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Quality of Internet Resources for Abdominal Aortic Aneurysm Patients
Tracy Cheun, MD, Mark Davies, MD, PhD, MBA.
UT HEALTH SAN ANTONIO, SAN ANTONIO, TX, USA.

OBJECTIVES: Patients increasingly use the internet to research their medical conditions and options for therapy, however the quality of information available has been questioned. The aim of this study is to systematically evaluate the quality of online resources available to patients regarding abdominal aortic aneurysm (AAA).
METHODS: Searches on Google, Yahoo, and Bing were performed using the query “abdominal aortic aneurysm,” which returned over 10 million hits. The first 50 results from each search engine were evaluated for inclusion. Inclusion criteria were English language websites educating patients about AAAs. Websites requiring subscription, academic journals, and websites for medical professionals were excluded. 37 websites were evaluated using the Website Assessment Tool, a validated 6-dimensional instrument developed to evaluate the quality of health-related websites. A weighted global score was converted to a 100-point scale.
RESULTS: Accountability was weak across all items, with only 30% of websites disclosing their authors and 43% citing sources. 40% had been updated within the last 2 years. Interactivity was poor, with only 1 website providing audiovisual support and none offering educational support or the ability to directly contact the author. 27% of websites were written below a high school reading level. Content quality was variable, with most websites clearly defining AAAs (91%) and remaining free of inaccuracies (81%) or opinion (95%). However, only 49% explained current screening recommendations, and 19% addressed prognosis. 73% explained the process of repairing a AAA (either open or endovascular), however, only 14% disclosed risks and complications of repair. Global scores ranged from 32 to 74, and on average was significantly superior to that of hemodialysis access websites in a previous study (53 vs 43; p<0.01). 24% carried Health on the Net certification, an online code of conduct intended to ensure accuracy and ethical quality of health-related websites. These did not score higher than non-certified sites (59 vs 51; p=0.1). 19% of websites offered Spanish translation, and only 1 website provided audio support for vision-impaired visitors.
CONCLUSIONS: This is the first systematic evaluation of the quality of online resources for AAA patients. Multidimensional quality is variable, however, AAA websites have an overall superior quality compared to a previous analysis of hemodialysis patient websites. Of note, accessibility is significantly lacking, and more should be invested to remediate this.


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