Vascular surgery and the Internet: A poor source of patient-oriented information

Objective: Increasing numbers of patients use the Internet to obtain medica l information. The Internet is easily accessible, but available information is under no guidelines or regulations. We sought to evaluate the type, qua lity, and focus of vascular disease information presented on the Internet a nd the role in patient education with simple search techniques. Methods: The arbitrarily chosen search phrases "abdominal aortic aneurysm ( AAA)," "carotid surgery (CEA)," "claudication surgery," and "leg gangrene s urgery" were entered into five common Internet search engines. No attempt w as made to refine searches. As indicated by the search engines, the 50 most commonly encountered web sites for both AAA and CEA were reviewed. The fir st 25 claudication sites and the first: 25 gangrene sites were combined for a total of 50 leg ischemia (LIS) sites. An information score (IS) was deve loped as a weighted score ranging from 0 (poor) to 100 (outstanding) and wa s designed to assess how well the web page educated the patient about the d isease, the treatment options, and the medical and surgical complications. Each vascular surgery web site was classified according to the author, the referenced information source, and the therapeutic recommendations. This wa s followed by an evaluation of each web site with the IS independently scor ed by two observers. Results: Of the 150 web sites, 146 were accessible. Ninety-six sites (65.8% ) had no useful patient-oriented information (IS < 10). The mean IS and the ranges were: AAA, 14.9 (0 to 72.0); CEA, 17.5 (0 to 77.0); and LIS, 12.2 ( 0 to 44.5; P = .9). The mean IS of the 59 sites with scores of more than 10 were: AAA, 39.8 (n = 17); CEA, 44.8 (n = 19); and LIS, 24.8 (n = 23; P <.0 1, as compared with LIS scores). Differences in IS between observers were n ot significant (P = .9). Misleading or unconventional care recommendations were recognized in one AAA site (1 of 47, 2.1%), two CEA sites (2 of 49, 4. 1%), and 13 LIS sites (13 of 50, 26.0%). The Joint Vascular Societies web p age was identified only as a tertiary link. Conclusion: Patient-oriented vascular surgery information, for common vascu lar diseases, is difficult to fmd on the Internet. The overall quality is p oor, and information is difficult to obtain in part because of the large nu mber of irrelevant sites. Of the sites that were relevant to patient educat ion (33%), one third presented information that was classified by the autho rs as misleading or unconventional. This was most apparent in the leg ische mia sites. The Internet is a poor overall source of patient;oriented vascul ar surgery information and education. Focused and refined searches and impr ovements in search engines and educational web sites may yield improved inf ormation. Public and medical community awareness needs to be improved regar ding the severe limitations of the Internet as an information resource.