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How is the Internet Educating our Obstetric Anesthesia Patients?
Abstract Number: S 23
Abstract Type: Original Research
Introduction: From 2000 to 2009, Internet users globally rose from 394 million to 1.858 billion. Health and medical information inquiries constitute 45% of all searches performed using the major internet search engines.1 This study was undertaken to compare online obstetrical anesthesia information provided by non-physicians (NP group) to physicians (P group) based sources in regards to rank, readability, design and content.
Method: Google, Bing and Yahoo were used to search terms - labor epidural - and - pain relief in labour - by 2 independent assessors. The first 10 websites retrieved for each search-term and engine were selected and ranked independently. Websites readability and design were assessed using the Fleisch Reading Ease Score (FRES)2 and the Minervation tool (LIDA ).2-3 Websites content were assessed based on best evidence on epidural analgesia and end points: risk of cesarean delivery, stage of labor for epidural catheter insertion and its effects on breast-feeding.4 Student t test and Fisher's Exact test were applied (SPSS V17 package; statistical significance at P<0.05)
Results: In total, 27 websites met criteria for review (NP group: n=18; P group: n=9). Only one site appeared in all 6 searches (www.pregnancy.about.com); 21.4% (N=6) noted physician input (4 Anesthetists, 1 Pediatric Endocrinologist, 1 Obstetrician) and 32% (N=9) of sources cited references - 60% of those dated 2001 or older. FRES was s higher for NP group when compared to P group (P=0.01) (Figure1). The overall LIDA score was similar in between groups, but usability and reliability scores were higher in P group (P=0.02; P=0.01). The proportion of sites stating “labor epidural as risk factor to increase cesarean delivery rate”, was significantly higher in the NP group when compared to P group (P=0.02).
Conclusions: Patient concerns regarding obstetric anesthesia are being answered through unregulated and potentially inaccurate internet sources. Physician based sources must improve their language for easier reading. As providers of this service, Obstetric Anesthetists and specialty professional organizations should consider how to effectively disseminate educational information to reach this target patient population.
Figure 1. FRES: Fleisch Reading Ease Score
References: 1) AJOG 2008;198:682.e1-5. 2) Cardiovasc Intervent Radiol 2012;35:1355-62 3) http://www.minervation.com 4) Wong C. ASA Refresher Courses in Anesthesiology 2010; 312:1-5.