title: Toward automated assessment of health Web page quality using the DISCERN instrument.
abstract: BACKGROUND
  As the Internet becomes the number one destination for obtaining health-related information, there is an increasing need to identify health Web pages that convey an accurate and current view of medical knowledge. In response, the research community has created multicriteria instruments for reliably assessing online medical information quality. One such instrument is DISCERN, which measures health Web page quality by assessing an array of features. In order to scale up use of the instrument, there is interest in automating the quality evaluation process by building machine learning (ML)-based DISCERN Web page classifiers.
  
  
  OBJECTIVE
  The paper addresses 2 key issues that are essential before constructing automated DISCERN classifiers: (1) generation of a robust DISCERN training corpus useful for training classification algorithms, and (2) assessment of the usefulness of the current DISCERN scoring schema as a metric for evaluating the performance of these algorithms.
  
  
  METHODS
  Using DISCERN, 272 Web pages discussing treatment options in breast cancer, arthritis, and depression were evaluated and rated by trained coders. First, different consensus models were compared to obtain a robust aggregated rating among the coders, suitable for a DISCERN ML training corpus. Second, a new DISCERN scoring criterion was proposed (features-based score) as an ML performance metric that is more reflective of the score distribution across different DISCERN quality criteria.
  
  
  RESULTS
  First, we found that a probabilistic consensus model applied to the DISCERN instrument was robust against noise (random ratings) and superior to other approaches for building a training corpus. Second, we found that the established DISCERN scoring schema (overall score) is ill-suited to measure ML performance for automated classifiers.
  
  
  CONCLUSIONS
  Use of a probabilistic consensus model is advantageous for building a training corpus for the DISCERN instrument, and use of a features-based score is an appropriate ML metric for automated DISCERN classifiers.
  
  
  BACKGROUND
  The code for the probabilistic consensus model is available at https://bitbucket.org/A_2/em_dawid/ .
authors.affiliation: Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Allam
authors.affiliation: Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano (Università della Svizzera Italiana), Lugano, Switzerland.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Schulz
authors.affiliation: Program for Computational Biology and Bioinformatics, Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Krauthammer
mesh_terms: D000465:Algorithms; D054626:Consumer Health Information / Q000592:standards*; D020407:Internet / Q000592:standards*; D011786:Quality Control
keywords: DISCERN; consensus model; health information quality; multicriteria instrument