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Evaluating the Quality and Readability of Online Resources for Labiaplasty

Pandya, Lopa K. MD; Hudson, Catherine O. MD; Lynch, Courtney D. PhD; Nekkanti, Silpa MD; Smith, Pamela E. MD; Hundley, Andrew F. MD

Female Pelvic Medicine & Reconstructive Surgery: April 12, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000725
Original Article: PDF Only

Objectives The aim of this study was to evaluate the quality, readability, and accuracy of Web-based information regarding labiaplasty and to characterize the types of Web sites providing this information.

Methods Investigators used 3 major search engines to query the internet using the search terms labiaplasty, labia reduction, and vaginal rejuvenation. Two validated tools were used to evaluate Web sites: the JAMA benchmark tool and the DISCERN instrument. Three physicians independently reviewed each Web site. Interrater agreement was assessed, and reviewer scores were averaged. Flesch-Kincaid reading ease and Flesch-Kincaid grade level of each site were assessed. Data were analyzed using Stata 14.0 (College Station, TX).

Results Of the 112 Web sites reviewed, 100 Web sites were from North America, 9 from Europe, 2 from Australia, and 1 from Asia. The median score using the JAMA tool was 1.0 (0.33–4.0), indicating low accountability, whereas the median score using the DISCERN tool was 28 (18.7–77) of 80 with higher scores indicating higher quality. Cohen’s weighted κ statistic (0.81) demonstrated near perfect agreement among reviewers for DISCERN scores. The median reading level was 11.9 (6.4–19.5). A majority of the Web sites (92) were for-profit businesses or blogs.

Conclusions The internet enables patients to research sensitive topics and seek answers without worry of social stigma. Online health-related information is a widely used yet poorly studied source of medical information. The majority of Web sites reviewed lack balanced, evidence-based information. Given the wide variation in the quality of information, physicians should guide patients to reputable online resources.

From the Division of Female Pelvic Medicine and Reconstructive Surgery, Ohio State University Wexner Medical Center, Columbus, OH.

Correspondence: Lopa K. Pandya, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, Ohio State University Wexner Medical Center, 395 W 12th Ave, 5th Floor, Columbus, OH 43215. E-mail:

The authors have declared they have no conflicts of interest.

This work was presented at the 43rd Annual Scientific Meeting of the International Urogynecological Association, June 29, 2018, Vienna, Austria, and at Pelvic Floor Disorders Week, October 9, 2018, Chicago, IL.

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