QUALITY, TRUSTWORTHINESS, READABILITY, AND ACCURACY OF MEDICAL INFORMATION REGARDING COMMON PEDIATRIC EMERGENCY MEDICINE-RELATED COMPLAINTS ON THE WEB

Background: The Internet is a universal source of information for parents of children with acute complaints. Objectives: We sought to analyze information directed at parents regarding common acute pediatric complaints. Methods: Authors searched three search engines for four complaints (child + fever, vomiting, cough, stomach pain), assessing the first 20 results for each query. Readability was evaluated using: Flesch-Kincaid Grade Level, Gunning Fog, Simple Measure of Gobbledygook, and the Coleman-Liau Index. Two reviewers independently evaluated Journal of the American Medical Association (JAMA) Benchmark Criteria and National Library of Medicine (NLM) Trustworthy scores. Two physicians (emergency medicine/EM, pediatric EM) analyzed text accuracy (number correct divided by total number of facts). Disagreements were settled by a third physician. Accuracy was defined as >= 95% correct, readability as an 8th-grade reading level, high quality as at least three JAMA criteria, and trustworthiness as an NLM score >= 3. Accurate and inaccurate websites were compared using chi-squared analysis and Mann-Whitney U test. Results: Eighty-seven websites (60%) were accurate (k = 0.94). Sixty (42%) of 144 evaluable websites were readable, 38 (26%) had high-quality JAMA criteria (kappa/k = 0.68), and 44 (31%) had reliable NLM trustworthy scores (k = 0.66). Accurate websites were more frequently published by professional medical organizations (hospitals, academic societies, governments) compared with inaccurate websites (63% vs. 33%, p < 0.01). There was no association between accuracy and physician authorship, search rank, quality, trustworthiness, or readability. Conclusion: Many studied websites had inadequate accuracy, quality, trustworthiness, and readability. Measures should be taken to improve web-based information related to acute pediatric complaints. (C) 2019 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).