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Original Investigation
November 03, 2016

Critical Analysis of the Quality, Readability, and Technical Aspects of Online Information Provided for Neck-Lifts

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
  • 2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
  • 3Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan
  • 4Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark
  • 5Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark
  • 6Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Newark
  • 7Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark
JAMA Facial Plast Surg. Published online November 3, 2016. doi:10.1001/jamafacial.2016.1219
Key Points

Question  Are there differences in the quality, readability, and technical aspects of private practice neck-lift websites compared with academic or reference sources?

Findings  Forty-five websites were included in this cross-sectional analysis (8 websites originated from academic or reference sources and 37 were considered private practices). The quality of academic or reference sources was significantly better than that of the private practice websites, but there was no significant difference between the 2 groups in readability or technical aspects.

Meaning  The quality of information on academic or reference websites was significantly better than that of private practice websites.

Abstract

Importance  The number of patients using the internet to obtain health information is growing. This material is unregulated and heterogeneous and can influence patient decisions.

Objective  To compare the quality, readability, and technical aspects of online information about neck-lifts provided by private practice websites vs academic medical centers and reference sources.

Design, Setting, and Participants  In this cross-sectional analysis conducted between November 2015 and January 2016, a Google search of the term neck-lift was performed, and the first 45 websites were evaluated. The websites were categorized as private practice vs other. Private websites (PWs) included sites created by private practice physicians. Other websites (OWs) were created by academic medical centers or reference sources.

Main Outcomes and Measures  Quality, readability, and technical aspects of online websites related to neck-lifts. Quality was assessed using the DISCERN criteria and the Health on the Net principles (HONcode). Readability was assessed using 7 validated and widely used criteria. Consensus US reading grade level readability was provided by a website (readabilityformulas.com). Twelve technical aspects were evaluated based on criteria specified by medical website creators.

Results  Forty-five websites (8 OWs [18%] and 37 PWs [82%]) were analyzed. There was a significant difference in quality between OWs and PWs based on the DISCERN criteria and HONcode principles. The DISCERN overall mean (SD) scores were 2.3 (0.5) for OWs and 1.3 (0.3) for PWs (P < .001). Of a total possible score of 14 using the HONcode analysis, the mean (SD) was 8.6 (1.8) (range, 5-11) for OW, and the mean (SD) was 5.8 (1.7) (range, 2-9) for PW. The mean (SD) readability consensus reading grade level scores were 11.7 (1.9) for OWs and 10.6 (1.9) for PWs. Of a total possible score of 12, the mean (SD) technical scores were 6.3 (1.8) (range, 4-9) for OWs and 6.4 (1.5) (range, 3-9) for PWs.

Conclusions and Relevance  Compared with PWs, OWs had a significantly higher quality score based on both the DISCERN criteria and HONcode principles. The mean readability for OWs and PWs was grade 11 and grade 10, respectively, significantly higher than the grade 7 level recommended by the National Institutes of Health. Assessment of technical criteria demonstrated room for improvement in providing links to social media and blogs and reducing advertisements. Improving the quality and readability of online information may result in increased patient understanding, more active patient involvement, and ultimately better outcomes. Enhancing the technical aspects of websites may increase website traffic and patient volume.

Level of Evidence  NA.

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