title: Quality of online information to support patient decision-making in breast cancer surgery.
abstract: BACKGROUND
  Breast cancer patients commonly use the internet as an information resource. Our objective was to evaluate the quality of online information available to support patients facing a decision for breast surgery.
  
  
  METHODS
  Breast cancer surgery-related queries were performed (Google and Bing), and reviewed for content pertinent to breast cancer surgery. The DISCERN instrument was used to evaluate websites' structural components that influence publication reliability and ability of information to support treatment decision-making. Scores of 4/5 were considered "good."
  
  
  RESULTS
  45 unique websites were identified. Websites satisfied a median 5/9 content questions. Commonly omitted topics included: having a choice between breast conservation and mastectomy (67%) and potential for 2nd surgery to obtain negative margins after breast conservation (60%). Websites had a median DISCERN score of 2.9 (range 2.0-4.5). Websites achieved higher scores on structural criteria (median 3.6 [2.1-4.7]), with 24% rated as "good." Scores on supporting decision-making questions were lower (2.6 [1.3-4.4]), with only 7% scoring "good."
  
  
  CONCLUSIONS
  Although numerous breast cancer-related websites exist, most do a poor job providing women with essential information necessary to actively participate in decision-making for breast cancer surgery. Providing easily- accessible, high-quality online information has the potential to significantly improve patients' experiences with decision-making.
authors.affiliation: School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
authors.forename: Jordan G
authors.initials: JG
authors.lastname: Bruce
authors.affiliation: Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Wisconsin Surgical Outcomes Research Program, Madison, Wisconsin.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Tucholka
authors.affiliation: Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Wisconsin Surgical Outcomes Research Program, Madison, Wisconsin.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Steffens
authors.affiliation: School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.|Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Wisconsin Surgical Outcomes Research Program, Madison, Wisconsin.|Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin.
authors.forename: Heather B
authors.initials: HB
authors.lastname: Neuman
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D020407:Internet / Q000592:standards*; D008408:Mastectomy; D008490:Medical Informatics / Q000379:methods* / Q000592:standards*; D010353:Patient Education as Topic; D011786:Quality Control
keywords: breast cancer; decision-making; information; internet