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. 2019 Sep;34(9):1884-1891.
doi: 10.1007/s11606-019-05109-0. Epub 2019 Jun 21.

Can Patients Trust Online Health Information? A Meta-narrative Systematic Review Addressing the Quality of Health Information on the Internet

Lubna Daraz  1 , Allison S Morrow  2 , Oscar J Ponce  2 , Bradley Beuschel  2 , Magdoleen H Farah  2 , Abdulrahman Katabi  2 , Mouaz Alsawas  2 , Abdul M Majzoub  2 , Raed Benkhadra  3 , Mohamed O Seisa  2 , Jingyi Francess Ding  2 , Larry Prokop  4 , M Hassan Murad  2
Affiliations

Can Patients Trust Online Health Information? A Meta-narrative Systematic Review Addressing the Quality of Health Information on the Internet

Lubna Daraz et al. J Gen Intern Med. 2019 Sep.

Abstract

Background: The Internet has become a leading source of health information accessed by patients and the general public. It is crucial that this information is reliable and accurate.

Objectives: The purpose of this systematic review was to evaluate the overall quality of online health information targeting patients and the general public.

Methods: The systematic review is based on a pre-established protocol and is reported according to the PRISMA statement. Eleven databases and Internet searches were performed for relevant studies. Descriptive statistics were used to synthesize data. The NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the methodological quality of the included studies.

Results: Out of 3393 references, we included 153 cross-sectional studies evaluating 11,785 websites using 14 quality assessment tools. The quality level varied across scales. Using DISCERN, none of the websites received a category of excellent in quality, 37-79% were rated as good, and the rest were rated as poor quality. Only 18% of websites were HON Code certified. Quality varied by affiliation (governmental was higher than academic, which was higher than other media sources) and by health specialty (likely higher in internal medicine and anesthesiology).

Conclusion: This comprehensive systematic review demonstrated suboptimal quality of online health information. Therefore, the Internet at the present time does not provide reliable health information for laypersons. The quality of online health information requires significant improvement which should be a mandate for policymakers and private and public organizations.

Keywords: Internet; health literacy; online health information; patient education; quality; systematic review.

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Conflict of interest statement

The authors declare that they do not have a conflict of interest.

Figures

Figure 1
Figure 1
Analytic framework. *Reasons for exclusion, study not about quality assessment; website information not targeted to patients; quality tool for printed materials; study in foreign language; study on websites’ quality of other languages; evaluate quality of patient record, patient portal; commercial/editorial/book.
Figure 2
Figure 2
PRISMA flow diagram. Figure 2 contains cutoff data inside the artwork. Please confirm if we can retain the current presentation.I have attached all the figures in original format which have appropriate quality. I hope these are helpful. Thank you.
Figure 3
Figure 3
Level of quality by type of organization—DISCERN. Figures 3–6 contain poor-quality text inside the artwork. Please do not re-use the file that we have rejected or attempt to increase its resolution and re-save. It is originally poor; therefore, increasing the resolution will not solve the quality problem. We suggest that you provide us the original format. We prefer replacement figures containing vector/editable objects rather than embedded images. Preferred file formats are eps, ai, tiff, and pdf.I have attached all the figures in original format which have appropriate quality. I hope these are helpful. Thank you.
Figure 4
Figure 4
Level of quality by type of organization—HON Code of Conduct.
Figure 5
Figure 5
Level of quality by health conditions—DISCERN.
Figure 6
Figure 6
Level of quality by health conditions—HON Code of Conduct.
See this image and copyright information in PMC

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