Evaluating the quality of Internet-derived information on plantar fasciitis

Patients seeking medical advice increasingly turn to the World Wide Web. To test the hypothesis that Internet-provided medical information often is inaccurate and biased, we selected a common musculoskeletal condition. Three common Internet search engines were used to search "plantar fasciitis" and "plantar fascitis." Combining the first 50 web addresses from each search engine for both phrases and eliminating duplicate sites resulted in a database of 152 websites. Each website then was analyzed for authorship, sponsoring agency, and presence of financial incentive. The informational value score of each site then was graded using a 10-point scale evaluating the following parameters: basic definition of plantar fasciitis, causes and risk factors, clinical symptoms, diagnostic tests, differential diagnosis, conservative and surgical treatment options, and complications. The overall mean information value score for all 152 sites was 3.8 points; 36% of the sites showed financial bias. The highest mean scores among all authorship and sponsorship categories belonged to orthopaedic surgeons and academic institutions with mean scores of 7.1 and 6.1 points, respectively. Sites without obvious financial bias had significantly higher information value scores than sites with financial interests. Healthcare professionals should consider these findings when advising patients.