Filling a void: thyroid cancer surgery information on the internet.
BACKGROUND
Thyroid cancer incidence is increasing, making it an important public health issue. Many patients use the Internet for health-related decisions. Our purposes were to measure the quality of thyroid cancer surgery information on the Internet, and to identify quality predictors.


METHODS
The 50 most popular thyroid cancer websites from Google, Yahoo, and MSN were identified. A novel 55-point instrument based on current clinical practice guidelines was designed and used by a Delphi panel of 5 "blinded" endocrine surgeons to assess website information. Each website was independently evaluated by two surgeons. Quality was related to website demographic data using the Student's t-test, chi-square, and ANOVA analyses.


RESULTS
Inter-rater reliability for quality scores was excellent (kappa = 0.81). Mean (% of overall quality) score was 21 (38%), and mean score for surgical content was low at 3.5 (29%). Only 50% of sites discussed indications for surgery; 8% length of surgery/anesthesia; 42% the role of lymphadenectomy; 44% recurrent laryngeal nerve injury/hoarseness and 42% hypoparathyroidism as potential complications; 16% recovery; and 20% recommendations for choosing a thyroid surgeon. Only 38% were updated within 2 years. On univariate analysis, no significant associations were found between surgical quality score and website country of origin, currency, sponsorship, authorship, oversight, or references.


CONCLUSIONS
Thyroid cancer surgery websites on the Internet are incomplete and outdated. No predictors of quality were identified. Significant improvement is needed in regulating information about thyroid cancer surgery on the Internet, and surgeons may contribute to this effort.
Yeo
Heather
H
Department of Surgery, Yale University, New Haven, Connecticut, USA.
Roman
Sanziana
S
Air
Mamie
M
Maser
Christina
C
Trapasso
Tara
T
Kinder
Barbara
B
Sosa
Julie Ann
JA
D003657:Decision Making; D003697:Delphi Technique; D006801:Humans; D007255:Information Services / Q000592:standards*; D020407:Internet; D015588:Observer Variation; D010353:Patient Education as Topic / Q000592:standards*; D017410:Practice Guidelines as Topic; D011786:Quality Control; D013964:Thyroid Neoplasms / Q000601:surgery*; D014481:United States