title: A multilingual evaluation of current health information on the Internet for the treatments of benign prostatic hyperplasia.
abstract: OBJECTIVE
  To compare the quality of current Internet information on benign prostatic hyperplasia (BPH) and its surgical and medical managements across four Western languages and a comparative analysis of website sponsors. BPH Internet information quality is particularly relevant in an era of expanding, minimally invasive and surgical therapies. However, no comprehensive analysis exists.
  
  
  METHODS
  World Health Organization Health on the Net (HON) principles may be applied to websites using an automated toolbar function. Using a search engine (www.google.com), 9,000 websites were assessed using keywords related to BPH and its medical and surgical treatment in English, French, German, and Spanish. The first 150 websites in each language had HON principles measured whilst a further analysis of site sponsorship was undertaken.
  
  
  RESULTS
  Very few BPH websites had greater than ten per cent HON accredited with significant differences (P<0.001) based on terms used for BPH, its medical and surgical management. Tertiles (thirds) of the first 150 websites returned differences in accredited websites (P<0.0001). English language had most accredited websites. Odds ratios for different terms returning accredited websites also were significantly different across terms (P<0.001). Websites were largely commercially sponsored.
  
  
  CONCLUSIONS
  A lack of validation of most BPH sites should be appreciated with discrepancies in quality and number of websites across diseases, languages and also between medical and alternate terms. Physicians should participate in and encourage the development of informative, ethical and reliable health websites on the Internet and direct patients to them.
authors.affiliation: Department of Surgery, Urology Unit, Austin Hospital, University of Melbourne, Melbourne, Australia.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Chen
authors.affiliation: Department of Surgery, Urology Unit, Austin Hospital, University of Melbourne, Melbourne, Australia.
authors.forename: Rustom P
authors.initials: RP
authors.lastname: Manecksha
authors.affiliation: Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Abouassaly
authors.affiliation: Department of Surgery, Urology Unit, Austin Hospital, University of Melbourne, Melbourne, Australia.
authors.forename: Damien M
authors.initials: DM
authors.lastname: Bolton
authors.affiliation: Munich Hospital Campus Harlaching, Ludwig-Maximilians-University, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Reich
authors.affiliation: Department of Surgery, Urology Unit, Austin Hospital, University of Melbourne, Melbourne, Australia ; Ludwig Institute for Cancer Research, Austin Hospital, Urology, Austin Hospital, Melbourne, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Lawrentschuk
keywords: Internet; Patient education; Pharmacology; Prostate; Surgery