Patients and clinicians managing patellofemoral pain should not rely on general web-based information

PainSci » bibliography » Silva et al 2020
updated Dec 2, 2023

One page on PainSci cites Silva 2020: The Complete Guide to Patellofemoral Pain Syndrome

PainSci commentary on Silva 2020: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This citation is so perfect for my purposes here that it’s like de Oliveira Silva et al. wanted to write a paper just for me. These authors read 40 webpages about patellofemoral pain and judged how well they harmonized with current expert consensus (as reported in papers like Crossley 2016, which is well known to me).

Almost half the articles they looked at did not mention their sources, and half of those that did. This page is littered with hundreds of obviously peer-reviewed citations. With summaries. And often detailed analysis.

The most common misinformation was broken definitions of patellofemoral pain (20% of pages), and about clinical examination (15%). This page goes into extraordinary detail about the official definition and where it comes from, and accurately reports the issues with clinical exams and tests, citing multiple sources.

22% of pages recommended surgery, which is bonkers — I downvote surgery in my second paragraph, and have a chapter titled “Surgery is only a last resort.”

Oliveira Silva et al. conclude:

Due to the commonality of PFP and potential for improving self-management, there is an urgent need to develop more accurate and comprehensive web-based patient education resources for PFP.

Or people could just read this one. 🙂

~ Paul Ingraham

original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To evaluate the credibility and accuracy of PFP-specific web-based content.

DESIGN: Cross-sectional evaluation of web-based information.

METHODS: The study protocol was registered with PROSPERO (CRD42018088671). Two search engines (Google and Bing) were used to search for websites offering information about PFP. Two reviewers assessed the websites for credibility-related and PFP-specific content. PFP-specific content was evaluated according to agreement with current international PFP consensus statements. Based on this, content was rated as (i) Accurate/Clearly described; (ii) Partially accurate/Description lacks clarity; (iii) Inaccurate/Misleading description; or (iv) Not mentioned.

RESULTS: After exclusion of duplicates, forty online websites were included in our analyses. 43% of websites did not mention their source of information, and 48% did not mention if the source material was peer-reviewed. Misleading/inaccurate information was most commonly found in the definition of PFP (20% websites) and clinical examination (15%). Twenty-two percent of websites recommended surgery as treatment. The item most frequently rated as accurate/clearly described was PFP terminology (87.5%).

CONCLUSION: This study highlights missing, inaccurate or poorly described web-based PFP information. Due to the commonality of PFP and potential for improving self-management, there is an urgent need to develop more accurate and comprehensive web-based patient education resources for PFP.

original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

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