Changes in Health Education Literacy After Structured Web-Based Education Versus Self-Directed Online Information Seeking in Patients Undergoing Carpal Tunnel Release Surgery: Nonrandomized, Controlled Study
Bibliographic record
Abstract
Background: With advancements in anesthesiologic and surgical techniques, many surgeries are now performed as day-surgery procedures, requiring greater responsibilities for self-management from patients during the perioperative process. Online health information often lacks reliability and comprehensibility, posing risks for patients with low health literacy. Carpal tunnel release (CTR) surgery, a common day-surgery procedure, necessitates effective patient education for optimal recovery and self-management. Objective: This study introduces the CTS Academy, a web-based education program designed for patients undergoing CTR day surgery. The study aimed to evaluate the CTS Academy's impact on patients' health education literacy (HEL) compared with self-directed online information seeking. Methods: A scoping review on education programs focusing on the perioperative process of CTR was conducted before this study. In a nonrandomized controlled study, 60 patients scheduled for CTR were assigned to 2 groups based on the patients' preferences; the test group used the CTS Academy, while the control group performed self-directed online searches. HEL was assessed using the Health Education Literacy of Patients with chronic musculoskeletal diseases (HELP) questionnaire, focusing on patients's comprehension of medical information (COMPR), patients's ability to apply health-related information in an everyday life (APPLY), and patient's ability to communicate with health care professional (COMM). Secondary outcomes included content comprehensibility, patient preferences, platform usability, and clinical carpal tunnel syndrome (CTS)-related parameters. Results: In the scoping review, 17 studies could be identified and included for full-text analysis. Eighteen patients each were included in the test group (13 women and 5 men) and in the control group (11 women and 7 men). The average time spent in the study was 167 and 176 days for the test and control groups, respectively. The test group showed significant improvements in APPLY (mean 28, SD 7.99 vs mean 24, SD 5.14; P<.05) and COMM (mean 30, SD 10.52 vs mean 25, SD 6.01; P=.02) after using the CTS Academy in a longitudinal analysis. No significant changes were observed in the control group. In a comparison between groups, the test group had significantly higher APPLY scores at follow-up (mean 24, SD 5.14 vs mean 33, SD 14.78; P=.044) and fewer comprehension issues at baseline (mean 38, SD 16.60 vs mean 50, SD 19.00; P=.03). The CTS-related knowledge assessment yielded 92% (66/72) versus 90% (65/72) correct answers in the test and control groups, respectively. The test group rated the CTS Academy highly in usability (6.22 of 7.00 points) and utility (6.13 of 7.00 points). Preferences leaned toward using CTS Academy alongside doctor consultations (16/18, 89%) and over self-directed searches (15/18, 84%). No significant differences were found in CTS-related symptoms between groups. Conclusions: The CTS Academy effectively enhanced patients' HEL, especially in applying and communicating medical information. The platform's usability and utility were rated favorably, and patients preferred it over independent online information seeking. This suggests that structured, web-based education enhances patient self-management during the day surgery process.
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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 | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".