DISCERN: an instrument for judging the quality of written consumer health information on treatment choices

Abstract Background Given the high prevalence of dietary and herbal supplement (DHS) use in tandem with the growing ease of internet access, patients commonly search online for consumer health information about these products. One common reason for DHSs use includes weight loss. Healthcare providers need to be aware of the quality of online information about DHSs for weight loss so they can adequately counsel their patients and provide them with guidance surrounding the identification of high-quality information resources. This study aimed to assess the quality of online DHSs consumer health information for weight loss that a “typical” patient might access online. Methods Six search terms were used to generate the first 20 websites on the Google search engine in four countries: Australia, Canada, the United Kingdom, and the United States (n = 480 websites). After applying exclusion criteria, eligible websites were quality assessed using the DISCERN instrument. This tool is comprised of 16 questions, each evaluated on a 5-point scale. The averages and standard deviations for each DISCERN instrument item, in addition to overall summed scores between 15 and 75 were calculated. Results Across 87 eligible websites, the mean summed score was 44.80 (SD = 11.53), while the mean overall DISCERN score of each website was 2.72 (SD = 0.99). In general, websites detailed and achieved their specified aims and described treatment benefits. However, most websites failed to describe the impact of treatment on overall quality of life and the impact of a no treatment option. The highest-scoring websites were largely government or health portal websites, while the lowest-scoring websites were largely commercial in nature. Conclusion High variability in DISCERN instrument scores was found across all websites assessed. Healthcare providers should be aware of the fact that their patients may be accessing misinformation online surrounding the use of DHSs for weight loss. Therefore, it is important for healthcare providers to ensure that they are providing their patients with guidance on how to identify high-quality resources online, in order that safe, effective, and evidence-based decisions are made surrounding the use of DHSs for weight loss.

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Cannabis for pain: a cross-sectional survey of the patient information quality on the Internet

Journal of Cannabis Research ◽

10.1186/s42238-021-00093-x ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Jeremy Y. Ng ◽

Darragh A. Dzisiak ◽

Jessica B. Saini

Keyword(s):

Health Information ◽

Pain Treatment ◽

Consumer Health Information ◽

Cannabis Use ◽

Online Information ◽

Consumer Health ◽

Cross Sectional Survey ◽

Eligibility Criteria ◽

Cross Sectional

Abstract Background Cannabis has increasingly become an alternative treatment for chronic pain, however, there is evidence of concomitant negative health effects with its long-term usage. Patients contemplating cannabis use for pain relief commonly see information online but may not be able to identify trustworthy and accurate sources, therefore, it is imperative that healthcare practitioners play a role in assisting them in discerning the quality of information. The present study assesses the quality of web-based consumer health information available at the intersection of cannabis and pain. Methods A cross-sectional quality assessment of website information was conducted. Three countries were searched on Google: Canada, the Netherlands, and the USA. The first 3 pages of generated websites were used in each of the 9 searches. Eligible websites contained cannabis consumer health information for pain treatment. Only English-language websites were included. Encyclopedias (i.e. Wikipedia), forums, academic journals, general news websites, major e-commerce websites, websites not publicly available, books, and video platforms were excluded. Information presented on eligible websites were assessed using the DISCERN instrument. The DISCERN instrument consists of three sections, the first focusing on the reliability of the publication, the second investigating individual aspects of the publication, and the third providing an overall averaged score. Results Of 270 websites identified across searches, 216 were duplicates, and 18 were excluded based on eligibility criteria, resulting in 36 eligible websites. The average summed DISCERN score was 48.85 out of 75.00 (SD = 8.13), and the average overall score (question 16) was 3.10 out of 5.00 (SD = 0.62). These overall scores were calculated from combining the scores for questions 1 through 15 in the DISCERN instrument for each website. Websites selling cannabis products/services scored the lowest, while health portals scored the highest. Conclusion These findings indicate that online cannabis consumer health information for the treatment/management of pain presents biases to readers. These biases included websites: (1) selectively citing studies that supported the benefits associated with cannabis use, while neglecting to mention those discussing its risks, and (2) promoting cannabis as “natural” with the implication that this equated to “safe”. Healthcare providers should be involved in the guidance of patients’ seeking and use of online information on this topic.

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A critical analysis of the literature on the Internet and consumer health information

Journal of Telemedicine and Telecare ◽

10.1258/1357633054461642 ◽

2005 ◽

Vol 11 (1_suppl) ◽

pp. 41-43 ◽

Cited By ~ 23

Author(s):

J A Powell ◽

P Lowe ◽

F E Griffiths ◽

M Thorogood

Keyword(s):

Health Care ◽

Health Information ◽

Critical Analysis ◽

Virtual Communities ◽

Consumer Health Information ◽

The Internet ◽

Online Information ◽

Consumer Health ◽

Online Social Support

A critical review of the published literature investigating the Internet and consumer health information was undertaken in order to inform further research and policy. A qualitative, narrative method was used, consisting of a three-stage process of identification and collation, thematic coding, and critical analysis. This analysis identified five main themes in the research in this area: (1) the quality of online health information for consumers; (2) consumer use of the Internet for health information; (3) the effect of e-health on the practitioner-patient relationship; (4) virtual communities and online social support and (5) the electronic delivery of information-based interventions. Analysis of these themes revealed more about the concerns of health professionals than about the effect of the Internet on users. Much of the existing work has concentrated on quantifying characteristics of the Internet: for example, measuring the quality of online information, or describing the numbers of users in different health-care settings. There is a lack of qualitative research that explores how citizens are actually using the Internet for health care.

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The quality of online consumer health information at the intersection of complementary and alternative medicine and arthritis

Advances in Rheumatology ◽

10.1186/s42358-021-00162-y ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Jeremy Y. Ng ◽

Alexandra Vacca ◽

Tanya Jain

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Health Information ◽

Consumer Health Information ◽

Consumer Health ◽

Health Providers ◽

Self Medication ◽

The Mean ◽

Complementary And Alternative

Abstract Background Complementary and alternative medicine (CAM) use is prevalent among patients living with arthritis. Such patients often seek information online, for the purpose of gaining a second opinion to their healthcare provider or even self-medication. Little is known about the quality of web-based consumer health information at the intersection of CAM and arthritis; thus, investigating the quality of websites containing this information was the purpose of this study. Methods Four unique search terms were searched on Google across four English-speaking countries. We assessed the first 20 results of each search, including them if they contained CAM consumer health information for the treatment and/or management of arthritis. Eligible websites were assessed in duplicate using the DISCERN instrument, which consists of 16-items designed to assess quality. Results Of total of 320 webpages, 239 were duplicates, and a total of 38 unique websites were deemed eligible and assessed using the DISCERN instrument. The mean summed DISCERN scores across all websites was 55.53 (SD = 9.37). The mean score of the overall quality of each website was 3.71 (SD = 0.63), thus the majority of websites are ranked as slightly above ‘fair’ quality. Conclusion Eligible websites generally received scores better than ‘moderate’ in terms of overall quality. Several shortcomings included a lack of transparency surrounding references used and underreporting of risks associated with treatment options. These results suggest that health providers should be vigilant of the variable quality of information their patients may be accessing online and educate them on how to identify high quality resources.

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Improving the Quality of Consumer Health Information on Wikipedia: Case Series

Journal of Medical Internet Research ◽

10.2196/12450 ◽

2019 ◽

Vol 21 (3) ◽

pp. e12450 ◽

Cited By ~ 4

Author(s):

Shira Schecter Weiner ◽

Jill Horbacewicz ◽

Lane Rasberry ◽

Yocheved Bensinger-Brody

Keyword(s):

Health Information ◽

Case Series ◽

Consumer Health Information ◽

Consumer Health

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Assessing the quality of information provided on websites selling Kratom (Mitragyna speciosa) to consumers in Canada

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00361-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jeremy Y. Ng ◽

Muhammad Ans ◽

Amn Marwaha

Keyword(s):

Health Information ◽

Consumer Health Information ◽

Poor Quality ◽

The Body ◽

Natural Health Products ◽

Consumer Health ◽

Quality Of Information ◽

Eligibility Criteria ◽

Mitragyna Speciosa

Abstract Background Amid a Canadian opioid crisis, many have turned to natural health products, such as kratom (Mitragyna speciosa), to manage their opioid withdrawal. Kratom has also been reported to relieve anxiety, improve stamina, and heighten physical performance. Given that kratom is not authorized for sale by Health Canada, many have turned to online retailers to purchase kratom due to its easy accessibility online. This study investigated the quality of consumer health information provided on the websites of online vendors selling kratom to consumers in Canada. Methods Following searches on Google.ca using search terms designed to simulate the information-seeking behaviour of a typical patient-user online, eligible websites were assessed using the 16-question DISCERN instrument, a tool designed to assess the quality of consumer health information. Searches were conducted on March 27, 2020 and only websites presenting information in English were included. Results A total of 200 webpages were identified; after screening based on eligibility criteria and combining different webpages that belonged to the same website, 51 websites were found to be eligible. The mean summed DISCERN score across all 51 websites was 36.95 (SD = 2.44) out of 75, which reflects poor quality consumer health information across the subset of websites. The overall quality of websites was poor, as 78% (n = 40) of vendors received a score of 2 or less out of 5. Conclusions Individuals who seek information about kratom online are frequently exposed to poor quality consumer health information. Those looking to purchase kratom online are not provided with the critical information necessary to make an informed decision regarding its use, such as the complete details about the risks and side effects or a description of how kratom affects the body. Given the growing interest in kratom, knowledge of the quality of information available can lead to improved dialogue between healthcare providers and patients.

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Assessing the quality of complementary and alternative medicine website information for cancer: A cross-sectional review and analysis

10.21203/rs.3.rs-900093/v1 ◽

2021 ◽

Author(s):

Harmy Thakar ◽

Sabrina L. Balkaran ◽

Jeremy Y. Ng

Keyword(s):

Alternative Medicine ◽

Health Information ◽

Information Quality ◽

Consumer Health Information ◽

Consumer Health ◽

Eligibility Criteria ◽

Cross Sectional ◽

Web Based ◽

Patients With Cancer

Abstract Patients with cancer frequently utilize complementary and alternative medicine (CAM); prior to this, many seek information about these therapies online. Little is known about the quality of this web-based consumer health information (CHI). The present study aimed to address this paucity of research by evaluating the quality of websites containing information on CAM treatments for cancer. Six unique search terms were entered into Google across four English-speaking countries. The first 20 results of each search were assessed and included if they contained CAM consumer health information for the treatment and/or management of cancer. Eligible websites were assessed using the 16-item DISCERN instrument, designed to evaluate information quality. Of the 480 identified websites, 387 were duplicates, and 53 fit the eligibility criteria and were assessed using the DISCERN instrument. Mean summed DISCERN scores across all websites was 53.08 (SD = 12.75), and mean scores of the overall quality of each website was 3.22 (SD = 0.80). Website CHI quality on CAM therapies for cancer were generally acceptable. Several website quality issues were identified, including a lack of transparency surrounding references, areas of uncertainty, consequences of foregoing treatment, and treatment impacts on quality of life.

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Quality of complementary and alternative medicine information for type 2 diabetes: a cross-sectional survey and quality assessment of websites

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03390-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jeremy Y. Ng ◽

Manav Nayeni ◽

Kevin Gilotra

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Alternative Medicine ◽

Health Information ◽

Healthcare Providers ◽

Consumer Health Information ◽

Consumer Health ◽

The Mean

Abstract Background The global prevalence of diabetes mellitus is projected to reach approximately 700 million by the year 2045, with roughly 90–95% of all diabetes cases being type 2 in nature. Patients with type 2 diabetes mellitus (T2DM) frequently seek information about complementary and alternative medicine (CAM) online. This study assessed the quality of publicly accessible websites providing consumer health information at the intersection of T2DM and CAM. Methods An online search engine (Google) was searched to identify pertinent websites containing information specific to CAM for T2DM patients, and the relevant websites were then screened with an eligibility criteria. Consumer health information found on eligible websites were then assessed for quality using the DISCERN instrument, a 16-item standardized scoring system. Results Across the 480 webpages identified, 94 unique webpages remained following deduplication, and 37 eligible webpages belonged to and were collapsed into 30 unique websites that were each assessed using the DISCERN instrument. The mean overall quality score (question 16) across all 30 assessed websites was 3.55 (SD = 0.86), and the mean summed DISCERN score was 52.40 (SD = 12.11). Eighty percent of websites presented a wide range of CAM treatment options with the associated benefits/risks of each treatment, but in 56.7% of the websites, the sources used to collect information were unreliable. Conclusion This study identified, assessed, and presents findings on the quality of online CAM information for T2DM. Although there were several high scoring websites, there was variability across most of the individual DISCERN items in the assessed websites. This study highlights the importance of awareness among healthcare providers regarding the reliability of online information about CAM treatment and management options for T2DM. Healthcare providers should be aware of patients' information seeking behaviour, guide them in navigating through the content they encounter online, and provide them with resources containing trustworthy and reliable information.

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