Rationale and Objective:
This study aimed to assess the quality of Internet information about common radiological investigations.
Materials and Methods
Four search engines (Google, Bing, Yahoo, and Duckduckgo) were searched using the terms “X-ray,” “cat scan,” “MRI,” “ultrasound,” and “pet scan.” The first 10 webpage results returned for each search term were recorded, and their quality and readability were analyzed by two independent reviewers (DJB and LCY), with discrepancies resolved by consensus. Analysis of information quality was conducted using validated instruments for the assessment of health-care information (DISCERN score is a multi-domain tool for assessment of health-care information quality by health-care professionals and laypeople (max 80 points)) and readability (Flesch-Kincaid and SMOG or Simple Measure of Gobbledygook scores). The search result pages were further classified into categories as follows: commercial, academic (educational/institutional), and news/magazine. Several organizations offer website accreditation for health-care information, and accreditation is recognized by the presence of a hallmark or logo on the website. The presence of any valid accreditation marks on each website was recorded. Mean scores between groups were compared for significance using the Student t test.
Results
A total of 200 webpages returned (108 unique website addresses). The average DISCERN score was <50 points for all modalities and search engines. No significant difference was seen in readability between modalities or between search engines. Websites carrying validated accreditation marks were associated with higher average DISCERN scores: X-ray (39.36 vs 25.35), computed tomography (45.45 vs 31.33), and ultrasound (40.91 vs 27.62) ( P < .01). Academic/government institutions produced material with higher DISCERN scores: X-ray (40.06 vs 22.23), magnetic resonance imaging (44.69 vs 29), ultrasound (46 vs 31.91), and positron emission tomography (45.93 vs 38.31) ( P < .01). Commercial websites produced material with lower mean DISCERN scores: X-ray (17.25 vs 31.69), magnetic resonance imaging (20.8 vs 40.1), ultrasound (24.11 vs 42.35), and positron emission tomography (24.5 vs 44.45) ( P < .01).
Conclusions
Although readability is adequate, the overall quality of radiology-related health-care information on the Internet is poor. High-quality online resources should be identified so that patients may avoid the use of poor-quality information derived from general search engine queries.
Introduction
Patients increasingly turn to the Internet for health-care information. Some analysts have concluded that as much as 4.5% of all queries to general Internet search engines are health care related in origin . The Pew Research Center in 2014 estimated that 87% of US adults use the Internet regularly and that 72% of those had searched online for health-care information within the previous year . Evidence has also demonstrated that although patients have a high degree of trust for the information that their doctor may provide, as few as 11% of patients will make their doctor their first port of call for that information, with most choosing online sources first .
There is an enormous amount of undifferentiated health-care information readily available online, but we continue to have a poor understanding of its implications for ongoing medical care and for how medical care is understood by our patients .
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Methods
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Results
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TABLE 1
Total Webpage Results for Each Modality
X-ray CT MRI Ultrasound PET Total Total no. of websites 40 40 40 40 40 200 No. of unique results 24 19 25 22 18 108
CT, computed tomography; MRI, magnetic resonance imaging; PET, positron emission tomography.
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Quality and Readability
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TABLE 2
Mean DISCERN Score and Range for Each Modality and Search Engine
Google Bing Yahoo Duckduckgo X-ray 35.4 (16–50) 34.9 (16–51) 22.6 (16–51) 28.1 (16–48) CT 43.8 (31–64) 43.5 (26–64) 44.7 (34–53) 37.1 (18–53) MRI 23.5 (16–49) 41.9 (29–51) 35.6 (16–51) 40.1 (26–51) Ultrasound 26.2 (16–48) 42.2 (30–50) 42.4 (26–50) 42.2 (35–49) PET 43.5 (26–50) 44.4 (29–52) 45.7 (38–52) 40.2 (23–50)
CT, computed tomography; MRI, magnetic resonance imaging; PET, positron emission tomography.
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Accreditation Markings
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Website Origins
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TABLE 3
Parent Websites That Produced Material with DISCERN Scores Greater Than or Equal to 50 Points
Name Number of Pages at or Above 50 Points http://www.radiologyinfo.org 4 http://patient.info 3 http://www.nhs.uk 3 www.medicalnewstoday.com 1 https://en.wikipedia.org 1 http://www.cancerresearchuk.org 1
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Discussion
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Study Limitations
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Conclusions
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