The Quality of Romanian Breast Cancer Websites: a Five-Year Longitudinal Assessment

What Patients Find on the Internet When Looking for Information About Percutaneous Coronary Intervention: Multilanguage Cross-sectional Assessment

BACKGROUND

The internet provides general users with wide access to medical information. However, regulating and controlling the quality and reliability of the considerable volume of available data is challenging, thus generating concerns about the consequences of inaccurate health care-related documentation. Several tools have been proposed to increase the transparency and overall trustworthiness of medical information present on the web.

OBJECTIVE

We aimed to analyze and compare the quality and reliability of information about percutaneous coronary intervention on English, German, Hungarian, Romanian, and Russian language websites.

METHODS

Following a rigorous protocol, 125 websites were selected, 25 for each language sub-sample. The websites were assessed concerning their general characteristics, compliance with a set of eEurope 2002 credibility criteria, and quality of the informational content (namely completeness and accuracy), based on a topic-specific benchmark. Completeness and accuracy were graded independently by 2 evaluators. Scores were reported on a scale from 0 to 10. The 5 language subsamples were compared regarding credibility, completeness, and accuracy. Correlations between credibility scores on the one hand, and completeness and accuracy scores, on the other hand, were tested within each language subsample.

RESULTS

The websites' compliance with credibility criteria was average at best with scores between 3.0 and 6.0. In terms of completeness and accuracy, the website subsets qualified as poor or average, with scores ranging from 2.4 to 4.6 and 3.6 to 5.3, respectively. English language websites scored significantly higher in all 3 aspects, followed by German and Hungarian language websites. Only German language websites showed a significant correlation between credibility and information quality.

CONCLUSIONS

The quality of websites in English, German, Hungarian, Romanian, and Russian languages about percutaneous coronary intervention was rather inadequate and may raise concerns regarding their impact on informed decision-making. Using credibility criteria as indicators of information quality may not be warranted, as credibility scores were only exceptionally correlated with content quality. The study brings valuable descriptive data on the quality of web-based information regarding percutaneous coronary intervention in multiple languages and raises awareness about the need for responsible use of health-related web resources.

General Characteristics and Quality of Stroke-Related Online Information – A Cross-Sectional Assessment of the Romanian and Hungarian Websites

Background: The quality of online health-related information may affect users’ understanding and medical decision-making with dramatic impact, particularly in case of stroke. Objective: The objective of this study was to assess the quality of information about stroke on the Romanian and Hungarian websites in terms of completeness and accuracy. Methods: The research was designed as an observational cross-sectional study. The sample included 25 Romanian and 25 Hungarian websites presenting information about stroke for the general public. General characteristics such as website ownership, main goal, website genre and medical approach were identified by the evaluators using a predetermined set of common instructions. The completeness and accuracy of the information were assessed by two independent assessors against a quality benchmark. Results: Overall, most of the websites were owned by private commercial companies (42%), had educational goal (66%), were designed as medical web-portals (46%) and had a conventional medicine approach (72%). Mean completeness score was 5.6 points (SD± 1.9) for Romanian sites and 4.1 points (SD ± 2.4) for Hungarian sites (p = 0.017). Mean accuracy score was 6.2 points (SD ± 1.1) for Romanian sites and 7.0 points (SD ± 0.7) for Hungarian sites (p = 0.02). Conclusions: The information about stroke on the Romanian and Hungarian websites had poor quality. Although we found statistically significant differences between the quality scores of the two language sub-samples and two site characteristics associated with significantly higher quality, the practical relevance of these findings for online health information seekers should be interpreted with caution.

Widely Accepted Credibility Criteria for Online Health-related Information Are Not Correlated with Content Quality of Stroke Webpages in Two Languages of Central and Eastern European Countries

Background: Finding accurate health-related information on the Internet may be a real challenge for users lacking the critical skills necessary to assess the validity of online content, even if they browse websites that are compliant with credibility criteria. The aim of the study was to check whether an overall high website credibility or compliance to any of the individual criteria for credibility are correlated/associated with a higher quality of health-related information on a sample of Romanian and Hungarian stroke-related websites.

Methods: The cross-sectional study included a sample of 50 websites presenting stroke for the general population in Romanian and Hungarian language. The websites’ compliance with 12 widely recognized credibility criteria, and the completeness and accuracy of the stroke-related articles found on the respective sites were systematically assessed by two independent evaluators applying a common evaluation procedure.

Results: The mean value of the credibility score was 4.3 points (95% CI: 3.9–4.8), the mean value of the completeness score was 4.8 points (95% CI: 4.2–5.5), and the mean value of the accuracy score was 6.6 points (95% CI: 6.3–6.8). Correlation coefficients between the credibility score and completeness/accuracy score did not reach statistical significance (Spearman rho = 0.038, p = 0.793 and Spearman rho = 0.156, p = 0.278, respectively). With a few exceptions, the t-tests for independent sample comparison have shown no significant differences between websites that complied and those that did not comply with each individual credibility criterion.

Conclusions: The mean credibility score of the Romanian and Hungarian stroke-related websites was poor and it was not correlated with neither completeness nor accuracy of the information displayed on the respective pages. With a few, practically irrelevant exceptions, compliance with individual credibility criteria was not associated with higher content quality on the investigated sample.