title: The quality and readability of internet information regarding clavicle fractures.
abstract: BACKGROUND
  The internet has become a major source of health information for patients. However, there has been little scrutiny of health information available on the internet to the public. Our objectives were to evaluate the quality and readability of information available on the internet regarding clavicle fractures and whether they changed with academic affiliation of the website or with complexity of the search term.
  
  
  METHODS
  Through a prospective evaluation of 3 search engines using 3 different search terms of varying complexity ("broken collarbone," "collarbone fracture," and "clavicle fracture"), we evaluated 91 website hits for quality and readability. Websites were specifically analyzed by search term and by website type. Information quality was evaluated on a four-point scale, and information readability was assessed using the Flesch-Kincaid score for reading grade level.
  
  
  RESULTS
  The average quality score for our website hits was low, and the average reading grade level was far above the recommended level. Academic websites offered significantly higher quality information, whereas commercial websites offered significantly lower quality information. The use of more complex search terms yielded information of higher reading grade level but not higher quality.
  
  
  CONCLUSIONS
  Current internet information regarding clavicle fractures is of low quality and low readability. Higher quality information utilizing more accessible language on clavicle fractures is needed on the internet. It is important to be aware of the information accessible to patients prior to their presentation to our clinics. Patients should be advised to visit websites with academic affiliations and to avoid commercial websites.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States. Electronic address: dzhang9@partners.org.
authors.forename: Dafang
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States. Electronic address: cschumacher@partners.org.
authors.forename: Charles
authors.initials: C
authors.lastname: Schumacher
authors.affiliation: Department of Orthopaedic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States; Harvard Medical School, Boston, MA 02115, United States. Electronic address: mbharris@partners.org.
authors.forename: Mitchel Byron
authors.initials: MB
authors.lastname: Harris
mesh_terms: D002968:Clavicle / Q000293:injuries*; D032882:Comprehension / Q000502:physiology*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000523:psychology*; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D020407:Internet / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care