(Poster 150) Patient Education Online for Dysfunctional Voiding: A DISCERN Quality Analysis

Objectives: Many women suffer from intermittent voiding and voiding dysfunction; yet, it was not until 2010, that IUGA/ICS had a joint commission to discuss its definition. The aim of this study is to evaluate the quality of patient-accessible websites addressing dysfunctional voiding in the context of the IUGA/ICS Joint commission definition of the term.

Methods: The Google search engine was used to perform a search of the following 2 terms: (1) “dysfunctional voiding” and (2) “female dysfunctional voiding”. The top 20 websites that resulted were then analyzed using the DISCERN quality appraisal tool. Websites under each term were categorized by domain suffix, such as “.com”. A Fleiss multi-rater kappa was performed to ensure interrater reliability among the 3 reviewers (1 OB/GYN resident, and 2 FPMRS fellows). A two-sample t-test was calculated to compare the mean scores between the 2 search terms mentioned above.

Results: The Fleiss multi-rater kappa between the reviewers was found to be ƙ= 0.742 which is considered substantial agreement and appropriate for investigational purposes. When comparing the term “dysfunctional voiding” to “female dysfunctional voiding” there was no statistically significant difference between the mean DISCERN scores (p-value= 0.41). The mean DISCERN score for “dysfunctional voiding” and “female dysfunctional voiding” were 35.83 and 35.01 respectively, consistent with poor quality of data. When looking at all 40 search terms, 45% were “.org”, 40% were “.com”, 7.5% were “.gov” and 7.5% were “.edu”. When breaking down the DISCERN scores for each website category, “.gov” received the highest scores ranging from 35 to 61, with scores between 52 and 60 being of good quality, but not excellent. Lastly, a sub-analysis of the data showed that when looking at the general search term “dysfunctional voiding” approximately 35% of the websites were specific to childhood voiding dysfunction.

Conclusions: The overall quality of data available on the Internet regarding dysfunctional voiding is poor and a significant portion of the information available is geared towards a pediatric population. Of the websites available, those ending in “.gov” seem to provide the highest quality of information. More work is needed to increase the quality of information on female dysfunctional voiding, especially in the context of the mainstay treatment option which includes behavioral modifications that often need to be performed outside the clinic.