Concussion information online: evaluation of information quality, content and readability of concussion-related websites

Background The internet plays an important role in the dissemination of health information to the general public. Information on orthopaedic sports medicine websites has been shown to be of a varying standard, and to date there has been no evaluation of the overall quality of concussion-related websites. Methods A four-stage methodological sampling technique was used to identify concussion-related websites. Websites were assessed for the presence of a quality standard (the HONcode), their adherence to current expert concussion knowledge using a custom-developed concussion checklist ('CONcheck'), and their readability using the established Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL). Results 43 Websites were identified from the search strategy with the majority (70%) not HONcode certified. A wide distribution of scores was seen for the CONcheck (0-22), FRE (16.3-77.4) and FKGL (6-17.8). Statistical analysis using independent t tests between websites with the HONcode and websites without the HONcode showed no significant differences between the two groups for CONcheck (t(41) = 0.571, p = 0.571), FRE (t(41) = 0.808, p = 0.424) and FKGL(t(41) = -0.964, p = 0.341) scores. Conclusions The variability in the standard of concussion-related websites highlights the need for sports medicine website providers to consider the delivery, content and readability of information to the public.