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      Quantifying the Quality of Web-Based Health Information on Student Health Center Websites Using a Software Tool: Design and Development Study

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          Abstract

          Background

          The internet has become a major source of health information, especially for adolescents and young adults. Unfortunately, inaccurate, incomplete, or outdated health information is widespread on the web. Often adolescents and young adults turn to authoritative websites such as the student health center (SHC) website of the university they attend to obtain reliable health information. Although most on-campus SHC clinics comply with the American College Health Association standards, their websites are not subject to any standards or code of conduct. In the absence of quality standards or guidelines, monitoring and compliance processes do not exist for SHC websites. Thus, there is no oversight of the health information published on SHC websites by any central governing body.

          Objective

          The aim of this study is to develop, describe, and validate an open-source software that can effectively and efficiently assess the quality of health information on SHC websites in the United States.

          Methods

          Our cross-functional team designed and developed an open-source software, QMOHI (Quantitative Measures of Online Health Information), that assesses information quality for a specified health topic from all SHC websites belonging to a predetermined list of universities. The tool was designed to compute 8 different quality metrics that quantify various aspects of information quality based on the retrieved text. We conducted and reported results from 3 experiments that assessed the QMOHI tool in terms of its scalability, generalizability in health topics, and robustness to changes in universities’ website structure.

          Results

          Empirical evaluation has shown the QMOHI tool to be highly scalable and substantially more efficient than manually assessing web-based information quality. The tool’s runtime was dominated by network-related tasks (98%), whereas the metric computations take <2 seconds. QMOHI demonstrated topical versatility, evaluating SHC website information quality for four disparate and broad health topics (COVID, cancer, long-acting reversible contraceptives, and condoms) and two narrowly focused topics (hormonal intrauterine device and copper intrauterine device). The tool exhibited robustness, correctly measuring information quality despite changes in SHC website structure. QMOHI can support longitudinal studies by being robust to such website changes.

          Conclusions

          QMOHI allows public health researchers and practitioners to conduct large-scale studies of SHC websites that were previously too time- and cost-intensive. The capability to generalize broadly or focus narrowly allows a wide range of applications of QMOHI, allowing researchers to study both mainstream and underexplored health topics. QMOHI’s ability to robustly analyze SHC websites periodically promotes longitudinal investigations and allows QMOHI to be used as a monitoring tool. QMOHI serves as a launching pad for our future work that aims to develop a broadly applicable public health tool for web-based health information studies with potential applications far beyond SHC websites.

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          Most cited references46

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          The framing of decisions and the psychology of choice

          The psychological principles that govern the perception of decision problems and the evaluation of probabilities and outcomes produce predictable shifts of preference when the same problem is framed in different ways. Reversals of preference are demonstrated in choices regarding monetary outcomes, both hypothetical and real, and in questions pertaining to the loss of human lives. The effects of frames on preferences are compared to the effects of perspectives on perceptual appearance. The dependence of preferences on the formulation of decision problems is a significant concern for the theory of rational choice.
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            DISCERN: an instrument for judging the quality of written consumer health information on treatment choices.

            To develop a short instrument, called DISCERN, which will enable patients and information providers to judge the quality of written information about treatment choices. DISCERN will also facilitate the production of new, high quality, evidence-based consumer health information. An expert panel, representing a range of expertise in consumer health information, generated criteria from a random sample of information for three medical conditions with varying degrees of evidence: myocardial infarction, endometriosis, and chronic fatigue syndrome. A graft instrument, based on this analysis, was tested by the panel on a random sample of new material for the same three conditions. The panel re-drafted the instrument to take account of the results of the test. The DISCERN instrument was finally tested by a national sample of 15 information providers and 13 self help group members on a random sample of leaflets from 19 major national self help organisations. Participants also completed an 8 item questionnaire concerning the face and content validity of the instrument. Chance corrected agreement (weighted kappa) for the overall quality rating was kappa = 0.53 (95% CI kappa = 0.48 to kappa = 0.59) among the expert panel, kappa = 0.40 (95% CI kappa = 0.36 to kappa = 0.43) among information providers, and kappa = 0.23 (95% CI kappa = 0.19 to kappa = 0.27) among self help group members. Higher agreement levels were associated with experience of using the instrument and with professional knowledge of consumer health information. Levels of agreement varied across individual items on the instrument, reflecting the need for subjectivity in rating certain criteria. The trends in levels of agreement were similar among all groups. The final instrument consisted of 15 questions plus an overall quality rating. Responses to the questionnaire after the final testing revealed the instrument to have good face and content validity and to be generally applicable. DISCERN is a reliable and valid instrument for judging the quality of written consumer health information. While some subjectivity is required for rating certain criteria, the findings demonstrate that the instrument can be applied by experienced users and providers of health information to discriminate between publications of high and low quality. The instrument will also be of benefit to patients, though its use will be improved by training.
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                Author and article information

                Contributors
                Journal
                JMIR Form Res
                JMIR Form Res
                JFR
                JMIR Formative Research
                JMIR Publications (Toronto, Canada )
                2561-326X
                February 2022
                2 February 2022
                : 6
                : 2
                : e32360
                Affiliations
                [1 ] Department of Computer Science San Francisco State University San Francisco, CA United States
                [2 ] School of Nursing San Francisco State University San Francisco, CA United States
                [3 ] Department of Economics San Francisco State University San Francisco, CA United States
                [4 ] Department of English Language and Literature San Francisco State University San Francisco, CA United States
                Author notes
                Corresponding Author: Anagha Kulkarni ak@ 123456sfsu.edu
                Author information
                https://orcid.org/0000-0002-1442-9153
                https://orcid.org/0000-0002-9013-1041
                https://orcid.org/0000-0003-3021-4408
                https://orcid.org/0000-0001-6680-1239
                https://orcid.org/0000-0001-7342-9893
                https://orcid.org/0000-0002-3651-3188
                https://orcid.org/0000-0002-5061-7637
                https://orcid.org/0000-0001-9881-2004
                https://orcid.org/0000-0003-4557-7156
                https://orcid.org/0000-0003-3640-2688
                Article
                v6i2e32360
                10.2196/32360
                8851325
                35107423
                8d53f95d-86c0-489b-bcff-11d4fc95f5b2
                ©Anagha Kulkarni, Mike Wong, Tejasvi Belsare, Risha Shah, Diana Yu Yu, Bera Coskun, Carrie Holschuh, Venoo Kakar, Sepideh Modrek, Anastasia Smirnova. Originally published in JMIR Formative Research (https://formative.jmir.org), 02.02.2022.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.

                History
                : 24 July 2021
                : 19 September 2021
                : 29 October 2021
                : 28 November 2021
                Categories
                Original Paper
                Original Paper

                online health information quality,information quality metrics,automated quantification tool,student health center websites,digital health,health information,health information websites,adolescents,online health,infodemiology,public health,health websites

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