title: Rare Diseases on the Internet: An Assessment of the Quality of Online Information.
abstract: The importance of the Internet as a medium for publishing and sharing health and medical information has increased considerably during the last decade. Nonetheless, comprehensive knowledge and information are scarce and difficult to find, especially for rare diseases. Additionally, the quality of health or medical information about rare diseases is frequently difficult to assess for the patients and their family members.
  
  
  
  The aim of this study is to assess the quality of information on the Internet about rare diseases. Additionally, the study aims to evaluate if the quality of information on rare diseases varies between different information supplier categories.
  
  
  
  A total of 13 quality criteria for websites providing medical information about rare diseases were transferred to a self-disclosure questionnaire. Identified providers of information on the Internet about rare diseases were invited to fill out the questionnaire. The questionnaire contained questions about the information provider in general (eg, supplier category, information category, language, use of quality certificates, and target group) and about quality aspects that reflect the 13 quality criteria. Differences in subgroup analyses were performed using t tests.
  
  
  
  We identified 693 websites containing information about rare diseases. A total of 123 questionnaires (17.7%) were completely filled out by the information suppliers. For the remaining identified suppliers (570/693, 82.3%), the questionnaires were filled out by the authors based on the information available on their website. In many cases, the quality of websites was proportionally low. Furthermore, subgroup analysis showed no statistically significant differences between the quality of information provided by support group/patient organization compared to medical institution (P=.19). The quality of information by individuals (patient/relative) was significantly lower compared to information provided by support group/patient organization (P=.001), medical institution (P=.009), and other associations and sponsoring bodies (P=.001) as well.
  
  
  
  Overall, the quality of information on the Internet about rare diseases is low. Quality certificates are rarely used and important quality criteria are often not fulfilled completely. Additionally, some information categories are underrepresented (eg, information about psychosocial counseling, social-legal advice, and family planning). Nevertheless, due to the high amount of information provided by support groups, this study shows that these are extremely valuable sources of information for patients suffering from a rare disease and their relatives.
authors.affiliation: Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
authors.forename: Frédéric
authors.identifier: 0000-0003-1138-0283
authors.initials: F
authors.lastname: Pauer
authors.affiliation: Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
authors.forename: Svenja
authors.identifier: 0000-0003-1342-7196
authors.initials: S
authors.lastname: Litzkendorf
authors.affiliation: Medical Informatics Group (MIG), University Hospital Frankfurt, Frankfurt am Main, Germany.
authors.forename: Jens
authors.identifier: 0000-0001-8625-0841
authors.initials: J
authors.lastname: Göbel
authors.affiliation: Medical Informatics Group (MIG), University Hospital Frankfurt, Frankfurt am Main, Germany.
authors.forename: Holger
authors.identifier: 0000-0001-8126-9535
authors.initials: H
authors.lastname: Storf
authors.affiliation: Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
authors.forename: Jan
authors.identifier: 0000-0002-0104-2267
authors.initials: J
authors.lastname: Zeidler
authors.affiliation: Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
authors.forename: Johann-Matthias
authors.identifier: 0000-0002-5322-9453
authors.initials: JM
authors.lastname: Graf von der Schulenburg
mesh_terms: D000328:Adult; D005260:Female; D057220:Health Literacy; D006801:Humans; D020407:Internet; D019359:Knowledge; D008297:Male; D010353:Patient Education as Topic / Q000458:organization & administration / Q000592:standards*; D035583:Rare Diseases; D011795:Surveys and Questionnaires
keywords: health information exchange; health literacy; quality indicators; rare disesases