Comparing Online Patient Searches About Carpal Tunnel Release Approaches: A Study on Modern Search Analytics

Using Google's "People Also Ask" feature, this study aims to characterize and compare frequently asked patient questions related to open (OCTR), endoscopic (ECTR), and ultrasound-guided (CTR-US) carpal tunnel release.

Search terms related to each surgical approach were entered into a new, incognito Google Chrome browser. For each term, the top 200 questions and corresponding websites were extracted. Questions were grouped using Rothwell's classification system, while websites were scored using the JAMA Benchmark Criteria. Fisher's exact tests were used to compare classifications, while t-tests were used to compare scores between approaches.

Of the 1200 question-website combinations initially extracted, a total of 477 combinations were included for analysis. There were 197 OCTR, 225 ECTR, 30 CTR-US, and 25 comparative combinations. The most common question subclassification was risk/complications for OCTR (19.8%), evaluation of surgery for ECTR (15.7%), and technical details for CTR-US (40%). More than 25% of answers to OCTR and ECTR questions came from social media or commercial sources, while no answers did for CTR-US. There were no significant differences across approaches in total JAMA scores. Despite only being associated with medical practice websites, comparative questions exhibited significantly lower JAMA scores (P < .01).

While patient questions and their associated websites on OCTR and ECTR exhibited similar classifications and quality respectively, surgeons should still emphasize the relative risks associated with ECTR. Furthermore, there is a need for high-quality online information on CTR-US and on comparisons between approaches.