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Quality of Information Available Via the Internet for Patients With Otological Conditions

Danino, Julian; Muzaffar, Jameel; Mitchell-Innes, Alistair; Howard, James; Coulson, Chris

doi: 10.1097/MAO.0000000000001151

Objective: Evaluate the type, content, and quality of information available via the Internet for patients with common otological conditions.

Methods: The Google search engine was used to generate responses for the following search terms: glue ear, otitis media, otosclerosis, Ménière's disease, cholesteatoma, and ear perforation. The first 10 websites for each search term were selected for analysis. Websites were evaluated with the validated DISCERN instrument (Institute of Health Sciences, University of Oxford, UK), the LIDA tool (Minervation Ltd, Oxford, UK), the Flesch Readability Formula, the Simple Measure Of Gobbledygook (SMOG) readability score, and against the Journal of the American Medical Association (JAMA) criteria. Comparisons were made with a similar study assessing quality of information in nonotological conditions.

Results: Mean SMOG score was 12.19 years of education (range, 6.2–22.8). The health on the net (HON) symbol appeared on 15 of 49 websites (30.61%). Pearson's r was used to identify interactions between variables and demonstrated a significant correlation between LIDA score and Google ranking (R2 = −0.1195, p = 0.002); between university/hospital affiliation and JAMA score (R2 = −1.7889, p = 0.0182) and commercial affiliation and JAMA score (R2 = 1.0561; p = 0.01). Multivariate linear regression analysis showed LIDA to be the strongest predictor of Google ranking (Page rank decreasing by 0.10572 per LIDA score; p = 0.01).

Conclusion: As websites with better Google ranking were only weakly associated with higher quality rankings patients would benefit from being directed to reliable websites by clinicians. There is currently a gap in the available resources for a high quality repository of otological information aimed at patients.

*Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Birmingham

Imperial College London, U.K

Address correspondence and reprint requests to Julian Danino, M.Sc., D.O.H.N.S., M.R.C.S., Queen Elizabeth Hospital, Birmingham B15 2TH, U.K.; E-mail:

The authors disclose no conflicts of interest.

Copyright © 2016 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company