Background: The internet is an emerging source of information for prostate cancer (PCa) patients. Since little is known about the quality of information on PCa provided online, we investigated its accordance to the latest European Association of Urology (EAU) guidelines. Methods: A total of 89 German web pages were included for analysis. A quality model classifying the provider of information and its expertise was introduced. Correctness of provided information was systematically compared to the EAU guidelines. Results: Information was provided by medical experts (41%), media (11%), and pharmaceutical companies (6%). Certificates were found in 23% with a significantly higher rate if provided by medical experts (p = 0.003). The minority of web pages showed information in accordance with the EAU guidelines regarding screening (63%), diagnosis (32%), classification (39%), therapy (36%), complications (8%), and follow-up (27%). Web pages by medical experts as well as websites with any kind of certification showed a significantly higher guideline conformity regarding diagnosis (p = 0.027, p = 0.002), therapy (p = 0.010, p = 0.011), follow-up (p = 0.005, p < 0.001), and availability of references (p = 0.017, p = 0.003). Conclusions: The present study reveals that online health information on PCa lacks concordance to current guidelines. Certified websites or websites provided by medical experts showed a significantly higher quality and accordance with guidelines.

Keywords:
Prostate carcinoma, Internet, Guidelines, Accordance, Information behavior, Information seeking
1.
Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW: Patients’ use of the Internet for medical information. J Gen Intern Med 2002; 17: 180–185.
2.
Wong MC, Goggins WB, Wang HH, Fung FD, Leung C, Wong SY, Ng CF, Sung JJ: Global incidence and mortality for prostate cancer: analysis of temporal patterns and trends in 36 countries. Eur Urol 2016; 70: 862–874.
3.
Xu S, Markson C, Costello KL, Xing CY, Demissie K, Llanos AA: Leveraging social media to promote public health knowledge: example of cancer awareness via twitter. JMIR Public Health Surveill 2016; 2:e17.
4.
Williamson JM, Skinner CI, Hocken DB: Death and illness as depicted in the media. Int J Clin Pract 2011; 65: 547–551.
5.
Buntrock S, Hopfgarten T, Adolfsson J, Onelöv E, Steineck G: The Internet and prostate cancer patients: searching for and finding information. Scand J Urol Nephrol 2007; 41: 367–374.
6.
Davison BJ, Breckon EN: Impact of health informationseeking behavior and personal factors on preferred role in treatment decision making in men with newly diagnosed prostate cancer. Cancer Nurs 2012; 35: 411–418.
7.
Zhou ES, Bober SL, Nekhlyudov L, Hu JC, Kantoff PW, Recklitis CJ: Physical and emotional health information needs and preferences of long-term prostate cancer survivors. Patient Educ Couns 2016; 99: 2049–2054.
8.
Quinn EM, Corrigan MA, McHugh SM, Murphy D, O’Mullane J, Hill AD, Redmond HP: Who’s talking about breast cancer? Analysis of daily breast cancer posts on the internet. Breast 2013; 22: 24–27.
9.
Broom A: Virtually he@lthy: the impact of internet use on disease experience and the doctor-patient relationship. Qual Health Res 2005; 15: 325–345.
10.
Diaz JA, Sciamanna CN, Evangelou E, Stamp MJ, Ferguson T. Brief report: what types of Internet guidance do patients want from their physicians? J Gen Intern Med 2005; 20: 683–685.
11.
Rosenberg SA, Francis D, Hullett CR, Morris ZS, Fisher MM, Brower JV, Bradley KA, Anderson BM, Bassetti MF, Kimple RJ: Readability of online patient educational resources Found on NCI-designated cancer center web sites. J Natl Compr Canc Netw 2016; 14: 735–740.
12.
Alba-Ruiz R, Bermúdez-Tamayo C, Pernett JJ, Garcia-Gutierrez JF, Cózar-Olmo JM, Valero-Aguilera B: Adapting the content of cancer web sites to the information needs of patients: reliability and readability. Telemed J E Health 2013; 19: 956–966.
13.
Ellimoottil C, Polcari A, Kadlec A, Gupta G: Readability of websites containing information about prostate cancer treatment options. J Urol 2012; 188: 2171–2175.
14.
Borgmann H, Wölm JH, Vallo S, Mager R, Huber J, Breyer J, Salem J, Loeb S, Haferkamp A, Tsaur I: Prostate cancer on the web-expedient tool for patients’ decision-making? J Cancer Educ 2017; 32: 135–140.
15.
Betschart P, Zumstein V, Hasan Ali O, Schmid HP, Abt D: Readability assessment of patient education material published by German-speaking associations of Urology. Urol Int 2017; 100: 79–84.
16.
Boyer C, Selby M, Appel RD: The health on the net code of conduct for medical and health web sites. Stud Health Technol Inform 1998; 52(pt 2):1163–1166.
17.
Nassiri M, Bruce-Brand RA, O'Neill F, Chenouri S, Curtin P: Perthes disease: the quality and reliability of information on the Internet. J Pediatr Orthop 2015; 35: 530–535.
18.
Weymann N, Härter M, Dirmaier J: Quality of online information on type 2 diabetes: a cross-sectional study. Health Promot Int 2015; 30: 821–831.
19.
Adorisio O, Silveri M, Rivosecchi M, Tozzi AE, Scottoni F, Buonuomo PS: Analysis of readability and quality of web pages addressing both common and uncommon topics in pediatric surgery. Eur J Pediatr Surg 2012; 22: 228–233.
20.
Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, Mottet N; European Association of Urology: EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol 2014; 65: 124–137.
21.
Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, Mottet N; European Association of Urology: EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol 2014; 65: 467–479.
22.
Friedman DB, Koskan A, Rose ID: Prostate cancer guidelines on Web 2.0-based sites: the screening dilemma continues online. J Cancer Educ 2011; 26: 188–193.
23.
Warren E, Footman K, Tinelli M, McKee M, Knai C: Do cancer-specific websites meet patient’s information needs? Patient Educ Couns 2014; 95: 126–136.
24.
Silk KJ, Perrault EK, Nazione S, Pace K, Hager P, Springer S: Localized prostate cancer treatment decision-making information online: improving its effectiveness and dissemination for nonprofit and government-supported organizations. J Cancer Educ 2013; 28: 709–716.
25.
Miller SM, Hudson SV, Hui SK, Diefenbach MA, Fleisher L, Raivitch S, Belton T, Roy G, Njoku A, Scarpato J, Viterbo R, Buyyounouski M, Denlinger C, Miyamoto C, Reese A, Baman J: Development and preliminary testing of PROGRESS: a Web-based education program for prostate cancer survivors transitioning from active treatment. J Cancer Surviv 2015; 9: 541–553.
26.
Joseph-Williams N, Evans R, Edwards A, Newcombe RG, Wright P, Grol R, Elwyn G: Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid. J Med Internet Res 2010; 12:e15.
27.
Groeben C, Ihrig A, Hölscher T, Krones T, Kessler E, Kliesch S, Wülfing C, Koch R, Wirth MP, Huber J: [Evaluation of the decision aid “Entscheidungshilfe Prostatakrebs from the patients” view: results from the first three months]. Urologe 2016; 55: 1586–1594.
28.
Bjoernes CD, Laursen BS, Delmar C, Cummings E, Nøhr C: A dialogue-based Web application enhances personalized access to healthcare professionals – an intervention study. BMC Med Inform Decis Mak 2012; 12: 96.
© 2018 S. Karger AG, Basel
2018
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.