A scoping review of information provided within degenerative cervical myelopathy education resources: Towards enhancing shared decision making

Umeria, Rishi; Mowforth, Oliver; Grodzinski, Ben; Karimi, Zahabiya; Sadler, Iwan; Wood, Helen; Sangeorzan, Irina; Fagan, Petrea; Murphy, Rory K.J.; McNair, Angus; Davies, Benjamin

doi:10.1371/journal.pone.0268220

Cited by 10 publications

(11 citation statements)

References 61 publications

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“…Few studies have assessed the quality of DCM information available to the public. 19,20 Patient awareness and education of the condition are generally lacking, and there is a paucity of trustworthy sources available outside of the clinical setting. 21 One study found that information on DCM across various media largely pertained to health professionals, with only 15% targeted toward patients or layperson.…”

Section: Discussionmentioning

confidence: 99%

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Quality Assessment of Degenerative Cervical Myelopathy Information on the Internet

Chong,

Zhu,

Baker

2023

Int J Spine Surg

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Background: Patient education is a key element of spinal surgery informed consent. Patients frequently access health information online, yet this information is unregulated and of variable quality. We aimed to assess the quality of information available on degenerative cervical myelopathy (DCM) websites with a focus on identifying high-quality information websites.Methods: We performed a Google search using keywords pertaining to DCM. The top 50 websites returned were classified based on their publication source, intended audience, and country of origin. The quality of these websites was assessed using both the DISCERN instrument and Journal of the American Medical Association (JAMA) benchmark criteria. We also utilized a novel Myelopathy Information Scoring Tool (MIST) to assess the comprehensiveness, accuracy, and detail of online DCM information.Results: The mean DISCERN score was 39.9 out of 80. Only one-quarter of these websites were rated "good" or "excellent" using DISCERN, and the remaining were rated "very poor," "poor," and "fair." The mean JAMA benchmark score was 1.6 out of 4, with 23 out of 50 websites scoring 0. Evaluation using MIST found a mean score of 25.6 out of 50. Using 30 points as a satisfactory MIST cutoff, 72% of DCM websites were deemed critically deficient and unsatisfactory for comprehensive patient education. Both DISCERN and MIST indicated poorest information pertaining to surgical risks and complications as well as treatment outcomes. Websites such as Orthoinfo. aaos. org and Myelopathy. org provided reliable, trustworthy, and comprehensive patient education.Conclusions: Information available on almost three-quarters of DCM websites was of poor quality, with information regarding complications and treatment outcomes most deficient. Clinicians should be aware of quality sites where patients may be directed to augment patient education and surgical counseling.

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Section: Discussionmentioning

confidence: 99%

“…21 One study found that information on DCM across various media largely pertained to health professionals, with only 15% targeted toward patients or layperson. 19 Another study on DCM and social media ( Twitter. com) reported that less than a third of tweets focused on spreading awareness and information.…”

Section: Discussionmentioning

confidence: 99%

Quality Assessment of Degenerative Cervical Myelopathy Information on the Internet

Chong,

Zhu,

Baker

2023

Int J Spine Surg

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“…Narrative reviews were selected because narrative reviews typically aim to provide educational content, and systematic reviews focus on specific clinical questions [ 20 , 21 ]. This methodology was formulated from a previously published scoping review on educational resources in degenerative cervical myelopathy- this confirmed most systematic reviews examined a clinical research question rather than provide educational content [ 22 ]. To consider an information bias (i.e.…”

Section: Methodsmentioning

confidence: 99%

“…For website-based resources, a hierarchical search strategy was employed to identify CSDH educational content with sequential searching of identified websites using page navigation, site search facilities, and finally in-page searching for the term ‘Chronic Subdural Haematoma’. Websites were chosen based on their popularity as a health information resource, as defined in a previous review [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Is information provided within chronic subdural haematoma education resources adequate? A scoping review

et al. 2023

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Background Chronic subdural haematoma (CSDH) is becoming increasingly prevalent, due to an aging population with increasing risk factors. Due to its variable disease course and high morbidity, patient centred care and shared decision making are essential. However, its occurrence in frail populations, remote from specialist neurosurgeons who currently triage treatment decisions, challenges this. Education is an important component of enabling shared decisions. This should be targeted to avoid information overload. However, it is unknown what this should be. Objectives Our objectives were to conduct analysis of the content of existing CSDH educational materials, to inform the development of patient and relative educational resources to facilitate shared decision making. Methods A literature search was conducted (July 2021) of MEDLINE, Embase and grey literature, for all self-specified resources on CSDH education, and narrative reviews. Resources were classified into a hierarchical framework using inductive thematic analysis into 8 core domains: Aetiology, epidemiology and pathophysiology; natural history and risk factors; symptoms; diagnosis; surgical management; nonsurgical management; complications and recurrence; and outcomes. Domain provision was summarised using descriptive statistics and Chi-squared tests. Results 56 information resources were identified. 30 (54%) were resources designed for healthcare professionals (HCPs), and 26 (46%) were patient-orientated resources. 45 (80%) were specific to CSDH, 11 (20%) covered head injury, and 10 (18%) referenced both acute and chronic SDH. Of 8 core domains, the most reported were aetiology, epidemiology and pathophysiology (80%, n = 45) and surgical management (77%, n = 43). Patient orientated resources were more likely to provide information on symptoms (73% vs 13%, p<0.001); and diagnosis (62% vs 10%, p<0.001) when compared to HCP resources. Healthcare professional orientated resources were more likely to provide information on nonsurgical management (63% vs 35%, p = 0.032), and complications/recurrence (83% vs 42%, p = 0.001). Conclusion The content of educational resources is varied, even amongst those intended for the same audience. These discrepancies indicate an uncertain educational need, that will need to be resolved in order to better support effective shared decision making. The taxonomy created can inform future qualitative studies.

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“…“What can I expect—When will I recover?” Frequent questions in those undergoing surgery for degenerative cervical myelopathy (DCM). 1a,2a…”

Section: Commentsmentioning

confidence: 99%

Timing of Recovery After Surgery for Patients With Degenerative Cervical Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network

et al. 2022

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BACKGROUND:The time course over which postoperative neurological recovery occurs after surgery for degenerative cervical myelopathy occurs is poorly understood. OBJECTIVE: To determine the time point at which patients experience significant neurological improvement. METHODS: We reviewed data from an ongoing prospective multicenter cohort study. We measured neurological function at 3 months, 1 year, and 2 years after surgery using the modified Japanese Orthopedic Association (mJOA) scale. We implemented minimal clinical important differences (MCIDs) to guide interpretation of mJOA scores, and we used 1-way analysis of variance to compare changes between followup intervals. RESULTS: Among 330 patients, the mean overall mJOA improved from 12.9 (SD 2.6) to 14.6 (SD 2.4) at 3 months, 14.7 (SD 2.4) at 1 year, and 14.8 (SD 2.5) at 2 years. The difference in means was statistically significant (P < .01) at the interval from baseline to 3 months postoperatively, but not from 3 months to 1 year or 1 year to 2 years. The MCID was reached by 161 patients at 3 months, 32 more at 1 year, and 15 more at 2 years, with a statistically significant difference only at 3 months. Patients with moderate or severe disease reached the MCID more frequently than those with mild disease. CONCLUSION: Among patients who underwent surgery for degenerative cervical myelopathy, most significant neurological improvement occurred by 3 months after surgery. These findings will facilitate valid discussions about postoperative expectations during shared clinical decision making between patients and their surgeons.

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A scoping review of information provided within degenerative cervical myelopathy education resources: Towards enhancing shared decision making

Cited by 10 publications

References 61 publications

Quality Assessment of Degenerative Cervical Myelopathy Information on the Internet

Quality Assessment of Degenerative Cervical Myelopathy Information on the Internet

Is information provided within chronic subdural haematoma education resources adequate? A scoping review

Timing of Recovery After Surgery for Patients With Degenerative Cervical Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network

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