title: Transrectal Ultrasound Guided Biopsy of the Prostate: Is the Information Accessible, Usable, Reliable and Readable?
abstract: OBJECTIVE
  To evaluate the accessibility, usability, reliability and readability of Internet information regarding transrectal ultrasound (TRUS) guided biopsy of the prostate.
  
  
  METHODS
  The terms "prostate biopsy", "TRUS biopsy" and "transrectal ultrasound guided biopsy of the prostate" were separately entered into the each of the top 5 most accessed Internet search engines. Websites were evaluated for accessibility, usability and reliability using the LIDA tool - a validated tool for the assessment of health related websites. Website readability was assessed using the Flesch Reading Ease Score and the Flesch Kincaid Grade Level.
  
  
  RESULTS
  Following the application of exclusion criteria, 82 unique websites were analyzed. There was a significant difference in scores depending on authorship categories (p ≤ 0.001), with health related charity websites scoring highest (mean 122.29 ± 13.98) and non-academic affiliated institution websites scoring lowest (mean 87 ± 19.76). The presence of advertisements on a website was associated with a lower mean overall LIDA tool score (p = 0.024). Only a single website adhered to the National Institutes for Health recommendations on readability.
  
  
  CONCLUSIONS
  This study demonstrates variability in the quality of information available to Internet users regarding TRUS biopsies. Collaboration of website design and clinical acumen are necessary to develop appropriate websites for patient benefit.
authors.affiliation: Department of Urology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: Ciaran E
authors.initials: CE
authors.lastname: Redmond
authors.affiliation: Department of Urology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Nason
authors.affiliation: Department of Urology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kelly
authors.affiliation: Department of Radiology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: Colm
authors.initials: C
authors.lastname: McMahon
authors.affiliation: Department of Radiology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: Colin P
authors.initials: CP
authors.lastname: Cantwell
authors.affiliation: Department of Urology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: David M
authors.initials: DM
authors.lastname: Quinlan
keywords: Internet; Prostate biopsy; Quality; Readability