LIDA Score Research Articles

Brain death and the internet: evaluating the readability and quality of online health information.

Brain death has been accepted medically and legally as biological death. Nevertheless, it is a difficult concept for the public to understand, resulting in a reliance on online resources for clarity. When the information is inaccurate, misleading, or elusive, the internet could have adverse effects on the public's decision-making. Here we aimed to assess the quality and readability of information regarding brain death on the internet. The five most popular search engines were queried using the keyword 'brain death' and the top 30 websites of each search engine were evaluated. Authorship was classified as medical or public. Gunning Fog Index (GFI) and Flesch Reading Ease Score (FRES) were calculated to analyze readability. The LIDA was used to assess quality. The overall LIDA score was 60,3%, with a mean score of 60.8%, 60.7%, and 59.3% for accessibility, usability, and reliability, respectively, indicating a moderate level. The accessibility of medical websites (P=0.037) and the reliability of public websites (P=0.031) were found to be significantly weaker. The average FRES was 41.6±14.6 rated as difficult, and the mean GFI was 15.7±3.4, indicating mean readability at "difficult, grade >10". Online health information on brain death exceeds the National Institutes of Health recommended reading levels. Our results emphasize the need to establish quality guidelines to improve the comprehensiveness of health website content. Brain death is still a contentious topic; therefore, reliable, and easy-to-read online educational materials can help public understand the concept of brain death and potentially improve the transplant rate.

Assessing the Quality of Online Health Information About Breast Cancer from Chinese Language Websites: Quality Assessment Survey.

BackgroundIn China, the internet has become one of the most important ways to obtain information about breast cancer. However, quantitative evaluations of the quality of Chinese health websites and the breast cancer treatment information they publish are lacking.ObjectiveThis study aimed to evaluate the quality of Chinese breast cancer websites and the value, suitability, and accuracy of the breast cancer treatment information they publish.MethodsChinese breast cancer health websites were searched and manually screened according to their Alexa and Baidu search engine rankings. For each website included in the survey, which was conducted on April 8, 2019, the three most recently published papers on the website that met the inclusion criteria were included for evaluation. Three raters assessed all materials using the LIDA, DISCERN, and Suitability Assessment of Materials (SAM) tools and the Michigan Checklist. Data analysis was completed with the Statistical Package for Social Sciences (SPSS) version 20.0 and Microsoft Excel 2010.ResultsThis survey included 20 Chinese breast cancer websites and 60 papers on breast cancer treatment. The LIDA tool was used to evaluate the quality of the 20 websites. The LIDA’s scores of the websites (mean=54.85, SD 3.498; total possible score=81) were low. In terms of the layout, color scheme, search facility, browsing facility, integration of nontextual media, submission of comments, declaration of objectives, content production method, and robust method, more than half of the websites scored 0 (never) or 1 (sometimes). For the online breast cancer treatment papers, the scores were generally low. Regarding suitability, 32 (53.33%) papers were evaluated as presenting unsuitable material. Regarding accuracy, the problems were that the papers were largely not original (44/60, 73%) and lacked references (46/60, 77%).ConclusionsThe quality of Chinese breast cancer websites is poor. The color schemes, text settings, user comment submission functions, and language designs should be improved. The quality of Chinese online breast cancer treatment information is poor; the information has little value to users, and pictorial information is scarcely used. The online breast cancer treatment information is accurate but lacks originality and references. Website developers, governments, and medical professionals should play a full role in the design of health websites, the regulation of online health information, and the use of online health information.

Quality of the patient-oriented web-based information on esophageal cancer

This study was aimed to analyze the readability and quality of patient education websites on esophageal cancer. Yahoo!, Google, and Bing search engines were searched using keywords esophageal cancer, esophageal tumor, esophageal tumor, esophageal malignancy, esophageal cancer, esophageal tumor, esophageal tumor, and esophageal malignancy. The first 50 websites resulting in each keyword search were evaluated using validated FRES, LIDA, and DISCERN scores to assess readability, usability, and reliability, and quality of information, respectively. Non-parametric tests were used for statistical analysis. A total of 108 eligible websites were included in the analysis. Thirty (27.8%) out of the 108 eligible web sites had obtained Health on the Net (HON) code certification. The median FRES score of the included websites was 48.25 out of 100 (range: 15.6-70.1). The median LIDA usability and reliability scores were 46.5 out of 54 (range: 22-54) and 39.0 out of 51 (range: 10-51), respectively. The median DISCERN score was 50.5 out of 80 (range: 23-79). A low DISCERN score (≤ 50%) was found in 50% (n = 54) of the websites. The DISCERN score was found to be significantly associated with LIDA usability, reliability, LIDA overall scores (p < 0.001), and HON code certification (p = 0.01). The quality of the websites providing patient-centered information on the Internet ranged between moderate and low with regards to readability, usability, and reliability scores. Better informed decisions on treatment may be facilitated with the access to good quality information online. Therefore, strategies need to be implemented to regulate and standardize websites to provide good quality, accurate information.

Quality of online information for the general public on COVID-19

ObjectivesTo analyse the quality of information included in websites aimed at the public on COVID-19. MethodsYahoo!, Google and Bing search engines were browsed using selected keywords on COVID-19. The first 100 websites from each search engine for each keyword were evaluated. Validated tools were used to assess readability [Flesch Reading Ease Score (FRES)], usability and reliability (LIDA tool) and quality (DISCERN instrument). Non-parametric tests were used for statistical analyses. ResultsEighty-four eligible sites were analysed. The median FRES score was 54.2 (range: 23.2−73.5). The median LIDA usability and reliability scores were 46 (range: 18−54) and 37(range:14−51), respectively. A low (<50 %) overall LIDA score was recorded for 30.9 % (n = 26) of the websites. The median DISCERN score was 49.5 (range: 21–77). The DISCERN score of ≤50 % was found in 45 (53.6 %) websites. The DISCERN score was significantly associated with LIDA usability and reliability scores (p < 0.001) and the FRES score (p = 0.024). ConclusionThe majority of websites on COVID-19 for the public had moderate to low scores with regards to readability, usability, reliability and quality. Practice ImplicationsPrompt strategies should be implemented to standardize online health information on COVID-19 during this pandemic to ensure the general public has access to good quality reliable information.

Evaluation of Hip Preservation-related Patient Education Materials From Leading Orthopaedic Academic Centers in the United States and Description of a Novel Video Assessment Tool.

Introduction:The readability, reliability, and quality of online hip preservation–related patient education materials from the top 20 orthopaedic academic centers in the United States were evaluated.Methods:The patient educational materials were evaluated with the following assessment tools: Flesch-Kincaid (FK) readability test, Flesch Reading Ease formula, LIDA instrument, and DISCERN tool. Videos were assessed using the Patient Educational Video Assessment Tool (PEVAT), an author-developed scoring system.Results:A total of 121 educational items were reviewed. Median (interquartile range) or mean ± SD of the FK level, Flesch Reading Ease, LIDA, and DISCERN scores were 11.00 (3.00), 47.32 ± 12.14, 41.00 (6.00), and 64.00 (7.00), respectively. Higher ranking was correlated with higher FK (ρ = −0.21, P value = 0.034), higher DISCERN score (ρ = −0.39, P value < 0.005), and a lower PEVAT score (r = 0.61, P value = 0.034). The PEVAT score found that 83% of videos were classified as high quality.Discussion:An analysis of the hip preservation patient education text articles found low readability. Overall, high ranking was associated with poorer readability, higher quality text content, and lower quality video content. Video content was found to be predominantly of high quality. Improving the educational accessibility and effect of hip preservation–related topics may result in improved treatment outcomes.

Quality of the patient-oriented information on thyroid cancer in the internet

ObjectivesThis study was conducted to analyse the readability and quality of patient education websites about thyroid cancer. MethodsYahoo!, Google and Bing were searched with their default settings using the keywords thyroid cancer, thyroid tumour, thyroid tumor, and thyroid malignancy for relevant websites. The first 50 websites obtained for each keyword and search engine were evaluated using validated Flesch Reading Ease Score (FRES), LIDA and DISCERN scores to assess readability, usability and reliability, and quality of information. Statistical analysis were done using non-parametric tests. ResultsThe analysis included 49 eligible websites selected out of 600 websites obtained from the search engines. Twenty-two (44.9%) web sites had obtained Health on the net foundation code of conduct (HON-code) certification. The included websites had a median FRES score of 55.3(range 25.3–85.3) and the LIDA reliability and usability scores were 22.0(range 14–30) and 39.0(range 28–50), respectively. The median DISCERN score was 48.0(range 33–63). A total DISCERN score of 50% or less (low score) was found in 28.5%(n = 14) of the websites. A significant association was found between LIDA usability and, reliability scores and DISCERN score (p<0.001, p=0.001, respectively). ConclusionThe quality of the websites, readability and usability scores were moderate or low based on the criteria used. Access to quality information may help with better informed decisions on treatment, follow up and prognosis. As the internet use by the public is ever increasing, implementing measures to ensure the quality information without a bias should be considered a priority.

Analysis of the quality of online resources for parents of children who are late to talk.

Internet usage worldwide has become a primary source of health-related information and an important resource for parents to find advice on how to promote their child's development and well-being. It is important that healthcare professionals understand what information is available to parents online to best support families and children. The current study evaluated the quality of online resources accessible for parents of children who are late to talk. Fifty-four web pages were evaluated for their usability and reliability using the LIDA instrument and Health on the Net Foundation code of conduct certification, and readability using the Flesch Reading Ease Score and Flesch-Kincaid Grade Level. Origin, author(s), target audience, topics discussed, terminology used, and recommendations were also examined. The majority of websites scored within the moderate range (50-90%) for total LIDA scores and usability, but scored in the low range for reliability (<50%). Significantly higher reliability scores (p < 0.001) were found for sites with Health on the Net Foundation code of conduct certification. Readability fell within the standard range. The largest proportion of websites were American, written by speech-language pathologists, with the most common topics being milestones, tips and strategies, and red flags. Discrepancies were mostly seen in terminology and misinformation, and when present, usually related to risk factors and causes. Prior to recommending websites to parents, health professionals should consider readability of the content, check that information is up-to-date, and confirm website sources and reputable authorship. Health professionals should also be aware of the types of unclear or inaccurate information to which parents of children who are late to talk may be exposed online.

The Accuracy of Information about Orthodontics Available on the Internet.

The aim of the present study was to evaluate the content of the informative websites related to orthodontic terms in Turkish and in English. Five different orthodontic terms ("orthodontic appliances (ortodontik aygıtlar)," "orthodontic braces (ortodontik braketler)," "orthodontic elastics (ortodontik elastikler)," "orthognathic surgery (ortognatik cerrahi)," and "orthodontic treatment (ortodontik tedavi)") both in Turkish and in English were searched using Google. There were 25 websites evaluated for each term. A total of 137 different websites were evaluated with three measurement tools: DISCERN (questionnaire, University of Oxford, 1999) (quality of information), LIDA (v1.2 Minervation, 2007) (accessibility, usability, and reliability), and AChecker (v0.1 ATutor, 2011) (accessibility). The mean overall score of the quality of information was "good" for terms in Turkish and in English. The LIDA score was classified as "moderate" for terms in Turkish and in English. More accessibility errors were found on the Turkish websites than on the English counterparts. Most of the statistical evaluations between Turkish and English terms were insignificant. However, intragroup evaluation of the terms mostly showed significant differences. Accessibility, usability, and reliability; quality of information; and scores of access errors showed variations among Turkish and English sites. The collaboration of website designers and clinicians to increase the quality level of the websites is recommended.

Factors Associated With Quality of Online Information on Trapeziometacarpal Arthritis.

People increasingly search the Internet for information about common medical problems such as trapeziometacarpal (TMC) joint arthritis. But this information can be biased, inaccurate, and misleading. Medical professionals should be aware of what patients may be reading about their condition because concepts and beliefs can affect symptoms, limitations, and decision making. This study sought factors associated with the quality of design and content of health information Web sites about TMC arthritis. Using 3 search engines we entered "thumb arthritis" and measured the quality of design and content of 67 Web sites using the DISCERN and LIDA tools, dominant tones using the IBM Watson Tone Analyzer, and readability, and we recorded Web site characteristics. All but 1 Web site exceeded the recommended sixth-grade reading level. We created 2 backward stepwise regression models to identify independent factors associated with Web site design and content quality. In multivariable analysis, the Web site not having a clear preference for treatment was independently associated with greater design and content quality measured by DISCERN. Health On the Net (HON) code certification-a code of conduct for medical Web sites-and nonprofit Web sites had higher LIDA scores. Online information on TMC arthrosis is difficult to read, often biased in favor of a particular treatment and influenced by profit and HONcode. Hand surgeons should prepare to gently correct misconceptions established or reinforced, in part, by material found on the Internet.

Assessment of the quality of patient-oriented information over internet on testicular cancer

BackgroundThis study aimed to assess the quality and readability of patient education information available on the internet on testicular cancer.MethodsInternet searches were performed using the keywords ‘testicular cancer’, ‘testicular tumour’, ‘testicular tumor’, ‘testicular malignancy’, ‘germ cell tumour’ and ‘germ cell tumor’ using Google, Yahoo! And Bing search engines with default settings. The first 50 web links appeared in each search engine were evaluated for their readability by using the validated Flesch Reading Ease Score (FRES) while accessibility, usability and reliability were assessed using the LIDA tool. The quality was assessed using DISCERN instrument. Non-parametric tests were used for statistical analysis.ResultsOverall, 900 websites were assessed and 62 websites were included in the analysis. Twenty two (22) websites (35.5%) were certified by Health on the Net Foundation code of conduct (HON code). The majority (n = 57, 91.9%) were non-governmental websites. The median FRES score was 51.6 (range: 28.1–74.1), the overall median LIDA score was 115 (range: 81–147); accessibility 55 (range: 46–61), reliability 22 (range: 8–45) and usability 38.5 (range: 21–50), while the median DISCERN score was 43.5 (range: 16–69). The DISCERN score was significantly associated with the overall LIDA score and usability and reliability components of the LIDA score (p < 0.001). However, no significant associations were observed between readability and accessibility. A significant correlation was noted between usability and reliability components of the LIDA score (Spearman’s rho: 0.789, p < 0.001).ConclusionIn this study, the readability, reliability and quality scores of most websites were found to be suboptimal and hence, there is potential for improvement. As the internet is expanding rapidly as a readily available source of information to the public, it is essential to implement steps to ensure that highest quality information is provided without any commercial motivation or bias.

An assessment of online information related to surgical obstructive sleep apnea treatment

BackgroundPatients are accessing online health information frequently and using it to guide treatment decisions. Few studies have been done assessing obstructive sleep apnea (OSA) information, and no studies have examined surgical resources for these patients.MethodsThis was a cross-sectional analysis. “Sleep surgery” and “sleep apnea surgery” were entered into Google, MSN Bing, and Yahoo! search engines. The first 25 results of each individual search were evaluated. Each unique site was assessed for content quality, accessibility, usability, reliability, and readability using validated instruments. The date of last update for each site was also documented.Results“Sleep surgery” was searched for an average of 1,703,991 (SD = 166,585) times per month from June 2015 to June 2016. 33 unique websites were identified. Sites were most often academically/government affiliated (10/33, 30.3%), health information sites (8/33, 24.2%), or non-profit/hospital related (8/33, 24.2%). The mean overall DISCERN score for quality was “good,” at 56.6 (range, 22–79). The mean overall LIDA score for accessibility, usability, and reliability was “moderate,” at 123.9 (range, 97–152). The mean Flesch Reading Ease score for readability was 49.77 (range 22.7-74.3); 7/33 (21.2%) scored above 60, the recommended range for average visitors. 60.6% (20/33) of the sites had been updated since January 1, 2014. There was no significant correlation between a websites’ position on a browser’s search and its DISCERN, LIDA, FRE, or total score.ConclusionsWith patients’ increasing reliance on Internet information, efforts to understand and improve websites’ quality and usefulness present unique opportunities in OSA surgery and beyond.

Orthodontic treatment modalities: a qualitative assessment of Internet information.

The present study aimed to determine the quality, accuracy, reliability and usability of Internet information, regarding different orthodontic treatment modalities. Google AdWords identified five popular keywords: Cosmetic braces, fixed braces, Removable braces, Quick braces and risks. These were entered in five search engines, with the resultant websites analysed using five validated assessment tools. Intra-examiner reliability was assessed, descriptive and inferential analysis of the data undertaken. Good intra-examiner reliability and consistency was observed. A total of 119 websites were included for analysis, with the keywords cosmetic and fixed braces accounting for 55% of identified websites. Invisalign was the most offered treatment (80%). Specialist orthodontists produced the highest, whilst general dentists advertising short-term options produced the lowest quality scoring websites. LIDA provided the most accurate assessment of quality (mean 62.02, SD 7.48). Regression analysis found a significant relationship between author type and a questions and answer sections with both Discern (P < 0.001) and LIDA (P = 0.002) scores, respectively. Quality of Information regarding orthodontic treatment was variable, with the highest scoring websites were produced by orthodontic specialists and Invisalign the most offered treatment. There is a clear need for valid and reliable websites to better guide patients.

Quality of Information Available Via the Internet for Patients With Otological Conditions.

Evaluate the type, content, and quality of information available via the Internet for patients with common otological conditions. The Google search engine was used to generate responses for the following search terms: glue ear, otitis media, otosclerosis, Ménière's disease, cholesteatoma, and ear perforation. The first 10 websites for each search term were selected for analysis. Websites were evaluated with the validated DISCERN instrument (Institute of Health Sciences, University of Oxford, UK), the LIDA tool (Minervation Ltd, Oxford, UK), the Flesch Readability Formula, the Simple Measure Of Gobbledygook (SMOG) readability score, and against the Journal of the American Medical Association (JAMA) criteria. Comparisons were made with a similar study assessing quality of information in nonotological conditions. Mean SMOG score was 12.19 years of education (range, 6.2-22.8). The health on the net (HON) symbol appeared on 15 of 49 websites (30.61%). Pearson's r was used to identify interactions between variables and demonstrated a significant correlation between LIDA score and Google ranking (R = -0.1195, p = 0.002); between university/hospital affiliation and JAMA score (R = -1.7889, p = 0.0182) and commercial affiliation and JAMA score (R = 1.0561; p = 0.01). Multivariate linear regression analysis showed LIDA to be the strongest predictor of Google ranking (Page rank decreasing by 0.10572 per LIDA score; p = 0.01). As websites with better Google ranking were only weakly associated with higher quality rankings patients would benefit from being directed to reliable websites by clinicians. There is currently a gap in the available resources for a high quality repository of otological information aimed at patients.

The Accessibility, Usability, and Reliability of Chinese Web-Based Information on HIV/AIDS.

Objective: The present study was designed to assess the quality of Chinese-language Internet-based information on HIV/AIDS. Methods: We entered the following search terms, in Chinese, into Baidu and Sogou: “HIV/AIDS”, “symptoms”, and “treatment”, and evaluated the first 50 hits of each query using the Minervation validation instrument (LIDA tool) and DISCERN instrument. Results: Of the 900 hits identified, 85 websites were included in this study. The overall score of the LIDA tool was 63.7%; the mean score of accessibility, usability, and reliability was 82.2%, 71.5%, and 27.3%, respectively. Of the top 15 sites according to the LIDA score, the mean DISCERN score was calculated at 43.1 (95% confidence intervals (CI) = 37.7–49.5). Noncommercial websites showed higher DISCERN scores than commercial websites; whereas commercial websites were more likely to be found in the first 20 links obtained from each search engine than the noncommercial websites. Conclusions: In general, the HIV/AIDS related Chinese-language websites have poor reliability, although their accessibility and usability are fair. In addition, the treatment information presented on Chinese-language websites is far from sufficient. There is an imperative need for professionals and specialized institutes to improve the comprehensiveness of web-based information related to HIV/AIDS.

Variable Quality and Readability of Patient-oriented Websites on Colorectal Cancer Screening.

The efficacy of colorectal cancer (CRC) screening is dependent on participation and subsequent adherence to surveillance. The internet increasingly is used for health information and is important to support decision making. We evaluated the accuracy, quality, and readability of online information on CRC screening and surveillance. A Website Accuracy Score and Polyp Score were developed, which awarded points for various aspects of CRC screening and surveillance. Websites also were evaluated using validated internet quality instruments (Global Quality Score, LIDA, and DISCERN), and reading scores. Two raters independently assessed the top 30 websites appearing on Google.com. Portals, duplicates, and news articles were excluded. Twenty websites were included. The mean website accuracy score was 26 of 44 (range, 9-41). Websites with the highest scores were www.cancer.org, www.bowelcanceraustralia.org, and www.uptodate.com. The median polyp score was 3 of 10. The median global quality score was 3of 5 (range, 2-5). The median overall LIDA score was 74% and the median DISCERN score was 45, both indicating moderate quality. The mean Flesch-Kincaid grade level was 11th grade, rating the websites as difficult to read, 30% had a reading level acceptable for the general public (Flesch Reading Ease > 60). There was no correlation between the Google rank and the website accuracy score (rs= -0.31; P= .18). There is marked variation in quality and readability of websites on CRC screening. Most websites do not address polyp surveillance. The poor correlation between quality and Google ranking suggests that screenees will miss out on high-quality websites using standard search strategies.

Adult orthodontics: a quality assessment of Internet information.

This study evaluated the quality, reliability and readability of information on the Internet on adult orthodontics. A quality assessment of adult orthodontic websites. Postgraduate Orthodontic Unit, Cork University Dental School and Hospital, Cork, Ireland. An Internet search using three search engines (Google, Yahoo and Bing) was conducted using the terms ('adult orthodontics' and 'adult braces'). The first 50 websites from each engine and under each search term were screened and exclusion criteria applied. Included websites were then assessed for quality using four methods: the HON seal, JAMA benchmarks, the DISCERN instrument and the LIDA tool. Readability of included websites was assessed using the Flesch Reading Ease Score (FRES). Only 13 websites met the inclusion criteria. Most were of US origin (n = 8; 61%). The authors of the websites were dentists (n = 5; 39%), professional organizations (n = 2; 15%), past patients (n = 2; 15%) and unspecified (n = 4; 31%). Only 1 website displayed the HON seal and three websites contained all JAMA benchmarks. The mean overall score for DISCERN was 3.9/5 and the mean total LIDA score was 115/144. The average FRES score was 63.1/100. The number of informative websites on adult orthodontics is low and these are of moderate quality. More accurate, high-quality Internet resources are required on adult orthodontics. Recommendations are made as to how this may be achieved.

Breast-feeding and malocclusions: The quality and level of evidence on the Internet for the public

BackgroundThe authors sought to assess the quality of information on the Internet for laypeople regarding the effect of breast-feeding on malocclusions and to determine the levels of evidence of the articles cited to support the information. MethodsThe first author (E.J.D.) entered a key word term, “breast-feeding and crooked teeth,” and a natural language term, “does breast-feeding protect against crooked teeth,” into 4 search engines. The author performed consecutive sampling of every Web site until 5 Web sites were identified that fulfilled the inclusion criteria per search engine, per search term, producing 40 Web sites for evaluation. The author assessed quality using the LIDA instrument and determined the levels of evidence of the cited articles according to the Joanna Briggs Institute Levels of Evidence. ResultsThe author determined that the quality of the Web sites was moderate, represented by a median overall LIDA score of 73%. The author identified only 2 high-quality Web sites. Nearly one-half of the Web sites cited a combined total of 10 scientific articles to support their content, and these ranged from moderate to very low levels of evidence. ConclusionsThe authors found the quality of freely available information on the Internet for laypeople about the protective effect of breast-feeding against malocclusions to be moderate and that the evidence base cited to support the content ranged from moderate to very low levels of evidence. Practical ImplicationsIncreasingly, patients are seeking health information online, although not all information is credible. Dental heath care practitioners should regularly review their practices’ Web sites to ensure that they are accessible and that the content is usable, reliable, and up-to-date, particularly as new, higher-level evidence becomes available.

Cardiac Resynchronization Therapy Online: What Patients Find when Searching the World Wide Web

To objectively assess the quality of information available on the World Wide Web on cardiac resynchronization therapy (CRT). Patients frequently search the internet regarding their healthcare issues. It has been shown that patients seeking information can help or hinder their healthcare outcomes depending on the quality of information consulted. On the internet, this information can be produced and published by anyone, resulting in the risk of patients accessing inaccurate and misleading information. The search term "Cardiac Resynchronisation Therapy" was entered into the three most popular search engines and the first 50 pages on each were pooled and analyzed, after excluding websites inappropriate for objective review. The "LIDA" instrument (a validated tool for assessing quality of healthcare information websites) was to generate scores on Accessibility, Reliability, and Usability. Readability was assessed using the Flesch Reading Ease Score (FRES). Of the 150 web-links, 41 sites met the eligibility criteria. The sites were assessed using the LIDA instrument and the FRES. A mean total LIDA score for all the websites assessed was 123.5 of a possible 165 (74.8%). The average Accessibility of the sites assessed was 50.1 of 60 (84.3%), on Usability 41.4 of 54 (76.6%), on Reliability 31.5 of 51 (61.7%), and 41.8 on FRES. There was a significant variability among sites and interestingly, there was no correlation between the sites' search engine ranking and their scores. This study has illustrated the variable quality of online material on the topic of CRT. Furthermore, there was also no apparent correlation between highly ranked, popular websites and their quality. Healthcare professionals should be encouraged to guide their patients toward the online material that contains reliable information.

The Quality of Rhinoplasty Health Information on the Internet.

Patients considering rhinoplasty often use internet health information resources before consultation with a surgeon. These can be beneficial and promote patient autonomy if high quality or be detrimental if misleading impressions about results and complications are reported as fact. This study aimed to objectively assess the quality of health information regarding rhinoplasty on the internet. The 3 most popular search engines in the United Kingdom (Google, Bing, and Yahoo) were searched using 4 different terms relating to rhinoplasty. The first 30 links from each search were collated; 360 links in total were screened. Sixty-six suitable websites were examined using the LIDA and DISCERN instruments and had their Flesch Reading Ease Scores (FRES) calculated. The websites displayed low LIDA reliability scores (22%), moderate usability (61%) and high accessibility scores (87%). There was no correlation between a website's search result rank and its LIDA score (Spearman ρ = 0.033, P = 0.799). The DISCERN scores were generally low (mean 54%) and displayed no correlation with website rank (Spearman ρ = 0.070, P = 0.564). FRES values were less readable than that recommended for health information (mean FRES = 57.8; recommended ≥70) and significantly correlated with website rank (Spearman ρ = -0.3164; P = 0.009). Rhinoplasty internet health information is generally of low quality, unreliable and less readable than recommended. Improvements are needed to increase the quality of internet rhinoplasty resources for patients.

The quality of information on the Internet on orthodontic retainer wear: a cross-sectional study

The objectives of this study were to assess the accessibility, usability, reliability and quality of information on the Internet written for the lay public about orthodontic retainers, and to elucidate the different retention protocols encouraged. A cross-sectional, observational study. Online, using a computer connected to the Internet in Australia. Two search terms; 'orthodontic retainer' and 'how long should someone wear a retainer after their braces are removed?' were entered alternatively into five search engines. Twenty results for each search term per search engine that fulfilled the inclusion criteria were evaluated in terms of accessibility, usability, reliability and quality of information using the LIDA and DISCERN instruments, ensuring there were no internal or cross-search engine duplicates. Any information about frequency and duration of retainer wear was also collected. Two hundred different websites were identified and assessed. The median overall LIDA score was 72%, corresponding to a moderate quality level. The median total DISCERN score was 47%. Twenty-two websites recommended patients adhere to the specific protocol prescribed to them by their practitioner. There were 45 (22.5%) and 28 (14%) websites advising indefinite use of removable and bonded retainers respectively. Information about retainers on the Internet is easily accessible and usable, though the quality of the content is generally of a moderate level. However, the information is not always accurate and reliable. Both full-time and part-time wear of removable retainers was suggested over greatly varying time periods. Indefinite wear of removable and bonded retainers was also advocated.