title: Accuracy of information about the intrauterine device on the Internet.
abstract: BACKGROUND
  Intrauterine devices (IUDs) are highly effective methods of contraception, but use continues to lag behind less effective methods such as oral contraceptive pills and condoms. Women who are aware of the actual effectiveness of various contraceptive methods are more likely to choose the IUD. Conversely, women who are misinformed about the safety of IUDs may be less likely to use this method. Individuals increasingly use the Internet for health information. Information about IUDs obtained through the Internet may influence attitudes about IUD use among patients.
  
  
  OBJECTIVE
  Our objective was to evaluate the quality of information about IUDs among World Wide Web sites providing contraceptive information to the public.
  
  
  METHODS
  We developed a 56-item structured questionnaire to evaluate the quality of information about IUDs available through the Internet. We then conducted an online search to identify web sites containing information about contraception and IUDs using common search engines. The search was performed in August 2013 and web sites were reviewed again in October 2015 to ensure there were no substantial changes.
  
  
  RESULTS
  Our search identified >2000 web sites, of which 108 were eligible for review; 105 (97.2%) of these sites contained information about IUDs. Of sites, 86% provided at least 1 mechanism of the IUD. Most web sites accurately reported advantages of the IUD including that it is long acting (91%), highly effective (82%), and reversible (68%). However, only 30% of sites explicitly indicated that IUDs are safe. Fifty percent (n = 53) of sites contained inaccurate information about the IUD such as an increased risk of pelvic inflammatory disease beyond the insertion month (27%) or that women in nonmonogamous relationships (30%) and nulliparous women (20%) are not appropriate candidates. Among sites, 44% stated that a mechanism of IUDs is prevention of implantation of a fertilized egg. Only 3% of web sites incorrectly stated that IUDs are an abortifacient. More than a quarter of sites listed an inaccurate contraindication to the IUD such as nulliparity, history of pelvic inflammatory disease, or history of an ectopic pregnancy.
  
  
  CONCLUSIONS
  The quality of information about IUDs available on the Internet is variable. Accurate information was mixed with inaccurate or outdated information that could perpetuate myths about IUDs. Clinicians need knowledge about accurate, evidence-based Internet resources to provide to women given the inconsistent quality of information available through online sources.
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St Louis School of Medicine, St Louis, MO. Electronic address: maddent@wustl.edu.
authors.forename: Tessa
authors.initials: T
authors.lastname: Madden
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, MO.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cortez
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, MO.
authors.forename: Marie
authors.initials: M
authors.lastname: Kuzemchak
authors.affiliation: Department of Communication and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kaphingst
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, MO.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Politi
mesh_terms: D054626:Consumer Health Information; D005260:Female; D006801:Humans; D020407:Internet; D007434:Intrauterine Devices; D010298:Parity; D018579:Patient Selection; D000292:Pelvic Inflammatory Disease; D011247:Pregnancy; D012449:Safety
keywords: Internet; health information; intrauterine device; intrauterine system