Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 31:26:e49514.
doi: 10.2196/49514.

Quality of Patient-Centered eHealth Information on Erosive Tooth Wear: Systematic Search and Evaluation of Websites and YouTube Videos

Affiliations

Quality of Patient-Centered eHealth Information on Erosive Tooth Wear: Systematic Search and Evaluation of Websites and YouTube Videos

Lena Holland et al. J Med Internet Res. .

Abstract

Background: Due to the declining prevalence of dental caries, noncarious tooth defects such as erosive tooth wear have gained increased attention over the past decades. While patients more frequently search the internet for health-related information, the quality of patient-centered, web-based health information on erosive tooth wear is currently unknown.

Objective: This study aimed to assess the quality of patient-centered, web-based health information (websites and YouTube videos) on erosive tooth wear.

Methods: German-language websites were systematically identified through 3 electronic search engines (google.de, bing.de or yahoo.de, and duckduckgo.com) in September 2021. Eligible websites were independently assessed for (1) technical and functional aspects via the LIDA instrument, (2) readability via the Flesch reading-ease score, (3) comprehensiveness of information via a structured checklist, and (4) generic quality and risk of bias via the DISCERN instrument by 2 different reviewers. An overall quality score (ie, higher scores being favored) generated from all 4 domains was used as the primary outcome. Quality scores from each domain were separately analyzed as secondary outcomes and compared by the Friedman test. The effect of practice-specific variables on quality scores of websites from private dental offices was assessed using generalized linear modeling. Eligible YouTube videos were judged based on (1) the comprehensiveness of information, (2) viewers' interaction, and (3) viewing rate. The comprehensiveness of information was compared between websites and YouTube videos using the Wilcoxon rank-sum test.

Results: Overall, 231 eligible websites and 7 YouTube videos were identified and assessed. The median overall quality of the websites was 33.6% (IQR 29.8%-39.2%). Secondary outcome scores amounted to 64.3% (IQR 59.8%-69.0%) for technical and functional aspects, 40.0% (IQR 34.0%-49.0%) for readability, 11.5% (IQR 3.9%-26.9%) for comprehensiveness of information, and 16.7% (IQR 8.3%-23.3%) for generic quality. While the comprehensiveness of information and generic quality received low scores, technical and functional aspects as well as readability resulted in higher scores (both Padjusted<.001). Regarding practice-specific variables, websites from private dental offices outside Germany (P=.04; B=-6.64, 95% CI -12.85 to -0.42) or from dentists who are a dental society member (P=.049; B=-3.55, 95% CI -7.09 to -0.01) resulted in lower readability scores (ie, were more difficult to read), while a shorter time since dentists' examination resulted in higher readability scores (P=.01; B=0.24 per year, 95% CI 0.05-0.43). The comprehensiveness of information from YouTube videos was 34.6% (IQR 13.5%-38.5%). However, the comprehensiveness of information did not vary between websites and YouTube videos (P=.09). Additionally, viewers' interaction (1.7%, IQR 0.7%-3.4%) and viewing rates (101%, IQR 54.6%-112.6%) were low.

Conclusions: The quality of German-language, patient-centered, web-based information on erosive tooth wear was limited. Especially, the comprehensiveness and trustworthiness of the available information were insufficient. Web-based information on erosive tooth wear requires improvement to inform patients comprehensively and reliably.

Keywords: consumer health information; dental erosion; dental sciences; digital media; erosive tooth wear; evidence-based dentistry; health education; information quality; internet; shared decision making.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: PK is Associate Editor of JMIR Medical Education at the time of this publication. Other authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Flowchart representing the systematic workflow of the evaluation.
Figure 2
Figure 2
For all websites, the overall quality score (averaging the results from all 4 domains) and quality scores of each domain (relative percentage of maximum possible score sum) are shown. Domain 1: technical and functional aspects (LIDA instrument, version 1.2; Minervation); domain 2: readability (Flesch reading-ease score, adapted by Amstad for the German language); domain 3: comprehensiveness of information; domain 4: generic quality and risk of bias (DISCERN instrument). Significant differences between domains are marked by different letters (P<.001 for the Friedman test followed by Dunn-Bonferroni post hoc tests). Outliers are marked with an asterisk (*).

Similar articles

References

    1. Rainie L, Fox S. The online health care revolution. Pew Research Center. 2000. [2022-02-18]. https://www.pewresearch.org/internet/2000/11/26/the-online-health-care-r...
    1. Luo A, Qin L, Yuan Y, Yang Z, Liu F, Huang P, Xie W. The effect of online health information seeking on physician-patient relationships: systematic review. J Med Internet Res. 2022;24(2):e23354. doi: 10.2196/23354. https://www.jmir.org/2022/2/e23354 v24i2e23354 - DOI - PMC - PubMed
    1. Wald HS, Dube CE, Anthony DC. Untangling the web—the impact of internet use on health care and the physician-patient relationship. Patient Educ Couns. 2007;68(3):218–224. doi: 10.1016/j.pec.2007.05.016.S0738-3991(07)00221-2 - DOI - PubMed
    1. Ní Ríordáin R, McCreary C. Dental patients’ use of the internet. Br Dent J. 2009;207(12):583–586; 575. doi: 10.1038/sj.bdj.2009.1137. https://www.nature.com/articles/sj.bdj.2009.1137 sj.bdj.2009.1137 - DOI - PubMed
    1. Verploegen VJN, Schuller AA. Erosive tooth wear: knowledge among young adults and their preferred information sources. Int J Dent Hyg. 2019;17(1):85–92. doi: 10.1111/idh.12367. - DOI - PubMed