Accepted for/Published in: Interactive Journal of Medical Research
Date Submitted: Aug 17, 2020
Date Accepted: Oct 2, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
CEA vs CAS: Assessing the quality, readability, and treatment preference of carotid artery disease websites
ABSTRACT
Background:
The internet is becoming increasingly more important in the new era of patient self-education. Carotid Endarterectomy (CEA) and Carotid Stenting (CAS) are both recognized interventions to treat patients with carotid artery stenosis. Using Google.com as a search platform, patients encounter a myriad of websites which have conflicting information, which is sometimes difficult to understand. This creates uncertainty or bias towards interventions for carotid artery disease.
Objective:
To explore the quality, readability, and treatment preference of carotid artery disease (CAD) websites.
Methods:
10 CAD-related keywords were searched in Google Canada. Returned links were assessed for publication date, medical specialty and industry affiliation, presence of RCT data, differentiation by symptomatic status, and favoured treatment. Website quality and readability were rated by the DISCERN instrument and Gunning Fog Index.
Results:
54 unique sites were identified. 18 (33.3%) were produced by medical societies or individual physicians, 11 (20.4%) by government organizations, nine (16.7%) by laypersons, and one (1.9%) was industry-sponsored. 26 sites (48.1%) distinguished symptomatic from asymptomatic CAD. A majority of sites overall (57.4%) and vascular-affiliated (72.7%) favoured CEA. In contrast, radiology- and cardiology-affiliated sites demonstrated the highest proportion of sites favoring CAS, though they were equally likely to favour CEA. A large proportion (38.9%) of sites received poor quality ratings (total DISCERN score<48), and the majority (75.9%) required a reading level greater than a high school senior.
Conclusions:
CAD websites are often produced by government organizations, medical societies, or physicians, especially vascular surgeons. Sites ranged in quality, readability, and differentiation by symptomatic status. Google searches of CAD-related terms are more likely to yield sites favouring CEA. Future research should determine the extent of website influence on CAD patients’ treatment decisions.
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