Assessing the Quality and Content of Accessible Information on the Internet Regarding Hallux Rigidus

• Main Author: Lukas Holzer MD, PhD
• Format: Article
• Language: English
• Published: SAGE Publishing 2017-09-01
• Series: Foot & Ankle Orthopaedics
• Online Access: https://doi.org/10.1177/2473011417S000195

Category: Midfoot/Forefoot Introduction/Purpose: The internet has grown into one of the biggest resource of easy accessible health information for the general public. Hallux rigidus (HR) is the most common arthritic disease pattern of the foot. There is no mutual consent on the ideal operative intervention for this disease. State of knowledge is essential for a decision to proceed with a HR specific treatment, since this decision is ultimately a shared one between the patient and the physician. Therefore, many patients comb through the internet for medical information related to this specific topic. The purpose of this study was to assess the quality and integrity of the online available informative content about HR using acknowledged scoring instruments, proven quality markers and a novel designed specific HR score. Methods: In December 2016 the search term “hallux rigidus” was used to search Google (Google Inc., Mountain View, CA, USA) by three independent reviewers (two experienced orthopedic surgeons and one trained medical student). The content of the first 50 hits were analyzed by the use of specific scores including the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria and the Health On the Net code (HONcode) as a seal of quality for providing complete and transparent health-related information. Also the Flesch Reading Ease (FRE), the Flesch Kincaid Grade Level (FKGL), and the Gunning Fog Index (GFI) were recorded as indicators for readability. Websites were classified as follows: academic, commercial, government or non-profit organization (NPO), physician or group, and unspecified. A HR-specific content score was developed consisting of 19 specified items to evaluate the overall aspects about the procedure, management and potential complications. Results: Of the 50 screened websites, 37 (74%) were included for analysis. Of these 37 websites, 20 were from a physician or group, 8 were commercial, 6 were academic, 3 were governmental or NPO and 1 was unspecified. The mean DISCERN score of the websites was 46±10. The highest score was 65 points, whereas the lowest was 21. HON Code certification was present in six (16%) and HON seal in two websites (5%). The FRE, RKGL and GFI were 43,2±14, 8,1±2, and 6,7±2 respectively. The HR specific content score was 7±3. Conclusion: Quality and content of accessible information on the internet on HR was analyzed by three individuals by various objective scores. 37 websites were included in the analysis. The majority of websites provided poor information on the management of HR. Patients need to be aware of this fact. In the future measures need to be taken to improve quality and content of HR related websites.