Assessing Quality of Patient Education Websites on DSM-IV Mood Disorders

During the last decade, the Internet has become an important patient education tool for those seeking to improve their health literacy. However, despite the proliferation of patient education websites, concerns remain regarding the quality of Internet-based health information. This study used a published instrument developed by Godin (2000; 2002; 2005) that assessed quality assurance of 50 websites providing patient education on DSM-IV mood disorders. Two raters, with acceptable Kappa inter-rater reliability coefficients found the following: 1) Only 39% of the sites provided information on the professional credentials of the author(s); 2) Less than 25% of the sites indicated the educational material was "peer reviewed" by appropriate parties; 3) Approximately 50% of the sites provided references to support narrative; 4) About 40% of the websites indicated a date of most recent update; however, the mean number of months since most recent update was 40 months (3.33 years); 5) While about 55% of the sites indicated how the website was financially supported, almost 80% provided advertisements that may pose perceived or real conflicts of interest; 6) Very few websites (20%) allowed for user interaction (i.e., question/answer scenarios), and none of the websites assessed used any form of behavior change theories; 7) Average readability index was measured at 11.5 grade level (even though most Americans read at 5th-7th grade reading level); and 8) An average of 4 direct cookies, and an average of 4.5 indirect cookies were placed on the hard drive of the two reviewers. Cookies being placed on hard drives pose significant confidentiality issues, especially if consumers access these websites at their places of employment. Results of this study are discussed within the context of efforts being made within federal public health organizations (i.e., NIH; FDA) to examine feasibility to oversee and regulate websites that originate within the United States.