Year 2024 / Volume 31 / Number 2

EJP article

Credibility, readability and content analysis of treatment recommendations for adolescents with nonspecific back pain published on consumer websites

Rev. Soc. Esp. Dolor. 2024; 31(2): 121-135

S. D. Hauber, K. Robinson, R. Fechner, J. W. Pate, K. O'Sullivan


ABSTRACT

Background: Parents may seek out health information online when their adolescent has nonspecific back pain to better understand treatment options. Such information directed towards consumers has not been previously analysed.
Methods: A descriptive cross-sectional content analysis was performed to describe the treatments recommended on consumer websites for nonspecific back pain in adolescents. The credibility and readability of the websites were also assessed. Systematic Google searches were completed in five countries, and relevant content from eligible web pages was analysed. An a priori codebook with 34 treatment-related codes was developed. Nine additional codes were inductively created during analysis. Credibility was assessed using the JAMA benchmark. Readability was assessed via the Flesch Kincaid Grade Level.
Results: Of 245 web pages, 48 were deemed eligible and analysed. Of 43 treatment codes, 37 were present in at least one web page. The five most frequently identified codes were See the doctor/get a diagnosis (found on 85 % of web pages), Ergonomics/posture/biomechanics (52 %), Reassurance (48 %), Physiotherapy (48 %) and Non-prescription pharmaceuticals/supplements (46 %). Only 21 % of the web pages met all four JAMA benchmark criteria, and 15 % cited at least one recent or high-quality source. The median Flesch Kincaid Grade Level score was 9.0 (range 3.5-12.9).
Conclusions: Parents of adolescents with nonspecific back pain may find that treatment recommendations published online are numerous and varied, with visits to the doctor encouraged. The credibility scores of these web pages are generally low, while the median reading level may be too high for the general population.
Significance Statement: This analysis reveals that public-facing websites with recommendations for treating adolescent nonspecific back pain do not cite the most recent, high-quality research. Although web pages correctly encourage physical activity and exercise over surgery and prescription medications, they do not reflect the psychologically informed or interdisciplinary care emphasized in recently published treatment recommendations. Clinicians must be aware that caregivers of their adolescent patients with nonspecific back pain may be exposed to online messages that encourage them to keep seeking a diagnosis.



RESUMEN

Antecedentes: Los padres pueden buscar información en internet sobre temas de salud cuando sus hijos sufren dolores de espalda inespecíficos, y así conocer mejor las opciones de tratamiento. Hasta ahora no se había analizado este tipo de información dirigida a los consumidores.
Métodos: Se realizó un análisis de contenido descriptivo transversal para describir los tratamientos recomendados en páginas web de consumidores para el dolor de espalda inespecífico en adolescentes. También se evaluó la credibilidad y legibilidad de los sitios web. Se realizaron búsquedas sistemáticas en Google en cinco países y se analizó el contenido relevante de las páginas web seleccionadas. Se elaboró un libro de códigos a priori con 34 códigos relacionados con el tratamiento. Durante el análisis se crearon inductivamente nueve códigos adicionales. La credibilidad se evaluó tomando como referencia la revista JAMA. La legibilidad se evaluó mediante la prueba de Flesch-Kincaid.
Resultados: De 245 páginas web, 48 se consideraron aptas y se analizaron. De los 43 códigos de tratamiento, 37 estaban presentes en al menos una página web. Los cinco códigos identificados con mayor frecuencia fueron: Consulte a su médico/obtenga un diagnóstico (en el 85 % de las páginas web), Ergonomía/postura/biomecánica (52 %), Tranquilidad (48 %), Fisioterapia (48 %) y Fármacos/suplementos sin receta (46 %). Solo el 21 % de las páginas web cumplían los cuatro criterios de referencia JAMA, y el 15 % citaban al menos una fuente reciente o de alta credibilidad. La puntuación media de la prueba de Flesch Kincaid fue de 9,0 (rango 3,5-12,9).
Conclusiones: Los padres de adolescentes con dolores de espalda inespecíficos pueden encontrar en internet un gran número y variedad de recomendaciones de tratamiento, con recomendaciones de acudir al médico. Las puntuaciones de credibilidad de estas páginas web suelen ser bajas, mientras que el nivel medio de lectura puede ser demasiado alto para la población general.
Declaración de importancia: Este análisis revela que las páginas web de acceso público con recomendaciones para tratar el dolor de espalda inespecífico en adolescentes no citan las investigaciones más recientes y de mayor calidad. Aunque las páginas web fomentan correctamente la actividad física y el ejercicio por delante de la cirugía y la medicación con receta, no reflejan la atención psicológicamente informada o interdisciplinaria que se destaca en las recomendaciones de tratamiento publicadas recientemente. Los médicos deben ser conscientes de que los padres de sus pacientes adolescentes con dolor de espalda inespecífico pueden estar expuestos a mensajes en internet que les alienten a seguir buscando un diagnóstico.





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Hauber S, Robinson K, Fechner R, Pate J, O'Sullivan K. Credibility, readability and content analysis of treatment recommendations for adolescents with nonspecific back pain published on consumer websites . Rev Soc Esp Dolor 2024; 31(2): 121-135


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