title: Does the quality, accuracy, and readability of information about lateral epicondylitis on the internet vary with the search term used?
abstract: BACKGROUND
  Concern exists over the quality, accuracy, and accessibility of online information about health care conditions. The goal of this study is to evaluate the quality, accuracy, and readability of information available on the internet about lateral epicondylitis.
  
  
  METHODS
  We used three different search terms ("tennis elbow," "lateral epicondylitis," and "elbow pain") in three search engines (Google, Bing, and Yahoo) to generate a list of 75 unique websites. Three orthopedic surgeons reviewed the content of each website and assessed the quality and accuracy of information. We assessed each website's readability using the Flesch-Kincaid method. Statistical comparisons were made using ANOVA with post hoc pairwise comparisons.
  
  
  RESULTS
  The mean reading grade level was 11.1. None of the sites were under the recommended sixth grade reading level for the general public. Higher quality information was found when using the terms "tennis elbow" and "lateral epicondylitis" compared to "elbow pain" (p < 0.001). Specialty society websites had higher quality than all other websites (p < 0.001). The information was more accurate if the website was authored by a health care provider when compared to non-health care providers (p = 0.003). Websites seeking commercial gain and those found after the first five search results had lower quality information.
  
  
  CONCLUSIONS
  Reliable information about lateral epicondylitis is available online, especially from specialty societies. However, the quality and accuracy of information vary significantly with the search term, website author, and order of search results. This leaves less educated patients at a disadvantage, particularly because the information we encountered is above the reading level recommended for the general public.
authors.affiliation: Department of Orthopaedic Surgery, Division of Hand and Upper Extremity Surgery, Hospital for Special Surgery, 523 E 72nd St, New York, NY 10021 USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Dy
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Taylor
authors.forename: Ronak M
authors.initials: RM
authors.lastname: Patel
authors.forename: Moira M
authors.initials: MM
authors.lastname: McCarthy
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Roberts
authors.forename: Aaron
authors.initials: A
authors.lastname: Daluiski
keywords: Health literacy; Internet; Lateral epicondylitis; Online education; Patient education; Readability; Tennis elbow