TY - JOUR AU - Nguyen, Derek AU - Javaheri, Jennifer AU - Sanchez, Ruth AU - Han, Vy PY - 2025/3/28 TI - Popular Treatments of Psoriasis on Social Media: Google Trends Analysis JO - JMIR Dermatol SP - e70067 VL - 8 KW - psoriasis KW - biologics KW - Google Trends KW - Reddit KW - Facebook KW - treatment UR - https://derma.jmir.org/2025/1/e70067 UR - http://dx.doi.org/10.2196/70067 ID - info:doi/10.2196/70067 ER - TY - JOUR AU - Perez-Bootello, Javier AU - Berna-Rico, Emilio AU - Abbad-Jaime de Aragon, Carlota AU - Cova-Martin, Ruth AU - Goni, Leticia AU - Ballester-Martinez, Asuncion AU - Jaen-Olasolo, Pedro AU - Mehta, Nehal AU - Gelfand, M. Joel AU - Martinez-Gonzalez, Angel Miguel AU - Gonzalez-Cantero, Alvaro PY - 2025/1/29 TI - Impact of the Mediterranean Diet on Patients With Psoriasis: Protocol for a Randomized Controlled Trial JO - JMIR Res Protoc SP - e64277 VL - 14 KW - psoriasis KW - Mediterranean diet KW - MedDiet KW - nutritional intervention KW - olive oil KW - inflammatory disease KW - Impact of the Mediterranean Diet on Patients with Psoriasis KW - MEDIPSO KW - dietary intervention KW - methodological analysis KW - randomized controlled trial KW - RCT KW - clinical trial KW - nutrition KW - diet KW - Europe N2 - Background: Psoriasis is an inflammatory disease primarily treated through molecular-targeted therapies. However, emerging evidence suggests that dietary interventions may also play a role in managing inflammation associated with this condition. The Mediterranean diet (MedDiet), prevalent in southern European countries, has been widely recognized for its ability to reduce cardiovascular mortality, largely due to its anti-inflammatory properties. This anti-inflammatory potential has prompted interest in exploring the MedDiet?s role in immune-mediated diseases, including psoriasis. Observational studies have indicated potential benefits, such as reductions in the Psoriasis Area and Severity Index. However, there is a need for well-designed clinical trials to address the methodological limitations of these studies and to establish specific dietary recommendations for psoriasis. Objective: This study aims to evaluate the impact of an intensive dietary intervention based on the MedDiet in patients with psoriasis. The study will assess the effects of this intervention on skin involvement, metabolic parameters, and inflammatory cytokines. In addition, the emotional well-being and quality of life of participants will be evaluated using validated questionnaires. A methodological analysis will also be conducted to enhance the design of future large-scale clinical trials. Methods: An open-label, single-blinded (evaluator) randomized controlled trial was designed to assess the impact of a high-intensity MedDiet intervention in patients with mild-to-moderate psoriasis. A total of 38 patients will be randomly assigned into 2 groups?an intervention group receiving the MedDiet intervention and a control group receiving standard care. The intervention group will participate in dietary education sessions aimed at adopting the MedDiet over 4 months, with monthly monitoring by experienced nutritionists. Participants will receive 500 mL of extra virgin olive oil per week, along with informative materials, recipes, and weekly menus. In contrast, the control group will receive standard low-fat diet recommendations without nutritionist monitoring. All participants will undergo a baseline visit, a 2-month follow-up visit, and a final visit at 4 months. Blood tests will be conducted at the beginning and end of the study. This study protocol was approved by the Institutional Review Board of the Hospital Ramón y Cajal (Madrid) in July 2023. Results: Enrollment concluded in October 2024, with data collection set to finish by February 2025. The findings will be presented at national and international conferences and published in peer-reviewed journals. Conclusions: This protocol outlines the design of a clinical trial that implements the MedDiet in patients with psoriasis to evaluate its benefits on skin involvement, systemic inflammation, and quality of life. Trial Registration: ClinicalTrials.gov NCT06257641; https://clinicaltrials.gov/study/NCT06257641 International Registered Report Identifier (IRRID): DERR1-10.2196/64277 UR - https://www.researchprotocols.org/2025/1/e64277 UR - http://dx.doi.org/10.2196/64277 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/64277 ER - TY - JOUR AU - Nigro, Rose Alexandra AU - Osman, Alim AU - Saal, Charles Ryan AU - Smith, James Robert PY - 2025/1/28 TI - Information Regarding Dermatology as Seen on the Social Media Platform TikTok JO - JMIR Dermatol SP - e59597 VL - 8 KW - internet KW - social media KW - dermatology KW - TikTok KW - health care information KW - dermatological content KW - statistical analysis KW - dermatologists KW - online content KW - misinformation KW - engagement KW - health information KW - patient health KW - web platforms KW - patient education KW - digital health KW - online information KW - skin care KW - online videos UR - https://derma.jmir.org/2025/1/e59597 UR - http://dx.doi.org/10.2196/59597 ID - info:doi/10.2196/59597 ER - TY - JOUR AU - Duggal, Keenan PY - 2025/1/17 TI - Patterns of Public Interest in Lipomas and Lipoma-Removal Procedures: Google Trends Analysis JO - JMIR Dermatol SP - e62993 VL - 8 KW - lipoma KW - fatty tumor KW - adipocyte KW - public interest KW - Google Trends N2 - Background: Lipomas are benign tumors composed of encapsulated adipocytes. Although relatively common, uncertainty remains about the population-level prevalence, the etiology, and the degree of public interest in lipomas and associated removal procedures. Objective: The spatiotemporal patterns of public interest in lipomas and lipoma removal procedures were characterized. Methods: Google Trends data that report the relative search volume (RSV) of Google queries pertaining to lipomas and their removal procedures at national and international levels were analyzed. To contextualize these trends, the RSV for lipomas was compared to that of several other common dermatological conditions in the United States. Results: In the United States, lipomas have consistently generated lower levels of public interest than other common dermatological conditions, but interest in the condition has been rising since the mid-2010s. Across the world, public interest in lipomas appears to be the highest in pockets of Eastern Europe, whereas in the United States, relative interest has been higher in Midwestern and Southern states. In addition, the interest in lipoma removal procedures has risen steadily from 2004 to the present, with particularly high RSVs coming from Southwestern states Conclusions: Dermatologists and plastic surgeons should be aware of the increasing public interest in lipomas and lipoma-removal procedures. Clinical awareness is especially important in states with an elevated interest in lipomas and their associated removal procedures. UR - https://derma.jmir.org/2025/1/e62993 UR - http://dx.doi.org/10.2196/62993 ID - info:doi/10.2196/62993 ER - TY - JOUR AU - Varghese, Johny Kevin AU - Singh, Som AU - Kamali, Emily AU - Qureshi, Fahad AU - Jamal, Aleena AU - Qureshi, Fawad PY - 2025/1/6 TI - Modern Digital Query Analytics of Patient Education Materials on Acanthosis Nigricans: Systematic Search and Content Analysis JO - JMIR Dermatol SP - e60210 VL - 8 KW - acanthosis nigricans KW - dermatology KW - patient education KW - public health KW - skin KW - readability KW - information resource KW - DISCERN KW - general public KW - reading level KW - information seeking KW - information behavior N2 - Background: Online digital materials are integral to patient education and health care outcomes in dermatology. Acanthosis nigricans (AN) is a common condition, often associated with underlying diseases such as insulin resistance. Patients frequently search the internet for information related to this cutaneous finding. To our knowledge, the quality of online educational materials for AN has not been systematically examined. Objective: The primary objective of this study was to profile the readability and quality of the content of publicly available digital educational materials on AN and identify questions frequently asked by patients. Methods: This study analyzed publicly available internet sources to identify the most frequent questions searched by patients regarding AN using the Google Rankbrain algorithm. Furthermore, available articles on AN were evaluated for quality and reading level using metrics such as the Brief DISCERN score, and readability was determined using three specific scales including the Flesch-Kincaid score, Gunning Fog index, and the Coleman-Liau index, based on literature. Results: Patients most frequently accessed facts on AN from government sources, which comprised 30% (n=15) of the analyzed sources. The available articles did not meet quality standards and were at a reading level not appropriate for the general public. The majority of articles (n=29/50, 58%) had substandard Brief DISCERN scores, failing to meet the criteria for good quality. Conclusions: Clinicians should be aware of the paucity of valuable online educational material on AN and educate their patients accordingly. UR - https://derma.jmir.org/2025/1/e60210 UR - http://dx.doi.org/10.2196/60210 ID - info:doi/10.2196/60210 ER - TY - JOUR AU - Brzozowska, Martyna Justyna AU - Gotlib, Joanna PY - 2025/1/6 TI - Social Media Potential and Impact on Changing Behaviors and Actions in Skin Health Promotion: Systematic Review JO - J Med Internet Res SP - e54241 VL - 27 KW - skin KW - social media KW - prevention KW - behavioral intervention KW - skin cancer KW - sun protection KW - acne N2 - Background: Social media is used as a tool for information exchange, entertainment, education, and intervention. Intervention efforts attempt to engage users in skin health. Objective: This review aimed to collect and summarize research assessing the impact of social media on skin health promotion activities undertaken by social media users. Methods: In accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, the following scientific databases were searched: Scopus, Web of Science, PubMed, Academic Search Ultimate (via EBSCO), Academic Research Source eJournals (via EBSCO), ERIC (via EBSCO), Health Source: Consumer Edition (via EBSCO), and Health Source: Nursing/Academic Edition (via EBSCO). Using ProQuest Dissertations and Theses, OpenGrey, Grey Literature Report, and MedNar, the search was supplemented with gray literature. Articles on skin care, skin health, skin diseases, skin protection, and educational activities promoting healthy skin on social media were selected for review (search date: February 6, 2023). The following qualification criteria were used: original research; research conducted on social media; and research topics regarding educational activities in skin health promotion, skin care, skin health, skin diseases, and skin protection. To assess the risk of bias, the following tools were used: the Cochrane Collaboration tool for risk-of-bias assessment (randomized controlled trials and quasi-experimental studies) and the Centre for Evidence-Based Medicine checklist (cross-sectional studies). Results: Altogether, 1558 works were considered, of which 23 (1.48%) qualified, with 3 (13%) studies on acne and 20 (87%) on skin cancer, sunscreen, and tanning. Social media interventions were dealt with in 65% (15/23) of the studies. The review made it possible to investigate cognitive and cognitive-behavioral interventions. In both observational and interventional studies, the most frequently discussed topics were skin exposure and protection against UV radiation and skin cancer. The analyzed research showed that social media is a source of information. Visualization has a strong impact on users. The involvement of social media users is measured through the amount of content shared and contributes to changing attitudes and behaviors regarding skin health. Conclusions: This review outlined the impact of social media, despite its heterogeneity, on users? skin health behaviors, attitudes, and actions. It identified strategies for digital interventions to promote skin health. In health sciences, a standardized tool is needed to assess the quality of social media digital interventions. This review has several limitations: only articles written in English were considered; ongoing studies were omitted; and there was a small number of interventional studies on acne and a lack of research on daily skin care, education, and antiaging activities on social media. Another limitation, resulting from the topic being too broad, was a failure to perform quantitative data analysis, resulting in the studies that qualified for the review being heterogeneous. UR - https://www.jmir.org/2025/1/e54241 UR - http://dx.doi.org/10.2196/54241 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/54241 ER - TY - JOUR AU - Szeto, D. Mindy AU - Alhanshali, Lina AU - Rundle, W. Chandler AU - Adelman, Madeline AU - Hook Sobotka, Michelle AU - Woolhiser, Emily AU - Wu, Jieying AU - Presley, L. Colby AU - Maghfour, Jalal AU - Meisenheimer, John AU - Anderson, B. Jaclyn AU - Dellavalle, P. Robert PY - 2024/12/11 TI - Dermatologic Data From the Global Burden of Disease Study 2019 and the PatientsLikeMe Online Support Community: Comparative Analysis JO - JMIR Dermatol SP - e50449 VL - 7 KW - Global Burden of Disease KW - GBD KW - PatientsLikeMe KW - PLM KW - online support communities KW - forums KW - users KW - social media KW - internet KW - demographics KW - lived experience KW - disability-adjusted life year KW - DALY KW - prevalence KW - dermatology KW - comparative analysis UR - https://derma.jmir.org/2024/1/e50449 UR - http://dx.doi.org/10.2196/50449 ID - info:doi/10.2196/50449 ER - TY - JOUR AU - Orr, Noreen AU - Rogers, Morwenna AU - Stein, Abigail AU - Thompson Coon, Jo AU - Stein, Kenneth PY - 2024/12/6 TI - Reviewing the Evidence Base for Topical Steroid Withdrawal Syndrome in the Research Literature and Social Media Platforms: An Evidence Gap Map JO - J Med Internet Res SP - e57687 VL - 26 KW - topical steroid withdrawal syndrome KW - evidence gap map KW - social media KW - blogs KW - Instagram KW - Reddit KW - topical corticosteroids N2 - Background: Within the dermatological community, topical steroid withdrawal syndrome (TSWS) is a medically contested condition with a limited research base. Published studies on TSWS indicate that it is a distinct adverse effect of prolonged use of topical corticosteroids, but there is a paucity of high-quality research evidence. Among the ?patient community,? awareness has been increasing, with rapid growth in social media posts on TSWS and the introduction of online communities such as the International Topical Steroid Awareness Network. This evidence gap map (EGM) was developed in response to recent calls for research to better understand TSWS and aims to be an important resource to guide both researchers and clinicians in the prioritization of research topics for further research. Objective: This study aims to identify the range, extent, and type of evidence on TSWS in the research literature and social media platforms using an EGM. Methods: The MEDLINE and Embase (Ovid), CINAHL (EBSCOhost), and ProQuest Dissertations & Theses and Conference Proceedings Citation Index (CPCI-Science and CPCI-Social Science & Humanities via Web of Science) databases were searched. The final search was run in November 2023. Study titles, abstracts, and full texts were screened by 2 reviewers, and a third was consulted to resolve any differences. Blogging sites WordPress, Medium, and Blogspot and Google were searched; Instagram and Reddit were searched for the 100 most recent posts on specific dates in February 2023. Blog titles, Instagram posts, and Reddit posts were screened for relevance by 2 reviewers. A data extraction tool was developed on EPPI-Reviewer, and data extraction was undertaken by one reviewer and checked by a second; any inconsistencies were resolved through discussion. We did not undertake quality appraisal of the included studies. EPPI-Reviewer and EPPI-Mapper were used to generate the interactive EGM. Results: Overall, 81 academic publications and 223 social media posts were included in the EGM. The research evidence mainly addressed the physical symptoms of TSWS (skin), treatments, and, to a lesser extent, risk factors and disease mechanisms. The social media evidence primarily focused on the physical symptoms (skin and nonskin), mental health symptoms, relationships, activities of everyday living, beliefs and attitudes, and treatments. Conclusions: The EGM shows that research evidence is growing on TSWS but remains lacking in several important areas: longer-term prospective observational studies to assess the safety of prolonged use of topical corticosteroids and to prevent addiction; qualitative research to understand the lived experience of TSWS; and longitudinal research on the patient?s ?TSWS journey? to healing. The inclusion of social media evidence is a methodological innovation in EGMs, recognizing the increased presence of #topicalsteroidwithdrawal on social media and how it can be used to better understand the patient perspective and ultimately, provide better care for people with TSWS. UR - https://www.jmir.org/2024/1/e57687 UR - http://dx.doi.org/10.2196/57687 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/57687 ER - TY - JOUR AU - Chang, Annie AU - Young, Jade AU - Para, Andrew AU - Lamb, Angela AU - Gulati, Nicholas PY - 2024/11/20 TI - Efficacy of ChatGPT in Educating Patients and Clinicians About Skin Toxicities Associated With Cancer Treatment JO - JMIR Dermatol SP - e54919 VL - 7 KW - artificial intelligence KW - ChatGPT KW - oncodermatology KW - cancer therapy KW - language learning model UR - https://derma.jmir.org/2024/1/e54919 UR - http://dx.doi.org/10.2196/54919 ID - info:doi/10.2196/54919 ER - TY - JOUR AU - Lim, Subin AU - Kooper-Johnson, Sarah AU - Chau, A. Courtney AU - Chen, Claire AU - Yang, Clarissa Fei-Shiuann AU - Cobos, Gabriela PY - 2024/10/1 TI - Google Search Trends About Systemic Psoriasis Treatment: What Do People Want to Know About Biologics and Janus Kinase Inhibitors? JO - JMIR Dermatol SP - e62948 VL - 7 KW - Google KW - psoriasis vulgaris KW - psoriasis KW - systemic treatment KW - biologics KW - small molecule inhibitors KW - adalimumab KW - apremilast KW - methotrexate KW - health care delivery KW - skin KW - dermatologist KW - medication UR - https://derma.jmir.org/2024/1/e62948 UR - http://dx.doi.org/10.2196/62948 UR - http://www.ncbi.nlm.nih.gov/pubmed/39243516 ID - info:doi/10.2196/62948 ER - TY - JOUR AU - Parmar, Pritika AU - Singal, Amit AU - Szeto, D. Mindy AU - Pathak, N. Gaurav AU - Taranto, Viktoria AU - Truong, M. Thu AU - Rao, Babar AU - Miranda, Andrade Andrea AU - Franco, VA Juan AU - Dellavalle, P. Robert PY - 2024/8/21 TI - From the Cochrane Library: Interventions for Chronic Pruritus of Unknown Origin JO - JMIR Dermatol SP - e53271 VL - 7 KW - Cochrane KW - systematic review KW - randomized controlled trial KW - RCT KW - pruritus KW - chronic pruritus KW - chronic pruritus of unknown origin KW - CPUO KW - serlopitant KW - dupilumab KW - pregabalin UR - https://derma.jmir.org/2024/1/e53271 UR - http://dx.doi.org/10.2196/53271 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/53271 ER - TY - JOUR AU - Mylle, Sofie AU - Papeleu, Jorien AU - Hoorens, Isabelle AU - Verhaeghe, Evelien AU - Brochez, Lieve PY - 2024/2/29 TI - The Value of Teledermatology Advice for Skin Toxicity in Oncology: Experience From a Pilot Study JO - JMIR Dermatol SP - e40053 VL - 7 KW - e-health KW - teledermatology KW - oncology KW - epidermal growth factor receptor KW - EGFR-inhibitors KW - skin toxicity KW - cancer KW - dermatology KW - therapy KW - pilot study UR - https://derma.jmir.org/2024/1/e40053 UR - http://dx.doi.org/10.2196/40053 UR - http://www.ncbi.nlm.nih.gov/pubmed/38422495 ID - info:doi/10.2196/40053 ER - TY - JOUR AU - Anaje, Chioma Chetanna AU - Okpala, Ifeanyi Chibuzo AU - Enechukwu, Anne Nkechi AU - Ezejiofor, Ifeanyi Ogochukwu AU - Malachy, Echezona Divinefavour AU - Nwiyi, Kenechukwu Obumneme PY - 2023/11/21 TI - The Impact of WhatsApp as a Health Education Tool in Albinism: Interventional Study JO - JMIR Dermatol SP - e49950 VL - 6 KW - WhatsApp KW - oculocutaneous albinism KW - health education KW - smartphone KW - mobile phone KW - teledermatology KW - photodermatoses KW - digital health intervention KW - photoprotection KW - West Africa KW - social media KW - albinism KW - albino KW - skin KW - dermatology KW - melanin KW - patient education KW - sun KW - sunscreen KW - discussion group KW - digital health education N2 - Background: Oculocutaneous albinism is a congenital disorder that causes hypopigmentation of the skin, hair, and eyes due to a lack of melanin. People with albinism are at increased risk of developing skin complications, such as solar keratosis and skin cancers, leading to higher morbidity. As education is crucial in managing albinism, leveraging information technology, such as WhatsApp, can provide an effective intervention for digital health education. Objective: This study aims to assess the impact of WhatsApp as a tool for providing health education among people with albinism. Methods: The design of the study was interventional. The intervention consisted of weekly health education sessions conducted in a WhatsApp group for the duration of 4 weeks. The topics discussed were knowledge of albinism, sun protection practices, the use of sunscreen, and myths about albinism. They were all covered in 4 WhatsApp sessions held in 4 separate days. A web-based questionnaire was filled out before and after the intervention by the participants. Mann-Whitney U test was used to compare the pre- and postknowledge scores. Spearman correlation was used to correlate data. Results: The mean age of the study participants was 28.28 (SD 11.57) years. The number of participants was 140 in the preintervention period and 66 in the postintervention period. A statistically significant increase in overall knowledge (P=.01), knowledge of sunscreen (P=.01), and knowledge of sun protection (P<.01) was observed following the intervention. Before the intervention, a positive correlation was observed between age (r=0.17; P=.03) and education level (r=0.19; P=.02) with participants? overall knowledge. However, after the intervention, there was no significant correlation between knowledge and age or education level. A percentage increase of 5.23% was observed in the overall knowledge scores following the intervention. Conclusions: WhatsApp is an effective tool for educating people with albinism and can act as an alternative to the conventional methods of health education. It shows promising outcomes irrespective of the health literacy level of people with albinism. This educational intervention can positively impact behavior change and translate to consistent sun protection practices. The limitations of this study include the possibility of social desirability bias and data security. UR - https://derma.jmir.org/2023/1/e49950 UR - http://dx.doi.org/10.2196/49950 UR - http://www.ncbi.nlm.nih.gov/pubmed/37988154 ID - info:doi/10.2196/49950 ER - TY - JOUR AU - Banala, Manisha AU - Mamidipaka, Anusha AU - Ogunleye, Temitayo PY - 2023/11/2 TI - Skin-Lightening Product Use Among South Asian Americans: Cross-Sectional Survey Study JO - JMIR Dermatol SP - e49068 VL - 6 KW - colorism KW - skin-lightening products KW - skin bleaching KW - South Asian Americans KW - South Asian immigrants N2 - Background: Despite their potential for adverse health effects, skin-lightening products remain popular among South Asian Americans. Objective: This study investigates attitudes toward skin tone and the prevalence and adverse effects of skin-lightening product use among South Asian Americans. Methods: We conducted a cross-sectional study, recruiting and surveying 175 women or nonbinary individuals meeting the following inclusion criteria: (1) lived in the United States, (2) identified as South Asian, and (3) were raised by parents born in South Asian countries. Results: Of the 175 participants, 55 (31%) respondents used a skin-lightening product before. Parental pressure to use skin-lightening products and decreased time spent in the United States were significantly associated with skin-lightening product use (odds ratio [OR] 8.51, 95% CI 3.33-21.78, P<.001, and OR 0.70, 95% CI 0.52-0.96, P=.03, respectively). Although only 6 of the 55 (11%) users reported being aware of the potential side effects of skin-lightening products, 33 (60%) reported adverse effects, with acne, skin sensitivity, and dry skin being the most common. Users and nonusers equally endorsed statements associating lighter skin with increased attractiveness (P=.31), marriageability (P=.94), social status (P=.98), self-esteem (P=.73), and respect received from others (P=.74). Conclusions: The use of skin-lightening products among South Asian Americans is common and linked to social and psychological factors. Parental pressure and cultural beauty standards may play a significant role in perpetuating this practice. This study highlights the need for educational campaigns about the potential health risks associated with skin-lightening and increased efforts to challenge harmful beauty standards. UR - https://derma.jmir.org/2023/1/e49068 UR - http://dx.doi.org/10.2196/49068 UR - http://www.ncbi.nlm.nih.gov/pubmed/37917151 ID - info:doi/10.2196/49068 ER - TY - JOUR AU - Lau, L. Karen P. AU - Agarwal, Payal AU - Parente, Laura AU - Marcello, Olivia AU - Lovas, Mike AU - Van, Jason AU - Vigod, N. Simone AU - Champagne, Trevor AU - Mohan, Tanya AU - Arents, WM Bernd AU - Burton, Tim AU - Flohr, Carsten AU - Drucker, M. Aaron PY - 2022/9/26 TI - Development of a Website for a Living Network Meta-analysis of Atopic Dermatitis Treatments Using a User-Centered Design: Multimethod Study JO - JMIR Dermatol SP - e41201 VL - 5 IS - 3 KW - atopic dermatitis KW - skin KW - dermatology KW - dermatitis KW - eczema KW - network meta-analysis KW - knowledge translation KW - health literacy KW - user-centered design KW - patient education KW - information seeking KW - health information KW - website development KW - web development KW - web design KW - website design KW - allergist KW - user experience KW - interface KW - usability KW - visualization KW - decision-making KW - online resource KW - education material N2 - Background: A rapid expansion of systemic immunological treatment options for atopic dermatitis (AD) has created a need for clinically relevant and understandable comparative efficacy and safety information for patients and clinicians. Given the scarcity of head-to-head trials, network meta-analysis (NMA) is an alternative way to enable robust comparisons among treatment options; however, NMA results are often complex and difficult to directly implement in shared decision-making. Objective: The aim of this study is to develop a website that effectively presents the results of a living systematic review and NMA on AD treatments to patient and clinician users. Methods: We conducted a multimethod study using iterative feedback from adults with AD, adult caregivers of children with AD, dermatologists, and allergists within a user-centered design framework. We used questionnaires followed by workshops among patients and clinicians to develop and improve the website interface. Usability testing was done with a caregiver of a patient with eczema. Results: Questionnaires were completed by 31 adults with AD or caregivers and 94 clinicians. Patients and caregivers felt it was very important to know about new treatments (20/31, 65%). Clinicians felt the lack of evidence-based comparisons between treatments was a barrier to care (55/93, 59%). ?Avoiding dangerous side effects? was ranked as the most important priority for patients (weighted ranking 5.2/7, with higher ranking being more important), and ?improving patients? overall symptoms? was the most important priority for clinicians (weighted ranking 5.0/6). A total of 4 patients and 7 clinicians participated in workshops; they appreciated visualizations of the NMA results and found the website valuable for comparing different treatments. The patients suggested changes to simplify the interface and clarify terminology related to comparative efficacy. The user in the usability testing found the website intuitive to navigate. Conclusions: We developed a website, ?eczematherapies.com,? with a user-centered design approach. Visualizations of NMA results enable users to compare treatments as part of their shared decision-making process. UR - https://derma.jmir.org/2022/3/e41201 UR - http://dx.doi.org/10.2196/41201 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632894 ID - info:doi/10.2196/41201 ER - TY - JOUR AU - Bailey, Michel Adrian Joseph AU - Li, Oi-Yee Heidi AU - Kirchhof, G. Mark PY - 2022/5/2 TI - Novel Kappa-Opioid Receptor Agonist for the Treatment of Cholestatic Pruritus: Systematic Review JO - JMIR Dermatol SP - e30737 VL - 5 IS - 2 KW - opioid KW - pruritus KW - cholestasis KW - dermatology KW - chronic pruritis KW - kappa-opioid receptor KW - opioid receptor UR - https://derma.jmir.org/2022/2/e30737 UR - http://dx.doi.org/10.2196/30737 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632854 ID - info:doi/10.2196/30737 ER - TY - JOUR AU - Marchetti, Armando Michael AU - Sar-Graycar, Liliane AU - Dusza, W. Stephen AU - Nanda, K. Japbani AU - Kurtansky, Nicholas AU - Rotemberg, M. Veronica AU - Hay, L. Jennifer PY - 2022/4/22 TI - Prevalence and Age-Related Patterns in Health Information?Seeking Behaviors and Technology Use Among Skin Cancer Survivors: Survey Study JO - JMIR Dermatol SP - e36256 VL - 5 IS - 2 KW - skin cancer KW - melanoma KW - health information KW - HINTS KW - internet KW - cancer KW - dermatology KW - information KW - oncology KW - survey KW - analysis N2 - Background: Information is an unmet need among cancer survivors. There is a paucity of population-based data examining the health information?seeking behaviors and attitudes of skin cancer survivors. Objective: We aimed to identify the prevalence and patterns of health information?seeking behaviors and attitudes among skin cancer survivors across age groups. Methods: We analyzed population-based data from the 2019 Health Information National Trends Survey 5 (Cycle 3). Results: The 5438 respondents included 346 (6.4%) skin cancer survivors (mean age 65.8 years); of the 346 skin cancer survivors, the majority were White (96.4% [weighted percentages]), and 171 (47.8%) were men. Most reported having ever looked for health- (86.1%) or cancer-related (76.5%) information; 28.2% stated their last search took a lot of effort, and 21.6% were frustrated. The internet was most often cited as being the first source that was recently used for health or medical information (45.6%). Compared to skin cancer survivors younger than 65 years old, those 65 years of age or older were more likely to see a doctor first for important health information (?65 years: 68.3%;<65 years: 36.2%; P<.001) and less likely to have health and wellness apps (?65 years: 26.4%; <65 years: 54.0%, P=.10), to have watched a health-related YouTube video (?65 years: 13.3%; <65 years: 27.4%; P=.02), and to have used electronic means to look for information (?65 years: 61.4%;<65 years: 82.3%, P<.001) Conclusions: Searches for health information are common among skin cancer survivors, but behaviors and attitudes are associated with age, which highlights the importance of access to doctors and personalized information sources. UR - https://derma.jmir.org/2022/2/e36256 UR - http://dx.doi.org/10.2196/36256 UR - http://www.ncbi.nlm.nih.gov/pubmed/36776536 ID - info:doi/10.2196/36256 ER - TY - JOUR AU - Hughes, Olivia AU - Hunter, Rachael PY - 2022/3/15 TI - The Importance of Exploring the Role of Anger in People With Psoriasis JO - JMIR Dermatol SP - e33920 VL - 5 IS - 1 KW - psoriasis KW - skin conditions KW - psychodermatology KW - stigma KW - chronic illness KW - dermatology KW - mental health KW - quality of life UR - https://derma.jmir.org/2022/1/e33920 UR - http://dx.doi.org/10.2196/33920 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632869 ID - info:doi/10.2196/33920 ER - TY - JOUR AU - Pulsipher, J. Kayd AU - Concilla, Anthony AU - Presley, L. Colby AU - Laughter, R. Melissa AU - Anderson, Jaclyn AU - Chea, Emily AU - Lim, Kristina AU - Rundle, W. Chandler AU - Szeto, D. Mindy AU - Dellavalle, Robert PY - 2022/3/1 TI - An Analysis of Skin of Color Content on TikTok JO - JMIR Dermatol SP - e33340 VL - 5 IS - 1 KW - internet KW - social media KW - TikTok KW - skin of color KW - SoC KW - influencer KW - user engagement KW - hashtag KW - dermatologist UR - https://derma.jmir.org/2022/1/e33340 UR - http://dx.doi.org/10.2196/33340 ID - info:doi/10.2196/33340 ER - TY - JOUR AU - Bonnell, N. Levi AU - Obi, Ngozi AU - Miller, Kimberly AU - Hu, Sophia AU - Dellavalle, Robert AU - Cockburn, Myles PY - 2022/1/25 TI - Intent to Change Sun-Protective Behaviors Among Hispanic People After a UV Photoaging Intervention: Cohort Study JO - JMIR Dermatol SP - e33339 VL - 5 IS - 1 KW - risk assessment KW - sun safety KW - intention to change KW - sun exposure behavior KW - melanoma KW - Hispanic KW - sun damage KW - skin cancer N2 - Background: Mortality rates from melanoma are higher among Hispanic populations than non-Hispanic White (NHW) populations. Interventions to improve sun safety are needed. The Reveal Imager is a camera that uses standard cross-polarized flash photography to record surface and subsurface skin conditions. Objective: This study aims to determine the intervention?s effectiveness in increasing awareness of sun damage and exposure reduction between Hispanic and NHW populations. Methods: A cohort of 322 participants, aged ?18 years, were recruited from community events in 2018. Baseline information was collected on demographics, sun exposure, and perception of risk factors. A facial image was then captured using the Reveal Imager. The results were explained and counseling on sun safety was given, followed by filling out an immediate postimage survey. Chi-square tests, analysis of variance, Wilcoxon signed-rank test, McNemar tests, and multivariable logistic regression were used. Results: At follow-up, 125 of 141 (89%) Hispanic participants reported that viewing the UV photoaged image influenced intent-to-change sun protection behaviors, compared to 88 of 121 (73%) NHW participants (odds ratio 2.9, 95% CI 1.5-5.6). Of 141 Hispanic participants, 96 (68%) reported that they intended to increase sunscreen use, compared to only 41 of 121 (34%) NHW participants (P<.001). Conclusions: We demonstrated an application of Reveal Imager for education and risk assessment. The Reveal Imager was especially helpful in motivating intention to change sun exposure among Hispanic populations. UR - https://derma.jmir.org/2022/1/e33339 UR - http://dx.doi.org/10.2196/33339 ID - info:doi/10.2196/33339 ER - TY - JOUR AU - Sager, A. Monique AU - Kashyap, M. Aditya AU - Tamminga, Mila AU - Ravoori, Sadhana AU - Callison-Burch, Christopher AU - Lipoff, B. Jules PY - 2021/9/30 TI - Identifying and Responding to Health Misinformation on Reddit Dermatology Forums With Artificially Intelligent Bots Using Natural Language Processing: Design and Evaluation Study JO - JMIR Dermatol SP - e20975 VL - 4 IS - 2 KW - bots KW - natural language processing KW - artificial intelligence KW - Reddit, medical misinformation KW - health misinformation KW - detecting misinformation KW - dermatology KW - misinformation N2 - Background: Reddit, the fifth most popular website in the United States, boasts a large and engaged user base on its dermatology forums where users crowdsource free medical opinions. Unfortunately, much of the advice provided is unvalidated and could lead to the provision of inappropriate care. Initial testing has revealed that artificially intelligent bots can detect misinformation regarding tanning and essential oils on Reddit dermatology forums and may be able to produce responses to posts containing misinformation. Objective: To analyze the ability of bots to find and respond to tanning and essential oil?related health misinformation on Reddit?s dermatology forums in a controlled test environment. Methods: Using natural language processing techniques, we trained bots to target misinformation, using relevant keywords and to post prefabricated responses. By evaluating different model architectures across a held-out test set, we compared performances. Results: Our models yielded data test accuracies ranging 95%-100%, with a Bidirectional Encoder Representations from Transformers (BERT) fine-tuned model resulting in the highest level of test accuracy. Bots were then able to post corrective prefabricated responses to misinformation in a test environment. Conclusions: Using a limited data set, bots accurately detected examples of health misinformation within Reddit dermatology forums. Given that these bots can then post prefabricated responses, this technique may allow for interception of misinformation. Providing correct information does not mean that users will be receptive or find such interventions persuasive. Further studies should investigate this strategy?s effectiveness to inform future deployment of bots as a technique in combating health misinformation. UR - https://derma.jmir.org/2021/2/e20975 UR - http://dx.doi.org/10.2196/20975 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632809 ID - info:doi/10.2196/20975 ER - TY - JOUR AU - Kim, William AU - Wolfe, M. Sophia AU - Zagona-Prizio, Caterina AU - Dellavalle, P. Robert PY - 2021/7/16 TI - Skin of Color Representation on Wikipedia: Cross-sectional Analysis JO - JMIR Dermatol SP - e27802 VL - 4 IS - 2 KW - skin of color KW - Wikipedia KW - dermatology KW - skin photographs KW - skin color KW - eHealth KW - representation KW - SOC KW - skin conditions KW - photos KW - images KW - medical images N2 - Background: Wikipedia is one of the most popular websites and may be a go-to source of health and dermatology education for the general population. Prior research indicates poor skin of color (SOC) photo representation in printed dermatology textbooks and online medical websites, but there has been no such assessment performed to determine whether this discrepancy also exists for Wikipedia. Objective: The aim of this study was to investigate the number and quality of SOC photos included in Wikipedia?s skin disease pages and to explore the possible ramifications of these findings. Methods: Photos of skin diseases from Wikipedia?s ?List of Skin Conditions? were assigned by three independent raters as SOC or non-SOC according to the Fitzpatrick system, and were given a quality rating (1-3) based on sharpness, size/resolution, and lighting/exposure. Results: We identified 421 skin disease Wikipedia pages and 949 images that met our inclusion criteria. Within these pages, 20.7% of images of skin diseases (196 of 949 images) were SOC and 79.3% (753 of 949 images) were non-SOC (P<.001). There was no difference in the average quality for SOC (2.05) and non-SOC (2.03) images (P=.81). However, the photo quality criteria utilized (sharpness, size/resolution, and lighting/exposure) did not capture all aspects of photo quality. Another limitation of this analysis is that the Fitzpatrick skin typing system is prone to subjectivity and was not originally intended to be utilized as a non-self SOC metric. Conclusions: There is SOC underrepresentation in the gross number of SOC images for dermatologic conditions on Wikipedia. Wikipedia pages should be updated to include more SOC photos to mend this divide to ameliorate access to accurate dermatology information for the general public and improve health equity within dermatology. UR - https://derma.jmir.org/2021/2/e27802 UR - http://dx.doi.org/10.2196/27802 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632806 ID - info:doi/10.2196/27802 ER - TY - JOUR AU - Basch, H. Corey AU - Laforet, E. Priscila AU - Hillyer, C. Grace AU - Seidel, J. Erica AU - Jaime, Christie PY - 2021/2/10 TI - Content in YouTube Videos for Rosacea: Cross-sectional Study JO - JMIR Dermatol SP - e24517 VL - 4 IS - 1 KW - rosacea KW - YouTube KW - social media KW - skin disease KW - skin KW - chronic KW - dermatology N2 - Background: Rosacea is an inflammatory skin disease that is chronic in nature. In addition to the physical symptoms, there are substantial quality of life issues that patients with rosacea experience, largely due to the visible nature in which rosacea manifests. Objective: The purpose of this study was to describe the content related to rosacea in highly viewed English- and Spanish-language videos on YouTube. Methods: We coded identifying information for each video and categories including characteristics of rosacea, clinical solutions, and alternative solutions. The 100 YouTube videos examined were viewed 18.5 million times between 2006 and 2020, and 57.3% (10,652,665/18,592,742) of these views were of consumer videos. Results: Videos posted by consumers more often promoted or were trying to sell a product or procedure (32/55, 58% of consumers vs 10/31, 32% of medical professionals and 4/14, 29% of television, internet, news, or entertainment sources; P=.03) and more frequently mentioned the use of makeup or other ways to cover up rosacea (30/55, 55% of consumers vs 6/31, 19% of medical professionals and 2/14, 14% of television, internet, news, or entertainment sources; P<.001). Videos sourced from medical professionals more often mentioned medication (17/31, 55%) than videos uploaded by consumers (14/55, 25%) or TV, internet, news, or entertainment sources (3/14, 21%) (P=.01). Conclusions: Given that rosacea is experienced differently for each person, consumer advice that works for one individual may not work for another. There is a need for reliable videos on rosacea to emphasize this and clarify misconceptions. UR - http://derma.jmir.org/2021/1/e24517/ UR - http://dx.doi.org/10.2196/24517 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632798 ID - info:doi/10.2196/24517 ER - TY - JOUR AU - Niu, Zhaomeng AU - Willoughby, Fitts Jessica AU - Coups, J. Elliot AU - Stapleton, L. Jerod PY - 2021/1/13 TI - Effects of Website Interactivity on Skin Cancer?Related Intentions and User Experience: Factorial Randomized Experiment JO - J Med Internet Res SP - e18299 VL - 23 IS - 1 KW - behavioral intention KW - computer-mediated communication KW - skin cancer KW - interactivity KW - user experience N2 - Background: Digital media technologies provide users with the ability to interact with content and to receive information based on their preferences and engagement. Objective: We used skin cancer and sun protection as a health topic to explore how modality interactivity, interface tools that afford users greater activity, resulting in greater depth and breadth of mentally representing and experiencing mediated content, and message interactivity, the extent to which the system allows users to exchange messages back and forth on health websites, influenced users? attitudes, knowledge, behavioral intentions, and experience. Methods: We employed a 2×2 (modality interactivity: high vs low; message interactivity: high vs low) between-subject online experiment for which 4 websites were created. Participants (n=293) were recruited using Amazon Mechanical Turk and randomly assigned into to 1 of 4 conditions. After browsing the website, participants completed an online survey regarding their experience and cognitive perceptions. General linear models and path analysis were used to analyze the data. Results: Both modality interactivity (P=.001) and message interactivity (P<.001) had an impact on intention to use sun protection. Attitudes toward health websites and perceived knowledge mediated the effects of modality interactivity and message interactivity on sun protection use intention, individually. Participants in the high modality interactivity and high message interactivity condition felt more satisfied (P=.02). Participants in the low message interactivity condition had more interest in the experience with health websites than participants in the high message interactivity condition (P=.044). Conclusions: Findings suggested that modality interactivity influenced intention to use sun protection directly as well as via attitudes toward the websites. Message interactivity impacted intention to use sunscreen directly and also through perceived knowledge. Implications for designing health websites and health intervention content are discussed. UR - http://www.jmir.org/2021/1/e18299/ UR - http://dx.doi.org/10.2196/18299 UR - http://www.ncbi.nlm.nih.gov/pubmed/33439131 ID - info:doi/10.2196/18299 ER - TY - JOUR AU - Dunnsiri, Teevit AU - Kawashita, Takumi AU - Lee, C. Sharon AU - Monga, Kumar Aaron AU - Woo, P. Benjamin K. PY - 2020/9/3 TI - Assessing YouTube as an Educational Tool for Shingles: Cross-Sectional Study JO - JMIR Dermatol SP - e20338 VL - 3 IS - 1 KW - YouTube KW - medical education KW - online KW - shingles KW - herpes zoster KW - peer review KW - dermatology KW - research background KW - content quality KW - views N2 - Background: YouTube is a popular platform with many videos, which have potential educational value for medical students. Due to the lack of peer review, other surrogates are necessary to determine the content quality of such educational videos. Few studies have analyzed the research background or academic affiliation of the physicians associated with the production of YouTube videos for medical education. The research background or academic affiliations of those physicians may be a reflection of the content quality of these educational videos. Objective: This study identifies physicians associated with the production of educational YouTube videos about shingles and analyzes those physicians based on their research background or academic affiliation, which may be good surrogates for video content quality. Methods: Using the YouTube search engine with default settings, the term ?shingles? was searched on May 8, 2020. A cross-sectional study was performed using the first 50 search results. A search on Scopus for each identified physician was performed, and data regarding their research background and academic affiliation were recorded. Results: Of the 50 YouTube videos, 35 (70%) were categorized as academic. Of the 35 academic videos, 24 (71%) videos featured physicians, totaling 25 physicians overall. Out of these 25 physicians, 5 (20%) had at least 1 shingles-related publication and 8 (32%) had an h-index >10. A total of 21 (84%) physicians held an academic affiliation. Conclusions: These results ensure to a certain degree the quality of the content in academic videos on YouTube for medical education. However, further evaluation is needed for this growing platform. UR - http://derma.jmir.org/2020/1/e20338/ UR - http://dx.doi.org/10.2196/20338 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/20338 ER - TY - JOUR AU - Koepp, Janine AU - Baron, Viviane Miriam AU - Hernandes Martins, Ricardo Paulo AU - Brandenburg, Cristine AU - Kira, Frare Ariane Tieko AU - Trindade, Devens Vanessa AU - Ley Dominguez, Manuel Luis AU - Carneiro, Marcelo AU - Frozza, Rejane AU - Possuelo, Gonçalves Lia AU - De Mello Pinto, Vinicius Marcus AU - Mahlmann Kipper, Liane AU - Pinheiro da Costa, Ercília Bartira PY - 2020/6/16 TI - The Quality of Mobile Apps Used for the Identification of Pressure Ulcers in Adults: Systematic Survey and Review of Apps in App Stores JO - JMIR Mhealth Uhealth SP - e14266 VL - 8 IS - 6 KW - software KW - portable app KW - mobile app KW - pressure sore KW - decubitus ulcer KW - wounds and injuries N2 - Background: The increasing global use of smartphones has contributed to the growing use of apps for various health conditions, showing promising results. Through mobile apps, it is possible to perform chronological and iconographic follow-up of wounds, such as pressure ulcers, using a simple and practical tool. However, numerous surveys have pointed out issues related to the functionality, design, safety, and veracity of app information. Objective: The objective of this study was to perform a systematic review of published studies regarding mobile apps and a systematic survey in app stores looking for apps developed to identify, evaluate, treat, and/or prevent pressure ulcers in adults, and to evaluate those apps based on software quality characteristics. Methods: This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The main bibliographic databases were searched between January 1, 2007 and October 15, 2018, and an app survey was performed in app stores. The selected studies were evaluated according to software quality characteristics by the International Organization for Standardization/International Electrotechnical Commission (ie, ISO/IEC 25010:2011) that involve functionality, efficiency, compatibility, usability, reliability, safety, maintenance, and portability. Results: The search in databases and web-based app stores returned a total of 2075 studies. After removal of duplicates and screening of titles and abstracts, 48 complete articles were evaluated for eligibility, and among these, six were included for qualitative synthesis. Conclusions: In this review, it was observed that all studies involved the initial phase of app development or improvement, and therefore, the apps still need to be evaluated using different software quality characteristics, so that in the future, a gold standard can be approached. Therefore, the prescription of an app for the identification, evaluation, treatment, and/or prevention of pressure ulcers in adults is currently limited. However, the evaluated studies provided important insights for future research. It is of utmost importance that future surveys develop apps jointly with users, using collaborative and cocreative processes and assess patients in real-world situations across different service settings, and they should consider different ethnicities, so that apps are useful to end users, such as patients, family members, health professionals, and students, in the health area. In addition, it is necessary for studies to describe the methodological course of app development in a clear and objective way in order to ensure reproducibility of the study and to offer inputs to allow future research to approach the development of ideal apps that are geared to positively impact the health of end users. Trial Registration: PROSPERO CRD42018114137; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=114137 UR - http://mhealth.jmir.org/2020/6/e14266/ UR - http://dx.doi.org/10.2196/14266 UR - http://www.ncbi.nlm.nih.gov/pubmed/32470916 ID - info:doi/10.2196/14266 ER - TY - JOUR AU - Nguyen, Huu Sau AU - Vu, Thu Giang AU - Nguyen, Hoang Long AU - Nguyen, Tat Cuong AU - Le, Thi Thu Hoai AU - Tran, Hoang Tung AU - Tran, Xuan Bach AU - Latkin, A. Carl AU - Tam, S. Wilson W. AU - Ho, H. Cyrus S. AU - Ho, M. Roger C. PY - 2020/3/23 TI - Understanding Social Media Use and Engagement Among Dermatology Patients to Inform Dermatological Prevention and Care in Vietnam: Cross-sectional Study JO - JMIR Dermatol SP - e13424 VL - 3 IS - 1 KW - dermatology KW - social media KW - engagement KW - prevention KW - Vietnam N2 - Background: Social media has emerged as a common source of dermatological information. Monitoring the patterns of social media use and engagement is important to counteract the limitations of social media. However, evidence in Vietnamese dermatology patients is lacking. Objective: This study aimed to explore social media use and engagement by dermatology patients and to identify factors associated with social media use and engagement. Methods: A cross-sectional study was conducted with 519 participants at the Vietnam National Hospital of Dermatology and Venereology during September to November 2018. Data about sociodemographic characteristics, social media use, and social media engagement were collected. Multivariate logistic and tobit regression models were used to identify factors associated with social media use and engagement. Results: Interest in information about ?cosmetic, beauty, and skincare techniques? was the greatest (184/519, 46.2%). The mean engagement score was 8.4 points (SD 2.4 points). Female patients were more likely to use social media (odds ratio [OR] 2.23, 95% CI 1.23-4.06) and be interested dermatological information on social media (OR 3.09, 95% CI 1.35-7.09). Women also had higher social media engagement scores (coefficient=0.68, 95% CI 0.17-1.18). Higher social media engagement scores were related with Instagram use (coefficient=0.58, 95% CI 0.00-1.15) and higher credibility scores for ?family members? (coefficient=0.15, 95% CI 0.03-0.26) and ?dermatology companies? (coefficient=0.22, 95% CI 0.04-0.39). Conclusions: This study discovered high social media usage among dermatology patients. However, only moderate utilization and credibility levels were reported regarding the use of social media as a source of dermatological information. More efforts should focus on involving dermatologists in the development of individualized information on social media targeting specific groups of dermatology patients. UR - http://derma.jmir.org/2020/1/e13424/ UR - http://dx.doi.org/10.2196/13424 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/13424 ER - TY - JOUR AU - Wiesner, Martin AU - Zowalla, Richard AU - Pobiruchin, Monika PY - 2020/3/11 TI - The Difficulty of German Information Booklets on Psoriasis and Psoriatic Arthritis: Automated Readability and Vocabulary Analysis JO - JMIR Dermatol SP - e16095 VL - 3 IS - 1 KW - readability KW - psoriasis KW - psoriatic arthritis KW - health literacy KW - health education N2 - Background: Information-seeking Psoriasis or Psoriatic Arthritis patients are confronted with numerous educational materials when looking through the internet. Literature suggests that only 17.0%-21.4% of (Psoriasis, Psoriatic Arthritis) patients have a good level of knowledge about psoriasis treatment and self-management. A study from 1994 found that English Psoriasis/Psoriatic Arthritis brochures required a reading level between grades 8-12 to be understandable, which was confirmed in a follow-up study 20 years later. As readability of written health-related text material should not exceed the sixth-grade level, Psoriasis/Psoriatic Arthritis material seems to be ill-suited to its target audience. However, no data is available on the readability levels of Psoriasis/Psoriatic Arthritis brochures for German-speaking patients, and both the volume and their scope are unclear. Objective: This study aimed to analyze freely available educational materials for Psoriasis/Psoriatic Arthritis patients written in German, quantifying their difficulty by assessing both the readability and the vocabulary used in the collected brochures. Methods: Data collection was conducted manually via an internet search engine for Psoriasis/Psoriatic Arthritis?specific material, published as PDF documents. Next, raw text was extracted, and a computer-based readability and vocabulary analysis was performed on each brochure. For the readability analysis, we applied the Flesch Reading Ease (FRE) metric adapted for the German language, and the fourth Vienna formula (WSTF). To assess the laymen-friendliness of the vocabulary, the computation of an expert level was conducted using a specifically trained Support Vector Machine classifier. A two-sided, two-sample Wilcoxon test was applied to test whether the difficulty of brochures of pair-wise topic groups was different from each other. Results: In total, 68 brochures were included for readability assessment, of which 71% (48/68) were published by pharmaceutical companies, 22% (15/68) by nonprofit organizations, and 7% (5/68) by public institutions. The collection was separated into four topic groups: basic information on Psoriasis/Psoriatic Arthritis (G1/G2), lifestyle, and behavior with Psoriasis/Psoriatic Arthritis (G3/G4), medication and therapy guidance (G5), and other topics (G6). On average, readability levels were comparatively low, with FRE=31.58 and WSTF=11.84. However, two-thirds of the educational materials (69%; 47/68) achieved a vocabulary score ?4 (ie, easy, very easy) and were, therefore, suitable for a lay audience. Statistically significant differences between brochure groups G1 and G3 for FRE (P=.0001), WSTF (P=.003), and vocabulary measure (L) (P=.01) exist, as do statistically significant differences for G2 and G4 in terms of FRE (P=.03), WSTF (P=.03) and L (P=.03). Conclusions: Online Psoriasis/Psoriatic Arthritis patient education materials in German require, on average, a college or university education level. As a result, patients face barriers to understanding the available material, even though the vocabulary used seems appropriate. For this reason, publishers of Psoriasis/Psoriatic Arthritis brochures should carefully revise their educational materials to provide easier and more comprehensible information for patients with lower health literacy levels. UR - http://derma.jmir.org/2020/1/e16095/ UR - http://dx.doi.org/10.2196/16095 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/16095 ER -