Examination of instruments used to rate quality of health information on the internet: chronicle of a voyage with an unclear destination

Abstract

Objective: This study updates work published in 1998, which found that of 47 rating instruments appearing on websites offering health information, 14 described how they were developed, five provided instructions for use, and none reported the interobserver reliability and construct validity of the measurements. Design: All rating instrument sites noted in the original study were visited to ascertain whether they were still operating. New rating instruments were identified by duplicating and enhancing the comprehensive search of the internet and the medical and information science literature used in the previous study. Eligible instruments were evaluated as in the original study. Results: 98 instruments used to assess the quality of websites in the past five years were identified. Many of the rating instruments identified in the original study were no longer available. Of 51 newly identified rating instruments, only five provided some information by which they could be evaluated. As with the six sites identified in the original study that remained available, none of these five instruments seemed to have been validated. Conclusions: Many incompletely developed rating instruments continue to appear on websites providing health information, even when the organisations that gave rise to those instruments no longer exist. Many researchers, organisations, and website developers are exploring alternative ways of helping people to find and use high quality information available on the internet. Whether they are needed or sustainable and whether they make a difference remain to be shown. What is already known on this topic The rapid growth of healthcare websites in the 1990s was accompanied by initiatives to rate their quality, including award-like symbols on websites A systematic review of the reliability and validity of such rating instruments, published in 1998, showed that they were incompletely developed What this study adds Few of the rating instruments identified in 1998 remain functional; 51 new instruments were identified Of the 51 newly identified instruments, 11 were not functional, 35 were available but provided no information, and five provided information but were not validated Many researchers, organisations, and website developers are exploring alternative ways of helping people to find high quality information on the internet