title: Lumbar disc herniation: evaluation of information on the internet.
abstract: METHODS
  An original study was performed evaluating the information presented on existing web sites for the topic of lumbar disc herniation.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the type and quality of internet information available to patients on the topic of lumbar disc herniation. Our secondary objectives were to rank the identified World Wide Web sites with respect to the caliber of relevant information and to determine the propensity for secondary commercial gain by the web site sponsors.
  
  
  BACKGROUND
  Two-thirds of the United States population "surfs" the internet. A substantial percentage of internet users search for medical information on the World Wide Web. Because no standards exist regarding the publication of medical literature on the internet, the relevant web sites vary dramatically in terms of content and quality. Misleading or inaccurate information poses a theoretical risk to patients seeking treatment for medical conditions. METHODS.: Five search terms (lumbar disc herniation, herniated nucleus pulposus, herniated disc, slipped disc, and sciatica) were entered into 5 commonly used search engines. The first 25 links displayed by each engine were evaluated for a theoretical total of 625 web sites. Each site was evaluated in terms of content, authorship, and secondary commercial gain. An information quality score of 0 to 25 points was generated for each site; a score of 20 or greater was indicative of "high-quality" content.
  
  
  RESULTS
  Our search identified 169 unique web sites of which only 16 (9.5%) scored >or=20 on the information quality score; 103 (60.9%) scored <or=10. The overall mean information quality score was 9. Highest mean scores were noted for commercial corporate (13.1) and hospital-based sites (11.2). Overall, 34.3% of sites sought secondary commercial gain. Higher scoring sites were more likely to appear within the first 10 links identified by each search engine.
  
  
  CONCLUSIONS
  The quality of internet information on lumbar disc herniation is variable. Less than 10% of relevant web sites were determined to be of high-quality. The vast majority of sites were of poor informational value and more than one-third sought secondary commercialgain. The rank list of high quality sites generated from ourinformational quality score should prove useful to patients seeking information on the internet pertaining to lumbar disc herniation.
authors.affiliation: Department of Orthopaedic Surgery, Brown University Medical School/Rhode Island Hospital, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Greene
authors.forename: A Joshua
authors.initials: AJ
authors.lastname: Appel
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reinert
authors.forename: Mark A
authors.initials: MA
authors.lastname: Palumbo
mesh_terms: D006801:Humans; D007255:Information Services / Q000592:standards*; D020407:Internet; D007405:Intervertebral Disc Displacement; D008159:Lumbar Vertebrae