ONLINE INFORMATION ABOUT THE EFFECTIVENESS OF SHOULDER SURGERY IS NOT EVIDENCE-BASED: A CONTENT ANALYSIS.
Published on Jun 12, 2021in Archives of Physical Medicine and Rehabilitation3.966
· DOI :10.1016/J.APMR.2021.03.041
ABSTRACT null null Objective null : To summarise the proportion of consumer webpages on subacromial decompression and rotator cuff repair surgery that make an accurate portrayal of the evidence for these surgeries (primary outcome), mention the benefits and harms of surgery, outline alternatives to surgery, and make various surgical recommendations. null null null Design null Content analysis. null null null Setting null Online consumer information about subacromial decompression and rotator cuff repair surgery. Webpages were identified through ( 1 ) Google searches using terms synonymous with ‘shoulder pain’ and ‘shoulder surgery’, and searching ‘orthopaedic surgeon’ linked to each Australian capital city, and ( 2 ) websites of relevant professional associations (e.g. Australian Orthopaedic Association). Two reviewers independently identified webpages and extracted data. null null null Participants null N/A null null null Intervention null N/A null null null Main outcome measure null Whether the webpage made an accurate portrayal of the evidence for subacromial decompression or rotator cuff repair surgery (primary outcome), mentioned benefits and harms of surgery, outlined alternatives to surgery, and made various surgical recommendations (e.g. delay surgery). Outcome data were summarised using counts and percentages. null null null Results null 155 webpages were analysed (n=89 on subacromial decompression, n=90 on rotator cuff repair, n=24 on both). Only 18% (n=16) and 4% (n=4) of webpages made an accurate portrayal of the evidence for subacromial decompression and rotator cuff repair surgery, respectively. For subacromial decompression and rotator cuff repair, respectively, 85% (n=76) and 80% (n=72) of webpages mentioned benefits, 38% (n=34) and 47% (n=42) mentioned harms, 94% (n=84) and 92% (n=83) provided alternatives to surgery, and 63% (n=56) and 62% (n=56) recommended delayed surgery (the most common recommendation). null null null Conclusion null Most online information about subacromial decompression and rotator cuff repair surgery does not accurately portray the best available evidence for surgery and may be inadequate to inform patient decision-making.