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Quality of Carpal Tunnel Syndrome Patient Education Handouts Available on the Internet: A Systematic Analysis of Content and Design

Published:September 18, 2021DOI:https://doi.org/10.1016/j.apmr.2021.08.010

      Abstract

      Objective

      To evaluate the quality of carpal tunnel syndrome (CTS) patient education handouts and identify the best resources for patients and clinicians.

      Design

      A document content analysis of handouts identified through a systematic internet search using 8 search terms on Google and Bing and a hand search of professional association websites.

      Setting

      Not applicable.

      Participants

      Documents (N=56) were identified from the top 50 search results across 16 individual searches. Included documents provided general patient education for CTS; descriptive websites, videos, and research studies were excluded.

      Interventions

      Not applicable.

      Main Outcome Measures

      Content analysis was conducted using the Information Score (IS) tool to evaluate completeness of information (0%-100%) and misleading treatment recommendations were identified. Design analysis was conducted using the Patient Material Assessment Tool for Printable Materials (PEMAT-P) (0%-100%) and 2 widely used readability formulas, Flesch Reading Ease and Flesch Kincaid Grade Level. Using these results, all handouts were rated with a summative 12-point scale.

      Results

      Of 805 unique search results, we included 56 CTS handouts. The average IS was 74.6%±17.9%, and 78.6% of the handouts mentioned non–evidence-based treatment recommendations. The average PEMAT-P score was 70.2%±10.9%, and the average readability grade level was 7.7±1.7. Only 3 handouts were identified as high quality based on the 12-point summative scores, 22 handouts had mixed quality, and 17 handouts had low quality on both content and design.

      Conclusions

      Findings of this study suggest a lack of high-quality and easily understandable CTS patient education handouts. Most handouts contained unreliable treatment information. Improvements are needed to ensure patients’ ability to understand and manage this condition.

      Keywords

      List of abbreviations:

      CTS (carpal tunnel syndrome), FRE (Flesch Reading Ease), FKGL (Flesch Kincaid grade level), IS (Information Score), PDF (Portable Document Format), PEMAT-P (Patient Material Assessment Tool for Printable Materials), URL (Uniform Resource Locator)
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