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Do US academic hospitals provide online information for patients about obstetric anesthesia?
Abstract Number: S-06
Abstract Type: Original Research
Introduction: Studies indicate that patients increasingly turn to the internet to access medical information.(1) However there has been limited examination of the presence and quality of patient electronic health information (EHI) about obstetric anesthesia.(2) In this observational study, we reviewed the websites of US academic hospitals with obstetric anesthesia fellowship programs (OAFPs) to assess the presence and readability of patient EHI related to obstetric anesthesia.
Methods: We identified 50 US hospitals with OAFPs from the SOAP website. For each institution, 2 non-physicians independently searched for EHI related to labor analgesia and anesthesia for Cesarean delivery on hospital websites with OAFPs. EHI was subsequently assessed for text readability using the Flesch-Kincaid grade formula (FKGF) and Flesch Reading Ease (FRE) tools. The FKGF indicates the grade level needed to comprehend written text. The FRE score (on a scale of 0-100) represents ease of reading, with the extremes of 0-30 “very difficult” and 91-100 “very easy”. Calculations are shown in Table 1. Inter-rater agreement was assessed using the kappa statistic. Data presented as n (%) and median [interquartile range].
Results: The 2 raters were able to locate EHI for obstetric anesthesia on 27 (54%) and 33 (66%) hospital websites respectively; kappa = 0.72. The raters located a specific obstetric anesthesia website or webpage with patient EHI for only 6 (12%) and 9 (18%) hospitals respectively; kappa = 0.71. Readability statistics for the 33 hospitals with obstetric anesthesia EHI are shown in Table 2. The median FKGF was 10th grade. The median FRE was 42.3, indicating a “difficult” ease of reading.
Conclusions: In this observational study, we observed that at least one third of hospitals with OAFPs lack online EHI about obstetric anesthesia. In addition, the FKGL level is higher than recommended by the American Medical Association and National Institute of Health; both organizations recommend patient education material should be no higher than 6th grade level.(1) Of the available EHI, the majority of content is difficult to read and requires reading comprehension level several grade levels above national guidelines for patient information. These data suggest that academic hospitals need to improve the quantity and quality of patient web-based EHI.
(1) JAMA 2005;165:2618-2623
(2) SOAP 2014 Meeting: Abstract T53.