Miller MJ, Schmitt MR, Wen FK. Assessing readability formula differences with written health information materials: application, results, and recommendations. Res Social Adm Pharm 2013; 9: 503-516 Im Internet: http://dx.doi.org/10.1016/j.sapharm.2012.05.009
• 75 Flesch R. A new readability yardstick. J Appl Psychol 1948; 32: 221-233 Im Internet http://doi.apa.org/getdoi.cfm?doi=10.1037/h0057532
• 76 Amstad T. Wie verständlich sind unsere Zeitungen? 1978
• 77 Kincaid JP, Fishburne J, Robert PR, Richard LC, Brad S.Derivation of New Readability Formulas (Automated Readability Index, Fog Count and Flesch Reading Ease Formula) for Navy Enlisted Personnel. 1975 Im Internet: http://www.dtic.mil/docs/citations/ADA006655
• 78 Gunning R. The technique of clear writing. New York, New York, USA: McGraw-Hill; 1952
• 79 McLaughlin GH. SMOG grading: A new readability formula. J Read 1969; 12: 639-646 Im Internet http://www.jstor.org/stable/40011226
• 80 Wild J, Pissarek M. Regensburger Analysetool für Texte. 2016; 12
• 81 Lenhard W, Lenhard A. Berechnung des Lesbarkeitsindex LIX nach Björnson. Bibergau 2014 Im Internet https://www.psychometrica.de/lix.html
• 82 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 Heal 1999; 53: 105-111 Im Internet: http://jech.bmj.com/cgi/doi/10.1136/jech.53.2.105
• 83 Allam A, Schulz PJ, Krauthammer M. Toward automated assessment of health Web page quality using the DISCERN instrument. J Am Med Informatics Assoc 2016; 24: ocw140 Im Internet https://academic.oup.com/jamia/article-lookup/doi/10.1093/jamia/ocw140
• 84 Charnock D. The discern handbook. Oxford: Radcliffe Medical Press Ltd; 1998. Im Internet: http://www.discern-genetics.org/discern.pdf%5Cnhttp://www.webcitation.org/6MhdgErhv
• 85 Rees CE, Ford JE, Sheard CE. Evaluating the reliability of DISCERN: a tool for assessing the quality of written patient information on treatment choices. Patient Educ Couns 2002; 47: 273-275 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/12088606
• 86 Charnock D, Shepperd S. Learning to DISCERN online: applying an appraisal tool to health websites in a workshop setting. Health Educ Res 2004; 19: 440-446 Im Internet https://academic.oup.com/her/article-lookup/doi/10.1093/her/cyg046
• 87 Boyer C, Selby M, Appel RD, Scherrer JR, Appel RD. The Health On the Net Code of Conduct for medical and health Websites. Comput Biol Med 1998; 28: 603-610 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/9861515
• 88 Boyer C, Appel RD, Ball MJ, Van Bemmel JH, Bergmans JP, Carpentier M, Hochstrasser D, Lindberg D, Miller R, Peterschmitt JC, Safran C, Thonnet M, Geissbühler A. Health on the net’s 20 years of transparent & reliable health information. Stud Health Technol Inform 2017; 228: 700-704
• 89 Boyer C, Dolamic L, Grabar N. Automated Detection of Health Websites’ HONcode Conformity: Can N-gram Tokenization Replace Stemming?. Stud Health Technol Inform 2015; 216: 1064 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/26262363
• 90 Boyer C, Dolamic L. Automated Detection of HONcode Website Conformity Compared to Manual Detection: An Evaluation. J Med Internet Res 2015; 17: e135 Im Internet: http://www.jmir.org/2015/6/e135/
• 91 Miller N, Lacroix EM, Backus JE. MEDLINEplus: building and maintaining the National Library of Medicine’s consumer health Web service. Bull Med Libr Assoc 2000; 88: 11-17 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/10658959
• 92 Meyer MF, Bacher R, Roth KS, Beutner D, Luers JC. Systematische Analyse der Lesbarkeit von Patienteninformationstexten auf Internetseiten deutscher nichtuniversitärer HNO-Kliniken. HNO 2014; 62: 186-195
• 93 Luers J-C, Gostian A-O, Roth KS, Beutner D. Lesbarkeit von medizinischen Texten im Internetangebot deutscher HNO-Universitätskliniken. HNO.2013: 61: 648–654 Im Internet: http://link.springer.com/10.1007/s00106-013-2674-7
• 94 Svider PF, Agarwal N, Choudhry OJ, Hajart AF, Baredes S, Liu JK, Eloy JA. Readability assessment of online patient education materials from academic otolaryngology-head and neck surgery departments. Am J Otolaryngol – Head Neck Med Surg 2013; 34: 31–35 Im Internet: doi: http://dx.doi.org/10.1016/j.amjoto.2012.08.001
• 95 Eloy JA, Li S, Kasabwala K, Agarwa N, Hansberry DR, Baredes S, Setzen M. Readability assessment of patient education materials on major otolaryngology association websites. Otolaryngol - Head Neck Surg (United States) 2012; 147: 848-854
• 96 Kasabwala K, Agarwal N, Hansberry DR, Baredes S, Eloy JA. Readability Assessment of Patient Education Materials from the American Academy of Otolaryngology—Head and Neck Surgery Foundation. Otolaryngol Neck Surg 2012; 147: 466-471 Im Internet: http://journals.sagepub.com/doi/10.1177/0194599812442783
• 97 Greywoode J, Bluman E, Spiegel J, Boon M. Readability analysis of patient information on the American Academy of Otolaryngology-Head and Neck Surgery website. Otolaryngol Head Neck Surg 2009; 141: 555-558 Im Internet: http://dx.doi.org/10.1016/j.otohns.2009.08.004
• 98 Atcherson SR, DeLaune AE, Hadden K, Zraick RI, Kelly-Campbell RJ, Minaya CP. A Computer-Based Readability Analysis of Consumer Materials on the American Speech-Language-Hearing Association Website. Contemp Issues Commun Sci Disord 2014; 41: 12-23 Im Internet http://search.ebscohost.com/login.aspx?direct=true&db = rzh&AN=2012595342&site=ehost-live
• 99 Nassif SJ, Wong K, Levi JR. The Índice Flesch-Szigriszt and Spanish Lexile Analyzer to evaluate Spanish patient education materials in otolaryngology. Laryngoscope 2018; 128: E21-E26 Im Internet: http://doi.wiley.com/10.1002/lary.26910
• 100 Kasabwala K, Misra P, Hansberry DR, Agarwal N, Baredes S, Setzen M, Anderson Eloy J. Readability assessment of the American Rhinologic Society patient education materials. Int Forum Allergy Rhinol 2013; 3: 325-333 Im Internet: http://doi.wiley.com/10.1002/alr.21097
• 101 Wong K, Levi JR. Readability of pediatric otolaryngology information by children’s hospitals and academic institutions. Laryngoscope 2017; 127: E138-E144
• 102 Hansberry DR, Agarwal N, Shah R, Schmitt PJ, Baredes S, Setzen M, Carmel PW, Prestigiacomo CJ, Liu JK, Eloy JA. Analysis of the readability of patient education materials from surgical subspecialties. Laryngoscope 2014; 124: 405-412 Im Internet: http://doi.wiley.com/10.1002/lary.24261
• 103 Narwani V, Nalamada K, Lee M, Kothari P, Lakhani R. Readability and quality assessment of internet-based patient education materials related to laryngeal cancer. Head Neck 2016; 38: 601-605 Im Internet: http://doi.wiley.com/10.1002/hed.23939
• 104 Varela-Centelles P, Ledesma-Ludi Y, Seoane-Romero JM, Seoane J. Information about oral cancer on the Internet: Our patient scannot understand it. Br J Oral Maxillofac Surg 2015; 53: 393-395 Im Internet: http://dx.doi.org/10.1016/j.bjoms.2015.01.020
• 105 Irwin JY, Thyvalikakath T, Spallek H, Wali T, Kerr AR, Schleyer T. English and Spanish oral cancer information on the internet: A pilot surface quality and content evaluation of oral cancer Web sites. J Public Health Dent 2011; 71: 106-116 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/21774133
• 106 Wong K, Gilad A, Cohen MB, Kirke DN, Jalisi SM. Patient education materials assessment tool for laryngectomy health information. Head Neck 2017; 1-8 Im Internet http://doi.wiley.com/10.1002/hed.24891
• 107 Albert Kong K, Hu A. Readability Assessment of Online Tracheostomy Care Resources. Otolaryngol Neck Surg 2015; 152: 272-278 Im Internet: http://journals.sagepub.com/doi/10.1177/0194599814560338
• 108 Wiriyakijja P, Fedele S, Porter S, Ni Riordain R. Web-based information on the treatment of oral leukoplakia - quality and readability. J Oral Pathol Med 2016; 45: 617-620 Im Internet: http://doi.wiley.com/10.1111/jop.12459
• 109 Ritchie L, Tornari C, Patel PM, Lakhani R. Glue ear: How good is the information on the World Wide Web?. J Laryngol Otol 2016; 130: 157-161
• 110 Pothier DD. Patients and the internet: are websites on glue ear readable?. Clin Otolaryngol 2005; 30: 566 Im Internet: http://doi.wiley.com/10.1111/j.1749-4486.2005.01115.x
• 111 Danino J, Muzaffar J, Mitchell-Innes A, Howard J, Coulson C. Quality of Information Available Via the Internet for Patients with Otological Conditions. Otol Neurotol 2016; 37: 1063-1065
• 112 Joseph J, Svider PF, Shaigany K, Eloy JA, McDonald PG, Folbe AJ, Hong RS. Hearing Aid Patient Education Materials: Is There Room for Improvement?. J Am Acad Audiol 2016; 27: 354-359 Im Internet http://openurl.ingenta.com/content/xref?genre=article&issn=1050-0545&volume=27&issue=4&spage=354
• 113 Seymour N, Lakhani R, Hartley B, Cochrane L, Jephson C. Cochlear implantation: An assessment of quality and readability of web-based information aimed at patients. Cochlear Implants Int 2015; 16: 321-325 Im Internet: http://www.tandfonline.com/doi/full/10.1179/1754762815Y.0000000015
• 114 McKearney TC, McKearney RM. The quality and accuracy of internet information on the subject of ear tubes. Int J Pediatr Otorhinolaryngol 2013; 77: 894-897 Im Internet: http://dx.doi.org/10.1016/j.ijporl.2013.03.021
• 115 Harris VC, Links AR, Hong P, Walsh J, Schoo DP, Tunkel DE, Stewart CM, Boss EF. Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement. Laryngoscope 2018; 128: 496-501 Im Internet: http://doi.wiley.com/10.1002/lary.26824
• 116 Cherla DV, Sanghvi S, Choudhry OJ, Jyung RW, Eloy JA, Liu JK. Readability Assessment of Internet-Based Patient Education Materials Related to Acoustic Neuromas. Otol Neurotol 2013; 34: 1349-1354 Im Internet http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00129492-201309000-00029
• 117 Misra P, Kasabwala K, Agarwal N, Eloy JA, Liu JK. Readability analysis of internet-based patient information regarding skull base tumors. J Neurooncol 2012; 109: 573-580
• 118 Haymes AT. The Quality of Rhinoplasty Health Information on the Internet. Ann Plast Surg 2016; 76: 143-149
• 119 Rayess H, Gupta A, Nissan M, Carron M, Zuliani G. Search Engine Optimization: An Analysis of Rhinoplasty Web sites. Facial Plast Surg 2017; 33: 665-669 Im Internet: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1607973
• 120 Rayess H, Zuliani GF, Gupta A, Svider PF, Folbe AJ, Eloy JA, Carron MA. Critical analysis of the quality, readability, and technical aspects of online information provided for neck-lifts. JAMA Facial Plast Surg 2017; 19: 115-120
• 121 Nissan ME, Gupta A, Rayess H, Black KZ, Carron M. Otoplasty Online Information: A Comprehensive Analysis of the Websites and Videos that Patients View Regarding Cosmetic Ear Surgery. Facial Plast Surg 2018; 34: 82-87
• 122 Alamoudi U, Hong P. Readability and quality assessment of websites related to microtia and aural atresia. Int J Pediatr Otorhinolaryngol 2015; 79: 151-156 Im Internet: http://dx.doi.org/10.1016/j.ijporl.2014.11.027
• 123 Acar B, Acar M, Ocak E, Kocaöz D, Koksal AO, Karasen RM. Accuracy of Internet guidance on pediatric otolaryngology procedures. Int J Pediatr Otorhinolaryngol 2014; 78: 2190-2192
• 124 McGoldrick DM, Kielty P, Cotter C. Quality of information about maxillofacial trauma on the Internet. Br J Oral Maxillofac Surg 2017; 55: 141-144 Im Internet: http://dx.doi.org/10.1016/j.bjoms.2016.09.020
• 125 Veer V, Alder G, Ullal U. The quality of snoring treatment information on the internet. Eur Arch Oto-Rhino-Laryngology 2014; 271: 3319-3323
• 126 San Giorgi MRM, de Groot OSD, Dikkers FG. Quality and readability assessment of websites related to recurrent respiratory papillomatosis. Laryngoscope 2017; 127: 2293-2297
• 127 Wong K, Levi JR. Partial Tonsillectomy: Content and Readability of Online Health Information. Ann Otol Rhinol Laryngol 2017; 126: 192-198
• 128 López-Jornet P, Camacho-Alonso F. The quality of patient-orientated Internet information on oral lichen planus: A pilot study. J Eval Clin Pract 2010; 16: 883-886
• 129 Kulasegarah J, Harney M, Walsh M, Walsh RM. The quality of information on three common ENT procedures on the Internet. Ir J Med Sci 2012; 181: 221-224 Im Internet: http://link.springer.com/10.1007/s11845-011-0787-0
• 130 Muthukumarasamy S, Osmani Z, Sharpe A, England RJA. Quality of information available on the World Wide Web for patients undergoing thyroidectomy: Review. J Laryngol Otol 2012; 126: 116-119
• 131 Ting K, Hu A. Evaluating the quality and readability of thyroplasty information on the internet. J Voice 2014; 28: 378-381 Im Internet: http://dx.doi.org/10.1016/j.jvoice.2013.10.011
• 132 Cherla DV, Sanghvi S, Choudhry OJ, Liu JK, Eloy JA. Readability assessment of internet-based patient education materials related to endoscopic sinus surgery. Laryngoscope 2012; 122: 1649-1654
• 133 Dueppen AJ, Bellon-Harn ML, Radhakrishnan N, Manchaiah V. Quality and Readability of English-Language Internet Information for Voice Disorders. J Voice 2017; 1-9 Im Internet: https://doi.org/10.1016/j.jvoice.2017.11.002
• 134 Alnafea S, Fedele S, Porter S, Ni Riordain R. Online Information on the Treatment of Burning Mouth Syndrome: Quality and Readability. J Oral Facial Pain Headache 2017; 31: 147-151 Im Internet: http://www.quintpub.com/journals/ofph/abstract.php?iss2_id=1445&article_id=17285&article=6&title=Online Information on the Treatment of Burning Mouth Syndrome: Quality and Readability#.WQOaDf1JmG8
• 135 O’Connell Ferster AP, Hu A. Evaluating the quality and readability of Internet information sources regarding the treatment of swallowing disorders. Ear Nose Throat J 2017; 96: 128-138 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/28346643
• 136 Davis KS, McCormick AA, Jabbour N. What might parents read: Sorting webs of online information on vascular anomalies. Int J Pediatr Otorhinolaryngol 2017; 93: 63-67 Im Internet: http://dx.doi.org/10.1016/j.ijporl.2016.12.004
• 137 Sanghvi S, Cherla DV, Shukla PA, Eloy JA. Readability assessment of internet-based patient education materials related to facial fractures. Laryngoscope 2012; 122: 1943-1948
• 138 Laplante-Lévesque A, Brännström KJ, Andersson G, Lunner T. Quality and readability of English-language internet information for adults with hearing impairment and their significant others. Int J Audiol 2012; 51: 618-626
• 139 Goslin RA, Elhassan HA. Evaluating internet health resources in ear, nose, and throat surgery. Laryngoscope 2013; 123: 1626-1631 Im Internet: http://doi.wiley.com/10.1002/lary.23773
• 140 Laplante-Lévesque A, Thorén ES. Readability of Internet Information on Hearing: Systematic Literature Review. Am J Audiol 2015; 24: 284 Im Internet: http://aja.pubs.asha.org/article.aspx?doi=10.1044/2015_AJA-14-0091
• 141 Hardey M. Public health and Web 2.0. J R Soc Promot Health 2008; 128: 181-189 Im Internet: http://rsh.sagepub.com/cgi/doi/10.1177/1466424008092228
• 142 Hesse BW, O’Connell M, Augustson EM, Chou W-YS, Shaikh AR, Rutten LJF. Realizing the promise of Web 2.0: engaging community intelligence. J Health Commun 2011; 16 (Suppl. 01) 10-31 Im Internet: http://www.tandfonline.com/doi/abs/10.1080/10810730.2011.589882
• 143 Lau AYS, Siek KA, Fernandez-Luque L, Tange H, Chhanabhai P, Li SYW, Elkin PL, Arjabi A, Walczowski L, Ang CS, Eysenbach G. The Role of Social Media for Patients and Consumer Health. Yearb Med Inform 2011; 20: 131-138 Im Internet: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1638751
• 144 Feng Y, Xie W. Digital divide 2.0: the role of social networking sites in seeking health information online from a longitudinal perspective. J Health Commun 2015; 20: 60-68 Im Internet: http://www.tandfonline.com/doi/abs/10.1080/10810730.2014.906522
• 145 Steele SR, Arshad S, Bush R, Dasani S, Cologne K, Bleier JIS, Raphaeli T, Kelz RR. Social media is a necessary component of surgery practice. Surg (United States) 2015; 158: 857-862 Im Internet: http://dx.doi.org/10.1016/j.surg.2015.06.002
• 146 Steehler KR, Steehler MK, Pierce ML, Harley EH. Social media’s role in otolaryngology-head and neck surgery: Informing clinicians, empowering patients. Otolaryngol Head Neck Surg 2013; 149: 521-524 Im Internet: http://journals.sagepub.com/doi/10.1177/0194599813501463
• 147 Farnan JM, Snyder Sulmasy L, Worster BK, Chaudhry HJ, Rhyne JA, Arora VM. American College of Physicians Ethics P and HRC, American College of Physicians Council of Associates, Federation of State Medical Boards Special Committee on Ethics and Professionalism* . Online medical professionalism: patient and public relationships: policy statement from the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med 2013; 158: 620-627 Im Internet: http://annals.org/article.aspx?doi=10.7326/0003-4819-158-8-201304160-00100
• 148 Walsh K. Social media and surgery: An alternative view. Surg (United States) 2016; 159: 978 Im Internet: http://dx.doi.org/10.1016/j.surg.2015.07.032
• 149 Park H, Rodgers S, Stemmle J. Analyzing health organizations’ use of twitter for promoting health literacy. J Health Commun 2013; 18: 410-425
• 150 Pershad Y, Hangge P, Albadawi H, Oklu R. Social Medicine: Twitter in Healthcare. J Clin Med 2018; 7: 121 Im Internet http://www.mdpi.com/2077-0383/7/6/121
• 151 Shafee T, Masukume G, Kipersztok L, Das D, Häggström M, Heilman J. Evolution of Wikipedia’s medical content: past, present and future. J Epidemiol Community Health 2017; 71: 1122-1129 Im Internet: http://jech.bmj.com/lookup/doi/10.1136/jech-2016-208601
• 152 Heilman JM, Kemmann E, Bonert M, Chatterjee A, Ragar B, Beards GM, Iberri DJ, Harvey M, Thomas B, Stomp W, Martone MF, Lodge DJ, Vondracek A, de Wolff JF, Liber C, Grover SC, Vickers TJ, Meskó B, Laurent MR. Wikipedia: a key tool for global public health promotion. J Med Internet Res 2011; 13: e14 Im Internet: http://www.jmir.org/2011/1/e14/
• 153 Laurent MR, Vickers TJ. Seeking health information online: does Wikipedia matter?. J Am Med Inform Assoc 2009; 16: 471-479 Im Internet: http://dx.doi.org/10.1197/jamia.M3059
• 154 Heilman JM, West AG. Wikipedia and Medicine: Quantifying Readership, Editors, and the Significance of Natural Language. J Med Internet Res 2015; 17: e62 Im Internet: http://www.jmir.org/2015/3/e62/
• 155 Zhang B. YouTube for Patient Education : A Deep Learning Approach for Understanding Medical Knowledge from User-Generated Videos. 2018; 2-4
• 156 Madathil KC, Rivera-Rodriguez AJ, Greenstein JS, Gramopadhye AK. Healthcare information on YouTube: A systematic review. Health Informatics J 2015; 21: 173-194 Im Internet: http://journals.sagepub.com/doi/10.1177/1460458213512220
• 157 Stamelou M, Edwards MJ, Espay AJ, Fung VSC, Hallett M, Lang AE, Tijssen MAJ, Bhatia KP. Movement Disorders on YouTube — Caveat Spectator. N Engl J Med 2011; 365: 1160-1161 Im Internet: http://www.nejm.org/doi/abs/10.1056/NEJMc1107673
• 158 Knight K, van Leeuwen DM, Roland D, Moll HA, Oostenbrink R. YouTube: Are parent-uploaded videos of their unwell children a useful source of medical information for other parents?. Arch Dis Child 2017; 102: 910-914 Im Internet: http://adc.bmj.com/lookup/doi/10.1136/archdischild-2016-311967
• 159 Fat MJL, Doja A, Barrowman N, Sell E. YouTube videos as a teaching tool and patient resource for infantile spasms. J Child Neurol 2011; 26: 804-809 Im Internet: http://journals.sagepub.com/doi/10.1177/0883073811402345
• 160 Delli K, Livas C, Vissink A, Spijkervet FKLL. Is YouTube useful as a source of information for Sjögren’s syndrome?. Oral Dis 2016; 22: 196-201 Im Internet: http://doi.wiley.com/10.1111/odi.12404
• 161 Nissan ME, Gupta A, Carron J, Rayess H, Carron M. Rhytidectomy: Analysis of Videos Available Online. Facial Plast Surg 2017; 33: 311-315 Im Internet: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1602163
• 162 Sorensen JA, Pusz MD, Brietzke SE. YouTube as an information source for pediatric adenotonsillectomy and ear tube surgery. Int J Pediatr Otorhinolaryngol 2014; 78: 65-70 Im Internet http://linkinghub.elsevier.com/retrieve/pii/S0165587613005314
• 163 Hassona Y, Taimeh D, Marahleh A, Scully C. YouTube as a source of information on mouth (oral) cancer. Oral Dis 2016; 22: 202-208 Im Internet http://doi.wiley.com/10.1111/odi.12434
• 164 Biggs TC, Bird JH, Harries PG, Salib RJ. YouTube as a source of information on rhinosinusitis: the good, the bad and the ugly. J Laryngol Otol 2013; 127: 749-754 Im Internet http://www.journals.cambridge.org/abstract_S0022215113001473
• 165 Eysenbach G, Powell J, Englesakis M, Rizo C, Stern A. Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions. BMJ 2004; 328: 1166 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/15142921%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC411092
• 166 Brownstein CA, Brownstein JS, Williams DS, Wicks P, Heywood JA. The power of social networking in medicine. Nat Biotechnol 2009; 27: 888-890 Im Internet http://www.nature.com/articles/nbt1009-888
• 167 Fornai F, Longone P, Cafaro L, Kastsiuchenka O, Ferrucci M, Manca ML, Lazzeri G, Spalloni A, Bellio N, Lenzi P, Modugno N, Siciliano G, Isidoro C, Murri L, Ruggieri S, Paparelli A. Lithium delays progression of amyotrophic lateral sclerosis. Proc Natl Acad Sci U S A 2008; 105: 2052-2057 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/18250315
• 168 Wicks P, Vaughan TE, Massagli MP, Heywood J. Accelerated clinical discovery using self-reported patient data collected online and a patient-matching algorithm. Nat Biotechnol 2011; 29: 411-414 Im Internet http://www.nature.com/articles/nbt.1837
• 169 Frost J, Okun S, Vaughan T, Heywood J, Wicks P. Patient-reported outcomes as a source of evidence in off-label prescribing: analysis of data from PatientsLikeMe. J Med Internet Res 2011; 13: e6 Im Internet http://www.jmir.org/2011/1/e6/
• 170 Reifegerste D, Baumann E. Medien und Gesundheit.. Wiesbaden: Springer Fachmedien Wiesbaden; 2018. Im Internet http://link.springer.com/10.1007/978-3-658-20013-8
• 171 Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs American Medical Association . Health Literacy: Report of the Council on Scientific Affairs. JAMA J Am Med Assoc 1999; 281: 552-557 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/22442354
• 172 Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health 2012; 12: 80 Im Internet http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-80
• 173 Levin-Zamir D, Bertschi I. Media Health Literacy, eHealth Literacy, and the Role of the Social Environment in Context. Int J Environ Res Public Health 2018; 15: 1643 Im Internet http://www.mdpi.com/1660-4601/15/8/1643
• 174 Norman CD, Skinner HA. eHealth Literacy: Essential Skills for Consumer Health in a Networked World. J Med Internet Res 2006; 8: e9 Im Internet http://www.jmir.org/2006/2/e9/
• 175 Griebel L, Enwald H, Gilstad H, Pohl A-L, Moreland J, Sedlmayr M. eHealth literacy research—Quo vadis?. Informatics Heal Soc Care 2017; 00: 1-16 Im Internet https://doi.org/10.1080/17538157.2017.1364247
• 176 DeWalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and health outcomes. J Gen Intern Med 2004; 19: 1228-1239 Im Internet http://link.springer.com/10.1111/j.1525-1497.2004.40153.x
• 177 Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Ann Intern Med 2011; 155: 97 Im Internet http://annals.org/article.aspx?doi=10.7326/0003-4819-155-2-201107190-00005
• 178 Bostock S, Steptoe A. Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ 2012; 344: e1602 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/22422872
• 179 Eysenbach G. The Impact of the Internet on Cancer Outcomes. CA Cancer J Clin 2003; 53: 356-371 Im Internet http://doi.wiley.com/10.3322/canjclin.53.6.356
• 180 Diviani N, van den Putte B, Giani S, van Weert JCMC. Low health literacy and evaluation of online health information: A systematic review of the literature. J Med Internet Res 2015; 17: 1-17 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/25953147
• 181 Zach L, Dalrymple PW, Rogers ML, Williver-Farr H. Assessing Internet access and use in a medically underserved population: Implications for providing enhanced health information services. Health Info Libr J 2012; 29: 61-71
• 182 Ramanadhan S, Viswanath K. Health and the Information Nonseeker: A Profile. Health Commun 2006; 20: 131-139 Im Internet http://www.tandfonline.com/doi/abs/10.1207/s15327027hc2002_4
• 183 Megwalu UC, Lee JY. Health Literacy Assessment in an Otolaryngology Clinic Population. Otolaryngol Neck Surg 2016; 155: 969-973 Im Internet http://journals.sagepub.com/doi/10.1177/0194599816664331
• 184 Safeer RS, Keenan J. Health literacy: The gap between physicians and patients. Am Fam Physician 2005; 72: 463-468 Im Internet https://www.aafp.org/afp/2005/0801/p463.html
• 185 Schaeffer D, Berens E-M, Vogt D. Gesundheitskompetenz der Bevölkerung in Deutschland: Ergebnisse einer repräsentativen Befragung. Dtsch Aerzteblatt Online. 2017; 114 Im Internet https://www.aerzteblatt.de/10.3238/arztebl.2017.0053
• 186 Jordan S, Hoebel J. Gesundheitskompetenz von Erwachsenen in Deutschland. Bundesgesundheitsblatt – Gesundheitsforsch - Gesundheitsschutz 2015; 58: 942-950 Im Internet http://link.springer.com/10.1007/s00103-015-2200-z
• 187 Sørensen K, Pelikan JM, Röthlin F, Ganahl K, Slonska Z, Doyle G, Fullam J, Kondilis B, Agrafiotis D, Uiters E, Falcon M, Mensing M, Tchamov K, van den Broucke S, Brand H. HLS-EU Consortium . Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health 2015; 25: 1053-1058 Im Internet https://academic.oup.com/eurpub/article-lookup/doi/10.1093/eurpub/ckv043
• 188 Nölke L, Mensing M, Krämer A, Hornberg C. Sociodemographic and health-(care-)related characteristics of online health information seekers: a cross-sectional German study. BMC Public Health 2015; 15: 31 Im Internet http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1423-0
• 189 Kruse RL, Koopman RJ, Wakefield BJ, Wakefield DS, Keplinger LE, Canfield SM, Mehr DR. Internet use by primary care patients: where is the digital divide?. Fam Med 2012; 44: 342-347 Im Internet http://www.ncbi.nlm.nih.gov/pubmed/23027117
• 190 Zok K. Unterschiede bei der Gesundheitskompetenz. Ergebnisse einer bundesweiten Repräsentativ-Umfrage unter gesetzlich Versicherten. WIdO-monitor 2014; 11: 1-12
• 191 Rogers SN, Rozek A, Aleyaasin N, Promod P, Lowe D. Internet use among head and neck cancer survivors in the North West of England. Br J Oral Maxillofac Surg 2012; 50: 208-214 Im Internet http://dx.doi.org/10.1016/j.bjoms.2011.03.264
• 192 Sheridan SL, Halpern DJ, Viera AJ, Berkman ND, Donahue KE, Crotty K. Interventions for individuals with low health literacy: A systematic review. J Health Commun 2011; 16: 30-54
• 193 Beerheide R. Ministerium sucht Schulterschluss. Dtsch Arztebl 2017; 114: A1223
• 194 Tan SS-L, Goonawardene N. Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review. J Med Internet Res 2017; 19: e9 Im Internet http://www.jmir.org/2017/1/e9/
• 195 Ball MJ, Lillis J. E-health: transforming the physician/patient relationship. Int J Med Inform 2001; 61: 1-10 Im Internet http://linkinghub.elsevier.com/retrieve/pii/S1386505600001301
• 196 Jutel A. “Dr. Google” and his predecessors. Diagnosis 2017; 0: 87-91 Im Internet http://www.degruyter.com/view/j/dx.ahead-of-print/dx-2016-0045/dx-2016-0045.xml
• 197 Hartzband P, Groopman J. Untangling the Web — Patients, Doctors, and the Internet. N Engl J Med 2010; 362: 1063-1066 Im Internet http://www.nejm.org/doi/abs/10.1056/NEJMp0911938
• 198 Murray E, Lo B, Pollack L, Donelan K, Catania J, Lee K, Zapert K, Turner R. The impact of health information on the Internet on health care and the physician-patient relationship: National U.S. survey among 1.050 U.S. Physicians. J Med Internet Res 2003; 5: 38-53
• 199 Davis JK. Dr. Google and Premature Consent: Patients Who Trust the Internet More Than They Trust Their Provider. HEC Forum 2017; 1-13
• 200 Woolf SH, Chan ECY, Harris R, Sheridan SL, Braddock CH, Kaplan RM, Krist A, O’Connor AM, Tunis S. Promoting Informed Choice: Transforming Health Care To Dispense Knowledge for Decision Making. Ann Intern Med 2005; 143: 293 Im Internet http://annals.org/article.aspx?doi=10.7326/0003-4819-143-4-200508160-00010
• 201 Sommerhalder K, Abraham A, Zufferey MC, Barth J, Abel T. Internet information and medical consultations: Experiences from patients’ and physicians’ perspectives. Patient Educ Couns 2009; 77: 266-271
• 202 Hart A, Henwood F, Wyatt S. The role of the internet in patient-practitioner relationships: Findings from a qualitative research study. J Med Internet Res 2004; 6: 1-7
• 203 Fergus TA, Dolan SL. Problematic internet use and internet searches for medical information: the role of health anxiety. Cyberpsychol Behav Soc Netw 2014; 17: 761-765 Im Internet http://online.liebertpub.com/doi/abs/10.1089/cyber.2014.0169
• 204 Ellingson MK, Bonk CM, Chamberlain AT. A survey-based study of Zika virus communication preferences among pregnant women in Georgia, United States. BMC Pregnancy Childbirth 2017; 17: 325 Im Internet http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1516-0
• 205 Hesse BW, Moser RP, Rutten LJ. Surveys of Physicians and Electronic Health Information. N Engl J Med 2010; 362: 859-860 Im Internet http://www.nejm.org/doi/abs/10.1056/NEJMc0909595
• 206 Illingworth P. Trust: The Scarcest of Medical Resources. J Med Philos 2002; 27: 31-46 Im Internet https://academic.oup.com/jmp/article-lookup/doi/10.1076/jmep.27.1.31.2969
• 207 Ahmad F, Hudak PL, Bercovitz K, Hollenberg E, Levinson W. Are Physicians Ready for Patients With Internet-Based Health Information?. J Med Internet Res 2006; 8: e22 Im Internet http://www.jmir.org/2006/3/e22/
• 208 Wayne I. Ethical considerations in revision rhinoplasty. Facial Plast Surg 2012; 28: 369-373
• 209 Szychta P, Zieliński T, Rykała J, Witmanowski H, Kruk-Jeromin J. Role of the internet in communication between patient and surgeon before rhinoplasty. J Plast Surg Hand Surg 2012; 46: 248-251
• 210 Balakrishnan V, Chandy Z, Verma SP. Are Online Zenker’s Diverticulum Materials Readable and Understandable?. Otolaryngol – Head Neck Surg (United States) 2016; 155: 758-763
• 211 Xie DX, Wang RY, Chinnadurai S. Readability of online patient education materials for velopharyngeal insufficiency. Int J Pediatr Otorhinolaryngol 2018; 104: 113-119 Im Internet https://doi.org/10.1016/j.ijporl.2017.09.016
• 212 Wozney L, Chorney J, Huguet A, Song JS, Boss EF, Hong P. Online Tonsillectomy Resources: Are Parents Getting Consistent and Readable Recommendations?. Otolaryngol – Head Neck Surg (United States) 2017; 156: 844-852