Assessment of the quality of web-based information on bunions

The Internet provides a large source of health-related information for patients. However, information on the Internet is mostly unregulated, ranging from factually correct to misleading or contradictory information. The objective of this study was to determine the quality of information available on World Wide Web on the topic of bunions.

Websites were identified using 3 search engines (Google, Yahoo, and MSN) and the search term bunions. The first 30 websites in each search were analyzed. Websites were assessed using the validated DISCERN rating instrument to determine the quality of health content and treatment information. The DISCERN tool possesses moderate to very good strength of interobserver agreement, ranging from .41 to .82.

A total of 90 websites were assessed and studied. Forty-eight sites were duplicated, leaving 42 unique sites. Of these, 60% (25/42) provided patient-related information, 21% (9/42) were advertisements, 7% (3/42) promoted medical centers, 5% (2/42) were dead links, 5% (2/42) were news articles, and 2% (1/42) was doctor's information. In determining the quality of unique sites, of a maximum score of 5, the average overall DISCERN score was 2.9 (range, 1.8 to 4.6). Only 24% (10/42) of websites were classified as "good" or "excellent." Although most websites contained information on symptoms, causes, risk factors, investigations, and treatment options on bunions, 60% (25/42) did not provide adequate information on the benefits for each treatment, 45% (19/42) did not contain any risks of treatment, and 76% (32/42) did not describe how treatment choices affect overall quality of life. The sources of information were clear in 33% (14/42), and the date when this information was reviewed was given in only 50% (21/42). Only 29% (12/42) of websites had been updated within the past 2 years.

Overall, the quality of patient information on bunions varies widely. We believe clinicians should guide patients in identifying the best possible and genuine information on the World Wide Web.

Patients are commonly using the internet as an information resource, in spite of the highly variable quality of this information. They should be encouraged to exercise caution and to utilize only well-known sites.