title: Commonly cited website quality criteria are not effective at identifying inaccurate online information about breast cancer.
abstract: BACKGROUND
  Consumers increasingly consult the Internet for breast cancer information. Concerned about accuracy, multiple organizations developed quality criteria for online content. However, the effectiveness of these tools is unknown. The authors determined whether existing quality criteria can identify inaccurate breast cancer information online.
  
  
  METHODS
  The authors identified 343 unique webpages by using 15 breast cancer-related queries on 5 popular web search-engines. Each page was assessed for 15 quality criteria and 3 website characteristics, link type (sponsored or not), search engine used to find the page, and domain extension. Two clinician-reviewers independently assessed accuracy and topics covered. The authors then determined whether quality criteria, website characteristics, and topics were associated with the presence of inaccurate statements.
  
  
  RESULTS
  The authors found 41 inaccurate statements on 18 webpages (5.2%). No quality criteria or website characteristic, singly or in combination, reliably identified inaccurate information. The total number of quality criteria met by a website accounted for a small fraction of the variability in the presence of inaccuracies (point biserial r=-0.128; df=341; P=.018; r2=0.016). However, webpages containing information on complementary and alternative medicine (CAM) were significantly more likely to contain inaccuracies compared with pages without CAM information (odds ratio [OR], 15.6; P<.001).
  
  
  CONCLUSIONS
  Most breast cancer information that consumers are likely to encounter online is accurate. However, commonly cited quality criteria do not identify inaccurate information. Webpages that contain information about CAM are relatively likely to contain inaccurate statements. Consumers searching for health information online should still consult a clinician before taking action.
authors.affiliation: School of Health Information Sciences, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA.
authors.forename: Elmer V
authors.initials: EV
authors.lastname: Bernstam
authors.forename: Muhammad F
authors.initials: MF
authors.lastname: Walji
authors.forename: Smitha
authors.initials: S
authors.lastname: Sagaram
authors.forename: Deepak
authors.initials: D
authors.lastname: Sagaram
authors.forename: Craig W
authors.initials: CW
authors.lastname: Johnson
authors.forename: Funda
authors.initials: F
authors.lastname: Meric-Bernstam
mesh_terms: D001943:Breast Neoplasms / Q000517:prevention & control* / Q000628:therapy; D000529:Complementary Therapies / Q000592:standards*; D005260:Female; D006801:Humans; D033181:Information Dissemination; D007255:Information Services / Q000592:standards*; D020407:Internet / Q000592:standards*; D008490:Medical Informatics / Q000592:standards* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000592:standards*