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NESS 2006 Annual Meeting
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Filling a Void: Thyroid Cancer Surgery Information on the Internet
Mamie Air, Sanziana A Roman, Heather Yeo, Christina Maser, Tara Trapasso, Barbara Kinder, Julie Ann Sosa
Yale University School of Medicine, New Haven, CT

Objective: Thyroid cancer is an important public health problem. The Internet is a popular health education tool. Our purposes were to measure the quality of thyroid cancer surgery information on the Internet and identify quality predictors.
Design: Cross-sectional cohort, survey
‘Setting.’ The 50 most popular URLs from Google, Yahoo, and MSN “thyroid cancer” queries were identified at an academic medical center.
‘Participants:’ 74% of websites were American, 50% for-profit, 28% dedicated to thyroid cancer, and 38% updated in the last 2 years; for-profit sites were older (p=.01). 70% of websites contained advertisements (mean, 3.7 ads/site). Government and non-profit sites contained more information about patient-support (80% vs. 36%; p=.05) and technologic advances (60%).
‘Intervention:’ A novel 55-point instrument based on practice guidelines and a Delphi panel was used by 5 ‘blinded’ endocrine surgeons to measure website information accuracy and completeness. Each site was independently evaluated by 2 surgeons.
Outcome measures: Quality scores subsequently related to site demographics (student’s t-test, Χ2 analysis, ANOVA).
Results: Inter-rater reliability for quality scores was excellent (κ=0.81). Mean±SD overall quality score was 21±12 (38%), and mean±SD score for surgical content was lowest - 3.5±3 (29%). There was no association between quality and site demographic variables. Only 50% of sites discussed surgery indications; 8% length of surgery/anesthesia; 42% the role of lymphadenectomy; 44% hoarseness and 42% hypoparathyroidism as complications; 16% recovery; and 20% recommendations for choosing a thyroid surgeon.
Conclusions: Thyroid cancer surgery information on the Internet is incomplete and outdated. Thyroid surgeons could help improve this void.

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