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Remondini T. et al., 2023: Survey of the quality and origins of websites on penile low-intensity shockwave therapy in Canada

Abstract

Introduction: The aim of this study was to establish the quality of patient-facing websites advertising low-intensity shockwave therapy (LISWT) for erectile dysfunction (ED) and Peyronie's disease (PD) patients in Canada.

Methods: Canadian websites offering LIWST for ED or PD were identified using online web searches. The characteristics of these websites were reviewed, along with examining the presence of HONCode certification, assigning a brief DISCERN score (a tool designed to evaluate health information online) and readability scores. We also examined the LIWST technology advertised, as well as benefits of LIWST cited by the websites.

Results: Twenty-five unique websites linked to 46 clinics were identified and reviewed. Twenty-four percent of websites were run by a urologist. Other specialties offering LISWT included general practitioners, anesthesiologists, naturopaths, nurse practitioners, physiotherapists, and registered massage therapists. Twenty-four percent of the websites advertised the use of a focused shockwave generator. Forty percent of the websites had peer-reviewed references. The average brief DISCERN score was 14 (standard deviation 3.4). There was no association between the physician-or non-physician-led websites and the use of peer-reviewed references, readability scores, the number of clinic locations, or higher brief discern scores.

Conclusions: LISWT is readily advertised online for ED and PD patients in Canada; however, only a minority use a focused shockwave generator. There is a wide diversity of practitioners offering LISWT. Websites offering LISWT are generally of poor quality and do not provide adequate information for patients to make educated treatment decisions.
Can Urol Assoc J. 2023 Aug 3. doi: 10.5489/cuaj.8303. Online ahead of print. PMID: 37549347. FREE ARTICLE

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Comments 1

Jens Rassweiler on Tuesday, 20 February 2024 09:50

Low-intensity shockwave therapy (LI-SWT) has gained attention as a potential treatment for erectile dysfunction (ED) and Peyronie's disease (PD). This study focuses on evaluating the quality of information provided by Canadian websites promoting LISWT for these conditions. Given the controversial evidence surrounding LI-SWT, understanding the characteristics of these websites is crucial for informed decision-making. This study aims to evaluate the quality and sources of information available on websites related to penile low-intensity shockwave therapy (LI-SWT) in Canada.
Website Identification: Canadian websites offering LISWT for ED or PD were identified through online searches using relevant keywords. The search was conducted in July 2020, yielding 25 relevant websites for evaluation.
Website Quality Assessment: Website quality was assessed using the brief discern instrument, evaluating criteria related to treatment choices. The presence of HONcode certification was noted. Readability was determined using the Flesch-Kincaid and Coleman-Liau indexes.
Thus, a survey of websites providing information on penile LI-SWT was conducted. Websites were identified through search engines using relevant keywords. The quality of information was assessed using a standardized tool, and the sources of information were analyzed to determine credibility.
Results: The study reviewed 25 unique websites linked to 46 clinics. While 24% of websites were run by urologists, various other specialties, including general practitioners, anesthesiologists, and naturopathic medicine practitioners, offered LISWT. Only 24% of websites used focused shockwave generators, and 40% provided peer-reviewed references. The average brief discern score was 14, indicating generally poor website quality. No websites had HONcode certification. The average readability level suggested a 12th-grade education. The study found no association between the involvement of physicians and website quality. However, a notable number of websites relied on anecdotal evidence or promotional materials.
Discussion: The quality of information on penile LI-SWT websites in Canada is diverse, indicating a need for standardized guidelines for online health information. Healthcare providers should be aware of the varying quality of online resources and guide patients to reliable sources for informed decision-making.
Low-intensity shockwave therapy (LISWT) has emerged as a widely available treatment for sexual dysfunction in Canada, with numerous websites promoting its usage for conditions such as erectile dysfunction (ED) and Peyronie's disease (PD). Despite its availability, this study highlights several concerning aspects of the online landscape related to LISWT.
Poor Website Quality: The majority of websites providing information on LISWT for sexual dysfunction were found to be of poor quality. They lacked the necessary depth and nuance required for patients to make informed decisions about their treatment options.
Limited Information on Alternative Treatments: Many clinics offering LISWT did not advertise or provide information on alternative treatments for ED or PD. This lack of comprehensive information may limit patients' understanding of the full spectrum of available therapies.
Prevalence of Radial Wave Generators: A notable finding was the significant use of radial wave generators in LISWT, despite limited supporting evidence compared to focused shockwave generators. This raises concerns about the scientific basis and efficacy of the technology promoted by these websites.
Potential for Misleading Patients: The overall quality and content of patient-facing websites may contribute to misinformation and potentially mislead patients seeking treatment options for sexual dysfunction. This is particularly concerning given the experimental nature of LISWT and its cost.
Conclusions: In light of these findings, there is a clear need for improved standards in the information provided on patient-facing websites related to sexual dysfunction treatments. Healthcare providers and regulatory bodies should work towards ensuring that patients have access to accurate, balanced, and comprehensive information to make well-informed decisions about their healthcare, especially in the context of emerging therapies like LISWT.

Jens Rassweiler

Low-intensity shockwave therapy (LI-SWT) has gained attention as a potential treatment for erectile dysfunction (ED) and Peyronie's disease (PD). This study focuses on evaluating the quality of information provided by Canadian websites promoting LISWT for these conditions. Given the controversial evidence surrounding LI-SWT, understanding the characteristics of these websites is crucial for informed decision-making. This study aims to evaluate the quality and sources of information available on websites related to penile low-intensity shockwave therapy (LI-SWT) in Canada. Website Identification: Canadian websites offering LISWT for ED or PD were identified through online searches using relevant keywords. The search was conducted in July 2020, yielding 25 relevant websites for evaluation. Website Quality Assessment: Website quality was assessed using the brief discern instrument, evaluating criteria related to treatment choices. The presence of HONcode certification was noted. Readability was determined using the Flesch-Kincaid and Coleman-Liau indexes. Thus, a survey of websites providing information on penile LI-SWT was conducted. Websites were identified through search engines using relevant keywords. The quality of information was assessed using a standardized tool, and the sources of information were analyzed to determine credibility. Results: The study reviewed 25 unique websites linked to 46 clinics. While 24% of websites were run by urologists, various other specialties, including general practitioners, anesthesiologists, and naturopathic medicine practitioners, offered LISWT. Only 24% of websites used focused shockwave generators, and 40% provided peer-reviewed references. The average brief discern score was 14, indicating generally poor website quality. No websites had HONcode certification. The average readability level suggested a 12th-grade education. The study found no association between the involvement of physicians and website quality. However, a notable number of websites relied on anecdotal evidence or promotional materials. Discussion: The quality of information on penile LI-SWT websites in Canada is diverse, indicating a need for standardized guidelines for online health information. Healthcare providers should be aware of the varying quality of online resources and guide patients to reliable sources for informed decision-making. Low-intensity shockwave therapy (LISWT) has emerged as a widely available treatment for sexual dysfunction in Canada, with numerous websites promoting its usage for conditions such as erectile dysfunction (ED) and Peyronie's disease (PD). Despite its availability, this study highlights several concerning aspects of the online landscape related to LISWT. Poor Website Quality: The majority of websites providing information on LISWT for sexual dysfunction were found to be of poor quality. They lacked the necessary depth and nuance required for patients to make informed decisions about their treatment options. Limited Information on Alternative Treatments: Many clinics offering LISWT did not advertise or provide information on alternative treatments for ED or PD. This lack of comprehensive information may limit patients' understanding of the full spectrum of available therapies. Prevalence of Radial Wave Generators: A notable finding was the significant use of radial wave generators in LISWT, despite limited supporting evidence compared to focused shockwave generators. This raises concerns about the scientific basis and efficacy of the technology promoted by these websites. Potential for Misleading Patients: The overall quality and content of patient-facing websites may contribute to misinformation and potentially mislead patients seeking treatment options for sexual dysfunction. This is particularly concerning given the experimental nature of LISWT and its cost. Conclusions: In light of these findings, there is a clear need for improved standards in the information provided on patient-facing websites related to sexual dysfunction treatments. Healthcare providers and regulatory bodies should work towards ensuring that patients have access to accurate, balanced, and comprehensive information to make well-informed decisions about their healthcare, especially in the context of emerging therapies like LISWT. Jens Rassweiler
Thursday, 06 February 2025