Teen suicide information on the internet: a systematic analysis of quality.
OBJECTIVE
To synthesize the literature on youth suicide risk factors (RFs) and prevention strategies (PSs); evaluate quality of information regarding youth suicide RFs and PSs found on selected Canadian websites; determine if website source was related to evidence-based rating (EBR); and determine the association of website quality indicators with EBR.


METHODS
Five systematic reviews of youth suicide research were analyzed to assemble the evidence base for RFs and PSs. The top 20 most commonly accessed youth suicide information websites were analyzed for quality indicators and EBR. Univariate logistic regression was conducted to determine if quality indicators predicted statements supported by evidence (SSEs). Multivariate analysis was used to calculate adjusted odds ratios for SSEs and quality indicators.


RESULTS
Only 44.2% of statements were SSEs. The 10 most highly ranked websites contained almost 80% of the total statements analyzed, and one-half had a negative EBR. Compared with government websites, nonprofit organization websites were more likely (OR 1.45, 95% CI 0.66 to 3.18), and personal and media websites were less likely (OR 0.62, 95% CI 0.26 to 1.47), to have a positive EBR. Crediting of an author (AOR 2.65, 95% CI 1.34 to 5.28), and recommendation to consult a health professional (AOR 2.08, 95% CI 1.18 to 3.68), increased the odds of SSEs.


CONCLUSIONS
Fundamental to addressing youth suicide is the availability of high-quality, evidence-based information accessible to the public, health providers, and policy-makers. Many websites, including those sponsored by the federal government and national organizations, need to improve the evidence-based quality of the information provided.
Szumilas
Magdalena
M
Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia. marklemstra@shaw.ca
Kutcher
Stan
S
D000293:Adolescent; D002170:Canada; D055317:Evidence-Based Practice; D006266:Health Education / Q000592:standards*; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D016017:Odds Ratio; D019984:Quality Indicators, Health Care; D012307:Risk Factors; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention