Web-based information on glaucoma

Abstract

Sir, Web-based information on glaucomaGlaucoma is the fourth most common search term in ophthalmology. 1 In western countries over 50% of patients use Internet for information. 2 In oculoplastic surgery the quality of web-based information has been investigated using an instrument published in the Journal of the American Medical Association (JAMA) which comprises four criteria: (1) authorship; (2) attribution of sources; (3) disclosure, for example, duality of interest declarations; (4) time records for posting information. 3,4 These yield a score from 0 to a maximum of 4. We have studied and presented outcomes for glaucoma using this instrument applied to the Google search engine. 5 Keyword expansion of the search term 'glaucoma' showed it to be by far the most popular search term on the subject. The first five pages of 'Google' were analysed for this search term over a 12-month period yielding 50 websites (10 per page). 5 This is as users of the Internet are much less likely to browse beyond the first five pages of a search engine. 3 'Pay per click' advertising links were ignored. Many websites were found to be of poor quality-28% scored zero JAMA points; 24% scored one point; 6% scored two points; 38% scored three points and 4% scored four points. An online encyclopedia was the most visited website (and scored three points). Charities were the most popular type of websites on page one of the Google search. NHS hospitals scored uniformly well (mean 3, mode 3, median 3). Peer-reviewed journals scored best. 'Medipedias' (online encylopedias) varied in quality and displayed a bimodal peak (0 and 3). The websites of professional bodies and charities scored almost zero (mean 0.3, median 0, mode 0 and mean 0.25, median 0, mode 0, respectively). Youtube videos scored poorly.The relative popularity of patient-friendly websites suggests that more patients are turning to the Internet to understand their glaucoma. This is useful as it may help busy clinicians explaining the need for compliance with treatment. However the quality of information on the Internet remains objectively poor in most cases. The 'Internet factor' may increasingly become important in understanding glaucoma outcomes.