JMIR Publications

ABSTRACT

Background:

Patients with knee osteoarthritis (OA) have a considerable need for information about their condition, its progression, and available treatments. Decision-making is often complex and requires evidence-based health information materials (HIMs). When medical consultations do not sufficiently address patients' needs, many seek additional information independently.

Objective:

This study aimed to examine the quality of German language HIMs on knee OA treatment and their suitability for supporting informed choice. In particular, the study analysed the content of HIMs and assessed the balance in the presentation of treatment options.

Methods:

A descriptive cross-sectional study was conducted. HIMs were identified through a combination of search strategies, including a systematic internet search using commonly used German terms related to the treatment of knee OA. Identified HIMs were independently assessed by two raters using the validated MAPPinfo checklist, which operationalises the criteria of the guideline evidence-based health information. Information quality was calculated on a scale from 0 to 100%, representing compliance with the quality standard. A descriptive content analysis was also carried out to examine the range and balance of treatment options presented, as well as the reporting of benefits and complications associated with total knee arthroplasty (TKA). The presence of certification was recorded.

Results:

A total of 94 HIMs were included. On average, materials met 14.6% of the quality criteria. HIMs from public and non-profit providers performed better (40.1% and 37.2%, respectively) than those from other providers. Fourteen HIMs presented treatment options in a balanced manner. Among the 78 HIMs that covered TKA, 38.5% did not report any benefits and 35.9% omitted potential complications. Certified HIMs showed only modestly higher information quality than uncertified materials (25.6% vs. 12.7%).

Conclusions:

Our results highlight the urgent need to improve the quality of German language HIMs on knee OA. The deficits identified are fundamental and affect all dimensions of information quality. Although HIMs from public or non-profit organisations have better information quality, they do not facilitate informed choice. The frequent omission of complications and benefits of TKA, and the unbalanced presentation of treatment options, can influence decisions. Until structural improvements are made, patients seeking quality information should favour materials from public or non-profit providers. Additionally, the MAPPinfo checklist could form the basis of a differentiated certification system to make information quality more transparent for patients.