Evidence map›Paper›PMID 28842989›Full record

ArticleThe Laryngoscope2018

Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement.

Vandra C Harris, Anne R Links, Paul Hong, Jonathan Walsh, Desi P Schoo, David E Tunkel, Charles M Stewart, Emily F Boss

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Laryngoscope, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed.

  1. Article
  2. Postoperative management of pediatric tympanostomy tubes: a Yo-IFOS consensus.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Article
  3. Assessing the understandability and actionability of online resources for patients undergoing hemodialysis.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2025
    Article
  4. Article
  5. Article
  6. A critical readability and quality analysis of internet-based patient information on neck dissections.World journal of otorhinolaryngology - head and neck surgery · 2023
    Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Readability and quality assessment of internet-based patient education materials related to nasal septoplasty.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2021
    Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Vandra C HarrisDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.ORCID 0000-0001-8741-756X
Anne R LinksDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
Paul HongDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.ORCID 0000-0002-8766-3266
Jonathan WalshDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
Desi P SchooDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
David E TunkelDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
Charles M StewartDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.
Emily F BossDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.

Funding

RESEARCH TRAINING IN OTOLARYNGOLOGYT32DC000027 · NIDCD · JOHNS HOPKINS UNIVERSITY · PI CAREY, JOHN PATRICK · 1989 to 2023
$5.5M
Shared Decision-Making and Outcomes in Pediatric Sleep-Disordered BreathingK08HS022932 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI BOSS, EMILY FRANCES · 2014 to 2018
$787k
AHRQ HHS K08 HS022932NIDCD NIH HHS T32 DC000027
6 · The paper itself

Abstract

objectiveTympanostomy tube (TT) placement is common in children; however, family-centeredness and utility of online information used for decision making and understanding is unknown. We evaluate the quality of leading Internet resources describing TT placement. STUDY

designCross-sectional descriptive design.

methodsWe performed a Google (Menlo Park, CA) search for terms related to TTs. We defined quality using scaled readability measures (Flesch Reading Ease and Flesch-Kincaid Grade-Level), understandability and actionability (Patient Education Materials Assessment Tool), shared decision-making centrality (Center for Medicare and Medicaid Services informed consent guidelines), and clinical practice guideline (CPG) compatibility. Three reviewers coded each measure. Fleiss κ interrater reliability analysis was performed.

resultsTen most frequently encountered websites were analyzed. One of 10 met national health literacy standards (mean 10th-grade level reading, median 9th, range 6-15th). All sites were understandable (mean understandability 81.9%, range 73%-92%). Most had low actionability scores (7 of 10, median 47%, mean 44.6%, range 0-80). Shared decision-making centrality was high (mean 5, range 4-6), but most did not list alternative treatment options. Although CPG compatibility was high (mean 3.4, range 1-4), many websites contained inconsistent recommendations about tube duration, follow-up, and water precautions. There was inter-rater agreement for understandability scoring (κ = 0.20; P = 0.02).

conclusionInternet resources about TT placement vary in quality pertaining to health literacy, principles of shared decision making, and consistency with practice guidelines. With growing emphasis on patient-/family-centered engagement in healthcare decision making, standardization of content and improved usability of educational materials for common surgical procedures in children such as tympanostomy tube placement should be a public health priority. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:496-501, 2018.

Indexed as

Middle Ear VentilationSearch EngineChildComprehensionConsumer Health InformationHealth LiteracyHumansInternetPatient Education as TopicReadingTeaching Materialsactionabilityclinical practice guidelineshealth literacyInternetpatient educationpatient education materialsPatient Education Materials Evaluation Tool (PEMAT)quality improvementreadabilityreadability formulaShared decision makingtympanostomy tubesunderstandability

Identifiers

PMID28842989
PMCPMC5771888

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.