Content, Readability, and Accountability of Freely Available Online Information for Patients Regarding Epiretinal Membranes.

PURPOSE: To assess content, readability, and accountability of online information for patients regarding epiretinal membranes (ERMs). METHODS: Cross-sectional study evaluating nine major medical websites on ERMs. Fifteen questions assessed patient-relevant content. Four indices estimated U.S. grade literacy level of the text. JAMA benchmarks (authorship, attribution, disclosure, currency) evaluated website accountability. RESULTS: Average content score was 36.78 (SD 13.91, 95% CI ±0.64) from a possible maximum of 60, with significant variability between websites (H = 22.68, p=0.004). Mean reading grade level was 12.29 (SD 2.30, 95% CI ±1.50). No website achieved all JAMA benchmarks; only one website fulfilled three of the four. Content score did not correlate with Google rank (order of listed websites, r = -0.23, p=0.55) or JAMA benchmarks (r = 0.19, p=0.62) but significantly correlated with mean reading grade (r = 0.67, p=0.05). CONCLUSION: Online information regarding ERMs varies significantly, may not adequately answer common patient questions, and is written at too complex a literacy level for the average patient.

Utilization of Online Resources by Patients in an Ophthalmic Emergency Department.

Objective To describe the utilization of online resources by patients prior to presentation to an ophthalmic emergency department (ED) and to assess the accuracy of online resources for ophthalmic diagnoses. Methods This is a prospective survey of patients presenting to an ophthalmic ED for initial evaluation of ocular symptoms. Prior to evaluation, patients completed surveys assessing ocular symptoms, Internet usage, and presumed self-diagnoses. Demographics and characteristics of Internet usage were determined. Accuracy of self-diagnoses was compared between Internet users and nonusers. Diagnoses were classified as high or low acuity based on agreement between senior authors. Results A total of 144 patients completed surveys. Mean (standard deviation) age was 53.2 years (18.0). One-third of patients used the Internet for health-related searches prior to presentation. Internet users were younger compared with nonusers (48.2 years [16.5] vs. 55.5 years [18.3], p = 0.02). There were no differences in sex, ethnicity, or race. Overall, there was a threefold difference in proportion of patients correctly predicting their diagnoses, with Internet users correctly predicting their diagnoses more often than nonusers (41 vs. 13%, p < 0.001). When excluding cases of known trauma, the difference in proportion increased to fivefold (Internet users 40% vs. nonusers 8%, p < 0.001). Upon classification by acuity level, Internet users demonstrated greater accuracy than nonusers for both high- (42 vs. 17%, p = 0.03) and low (41 vs. 10%, p = 0.001)-acuity diagnoses. Greatest accuracy was in cases of external lid conditions such as chalazia and hordeola (100% [4/4] of Internet users vs. 40% (2/5) of nonusers), conjunctivitis (43% [3/7] of Internet users vs. 25% [2/8] of nonusers), and retinal traction or detachments (57% [4/7] of Internet users vs. 0% [0/4] of nonusers). The most frequently visited Web sites were Google (82%) and WebMD (40%). Patient accuracy did not change according to the number of Web sites visited, but patients who visited the Mayo Clinic Web site had greater accuracy compared with those who visited other Web sites (89 vs. 30%, p = 0.003). Conclusion Patients with ocular symptoms may seek medical information on the Internet before evaluation by a physician in an ophthalmic ED. Online resources may improve the accuracy of patient self-diagnosis for low- and high-acuity diagnoses.