Scoliosis-specific information on the internet: has the "information highway" led to better information provision?

A quality-control Internet-based study using recognized quality scoring systems.

To evaluate the quality of information available on the Internet.

The quality of information available is of poor quality and unreliable, and this study was to determine if it has improved in line with the exponential increase in Internet-based information since the last time it was reviewed in 2005.

To identify potential Web sites, the 5 most commonly accessed search engines were identified and a search for "scoliosis" was performed on each. The top 100 Web sites were reviewed. Each Web site was categorized according to its authorship and assessed using recognized scoring systems (Journal of American Medical Association [JAMA] and DISCERN criteria, scoliosis-specific content quality). The presence of the Health on the Net code, a reported quality-assurance marker, was noted.

Forty-one unique Web sites were identified and analyzed. Five were academic, 11 were produced by physicians, 5 were commercial, 3 were nonphysician sites, 6 were attached to discussion groups or social media sites, 3 were media related, and 8 were not otherwise classifiable. There were significant differences noted between the authorship categories on the DISCERN score, JAMA benchmark criteria, and scoliosis-specific content quality score, (P = 0.001, <0.0001, and 0.009, respectively) with academic- and physician-related Web sites containing better-quality information. Internet sites with a Health on the Net code demonstrated higher-quality scoliosis-specific information than those without the code (P = 0.1368).

The overall quality of information regarding scoliosis remains poor despite an exponential increase in the number of sites available. Patients need to be educated about appropriate Internet use-academic- and physician-provided sites have been shown to contain better-quality information. We have a potential role as clinicians to not only direct patients to appropriate sites but also to help in developing content on the Internet.