International assessment on quality and content of internet information on osteoarthritis

Generalized pustular psoriasis (GPP) is a multisystem disease with potentially life-threatening adverse effects. As patients increasingly seek health information online, and as the landscape for GPP changes, the quality of online health information (OHI) becomes progressively more important. This paper is the first of its kind to examine the quality, comprehensiveness and readability of online health information for GPP. Similar to pre-existing studies evaluating OHI, this paper examines 5 key search terms for GPP- 3 medical and 2 laymen. For each search term, the results were evaluated based on HONcode accreditation, an enhanced DISCERN analysis and a number of readability indices. Of the 500 websites evaluated, 84 (16.8%) were HONcode-accredited. Mean DISCERN scores of all websites were 74.9% and 38.6% for website reliability and treatment sections, respectively, demonstrating key gaps in comprehensiveness and reliability of GPP-specific OHI. Additionally, only 4/100 websites (4%) analysed for readability were written at the NIH-recommended sixth-grade level. Academic websites were significantly more difficult to read than governmental websites. This further exacerbates the patient information gap, particularly for patients with low health literacy, who may already be at higher risk of not receiving timely medical care.

BackgroundPeople increasingly use the Internet to seek health information. However, the overall quality of online health information remains low. This situation is exacerbated by the unprecedented “infodemic”, which has had negative consequences for patients. Therefore, it is important to understand how users make judgements about health information by applying different judgement criteria.ObjectiveThe objective of this study is to determine how patients apply different criteria in their judgement of the quality of online health information during the pandemic. In particular, we investigate whether there is consistency between the likelihood of using a particular judgement criterion and its perceived importance among different groups of users.MethodsA cross-sectional survey was conducted in one of the leading hospitals in a coastal province of China with a population of forty million. Combined-strategy sampling was used to balance the randomness and the practicality of the recruiting process. A total of 1063 patients were recruited for this study. Chi-square and Kruskal–Wallis analyses were used to analyse the survey data.ResultsIn general, patients make quality judgement of health information more frequently based on whether it is familiar, aesthetic, and with expertise. In comparison, they put more weights on whether health information is secure, trustworthy, and with expertise when determining its quality. Criteria that were considered more important were not always those with a higher likelihood of being used. Patients may not use particular criteria, such as familiarity, identification, and readability, more frequently than others even if they consider them to be more important than other do and vice versa. Surprisingly, patients with a primary school degree put more weight on whether health information is comprehensive than those with higher degrees do in determining its quality. However, they are less likely to use this guideline in practice.ConclusionsTo the best of our knowledge, this is the first study to investigate the consistency between the likelihood of using certain quality judgement criteria and their perceived importance among patients grouped by different demographic variables and eHealth literacy levels. The findings highlight how to improve online health information services and provide fine-grained customization of information for users.

The Internet has been considerably used as an essential source for health information. A previous study conducted at King Saud bin Abdulaziz University for Health Science (KSAUHS) to assess the quality of online health information in Arabic language has fueled the motivation to establishing a comprehensive trusted health website in the Arabic and English languages. This initiative is called King Abdullah Arabic Health Encyclopedia (KAAHE) portal. This research is a continuation study which aims to assess the quality of online health portals in languages spoken in Asian countries other than Arabic and English, against Health on the Net (HON) standards and the results would be used to choose which languages to be added to KAAHE in order to widen its users’ group. This study is a quantitative cross-sectional prospective study. The criteria used to choose the languages for this study are based on the languages spoken in countries with the highest literacy and internet access rate in addition to highest population enumeration among Asian countries. Japan (Japanese language), South Korea (Korean language), Singapore (Chinese language) and Malaysia (Malay language) countries languages were chosen based on those criteria. Data collection methods used are: thru Saudi embassies in the selected countries, medical attaches and secretaries of the selected countries’ embassies in Saudi Arabia (in Riyadh, Diplomatic quarter), and local Google search engine in each country. After applying the refining process on the data collected, a simple random sampling technique is used to choose 10 portals for each language. The portals are assessed in terms of meeting HON international standards. The result is analyzed and shows variety quality level in meeting HON standards among the health portals. The assessment results show that Japanese health websites reach the highest compliance percentage among other languages’ health portals while Malaysian health websites were the lowest in reaching the compliance percentage against HON international standards.

The Internet has become a leading source of health information accessed by patients and the general public. It is crucial that this information is reliable and accurate. The purpose of this systematic review was to evaluate the overall quality of online health information targeting patients and the general public. The systematic review is based on a pre-established protocol and is reported according to the PRISMA statement. Eleven databases and Internet searches were performed for relevant studies. Descriptive statistics were used to synthesize data. The NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the methodological quality of the included studies. Out of 3393 references, we included 153 cross-sectional studies evaluating 11,785 websites using 14 quality assessment tools. The quality level varied across scales. Using DISCERN, none of the websites received a category of excellent in quality, 37-79% were rated as good, and the rest were rated as poor quality. Only 18% of websites were HON Code certified. Quality varied by affiliation (governmental was higher than academic, which was higher than other media sources) and by health specialty (likely higher in internal medicine and anesthesiology). This comprehensive systematic review demonstrated suboptimal quality of online health information. Therefore, the Internet at the present time does not provide reliable health information for laypersons. The quality of online health information requires significant improvement which should be a mandate for policymakers and private and public organizations.

Background and aimsSystemic lupus erythematosus (SLE) is a complex multi-system autoimmune disorder. Patients frequently access the internet to increase their knowledge about the condition.We assessed the quality, reliability and readability...

An evaluation of the readability, quality, and accuracy of online health information regarding the treatment of hypospadias

People in China and India, the two largest developing countries, are relying increasingly on the web for health related information. As a result, the quality of online health information becomes critical due to its profound implications on people’s health. A lack of research exists in literature on the quality of online health information available in developing countries, especially for China and India. In this paper, we perform a comparative analysis of the quality of online health information in China and India using the USA as the benchmark and provide recommendations for improvements to health information portals in these two countries.

Wikipedia has been increasingly used as a health education tool, and is widely used by medical students and health professionals as a source of health information, which influences clinical practices and the health of users, highlighting the importance of the quality of available health information. Through the “WikiProject Medicine” Project, initiatives are developed to evaluate and improve the quality of Wikipedia health information, including Parkinson's disease (Matheson and Matheson-Monnet 2017; Joorabch Doherty and Dawson , 2020; Wikipedia, 2025; Herbert et al., 2015; Smith, 2020). However, there is still a lack of adequate methodology to evaluate the quality of health information available online, including Wikipedia articles (Dominguesand Lopes, 2019; Smith, 2020; da Silva Couto, 2021). Therefore, this protocol aims to present evaluation guidelines to compare the quality of online health information, specifically related to Parkinson's disease, available on Wikipedia in multiple languages, in order to ensure the quality of information about Parkinson's disease.

Background Wikipedia is frequently used as a source of health information. However, the quality of its content varies widely across articles. The DISCERN tool is a brief questionnaire developed in 1996 by the Division of Public Health and Primary Health Care of the Institute of Health Sciences of the University of Oxford. They claim it provides users with a valid and reliable way of assessing the quality of written information. However, the DISCERN instrument’s reliability in measuring the quality of online health information, particularly whether or not its scores are affected by reader biases about specific publication sources, has not yet been explored. Methods This study is a double-blind randomized assessment of a Wikipedia article versus a BMJ literature review using a modified version of the DISCERN tool. Participants will include physicians and medical residents from four university campuses in Ontario and British Columbia and will be randomized into one of four study arms. Inferential statistics tests (paired t-test, multi-level ordinal regression, and one-way ANOVA) will be conducted with the data collected from the study. Outcomes The primary outcome of this study will be to determine whether a statistically significant difference in DISCERN scores exists, which could suggest whether or not how health information is packaged influences how it is assessed for quality. Plain Language Summary The internet, and in particular Wikipedia, is an important way for professionals, students and the public to obtain health information. For this reason, the DISCERN tool was developed in 1996 to help users assess the quality of the health information they find. The ability of DISCERN to measure the quality of online health information has been supported with research, but the role of bias has not necessarily been accounted for. Does how the information is packaged influence how the information itself is evaluated? This study will compare the scores assigned to articles in their original format to the same articles in a modified format in order to determine whether the DISCERN tool is able to overcome bias. A significant difference in ratings between original and inverted articles will suggest that the DISCERN tool lacks the ability to overcome bias related to how health information is packaged.

BackgroundAs the quality of online health information remains questionable, there is a pressing need to understand how consumers evaluate this information. Past reviews identified content-, source-, and individual-related factors that influence consumer judgment in this area. However, systematic knowledge concerning the evaluation process, that is, why and how these factors influence the evaluation behavior, is lacking.ObjectiveThis review aims (1) to identify criteria (rules that reflect notions of value and worth) that consumers use to evaluate the quality of online health information and the indicators (properties of information objects to which criteria are applied to form judgments) they use to support the evaluation in order to achieve a better understanding of the process of information quality evaluation and (2) to explicate the relationship between indicators and criteria to provide clear guidelines for designers of consumer health information systems.MethodsA systematic literature search was performed in seven digital reference databases including Medicine, Psychology, Communication, and Library and Information Science to identify empirical studies that report how consumers directly and explicitly describe their evaluation of online health information quality. Thirty-seven articles met the inclusion criteria. A qualitative content analysis was performed to identify quality evaluation criteria, indicators, and their relationships.ResultsWe identified 25 criteria and 165 indicators. The most widely reported criteria used by consumers were trustworthiness, expertise, and objectivity. The indicators were related to source, content, and design. Among them, 114 were positive indicators (entailing positive quality judgments), 35 were negative indicators (entailing negative judgments), and 16 indicators had both positive and negative quality influence, depending on contextual factors (eg, source and individual differences) and criteria applied. The most widely reported indicators were site owners/sponsors; consensus among multiple sources; characteristics of writing and language; advertisements; content authorship; and interface design.ConclusionsConsumer evaluation of online health information is a complex cost-benefit analysis process that involves the use of a wide range of criteria and a much wider range of quality indicators. There are commonalities in the use of criteria across user groups and source types, but the differences are hard to ignore. Evidently, consumers’ health information evaluation can be characterized as highly subjective and contextualized, and sometimes, misinformed. These findings invite more research into how different user groups evaluate different types of online sources and a personalized approach to educate users about evaluating online health information quality.

Both the Internet and social media have become important tools that patients and health professionals, including health professional students, use to obtain information and support their decision-making surrounding health care. Students in the health sciences require increased competence to select, appraise, and use online sources to adequately educate and support patients and advocate for patient needs and best practices. The purpose of this study was to ascertain if second year nursing students have the ability to critically identify and evaluate the quality of online health information through comparisons between student and expert assessments of selected online health information postings using an adapted Trust in Online Health Information scale. Interviews with experts provided understanding of how experts applied the selected criteria and what experts recommend for implementing nursing informatics literacy in curriculums. The difference between student and expert assessments of the quality of the online information is on average close to 40%. Themes from the interviews highlighted several possible factors that may influence informatics competency levels in students, specifically regarding the critical appraisal of the quality of online health information.

BackgroundRecent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information.ObjectiveThe main aim of this study was to review existing evidence on the association between low health literacy and (1) people’s ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information.MethodsFive academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels.ResultsAfter abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive.ConclusionsThe findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review, future research in this field should (1) specifically focus on health literacy, (2) devote more attention to the identification of the different criteria people use to evaluate online health information, (3) develop shared definitions and measures for the most commonly used outcomes in the field of evaluation of online health information, and (4) assess the relationship between the different evaluative dimensions and the role played by health literacy in shaping their interplay.

The opioid crisis in the US remains a critical public health issue. Accessible, high-quality online health information is vital for educating the public about opioid use disorder (OUD) and available treatment options. This study aims to evaluate and compare the readability, accessibility, and quality of OUD-related information on government and non-government websites to identify areas for improvement. A total of 30 websites, 21 government-operated and 9 non-governmental, were selected through a systematic search. Readability was assessed using Gunning Fog, Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease Score (FRES) tests. Accessibility was evaluated using the WAVE tool, which checks for errors and adherence to Web Content Accessibility Guidelines (WCAG). Quality was measured using the DISCERN Instrument, a standardized tool for evaluating the quality of health information. Data were analyzed for statistical differences between government and non-government websites. The average readability grade level across all websites was 14.63 and average FRES score was 31.63, indicating content requiring advanced reading skills, with no significant difference between government and non-government websites. Accessibility issues were more prevalent on non-government websites. Government websites scored significantly lower in terms of quality, with 80.95% of them rated as "poor" or "very poor" compared with 22.22% of non-government websites. The overall quality scores for both groups remained suboptimal, with an average DISCERN score of 39.52 out of 80. The findings highlight a critical need for improvements in the readability, accessibility, and quality of online health information on OUD. Government websites, in particular, require enhancements to ensure they meet the public's need for reliable, accessible, and comprehensible health resources.

Although much is known about the quality of online health information (OHI) for many malignancies, the availability of high-quality OHI for oncologic treatments remains undefined. Furthermore, search strategies that improve quality of radiation oncology OHI, and disparities in availability of high-quality OHI, are not well-described. Forty phrases describing malignancies and their treatment modalities (radiation, chemotherapy, and surgery), and 57 phrases describing radiation oncology treatments, including abbreviations for some treatments and translations in different languages, were generated. The Health on the Net Foundation framework for assessing OHI quality was applied to the top 100 websites listed for each search phrase. The availability of high-quality OHI between malignancies and treatment modalities, and among treatment modalities, was compared. The roles of radiation oncology term abbreviation, search result order, patient gender, and language, on availability of high-quality OHI, were also assessed. Among the first 10, 20, and 50 websites for each search phrase, there were significantly more high-quality websites for phrases describing malignancies compared with respective treatment modalities (P < 0.02 for all). There were no differences among treatment modalities. Among radiation oncology treatment phrases, there were no significant differences between searches for full-name phrases and their respective abbreviations, though earlier results were more likely to be of high quality. Gender did not affect quality of OHI, though language did. Availability of high-quality OHI for cancer treatments lags behind that of cancer OHI. For radiation oncology treatment OHI, search strategies and patient disparities highlight potential areas for provider intervention and increased quality of OHI.

PurposeTo identify differences in the content and quality of online health information for pelvic organ prolapse (POP) presented in social media and digital search engines to sustainably enhance patient guidance for adequate platforms for seeking online health information on POP.MethodsThe platforms Google search, Facebook, Instagram, LinkedIn, and YouTube were searched for the keyword “pelvic organ prolapse”. Results were categorized as useful, misleading, advertising, and personal experience. Data were categorized into healthcare professionals, professional organisations, industry, patients, and individuals. The readability score and Health On the Net (HON) code seal were analyzed for Google. Descriptive and univariate analysis was performed.ResultsThe source with the highest quantity of useful content was YouTube whereas LinkedIn included mostly advertisement and misleading content. YouTube and Google provided the greatest variety of health information. Social media platforms identified emotional distress and sleep disturbances as a common side effect of POP which is limited considered in clinical practice and provide novel insights of bothersome symptoms related to the disease. The spectrum of different surgical techniques was limited in all platforms. Only 12 (40.0%) were HON-qualified websites with a mean readability score of 10.4 which is considered fairly difficult to read.ConclusionBesides Google search, YouTube was identified as a valuable online source for POP information. However, encompassing information of surgical techniques was limited in all platforms. Urogynecological association may contribute to improve patient information by providing online health information which is complete and easy to understand.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00345-022-04129-6.