Credibility, accuracy and comprehensiveness of readily available internet-based information on treatment and management of Peripheral Artery Disease and Intermittent Claudication: A Systematic Review (Preprint)

Abstract

BACKGROUND Peripheral artery disease (PAD) affects millions of people worldwide and a core component of management of the condition is self-management. The internet is an important source of health information for many people. However, the content of websites regarding treatment recommendations for PAD has not been fully evaluated. OBJECTIVE This study aimed to assess their credibility, accuracy, and comprehensiveness of websites, found via a common search engine, by comparing the content to current guidelines for treatment and management of peripheral artery disease (PAD) and intermittent claudication (IC). METHODS A systematic review of websites from hospitals, universities, government, consumer organisations and professional associations in the United States and United Kingdom was conducted. Website recommendations for treatment of PAD/IC were coded against the National Institute for Health and Care Excellence (NICE) guidelines and the American Heart Association (AHA) guidelines. Primary outcomes were website credibility (Journal of the American Medical Association 4-item benchmark), accuracy of the website (% of accurate recommendations) and comprehensiveness of website recommendations (% of guideline recommendations that were appropriately covered). Secondary outcomes were readability (Flesch-Kincaid Grade Level) and website quality (HONcode). RESULTS After screening, 62 websites were included in analysis. Only 45.2% of websites met credibility requirement by stating they were updated after the NICE guidelines were published. Declaration of authorship, funding and presence of reference lists were less commonly reported. Regarding accuracy, 81.2% of website recommendations were deemed accurate when compared to NICE and AHA recommendations. Comprehensiveness was low, with an average of 40.4% of guideline treatment recommendations being appropriately covered by websites. In most cases, readability scores were found to be too complex for online consumer health information. CONCLUSIONS Online information from reputable sources about the treatment and management for PAD and IC are generally accurate but have low comprehensiveness, credibility and readability.