JMIR Publications

ABSTRACT

Background:

There is increasing interest in shared decision making (SDM) in Australia. Question prompt lists (QPLs) support question asking by patients, a key part of SDM. QPLs have been studied in a variety of settings, and increasingly the internet provides a source of suggested questions for patients. Environmental scans have been shown to be useful in assessing the availability and quality of online SDM tools.

Objective:

To assess the number, clinical application, accessibility and readability of QPLs available to users via Google.com.au

Methods:

Our environmental scan used search terms derived from literature and reputable websites to search for QPLs available via Google.com.au. Following removal of duplicates from the 4000 URLs and 22 reputable sites, inclusion and exclusion criteria were applied to create a list of unique QPLs. QPLs were further assessed for list length, proxy measures of quality such as a date of review, and evidence of doctor endorsement. Readability of a sample on QPL instructions and the QPLs themselves was assessed using Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FK) scores.

Results:

Our environmental scan identified 173 unique QPLs available to users. Lists ranged in length from one question to over 200. Just over half (57%) had a listed date of creation or update and 24% had evidence of authorship or source. FK grade levels for instructions was higher than for the QPLs (Grade 8 cf. grade 5). There was a one and half grade difference between QPLs from reputable sites compared with other sites (4.1 cf. 5.6).

Conclusions:

People seeking questions to ask their doctor using Google.com.au encounter a vast number of questions lists which they can use to prepare for consultations with their doctors. Markers of the quality or usefulness of various types of online QPLs, surrogate or direct, have not yet been established which makes it difficult to assess the value of the abundance of lists. Doctor endorsement of question asking has previously been shown to be an important factor in the effectiveness of QPLs (Sansoni et al. 2014), but information regarding this is not readily available online. Whether these diverse question prompt lists are endorsed by medical practitioners warrants further investigation.