A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery.
BACKGROUND
The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery.


METHODS
This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0).


RESULTS
Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8).


CONCLUSIONS
Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.
['Fowler|G E|GE|http://orcid.org/0000-0002-4133-802X', 'Baker|D M|DM|http://orcid.org/0000-0002-3708-790X', 'Lee|M J|MJ|http://orcid.org/0000-0001-9971-1635', 'Brown|S R|SR|']
D032882:Comprehension D054626:Consumer Health Information D003657:Decision Making D006801:Humans D020407:Internet D010353:Patient Education as Topic D012005:Rectal Prolapse
Online resources Decision-making Rectal prolapse Surgery