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The quality of pediatric orthopaedic information on the internet
Brenton Winship1, Margaret Grisell, Carolyn B Yang
1*Department of Orthopaedic Surgery, Shriners Hospital for Children Northern California, Sacramento §Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Davis, CA †Department of Orthopaedic Surgery, St Louis University, St Louis, MO ‡Department of Orthopaedic Surgery, Kaiser Permanente, Salem, OR.
Insights
Online health information varies in quality. Nonprofit and academic websites offer the most reliable pediatric orthopaedic content, while commercial and physician sites are less trustworthy.
Area of Science:
- Orthopaedic Surgery
- Health Informatics
- Medical Internet Research
Background:
- Patients increasingly use the internet for health information.
- The reliability and accuracy of online health information are often uncertain.
- This study assesses the quality of online information for pediatric orthopaedic conditions.
Purpose of the Study:
- To evaluate the quality and content of internet web pages for 10 common pediatric orthopaedic diagnoses.
- To compare the reliability of information from academic, commercial, nonprofit, and physician-run websites.
Main Methods:
- Identified 10 common pediatric orthopaedic diagnoses.
- Searched popular search engines to find the top 10 websites for each diagnosis.
- Evaluated websites using Health On the Net (HON) criteria and custom content-based grading sheets focusing on disease summary, pathogenesis, diagnosis, treatment, and prognosis.
Main Results:
- Academic websites scored highest in content quality (60.8%), while commercial websites scored lowest (46.7%).
- Osteochondroma websites had the highest content scores (75.8%), whereas polydactyly websites had the lowest (39.3%).
- Developmental dysplasia of the hip websites had the highest HON scores (65.0), while brachial plexus birth palsy websites scored lowest (42.6%).
Conclusions:
- Online pediatric orthopaedic information quality varies significantly.
- Nonprofit and academic websites are the most reliable sources.
- Physicians should discuss internet-sourced information with patients to manage expectations and ensure accuracy.
Background:
Many patients use the Internet for health information. However, there are few guarantees to the reliability and accuracy of this information. This study examined the quality and content of the Internet Web pages for 10 common pediatric orthopaedic diagnoses.
Methods:
We identified 10 common diagnoses in pediatric orthopaedics: brachial plexus injury, cerebral palsy, clubfoot, developmental dysplasia of the hip, leg length discrepancy, osteochondroma, polydactyly, scoliosis, spina bifida, and syndactyly. We used 2 of the most popular search engines to identify the top 10 Web sites for each disease. We evaluated the Web sites utilizing both the quality-based Health On the Net (HON) Foundation criteria and our own content-based grading sheets. The custom grading sheets focused on essential information about disease summary, pathogenesis, diagnosis, treatment, and prognosis.
Results:
Three orthopaedic surgeons graded 98 academic, commercial, nonprofit, and physicians' Web sites for 10 diseases. Academic Web sites scored the highest in content (mean, 60.8% ± 15.5%), whereas commercial Web sites scored the lowest (mean, 46.7% ± 22.2%). Among the diagnoses, osteochondroma Web sites had the highest content scores (mean, 75.8% ± 11.8%), whereas polydactyly Web sites had the lowest content scores (mean, 39.3% ± 15.7%). In contrast, Web sites about developmental dysplasia of the hip had the highest HON scores (65.0 ± 11.1), whereas those about brachial plexus birth palsy scored the lowest (42.6% ± 16.9%). Among the content subgroups, scores were generally higher for disease summary and diagnostics and lower for prognosis.
Conclusions:
The Internet Web sites reviewed demonstrated a wide range of content and information. We found that nonprofit and academic Web sites were the most reliable sources, whereas commercial and, surprisingly, physician-run Web sites were the least reliable. We advise physicians to talk to their patients about the information they get on the Internet and how it dictates their expectations. We hope this study, combined with further understanding of how our patients use this information, can help improve the Internet content.
Clinical Relevance:
Physicians should know that their patients may be receiving misleading information from the Internet and be able to discuss this with their patients.
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