Breast cancer information on the internet: type of websites, accuracy and readability of online resources


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Nadia Arif1,Pietro Ghezzi1
1Brighton and Sussex Medical School

Abstract

Background

Offering breast cancer patients treatment choice has become a priority as the involvement of patients in the decision-making process is associated with improved physical and psychological outcomes. The Internet is increasingly being used by patients to find health information. The aim of this project is to evaluate the quality of online resources on breast cancer treatment options.

Method

We used 'Google.co.uk' to search for 'breast cancer treatment options' and 188 websites were classed into typologies (commercial, government, health portal, news, non-profit, others, professional and scientific journals) and assessed for their JAMA score (presence of author, date, references and ownership disclosure) by two investigators (interrater reliability >0.9). Display of certification from the Health-on-Net foundation (HONcode) and ease of readability of the websites were also assessed. Content analysis was undertaken to ascertain which treatment options, and whether clinical trials, were discussed.

Results

The most common typologies returned by Google were professional (42%) followed by non-profit websites (17%). Non-profit (70%) and government (20%) websites were over-represented in the top 10 websites returned by Google. We found that health portals were of higher quality (median JAMA=4) whilst professional (median JAMA=1) and commercial (median JAMA=2) websites were of poorer quality. 62% of websites certified by HONcode were health portals. Overall, readability was higher than previously reported for other conditions, and Google ranked websites with better readability higher. Content analysis showed that most websites discussed medical and surgical treatment options (n=120). Few websites, a large proportion with commercial affiliations, discussed complementary and alternative medicine (n=21). Only 10% of the websites discussed clinical trials.

Conclusion

The quality of online information relating to breast cancer is variable, however it is reassuring that the main search engine does not rank commercial or low quality websites highly in the top 10 results.