Search

Background Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty. Methods An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES). Results Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P

Social media as well as YouTube are widely used to gain information on medical conditions. We aimed to assess and evaluate the quality and reliability of YouTube videos on ocular allergies and determine whether they are a trustworthy source of information. The first 60 videos from the search terms 'allergic conjunctivitis', 'atopic conjunctivitis', 'allergic conjunctivitis symptoms', and 'allergic conjunctivitis eye drops' were analyzed using modified DISCERN, Global Quality Score, Journal of the American Medical Association scores, and Health on the Net Code criteria. The total number of views, view ratio, likes, comments, and duration were recorded, and videos were evaluated as useful, non-useful, and misleading. The average mDISCERN score for the videos was 3.25 ± 0.76 (moderate), the average JAMA score was 2.76 ± 0.64 (intermediate), the average GQS score was 3.13 ± 0.8 (intermediate), and the average HONcode score was 7.8 ± 2.6 (intermediate). The most common video source was health professionals (61.9%). Videos on allergic conjunctivitis while having reliable publishers are of moderate quality. Quality regulation of content uploaded on allergic conjunctivitis is needed. Health professionals should try to improve video content and provide more information on the treatment of allergic conjunctivitis. [ABSTRACT FROM AUTHOR]

Background: Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty. Methods: An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES). Results: Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages. Conclusions: Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Websites have become a primary way for patients to access health-related information, which allows patients to not only understand their condition better but also to engage in better decision making with their health care provider. However, this can be a double-edged sword, as information patients access may not be of high quality, easily readable, or could be biased based on website authorship. This study examines the readability and content quality of common websites about shoulder pain, with a specific focus on biomedical vs. psychosocial information. The Flesch reading-ease score (FRES) and Flesch-Kincaid grade level (FKGL) instruments were used to assess website readability. Health on the net code of conduct (HONcode) certification and the DISCERN tool were used to evaluate the reliability and quality of information. Lastly, shoulder-specific content quality and focus was gauged using a Shoulder-specific Website Appraisal Tool (SWAT) created for this study. A systematic search protocol was used to identify popular shoulder injury websites. The websites were identified using 5 search terms (shoulder pain , shoulder muscle pain , shoulder impingement , shoulder rotator cuff pain , and shoulder pain diagnosis) across 5 English-speaking regions (United States, Canada, United Kingdom, Australia, and New Zealand) using the Google search engine. The top 10 websites for each term and region combination were included and combined, yielding 41 original websites for appraisal; several (6) websites were omitted as duplicates, behind paywalls, or nontext (video) for a total of 35 websites appraised. On average, the FRES shoulder pain websites readability was 55.37, which is categorized as "fairly difficult" to read, and a seventh- or eighth-grade reading level based on the FKGL. For trustworthiness and bias, 57% (20 of 35) of the websites were HONcode certified. The quality of health care information using the DISCERN score averaged 50.92%. Examining shoulder-specific content quality, the average SWAT score was 10.54 out of 14 possible points, with only 1 website reporting information on psychosocial aspects of shoulder pain. This study suggests that shoulder pain websites present information that is at too high of a reading level for public consumption, has a strong bias toward biomedical causes of shoulder pain, and would benefit from implementation of website screening tools to improve evidence-based content. [ABSTRACT FROM AUTHOR]

Abstract Background The Internet is commonly used by patients to acquire health information. To date, no studies have evaluated the quality of information available on YouTube regarding lymphangioleiomyomatosis (LAM). Our aim was to determine the quality and content of YouTube videos regarding LAM and to compare the information provided with current knowledge and guidelines about the disease. Methods The first 200 video hits on YouTube in English for the search term “lymphangioleiomyomatosis” were recorded. All videos suitable for patient education on LAM were included. Video quality was analyzed independently by two investigators utilizing the Health on the Net (HONcode) score, which assesses whether websites provide understandable, accessible, and trustworthy health information; the DISCERN score, which evaluates the quality of information about treatment decisions; and a newly developed LAM-related content score (LRCS) with 31 guideline elements. Results The search identified 64 eligible videos. The “engagement rate” of 0.3 was low, with a median number of views of 408 (range 42–73,943), a median of 4 likes (range 0–2082), and the majority (53%) receiving a low HONcode score (≤ 2) and only 10% of videos achieving a high score (> 5). The median DISCERN score was 28 (range 15–61, maximum possible score 80), indicating poor video quality and reliability. The median LRCS was 8 (range 0–29, maximum possible score 31) and videos frequently failed to provide sources of information. Conclusions Online resources could contribute to the limited and often inaccurate information available to patients with LAM, with only a few YouTube videos providing high-quality patient-relevant information.

Background: The Internet is commonly used by patients to acquire health information. To date, no studies have evaluated the quality of information available on YouTube regarding lymphangioleiomyomatosis (LAM). Our aim was to determine the quality and content of YouTube videos regarding LAM and to compare the information provided with current knowledge and guidelines about the disease.Methods: The first 200 video hits on YouTube in English for the search term "lymphangioleiomyomatosis" were recorded. All videos suitable for patient education on LAM were included. Video quality was analyzed independently by two investigators utilizing the Health on the Net (HONcode) score, which assesses whether websites provide understandable, accessible, and trustworthy health information; the DISCERN score, which evaluates the quality of information about treatment decisions; and a newly developed LAM-related content score (LRCS) with 31 guideline elements.Results: The search identified 64 eligible videos. The "engagement rate" of 0.3 was low, with a median number of views of 408 (range 42-73,943), a median of 4 likes (range 0-2082), and the majority (53%) receiving a low HONcode score (≤ 2) and only 10% of videos achieving a high score (> 5). The median DISCERN score was 28 (range 15-61, maximum possible score 80), indicating poor video quality and reliability. The median LRCS was 8 (range 0-29, maximum possible score 31) and videos frequently failed to provide sources of information.Conclusions: Online resources could contribute to the limited and often inaccurate information available to patients with LAM, with only a few YouTube videos providing high-quality patient-relevant information. [ABSTRACT FROM AUTHOR]

Background: Suicide represents a public health concern, imposing a dramatic burden. Prosuicide websites are "virtual pathways" facilitating a rise in suicidal behaviors, especially among socially isolated, susceptible individuals. Objective: The aim of this study is to characterize suicide-related webpages in the Italian language. Methods: The first 5 most commonly used search engines in Italy (ie, Bing, Virgilio, Yahoo, Google, and Libero) were mined using the term "suicidio" (Italian for suicide). For each search, the first 100 webpages were considered. Websites resulting from each search were collected and duplicates deleted so that unique webpages could be analyzed and rated with the HONcode instrument Results: A total of 65 webpages were included: 12.5% (8/64) were antisuicide and 6.3% (4/64) explicitly prosuicide. The majority of the included websites had a mixed or neutral attitude toward suicide (52/64, 81.2%) and had informative content and purpose (39/64, 60.9%). Most webpages targeted adolescents as an age group (38/64, 59.4%), contained a reference to other psychiatric disorders or comorbidities (42/64, 65.6%), included medical/professional supervision or guidance (45/64, 70.3%), lacked figures or pictures related to suicide (41/64, 64.1%), and did not contain any access restraint (62/64, 96.9%). The major shortcoming to this study is the small sample size of webpages analyzed and the search limited to the keyword "suicide." Conclusions: Specialized mental health professionals should try to improve their presence online by providing high-quality material. [ABSTRACT FROM AUTHOR]

Online health misinformation is a growing problem, and health information professionals and consumers would benefit from an evaluation of health websites for reliability and trustworthiness. Terms from the Google COVID-19 Search Trends dataset were searched on Google to determine the most frequently appearing consumer health information websites. The quality of the resulting top five websites was evaluated. The top five websites that appeared most frequently were WebMD, Mayo Clinic, Healthline, MedlinePlus, and Medical News Today, respectively. All websites, except Medline Plus, received HONcode certification. Based on DISCERN and CRAAP scores, MedlinePlus was found to be the most reliable health website. [ABSTRACT FROM AUTHOR]

Purpose The aim of the present study is to assess the quality and reliability of web-based information about restorative treatment in pediatric patients on the internet using different scales. Materials and Methods Websites obtained by using keywords about restorative treatment in pediatric patients on Google and Yandex were included in the study. The study was conducted in English on a total of 440 websites. Websites were evaluated using the quality criteria for consumer health information (DISCERN toolkit), Journal of American Medical Association (JAMA) benchmarks, and Health on the Net Code of Conduct Certification (HONCode). Results The mean DISCERN points of the websites were moderate. Among the evaluated websites, the quality of the knowledge in 20% of the websites was low. The rate of websites with a score below 40 was 37.5%. None of them has reached an excellent score. No websites met all JAMA criteria. There was no HONCode Certificate on any website. Conclusion This study showed that the quality of the web-based information about restorative treatment in pediatric patients was generally inadequate and scientifically imperfect. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has generated an increase in information about this disease, so it is essential to guarantee the credibility and reliability of the web pages that provide this information. Objective: To evaluate the reliability of health information in Spanish on COVID-19 in Google, considering the criteria of the HONcode tool. Material and methods: Observational cross-sectional study. Google web pages were analyzed on December 2020 from Lima-Peru, using 4 terms. The reliability of the health information on the web pages was evaluated using HONcode tool (version 3.1.3). They were classified according to the source of information and its origin. Statistical analysis was performed for a significance level of p <0.05. Results: 200 web pages in Spanish were evaluated, 16.5% had a HONcode certificate, the majority was from the WHO (33.3%), the main source of information was "academic-professional" (30.0%). In addition, 33.0% of the web pages were Peruvian from the governmental type (42.4%), but none had a HONcode certificate. Conclusions: Only one in six web pages provided reliable health information on COVID-19. In addition, the presence of the WHO web pages in providing health information on COVID-19 on Google is distinguished. Although this study highlights the web pages of international organizations, it is necessary to strengthen communication from the Peruvian government web pages. [ABSTRACT FROM AUTHOR]

Internet has become a widely used resource for obtaining medical information. However, the quality of information on online platforms is still debated. Our goal is to evaluate YouTube video platform regarding its‟ usefulness and reliability in terms of teaching the steps of Double kissing crush (DK-crush) technique. "DK-crush", "DK-crush stenting technique", "DK-crush technique" were the key words queried on the search bar of http://www.YouTube.com. All the videos were screened and those videos in English and Turkish and those videos without voice yet involves the explanation of DK-Crush technique were included. Each video was scored according to the reference article in which the steps of the technique were explained in detail. According to the steps in the reference article, the videos were scored. One point was given for each step shown and 0 for those steps that are not demonstrated, therefore the "total DK-crush step score" (TDCS) was calculated for each video. Our aim was to evaluate the compatibility of the videos with the reference article. In addition, it was aimed to evaluate videos with HONcode, JAMA benchmark and modified DISCERN tools which are instruments to evaluate the reliability, credibility and quality of the medical information served on the internet. A total of 26 videos met inclusion criteria and were included in the analysis. The median number of views of the videos was 1037 (IQR 194 to 4930) with a median duration of 8.55(IQR 3.19 to 15.2). The median number of the criteria consistent with the reference criteria was 12 (IQR 9,25 to 12), most videos met all the essential criteria and have certain amount of correlation with the scoring systems. Although most videos were compatible with the reference technique, we found mild correlation between modified Discern score and total DK-Crush step score. Furthermore when comparing the number of views, likes, duration of video, HONcode score and the total DK-crush step score(TDCS) were likely to be higher in the videos downloaded or presented by individuals with academic degrees.(p:0.004,p:0.02, p:0.02, p:0.02, p:0.03 respectively). All of the videos on DK crush was prepared by healthcare professionals yet not all the uploaders or presenters in the videos have academic titles. Those videos in which DK-Crush technique was performed and presented by those with academic degrees are likely to be more instructive according to our results. Compared to the reference publication, most videos were compatible in terms of fitting the procedural steps of DK-crush. Among all videos HONcode and JAMA score has no correlation with DK-Crush step scores, yet modified Discern has mild correlation with total DK-crush step score. [ABSTRACT FROM AUTHOR]

While the health website is an easily accessible source for patients to use when seeking health information, the quality of online health information has been a critical issue that concerns all stakeholders in healthcare. The aim of this research was to examine the relationship between users' evaluation of the health website quality and their gaze behavior on the web pages. Eye tracking and a self-report questionnaire based on the HONcode principles were used to address the objective. We found that (1) the evaluations of authority, privacy, financial disclosure, and advertising policy are positively correlated with the fixation count and total fixation duration toward corresponding page components, while the evaluations of complementarity and attribution are negatively correlated with the fixation count and total fixation duration to corresponding page components; and (2) the fixation count and total fixation duration toward health information sources are negatively related to the evaluation of health website quality, while the fixation count and total fixation duration to site owner are positively related to the quality evaluation. Users' attention to page components is closely related to the evaluation of principles, and also has a certain impact on the overall quality evaluation of a health website. Based on the findings, our research may serve to improve the health website design and be a foundation to develop an automatic evaluation approach of the health website quality. [ABSTRACT FROM AUTHOR]

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Background: An increasing number of users are turning to web-based sources as an important source of health care guidance information. Thus, trustworthy sources of information should be automatically identifiable using objective criteria., Objective: The purpose of this study was to automate the assessment of the Health on the Net Foundation Code of Conduct (HONcode) criteria, enhancing our ability to pinpoint trustworthy health information sources., Methods: A data set of 538 web pages displaying health content was collected from 43 health-related websites. HONcode criteria have been considered as web page and website levels. For the website-level criteria (confidentiality, transparency, financial disclosure, and advertising policy), a bag of keywords has been identified to assess the criteria using a rule-based model. For the web page-level criteria (authority, complementarity, justifiability, and attribution) several machine learning (ML) approaches were used. In total, 200 web pages were manually annotated until achieving a balanced representation in terms of frequency. In total, 3 ML models-random forest, support vector machines (SVM), and Bidirectional Encoder Representations from Transformers (BERT)-were trained on the initial annotated data. A second step of training was implemented for the complementarity criterion using the BERT model for multiclass classification of the complementarity sentences obtained by annotation and data augmentation (positive, negative, and noncommittal sentences). Finally, the remaining web pages were classified using the selected model and 100 sentences were randomly selected for manual review., Results: For web page-level criteria, the random forest model showed a good performance for the attribution criterion while displaying subpar performance in the others. BERT and SVM had a stable performance across all the criteria. BERT had a better area under the curve (AUC) of 0.96, 0.98, and 1.00 for neutral sentences, justifiability, and attribution, respectively. SVM had the overall better performance for the classification of complementarity with the AUC equal to 0.98. Finally, SVM and BERT had an equal AUC of 0.98 for the authority criterion. For the website level criteria, the rule-based model was able to retrieve web pages with an accuracy of 0.97 for confidentiality, 0.82 for transparency, and 0.51 for both financial disclosure and advertising policy. The final evaluation of the sentences determined 0.88 of precision and the agreement level of reviewers was computed at 0.82., Conclusions: Our results showed the potential power of automating the HONcode criteria assessment using ML approaches. This approach could be used with different types of pretrained models to accelerate the text annotation, and classification and to improve the performance in low-resource cases. Further work needs to be conducted to determine how to assign different weights to the criteria, as well as to identify additional characteristics that should be considered for consolidating these criteria into a comprehensive reliability score., (©Azadeh Bayani, Alexandre Ayotte, Jean Noel Nikiema. Originally published in JMIR Formative Research (https://formative.jmir.org), 22.12.2023.)

Purpose: (i) to assess the quality of health websites on kidney transplant and (ii) to evaluate the accessibility of these websites and their concordance with the existing guidelines. Materials and Methods: The terms "kidney transplantation" and "renal transplantation" were searched in the three most popular search engines Google, Yahoo, and Bing. 58 unique websites were eligible for the analysis . The Websites accessibility was evaluated using the AChecker tool. Kruskal-Wallis test was performed to examine any significant difference between accessibility issues across different domains. The eligible websites were screened for quality based on the HONcode of conducts. Moreover, the daily traffic data of each website was determined by Alexa. The correlation of known accessibility problems with website popularity was examined too. Result: The main reported known problems belonged to "scripts must have functional text," "text equivalents," "accessible forms," and "text links for server-side image map". Although the mean accessibility errors in governmental (10.25 ± 7.274) and organizational (12.31 ± 9.469) websites were less than those in the other domains, the differences were not significant (P = 0.60). Findings showed no significant correlation (P > 0.05) between the extent of known problems (16.50 ± 12.18) and Alexa ranking (253675.07 ± 534690.947). Furthermore, most websites on kidney transplant were not certified by the HONcode. Conclusion: The health websites designers should be aware of accessibility problems, because there is a growing population of potential users with disabilities. This study indicated the need to ensure the compliance of kidney transplant websites with accessibility guidelines such as Section 508. Furthermore, most surveyed websites were of poor quality and unreliable. Therefore, physicians should warn their patients about unqualified online health information and guide them to websites which are more reliable. [ABSTRACT FROM AUTHOR]

When a new disease develops, people are looking for information about that disease where the internet is considered as one of the sources of health information. Beside empowering individuals to identify and select valid information, reliable and up-to-date websites should also be introduced for them. Therefore, the present study aimed to evaluate and identify the high quality websites on Ebola virus and disease. To do this study, the term "Ebola" was searched for in Google, Yahoo, and Bing search engines using the Google Chrome browser. Three pages were obtained from the search in these three selected search engines and were examined, with the exclusion of duplicate websites, non-English websites, the results related to news, images, ads, and inaccessible websites; finally, 43 websites out of the 90 retrieved websites were selected for evaluation. The research tools included the HONcode toolbar and an eight-item checklist was developed by the researchers based on the HONcode of conducts. The result showed that out of 43 websites evaluated, only 6 websites (14%) were trustable and the 86% were not approved after evaluation based on the HONcode criteria. Only 37% of evaluated websites have been considered complementarity criterion. Justifiability was the most considered criterion and 95% of evaluated websites had paid to distribute information fairly enough. Online information about Ebola is available on many websites and this information affects people's health decisions and behaviors. Physicians and other health professionals can help patients and other community members to find their needed information on infectious diseases (e.g. on Ebola) from the most reputable and valid international websites. [ABSTRACT FROM AUTHOR]

Objective: The patients involvement in disease management can decrease economic burden on diabetic patients and society. Quality health information may help patients to involve in their health management. Thus, individuals need to find the additional information from other information resources such as health websites. Nevertheless, health websites vary in quality and reliability. Therefore, it is of great importance to identify trustable health websites on diabetes. Thus, the aim of the present study was to evaluate the reliability of health websites concerning diabetes. Materials and methods: The keyword ''diabetes mellitus '' was entered as a search term into the three most used search engines Google, Yahoo and Bing. The results for first three pages reported by each search engine were selected. After excluding 19 websites, 71 unique websites were eligible for examination. The reliability of websites was evaluated manually using the HONcode of conduct tool by both researchers. Furthermore, HONcode toolbar function was used to recognize officially verified websites. Results: Only 19 out of 71 websites were officially verified by HONcode foundation. None of the other retrieved websites achieved all 8 principles. Most of the retrieved websites were commercial (67.6%) and the minimum number of the them belongs to university websites (1.4%). The highest and lowest compliance with the HON principles belonged to justifiability (99%), and attribution (51%). Conclusion: Diabetic patients need high quality information from trustworthy websites to decide better about their health. Thus, physicians should have knowledge about the variable quality of health websites and guide their patients to reliable online resources.ern [ABSTRACT FROM AUTHOR]

When searching on the Web, laypersons and professionals have difficulty in determining the quality or trustworthiness of health websites. No simple approach can differentiate among trustworthy and unreliable health websites in the results provided by major search engines such as Google, Yahoo or Bing. The European project Kconnect proposes to classify the reliability and readability levels of health-related Web sites and pages, tools according to the detection of HONcode criteria, the Health On the Net Foundation (HON) Code of Conduct using automated tools that examine how technical the health information contained in each document is. This article focuses on enhancement of automated detection of HONcode criteria in real-time settings. Applications of the approach include integration into the HONcode certification process, and embedding it as generic filtering tool into user-centered health domain search engines as well as into major general search engines such as a Web browser extension. [ABSTRACT FROM AUTHOR]

The objective of this study was to describe and assess the quality of the direct-to-consumer medical teleconsultation landscape in three Canadian provinces. An environmental scan of primary care teleconsultation platforms was conducted in January 2022 to identify medical teleconsultation platforms in Quebec (Qc), Ontario, and British Columbia (BC). The quality of each teleconsultation platform was assessed using a modified version of the HONcode principles. Nineteen different direct-to-consumer medical teleconsultation platforms were identified across the three provinces. The quality of these teleconsultation platforms was very heterogeneous. The landscape of virtual primary care is changing rapidly in the Canadian ecosystem, and the transparency of current teleconsultation platforms could be improved. [ABSTRACT FROM AUTHOR]

Résumé Le but de ce travail était de recenser les sites internet des chirurgiens membres de la Société française de chirurgie de la main (SFCM), en étudier le contenant et le contenu, et proposer une charte déontologique commune. Le recensement des sites internet des chirurgiens de la main membres de la SFCM a été obtenu grâce à un sondage par questionnaire en ligne, comportant 17 items concernant le mode d’exercice du chirurgien et le site internet lui-même. Quarante-six membres de la SFCM sur 568 ont répondu au questionnaire : 9 membres juniors, 6 membres associés et 31 membres titulaires. Au total, 12,5 % possédaient la certification HONcode. Ils comportaient des documents pédagogiques destinés aux patients dans 80,95 % des pathologies non urgentes, et dans 68,42 % des situations d’urgence. Les réponses aux questions portant sur la fréquentation et le coût d’entretien des sites internet étaient inexploitables. Il serait intéressant de créer une charte déontologique spécifique à la chirurgie de la main, gratuite, certifiée par la SFCM, en partenariat avec la Haute Autorité de santé (HAS). The aim of this work was to identify the websites of the members of the French Society for Hand Surgery, examine the container and the content, and propose a common code of ethics. The census of Websites of the French Society for Hand Surgery Internet members was obtained through a survey questionnaire with 17 items online on the mode of exercise of the surgeon and the website itself. Forty-six out of 568 members of the SFCM responded to the questionnaire: 9 junior members, 6 associate members and 31 full members. A total of 12.5 % had the HONcode certification. They included educational materials for patients in 80.95 % of non-urgent conditions, and 68.42 % of emergency. Answers to questions about attendance and the cost of maintenance of websites were unusable. It would be interesting to create a specific code of ethics for hand surgery, free, certified by the SFCM, in partnership with the High Authority in Health (HAS, in French). [ABSTRACT FROM AUTHOR]

Study Design. An Internet-based evaluation of Web sites using a validated assessment tool. Objective. To evaluate the quality of information on scoliosis Web sites recommended by UK NHS consultants. Summary of Background Data. One of the most common sources of inquiry on the Web is for the purposes of health-related information. The number of Web sites in the field of scoliosis has increased, yet the quality of information is reported to continue to be of poor quality. The 2 previous studies in this area identified Web sites for evaluation through the use of a single search term, "scoliosis," on the 5 most popular search engines. Methods. Seven Web sites were identified for inclusion in this study from the results of a survey of UK NHS consultants. These were independently evaluated by 3 reviewers using a validated information assessment tool, the DISCERN instrument. DISCERN scores were analyzed for correlation between reviewers. Web sites were also analyzed for the presence or absence of the quality assurance certification, Health On the Net code. Results. Significant correlations between the DISCERN scores were found for reviewers 1 and 2 (τ = 0.878, P = 0.006) and reviewers 2 and 3 (τ = 0.732, P = 0.029). The highest mean cumulative score for all items achieved by any of the Web sites evaluated was 49 (maximum = 80, minimum = 15). Only one Web site was found to display the Health On the Net code. Conclusion. Healthcare professionals should be aware of the content of Web sites that they recommend to patients. Web sites should be designed so the content suits patient needs. Web sites should be maintained such that content is up to date, evidence based, impartial, and written in plain language. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Many patients and their parents utilize the Internet for health-related information, but quality is largely uncontrolled and unregulated. The Health on the Net Foundation Code (HONcode) and DISCERN Plus were used to evaluate the pediatric urological search terms ‘circumcision,’ ‘vesicoureteral reflux’ and ‘posterior urethral valves’. Materials and methods: A google.com search was performed to identify the top 20 websites for each term. The HONcode toolbar was utilized to determine whether each website was HONcode accredited and report the overall frequency of accreditation for each term. The DISCERN Plus instrument was used to score each website in accordance with the DISCERN Handbook. High and low scoring criteria were then compared. Results: A total of 60 websites were identified. For the search terms ‘circumcision’, ‘posterior urethral valves’ and ‘vesicoureteral reflux’, 25–30% of the websites were HONcode certified. Out of the maximum score of 80, the average DISCERN Plus score was 60 (SD = 12, range 38–78), 40 (SD = 12, range 22–69) and 45 (SD = 19, range 16–78), respectively. The lowest scoring DISCERN criteria included: ‘Does it describe how the treatment choices affect overall quality of life?’, ‘Does it describe the risks of each treatment?’ and ‘Does it provide details of additional sources of support and information?’ (1.35, 1.83 and 1.95 out of 5, respectively). Conclusions: These findings demonstrate the poor quality of information that patients and their parents may use in decision-making and treatment choices. The two lowest scoring DISCERN Plus criteria involved education on quality of life issues and risks of treatment. Physicians should know how to best use these tools to help guide patients and their parents to websites with valid information. [Copyright &y& Elsevier]

Objective To further evaluate the quality of information available on the Internet with regard to the management of localized renal cancer, we evaluated websites providing information on 'partial nephrectomy' in conjunction with the Health On the Internet ( HON) Foundation. Many patients now utilize the Internet as a resource to provide further information on disease, treatments and outcomes, and health information on the Internet is largely unregulated. Inaccurate information may contribute to unrealistic expectations and dissatisfied patients., Patients and Methods A google.com search identified the top 30 websites for the search term 'partial nephrectomy'., The HON Foundation evaluated each website according to the eight principles for Health on the Internet code of conduct ( HONcode) certification and reported the overall frequency of certification, as well as individual website compliance with each of the principles., Results Overall, seven (23.3%) of 30 websites met the requirements of HONcode certification and an additional two (6.7%) websites were under review to maintain their certification based on updating their resources., The remaining 21 (70%) websites did not meet the standards for certification., The lowest performing criteria included proper citation of medical information and a clear distinction of advertising from editorial content., Conclusions The low rate of HONcode compliance for these websites illustrates the poor quality of information that patients may encounter when researching options for nephron-sparing surgery, which may have a significant impact on patient decision-making and treatment choices., Physicians should be aware of the quality of Internet resources and how to best use these tools to help guide patients to websites with valid information. [ABSTRACT FROM AUTHOR]

Previous surveys showed a poor quality of the web sites providing health information about low back pain. However, the rapid and continuous evolution of the Internet content may question the current validity of those investigations. The present study is aimed to quantitatively assess the quality of the Internet information about low back pain retrieved with the most commonly employed search engines. An Internet search with the keywords "low back pain" has been performed with Google, Yahoo!® and Bing™ in the English language. The top 30 hits obtained with each search engine were evaluated by five independent raters and averaged following criteria derived from previous works. All search results were categorized as declaring compliant to a quality standard for health information (e.g. HONCode) or not and based on the web site type (Institutional, Free informative, Commercial, News, Social Network, Unknown). The quality of the hits retrieved by the three search engines was extremely similar. The web sites had a clear purpose, were easy to navigate, and mostly lacked in validity and quality of the provided links. The conformity to a quality standard was correlated with a marked greater quality of the web sites in all respects. Institutional web sites had the best validity and ease of use. Free informative web sites had good quality but a markedly lower validity compared to Institutional websites. Commercial web sites provided more biased information. News web sites were well designed and easy to use, but lacked in validity. The average quality of the hits retrieved by the most commonly employed search engines could be defined as satisfactory and favorably comparable with previous investigations. Awareness of the user about checking the quality of the information remains of concern. [ABSTRACT FROM AUTHOR]

Question answering systems try to give precise answers to a user's question posed in natural language. It is of utmost importance that the answers returned are relevant to the user's question. For clinical QA, the trustworthiness of answers is another important issue. Limiting the document collection to certified websites helps to improve the trustworthiness of answers. On the other hand, limited document collections are known to harm the relevancy of answers. We show, however, in a comparative evaluation, that promoting trustworthiness has no negative effect on the relevance of the retrieved answers in our clinical QA system. On the contrary, the answers found are in general more relevant. [ABSTRACT FROM AUTHOR]

Antidepressant medications have been the fastest growing category of use of pharmaceutical products over the past decade. Selected Internet web sites providing information on antidepressant medications were identified and assessed using code of conduct criteria for posting health information on the Internet as developed by the Health on the Internet Foundation. Thirteen representative web sites were evaluated. Degree of compliance with each of the eight criterion varied by site, though all 13 sites met the criterion for legality of content and conduct on their web site. WebMD and FamilyDoctor.org met most of the criteria, while pharmaceutical company sites tended to meet the fewest criteria. [ABSTRACT FROM AUTHOR]

This study aims to show that health websites not asking for HONcode certification (Control sample websites A) do not respect elementary ethical standards such as the HONcode. The HONcode quality and ethical standards and the certification process have been developed by the Health on the Net Foundation to improve the transparency of the health and medical information found on the Internet. We compared the compliance with the 8 HONcode principles, and respectively the respect of principles 1 (authority), 4 (assignment), 5 (justification) and 8 (honesty in advertising and editorial policy) by certified websites (A) and by health websites which have not requested the certification (B). The assessment of the HONcode compliance was performed by HON evaluators by the same standards for all type of sites. Results shows that 0.6% of health websites not asking for HONcode certification does respect the eight HONcode ethical standards vs. 89% of certified websites. Regarding the principles 1, 4, 5 and 8, 1.2% of B respect these principles vs. 92% for A. The certification process led health websites to respect the ethical and quality standards such as the HONcode, and disclosing the production process of the health website. [ABSTRACT FROM AUTHOR]

The majority of the adult population in both Europe and North America have access to the internet. Over 70% state that they have used the internet to look for health information and the majority started their search at a search engine. Given that search engines list sites according to popularity and not quality, it is imperative that users have a means of discerning trustworthy and honest information from non-reliable health information. The HONcode, a set of eight quality guidelines, ensures access to standardized trustworthy health information which can be used as a tool to guide consumers. [ABSTRACT FROM AUTHOR]

The objective of this study was to describe and assess the quality of the direct-to-consumer medical teleconsultation landscape in three Canadian provinces. An environmental scan of primary care teleconsultation platforms was conducted in January 2022 to identify medical teleconsultation platforms in Quebec (Qc), Ontario, and British Columbia (BC). The quality of each teleconsultation platform was assessed using a modified version of the HONcode principles. Nineteen different direct-to-consumer medical teleconsultation platforms were identified across the three provinces. The quality of these teleconsultation platforms was very heterogeneous. The landscape of virtual primary care is changing rapidly in the Canadian ecosystem, and the transparency of current teleconsultation platforms could be improved.

Background: Suicide represents a public health concern, imposing a dramatic burden. Prosuicide websites are "virtual pathways" facilitating a rise in suicidal behaviors, especially among socially isolated, susceptible individuals., Objective: The aim of this study is to characterize suicide-related webpages in the Italian language., Methods: The first 5 most commonly used search engines in Italy (ie, Bing, Virgilio, Yahoo, Google, and Libero) were mined using the term "suicidio" (Italian for suicide). For each search, the first 100 webpages were considered. Websites resulting from each search were collected and duplicates deleted so that unique webpages could be analyzed and rated with the HONcode instrument., Results: A total of 65 webpages were included: 12.5% (8/64) were antisuicide and 6.3% (4/64) explicitly prosuicide. The majority of the included websites had a mixed or neutral attitude toward suicide (52/64, 81.2%) and had informative content and purpose (39/64, 60.9%). Most webpages targeted adolescents as an age group (38/64, 59.4%), contained a reference to other psychiatric disorders or comorbidities (42/64, 65.6%), included medical/professional supervision or guidance (45/64, 70.3%), lacked figures or pictures related to suicide (41/64, 64.1%), and did not contain any access restraint (62/64, 96.9%). The major shortcoming to this study is the small sample size of webpages analyzed and the search limited to the keyword "suicide.", Conclusions: Specialized mental health professionals should try to improve their presence online by providing high-quality material., (©Wen Chen, Andrea Boggero, Giovanni Del Puente, Martina Olcese, Davide Prestia, Haitham Jahrami, Nasr Chalghaf, Noomen Guelmami, Fairouz Azaiez, Nicola Luigi Bragazzi. Originally published in JMIR Formative Research (https://formative.jmir.org), 11.11.2021.)

(1) Background: Different sources of information are used by the population regarding skin cancer prevention. The pertinent quality of information that can be retrieved via an internet search engine needs assessment; (2) Methods: Four topical searches in common language were entered into Google™. The first 200 "hits" were stored for further use. Eligible websites were evaluated using content-based criteria based on the current German medical guideline "Skin cancer prevention" and employing generic (DISCERN, HONcode) quality criteria. (3) Results: Overlap between the four search results was between 0 and 7 of 200. The completeness of relevant content was scored with a median of 10 points (first quartile (Q1):6; Q3:14) and thus, it was much lower than the theoretical maximum of 43 points. Global quality, with a maximum of 10 points, was 3 in median (Q1:2; Q3:4). Quality and completeness, respectively, were somewhat higher in the higher ranks of search results. The generic quality was moderate. (4) Conclusions: A direct comparison with other sources of information (print, audio-visual, presentation, or personal counselling) is not possible, but important deficits concerning the quality and scope of relevant information on the internet are demonstrated. [ABSTRACT FROM AUTHOR]

Background: As representatives of health information communication platforms accessed through mobile phones and mobile terminals, health-related WeChat public accounts (HWPAs) have a large consumer base in the Chinese-speaking world. However, there is still a lack of general understanding of the status quo of HWPAs and the quality of the articles they release., Objective: The aims of this study were to assess the conformity of HWPAs to the Health on the Net Foundation Code of Conduct (HONcode) and to evaluate the suitability of articles disseminated by HWPAs., Methods: The survey was conducted from April 23 to May 5, 2019. Based on the monthly (March 1-31, 2019) WeChat Index provided by Qingbo Big Data, the top 100 HWPAs were examined to evaluate their HONcode compliance. The first four articles published by each HWPA on the survey dates were selected as samples to evaluate their suitability. All materials were assessed by three raters. The materials were assessed using the HONcode checklist and the Suitability Assessment of Materials (SAM) score sheet. Data analysis was performed with SPSS version 17.0 (SPSS Inc, Chicago, IL, USA) and Excel version 2013 (Microsoft Inc, Washington DC, USA)., Results: A total of 93 HWPAs and 210 of their released articles were included in this study. For six of the eight principles, the 93 HWPAs nearly consistently did not meet the requirements of the HONcode. The HWPAs certified by Tencent Corporation (66/93, 71%) were generally slightly superior to those without such certification (27/93, 29%) in terms of compliance with HONcode principles. The mean SAM score for the 210 articles was 67.72 (SD 10.930), which indicated "adequate" suitability. There was no significant difference between the SAM scores of the articles published by certified and uncertified HWPAs (P=.07), except in the literacy requirements dimension (t df=97 =-2.418, P=.02)., Conclusions: The HWPAs had low HONcode conformity. Although the suitability of health information released by HWPAs was at a moderate level, there were still problems identified, such as difficulty in tracing information sources, excessive implicit advertisements, and irregular usage of charts. In addition, the low approval requirements of HWPAs were not conducive to improvement of their service quality., (©Fuzhi Wang, Zhuoxin Wang, Weiwei Sun, Xiumu Yang, Zhiwei Bian, Lining Shen, Wei Pan, Peng Liu, Xingzhi Chen, Lianguo Fu, Fan Zhang, Dan Luo. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 08.05.2020.)

Background: The internet has become an important source of health information for users worldwide. The novel coronavirus caused a pandemic search for information with broad dissemination of false or misleading health information., Objective: The aim of this study was to evaluate the quality and readability of online information about the coronavirus disease (COVID-19), which was a trending topic on the internet, using validated instruments and relating the quality of information to its readability., Methods: The search was based on the term "Wuhan Coronavirus" on the Google website (February 6, 2020). At the search time, the terms "COVID-19" or "SARS-CoV-2" (severe acute respiratory syndrome coronavirus 2) did not exist. Critical analysis was performed on the first 110 hits using the Health on the Net Foundation Code of Conduct (HONcode), the Journal of the American Medical Association (JAMA) benchmark, the DISCERN instrument, and Google ranking., Results: The first 110 websites were critically analyzed, and only 1.8% (n=2) of the websites had the HONcode seal. The JAMA benchmark showed that 39.1% (n=43) of the websites did not have any of the categories required by this tool, and only 10.0% (11/110) of the websites had the four quality criteria required by JAMA. The DISCERN score showed that 70.0% (n=77) of the websites were evaluated as having a low score and none were rated as having a high score., Conclusions: Nonhealth personnel and the scientific community need to be aware about the quality of the information they read and produce, respectively. The Wuhan coronavirus health crisis misinformation was produced by the media, and the misinformation was obtained by users from the internet. The use of the internet has a risk to public health, and, in cases like this, the governments should be developing strategies to regulate health information on the internet without censuring the population. By February 6, 2020, no quality information was available on the internet about COVID-19., (©Jose Yunam Cuan-Baltazar, Maria José Muñoz-Perez, Carolina Robledo-Vega, Maria Fernanda Pérez-Zepeda, Elena Soto-Vega. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 09.04.2020.)

The Internet, and particularly YouTube, has been found to be and continues to develop as a resourceful educational space for health-related information. Understanding physical literacy as a lifelong health-related outcome and facilitator of an active lifestyle, we sought to assess the content, exposure, engagement, and information quality of uploaded physical literacy videos on YouTube. Two researchers collected 300 YouTube videos on physical literacy and independently coded each video's: title, media source of upload, content topics related to physical literacy, content delivery style, and adherence to adapted Health on the Net Foundation Code of Conduct (HONcode) principles of information quality. Physical literacy videos that focused on physical activity and behaviors were the strongest predictor of high quality ratings, followed closely by videos covering affective domains (motivation, confidence, and self-esteem) of physical literacy. The content delivery method was also important, with videos utilizing presentations and testimonials containing high quality information about physical activity. Thus, providers of physical literacy and health-related online video content should be aware of and adhere to the expected quality standards. As health information expectations and ethical standards increase, the Internet, and specifically YouTube, has the potential to enhance video resources, virtual networking opportunities, as well as the sharing, dissemination, accumulation, and enrichment of physical literacy information for all.