bims-librar 2025-11-09 papers

bims-librar

Biomed News

on Biomedical librarianship

Issue of 2025–11–09
34 papers selected by
Thomas Krichel, Open Library Society

Exploring clinician expectations and preferences of library subject guides.
Digitising health history: The creation, function and implementation of the Norwegian Health Archives Registry.
OmixLitMiner 2: Guided Literature Mining for Automated Categorization of Marker Candidates in Omics Studies.
AI-powered knowledge organization: a next-generation approach to library classification using DeepSeek-R1.
Evaluation of appropriateness and readability of responses of large language models (ChatGPT-4o, Gemini, DeepSeek and Copilot) to frequently asked questions about congenital nasolacrimal duct obstruction.
Artificial intelligence meets medical rarity: evaluating ChatGPT's responses on post-orgasmic illness syndrome.
ChatGPT in general surgery: a cross-sectional study assessing its response to patient questions.
Readability, linguistic complexity, and stigma in ChatGPT responses to opioid use disorder FAQs: A comparative analysis.
Appraisal of ChatGPT's responses to common patient questions regarding acromioclavicular joint dislocations.
Comment on "Readability, understandability, and quality of online education materials and large language models for retrograde cricopharyngeal muscle dysfunction".
Misinformation in YouTube Videos About Chiropractic Treatment for Otitis Media.
Systemic Evaluation of Quality, Readability, and Integrity of Online Breast Reconstruction Resources.
Evaluating the Readability and Understandability of Online Patient Materials Regarding Balloon Sinuplasty.
A Critical Assessment of the Readability and Ethnic Inclusivity of Online Patient Materials for Microtia.
Analysis of the Quality of Stuttering Content on Douyin in China.
Vitiligo Content on Google: A Cross-Sectional Analysis Assessing Readability, Quality, and Timeliness.
Corrigendum to "Readability, Understandability, and Quality of Online Education Materials for Vocal Fold Nodules" [J Voice, Vol. 34, Issue 2 (2020), Pages 302.e15-302.e20].
Letter to the editor regarding YouTube as a Source of Patient Education in Medulloblastoma: How Reliable is It?
In Reply to the Letter to the Editor Regarding "YouTube as a Source of Patient Education in Medulloblastoma: How Reliable Is It?"
ERRATUM: Quality and reliability of YouTube videos on fascial sling surgery.
A Content Analysis of Health-Related Epigenetic Information in YouTube Videos.
Didactic and Content Quality of Basic Life Support Videos on YouTube: Cross-Sectional Study.
The state of online information about Platelet-rich plasma (PRP): what are patients asking and what are their sources of information?
Assessment of information quality and reliability of short videos related to lumbar disc herniation on selected video platforms.
Quality Analysis of Stroke-Related Videos on Video Platforms: Cross-Sectional Study.
The quality and content of gonorrhea-related short videos on TikTok: A cross-sectional study.
Reliability, quality, and science popularization of diabetes knowledge information in China video sharing platform: A cross-sectional study.
Health Information Behavior in Parents of Children With Congenital Heart Disease in China: Qualitative Study Through the Lens of Chinese Culture.
Is Online Health Information a Threat?-Untangling the Longitudinal Associations Among Health Information Scanning, Seeking, and Risk Perceptions.
Trajectories and Influencing Factors of Online Health Information-Seeking Behaviors Among Community-Dwelling Older Adults: Longitudinal Mixed Methods Study.
Exploring generational and educational disparities in online health information seeking in China: The moderating role of internet use.
Associations Between Online Search Trends and Outpatient Visits for Common Medical Symptoms in the United States from 2004 to 2019: Time Series Ecological Study.
Digital information-seeking behaviors among cancer survivors: associations with sociodemographic determinants, cancer history, and perceived health.
Factors associated with internet use to obtain oral health-related information.

Med Ref Serv Q. 2025 Nov 03. 1-20

Exploring clinician expectations and preferences of library subject guides.

Anna Biszaha.

  Using semi-structured interviews, this study aimed to qualitatively explore the expectations and preferences of clinical users when engaging with library subject guides. Participants were generally unaware that subject guides existed but showed some preference toward guides that were quick and easy to use and provided independent learning materials, as well as resource access and guidance. Barriers to use in clinical practice included time, awareness, and issues of guide design and cognitive load. The results of this study will help inform the development of customized subject guides targeting this special population.

Keywords:  Health sciences libraries; clinical users; library guides; qualitative research; user research

DOI:  https://doi.org/10.1080/02763869.2025.2573359
Health Inf Manag. 2025 Nov 07. 18333583251389095

Digitising health history: The creation, function and implementation of the Norwegian Health Archives Registry.

Gina Helstad, Pierre Lison, Elin Tuveng, Kari Nytrøen.

   CONTEXT: The Norwegian Health Archives Registry (NHAR) is a national initiative dedicated to digitising, centralising, and providing access to historical full-text patient health records (PHRs) for research purposes. Established in 2019, NHAR includes PHRs from the deceased population in Norway's specialist healthcare services, offering a unique long-term data source for future research. NHAR has now digitised 1.7 million paper-based PHRs, covering medical history dating back to 1875. The registry is now expanding to include digital-born PHRs.
AIM: This article describes NHAR's innovation potential as a health registry, its data management processes, and the integration of artificial intelligence (AI) tools to facilitate data management and research in compliance with strict health data regulations.
PRACTICE INNOVATION: NHAR's data value chain includes structured metadata acquisition, large-scale digitisation and secure data delivery for research. The workflow includes a custom optical character recognition (OCR) tool tailored to Norwegian medical terminology, concept-based search tools for unstructured clinical full text and robust strategies for long-term data management. A novel AI-based de-identification system automatically detects and masks personal identifiers in digitised PHRs.
LESSONS LEARNED: Despite these innovations, challenges persist in processing handwritten and historical PHRs due to OCR limitations and language-specific complexities. Key challenges include improving data quality, enhancing OCR accuracy and refining AI tools for information retrieval, data extraction and de-identification.
CONCLUSION: NHAR offers significant potential for interdisciplinary research across various medical fields.Implications for health information management practice:NHAR establishes a foundation for secure access to historical health data and introduces advanced data management strategies to facilitate future research.

Keywords:  computerised health records; data protection; health information management; health policy; medical records systems; personal artificial intelligence; privacy; registries; retrospective studies

DOI:  https://doi.org/10.1177/18333583251389095
Proteomics. 2025 Nov 02. e70070

OmixLitMiner 2: Guided Literature Mining for Automated Categorization of Marker Candidates in Omics Studies.

Antonia Gocke, Bente Siebels, Jelena Navolić, Carla Reinbold, Julia E Neumann, Stefan Kurtz, Hartmut Schlüter.

  Omics analyses are crucial for understanding molecular mechanisms in biological research. The vast quantity of detected biomolecules presents a significant challenge in identifying potential biomarkers. Traditional methods rely on labor-intensive literature mining to extract meaningful insights from long lists of regulated candidates of biomolecules. To address this, we developed OmixLitMiner 2 (OLM2) to improve the efficiency of omics data interpretation, speed up the validation of results and accelerate further evaluation based on the selection of marker candidates for subsequent experiments. The updated tool utilizes UniProt for synonym and protein name retrieval and employs the PubMed database as well as PubTator 3.0 for searching titles or abstracts of available biomedical literature. It allows for advanced keyword-based searches and provides classification of proteins or genes with respect to their representation in the literature in relation to scientific questions. OLM2 offers improved functionality over the previous version and comes with a user-friendly Google Colab interface. In comparison to the previous version, OLM2 improves the retrieval of relevant publications and the classification of biomolecules. We use a case study of spatially resolved proteomic data from the mouse brain cortex to demonstrate that the tool significantly reduces the time compared to manual searches and enhances the interpretability of molecular analysis.

Keywords:  OmixLitMiner; PubTator3.0; literature mining; proteomics; transcriptomics

DOI:  https://doi.org/10.1002/pmic.70070
Sci Rep. 2025 Nov 03. 15(1): 38394

AI-powered knowledge organization: a next-generation approach to library classification using DeepSeek-R1.

Na Feng.

  With the advancement of information technology, libraries have shifted from traditional physical services to an integrated "offline + online" model, becoming digital hubs in the national public cultural service system. However, current book classification still relies primarily on manual efforts, which suffers from inefficiency and inconsistent standards, making it difficult to meet the growing demand for processing massive volumes of books. Leveraging the latest developments in artificial intelligence, this paper proposes an automatic book classification algorithm based on the DeepSeek-R1-Distill model to improve classification accuracy and efficiency. Experimental results demonstrate that the algorithm achieves an average F1-score of over 87% in a 21-category Chinese book classification task, validating its effectiveness. Future work could explore the integration of more advanced large language models and domain-adaptive pre-training strategies to further advance classification capabilities. This research contributes a novel technical pathway toward intelligent book classification and underscores the significant potential of large language models in library and information science, offering both theoretical insights and practical value for the evolution of next-generation knowledge organization systems.

Keywords:  Book classification; DeepSeek-R1-Distill model; Domain-adaptive pre-training; Large language models

DOI:  https://doi.org/10.1038/s41598-025-22272-z
J Fr Ophtalmol. 2025 Oct 31. pii: S0181-5512(25)00260-8. [Epub ahead of print]48(10): 104678

Evaluation of appropriateness and readability of responses of large language models (ChatGPT-4o, Gemini, DeepSeek and Copilot) to frequently asked questions about congenital nasolacrimal duct obstruction.

M M Sönmez, E E Baydemir, E S Elibol.

   PURPOSE: To compare the appropriateness and readability of responses generated by four different large language models (LLMs) to frequently asked questions about congenital nasolacrimal duct obstruction (CNLDO).
METHODS: Twenty-five frequently asked questions (FAQs) related to CNLDO were answered by four LLMs: ChatGPT-4o, Gemini, DeepSeek, and Microsoft Copilot. Two experienced oculoplastic surgeons evaluated the responses for appropriateness and comprehensiveness using a Likert scale. In addition, the readability of the responses was assessed using an online readability tool.
RESULTS: ChatGPT-4o demonstrated significantly higher accuracy in the treatment and management category (P=0.001). Overall, DeepSeek provided the most appropriate responses across all categories (P=0.001). While DeepSeek achieved the highest total Likert scores, the differences among the models were not statistically significant (P=0.2). In terms of readability, Gemini and Copilot produced more readable texts, whereas DeepSeek's responses were more complex and structured.
CONCLUSIONS: DeepSeek showed superior performance in appropriateness and comprehensiveness across all questions related to CNLDO. However, its responses were less readable compared to those of the other LLMs, which may limit accessibility for some users.

Keywords:  ChatGPT-4o; Chatbots; Congenital nasolacrimal duct obstruction; Copilot; DeepSeek; Gemini; Obstruction congénitale du canal nasolacrymal

DOI:  https://doi.org/10.1016/j.jfo.2025.104678
Int J Impot Res. 2025 Nov 05.

Artificial intelligence meets medical rarity: evaluating ChatGPT's responses on post-orgasmic illness syndrome.

Doğukan Sökmen, Ahmet Tevfik Albayrak, Zülfü Sertkaya, Yaşar Başağa, Ege Can Serefoglu.

Post-Orgasmic Illness Syndrome (POIS) is a rare and debilitating condition characterized by systemic and cognitive symptoms following ejaculation. As patients increasingly seek health information from artificial intelligence (AI) tools such as ChatGPT, evaluating the accuracy, consistency, and readability of these responses is especially important in the context of underrecognized conditions like POIS, where patients often encounter limited access to specialist care and evidence-based educational resources. This makes generative AI a likely source of health information, underscoring the need to evaluate the accuracy, consistency, and readability of its outputs. This study assessed the performance of ChatGPT version 4o (ChatGPT-4o) in generating patient-directed responses to POIS-related questions. Sixteen real-world questions were selected across four content domains: epidemiology, treatment, treatment risks, and counseling. Each question was submitted to ChatGPT-4o on two different days using separate accounts. Responses were independently graded by three English-speaking urologists with expertise in men's sexual health and andrology using a validated 4-point scale: "correct and comprehensive," "correct but inadequate," "mixed correct and incorrect," and "completely incorrect." Reproducibility was defined by whether the two responses received the same grading category, and Cohen's kappa coefficient (κ) was calculated to measure inter-rater agreement. Readability was assessed using the Gunning Fog Index (GFI). ChatGPT-4o demonstrated high performance in the epidemiology and counseling domains, achieving 100% accuracy and 100% reproducibility (κ = 1.00). However, accuracy dropped to 50% in the treatment and risk domains, with lower reproducibility (κ = 0.25). Readability scores worsened significantly from Day 1 to Day 2 across all domains (p < 0.05), indicating a shift toward more linguistically complex, less accessible language. While ChatGPT-4o shows potential in supporting patient education for rare conditions like POIS, its variability in treatment content and elevated language complexity limit its reliability as a stand-alone medical resource. These findings underscore the need for expert oversight and further model refinement before large language models can be safely integrated into clinical patient communication.

DOI: https://doi.org/10.1038/s41443-025-01200-9
Ann Med Surg (Lond). 2025 Nov;87(11): 7044-7050

ChatGPT in general surgery: a cross-sectional study assessing its response to patient questions.

Sebastian Lünse, Eric L Wisotzky, Johannes Höhn, Christoph Paasch, Frank Meyer, Richard Hunger, René Mantke.

   Background: The artificial intelligence-based large language model ChatGPT (OpenAI, San Francisco/CA, USA) has taken human-machine interaction to the next level since its launch in November 2022. As a program that mimics human conversations over a text-based communication interface, ChatGPT has the potential to be used in a variety of healthcare settings, including patient information. The present study aimed to assess the abilities of ChatGPT in responding to patient questions regarding general surgery.
Methods: A questionnaire-based cross-sectional study, comprising a total of 30 commonly asked questions by patients about appendicitis, cholecystitis, and inguinal hernia repair, were submitted to ChatGPT (version 3.5) on April 23, 2024. The responses were assessed by experienced surgeons from three German university hospitals using a modified global quality scale (GQS), which comprises a 5-point scale ranging from 1 ("very poor") to 5 ("excellent"). Readability was assessed by using the Flesch Kincaid Reading Ease (FKRE) score and Simple Measure of Gobbledygook (SMOG).
Results: The study included 15 participating surgeons. The mean GQS score for ChatGPT-generated responses to patient questions was 4.2 ± 0.88 (mean ± standard deviation), reflecting good quality. The mean FKRE score was 24.3 ± 7.35 and the mean SMOG score was 13.9 ± 1.22, indicating a difficult to very difficult reading level best suited for university graduates. The majority of participating surgeons (n = 9, 60%) indicated that they would use ChatGPT after appropriate further development.
Conclusion: The artificial intelligence-based large language model ChatGPT has enormous potential to become a useful tool for providing information to patients about general surgery. However, when carefully considering its limitations, such as low readability for general audience and nonevidence-based sources of information, there must be improvements before future implementation in surgery-related patient interactions.

Keywords:  ChatGPT; artificial intelligence; cross-sectional study; healthcare documentation; natural language processing; surgical reports

DOI:  https://doi.org/10.1097/MS9.0000000000003939
Am J Addict. 2025 Nov 04.

Readability, linguistic complexity, and stigma in ChatGPT responses to opioid use disorder FAQs: A comparative analysis.

Vitor M Campos, Daniel L Heringer, Gabriel P A Costa, Henrique N P Oliva, Akhil Anand.

BACKGROUND AND OBJECTIVES: AI chatbots are increasingly used in patient education. For opioid use disorder (OUD), content must be readable and non-stigmatizing. We compared ChatGPT responses with U.S. health organization FAQs on readability, complexity, and stigma.
METHODS: We analyzed 50 OUD FAQs paired with ChatGPT GPT-4o responses. Outcomes included word and sentence counts, lexical density, and six readability indices. Paired differences were tested with t tests or Wilcoxon signed-rank tests.
RESULTS: ChatGPT responses were longer than FAQs, with a mean word count of 253.7 vs. 76.6 (difference 177; 95% CI, 151-203) and sentence count of 18.2 vs. 9.0 (difference 9.2; 95% CI, 7.6-10.9). Lexical density was higher by 6.5 percentage points (95% CI, 4.0-9.0), with more characters (0.55; 95% CI, 0.40-0.70) and syllables per word (0.19; IQR, 0.14-0.24). Readability grade levels were consistently higher: Coleman-Liau +3.43, Gunning Fog +3.47, SMOG + 2.96, Flesch-Kincaid +3.61, Automated Readability Index +4.33, and Flesch Reading Ease -20.4 (all p < .05). Stigmatizing term frequency was similar, 0.98 vs. 0.28 per answer (95% CI, -1.3 to +3.3).
DISCUSSION: ChatGPT responses were longer and more complex than FAQs, although the frequency of stigmatizing language was similar.
CONCLUSIONS: ChatGPT produced more comprehensive but less readable content than FAQs, revealing a gap with health literacy standards. While stigmatizing terms were uncommon unless simplified, length and complexity may hinder use.
SCIENTIFIC SIGNIFICANCE: Findings quantify readability and stigma trade-offs in AI-generated OUD education and emphasize the need for plain language prompting and human review.

DOI: https://doi.org/10.1111/ajad.70101
JSES Rev Rep Tech. 2025 Nov;5(4): 616-620

Appraisal of ChatGPT's responses to common patient questions regarding acromioclavicular joint dislocations.

Eduard Van Eecke, Wouter Schroven, Maxim Vanderstappen, Simran Grewal, Michel P J van den Bekerom.

   Background: ChatGPT, an expanding artificial intelligence platform, is rapidly becoming a source of medical knowledge for patients. The purpose of this study is to evaluate the quality and readability of information provided by ChatGPT 4.0 in response to the most frequently asked patients' questions regarding acromioclavicular (AC) joint dislocations.
Methods: Twenty-five frequently asked patient questions regarding AC joint dislocations were posed to ChatGPT 4.0. The quality and accuracy of the responses was graded by two fellowship-trained shoulder surgeons using a 5-point Likert scale. Responses were analyzed for readability using six established metrics.
Results: ChatGPT provided responses to 25 frequently asked questions, with consensus reached on 12 questions. The final average score was 4/5, reflecting good quality with minor inaccuracies. Treatment-related questions scored lower compared to other categories, with a significant difference observed between treatment and rehabilitation (P = .025). Cohen's kappa indicated poor correlation (0.085), though the percent agreement was 48%, increasing to 100% when allowing for a 1-point difference. Readability scores revealed moderate difficulty levels, suitable for a high school-level audience.
Conclusion: ChatGPT delivers accurate and easily comprehensible information on AC joint dislocations, highlighting its potential to improve patient education. Although the model generally provides high-quality responses, its limitations in addressing treatment-related questions underscore the importance of clinician oversight. ChatGPT can therefore serve as a valuable complement to traditional patient education methods.

Keywords:  Acromioclavicular dislocation; Artificial intelligence (AI); ChatGPT; Internet; Patient education; Sports medicine

DOI:  https://doi.org/10.1016/j.xrrt.2025.06.020
Eur Arch Otorhinolaryngol. 2025 Nov 05.

Comment on "Readability, understandability, and quality of online education materials and large language models for retrograde cricopharyngeal muscle dysfunction".

Raşit Eren Büyüktoka.

DOI: https://doi.org/10.1007/s00405-025-09827-6
Cureus. 2025 Oct;17(10): e93728

Misinformation in YouTube Videos About Chiropractic Treatment for Otitis Media.

Luke Reardon, Erin M Gawel, Shiven Sharma, Deepthi S Akella, David Riccio, Michele M Carr.

   INTRODUCTION: This study analyzes the prevalence and characteristics of misinformation in YouTube videos about chiropractic treatment for otitis media (OM).
METHODS: YouTube was searched in January 2023 (Incognito mode, US region) using the terms "chiropractic treatment for otitis media", "chiropractic ear infection", and "chiropractic ear problems". The first 50 English-language videos ranked by relevance were evaluated. Two independent reviewers extracted metadata (views, duration, likes, comments, upload source) and coded for references to evidence-based therapies, chiropractic techniques, and misinformation themes ("fixing" nerves or the Eustachian tube); a third reviewer resolved discrepancies. Descriptive statistics summarized video characteristics and engagement. A parallel PubMed search identified published literature on the most commonly mentioned techniques.
RESULTS: Fifty videos accrued 2,600,209 views, with a mean of 192 seconds, and generated 21,102 likes and 1,766 comments. Chiropractors produced 42 videos (84% of the content); hospital or academic channels contributed two videos (4%). Only three videos (6%) cited scientific sources. Twenty-five videos claimed that chiropractic manipulation could "fix" the Eustachian tube, and 14 videos (28%) asserted nerve correction; none mentioned antibiotics or tympanostomy tubes. Upper‑cervical adjustments (32 videos, 64%) and ear‑massage maneuvers (25 videos, 50%) were the most frequently promoted techniques, despite limited or low‑quality supporting evidence in published literature.
CONCLUSIONS: Misinformation about chiropractic treatment for OM is widespread and highly viewed on YouTube. The omission of proven therapies and promotion of unverified claims pose risks for delayed care and preventable harm. Efforts from clinicians, professional societies, educators, and platforms are needed to elevate accurate content, promote media literacy, and reduce exposure to misleading medical information.

Keywords:  chiropractic treatment; medical misinformation; otitis media; social media; youtube

DOI:  https://doi.org/10.7759/cureus.93728
Clin Breast Cancer. 2025 Oct 06. pii: S1526-8209(25)00289-7. [Epub ahead of print]

Systemic Evaluation of Quality, Readability, and Integrity of Online Breast Reconstruction Resources.

Reza Shahriarirad, Nishant Kumar, Aparna Vijayasekaran.

   BACKGROUND: Patients increasingly turn to online resources for breast reconstruction information, yet the quality, readability, and inclusivity of such materials remain unclear. This study assessed top-ranking websites for content accuracy, usability, visual representation, readability, and search engine visibility.
METHODS: The top 10 English-language websites were selected based on rankings from major search engines and top search engine optimization (SEO) metrics. Two independent reviewers evaluated each site using JAMA benchmarks, the DISCERN instrument, and a modified EQIP tool. Readability was assessed using Flesch-Kincaid Reading Ease, Gunning Fog, SMOG, Coleman-Liau, Automated Readability Index, and the percentage of complex words. Additional analyses examined image diversity (skin tone and body type) and content. Inter-rater reliability was confirmed using Cohen's κ and intraclass correlation coefficients.
RESULTS: Twelve websites were analyzed, and only 41.7% met all 4 JAMA benchmarks. DISCERN scores rated just 1 site as "excellent," with nonprofit sources performing significantly better (P = .019). EQIP findings showed only 25% were of good quality, with frequent gaps in procedural details and decision-making support. Sites covered 62.2% of essential content, with limited focus on financial aspects or patient experiences. Only 33.4% met the recommended 8th-grade reading level. Image analysis showed 76.7% of websites portrayed only light skin tones, and 71% depicted a lean body type.
CONCLUSION: Online breast reconstruction resources are often inconsistent, hard to understand, and lack diversity. More readable, inclusive, and trustworthy content is needed. Clinicians should guide patients to reliable sources and support efforts to improve online health education.

Keywords:  Health education; Health literacy; Internet; Patient education; Plastic and reconstructive surgery

DOI:  https://doi.org/10.1016/j.clbc.2025.09.021
OTO Open. 2025 Oct-Dec;9(4):9(4): e70176

Evaluating the Readability and Understandability of Online Patient Materials Regarding Balloon Sinuplasty.

Shreya R Bhalla, Lauren E Bancalari, Ariana L Shaari, Justin P McCormick.

   Objective: An increasing number of patients are electing to undergo balloon sinuplasty for treatment of chronic rhinosinusitis due to its minimally invasive nature. This study aimed to evaluate the readability and understandability of online patient education materials (PEMs) related to balloon sinuplasty.
Study Design: Cross sectional.
Setting: Digital environment.
Methods: A Google search was performed using 6 different search terms related to balloon sinuplasty. Websites related to PEMs for balloon sinuplasty were included. Four different measures of readability were utilized to assess the readability of each website: Flesch-Kincaid Grade Level (FKGL), Flesch-Kincaid Reading Ease (FKRE), Gunning-Fog Index, and Simple Measure of Gobbledygook Index. Understandability was determined using the Patient Education Materials Assessment Tool (PEMAT).
Results: Fifty-three online PEMs related to balloon sinuplasty were included. The average FKGL was 9.07 ± 2.1, which is higher than the recommended grade reading levels. The average FKRE was 45.11 ± 9.3, indicating they were difficult for the general public to read. The mean PEMAT was 49.7 ± 16.3%, which is lower than the accepted standard of 80%, which indicates materials are not readily understandable. Most PEMs were obtained from private medical clinics (79.2%, N = 42).
Conclusion: Online PEMs related to balloon sinuplasty are written above the recommended 6th grade reading level. Poor readability was seen across all readability measures and all material categories. Patients and clinicians alike should be aware of the shortcomings of online materials and consider the effects on patient understanding and decision making.

Keywords:  chronic rhinosinusitis; comprehension; decision making; patient education; sinusitis

DOI:  https://doi.org/10.1002/oto2.70176
Cleft Palate Craniofac J. 2025 Nov 05. 10556656251369339

A Critical Assessment of the Readability and Ethnic Inclusivity of Online Patient Materials for Microtia.

Sam Boroumand, Sydney R Aquilina, Emily Gu, Gabriel Carrillo, Jeremy A Goss, Omar Allam, Michael Alperovich.

  ObjectiveOnline patient education resources need to be at an acceptable reading level for public consumption and should capture the diversity of the patient population they are intended for. The purpose of this study was to assess the suitability of online materials for microtia.DesignPerformed cross-sectional survey and inventory of Google search results for "microtia."SettingPerformed online internet search.Patients, Participantsn/aInterventionsn/aMain Outcome MeasuresThe readability of each site was evaluated utilizing 6 different validated readability instruments and their quality was assessed with the JAMA Benchmark criteria. The proportion of sites containing visual patient representations of microtia was noted and the Fitzpatrick scale was employed to assess for diversity of this representation.ResultsFrom the 99 unique sites identified, 40 were from academic hospitals, 32 were by private hospitals/physicians, 15 were government/non-profit organizations, and 12 were third-party informational sites. Microtia material found online was written at over a 10th grade reading level which is well-above the NIH/AMA recommended 6th grade reading level; third-party informational sites had the highest average JAMA Benchmark scores (2.33 ± 1.30, P < .01). 43.4% of identified microtia sites included some type of microtia illustrations and only 27.3% included representation other than White.ConclusionsThe patient education materials for microtia found on hospital and organization websites exceed the complexity appropriate for general medical information consumption. Efforts should be made to make material more readable for the general public and illustrations should be more representative given the condition's higher prevalence among ethnic minorities.

Keywords:  ethnic; internet; microtia; online; readability

DOI:  https://doi.org/10.1177/10556656251369339
Int J Lang Commun Disord. 2025 Nov-Dec;60(6):60(6): e70155

Analysis of the Quality of Stuttering Content on Douyin in China.

Yu-An Chen, Hiu Lam Leung, Shoko Miyamoto.

   BACKGROUND: Stuttering, a neurodevelopmental disorder, remains widely misunderstood in China. While Chinese social media platforms like Douyin are increasingly used for health information, no studies have evaluated the quality of stuttering-related content online, particularly for this stigmatized condition.
AIMS: This study aims to review and analyse the quality of stuttering-related Douyin videos in China.
METHODS AND PROCEDURES: A sample of 100 top-liked stuttering-related videos was collected between 12 and 15 May 2024. The videos were classified into three categories as follows: Useful (U), Personal experience (P) and Misleading (M), and four features were extracted for analysis. The Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) was employed to evaluate the comprehensibility and actionability percentiles of these videos.
RESULTS AND OUTCOMES: Through review and analysis, we found that 4% of the videos was classified as useful, 22% was classified as personal experience, and 74% was classified as misleading. Misleading videos are more likely to be liked by viewers. The evaluation results from the PEMAT-A/V indicated an average understandability score of 53.0% and an average actionability score of 24.3%, which are considered to have low understandability and low actionability.
CONCLUSIONS AND IMPLICATIONS: Based on our analysis of Douyin's video content, audience behaviour and previous research, this study reveals that the prevalent misinformation may mislead the Chinese public and people who stutter about stuttering on the platform. These findings highlight the need to raise public awareness about unreliable stuttering-related content on social media and inform evidence-based education initiatives.
WHAT THIS PAPER ADDS: What is already known on this subject Most studies on stuttering attitudes in China indicate that the Chinese public has a positive attitude toward accessing information about stuttering, such as through the Internet or video. However, this seems to contradict the overall negative attitudes toward stuttering commonly observed among the Chinese population (Chen et al. 2024; Chen et al. 2025; Ma et al. 2024; Ip et al. 2012; Üstün-Yavuz et al. 2021). Ma et al. (2023) highlighted that many self-proclaimed 'stuttering correctionists', lacking professional training in relevant fields, are actively spreading misinformation about stuttering in China. What this paper adds to existing knowledge On Douyin, misleading videos about stuttering likely far outnumber useful ones and tend to have low understandability and actionability. What are the potential or actual clinical implications of this work? This study aids readers in understanding the prevalence of misinformation about stuttering on Chinese new media platforms and how professionals can improve this environment. Furthermore, professionals can utilize the findings of this study to inform stutterers or those seeking to learn about stuttering, thereby enhancing their awareness of online information.

Keywords:  China; Douyin; PEMAT‐A/V; actionability; stuttering; understandability

DOI:  https://doi.org/10.1111/1460-6984.70155
J Cutan Med Surg. 2025 Nov 04. 12034754251391807

Vitiligo Content on Google: A Cross-Sectional Analysis Assessing Readability, Quality, and Timeliness.

Shahnawaz Towheed, Hessa Asmani, Karanvir Singh, Gresha Shah, Ajith Cy, Miriam Weinstein, Cathryn Sibbald.



Keywords:  Google; online resources; readability; timeliness; vitiligo

DOI:  https://doi.org/10.1177/12034754251391807
J Voice. 2025 Nov 04. pii: S0892-1997(25)00369-8. [Epub ahead of print]

Corrigendum to "Readability, Understandability, and Quality of Online Education Materials for Vocal Fold Nodules" [J Voice, Vol. 34, Issue 2 (2020), Pages 302.e15-302.e20].

Can Doruk, Necati Enver, Berkay Çaytemel, Elad Azizli, Bora Başaran.

DOI: https://doi.org/10.1016/j.jvoice.2025.09.005
World Neurosurg. 2025 Nov 03. pii: S1878-8750(25)00970-2. [Epub ahead of print] 124612

Letter to the editor regarding YouTube as a Source of Patient Education in Medulloblastoma: How Reliable is It?

Fabio Garissa, Muhammad Riaz.

DOI: https://doi.org/10.1016/j.wneu.2025.124612
World Neurosurg. 2025 Nov 05. pii: S1878-8750(25)00986-6. [Epub ahead of print] 124628

In Reply to the Letter to the Editor Regarding "YouTube as a Source of Patient Education in Medulloblastoma: How Reliable Is It?"

Eray Abat, Nimetullah Alper Durmus.

DOI: https://doi.org/10.1016/j.wneu.2025.124628
Rev Assoc Med Bras (1992). 2025 Nov 03. pii: S0104-42302025001101501. [Epub ahead of print]71(11): e20250140ER

ERRATUM: Quality and reliability of YouTube videos on fascial sling surgery.

[This corrects the article doi: 10.1590/1806-9282.20250140].

DOI: https://doi.org/10.1590/1806-9282.20250140-ER
Genet Med. 2025 Nov 04. pii: S1098-3600(25)00278-3. [Epub ahead of print] 101631

A Content Analysis of Health-Related Epigenetic Information in YouTube Videos.

Aantaki Raisa, Irania Santaliz Moreno, Amy Ayala, Jada G Hamilton, Jessica Mozersky, Erin Linnenbringer, Julia Maki, Amy McQueen, George P Souroullas, Erika A Waters.

PURPOSE: This study aimed to explore how health-related epigenetic concepts are depicted in YouTube videos, a widely accessed platform for informal science education. As epigenetics becomes increasingly relevant to medical therapeutics, it is essential to understand what information is being disseminated in the public sphere.
METHOD: We conducted a content analysis of 296 YouTube videos about epigenetics that were under 10 minutes in length. We transcribed and analyzed the videos using an iteratively developed codebook and then categorized relevant codes as categories.
RESULTS: We identified seven categories: 1) defining epigenetics, 2) causes of epigenetic changes, 3) effects of epigenetic change, 4) epigenetic inheritability, 5) application of epigenetics, 6) personal control, and 7) epigenetic mysticism. While the content about the molecular epigenetic mechanisms mostly aligned with the latest scientific findings, there were numerous unsubstantiated and exaggerated claims about effects of epigenetics on human health, especially disease outcomes.
CONCLUSION: We identified several scientific concepts described on YouTube regarding epigenetics. Our findings also reveal what information about epigenetics is widely shared in the public sphere, helping identify key misconceptions to address and guiding the development of strategies for accurate science communication.

DOI: https://doi.org/10.1016/j.gim.2025.101631
JMIR Form Res. 2025 Nov 05. 9 e69103

Didactic and Content Quality of Basic Life Support Videos on YouTube: Cross-Sectional Study.

Jasmina Sterz, Yvonne Beaugé, Pia Tueckmantel, Lena Bepler, Armin N Flinspach, Yves Gramlich, René Verboket, Philip Bintaro, Maren Janko, Mairen H Flinspach, Michael Merker, Sven Bepler, Jan T Vollrath, Sebastian H Voß, Miriam Rüsseler.

   Background: Cardiopulmonary resuscitation (CPR) is vital for improving patient outcomes in medical emergencies. Both laypersons and health care professionals often seek guidance on performing CPR. In today's digital age, many turn to easily accessible platforms such as YouTube for practical skills.
Objective: This study evaluates the didactic and content quality of CPR videos on YouTube using comprehensive checklists and investigates the association between the assigned quality scores and type of publisher, view count, and video rankings.
Methods: Videos were included based on defined search terms and exclusion criteria. Two emergency physicians rated each video independently using validated checklists concerning content and didactic quality. Linear regression analysis was performed to assess the relationships between video quality scores and view counts, as well as video rankings.
Results: Of the 250 videos identified, 74 (29.6%) met the inclusion criteria. On the content checklist, videos scored an average of 56.5% (SD 19.2%), and on the didactic checklist, they scored 66.6% (SD 14.3%); none achieved the maximum score. Videos from official medical institutions scored significantly higher in content quality compared to nonofficial sources (P=.04). Video quality scores were not associated with video rankings or view counts.
Conclusions: The study highlights substantial variability in the didactic and content quality of CPR-related videos on YouTube. For medical educators, this underlines the need to curate and recommend reliable online resources or to develop new high-quality content aligned with established checklists. For the general public, the findings caution against relying on popularity metrics as indicators of accuracy and emphasize the importance of guidance from trusted institutions.

Keywords:  CPR; YouTube; basic life support; cardiopulmonary resuscitation; content quality; didactic quality; medical education; quality assessment

DOI:  https://doi.org/10.2196/69103
Phys Sportsmed. 2025 Nov 07. 1-8

The state of online information about Platelet-rich plasma (PRP): what are patients asking and what are their sources of information?

Aaron Z Chen, Kyle K Obana, Christian Law, Michael A Mastroianni, Matthew L Magruder, Bryan M Saltzman, David P Trofa.

   OBJECTIVES: Platelet-rich plasma (PRP) has emerged as a promising treatment option in orthopedics, albeit with mixed clinical data. Therefore, patient interest in PRP has grown, reflected as an increase in the number of PRP-related internet searches. The aims of this study are to 1) investigate the most frequently searched online patient questions related to platelet-rich plasma (PRP) and 2) evaluate the quality of websites providing information.
METHODS: Three PRP-related search queries were entered into Google Web Search and the 100 most common questions for each query were included. Questions were categorized based on Rothwell's Classification of Questions (Fact, Policy, Value) and further subcategorized based on their content. Websites were further categorized by type (Academic, Commercial, Government, Medical Practice, Single Surgeon Personal, and Social Media) and evaluated based on the JAMA Benchmark Criteria for website quality. Statistical analysis was performed with descriptive statistics and reported as percentages where appropriate.
RESULTS: Most questions fell into the Rothwell Value (43.0%) and Fact (40.6%) categories. The most common questions that patients had about PRP pertained to efficacy of treatment (14.0%), comparison of treatment with other options (13.0%), and cost (10.9%). The most common sources of information were medical practice (50.9%) and single surgeon personal websites (14.7%), which had low website quality with JAMA Benchmark criteria of 0.68 ± 0.87, and 0.58 ± 0.85, respectively.
CONCLUSION: The most common questions patients had about PRP pertained to the evaluation of its effectiveness and how it compared with other treatment options. Notably, patients received most information from websites of low quality, highlighting the potential for bias and misinformation. Physicians should use these results instead provide up-to-date, evidence-driven information about PRP to help guide patient expectations.

Keywords:  Google; PRP; Platelet-rich plasma; internet search; online information

DOI:  https://doi.org/10.1080/00913847.2025.2586451
Digit Health. 2025 Jan-Dec;11:11 20552076251393278

Assessment of information quality and reliability of short videos related to lumbar disc herniation on selected video platforms.

Yuehua Wang, Sheng Lian, Longteng Liao, Wenyu Wang.

   Background: Lumbar disc herniation is a common chronic condition among working people. In China, the number of popular scientific videos on health and disease knowledge is increasing on short video platforms, but there is still a lack of sufficient research to evaluate the quality of these short videos. The main objective of this study was to evaluate the quality, reliability, and content completeness of lumbar disc herniation related videos posted on four major short video platforms in China.
Methods: The keyword "lumbar disc herniation" was entered into four major Chinese short video platforms; videos were sorted by the number of likes, and the top 100 were collected. After sifting through the collected videos, their quality was assessed using the Global Quality Score (GQS), DISCERN tool, and content completeness score.
Results: A total of 400 videos were collected from four short video platforms, Douyin, Bilibili, Kuaishou, and Xiaohongshu, leaving 384 videos after screening. The largest group of uploaders was orthopedic surgeons (24.2%), while the smallest was organizations (2.6%). For short video content, the most frequently mentioned content was treatment (83.9%), followed by diagnosis (14.8%). The average number of likes for each video was 25,998. The mean GQS score, DISCERN score and content completeness score of these videos were 2 ± 0.85, 1.71 ± 0.76, and 1.38 ± 0.76. There was little difference in content completeness among the platforms, but Douyin had higher video quality scores.
Conclusions: In summary, the overall quality scores of lumbar disc herniation-related short videos were not high. Short video quality on Douyin was higher than that of other platforms. The quality of videos posted by orthopedic surgeons was better than that posted by other groups. Short videos with a high number of likes tend to have higher GQS and DISCERN scores.

Keywords:  Lumbar disc herniation; content completeness; health information; quality; reliability; short videos

DOI:  https://doi.org/10.1177/20552076251393278
JMIR Form Res. 2025 Nov 03. 9 e80458

Quality Analysis of Stroke-Related Videos on Video Platforms: Cross-Sectional Study.

Shao-Jie Nie, Shuai-Nan Ning, Qi-Chao Ding, Jie Hou, Yue-Yang Luo, Hai-Yang Wang.

   Background: Stroke has become a global public health problem due to its high incidence, disability, and mortality. In China, TikTok and Bilibili, as mainstream video-sharing platforms, serve as key sources of getting stroke-related information for people, yet their videos' content quality and reliability remain insufficiently evaluated.
Objective: This cross-sectional study aimed to analyze the content and quality of stroke-related videos on Chinese video-sharing platforms.
Methods: In March 2025, stroke-related videos were retrieved from TikTok and Bilibili using the search term "" (Chinese for stroke). Eligible videos were analyzed for metadata and content indicators. Researchers assessed video quality using validated tools: the Global Quality Scale (GQS), modified DISCERN (mDISCERN), and Patient Education Materials Assessment Tool (PEMAT). Statistical analyses were performed with Python, including descriptive statistics, group comparisons (Kruskal-Wallis tests), and Spearman's rank correlation to evaluate variable associations, with all P values adjusted for multiple comparisons using the Bonferroni method. A binary classification predictive model was developed using the random forest algorithm, accompanied by feature importance analysis.
Results: Among the stroke-related videos from Bilibili (n=157) and TikTok (n=149), popular science education content predominated (204/306, 66.7%). Bilibili videos were primarily categorized as professional lectures (83/157, 52.9%), while most TikTok videos were popular science education (139/149, 93.3%). TikTok videos demonstrated significantly higher median likes and comments (P<.001) and shorter durations compared to Bilibili (P<.001). No significant differences were observed in median GQS (4) or mDISCERN scores (3) between platforms (P>.05). Videos produced by professional teams exhibited significantly higher GQS and PEMAT-A/V scores than those created by independent content creators (P<.05). Popular science education videos achieved higher PEMAT-A/V actionability scores than professional lectures (P<.001), while videos addressing treatment options scored lowest in GQS (P<.05). Strong positive correlations were identified among user engagement parameters (likes, shares, comments; ρ=0.81-0.90, P<.001), but only weak correlations were found between engagement and quality scores (ρ<0.3). Machine learning modeling (AUC=0.58) identified video duration (importance score: 0.15) and uploader subscriber count (importance score: 0.13) as key predictors of content quality.
Conclusions: The quality of stroke-related videos on TikTok and Bilibili remains suboptimal. Content uploaded by certified physicians and institutions received higher GQS/mDISCERN scores, confirming that medical authority is a key quality indicator. Our exploratory random-forest model, which used only basic metadata (duration, likes, subscriber count), achieved an area under the curve of 0.58, indicating that surface engagement metrics alone are insufficient to discriminate high- from low-quality material. Consequently, future screening algorithms should incorporate content-based features (eg, captions, medical keywords, visual cues) and creator credentials rather than relying solely on readily available interaction parameters. Multi-platform, larger-scale datasets are warranted to develop clinically useful prediction tools.

Keywords:  PEMAT-A/V; Patient Education Materials Assessment Tool; TikTok; quality assessment; short videos; stroke; video quality

DOI:  https://doi.org/10.2196/80458
Digit Health. 2025 Jan-Dec;11:11 20552076251391170

The quality and content of gonorrhea-related short videos on TikTok: A cross-sectional study.

Kaidi Zhao, Junlan Yang, Jiashu Liu.

   Background: Gonorrhea is a common sexually transmitted disease that remains highly prevalent worldwide. Social media platforms such as TikTok have become important sources of public health information, yet the quality and reliability of video content on these platforms remain unclear. This study aimed to evaluate the content, quality, and reliability of gonorrhea-related short videos on TikTok.
Methods: A cross-sectional analysis was conducted on 71 gonorrhea-related short videos on TikTok. Video characteristics, uploader types, and content themes were extracted. The Global Quality Score (GQS) and modified DISCERN (mDISCERN) tool were used to assess video quality and reliability. Correlation analysis was performed between video metrics and quality scores.
Results: The videos were generally short in duration (median: 49.00 s) but exhibited high user engagement. Common topics included clinical manifestations (64.79%), transmission routes (47.89%), and diagnosis (45.07%), while prevention, treatment and prognosis were less frequently discussed. The main uploaders were dermatologists, urologists, and individual users. Videos uploaded by healthcare professionals had significantly higher GQS scores than those from individual users, with a similar but statistically insignificant trend in mDISCERN scores. Positive correlations were found among engagement metrics (likes, favorites, comments, and shares), but no correlation was observed between engagement and video quality.
Conclusions: Gonorrhea-related TikTok videos are highly interactive but generally lack in quality, reliability, and content coverage. Increasing professional involvement and improving platform-level content regulation are essential to enhance the educational value of health information delivered via TikTok platforms.

Keywords:  Gonorrhea; TikTok; health information; information quality; short video

DOI:  https://doi.org/10.1177/20552076251391170
Digit Health. 2025 Jan-Dec;11:11 20552076251393298

Reliability, quality, and science popularization of diabetes knowledge information in China video sharing platform: A cross-sectional study.

Ke-Xin Sun, Chen Cui, Fei Mu, Meng Tang, Rui Gong, Zhen Yan, Jin-Yi Zhao, Jing-Wen Wang.

   Objective: More and more diabetes individuals are using internet video platforms for self-management of blood glucose in China. TikTok, WeChat, and Bilibili have gained popularity because of easy access to health information. However, the quality, reliability, and science popularization of health information on these platforms have still not been fully assessed, and studies comparing the three platforms are lacking. A cross-sectional study was established to evaluate the reliability, quality, and science popularization of diabetes health information on Chinese Internet video platforms.
Methods: This study used "diabetes" as a keyword to identify the top 100 videos meeting the specified criteria on each platform, resulting in 300 videos. The modified DISCERN score, the Journal of the American Medical Association Score (JAMA) benchmark criteria, and Global Quality Scores (GQS) were employed to assess the reliability of videos. This study developed criteria to evaluate the science popularization of the platforms. Each video was assessed based on the health information categories recommended by the Chinese Diabetes Guidelines (2024).
Results: Of the videos retrieved, 50.67% (152/300) were posted by certified medical professionals. Patient education was the most frequently discussed topic (120/300, 40.00%), including diet and lifestyle interventions. The median DISCERN score for the 300 videos was 3.00 (interquartile range (IQR): 2.00-4.00). The science dissemination score was 67.00 (IQR: 58.00-74.25), and the median GQS was 3. There was no significant difference in JAMA scores among the three platforms (p = 0.095). Bilibili received the highest science popularization score (median: 70.00, IQR: 63.45-77.00) and guideline score (median: 2.00, IQR: 1.00-4.00). Although healthcare professionals have a higher audience focus, video quality is inferior to non-healthcare professionals.
Conclusion: The results of this cross-sectional study suggest that videos of diabetes information from Internet platforms in China are not satisfactory. Compared with TikTok and WeChat, Bilibili has the highest quality of popular science videos. Health regulatory authorities should improve the enthusiasm of professional medical staff to participate in scientific communication, crack down on false information, and improve the quality of popular science works and public health literacy.

Keywords:  Diabetes; information quality; science popularization; social media

DOI:  https://doi.org/10.1177/20552076251393298
J Med Internet Res. 2025 Nov 04. 27 e80784

Health Information Behavior in Parents of Children With Congenital Heart Disease in China: Qualitative Study Through the Lens of Chinese Culture.

Jingran Yang, Fang Ma, Yu Wang, Xingchun Yang, Min Zhou, Yimei Zhang, Ruijie YangLan, Qinglan Li.

   Background: Parents of children with congenital heart disease (CHD) serve as primary caregivers and play a central role in decisions regarding their children's health care, development, and overall well-being. Their health information behavior directly influences the care decisions and outcomes of their children. In China, the online health information environment is vast but varies in quality, which places a significant information-seeking burden on them in the digital age. Moreover, Chinese cultural backgrounds shape parents' views, perspectives, and practices related to health information. To date, there have been no studies in China reporting on the experiences of parents of children with CHD concerning their health information behavior.
Objective: The aim of this study was to explore the experiences of health information behavior among parents of children with CHD during the disease journey through the lens of Chinese culture.
Methods: This study used a descriptive phenomenological qualitative method. Face-to-face, semistructured, and in-depth interviews were conducted with parents of children with CHD from March to July 2025 at a tertiary grade A hospital located in Kunming, Yunnan Province, China. Data were collected and managed using the NVivo 12.0 software (QSR International), and thematic analysis was applied to identify and interpret participants' experiences and perspectives.
Results: A total of 24 parents of children with CHD participated in this study, including 6 fathers and 18 mothers. In total, 6 themes emerged from the data: (1) Looking for health information both online and offline; (2) Seeking health information from professionals and peers as well; (3) Evolving health information needs in the disease journey; (4) Showing diverse attitudes toward health information seeking; (5) Positive and negative feelings during health information behavior process; and (6) Disclosure versus concealment of children's disease information.
Conclusions: Parents of children with CHD seek health information from both online and offline sources and also combine health information from professionals and peers. Medical institutions should provide authoritative information resources, while regulatory authorities should conduct professional reviews before disseminating health information online to foster a reliable information environment. Additional efforts should focus on utilizing rehabilitation narratives from peer networks, delivering personalized information support tailored to parents' information-seeking styles and children's disease stages, and offering training and services to stimulate and cultivate a conscious decision-making process regarding disease disclosure and sharing.

Keywords:   information seeking; congenital heart disease; experiences; health information behavior; online; parents; qualitative study

DOI:  https://doi.org/10.2196/80784
Risk Anal. 2025 Nov 06.

Is Online Health Information a Threat?-Untangling the Longitudinal Associations Among Health Information Scanning, Seeking, and Risk Perceptions.

Han Zheng.

  In today's algorithm-driven era, individuals not only actively seek health information through search engines or health websites but also passively encounter health-related content while browsing social media feeds. These two distinct behaviors (i.e., intentional information seeking and incidental information scanning) may each contribute to individuals' perceptions of health risks. A substantial body of work has examined the relationship between online health information behaviors (e.g., seeking) and risk perceptions across various contexts. However, the findings on the directionality of these relationships remain equivocal. Drawing on the literature on health information acquisition, this study investigates the longitudinal associations among online health information seeking, scanning, and risk perceptions. Data from a three-wave panel survey with 654 participants indicate that health information scanning and seeking exhibit a stable, reciprocal relationship over time. Moreover, information seeking is positively associated with risk perceptions across waves, whereas information scanning does not exert a direct effect. These findings contribute to theoretical developments in digitally mediated risk communication by highlighting the temporal dynamics and interplay of online information behaviors. They also offer practical guidance for designing more targeted and psychologically informed digital health communication strategies.

Keywords:  cross‐lagged panel model; information scanning; online health information seeking; risk perceptions

DOI:  https://doi.org/10.1111/risa.70145
J Med Internet Res. 2025 Nov 05. 27 e77549

Trajectories and Influencing Factors of Online Health Information-Seeking Behaviors Among Community-Dwelling Older Adults: Longitudinal Mixed Methods Study.

Ting Wang, Qian Dong, Qun Sun, Hui Dong, Xiaolong Bu, Yanan Wang, Yanni Su, Cuiping Liu.

   Background: The internet has emerged as a critical avenue for the public to access health information resources. As online health information is a key resource for older adults, the factors influencing their online health information-seeking behaviors (OHISBs) are crucial.
Objective: This study aims to examine the trajectories and influencing factors of OHISB among community-dwelling older adults and to explore their attitudes toward this information in daily contexts.
Methods: A longitudinal mixed methods study was conducted involving 346 older adults from three communities in Shandong Province, China. In the quantitative phase, data were collected at three time points: baseline (T1), 6 months postbaseline (T2), and 12 months postbaseline (T3). Latent class growth modeling and logistic regression identified trajectories and predictors of OHISB, while a cross-lagged panel model analyzed longitudinal relationships among digital health literacy (DHL), technology anxiety (TA), and OHISB. Subsequently, we conducted semistructured, in-depth interviews with 16 older adults from different OHISB trajectory subgroups using a descriptive phenomenological approach. Quantitative and qualitative results were integrated via triangulation.
Results: Latent class growth modeling identified three OHISB trajectories: low-level declining group (92/346, 26.6%), medium-level stable group (187/346, 54%), and high-level declining group (67/346, 19.4%). Multivariate logistic regression identified household registration, education, income, chronic disease status, internet frequency and duration, online health information attitude and experience, DHL, and TA as significant predictors of OHISB trajectory. TA mediated the relationship between DHL and OHISB, with an effect size of 0.04 (SE 0.014, 95% CI 0.0123-0.068). Qualitative interviews with 16 participants revealed four themes: personal cognition, emotional experience, external environment, and behavioral choices. The quantitative study elucidated the pathway between DHL, TA, and OHISB, providing a data-driven foundation for the qualitative inquiry. In a complementary manner, the qualitative study revealed themes not captured quantitatively-particularly how personal factors influence behavior through attitudes-and elaborated on sources of social support and the role of the medical environment. Together, both methods convergently demonstrate that older adults' information behavior is not static but shaped by individual and environmental factors, resulting in distinct behavioral patterns.
Conclusions: Both quantitative and qualitative findings clarified the developmental process of OHISB among older adults in communities and the important effects of DHL, TA, and risk perception on OHISB. Although self-efficacy, health anxiety, self-perceived aging, social support, and health care environment were not addressed in the quantitative study, they emerged as important factors shaping older adults' OHISB in qualitative interviews. Personalized intervention measures should target various OHISB trajectory characteristics and their influencing factors to enhance the health conditions of community-dwelling older adults.

Keywords:  aged; digital health; information-seeking behaviors; internet; qualitative research; quantitative research

DOI:  https://doi.org/10.2196/77549
Digit Health. 2025 Jan-Dec;11:11 20552076251393378

Exploring generational and educational disparities in online health information seeking in China: The moderating role of internet use.

Lijuan Zhao, Tianyuan Liu.

   Objective: To investigate the generational and educational gaps in online health information seeking (OHIS) in China and to analyze the connections between internet use and these disparities.
Methods: Utilizing data from the Chinese General Social Survey 2021, binary logistic regression analysis was employed to examine the associations between age groups (18-40 years, 41-59 years, and ≥60 years), educational levels (middle school or below, high school, and college or above), and OHIS. Furthermore, we calculated the marginal effects of the main predictors at different levels of the moderator, along with the second difference between distinct levels of the main predictor, to rigorously assess the moderating effect of internet use.
Results: The results indicated significant generational differences, with middle-aged and older adults less likely to engage in OHIS than younger adults. A clear educational gap was also revealed, as individuals with high school and college attainments were more inclined to engage in OHIS than those with a middle school education or below. Importantly, the interaction effect demonstrated the association between internet use and narrowing these generational and educational disparities.
Conclusions: This study sheds light on generational and educational gaps in OHIS in China, investigating the relationship between internet use and the reduction of these disparities in OHIS.

Keywords:  CGSS; Online health information seeking; educational gaps; generational gaps; internet usage

DOI:  https://doi.org/10.1177/20552076251393378
JMIR Form Res. 2025 Nov 04. 9 e77274

Associations Between Online Search Trends and Outpatient Visits for Common Medical Symptoms in the United States from 2004 to 2019: Time Series Ecological Study.

Ryan Heumann, Steven R Steinhubl.

   Background: The seemingly endless amount of information available on the internet at the touch of a few buttons has increasingly served as a resource for individuals to find health information over the last 20+ years. Previous research in the field of infodemiology suggests that this change in use of the internet by the public to find health information has an impact on their interaction with the health care system. However, to this date, no study has directly juxtaposed the growth of internet searching and the number of visits to ambulatory care centers for the same concerns over the last two decades of internet growth.
Objective: This study aimed to explore the relationship between online searches for three common primary care concerns and ambulatory visits for those same concerns during 2004-2019.
Methods: The National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey data were searched between the years 2004 and 2019 in order to estimate the number of annual ambulatory care visits for cough, sore throat, and abdominal pain. Google Trends data were explored to analyze the number of people searching for information about the same complaints over the same years. Cross correlation, time series regression, and Granger causality analysis were performed to analyze patterns and causality.
Results: Google Trends data showed that the number of searches for the common primary care symptoms "cough," "sore throat," and "stomach pain" in the United States grew by 208%, 290%, and 490%, respectively, between 2004 and 2019. However, over the same time, United States population-adjusted outpatient visits for cough and sore throat decreased by 41.5% and 40%, respectively, and stomach pain visits remained unchanged. According to conservative estimation, analysis concluded that an increase in internet searches for cough can predict a decline in ambulatory visits for that symptom.
Conclusions: This supports that, on a population level, exploring online health information about some common, acute symptoms did not lead to increase in care seeking, but instead, suggests that a substantial portion of the population found the information to be reassuring or informative enough to not feel the need to seek care from a primary health care provider. With the rapid evolution and availability of more detailed and personalized information from various large language models, it is likely that internet search habits of users will continue to grow, and with it, continue to transform interactions with the health care system.

Keywords:  ambulatory care; digital health; health information; infodemiology; internet; patient education; primary care

DOI:  https://doi.org/10.2196/77274
J Cancer Surviv. 2025 Nov 06.

Digital information-seeking behaviors among cancer survivors: associations with sociodemographic determinants, cancer history, and perceived health.

Roberto M Benzo, Macy K Tetrick, Jessica L Krok-Schoen, Theodore M Brasky, Peter Washington, Electra D Paskett, Frank J Penedo, Rujul Singh, Michael Shechtman, Soledad A Fernandez, Sachin Kumar, Mahkameh Mallahzadeh, James L Fisher.

   PURPOSE: This study aimed to examine general and digital information-seeking behaviors among U.S. cancer survivors and assess how these behaviors are patterned by sociodemographic and clinical factors. The study addressed a key gap in prior research by using registry-confirmed cancer data to explore disparities in digital engagement.
METHODS: Data were drawn from the 2021 Health Information National Trends Survey-Surveillance, Epidemiology, and End Results Program (HINTS-SEER), which included 1,234 cancer survivors from three SEER registries. Multivariable logistic regression models evaluated associations between information-seeking (general and digital) and sociodemographic (e.g., age, sex, income) and clinical factors (e.g., cancer site, stage at diagnosis, treatment effects).
RESULTS: Most survivors (77.8%) reported having sought cancer-related information, and 73.9% used digital tools to look for health information. Survivors who were younger, female, more educated, and with higher income were significantly more likely to engage in both general and digital information-seeking when compared to older, male, or less educated. Survivors reporting cancer- and treatment-related nausea or neuropathy were more likely to engage in information-seeking when compared to survivors without these symptoms.
CONCLUSIONS: Cancer survivors' engagement in information-seeking, especially through digital tools, is shaped by heterogeneity in age, sex, education, income, and clinical experiences. These findings highlight the persistence of the digital divide in survivorship care.
IMPLICATIONS FOR CANCER SURVIVORS: Equity-focused efforts are needed to support digital access and literacy among underserved survivors. Tailored interventions, plain-language digital content, and provider-facilitated referrals to digital evidence-based resources may help bridge informational gaps and enhance survivorship self-management.

Keywords:  Cancer communication; Cancer information; Cancer survivors; Health information seeking

DOI:  https://doi.org/10.1007/s11764-025-01927-w
Can J Dent Hyg. 2025 Oct;59(3): 171-177

Factors associated with internet use to obtain oral health-related information.

Alcir José de Oliveira Júnior, Beatriz Loureiro Santos, Fábio Luiz Mialhe.

Background: In recent decades, there has been an increase in internet searches for oral health information by patients, but little is known about which factors may influence this process. This cross-sectional study investigates factors associated with internet use to obtain oral health-related information in a sample of adults.
Methods: Adult users of 6 Primary Health Care (PHC) centres located in a city in the interior of the state of São Paulo, Brazil, were recruited to participate in the study. Data were collected on socioeconomic, behavioural, and dental characteristics, and internet use to obtain information about oral health. Simple and multiple logistic regression were performed for analysis between predictor variables and the outcome (internet use).
Results: A sample of 301 adults participated in the study. In the final adjusted model, users with secondary education (OR = 2.53; 95% CI:1.11-5.79), who more frequently searched the internet for health information (OR = 2.89; 95% CI: 1.25-4.20), who thought the internet was more useful for making health decisions (OR = 2.56; 95% CI: 1.47-4.48), who had spoken to a health care professional in the last 12 months about information obtained on the internet (OR = 3.10; 95% CI: 1.77-5.44), whose last dental consultation was prompted by urgent reasons (OR = 2.30; 95% CI: 1, 25-4.23), and who had greater autonomy in decision making related to oral health (OR = 1.89; 95% CI: 1.10-3.27) were more likely to use the internet to obtain oral health-related information (p < 0.05).
Conclusion: Sociodemographic, behavioural, and dental factors were associated with internet use to obtain oral health-related information in adults.

Keywords: internet use; oral health; primary health care