Comparison of Festoons across Google and Pubmed Search Results
Methods/Technique: Data for this study was collected from both Google and PubMed. Specifically, the top ten results generated by each search engine following a search for the term “festoons” were used. For each of the websites and articles the search results corresponded to, four pieces of information were collected: the type of doctor behind the publication, how they defined festoons, how they described the pathophysiology of festoons, and the specific type of intervention they recommended for the treatment of festoons.
For each PubMed hit with more than one author, the specialty of the primary author was used. For websites that did not credit a specific physician behind their festoons page, the specialties of all physicians listed on the clinic website’s physicians page were used. In addition, ophthalmologists who completed a fellowship in oculoplastic surgery were included only in the count of oculoplastic surgeons.
In order to compare the sources’ definitions of festoons, keywords were used to identify sources with similar definitions. Keywords describing the characteristics of the condition and others describing the location in which it manifests were chosen. A similar approach was taken when comparing each source’s description of the pathophysiology behind the formation of festoons. Finally, treatment recommendations were categorized as noninvasive, invasive, or both. Specific interventions were not compared in this study.
Results/Complications: The results of this study are summarized in Table 1.
It is important to note that only the abstract of the third PubMed result was accessible. While the contributing doctor was found to be a plastic surgeon, their definition, pathophysiology, and treatment recommendations of festoons could not be determined.
For all sources in which both noninvasive and invasive interventions were listed as potential treatment options, the majority used the severity of the patient's festoons as the determining factor. Noninvasive options were consistently recommended for mild cases, while invasive approaches were reserved for severe cases or those in which noninvasive treatments have proven ineffective.
Conclusion: The Google results corresponded predominantly to oculoplastic surgeons (6/10), while the leading contributors of the PubMed results were plastic surgeons (5/10). This suggests that the information that patients who are looking to educate themselves on the topic of festoons are exposed to does not usually come from the same type of doctors who have published the top peer-review data on the topic.
While oculoplastic surgeons and plastic surgeons define festoons and its pathophysiology similarly, the findings of this study indicate that they tend to recommend opposing types of treatments. The main contributors of the Google results, oculoplastic surgeons, heavily favored treatments that are either noninvasive (3/6) or dependent on severity (2/6). This directly opposes the predominant treatment recommendation indicated by the PubMed results. In this case, plastic surgeons were the leading contributors to the data, and the majority favored invasive treatments (3/4). 1/4 considered both noninvasive and invasive treatment, with their decision dependent on the severity of the festoons. More importantly, none of them (0/4) indicated that noninvasive interventions were their preferred form of treatment for festoons.
Because most patients opt to use Google as opposed to PubMed to educate themselves on their medical concerns, the majority of festoons patients are likely to be directed to treatment options that are not generally supported or recommended by the top peer-reviewed literature on the topic. Exposure to potentially inappropriate treatment options poses a risk for patients. Not only might this prevent patients from receiving proper treatment, but may also result in them undergoing unnecessary procedures, each of which is costly to the patient, is unlikely to successfully address their concerns, and has its own inherent risks.