title: Perthes Disease: The Quality and Reliability of Information on the Internet.
abstract: BACKGROUND
  Research has shown that up to 89% of parents used the Internet to seek health information regarding their child's medical condition. Much of the information on the Internet is valuable; however, the quality of health information is variable and unregulated. The aim of this study was to evaluate the quality and content of information about Perthes disease on the Internet using recognized scoring systems, identification of quality markers, and describe a novel specific score.
  
  
  METHODS
  We searched the top 3 search engines (Google, Yahoo!, and Bing) for the following keywords: "Perthes disease." Forty-five unique Web sites were identified. The Web sites were then categorized by type and assessed using the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria, and a novel Perthes-specific Content score. The presence of the Health On the Net (HON) code, a reported quality assurance marker, was noted.
  
  
  RESULTS
  Of the Web sites analyzed, the Majority were Governmental and Nonprofit Organizations (NPO) (37.8%), followed by commercial Web sites (22.2%). Only 6 of the Web sites were HONcode certified. The mean DISCERN score was 53.1 (SD=9.0). The Governmental and NPO Web sites had the highest overall DISCERN scores followed closely by Physician Web sites. The mean JAMA benchmark criteria score was 2.1 (SD=1.2). Nine Web sites had maximal scores and the Academic Web sites had the highest overall JAMA benchmark scores. DISCERN scores, JAMA benchmark scores, and Perthes-specific Content scores were all greater for Web sites that bore the HONcode seal.
  
  
  CONCLUSIONS
  The quality of information available online regarding Perthes disease is of variable quality. Governmental and NPO Web sites predominate and also provide higher quality content. The HONcode seal is a reliable indicator of Web site quality.
  
  
  CONCLUSIONS
  Physicians should recommend the HONcode seal to their patients as a reliable indicator of Web site quality or, better yet, refer patients to sites they have personally reviewed. Supplying parents with a guide to health information on the Internet will help exclude Web sites as sources of misinformation.
authors.affiliation: *Department of Trauma & Orthopedic Surgery, St. Vincent's University Hospital, Dublin, Republic of Ireland †Department of Statistics & Actuarial Science, University of Waterloo, ON, Canada.
authors.forename: Mujtaba
authors.initials: M
authors.lastname: Nassiri
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bruce-Brand
authors.forename: Francis
authors.initials: F
authors.lastname: O'Neill
authors.forename: Shojaeddin
authors.initials: S
authors.lastname: Chenouri
authors.forename: Paul
authors.initials: P
authors.lastname: Curtin
mesh_terms: D006801:Humans; D033181:Information Dissemination / Q000379:methods; D057226:Information Seeking Behavior; D016247:Information Storage and Retrieval / Q000379:methods / Q000592:standards*; D020407:Internet / Q000592:standards*; D007873:Legg-Calve-Perthes Disease; D010290:Parents / Q000523:psychology*; D011786:Quality Control; D015203:Reproducibility of Results; D014481:United States