The quality of information on anxiety-related websites: A systematic search about the most online item searched after Covid-19 pandemics.

Background: The acquisition of health information via the internet has emerged as a prevalent approach within the general population and is likely to exert an influence on health decision-making processes. This study aims to evaluate the comprehensive quality of online information about anxiety treatment and management comparing websites in English, which is widely used for international scientific communication, and Italian, a popular local language. It was used a multidimensional methodology that assesses scientific quality of information; readability of the website; the technological quality of the website and the website's popularity ranking.
Methods: We conducted a systematic search on four widely used online search engines. Duplicated, unrelated websites, and scientific papers were excluded. The assessment included the use of several criteria and tools: the DISCERN scale, the JAMA benchmark criteria, adherence to the Health on the Net Code; the Nibbler tool; PageRank; and the Flesch Reading Ease test/the Gulpease readability index.
Results: 78 websites in Italian and 60 in English were evaluated. Quality of information of the English websites was higher than that of the Italian ones, but only a small percentage of them reported high level information about all treatment types and shared decision-making process. Technological quality was higher in English websites. In general, all websites were difficult to read, requiring reading skills at the high school level or higher.
Conclusions: These results can promote future guidelines to improve online health information. Users should be able to find information about all treatment types (pharmacological and psychosocial) in line with the current guidelines for the treatment and the management of anxiety disorders. This would help internet users to achieve a higher level of quality information.
Competing Interests: Declaration of competing interest All the authors Paola Melis, Alessandra Perra, Antonio Egidio Nardi, Thurayya Zreik, Antonio Preti, Mauro Giovanni Carta declare: - There are no any relevant conflict of interest at any time and during the 36 months prior to publication; - There are no any patents, wether palenned, pending or issued, broadly, relevant to the work; - There are no other relationships/conditions/circumstances that present a potential conflict of interest; - In general the authors have nothing to disclose.
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