Abstract：
BACKGROUND: Parathyroidectomy is recommended for severe secondary hyperparathyroidism (SHPT) due to end-stage kidney disease (ESKD), but surgery is underutilized. High quality and accessible online health information, recommended to be at a 6th-grade reading level, is vital to improve patient health literacy. This study evaluated available online resources for SHPT from ESKD based on information quality and readability.
METHODS: Three search engines were queried using the terms \"parathyroidectomy for secondary hyperparathyroidism,\" \"parathyroidectomy kidney/renal failure,\" \"parathyroidectomy dialysis patients,\" \"should I have surgery for hyperparathyroidism due to kidney failure?,\" and \"do I need surgery for hyperparathyroidism due to kidney failure if I do not have symptoms?\" Websites were categorized by source and origin. Two independent reviewers determined information quality using JAMA (0-4) and DISCERN (1-5) frameworks, and scores were averaged. Cohen\'s kappa evaluated inter-rater reliability. Readability was determined using the Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, and Simple Measure of Gobbledygook tools. Median readability scores were calculated, and corresponding grade level determined. Websites with reading difficulties >6th grade level were calculated.
RESULTS: Thirty one (86.1%) websites originated from the U.S., with most from hospital-associated (63.9%) and foundation/advocacy sources (30.6%). The mean JAMA and DISCERN scores for all websites were 1.3 ± 1.4 and 2.6 ± 0.7, respectively. Readability scores ranged from grade level 5-college level, and most websites scored above the recommended 6th grade level.
CONCLUSIONS: Patient-oriented websites tailoring SHPT from ESKD are at a reading level higher than recommended, and the quality of information is low. Efforts must be made to improve the accessibility and quality of information for all patients.
METHODS: Three search engines were queried using the terms \"parathyroidectomy for secondary hyperparathyroidism,\" \"parathyroidectomy kidney/renal failure,\" \"parathyroidectomy dialysis patients,\" \"should I have surgery for hyperparathyroidism due to kidney failure?,\" and \"do I need surgery for hyperparathyroidism due to kidney failure if I do not have symptoms?\" Websites were categorized by source and origin. Two independent reviewers determined information quality using JAMA (0-4) and DISCERN (1-5) frameworks, and scores were averaged. Cohen\'s kappa evaluated inter-rater reliability. Readability was determined using the Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, and Simple Measure of Gobbledygook tools. Median readability scores were calculated, and corresponding grade level determined. Websites with reading difficulties >6th grade level were calculated.
RESULTS: Thirty one (86.1%) websites originated from the U.S., with most from hospital-associated (63.9%) and foundation/advocacy sources (30.6%). The mean JAMA and DISCERN scores for all websites were 1.3 ± 1.4 and 2.6 ± 0.7, respectively. Readability scores ranged from grade level 5-college level, and most websites scored above the recommended 6th grade level.
CONCLUSIONS: Patient-oriented websites tailoring SHPT from ESKD are at a reading level higher than recommended, and the quality of information is low. Efforts must be made to improve the accessibility and quality of information for all patients.
摘要：
背景：对于因终末期肾病（ESKD）引起的严重继发性甲状旁腺功能亢进（SHPT），建议行甲状旁腺切除术，但是手术没有得到充分利用.高质量和可访问的在线健康信息，建议达到六年级的阅读水平，对提高患者健康素养至关重要。本研究基于信息质量和可读性评估了ESKD提供的SHPT在线资源。
方法：使用术语“继发性甲状旁腺功能亢进的甲状旁腺切除术，甲状旁腺切除术肾/肾衰竭，甲状旁腺切除术透析患者，\"\"我应该为肾功能衰竭引起的甲状旁腺功能亢进做手术吗？，\"和\"如果我没有症状，我是否需要因肾衰竭导致的甲状旁腺功能亢进手术？\"网站按来源和来源进行分类。两名独立的审阅者使用JAMA(0-4)和DISCERN(1-5)框架确定信息质量，分数是平均的。科恩的卡帕评估了评估者间的可靠性。可读性是使用FleschKincaid阅读易读性来确定的，FleschKincaid等级,和Gobbledygook工具的简单测量。计算中值可读性得分，并确定相应的等级。计算了阅读困难>6年级的网站。
结果：有31个（86.1%）的网站来自美国，其中大部分来自医院相关（63.9%）和基金会/宣传来源（30.6%）。所有网站的平均JAMA和DISCERN评分分别为1.3±1.4和2.6±0.7。可读性分数从5年级到大学级别，大多数网站的得分都在推荐的六年级以上。
结论：从ESKD定制SHPT的以患者为导向的网站的阅读水平高于推荐水平，信息质量低。必须努力提高所有患者的信息获取和质量。
方法：使用术语“继发性甲状旁腺功能亢进的甲状旁腺切除术，甲状旁腺切除术肾/肾衰竭，甲状旁腺切除术透析患者，\"\"我应该为肾功能衰竭引起的甲状旁腺功能亢进做手术吗？，\"和\"如果我没有症状，我是否需要因肾衰竭导致的甲状旁腺功能亢进手术？\"网站按来源和来源进行分类。两名独立的审阅者使用JAMA(0-4)和DISCERN(1-5)框架确定信息质量，分数是平均的。科恩的卡帕评估了评估者间的可靠性。可读性是使用FleschKincaid阅读易读性来确定的，FleschKincaid等级,和Gobbledygook工具的简单测量。计算中值可读性得分，并确定相应的等级。计算了阅读困难>6年级的网站。
结果：有31个（86.1%）的网站来自美国，其中大部分来自医院相关（63.9%）和基金会/宣传来源（30.6%）。所有网站的平均JAMA和DISCERN评分分别为1.3±1.4和2.6±0.7。可读性分数从5年级到大学级别，大多数网站的得分都在推荐的六年级以上。
结论：从ESKD定制SHPT的以患者为导向的网站的阅读水平高于推荐水平，信息质量低。必须努力提高所有患者的信息获取和质量。
