A Quality Assessment of Online Patient Information Regarding Rhinoplasty

Abstract

There is a large demand for online patient information for patients considering rhinoplasty. While there are many resources available, the quality and content of the information provided are unknown. This study aimed to assess the quality of the most popular information available online, using the “Ensuring Quality Information for Patients” (EQIP) tool to evaluate the content, structure, and readability of patient information on websites. Search terms including nose operation, nose job, nose reshaping, nose tip surgery, rhinoplasty, septorhinoplasty, were identified using Google AdWords and Trends. Unique links from the first 10 pages for each term were identified and evaluated with websites written in English and for general non-medical public use were included. 295 websites met the eligibility criteria with a median overall EQIP score of 17. Only 33% contained balanced information on the risks and benefits. Bleeding and infection risk was only mentioned in 29% and 27% of websites, respectively. Two percent described complication rates of the procedures and only 20% of articles explained further surgery may be required to achieve patient cosmetic or functional satisfaction. Information regarding rhinoplasty available online is currently of poor quality. The lack of effective risk counselling, possible outcome management, and complications may likely lead to unrealistic expectations of rhinoplasty. It is crucial the risks of surgery are communicated to the patient to ensure they can make an informed decision. Improved education through online resources would likely help to promote more realistic patient expectations.

Keywords

rhinoplasty - online information - patient expectations

Publication History

Article published online:
28 September 2021

• References

• 1 The International society of Aesthetic Plastic Surgery. ISAPS Global Survey Results 2019. Accessed June 09, 2021 at: https://www.isaps.org/wp-content/uploads/2020/12/Global-Survey-2019.pdf
• 2 Montemurro P, Porcnik A, Hedén P, Otte M. The influence of social media and easily accessible online information on the aesthetic plastic surgery practice: literature review and our own experience. Aesthetic Plast Surg 2015; 39 (02) 270-277
• 3 Gualtieri, Lisa. The doctor as the second opinion and the internet as the first. Presented at: Proceedings of the 27th International Conference on Human Factors in Computing Systems, CHI; June 9, 2009
• 4 Lundberg GD, Lundberg PL. Web-enabled medicine: the challenge of ensuring quality information and care. In: Ball MJ, Simborg DW, Albright JW, Douglas JV. Healthcare Information Management Systems. New York, NY: Springer; 2004: 478-494
• 5 Tan SS, Goonawardene N. Internet health information seeking and the patient-physician relationship: a systematic review. J Med Internet Res 2017; 19 (01) e9
• 6 Melloul E, Raptis DA, Oberkofler CE, Dutkowski P, Lesurtel M, Clavien PA. Donor information for living donor liver transplantation: where can comprehensive information be found?. Liver Transpl 2012; 18 (08) 892-900
• 7 Vaona A, Marcon A, Rava M. et al. Quality evaluation of JAMA Patient Pages on diabetes using the Ensuring Quality Information for Patient (EQIP) tool. Prim Care Diabetes 2011; 5 (04) 257-263
• 8 Moult B, Franck LS, Brady H. Ensuring quality information for patients: development and preliminary validation of a new instrument to improve the quality of written health care information. Health Expect 2004; 7 (02) 165-175
• 9 McCool ME, Wahl J, Schlecht I, Apfelbacher C. Evaluating written patient information for eczema in German: comparing the reliability of two instruments, DISCERN and EQIP. PLoS One 2015; 10 (10) e0139895
• 10 Palma AF, Zuk G, Raptis DA. et al. Quality of information for women seeking breast augmentation in the Internet. J Plast Surg Hand Surg 2016; 50 (05) 262-271
• 11 Zuk G, Palma AF, Eylert G, Raptis DA, Guggenheim M, Shafighi M. Systematic review of quality of patient information on liposuction in the internet. Plast Reconstr Surg Glob Open 2016; 4 (06) e759
• 12 Fan KS, Ghani SA, Machairas N. et al. COVID-19 prevention and treatment information on the internet: a systematic analysis and quality assessment. BMJ Open 2020; 10 (09) e040487
• 13 The eBusiness. Top 15 Best Search Engines | February 2020. Accessed June 09, 2021 at: http://www.ebizmba.com/articles/search-engines
• 14 Search Engine Watch. Young RD, Search Engine Watch. Google Hits the Billion Monthly Unique Visitors Mark. Vol. 2020, Searchenginewatch.Com. 2011 [cited October 17, 2020]:1–7. Accessed June 09, 2021 at: https://www.searchenginewatch.com/2011/06/23/google-hits-the-billion-monthly-unique-visitors-mark
• 15 Google. Alphabet. Accessed June 09, 2021 at: https://www.google.co.uk.
• 16 Raptis DA, Sinanyan M, Ghani S, Soggiu F, Gilliland JJ, Imber C. Quality assessment of patient information on the management of gallstone disease in the internet—a systematic analysis using the modified ensuring quality information for patients tool. HPB (Oxford) 2019; 21 (12) 1632-1640
• 17 Vetter D, Ruhwinkel H, Raptis DA, Bueter M. Quality assessment of information on bariatric surgery websites. Obes Surg 2018; 28 (05) 1240-1247
• 18 Zuk G, Reinisch KB, Raptis DA, Fertsch S, Guggenheim M, Palma AF. Dupuytren disease: is there enough comprehensive patient information on the Internet?. Interact J Med Res 2017; 6 (01) e7
• 19 Google. Google Ads—Get More Customers With Easy Online Advertising. Accessed June 09, 2021 at: https://ads.google.com/intl/en_GB/home
• 20 Google. Google Trends. Accessed June 09, 2021 at: https://trends.google.com/trends
• 21 European Academy of Facial Plastic Surgery. What is rhinoplasty (nose surgery)?—EAFPS. Accessed June 09, 2021 at: https://eafps.org/rhinoplasty
• 22 Rowe-Jones J. ENT UK. Surgery of the nose—rhinoplasty. Accessed June 09, 2021 at: https://www.entuk.org/surgery-nose-rhinoplasty
• 23 Charvet-Berard AI, Chopard P, Perneger TV. Measuring quality of patient information documents with an expanded EQIP scale. Patient Educ Couns 2008; 70 (03) 407-411
• 24 British Medical Association. BMA Patient Information Awards. 2018. Accessed June 09, 2021 at: https://www.bma.org.uk/library/patient-information-awards
• 25 International Patient Decision Aid Standards Collaboration. IPDAS Collaboration Background Document. Vol. 2018. 2005. Accessed June 09, 2021 at: http://ipdas.ohri.ca/IPDAS_Background.pdf
• 26 Raptis DA. rBiostatistics.com (alpha version) | rBiostatistics.com. [Internet]. 2017. Accessed June 09, 2021 at: https://www.rbiostatistics.com
• 27 Torto FL, Marcasciano M, Frattaroli JM. et al. Quality assessment of online information on body contouring surgery in postbariatric patient. Aesthetic Plast Surg 2019; (e-pub ahead of print) DOI: 10.1007/s00266-019-01535-x.
• 28 General Medical Council guidance for doctors, decision making and consent. November 2020. Accessed June 09, 2021 at: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/decision-making-and-consent
• 29 Houts PS, Bachrach R, Witmer JT, Tringali CA, Bucher JA, Localio RA. Using pictographs to enhance recall of spoken medical instructions. Patient Educ Couns 1998; 35 (02) 83-88
• 30 Thomson AM, Cunningham SJ, Hunt NP. A comparison of information retention at an initial orthodontic consultation. Eur J Orthod 2001; 23 (02) 169-178
• 31 Barry MJ, Edgman-Levitan S. Shared decision making—pinnacle of patient-centered care. N Engl J Med 2012; 366 (09) 780-781
• 32 Ors S, Ozkose M. Late postoperative massive bleeding in septorhinoplasty: a prospective study. Plast Surg (Oakv) 2016; 24 (02) 96-98
• 33 Layliev J, Gupta V, Kaoutzanis C. et al. Incidence and preoperative risk factors for major complications in aesthetic rhinoplasty: analysis of 4978 patients. Aesthet Surg J 2017; 37 (07) 757-767
• 34 Heilbronn C, Cragun D, Wong BJF. Complications in rhinoplasty: a literature review and comparison with a survey of consent forms. Facial Plast Surg Aesthet Med 2020; 22 (01) 50-56
• 35 Khansa I, Khansa L, Pearson GD. Patient satisfaction after rhinoplasty: a social media analysis. Aesthet Surg J 2016; 36 (01) NP1-NP5
• 36 Savage JR, Weiner GM. Litigation in otolaryngology—trends and recommendations. J Laryngol Otol 2006; 120 (12) 1001-1004
• 37 Frueh FS, Palma AF, Raptis DA, Graf CP, Giovanoli P, Calcagni M. Carpal tunnel syndrome: analysis of online patient information with the EQIP tool. Chir Main 2015; 34 (03) 113-121
• 38 Dorfman RG, Mahmood E, Ren A. et al. Google ranking of plastic surgeons values social media presence over academic pedigree and experience. Aesthet Surg J 2019; 39 (04) 447-451
• 39 Lopez J, Lopez S, Means J. et al. Financial conflicts of interest: an association between funding and findings in plastic surgery. Plast Reconstr Surg 2015; 136 (05) 690e-697e
• 40 George CF, Waters WE, Nicholas JA. Prescription information leaflets: a pilot study in general practice. Br Med J (Clin Res Ed) 1983; 287 (6400): 1193-1196
• 41 Bunker TD. An information leaflet for surgical patients. Ann R Coll Surg Engl 1983; 65 (04) 242-243