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The quality of online information on Legg–Calvé–Perthes disease: can we do better?

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

A Correction to this article was published on 13 September 2023

This article has been updated

Abstract

Introduction

As patients increasingly utilize the Internet to obtain health-related information, the accuracy and usability of information prove critical, especially for patients and parents seeking care for relatively common orthopedic childhood disorders such as Legg–Calvé–Perthes (LCP) disease. Therefore, the purpose of this study is to evaluate available online health information regarding LCP disease. The study specifically seeks to (1) examine the accessibility, usability, reliability, and readability of online information, (2) compare the quality of sites from different sources, and (3) determine whether Health on the Net Foundation Code (HON-code) certification guarantees higher quality of information.

Materials and methods

Websites from a query of both Google and Bing were compiled and scored using the Minervalidation tool (LIDA), an appraisal tool quantifying website quality, along with the Flesch–Kinkaid (FK) analysis, a metric assessing readability of content. All sites were organized based on source category [academic, private physician/physician group, governmental/non-profit organization (NPO), commercial, and unspecified] and HON-code certification.

Results

Physician-based and governmental/NPO sites had the highest accessibility, the unspecified site group were the most reliable and usable, and the physician-based group was found to require the least education to comprehend. Unspecified sites had a significantly higher rating of reliability than physician sites (p = 0.0164) and academic sites (p < 0.0001). HON-code-certified sites were found to have greater scores across quality domains along with being easier to read compared to sites without certification, with significantly higher reliability scoring (p < 0.0001).

Conclusions

As a whole, information on the Internet regarding LCP disease is of poor quality. However, our findings also encourage patients to utilize HON-code-certified websites due to their significantly higher reliability. Future studies should analyze methods of improving this publicly available information. Additionally, future analyses should examine methods for patients to better identify reliable websites, as well as the best mediums for optimized patient access and comprehension.

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Data availability

The data that support the findings of this study are available from the authors, upon reasonable request.

Change history

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Authors and Affiliations

  1. Drexel University College of Medicine, 2900 West Queen Lane, Philadelphia, PA, 19129, USA

    James A. Nassur

  2. Department of Orthopaedic Surgery, Larkin Community Hospital, 7031 SW 62nd Avenue, Miami, FL, 33143, USA

    Linsen T. Samuel & Atul F. Kamath

  3. Department of Orthopaedic Surgery, Rush University Medical Center, 1620 West Harrison Street, Chicago, IL, 60612, USA

    Alexander J. Acuña

  4. Department of Pediatric Orthopaedics, Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard Philadelphia, Pennsylvania, 19104, USA

    Bridget Ellsworth

  5. Center for Hip Preservation, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, 9500 Euclid Avenue, Mailcode A40, Cleveland, OH, 44195, USA

    Atul F. Kamath

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  1. James A. Nassur
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Corresponding author

Correspondence to Atul F. Kamath.

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Conflict of interest

James A. Nassur, Linsen T. Samuel, Alexander J. Acuña, and Bridget Ellsworth have no relevant financial or non-financial interests to disclose. Atul Kamath is on the board or is a committee member of the American Academy of Orthopaedic Surgeons, the American Association of Hip and Knee Surgeons, and the Anterior Hip Foundation and receives no compensation from any of these organizations. Atul Kamath is a paid consultant to BodyCad, Ortho Development, United Ortho, and Zimmer. Atul Kamath owns IP royalties at Innomed and owns stock/stock options at Johnson & Johnson, Procter & Gamble, and Zimmer. Atul Kamath has received speaker honorarium from Zimmer.

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Nassur, J.A., Samuel, L.T., Acuña, A.J. et al. The quality of online information on Legg–Calvé–Perthes disease: can we do better?. Arch Orthop Trauma Surg 143, 6569–6576 (2023). https://doi.org/10.1007/s00402-023-04974-z

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