Quality of Web-Based Information on Epidural Anesthesia

Abstract

INTRODUCTION: Many American adults use the Internet as a source of health information, and many adults also have difficulty understanding and using health information. Epidural anesthesia is the most commonly used method of pain control in labor, but patients' knowledge is varied. Assessment of web-based information can inform doctor–patient dialogues and decision-making practices. METHODS: Four search engines (Google, Yahoo, Bing, and Ask) were queried for the search term “epidural.” The web sites on the first page of each search engine were used for analysis. Web sites were categorized as commercial, national health organizations, or reference sites. Paid advertisements were not evaluated. Web sites were evaluated using DISCERN, a 16-question validated instrument designed to assess quality based on aims, relevance, references, treatment options, and overall impression. RESULTS: Forty unique sites were identified. Of these, 13 were paid advertisements so 27 sites were evaluated. Eight were commercial sites, nine were national health organizations, and 10 were reference sites. The overall mean DISCERN score was 45.8±13.5. Eight were of poor quality (score less than 44), 18 of average quality (score 44–67), and one of excellent quality (score greater than 67). There were no significant differences with respect to search engine used or type of web site. CONCLUSION: When patients search the Internet for information regarding epidural in labor, the majority of web sites encountered are of average to poor quality. Clinicians should educate patients regarding epidural anesthesia during labor and discuss the limitations of available web resources.