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Research

Aortic valve surgery: how reliable are health information websites?

Ming Yi Lai, Hilary McDermott and John B Chambers
BJGP Open 2017; 1 (1): bjgpopen17X100665. DOI: https://doi.org/10.3399/bjgpopen17X100665
Ming Yi Lai
1Medical Student, University of Cambridge, , UK
2Honorary research fellow, Guy's and St Thomas' Hospital NHS Foundation Trust, , UK
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  • For correspondence: myl35@cam.ac.uk
Hilary McDermott
3Patient, Guy’s and St Thomas’ Hospital NHS Foundation Trust, , UK
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John B Chambers
4Professor of Clinical Cardiology, Guy’s and St Thomas’ Hospital NHS Foundation Trust, , UK
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Article Figures & Data

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  • Figure 1.
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    Figure 1. Histogram showing distribution of scores.

Tables

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    Table 1. Scores achieved by a sample of websites assessed
    URLScore
    http://www.nhsdirect.wales.nhs.uk/encyclopaedia/a/article/aorticvalvereplacement/14
    http://www.nhs.uk/conditions/Aorticvalvereplacement/Pages/Whatisitpage.aspx13
    http://www.nhsinform.co.uk/health-library/articles/a/aorticvalvereplacement/whatisitpage/ 13
    http://www.healthgrades.com/procedures/heart-valve-replacement 12
    http://heart.uvahealth.com/services/cardiac-valve-center/treatment-and-research/aortic-valve-replacement 12
    http://www.hopkinsmedicine.org/healthlibrary/test_procedures/cardiovascular/heart_valve_repair_or_replacement_surgery_92,P07975/ 10
    http://umm.edu/programs/heart/services/treatments/valve-disease-program/aortic-valve-repair 8
    http://www.surgeryencyclopedia.com/A-Ce/Aortic-Valve-Replacement.html5
    http://www.bupa.co.uk/health-information/directory/h/heart-valve-disease 4
    https://www.youtube.com/watch?v=ldvchT0LHF0 2
    http://www.emoryhealthcare.org/medicaladvances/heart-vascular-etma/transcatheter-aortic-valve-implantation.html 0
    http://www.universityhealthsystem.com/tavr-transcatheter-aortic-valve-replacement 0
    http://cardiac.northshorelij.com/patient-services/tavr2 0
    https://www.carilionclinic.org/heart-vascular/tavr-procedure –1
    http://www.sanfordhealth.org/services/transcatheteraorticvalvereplacement –1
    • View popup
    Table 2. Comparison by category of web hosts
    Type of website
    Organisational/educational,
    n = 33
    Hospital,
    n = 24
    Commercial,
    n = 8
    Video,
    n = 14
    Total,
    n = 79
    Median score (range)7 (2 to 14)2 (−1 to 10)2.5 (0 to 9)5 (2 to 11)5 (−1 to 14)
    Health On the Net Foundation accredited, n (%)4 (12)2 (8)01 (8)7 (9)
    Limitations, n (%)
    No information provided on:
     ● Recovery process
     ● Symptoms indicating surgery
     ● Intraoperative risks
     ● Postoperative complications
     ● Indications for type of prosthesis
     ● Evaluating benefits/disadvantages for each type of prosthesis
     
    11 (33)
    8 (24)
    10 (30)
    15 (45)
    6 (18)
    11 (33)
     
    13 (54)
    11 (46)
    16 (67)
    18 (75)
    15 (63)
    18 (75)
     
    3 (38)
    5 (63)
    6 (75)
    6 (75)
    5 (63)
    7 (88)
     
    3 (23)
    4 (31)
    9 (69)
    8 (62)
    8 (62)
    10 (77)
     
    30 (38)
    28 (36)
    41 (53)
    47 (60)
    34 (44)
    46 (59)
    Bias in favour of:
    •  ● A procedure (Transcatheter aortic valve replacement / minimally invasive procedure)

    •  ● A type and/or make of prosthetic valve

     
    10 (30)
     
    1 (3)
     
    11 (46)
     
    1 (4)
     
    1 (13)
     
    2 (25)
     
    2 (15)
     
    0
     
    24 (31)
     
    4 (5)
    Contains false information00000
    • View popup
    Appendix 1. Scoring criteria
    Positive
    1. Multiple types of grafts: biological and mechanical with guide to who has which (age >65 years biological)

      • 0 – Mentions only one graft

      • 1 – Mentions all but does not offer guide

      • 2 – Mentions all and offers guide

    2. Multiple types of procedure: Thoracotomy, minimally invasive procedure, transcatheter aortic valve replacement

      • 0 – Mentions only one method

      • 1 – Mentions some

      • 2 – Mentions all

    3. Advantages and disadvantages of biological and mechanical (warfarin, clicking, deterioration)

      • 0 – No evaluation given

      • 1 – Partial evaluation given (for example, advantages of both or advantages and disadvantages of one)

      • 2 – Full evaluation given

    4. In op complications

      • 0 – Does not mention

      • 1 – Mentions some and does not offer evaluation

      • 2 – Comprehensive with evaluation

    5. Post op complications (heartblock, thromboembolism, deterioration)

      • 0 – Does not mention

      • 1 – Mentions some and does not offer evaluation

      • 2 – Comprehensive with evaluation

    6. Indications for surgery — symptoms

      • 0 – Does not mention

      • 1 – Mentions some and does not offer evaluation

      • 2 – Comprehensive with evaluation

    7. Recovery (time off work usually 2–3 months, valve noise)

      • 0 – Does not mention

      • 1 – Mentions some and does not offer evaluation

      • 2 – Comprehensive with evaluation

    Negative
    1. Misleading in terms of main procedure (for example, transcatheter procedure, minithoracotomy as mainstay)

      • 0 – Not evident

      • 1 – Unclear

      • 2 – Clearly supporting one form of procedure

    2. Bias towards type/make of graft

      • 0 – Not evident

      • 1 – Partially supports one or a few type(s)/make(s) of valve

      • 2 – Clearly supporting one type/make of valve

    3. Provides false information of any sort

      • 0 – Not evident

      • 1 – Occurs once

      • 2 – Occurs more than once


    Scoring system designed based on:
    1. Information known to be important and likely to be of interest to a patient

    2. Previously published test for reliability of internet information12

    3. Aspects of HON guideline criteria11

    • View popup
    Appendix 2. List of websites evaluated
    1. Google http://www.nhs.uk/conditions/Aorticvalvereplacement/Pages/Whatisitpage.aspx

    2. Google https://en.wikipedia.org/wiki/Aortic_valve_replacement

    3. Google http://www.webmd.com/heart/aortic-valve-replacement-surgery

    4. Google https://www.youtube.com/watch?v=5jLfPlQBYuw

    5. Google https://www.nlm.nih.gov/medlineplus/ency/article/007407.htm

    6. Google http://my.clevelandclinic.org/services/heart/disorders/valvetreatment/aorticvalvesurgery

    7. Google http://www.texasheart.org/HIC/Topics/Proced/vsurg.cfm

    8. Google http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Options-for-Heart-Valve-Replacement_UCM_450816_Article.jsp

    9. Google http://www.heartsurgeons.com/procedures3.html

    10. Google http://www.cts.usc.edu/aorticvalvereplacement.html

    11. Google http://www.nhsdirect.wales.nhs.uk/encyclopaedia/a/article/aorticvalvereplacement/

    12. Google http://www.onxlti.com/message-to-patients/tissue-or-mechanical-heart-valve/

    13. Google http://www.surgeryencyclopedia.com/A-Ce/Aortic-Valve-Replacement.html

    14. Google http://www.sts.org/patient-information/valve-repair/replacement-surgery/aortic-valve

    15. Google http://www.papworthhospital.nhs.uk/content.php?/our_services/cardiac_services_heart/avr

    16. Google http://www.heart-valve-surgery.com/aortic-valve-replacement-surgery.php

    17. Google http://www.mayoclinic.org/diseases-conditions/aortic-stenosis/basics/treatment/con-20026329

    18. Google http://www.hopkinsmedicine.org/heart_vascular_institute/conditions_treatments/treatments/valve_aortic.html

    19. Google http://newheartvalve.com/treatment-options

    20. Google https://www.surgery.medsch.ucla.edu/cardiac/Clinical_Aortic%20Valve%20Replacement.shtml

    21. Google http://emedicine.medscape.com/article/903836-overview

    22. Google http://www.webmd.boots.com/heart-disease/guide/valve-disease-treatment

    23. Google http://www.yourheartvalve.com/productinformation/pages/aorticvalveporcine.aspx

    24. Google http://www.edwards.com/procedures/aorticstenosis/Pages/aorticstenosis.aspx

    25. Google http://umm.edu/programs/heart/services/treatments/valve-disease-program/aortic-valve-repair

    26. Google http://www.ctsnet.org/article/aortic-valve-replacement-edwards-intuity-sutureless-bioprosthesis-through-right-anterior

    27. Yahoo https://www.bhf.org.uk/heart-health/treatments/valve-heart-surgery.aspx

    28. Yahoo https://www.nlm.nih.gov/medlineplus/ency/article/002954.htm

    29. Yahoo http://www.bmihealthcare.co.uk/treatment/treatmentsdetail?p_name=Aortic%20valve%20replacement&p_treatment_id=185

    30. Yahoo http://www.bupa.co.uk/health-information/directory/h/heart-valve-surgery

    31. Yahoo https://en.wikipedia.org/wiki/Aortic_valve

    32. Yahoo http://heart.emedtv.com/aortic-valve-replacement/aortic-valve-replacement.html

    33. Yahoo http://www.nhsinform.co.uk/health-library/articles/a/aorticvalvereplacement/whatisitpage/

    34. Yahoo http://www.hopkinsmedicine.org/healthlibrary/test_procedures/cardiovascular/heart_valve_repair_or_replacement_surgery_92,P07975/

    35. Yahoo https://www.bhf.org.uk/heart-matters-magazine/medical/valve-disease

    36. Yahoo http://www.healthgrades.com/procedures/heart-valve-replacement

    37. Yahoo http://www.heartfoundation.org.au/SiteCollectionDocuments/Heart-valve-surgery.pdf

    38. Yahoo http://www.medtronic.com/patients/heart-valve-disease/after-surgery/index.htm

    39. Yahoo https://www.floridahospital.com/aortic-valve-replacement

    40. Yahoo http://www.bupa.co.uk/health-information/directory/h/heart-valve-disease

    41. Bing http://www.webmd.com/heart-disease/video/aortic-valve-replacement

    42. Bing http://emedicine.medscape.com/article/780702-overview

    43. Bing http://www.rbht.nhs.uk/patients/why-us/patients-stories/keyhole-surgery/

    44. Ask Jeeves https://www.nlm.nih.gov/medlineplus/ency/article/007408.htm

    45. Ask Jeeves http://www.harthosp.org/heart/tavr/default.aspx

    46. Ask Jeeves http://wexnermedical.osu.edu/patient-care/healthcare-services/heart-vascular/conditions-treatments/aortic-valve-replacement

    47. Ask Jeeves http://heart.uvahealth.com/services/cardiac-valve-center/treatment-and-research/aortic-valve-replacement

    48. Ask Jeeves http://www.emoryhealthcare.org/medicaladvances/heart-vascular-etma/transcatheter-aortic-valve-implantation.html

    49. Ask Jeeves http://www.upmc.com/services/heart-vascular/services/programs/Pages/center-aortic-valve-disease.aspx

    50. Ask Jeeves https://www.utswmedicine.org/conditions-specialties/heart/programs/cardiothoracic-surgery/transcatheter-aortic-valve-replacement.html

    51. Ask Jeeves http://www.stvincents.org/medical-services/cardiology/regional-heart-center-services/aortic-valve-replacement-tavr

    52. Ask Jeeves https://www.uahealth.com/services/heart-surgery/transcatheter-aortic-valve-replacement-tavr

    53. Ask Jeeves https://www.dukemedicine.org/treatments/heart/aortic-valve-disease

    54. Ask Jeeves https://www.scripps.org/services/heart-care__interventional-cardiology/transcatheter-aortic-valve-replacement-tavr

    55. Ask Jeeves https://www.floridahospital.com/tampa/cardiovascular/valve-center-program/transcatheter-aortic-valve-replacement-tavr

    56. Ask Jeeves http://heartcaremw.com/services/heart-valve-clinics/tavr.html

    57. Ask Jeeves http://heart.ucla.edu/body.cfm?id=170

    58. Ask Jeeves https://www.sharecare.com/health/heart-surgeries/what-risks-aortic-valve-replacement

    59. Ask Jeeves http://www.universityhealthsystem.com/tavr-transcatheter-aortic-valve-replacement

    60. Ask Jeeves http://www.cigna.com/healthwellness/hw/medical-topics/aortic-valve-stenosis-uf4513abc

    61. Ask Jeeves https://www.carilionclinic.org/heart-vascular/tavr-procedure

    62. Ask Jeeves http://www.hoag.org/Specialty/Heart-and-Vascular-Institute/Pages/Transcatheter-Aortic-Valve-Replacement-TAVR/Transcatheter-Aortic-Valve-Replacement-TAVR.aspx

    63. Ask Jeeves http://cardiac.northshorelij.com/patient-services/tavr2

    64. Ask Jeeves http://www.sanfordhealth.org/services/transcatheteraorticvalvereplacement

    65. Ask Jeeves http://www.medstarunionmemorial.org/our-services/heart-care/treatments/surgery/transcatheter-aortic-valve-replacement-tavr/#q={}

    66. Ask Jeeves http://www.cedars-sinai.edu/Patients/Programs-and-Services/Heart-Institute/Centers-and-Programs/Cardiothoracic-Surgery-Services/Heart-Valve-Repair-and-Replacement/

    67. Ask Jeeves http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/CT02lite_en

    68. Youtube https://www.youtube.com/user/BritishHeartFound?v=fIbwK9_DKfU

    69. Youtube https://www.youtube.com/watch?v=C-sIdppyaPQ

    70. Youtube https://www.youtube.com/watch?v=m5DnlWun8oE

    71. Youtube https://www.youtube.com/watch?v=9m1zMWymn2U

    72. Youtube https://www.youtube.com/watch?v=Nae1hWRGpPQ

    73. Youtube https://www.youtube.com/watch?v=MmOadWd8Lys

    74. Youtube https://www.youtube.com/watch?v=w8FxMEgIxUk

    75. Youtube https://www.youtube.com/watch?v=2vf9TwktzTk

    76. Youtube https://www.youtube.com/watch?v=2gZX-MjcKnw

    77. Youtube https://www.youtube.com/watch?v=ldvchT0LHF0

    78. Youtube https://www.youtube.com/watch?v=_icWNXzTLsk

    79. Youtube https://www.youtube.com/watch?v=psE7nGhaXOY

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Aortic valve surgery: how reliable are health information websites?
Ming Yi Lai, Hilary McDermott, John B Chambers
BJGP Open 2017; 1 (1): bjgpopen17X100665. DOI: 10.3399/bjgpopen17X100665

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Aortic valve surgery: how reliable are health information websites?
Ming Yi Lai, Hilary McDermott, John B Chambers
BJGP Open 2017; 1 (1): bjgpopen17X100665. DOI: 10.3399/bjgpopen17X100665
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Keywords

  • aortic valve replacement
  • cardiology
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