Online Information About the Effectiveness of Shoulder Surgery Is Not Based on the Best Available Evidence: A Content Analysis |
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| Affiliation: | 4. Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Kensington, New South Wales, Australia;5. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;6. Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia;7. School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;1. Notre Dame School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia;2. Clinical Governance Unit, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia;3. Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia;4. Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Kensington, New South Wales, Australia;5. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;6. Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia;7. School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;1. School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada;2. Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada;3. Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada;4. Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada;5. School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom;6. Therapy Department, Central London Community Healthcare National Health Service Trust, London, United Kingdom;7. Department of Physical Therapy & Rehabilitation Science, College of Health Sciences, Qatar University, Doha, Qatar;8. Department of Occupational Medicine, Regional Hospital West Jutland University Research Clinic, Herning, Denmark;9. Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark;10. The Running Clinic, Quebec, Canada;1. Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan;2. Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan;3. Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan;4. Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung City, Taiwan;5. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan;6. Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu, Taiwan;7. Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan;8. School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;9. Department of Physical Medicine and Rehabilitation, Chung Shan Medical Center, Taiwan;10. Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan;1. Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD;2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD;3. Department of Clinical Foundations, Ross University School of Medicine, St. Michael, Barbados;4. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH;5. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD;6. Department of Pediatric Rehabilitation, Kennedy Krieger Institute, Baltimore, MD;1. Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain;2. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France;3. Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, United Kingdom;4. Philipps University of Marburg, Marburg, Germany;5. Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, Garches, France;6. EA4047, UFR des Sciences de la Santé, University Versailles Saint Quentin en Yvelines, “Handi-Resp”, France;7. ICREA, Barcelona, Spain;8. School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom;9. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea;10. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom |
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| Abstract: | ObjectiveTo summarize the proportion of consumer webpages on subacromial decompression and rotator cuff repair surgery that make an accurate portrayal of the evidence for these operations (primary outcome), mention the benefits and harms of surgery, outline alternatives to surgery, and make various surgical recommendations.DesignContent analysis.SettingOnline consumer information about subacromial decompression and rotator cuff repair surgery. Webpages were identified through (1) Google searches using terms synonymous with “shoulder pain” and “shoulder surgery” and searching “orthopedic surgeon” linked to each Australian capital city and (2) websites of relevant professional associations (eg, Australian Orthopaedic Association). Two reviewers independently identified webpages and extracted data.ParticipantsNot applicable.InterventionsNot applicable.Main Outcome MeasuresWhether the webpage made an accurate portrayal of the evidence for subacromial decompression or rotator cuff repair surgery (primary outcome), mentioned benefits and harms of surgery, outlined alternatives to surgery, and made various surgical recommendations (eg, delay surgery). Outcome data were summarized using counts and percentages.ResultsA total of 155 webpages were analyzed (n=89 on subacromial decompression, n=90 on rotator cuff repair, n=24 on both). Only 18% (n=16) and 4% (n=4) of webpages made an accurate portrayal of the evidence for subacromial decompression and rotator cuff repair surgery, respectively. For subacromial decompression and rotator cuff repair, respectively, 85% (n=76) and 80% (n=72) of webpages mentioned benefits, 38% (n=34) and 47% (n=42) mentioned harms, 94% (n=84) and 92% (n=83) provided alternatives to surgery, and 63% (n=56) and 62% (n=56) recommended delayed surgery (the most common recommendation).ConclusionsMost online information about subacromial decompression and rotator cuff repair surgery does not accurately portray the best available evidence for surgery and may be inadequate to inform patient decision making. |
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