title: Patient Information Websites About Medically Induced Second-Trimester Abortions: A Descriptive Study of Quality, Suitability, and Issues.
abstract: Patients undergoing medically induced second-trimester abortions feel insufficiently informed and use the Web for supplemental information. However, it is still unclear how people who have experience with pregnancy termination appraise the quality of patient information websites about medically induced second-trimester abortions, whether they consider the websites suitable for patients, and what issues they experience with the websites.
  
  
  
  Our objective was to investigate the quality of, suitability of, and issues with patient information websites about medically induced second-trimester abortions and potential differences between websites affiliated with the health care system and private organizations.
  
  
  
  We set out to answer the objective by using 4 laypeople who had experience with pregnancy termination as quality assessors. The first 50 hits of 26 systematic searches were screened (N=1300 hits) using search terms reported by the assessors. Of these hits, 48% (628/1300) were irrelevant and 51% (667/1300) led to websites about medically induced second-trimester abortions. After correcting for duplicate hits, 42 patient information websites were included, 18 of which were affiliated with the health care system and 24 with private organizations. The 4 assessors systematically assessed the websites with the DISCERN instrument (total score range 16-80), the Ensuring Quality Information for Patients (EQIP) tool (total score range 0-100), as well as questions concerning website suitability and perceived issues.
  
  
  
  The interrater reliability was 0.8 for DISCERN and EQIP, indicating substantial agreement between the assessors. The total mean score was 36 for DISCERN and 40 for EQIP, indicating poor overall quality. Websites from the health care system had greater total EQIP (45 vs 37, P>.05) and reliability scores (22 vs 20, P>.05). Only 1 website was recommended by all assessors and 57% (24/42) were rated as very unsuitable by at least one assessor. The most reported issues with the websites involved lack of information (76%, 32/42), and poor design (36%, 15/42).
  
  
  
  The high number of irrelevant hits and poor quality of patient information websites are considerable issues that must be addressed and considered when consulting patients awaiting medically induced second-trimester abortions. In clinical encounters, health professionals should initiate discussions concerning websites about medically induced second-trimester abortions and inform patients about the issues and quality deficits associated with these websites.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Tommy
authors.identifier: 0000-0003-4141-8692
authors.initials: T
authors.lastname: Carlsson
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.|Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
authors.forename: Ove
authors.identifier: 0000-0003-2989-4303
authors.initials: O
authors.lastname: Axelsson
mesh_terms: D000019:Abortifacient Agents; D000028:Abortion, Induced / Q000193:education* / Q000379:methods; D054626:Consumer Health Information / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D020407:Internet; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D011247:Pregnancy; D011262:Pregnancy Trimester, Second
chemical_list: D000019:Abortifacient Agents
keywords: Internet; consumer health information; induced abortion; information literacy; popular works; second pregnancy trimester