Scoliosis Information on the Internet

Introduction/Purpose: Two-thirds of the US population now “surfs” the internet, and over 80% of American internet users report confidence in finding good health information online. A recent survey of pediatric orthopaedic patients and their families found 87% of those being seen for scoliosis found the internet helpful as a source of information to better understand their diagnosis. The purpose of this study was to evaluate the type and quality of internet information patients encounter on the topic of scoliosis. In addition, to identify the general and specific types of world wide web sites that provide the highest caliber information and to determine the propensity for these sites to seek secondary commercial gain.

Methods: The term scoliosis was entered into five search engines. The first 25 results were evaluated from each search for a theoretical total of 125 web sites. The sites were evaluated for authorship, patient related information, completeness, accuracy, secondary commercial gain, and unconventional information. The information quality score (IQS) consisted of 25 variables comprising disease summary, patient evaluation, treatment options, and complications/results. A web site with all variables covered would score a complete 25. Out of the 25 IQS variables, 10 were utilized to examine accuracy. This was expressed as a percentage.

Results: 38 unique web sites were identified. The overall mean IQS (out of possible 25) was 11.0. The overall accuracy was 52%. Highest mean scores were noted for academic web sites (15.5). Accuracy was significantly higher for academic (68%), practice based (67%), and professional society web sites (62%) when compared with all other site authorships (<50 %). Out of the 38 web sites, 32 contained patient related information; therefore, other 6 were excluded from these calculations. Secondary commercial gain was present in 37% and its presence culminated a statistically significant lower IQS (7.6 with versus 13.1 without) accuracy scores (30% 65% without). In addition, seven sites displaying unconventional information accumulated mean 5.9, 29% compared 12.4 58% when not present. The following six scored> or = to 18 for IQS, representing the top 90th percentile:

1) www.orthospine.com

2) www.espine.com

3) www.vh.org/providers/textbooks.AIS/AIS.html

4) www.spine-health.com/topics/cd/scol/scol01.html

5) www.iscoliosis.com

6) www.srs.org

Discussion/Conclusions: The web sites evaluated for scoliosis overall scored in an average range for both the completeness of information and accuracy. There were sites identified that contained high quality information (see above), however, even these sites maintained a mean accuracy of only 62%. Over one-third of sites sought secondary commercial gain, and its presence signified a significant drop in the quality of information displayed. Most sites did not present unconventional information, however, those that did scored significantly lower in both the completeness and accuracy of information contained. Based on the large proportion of pediatric orthopaedic patients who desire their physicians to recommend quality web sites for scoliosis information, it would be prudent to supply patients with the above list to encourage self-education and to propagate the idea that “information is therapy.”