Female fertility in the cancer setting: availability and quality of online health information

Figures & data

Figure 1. PRISMA flow diagram search method.

Table 1. Website content: availability of basic information on oncofertility^a.

Items	All websites (n = 103)^b	Oncology (n = 69)	Fertility (n = 27)^c	Oncofertility (n = 7)	p Value	Professional (n = 32)^d	Patient (advocacy) (n = 69)	Governmental (n = 2)	p Value
1. Full-access	103 (99)	69 (100)	27 (96)	7 (100)	0.34	32 (97)	69 (100)	2 (100)	0.34
2. Effect of cancer (treatment) on fertility	70 (68)	46 (67)	17 (63)	7 (100)	0.16	23 (72)	45 (65)	2 (100)	0.62
3. Female specific information	66 (64)	43 (62)	16 (59)	7 (100)	0.12	22 (69)	42 (61)	2 (100)	0.51
4. Fertility preservation option	54 (52)	35 (51)	12 (44)	7 (100)	0.02	15 (47)	37 (54)	2 (100)	0.51
5. Oncofertility	33 (32)	19 (28)	7 (26)	7 (100)	<0.001	10 (31)	21 (30)	2 (100)	0.18

Key.

^a Data presented as number (%). Websites divided by oncology, fertility and oncofertility organizations as well as affiliation.

^b For I1, n = 104; for I2–5, n = 103.

^c For I1, n = 28; for I2–5, n = 27.

^d For I1, n = 33; for I2–5, n = 32.

Table 2. Websites content: availability of specific oncofertility topics^a.

Items	Oncology (n = 19)	Fertility (n = 7)	Oncofertility (n = 7)	p Value	Professional (n = 10)	Patient (advocacy) (n = 21)	Governmental (n = 2)	p Value
6. Fertility (preservation) options (max 11)^b	7 (5–8)	4 (3–9)	9 (8–10)	0.07	8 (5–10)	7 (5–9)	6 (4;7)^c	0.63
7. Referral information to local clinic(s) or health care professional	11 (58)	4 (57)	5 (71)	0.89	6 (60)	12 (57)	2 (100)	0.73
8. Decision aid tool available	3 (16)	2 (29)	4 (57)	0.12	4 (40)	5 (24)	0 (0)	0.44
9. Moral and ethical considerations	10 (53)	3 (43)	5 (71)	0.71	6 (60)	12 (57)	0 (0)	0.39
10. Risks and benefits	14 (74)	5 (71)	7 (100)	0.50	8 (80)	17 (81)	1 (50)	0.49
11. Success rates	11 (58)	5 (71)	6 (86)	0.48	8 (80)	13 (62)	1 (50)	0.49
12. Costs of reimbursement facilities	4 (21)	2 (29)	4 (57)	0.29	3 (30)	7 (33)	0 (0)	>0.99
13. Audiovisual resources	3 (16)	4 (57)	4 (57)	0.03	6 (60)	5 (24)	0 (0)	0.11
14a. Social media links	19 (100)	6 (86)	7 (100)	0.42	9 (90)	21 (100)	2 (100)	0.36
14b. How many of 6 social media links does the website have?^b	4 (3–5)	4 (1–5)	3 (2–4)	0.49	3 (2–3)	4 (3–5)	5 (6;4)^c	0.04^d
15. HONcode certification	4 (21)	1 (14)	0 (0)	0.80	1 (10)	4 (19)	0 (0)	>0.99

Key.

^a Data presented as Number (%). Websites divided by oncology, fertility and oncofertility organizations as well as affiliation;.

^b Data presented as Median (interquartile range, IQR);.

^c IQR not calculated due to small sample, exact numbers used;.

^d No statistically significant comparisons using Bonferroni correction.

Table 3. Availability of specific topics I7–12^a.

Items	Oncology (n = 19)	Fertility (n = 7)	Oncofertility (n = 7)	p Value	Professional (n = 10)	Patient (n = 21)	Governmental (n = 2)	p Value
Specific topics I 7–12^b	2 (1–4)	3 (2–5)	4 (4–6)	0.11	4 (2–5)	3 (2–5)	2 (1;3)^c	0.51

Key.

^a Data presented as median (interquartile range, IQR). Websites divided by oncology, fertility and oncofertility organizations as well as affiliation.

^b Six topics: referral information, decision-aid tool, moral and ethical considerations, risks and benefits, success rates, costs.

^c IQR not calculated due to small sample, exact numbers used.

Table 4. Quality of web content^a.

Items	Oncology (n = 19)	Fertility (n = 7)	Oncofertility (n = 7)	p Value	Professional (n = 10)	Patient (advocacy) (n = 21)	Governmental^b (n = 2)	p Value
Reliability (DISCERN) (8–40)	30 (28–34)	33 (32–36)	33 (30–36)	0.13	33 (31–35)	31 (28–36)	27 (26;28)	0.15
Quality of information on treatment choices (DISCERN) (7–35)	26 (20–32)	26 (21–28)	30 (29–33)	0.05	29 (25–32)	27 (23–31)	25 (17;33)	0.83
Overall rating of the publication (DISCERN) (1–5)	3 (3–4)	3 (3–4)	4 (4–5)	0.06	4 (3–5)	4 (3–5)	3 (3;3)	0.43
Total score (DISCERN) (16–80)	58 (53–65)	61 (57–67)	69 (62–69)	0.09	62 (59–70)	60 (54–69)	55 (46;64)	0.53
Usability (LIDA) (0–54)	48 (46–51)	42 (38–52)	48 (44–53)	0.28	46 (40–51)	48 (46–52)	47 (51;42)	0.79
Reliability (LIDA) (0–27)	17 (14–18)	16 (14–18)	19 (10–20)	0.82	16 (12–20)	17 (14–19)	17 (17;16)	0.99
Readability (FKGL) (range 3–12)	10 (10–12)	12 (9–12)	12 (12–12)	0.04	12 (9–12)	11 (10–12)	10 (8;12)	0.72

Key.

^a Data presented as median (interquartile ranges). Websites divided by oncology, fertility and oncofertility organizations as well as affiliation.

^b IQR not calculated due to small sample, exact numbers used.