J Shoulder Elbow Surg. 2023 May 30. pii: S1058-2746(23)00416-0. [Epub ahead of print]
BACKGROUND: Patients undergoing rotator cuff surgery often search the internet for information regarding the procedure. One popular source, Google, compiles frequently asked questions and links to websites that may provide answers. This study provides an analysis of the most frequently searched questions associated with rotator cuff surgery. We hypothesize that there are distinct search patterns associated with online queries about rotator cuff surgery that could provide unique insights into patient concerns.METHODS: A set of search terms were entered into Google Web Search using a clean-install Google Chrome browser. Frequently associated questions and their webpages were extracted to a database via a data mining extension. Questions were categorized by topics relevant for rotator cuff arthroscopy. Websites were categorized by source and scored for quality utilizing JAMA Benchmark criteria. Pearson's chi-squared tests were used to analyze nominal data. Student t-tests were performed to compare JAMA Benchmark Scores.
RESULTS: Of the 595 questions generated from the initial search, 372 unique questions associated with 293 websites were extracted and categorized. The most popular question topics were Activities/Restrictions (20.7%), Pain (18.8%), and Indications/Management (13.2%). The two most common websites searched were Academic (35.2%) and Medical Practice (27.4%). Commercial websites were significantly more likely to be associated with questions about cost (57.1% of all Cost questions, P = 0.01), Anatomy/Function (62.5%, P = 0.001), and Evaluation of Surgery (47.6%, P < 0.001). Academic websites were more likely to be associated with questions about Technical Details of Surgery (58.1%, P < 0.001). Medical Practice and Social Media websites were more likely associated with activities/restrictions (48.1%, P < 0.001, and 15.6%, P < 0.001, respectively). Government websites were more likely associated with timeline of recovery (12.8%, P = 0.01). On a scale of 0-4, Commercial and Academic websites had the highest JAMA scores (3.06 and 2.39, respectively).
CONCLUSION: Patients seeking information regarding rotator cuff repair primarily utilize the Google search engine to ask questions regarding postoperative activity and restrictions, followed by pain, indications, and management. Academic websites, which were associated with technical details of surgery, and medical practice websites, which were associated with activities/restrictions, were the two most commonly searched resources. These results emphasize the need for orthopedic surgeons to provide detailed and informative instructions to patients undergoing rotator cuff repair, especially in the postoperative setting.
Keywords: health literacy; machine learning; online health information; patient education; rotator cuff repair; shoulder arthroscopy