{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:18:01Z","timestamp":1781075881784,"version":"3.54.1"},"reference-count":54,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Phlebology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The incidence of lipedema is poorly described due to its confusion with lymphedema. Patient education is crucial for treatment and prevention strategies but also for improving healthcare outcomes. This study assessed and compared the quality of English and Spanish online resources for patients suffering from lipedema using a multimetric approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A deidentified Google search using the terms \u201clipedema\u201d and \u201clipedema espa\u00f1ol\u201d was conducted. The first 10 academic\/organizational websites in each language were selected. Quality assessment was performed using the Patient Education and Materials Assessment Tool (PEMAT), Cultural Sensitivity Assessment Tool (CSAT), Simple Measure of Gobbledygook (SMOG), and facticity criteria to evaluate understandability and actionability, cultural sensitivity, readability, and factual quality, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>English webpages scored 73.70% for understandability and 35.0% for actionability, while Spanish webpages scored 75.05% and 21.0%, respectively; no significant differences were found between languages in understandability (p = .970) and actionability (p = .895). A significantly higher proportion of Spanish resources was found to be culturally sensible than English resources (90% vs 70%; p &lt; .001). However, no significant differences were found in the cultural sensitivity score (English 2.87 vs Spanish 3.01; p = .677). The grade reading level for Spanish materials was significantly lower compared to English materials (11.08 vs 13.45; p = .006). Factual quality was low across both languages according to the facticity framework, though English materials scored higher than Spanish (2.20 vs 1.00; p = .051).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results suggest that online English and Spanish materials on lipedema have inadequate actionability, facticity, and reading grade levels for patients. Nonetheless, the levels of understandability and cultural sensitivity are acceptable. Enhancing the quality of online health literature for lipedema patients presents an opportunity to alleviate psychosocial burdens and address misconceptions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02683555251372218","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T08:49:12Z","timestamp":1756111752000},"page":"365-372","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Quality assessment of online health resources for lipedema: A multimetric analysis"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8206-0448","authenticated-orcid":false,"given":"Agustin N.","family":"Posso","sequence":"first","affiliation":[{"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria J.","family":"Escobar-Domingo","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Mustoe","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micaela","family":"Tobin","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Fanning","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruv","family":"Singhal","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard T.","family":"Lee","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-34-5-1243"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33313"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001043"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000363503.92360.91"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.91a.23084"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/aps.2011.153"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-021-01174-y"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-019-00703-x"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5729"},{"key":"e_1_3_6_11_2","volume-title":"Health literacy: a manual for clinicians","author":"Weiss B","year":"2003","unstructured":"Weiss B. 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