title: Quality assessment of websites providing educational content for patients with rheumatoid arthritis.
abstract: We performed an environmental scan of currently available websites providing educational information about rheumatoid arthritis (RA) and evaluated the quality of these websites.
  
  
  
  We searched three separate search engines, Google, Bing, and Ask.com, on August 27, 2015, using two search terms, "arthritis" and "rheumatoid." Only patient education websites were included. Two independent investigators evaluated the accuracy, completeness, technical elements, design and esthetics, readability, usability, and accessibility of the websites. The navigation experience was also evaluated by an adult training expert.
  
  
  
  We identified 46 websites. Nearly all websites (98%) provided accurate information. However, no website covered all essential RA topics. Common essential topics not covered included epidemiology, pathogenesis, treatment and disease monitoring, complications, self-management, risks and benefits of treatment, prognosis, treatment adherence, questions for patients to ask their doctors, and costs. For the technical elements, all websites disclosed their ownership, but the date that the content was last updated was mentioned in only 10 websites, ranging from 2007 to 2015. The mean reading level was grade 12.1 (standard deviation ±2.3). Most websites (78%) were easy to navigate but only 33% were friendly for people with visual and/or hearing impairments. The navigation experience was rated fair or poor in 41% of the websites.
  
  
  
  Current patient information on the Internet does not comprehensively address all educational needs of patients with RA, and is often outdated. The findings from our study highlight potential areas for improvement in online education materials for patients with RA.
authors.affiliation: Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Harish Rajashekarappa
authors.initials: HR
authors.lastname: Siddhanamatha
authors.affiliation: Massachusetts College of Pharmacy and Health Sciences (MCPHS) University, Worcester, MA.
authors.forename: Eric
authors.initials: E
authors.lastname: Heung
authors.affiliation: Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Maria de Los Angeles
authors.initials: MLA
authors.lastname: Lopez-Olivo
authors.affiliation: Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX; Rheumatology & Rehabilitation Department, Assiut University Hospitals, Assiut, Egypt.
authors.forename: Noha
authors.initials: N
authors.lastname: Abdel-Wahab
authors.affiliation: The University of Houston, Houston, TX.
authors.forename: Ana
authors.initials: A
authors.lastname: Ojeda-Prias
authors.affiliation: Lonestar College, Montgomery, TX.
authors.forename: Irmgard
authors.initials: I
authors.lastname: Willcockson
authors.affiliation: Healthy Motivation, Santa Barbara, CA.
authors.forename: Amye
authors.initials: A
authors.lastname: Leong
authors.affiliation: Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: msalmazor@mdanderson.org.
authors.forename: Maria Eugenia
authors.initials: ME
authors.lastname: Suarez-Almazor
mesh_terms: D001172:Arthritis, Rheumatoid; D032882:Comprehension; D006801:Humans; D020407:Internet / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards*
keywords: Education; Patient; Quality reporting; Rheumatoid arthritis; Websites