title: Assessing the quality of online information for patients with carotid disease.
abstract: BACKGROUND
  Controversy exists relating to carotid endarterectomy (CEA) versus carotid artery stenting (CAS). We aimed to assess the quality of online patient information relating to both.
  
  
  METHODS
  The Google search engine was searched for "carotid endarterectomy" and "carotid stenting". The first 50 webpages returned were assessed. The Gunning Fog Index (GFI) and Flesch Reading Ease Score (FRES) were calculated to assess readability. The LIDA tool (Minervation Ltd., Oxford, U.K.) was used to assess accessibility, usability and reliability.
  
  
  RESULTS
  20% (n = 10) of the webpages returned for CEA were from peer reviewed sources with 34% (n = 17) posted by hospitals or health services. Comparatively, for CAS, 40% (n = 20) were peer reviewed with 16% (n = 8) posted by hospitals or health services. GFI and FRES scores indicated webpages for both CEA and CAS had poor general readability. Webpages for CEA were easier to read than those for CAS (mean FRES difference of 6.7 (95% CI 0.51 to 12.93, p = 0.03). Median LIDA scores demonstrated acceptable reliability, accessibility and usability of information for both CEA and CAS webpages. The more readable webpages were not associated with higher LIDA scores for either CEA or CAS webpages.
  
  
  CONCLUSIONS
  Webpages providing information on carotid disease management must be made more readable. Online information currently available to patients regarding CAS is more difficult to read and comprehend than CEA.
authors.affiliation: Department of Vascular Surgery, UL Hospitals, University Hospital Limerick, Limerick, Ireland.
authors.forename: C J
authors.initials: CJ
authors.lastname: Keogh
authors.affiliation: Department of Vascular Surgery, UL Hospitals, University Hospital Limerick, Limerick, Ireland.
authors.forename: S M
authors.initials: SM
authors.lastname: McHugh
authors.affiliation: Department of Vascular Surgery, UL Hospitals, University Hospital Limerick, Limerick, Ireland. Electronic address: mary.clarkemoloney@hse.ie.
authors.forename: M
authors.initials: M
authors.lastname: Clarke Moloney
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Hannigan
authors.affiliation: Department of Vascular Surgery, UL Hospitals, University Hospital Limerick, Limerick, Ireland.
authors.forename: D A
authors.initials: DA
authors.lastname: Healy
authors.affiliation: Department of Vascular Surgery, UL Hospitals, University Hospital Limerick, Limerick, Ireland.
authors.forename: P E
authors.initials: PE
authors.lastname: Burke
authors.affiliation: Department of Vascular Surgery, UL Hospitals, University Hospital Limerick, Limerick, Ireland.
authors.forename: E G
authors.initials: EG
authors.lastname: Kavanagh
authors.affiliation: Department of Vascular Surgery, UL Hospitals, University Hospital Limerick, Limerick, Ireland.
authors.forename: P A
authors.initials: PA
authors.lastname: Grace
authors.affiliation: Department of Vascular Surgery, UL Hospitals, University Hospital Limerick, Limerick, Ireland; Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: S R
authors.initials: SR
authors.lastname: Walsh
mesh_terms: D016893:Carotid Stenosis; D032882:Comprehension; D054626:Consumer Health Information / Q000379:methods / Q000592:standards*; D016894:Endarterectomy, Carotid; D006801:Humans; D020407:Internet; D057386:Search Engine; D015607:Stents
keywords: Carotid endarterectomy; Carotid stenting; Google; Online patient information; Search engine