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      Online Health Information Regarding Male Infertility: An Evaluation of Readability, Suitability, and Quality

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          Abstract

          Background

          Many men lack knowledge about male infertility, and this may have consequences for their reproductive and general health. Men may prefer to seek health information online, but these sources of information vary in quality.

          Objective

          The objective of this study is to determine if online sources of information regarding male infertility are readable, suitable, and of appropriate quality for Internet users in the general population.

          Methods

          This study used a cross-sectional design to evaluate online sources resulting from search engine queries. The following categories of websites were considered: (1) Canadian fertility clinics, (2) North American organizations related to fertility, and (3) the first 20 results of Google searches using the terms “male infertility” and “male fertility preservation” set to the search locations worldwide, English Canada, and French Canada. Websites that met inclusion criteria (N=85) were assessed using readability indices, the Suitability Assessment of Materials (SAM), and the DISCERN tool. The associations between website affiliation (government, university/medical, non-profit organization, commercial/corporate, private practice) and Google placement to readability, suitability, and quality were also examined.

          Results

          None of the sampled websites met recommended levels of readability. Across all websites, the mean SAM score for suitability was 45.37% (SD 11.21), or “adequate”, while the DISCERN mean score for quality was 43.19 (SD 10.46) or “fair”. Websites that placed higher in Google obtained a higher overall score for quality with an r (58) value of -.328 and a P value of .012, but this position was not related to readability or suitability. In addition, 20% of fertility clinic websites did not include fertility information for men.

          Conclusions

          There is a lack of high quality online sources of information on male fertility. Many websites target their information to women, or fail to meet established readability criteria for the general population. Since men may prefer to seek health information online, it is important that health care professionals develop high quality sources of information on male fertility for the general population.

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          Most cited references67

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          Crossing the Quality Chasm: A New Health System for the 21st Century

          B. Bloom (2002)
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            Fertility knowledge and beliefs about fertility treatment: findings from the International Fertility Decision-making Study.

            How good is fertility knowledge and what are treatment beliefs in an international sample of men and women currently trying to conceive?
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              Fertility of male survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

              This study was undertaken to determine the effect of treatment for childhood cancer on male fertility. We reviewed the fertility of male Childhood Cancer Survivor Study survivor and sibling cohorts who completed a questionnaire. We abstracted the chemotherapeutic agents administered, the cumulative dose of drug administered for selected drugs, and the doses and volumes of all radiation therapy from medical records. Risk factors for siring a pregnancy were evaluated using Cox proportional hazards models. The 6,224 survivors age 15 to 44 years who were not surgically sterile were less likely to sire a pregnancy than siblings (hazard ratio [HR], 0.56; 95% CI, -0.49 to 0.63). Among survivors, the HR of siring a pregnancy was decreased by radiation therapy of more than 7.5 Gy to the testes (HR, 0.12; 95% CI, -0.02 to 0.64), higher cumulative alkylating agent dose (AAD) score or treatment with cyclophosphamide (third tertile HR, 0.42; 95% CI, -0.31 to 0.57) or procarbazine (second tertile HR, 0.48; 95% CI, -0.26 to 0.87; third tertile HR, 0.17; 95% CI, -0.07 to 0.41). Compared with siblings, the HR for ever siring a pregnancy for survivors who had an AAD score = 0, a hypothalamic/pituitary radiation dose = 0 Gy, and a testes radiation dose = 0 Gy was 0.91 (95% CI, 0.73 to 1.14; P = .41). This large study identified risk factors for decreased fertility that may be used for counseling male cancer patients.
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                Author and article information

                Contributors
                Journal
                Interact J Med Res
                Interact J Med Res
                IJMR
                Interactive Journal of Medical Research
                JMIR Publications (Toronto, Canada )
                1929-073X
                Oct-Dec 2016
                21 October 2016
                : 5
                : 4
                : e25
                Affiliations
                [1] 1Jewish General Hospital Department of Psychiatry Montreal, QCCanada
                [2] 2Ingram School of Nursing McGill University Montreal, QCCanada
                [3] 3St.Mary's Research Centre Montreal, QCCanada
                [4] 4Lady Davis Institute for Medical Research Montreal, QCCanada
                [5] 5Department of Psychiatry McGill University Montreal, QCCanada
                Author notes
                Corresponding Author: Phyllis Zelkowitz phyllis.zelkowitz@ 123456mcgill.ca
                Author information
                http://orcid.org/0000-0001-6248-9209
                http://orcid.org/0000-0002-1478-0621
                http://orcid.org/0000-0001-8921-3931
                http://orcid.org/0000-0002-9202-9251
                http://orcid.org/0000-0002-1965-5731
                Article
                v5i4e25
                10.2196/ijmr.6440
                5097174
                27769954
                148676d3-e2f6-43b0-bf60-360e09a8bae9
                ©Stephanie Robins, Helena J Barr, Rachel Idelson, Sylvie Lambert, Phyllis Zelkowitz. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 21.10.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Interactive Journal of Medical Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.i-jmr.org/, as well as this copyright and license information must be included.

                History
                : 3 August 2016
                : 14 September 2016
                : 23 September 2016
                : 24 September 2016
                Categories
                Original Paper
                Original Paper

                male infertility,fertility preservation,internet,online health information,men’s health

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