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Comprehensive Assessment of Vascularized Composite Allotransplantation Patient-Oriented Online Resources

Noel, Daphney Y. BA*; Kimberly, Laura L. MSW, MBE*†; DeMitchell-Rodriguez, Evellyn M. BS*; Levy-Lambert, Dina BS*; Ramly, Elie P. MD*; Alfonso, Allyson R. BS, BA*; Jacoby, Adam MD*; Gelb, Bruce E. MD; Diaz-Siso, J. Rodrigo MD*; Kantar, Rami S. MD*; Rodriguez, Eduardo D. MD, DDS*

doi: 10.1097/SAP.0000000000001931
Transplantation Surgery and Research

Introduction Online resources have become a major source of medical information for the general public. To date, there has not been an assessment of patient-oriented online resources for face and upper extremity transplantation candidates and patients. The goal of this study is to perform a comprehensive assessment of these resources.

Methods Our analysis relied on 2 dimensions: comprehensiveness and readability. Comprehensiveness was evaluated using 14 predetermined variables. Readability was evaluated using 8 different readability scales through the Readability Studio Professional Edition Software (Oleander Software, Ltd, Vandalia, Ohio). Data were also collected from solid organ transplantation (SOT), specifically kidney and liver, programs for comparison.

Results Face and upper extremity transplantation programs were significantly more likely to list exclusion criteria (73.9% vs 41.2%; P = 0.02), the need for life-long immunosuppression (87.0% vs 58.8%; P = 0.02), and benefits of transplantation (91.3% vs 61.8%; P = 0.01) compared with SOT programs. The average readability level of online resources by all face and upper extremity transplantation programs exceeded the sixth grade reading level recommended by the National Institutes of Health and the American Medical Association. The average reading grade level of online resources by these programs was also significantly higher than those of SOT with both exceeding the recommended reading level (13.95 ± 1.55 vs 12.60 ± 1.65; P = 0.003).

Conclusions Future efforts in face and upper extremity transplantation should be directed toward developing standardized, comprehensive, and intelligible resources with high-quality content and simple language.

From the *Hansjörg Wyss Department of Plastic Surgery,

Division of Medical Ethics, and

Division of Transplant Surgery, New York University Langone Health, New York, NY.

Received November 16, 2018, and accepted for publication, after revision February 15, 2019.

Conflicts of interest and sources of funding: none declared.

Reprints: Eduardo D. Rodriguez, MD, DDS, Helen L. Kimmel Professor of Reconstructive Plastic Surgery, Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, 307 E 33rd St, New York, NY 10016. E-mail:

Online date: June 20, 2019

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