Abstract：
BACKGROUND: Online resources are important for patient self-education and reflect public interest. We described commonly asked questions regarding the direct anterior versus posterior approach (DAA, PA) to total hip arthroplasty (THA) and the quality of associated websites.
METHODS: We extracted the top 200 questions and websites in Google\'s \"People Also Ask\" section for 8 queries on January 8, 2023, and grouped websites and questions into DAA, PA, or comparison. Questions were categorized using Rothwell\'s classification (fact, policy, value) and THA-relevant subtopics. Websites were evaluated by information source, Journal of the American Medical Association Benchmark Criteria (credibility), DISCERN survey (information quality), and readability.
RESULTS: We included 429 question/website combinations (questions: 52.2% DAA, 21.2% PA, 26.6% comparison; websites: 39.0% DAA, 11.0% PA, 9.6% comparison). Per Rothwell\'s classification, 56.2% of questions were fact, 31.7% value, 10.0% policy, and 2.1% unrelated. The THA-specific question subtopics differed between DAA and PA (P < .001), specifically for recovery timeline (DAA 20.5%, PA 37.4%), indications/management (DAA 13.4%, PA 1.1%), and technical details (DAA 13.8%, PA 5.5%). Information sources differed between DAA (61.7% medical practice/surgeon) and PA websites (44.7% government; P < .001). The median Journal of the American Medical Association Benchmark score was 1 (limited credibility, interquartile range 1 to 2), with the lowest scores for DAA websites (P < .001). The median DISCERN score was 55 (\"good\" quality, interquartile range 43 to 65), with the highest scores for comparison websites (P < .001). Median Flesch-Kincaid Grade Level scores were 12th grade level for both DAA and PA (P = .94).
CONCLUSIONS: Patients\' informational interests can guide counseling. Internet searches that explicitly compare THA approaches yielded websites that provide higher-quality information. Providers may also advise patients that physician websites and websites only describing the DAA may have less balanced perspectives, and limited information regarding surgical approaches is available from social media resources.
METHODS: We extracted the top 200 questions and websites in Google\'s \"People Also Ask\" section for 8 queries on January 8, 2023, and grouped websites and questions into DAA, PA, or comparison. Questions were categorized using Rothwell\'s classification (fact, policy, value) and THA-relevant subtopics. Websites were evaluated by information source, Journal of the American Medical Association Benchmark Criteria (credibility), DISCERN survey (information quality), and readability.
RESULTS: We included 429 question/website combinations (questions: 52.2% DAA, 21.2% PA, 26.6% comparison; websites: 39.0% DAA, 11.0% PA, 9.6% comparison). Per Rothwell\'s classification, 56.2% of questions were fact, 31.7% value, 10.0% policy, and 2.1% unrelated. The THA-specific question subtopics differed between DAA and PA (P < .001), specifically for recovery timeline (DAA 20.5%, PA 37.4%), indications/management (DAA 13.4%, PA 1.1%), and technical details (DAA 13.8%, PA 5.5%). Information sources differed between DAA (61.7% medical practice/surgeon) and PA websites (44.7% government; P < .001). The median Journal of the American Medical Association Benchmark score was 1 (limited credibility, interquartile range 1 to 2), with the lowest scores for DAA websites (P < .001). The median DISCERN score was 55 (\"good\" quality, interquartile range 43 to 65), with the highest scores for comparison websites (P < .001). Median Flesch-Kincaid Grade Level scores were 12th grade level for both DAA and PA (P = .94).
CONCLUSIONS: Patients\' informational interests can guide counseling. Internet searches that explicitly compare THA approaches yielded websites that provide higher-quality information. Providers may also advise patients that physician websites and websites only describing the DAA may have less balanced perspectives, and limited information regarding surgical approaches is available from social media resources.
摘要：
背景：在线资源对于患者的自我教育很重要，反映了公众的兴趣。我们描述了关于直接前后入路的常见问题（DAA，PA）对全髋关节置换术（THA）和相关网站的质量。
方法：我们在2023年1月8日提取了Google的“PeopleAlsoAsk”部分中的前200个问题和网站，用于八个查询，并将网站和问题分组为DAA，PA,或比较。使用Rothwell的分类对问题进行了分类(事实，政策,值)和与THA相关的子主题。网站按信息源进行了评估，美国医学会杂志(JAMA)基准标准(可信度)，否认调查(信息质量)，和可读性。
结果：我们包括429个问题/网站组合（问题：52.2％DAA，21.2%PA,26.6%比较；网站：39.0%DAA，11.0%PA，9.6%比较）。根据罗斯威尔的分类，56.2%的问题是事实，31.7%值，10.0%的政策，和2.1%无关。DAA和PA之间的THA特定问题子主题不同（P<0.001），特别是恢复时间表(DAA20.5%，PA37.4%)，适应症/管理（DAA13.4%，PA1.1%），和技术细节(DAA13.8%，PA5.5%）。DAA（61.7％的医疗实践/外科医生）和PA网站（44.7％的政府；P<0.001）之间的信息源存在差异。JAMA基准得分中位数为1(可信度有限，四分位数间距1至2)，DAA网站得分最低（P<0.001）。DISCERN评分中位数为55分(“良好”质量，四分位数间距43到65)，比较网站得分最高(P<0.001)。DAA和PA的Flesch-Kincaid成绩中位数均为12年级（P=0.94）。
结论：患者的信息兴趣可以指导咨询。明确比较THA方法的互联网搜索产生了提供更高质量信息的网站。提供者还可以告知患者，医生网站和仅描述DAA的网站可能具有不太平衡的观点，关于手术方法的有限信息可从社交媒体资源获得。
方法：我们在2023年1月8日提取了Google的“PeopleAlsoAsk”部分中的前200个问题和网站，用于八个查询，并将网站和问题分组为DAA，PA,或比较。使用Rothwell的分类对问题进行了分类(事实，政策,值)和与THA相关的子主题。网站按信息源进行了评估，美国医学会杂志(JAMA)基准标准(可信度)，否认调查(信息质量)，和可读性。
结果：我们包括429个问题/网站组合（问题：52.2％DAA，21.2%PA,26.6%比较；网站：39.0%DAA，11.0%PA，9.6%比较）。根据罗斯威尔的分类，56.2%的问题是事实，31.7%值，10.0%的政策，和2.1%无关。DAA和PA之间的THA特定问题子主题不同（P<0.001），特别是恢复时间表(DAA20.5%，PA37.4%)，适应症/管理（DAA13.4%，PA1.1%），和技术细节(DAA13.8%，PA5.5%）。DAA（61.7％的医疗实践/外科医生）和PA网站（44.7％的政府；P<0.001）之间的信息源存在差异。JAMA基准得分中位数为1(可信度有限，四分位数间距1至2)，DAA网站得分最低（P<0.001）。DISCERN评分中位数为55分(“良好”质量，四分位数间距43到65)，比较网站得分最高(P<0.001)。DAA和PA的Flesch-Kincaid成绩中位数均为12年级（P=0.94）。
结论：患者的信息兴趣可以指导咨询。明确比较THA方法的互联网搜索产生了提供更高质量信息的网站。提供者还可以告知患者，医生网站和仅描述DAA的网站可能具有不太平衡的观点，关于手术方法的有限信息可从社交媒体资源获得。
