(025) Disclosure of Mid-Urethral Sling and Radical Prostatectomy Risks: A Comparative Analysis of Hospital-Affiliated Online Resources
Bibliographic record
Abstract
Abstract Introduction Radical prostatectomy (RP) involves the removal of the prostate gland to treat cancer. The mid-urethral sling (MUS) procedure, used to correct symptoms of stress urinary incontinence in women, affects anterior vaginal wall female periurethral tissue (AVW-FPT). Glandular structures in AVW-FPT have similar immunohistochemistry to prostatic tissue. Erectile dysfunction and female orgasmic disorder have been reported following RP and MUS, respectively. The disclosure of these, and other associated risks, in patient education materials has yet to be assessed. Further investigation is required to determine if and how risk information reported in the literature is presented to patients, as it may impact the ability of patients to make informed health-related decisions. Objective To assess the level of knowledge translation to patients of reported risks associated with MUS and RP procedures in hospital affiliated online resources (HAORs) from Canada, Australia, and the United Kingdom, and to evaluate the accessibility of this information using validated measures of health literacy. Methods A list of healthcare institutions in Canada, Australia, and the UK was generated. RP and MUS-specific HAORs were collected from all institutions. Qualitative analysis of 35 HAORs (RP n=20 and MUS n=15) was conducted using NVivo12. The Patient Education Materials Assessment Tool- Print version (PEMAT-P), was used to determine understandability and actionability, and the Flesch-Kincaid Grade Level (FKGL), Gunning Fox Index (GFI), and Simple Measure of Gobbledygook (SMOG) were used to assess the readability. Results Most RP and MUS HAORs were written higher than the recommended grade 5/6 reading level and were below the threshold values for understandability and actionability. The majority of Canadian MUS HAORs met the adequate threshold values for understandability and actionability, unlike the MUS HAORs from Australia and the UK and the RP resources from all three regions. There was inconsistency between the risks reported in the RP and MUS HAORs from Canada and Australia compared to the risks commonly reported in literature. The organization of information including the use of diagrams and medical jargon in the HAORs differed between RP and MUS documents and across the three regions. RP HAORs used diagrams more consistently than MUS HAORs and scored higher on measures of understandability and actionability. The RP and MUS HAORs from the three regions that used medical jargon scored lower on measures of readability. There was inconsistency in the reporting of sexual health risks between the RP and MUS HAORs in all three regions. MUS HAORs less consistently reported sexual health risks following surgery compared to RP HAORs. Conclusions HAORs are important means by which health-related information is translated to patients. There were inconsistencies in the risk information reported for RP versus MUS in Canada, Australia, and the UK. This discordance may impact patient decision-making and health outcomes. The development of guidelines for HAORs curation for healthcare institutions operating under similar healthcare frameworks may be beneficial in ensuring equal access to health information for all patients. Disclosure No
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.040 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".