Surfing for back pain patients - The nature and quality of back pain information on the Internet

Study Design. A prospective, systematic review of web sites related to back pain. Objective. To assess the nature and quality of back pain-related informatio n on the World Wide Web during a 2-year period. Summary of Background Data. The Internet has become a rich source of medica l information. Limited knowledge is available, however, about the quality o f online resources. Although previous systematic reviews on medical-related web sites found problems in varying degrees with the credibility of inform ation, no such review was conducted to assess the back pain-related sites. Methods. A search of web sites was conducted in November 1996 using five se arch engines (AltaVista, Infoseek, Lycos, Yahoo, and Magellan) and two key terms ("back pain" and "back problems"). A sample of sites was evaluated by two independent reviewers. Each site was described by the type and nature of the sponsor, target audience, and content. Overall quality was assessed in terms of evidence-based information available. Results. Seventy-four web sites were reviewed in 1996, and nine of them (12 .2%) were identified as high-quality sites. Advertising was the focus of 80 .8% of the sites. Eleven sites (14.9%) were found to be discontinued 1 year later, and 20 (27.0%) were not accessible by the reviewers at the a-year f ollow-up evaluation. Of the remaining 54 sites, 44.4% were produced by for- profit companies, and most sites targeted people with back pain (63.0%). On ly seven out of the nine high-quality sites held their ratings at the 2-yea r follow-up evaluation. Conclusion. Most back pain-related web sites can be classified as advertisi ng. The quality varied considerably, resulting in difficulties for patients to find useful information in this field. The increasing number of people seeking medical information on the Web creates a need for more high quality sites. Further, systematic review of web sites should be encouraged to mon itor the accuracy of Internet publication.