Assessing the Quality of Online Patient Decision Aids for Urological Conditions

Introduction: A growing number of patients use online patient decision aids (PtDAs) due to their easy accessibility. However, PtDAs found on the internet are not regulated and vary in quality and readability. The aim of this study is to assess urological PtDAs for their readability, quality as consumer health information and quality as decision aid.

Methods: Searches were conducted on Google, PubMed®, Embase® and decision aid repositories for patient decision aids on pelvic organ prolapse, urinary incontinence, benign prostatic hyperplasia and overactive bladder. The decision aids were screened for relevance and patient directed nature. They were then evaluated using 4 readability formulas, the validated DISCERN quality criteria and the International Patient Decision Aids Standards v4.0 minimum standards criteria.

Results: Our search revealed 23 patient decision aids, of which 14 were ultimately included for analysis. The mean grade level readability score calculated by the 4 readability formulas was 11, far exceeding the 6th grade reading level recommended by the National Institutes of Health. The average DISCERN score was 57.6 (SD 6.7), which indicates "good" quality as online health information. The average International Patient Decision Aids Standards v4.0 minimum standards criteria score was 8.3 (SD 1.5), with none meeting all 12 minimum requirements of a patient decision aid.

Conclusions: Online patient decision aids for pelvic organ prolapse, urinary incontinence, benign prostatic hyperplasia and overactive bladder require a higher reading level than recommended by the National Institutes of Health. While decision aids are acceptable as online health information, none meets all 12 international standards for patient decision aids.