title: Evaluating the Quality, Accuracy, and Readability of Online Resources Pertaining to Hallux Valgus.
abstract: BACKGROUND
  The Internet is one of the most widely utilized resources for health-related information. Evaluation of the medical literature suggests that the quality and accuracy of these resources are poor and written at inappropriately high reading levels. The purpose of our study was to evaluate the quality, accuracy, and readability of online resources pertaining to hallux valgus.
  
  
  METHODS
  Two search terms ("hallux valgus" and "bunion") were entered into Google, Yahoo, and Bing. With the use of scoring criteria specific to hallux valgus, the quality and accuracy of online information related to hallux valgus was evaluated by 3 reviewers. The Flesch-Kincaid score was used to determine readability. Statistical analysis was performed with t tests and significance was determined by P values <.05.
  
  
  RESULTS
  Sixty-two unique websites were evaluated. Quality was significantly higher with use of the search term "bunion" as compared to "hallux valgus" (P = .045). Quality and accuracy were significantly higher in resources authored by physicians as compared to nonphysicians (quality, P = .04; accuracy, P < .001) and websites without commercial bias (quality, P = .038; accuracy, P = .011). However, the reading level was significantly more advanced for websites authored by physicians (P = .035). Websites written above an eighth-grade reading level were significantly more accurate than those written at or below an eighth-grade reading level (P = .032).
  
  
  CONCLUSIONS
  The overall quality of online information related to hallux valgus is poor and written at inappropriate reading levels. Furthermore, the search term used, authorship, and presence of commercial bias influence the value of these materials. It is important for orthopaedic surgeons to become familiar with patient education materials, so that appropriate recommendations can be made regarding valuable resources.
  
  
  METHODS
  Level IV.
authors.affiliation: Division of Orthopaedic Surgery, Albany Medical Center, Albany, New York jptartag@gmail.com.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Tartaglione
authors.affiliation: Division of Orthopaedic Surgery, Albany Medical Center, Albany, New York.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Rosenbaum
authors.affiliation: Division of Orthopaedic Surgery, Albany Medical Center, Albany, New York.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Abousayed
authors.affiliation: Division of Orthopaedic Surgery, Albany Medical Center, Albany, New York.
authors.forename: Shazaan F
authors.initials: SF
authors.lastname: Hushmendy
authors.affiliation: Division of Orthopaedic Surgery, Albany Medical Center, Albany, New York.
authors.forename: John A
authors.initials: JA
authors.lastname: DiPreta
mesh_terms: D022126:Access to Information; D006215:Hallux Valgus; D057220:Health Literacy; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D020407:Internet; D010353:Patient Education as Topic; D057386:Search Engine
keywords: Internet; bunion; great toe; hallux valgus; online search