JMIR Publications

ABSTRACT

Background:

Shared decision-making (SDM) is critical for managing clinically ambiguous conditions like benign breast disease (BBD), requiring reliable health information. In China, WeChat public accounts (WPAs) of hospitals serve as a major health information channel, yet their quality remains unevaluated.

Objective:

To evaluate the quality of BBD-related articles on hospital WPAs in China.

Methods:

Using a multi-stage stratified random sampling approach, we conducted a nationwide survey examining the quality of articles published from January 2020 to November 2024. The articles were evaluated for accessibility (readability, image quality, user-friendliness) and for SDM-readiness (credibility, balance, decision relevance), using validated instruments and content analysis.

Results:

Among 276,617 articles from 158 sampled hospitals, 464 were related to BBD. Accessibility was generally good: 72.4% were written at a junior high school level. Visual presentation was acceptable, though only 10.2% had complete image labeling. PEMAT-P scores showed moderate understandability (73.6%±17.3%) but limited actionability (50.0%±23.2%). For SDM-readiness, the mean QUEST score was 14.9±4.7 (out of 28), with treatment-related articles scoring lower than prevention-related ones (p < 0.001). Balance evaluation using Brief DISCERN showed 84.3% were below the high-quality threshold, often lacking information on treatment risks and quality-of-life impacts. Decision relevance revealed variability in surgical recommendations, especially excision criteria and pregnancy-related guidance.

Conclusions:

WPAs articles on BBD showed good accessibility but substantial gaps in SDM support, particularly in information balance and decision relevance. Standardized guidelines and quality improvements are needed to enhance patient-centered online health services. Clinical Trial: This study was approved by the Ethics Committee of Chongqing University Three Gorges Hospital (KLS2025122).