Online Information

Patients at risk for Diabetic Retinopathy or with a new diagnosis of DR may attempt to supplement information; from their ophthalmologist and primary care physicians by conducting research on the internet. The Pew Research Center found that 72% of adults who use the internet search for health-related material. Studies have found that online information can have an important role in patient decision-making and treatment. However, no standard exists to date regarding the accuracy or quality of the content displayed.

Online information can therefore be incomplete; be inaccurate, or have an underlying commercial bias. Thus, the usefulness of these resources can vary greatly by source. Online information on diabetic retinopathy is generally low quality and varies by source; a cross-sectional study of 11 medical websites found. “Too often websites are either too basic and incorrect or more accurate but too complex in their language and word choice,” study co-author Jayanth Sridhar, MD, assistant professor of clinical ophthalmology at Bascom Palmer Eye Institute, told

The content analysis

“However, this is likely dictated by the primary sources either being a layperson writing an article; or a clinician author without experience writing for the general public.” Website accuracy analyzed from December 2018 to January 2019 using 26 questions to address information most pertinent to patients, and answers; evaluated by two vitreoretinal fellows and a vitreoretinal surgeon on a scale of 0 to 4.

But all statistical analysis performed with IBM SPSS Statistics for Windows, version 25.0 (IBM Corp). For the content analysis, the data treated as ordinal variables and analyzed with the Kruskal-Wallis test (with H being the test statistic). A post hoc Dunn-Bonferroni test performed to evaluate pairwise comparisons. However, to evaluate the correlation between accuracy and ranking, a Spearman correlation test use. Statistical significance set at P ≤ .005 for the main comparisons and Spearman correlation; and at P ≤ .05 for pairwise comparisons.

Searching for online information

Sites analyzed included the American Academy of Ophthalmology, American Society of Retina Specialists, Wikipedia, WebMD, Mayo Clinic, Medical News Today, MedicineNet, National Eye Institute, All About Vision, American Optometric Association and EyeWiki. The average accuracy score was 55.76 of a possible 104 points, and mean readability the necessary grade level to understand the data given was 11.3. A statistically significant variation in quality of website data also found across all websites (= .004).

No correlations found between content accuracy and average reading grade or between content accuracy and JAMA benchmarks, with none of the selected sites achieving all four benchmarks of attribution, disclosure, authorship or currency. “Physicians were prepared to better educate patients and colleagues who are searching for online information,” Sridhar said. “There appears to be a gap that needs to addressed to make online resources both readily understandable by the layperson and clinically accurate.”