title: Bladder cancer facts: accuracy of information on the Internet.
abstract: OBJECTIVE
  Patients continually seek information regarding the etiology, diagnosis, management and treatment of bladder cancer. The Internet has a growing number of health web sites and it is a tremendous resource for medical information. We examined the accuracy and completeness of bladder cancer sites on the World Wide Web.
  
  
  METHODS
  Internet searching was performed by retrieving the first 30 universal resource locators from 8 popular search engines using the search term bladder cancer. A total of 38 independent web sites were evaluated. Other sites were inaccessible, duplicates or only contained linked pages. Two reviewers evaluated the accuracy and completeness of information using a predetermined 41-point checklist rating instrument that evaluated essential information related to bladder cancer. The kappa statistic was used to evaluate interrater variability.
  
  
  RESULTS
  The mean kappa statistic for evaluable variables was 0.70. Most nonevaluable variables had excellent agreement, indicating good overall interrater reliability. No rating factor was present on 100% of sites. Eight factors were present and accurate on 80% to 90% of web pages and related to signs/symptoms, risk factors, diagnostic tests and treatment of early stage disease. Six factors were inaccurate on 32% of sites, including incidence (7), staging (3), recurrence (1), and treatment of early invasive (1) and metastatic (1) disease.
  
  
  CONCLUSIONS
  Bladder cancer information retrieved from the majority of medical web sites was incomplete. However, general information relating to presentation, diagnosis, staging and treatment of low stage disease was present and accurate on most sites. Although inaccurate information was detected on 32% of the sites, it tended to be related to outdated information. It is reasonable to refer patients to select comprehensive web sites to obtain pertinent information about bladder cancer.
authors.affiliation: Department of Urology, University of Michigan, 1500 E. Medical Center Drive, Box 0330, Ann Arbor, MI 48109-0330, USA. ctlee@umich.edu
authors.forename: Cheryl T
authors.initials: CT
authors.lastname: Lee
authors.forename: Clayton A
authors.initials: CA
authors.lastname: Smith
authors.forename: Janette M
authors.initials: JM
authors.lastname: Hall
authors.forename: W Bedford
authors.initials: WB
authors.lastname: Waters
authors.forename: J Sybil
authors.initials: JS
authors.lastname: Biermann
mesh_terms: D006801:Humans; D016247:Information Storage and Retrieval; D020407:Internet; D015588:Observer Variation; D010353:Patient Education as Topic; D015203:Reproducibility of Results; D001749:Urinary Bladder Neoplasms