title: Information about liver transplantation on the World Wide Web.
abstract: Orthotopic liver transplant (OLTx) has evolved to a successful surgical management for end-stage liver diseases. Awareness and information about OLTx is an important tool in assisting OLTx recipients and people supporting them, including non-transplant clinicians. The study aimed to investigate the nature and quality of liver transplant-related patient information on the World Wide Web. Four common search engines were used to explore the Internet by using the key words 'Liver transplant'. The URL (unique resource locator) of the top 50 returns was chosen as it was judged unlikely that the average user would search beyond the first 50 sites returned by a given search. Each Web site was assessed on the following categories: origin, language, accessibility and extent of the information. A weighted Information Score (IS) was created to assess the quality of clinical and educational value of each Web site and was scored independently by three transplant clinicians. The Internet search performed with the aid of the four search engines yielded a total of 2,255,244 Web sites. Of the 200 possible sites, only 58 Web sites were assessed because of repetition of the same Web sites and non-accessible links. The overall median weighted IS was 22 (IQR 1 - 42). Of the 58 Web sites analysed, 45 (77%) belonged to USA, six (10%) were European, and seven (12%) were from the rest of the world. The median weighted IS of publications originating from Europe and USA was 40 (IQR = 22 - 60) and 23 (IQR = 6 - 38), respectively. Although European Web sites produced a higher weighted IS [40 (IQR = 22 - 60)] as compared with the USA publications [23 (IQR = 6 - 38)], this was not statistically significant (p = 0.07). Web sites belonging to the academic institutions and the professional organizations scored significantly higher with a median weighted IS of 28 (IQR = 16 - 44) and 24(12 - 35), respectively, as compared with the commercial Web sites (median = 6 with IQR of 0 - 14, p = .001). There was an Intraclass Correlation Coefficient (ICC) of 0.89 and an associated 95% CI (0.83, 0.93) for the three observers on the 58 Web sites. The study highlights the need for a significant improvement in the information available on the World Wide Web about OLTx. It concludes that the educational material currently available on the World Wide Web about liver transplant is of poor quality and requires rigorous input from health care professionals. The authors suggest that clinicians should pay more attention to take the necessary steps to improve the standard of information available on their relevant Web sites and must take an active role in helping their patients find Web sites that provide the best and accurate information specifically applicable to the loco-regional circumstances.
authors.affiliation: University Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: F
authors.initials: F
authors.lastname: Hanif
authors.forename: R
authors.initials: R
authors.lastname: Sivaprakasam
authors.forename: A
authors.initials: A
authors.lastname: Butler
authors.forename: E
authors.initials: E
authors.lastname: Huguet
authors.forename: G J
authors.initials: GJ
authors.lastname: Pettigrew
authors.forename: E D A
authors.initials: ED
authors.lastname: Michael
authors.forename: R K
authors.initials: RK
authors.lastname: Praseedom
authors.forename: N V
authors.initials: NV
authors.lastname: Jamieson
authors.forename: J A
authors.initials: JA
authors.lastname: Bradley
authors.forename: P
authors.initials: P
authors.lastname: Gibbs
mesh_terms: D006801:Humans; D020407:Internet; D016031:Liver Transplantation / Q000379:methods*; D008490:Medical Informatics; D010353:Patient Education as Topic; D006113:United Kingdom