RESULTS: Websites were classified as: 43% hospital based, 12% fertility clinic based, 5% other clinic based, 33% society/association based, and 7% government based. The mean total DISCERN score was 44 AE 12 (maximum score 80). 75% (45/60) of websites had clear aims or achieved their aims (scores of 4 or 5 [good]), but only 15% (9/60) described areas of clinical uncertainty. 25% (15/60) described the benefits of treatments, but only 5% (3/ 60) described the risks of treatments. 72% (43/60) provided unbiased information. 68% (41/60) websites made it clear that there was more than one possible treatment choice. 27% (16/60) of websites encouraged shared decision making. Overall, 60% (36/60) of websites were ''poor quality'' (score 1-2-3) on the final question of the DISCERN instrument. Only 4/60 (6.7%) websites met all four JAMA benchmark criteria. The mean Dale-Chall score was 9.53 +/-1.30, indicating a college or graduate degree level of readability. The mean Flesh Reading Ease index was 34.01 +/-16.26, indicating a graduate degree level of readability. 20% (12/60) of websites were HONcode certified.CONCLUSIONS: Websites on ''male infertility'' are of low quality, and only 6.7% met JAMA benchmark criteria. Minimal information on treatments was present, with only 25% of websites describing treatment benefits, but only 5% describing treatment risks. Only 15% of websites described areas of clinical uncertainty. Despite that these websites were written at a college to graduate degree level of reading, only 27% encouraged shared decision making. Reassuringly, most of these websites were hospital based, and 72% provided unbiased information. Patients should be cautioned that incomplete and potentially biased information on male infertility is prevalent online.
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