"Headache" Online Information: An Evaluation of Readability, Quality, Credibility, and Content

Headache is experienced by more than half of the world population each year. In this study, we evaluate the content, quality, and health literacy required to understand online information for patients with headaches.

We selected 4 commonly used search engines (Google, Yahoo, Bing, and Ask.com) and searched using the term "headache." The 30 top hits on each site were selected for review. After exclusions, we examined the websites for completeness of content, readability, credibility, and quality.

A total of 28 websites were included. None of the websites met our criteria for completeness. Using 2 standard measures of readability, most websites required reading skills at the 10th-grade level or greater. Only 4 of the 28 websites were readable below the eighth-grade level. Only 3 websites fulfilled all 4 credibility criteria of authorship, currency, citations, and disclosure. Most websites did not list authorship, and only 17% reported disclosures of conflicts of interest. When assessing quality of treatment information using the DISCERN tool, scores ranged from 23 to 59, with a mean score of 41, which could be interpreted as "fair" quality.

We found variable content and quality in online headache websites for patients. Many of these websites failed to disclose information about authorship, conflicts of interest, and details on the prognosis or prevention of headaches. Readability, credibility, completeness, and quality of information were lacking in most websites.