An analysis of cluster headache information provided on internet websites

Online information for spontaneous coronary artery dissection (SCAD) survivors and their families: A systematic appraisal of content and quality of websites

BACKGROUND

Spontaneous coronary artery dissection (SCAD) survivors often seek information online. However, the quality and content of websites for SCAD survivors is uncertain. This review aimed to systematically identify and appraise websites for SCAD survivors.

METHODS

A systematic review approach was adapted for websites. A comprehensive search of SCAD key-phrases was performed using an internet search engine during January 2023. Websites targeting SCAD survivors were included. Websites were appraised for quality using Quality Component Scoring System (QCSS) and Health Related Website Evaluation Form (HRWEF), suitability using the Suitability Assessment Method (SAM), readability using a readability generator, and interactivity. Content was appraised using a tool based on SCAD international consensus literature. Raw scores from tools were concerted to percentages, then classified variably as excellent through to poor.

RESULTS

A total of 50 websites were identified and included from 600 screened. Overall, content accuracy/scope (53.3 ± 23.3) and interactivity (67.1 ± 11.5) were poor, quality was fair (59.1 ± 22.3, QCSS) and average (83.1 ± 5.8, HRWEF) and suitability was adequate (54.9 ± 13.8, SAM). The mean readability grade was 11.6 (±2.3), far exceeding the recommendations of ≤ 8. By website type, survivor affiliated and medically peer-reviewed health information websites scored highest. Appraisal tools had limitations, such as overlapping appraisal of similar things and less relevant items due to internet modernity.

CONCLUSION

Many online websites are available for SCAD survivors, but often have limited and/or inaccurate content, poor quality, are not tailored to the demographic, and are difficult to read. Appraisal tools for health website require consolidation and further development.

Assessment of the Quality, Accountability, and Readability of Online Patient Education Materials for Optic Neuritis

Most cases of optic neuritis (ON) occur in women and in patients between the ages of 15 and 45 years, which represents a key demographic of individuals who seek health information using the internet. As clinical providers strive to ensure patients have accessible information to understand their condition, assessing the standard of online resources is essential. To assess the quality, content, accountability, and readability of online information for optic neuritis. This cross-sectional study analyzed 11 freely available medical sites with information on optic neuritis and used PubMed as a gold standard for comparison. Twelve questions were composed to include the information most relevant to patients, and each website was independently examined by four neuro-ophthalmologists. Readability was analyzed using an online readability tool. Journal of the American Medical Association (JAMA) benchmarks, four criteria designed to assess the quality of health information further were used to evaluate the accountability of each website. Freely available online information. On average, websites scored 27.98 (SD ± 9.93, 95% CI 24.96-31.00) of 48 potential points (58.3%) for the twelve questions. There were significant differences in the comprehensiveness and accuracy of content across websites (p < .001). The mean reading grade level of websites was 11.90 (SD ± 2.52, 95% CI 8.83-15.25). Zero websites achieved all four JAMA benchmarks. Interobserver reliability was robust between three of four neuro-ophthalmologist (NO) reviewers (ρ = 0.77 between NO3 and NO2, ρ = 0.91 between NO3 and NO1, ρ = 0.74 between NO2 and NO1; all p < .05). The quality of freely available online information detailing optic neuritis varies by source, with significant room for improvement. The material presented is difficult to interpret and exceeds the recommended reading level for health information. Most websites reviewed did not provide comprehensive information regarding non-therapeutic aspects of the disease. Ophthalmology organizations should be encouraged to create content that is more accessible to the general public.

Googling for Neurological Disorders: From Seeking Health-Related Information to Patient Empowerment, Advocacy, and Open, Public Self-Disclosure in the Neurology 2.0 Era

Since its introduction, the internet has played a major role in reshaping patient-physician communication and interactions, having fostered a shift from a paternalistic to a patient-centered model. Because of its dynamic nature, the internet has been used as a platform to not only disseminate knowledge—favored by improved access to an increasing wealth of available resources—but also to spread advocacy and awareness, contribute to fund-raising, and facilitate open, public self-disclosure of one’s own disease, thus eliminating any taboo and reducing the stigma associated with it. The era of Medicine 2.0 is characterized by openness, collaboration, participation, and social networking. The current situation is completely different from the time when Lorenzo Odone’s parents, after his diagnosis of adrenoleukodystrophy, decided to attend medical school in order to collect information about a devastating, unknown disease and had to contend with medical authorities at that establishment to convince them of the alleged effectiveness and safety of their discovered therapeutics. Orphan and rare neurological diseases have currently received recognition on web-based resources. However, while the intention is not to ridicule Odone’s family legacy and the “complicated lessons” they have reported, some issues should be carefully addressed by health authorities, such as the reputability, reliability, and accuracy of material available on the internet and prevention of the dissemination of material that could instill illusions and unjustified hopes in individuals seeking medical treatment. Neurologists should be aware of such digital resources, participate in web-based activities, and recommend select high-quality websites to their patients.

Assessment of Online Sites Reliability, Accountability, Readability, Accessibility, and Translation for Intravitreal Injections

PURPOSE

Patients increasingly use the internet to access health-related information to better understand their treatments. This study compares the quality, accountability, readability, accessibility, and presence of translation between private and academic online source material available to the public regarding intravitreal injections (IVIs).

DESIGN

Cross-sectional analysis.

PARTICIPANTS

Top 20 websites on a Google search for the terms eye injections, intravitreal injections, and anti-VEGF injections.

METHODS

Websites were classified as private or academic. Quality and accountability were assessed using the internationally recognized DISCERN criteria and the Health on the Net Code of Conduct (HONcode). Readability was evaluated using an online tool that provides a consensus readability grade. The presence of and languages available for translation were recorded.

MAIN OUTCOME MEASURES

The primary outcome measure was a comparison of the DISCERN and HONcode quality and accountability scores between academic and private websites. Secondary outcome measures included evaluating readability, accessibility, and presence of translation (in particular, Spanish).

RESULTS

Eleven academic and 9 private websites were included. The overall mean score using DISCERN criteria for the academic websites (3.11 ± 0.46) was significantly higher than that of private websites (2.23 ± 0.61; P < 0.007). Similarly, of a possible total of 14 points for the HONcode, the average quality score for academic websites (10.91 ± 2.66) was higher compared with that for private websites (6.44 ± 3.36; P < 0.009). The mean consensus reading grade level was similar between academic (11.73 ± 1.68) and private (11.78 ± 1.48) websites (P = 0.94). Spanish translation was offered by only 7 of the 20 websites (5 academic and 2 private websites).

CONCLUSIONS

The overall quality and accountability of online content for academic sites was significantly higher compared with that of private websites. Translation was rarely provided, and the readability grade level was significantly higher for both groups than recommended. Improving the quality, accountability, readability, and accessibility and incorporating translation in websites can help to improve patients' health literacy regarding IVIs, potentially leading to increased adherence to therapy plans and improved treatment outcomes.

Infant Feeding Websites and Apps: A Systematic Assessment of Quality and Content

Background

Internet websites and smartphone apps have become a popular resource to guide parents in their children’s feeding and nutrition. Given the diverse range of websites and apps on infant feeding, the quality of information in these resources should be assessed to identify whether consumers have access to credible and reliable information.

Objective

This systematic analysis provides perspectives on the information available about infant feeding on websites and smartphone apps.

Methods

A systematic analysis was conducted to assess the quality, comprehensibility, suitability, and readability of websites and apps on infant feeding using a developed tool. Google and Bing were used to search for websites from Australia, while the App Store for iOS and Google Play for Android were used to search for apps. Specified key words including baby feeding, breast feeding, formula feeding and introducing solids were used to assess websites and apps addressing feeding advice. Criteria for assessing the accuracy of the content were developed using the Australian Infant Feeding Guidelines.

Results

A total of 600 websites and 2884 apps were screened, and 44 websites and 46 apps met the selection criteria and were analyzed. Most of the websites (26/44) and apps (43/46) were noncommercial, some websites (10/44) and 1 app were commercial and there were 8 government websites; 2 apps had university endorsement. The majority of the websites and apps were rated poor quality. There were two websites that had 100% coverage of information compared to those rated as fair or poor that had low coverage. Two-thirds of the websites (65%) and almost half of the apps (47%) had a readability level above the 8th grade level.

Conclusions

The findings of this unique analysis highlight the potential for website and app developers to merge user requirements with evidence-based content to ensure that information on infant feeding is of high quality. There are currently no apps available to consumers that address a variety of infant feeding topics. To keep up with the rapid turnover of the evolving technology, health professionals need to consider developing an app that will provide consumers with a credible and reliable source of information about infant feeding, using quality assessment tools and evidence-based content.

Adding Dimensions to the Analysis of the Quality of Health Information of Websites Returned by Google: Cluster Analysis Identifies Patterns of Websites According to their Classification and the Type of Intervention Described

Background and aims

Most of the instruments used to assess the quality of health information on the Web (e.g., the JAMA criteria) only analyze one dimension of information quality (IQ), trustworthiness. In this study, we analyzed the type of intervention that websites describe, whether supported by evidence-based medicine (EBM) or not, to provide a further dimension of IQ, accuracy, and correlated this with the established criteria.

Methods

We searched Google for “migraine cure” and analyzed the first 200 websites for: (1) JAMA criteria (authorship, attribution, disclosure, currency); (2) class of websites (commercial, health portals, professional, patient groups, no-profit); and (3) type of intervention described (approved drugs, alternative medicine, food, procedures, lifestyle, drugs still at the research stage). We used hierarchical cluster analysis to identify different patterns of websites according to their classification and the information provided. Subgroup analysis on the first 10 websites returned was performed.

Results

Google returned health portals (44%), followed by commercial websites (31%) and journalism websites (11%). The type of intervention mentioned most often was alternative medicine (55%), followed by procedures (49%), lifestyle (42%), food (41%), and approved drugs (35%). Cluster analysis indicated that health portals are more likely to describe more than one type of treatment while commercial websites most often describe only one. The average JAMA score of commercial websites was significantly lower than for health portals or journalism websites, and this was mainly due to lack of information on the authors of the text and indication of the date the information was written. Looking at the first 10 websites from Google, commercial websites are underrepresented and approved drugs overrepresented.

Conclusion

Analyzing the type of therapies/prevention methods provides additional information to the trustworthiness measures, such as the JAMA score, and could be a convenient and objective indicator of websites whose information is based on EBM.

A Methodology to Analyze the Quality of Health Information on the Internet

Purpose

The purpose of this work was to evaluate the criteria used to assess the quality of information on diabetic neuropathy on the Internet.

Methods

Different search engines (Google, Yahoo, Bing, and Ask) and 1 governmental health website (MedlinePlus) were studied. The websites returned (200 for each search engine) were then classified according to their affiliation (eg, commercial, professional, patient groups). A scoring system was devised from the literature to assess quality of information. Websites were also analyzed using the 2 most widely used instruments for assessing the quality of health information, the Journal of the American Medical Association (JAMA) scoring system and the Health On the Net Foundation (HON) certification.

Results

Professional websites or health portals scored better according to most criteria. Google and MedlinePlus returned results scoring significantly higher than other engines in some of the criteria. The use of different instruments gave different results and indicates that the JAMA score and the HON certification may not be sufficient ones.

Conclusions

This methodology could be used to evaluate the reliability and trustworthiness of information on the Internet on different topics to identify topic areas or websites where the available information is not appropriate.

The quality of health information on allergic rhinitis, rhinitis, and sinusitis available on the internet

Purpose

The internet has become one of the most important media outlets used to obtain health information. Therefore, the quality of health information available on the internet is very important. We evaluated the quality of internet-derived health information on allergic rhinitis, rhinitis and sinusitis and compared these results to those of previous studies performed five years ago.

Methods

The terms "allergic rhinitis (AR)", "rhinitis" and "sinusitis" were searched among the four most commonly used search engines in South Korea. These websites were evaluated according to the author, the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire and the Allergic rhinitis and its Impact on Asthma (ARIA) 2008 Update.

Results

A total of 120 websites were obtained and analyzed. For all diseases, "Oriental physician" had the largest portion (almost half of all websites), followed by "Western physician". Based on analyses using the JAMA benchmark, "Attribution" and "Disclosure" were ignored in almost all surveyed websites. According to the scores of the DISCERN question, the majority of websites did not supply appropriate references for their health information, and information on the negative aspects of treatment such as risks and uncertainty was not provided in several websites. In an analysis based on the ARIA 2008 Update concepts, 65% of websites pertaining to health information on AR contained unreliable information.

Conclusions

The quality of health information on the internet was not acceptable. Thus, governmental regulation or control to improve the quality of health information is required.

Developments in the use of e-health for chronic pain management

SUMMARY Recognition that changes are required in how chronic conditions are managed, combined with advances in technology, has led to the emergence of e-health as a possible solution. This selective review seeks to illustrate some of the ways in which e-health has been applied to chronic pain. Examples of technology use are provided within the areas of information provision, assessment and monitoring, and remote therapy, and the various strengths and weaknesses associated with each method are highlighted. One of the main concerns is that, despite enthusiastic promises, evidence of e-health for pain management is often based on small numbers and few randomized controlled trials. However, the situation is improving, especially within the field of internet-based interventions where the number of higher quality trials is increasing, and results to date are encouraging. A sense of cautious optimism seems reasonable when considering the potential of e-health for the management of chronic pain.

A nationwide evaluation on electronic medication-related information provided by hospital websites

RATIONAL, AIMS AND OBJECTIVES

The aim of this study was to describe the characteristics of electronic medication-related information (e-MRI) via Internet offered by the hospital settings in Taiwan.

METHODS

The structured Internet search and comprehensive review were performed on the most commonly used search engines in Taiwan. The assessment checklists were developed to describe the characteristics of general, e-MRI in the years 2008 and 2010, and specific digoxin information in 2011 based on the operational definitions derived from other studies. The descriptive analyses and chi-square tests for the retrieved data were performed.

RESULTS

With approximately 15% of hospital settings providing general, e-MRI on their websites, their content varied but was not statistically significant, and different among the providers from different levels of hospitals and in different years. More medical centres provided the information with the updated dates and contact approaches than the smaller scale hospitals. Little was found about reference citation and authorships for those general, e-MRI websites. More medical centres created the accesses to search for the individual prescription in the corresponding settings and the specific information about digoxin storage. However, more district hospitals provided the precaution and dosage form information about digoxin.

CONCLUSIONS

The providers to offer the e-MRI via hospital websites in Taiwan could be more responsible for its update, authorship and evidence. Further, the provision of electronic medication-related information via the Internet should be regularly examined or audited by the neutral personnel or organizations to ensure its quality.

Assessing the quality, suitability and readability of internet-based health information about warfarin for patients

BACKGROUND

Warfarin is a high-risk medication where patient information may be critical to help ensure safe and effective treatment. Considering the time constraints of healthcare providers, the internet can be an important supplementary information resource for patients prescribed warfarin. The usefulness of internet-based patient information is often limited by challenges associated with finding valid and reliable health information. Given patients' increasing access of the internet for information, this study investigated the quality, suitability and readability of patient information about warfarin presented on the internet.

METHOD

Previously validated tools were used to evaluate the quality, suitability and readability of patient information about warfarin on selected websites.

RESULTS

The initial search yielded 200 websites, of which 11 fit selection criteria, comprising seven non-commercial and four commercial websites. Regarding quality, most of the non-commercial sites (six out of seven) scored at least an 'adequate' score. With regard to suitability, 6 of the 11 websites (including two of the four commercial sites) attained an 'adequate' score. It was determined that information on 7 of the 11 sites (including two commercial sites) was written at reading grade levels beyond that considered representative of the adult patient population with poor literacy skills (e.g. school grade 8 or less).

CONCLUSION

Despite the overall 'adequate' quality and suitability of the internet derived patient information about warfarin, the actual usability of such websites may be limited due to their poor readability grades, particularly in patients with low literacy skills.

[Study of the health food information for cancer patients on Japanese websites]

The aim of this paper is to evaluate the reliability of websites providing health food information for cancer patients and, to assess the status to get this information online. We used four common Japanese search engines (Yahoo!, Google, goo, and MSN) to look up websites on Dec. 2, 2008. The search keywords were "health food" and "cancer". The websites for the first 100 hits generated by each search engine were screened and extracted by three conditions. We extracted 64 unique websites by the result of retrieval, of which 54 websites had information about health food factors. The two scales were used to evaluate the quality of the content on 54 websites. On the scale of reliability of information on the Web, the average score was 2.69+/-1.70 (maximum 6) and the median was 2.5. The other scale was matter need to check whether listed to use safely this information. On this scale, the average score was 0.72+/-1.22 (maximum 5) and the median was 0. Three engines showed poor correlation between the ranking and the latter score. But several websites on the top indicated 0 score. Fifty-four websites were extracted with one to four engines and the average number of search engines was 1.9. The two scales were positively correlated with the number of search engines, but these correlations were very poor. Ranking high and extraction by multiple search engines were of minor benefit to pick out more reliable information.