title: Internet search term affects the quality and accuracy of online information about developmental hip dysplasia.
abstract: BACKGROUND
  The recent emphasis on shared decision-making has increased the role of the Internet as a readily accessible medical reference source for patients and families. However, the lack of professional review creates concern over the quality, accuracy, and readability of medical information available to patients on the Internet.
  
  
  METHODS
  Three Internet search engines (Google, Yahoo, and Bing) were evaluated prospectively using 3 difference search terms of varying sophistication ("congenital hip dislocation," "developmental dysplasia of the hip," and "hip dysplasia in children"). Sixty-three unique Web sites were evaluated by each of 3 surgeons (2 fellowship-trained pediatric orthopaedic attendings and 1 orthopaedic chief resident) for quality and accuracy using a set of scoring criteria based on the AAOS/POSNA patient education Web site. The readability (literacy grade level) of each Web site was assessed using the Fleisch-Kincaid score.
  
  
  RESULTS
  There were significant differences noted in quality, accuracy, and readability of information depending on the search term used. The search term "developmental dysplasia of the hip" provided higher quality and accuracy compared with the search term "congenital hip dislocation." Of the 63 total Web sites, 1 (1.6%) was below the sixth grade reading level recommended by the NIH for health education materials and 8 (12.7%) Web sites were below the average American reading level (eighth grade).
  
  
  CONCLUSIONS
  The quality and accuracy of information available on the Internet regarding developmental hip dysplasia significantly varied with the search term used. Patients seeking information about DDH on the Internet may not understand the materials found because nearly all of the Web sites are written at a level above that recommended for publically distributed health information.
  
  
  CONCLUSIONS
  Physicians should advise their patients to search for information using the term "developmental dysplasia of the hip" or, better yet, should refer patients to Web sites that they have personally reviewed for content and clarity. Orthopaedic surgeons, professional societies, and search engines should undertake efforts to ensure that patients have access to information about DDH that is both accurate and easily understandable.
authors: Department of Orthopaedic Surgery, Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021, USA. fabricantp@hss.edu
authors: Peter D
authors: PD
authors: Fabricant
authors: Christopher J
authors: CJ
authors: Dy
authors: Ronak M
authors: RM
authors: Patel
authors: John S
authors: JS
authors: Blanco
authors: Shevaun M
authors: SM
authors: Doyle
mesh_terms: D022126:Access to Information; D032882:Comprehension; D006266:Health Education / Q000379:methods / Q000592:standards*; D057220:Health Literacy; D006618:Hip Dislocation, Congenital; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D020407:Internet / Q000592:standards*; D011446:Prospective Studies; D057386:Search Engine