Evaluating internet health resources in ear, nose, and throat surgery

To assess the quality, accessibility, usability, reliability, and readability of Web sites that provide information on common ear, nose, and throat conditions.

Several standardized and validated appraisal instruments and questionnaires designed to rate Web sites providing online health information were used to evaluate the content of online ear, nose, and throat health information.

The terms "cholesteatoma," "sinusitis," "tonsillitis," "acute otitis media," "epistaxis," and "quinsy" (peritonsillar abscess), representing six common ear, nose, and throat conditions, were entered separately into the Internet search engine Google. Web sites satisfying the inclusion criteria from the first 30 results of each search were evaluated for content quality using the DISCERN rating instrument, for accessibility, usability, and reliability using the LIDA rating instrument, and for readability using the Flesch Reading Ease score.

Of the 180 Web sites identified, 124 (68.9%) satisfied the inclusion criteria. The mean overall DISCERN score for quality was "poor," at 39/80 (range, 16-70). The DISCERN instrument rated 2 (1.6%) Web sites as "excellent," 14 (11.3%) as "good," 40 (32.3%) as "fair," 38 (30.6%) as "poor," and 30 (24.2%) as "very poor." The mean overall LIDA score for accessibility, usability, and reliability was "moderate," at 114/165 (69.3%; range, 61-142). The mean Flesch Reading Ease score for the readability of Web sites was 42.3/100 (range, 10.7-71.9).

The use of validated instruments is necessary to reduce the risks from patients accessing misinformation. They can guide health care professionals with their role in directing patients to high-quality sources of information and endorsing Web sites that meet high standards.