Assessment of readability, quality and popularity of online information on ureteral stents

To evaluate the quality and readability of online information on ureteral stents. Google.com was queried using the search terms ureteric stent, ureteral stent, double J stent and, Kidney stent derived from Google AdWords. Website popularity was determined using Google Rank and the Alexa tool. Website quality assessment was performed using the following criteria: Journal of the American Medical Association (JAMA) benchmarks, Health on the Net (HON) criteria, and a customized DISCERN questionnaire. The customized DISCERN questionnaire was developed by combining the short validated DISCERN questionnaire with additional stent-specific items including definition, placement, complications, limitations, removal and when to seek help. Scores related to stent items were considered as the stent score (SS). Readability was evaluated using five readability tests. Thirty-two websites were included. The mean customized DISCERN score and stent score were 27.1 +/- 7.1 (maximum possible score = 59) and 14.6 +/- 3.8 (maximum possible score = 24), respectively. A minority of websites adequately addressed stent removal and when to seek medical attention. Only two websites (6.3%) had HON certification (drugs.com, radiologyinfo.org) and only one website (3.3%) met all JAMA criteria (bradyurology.blogspot.com). Readability level was higher than the American Medical Association recommendation of sixth-grade level for more than 75% of the websites. There was no correlation between Google rank, Alexa rank, and the quality scores (P > 0.05). Among the 32 most popular websites on the topic of ureteral stents, online information was highly variable. The readability of many of the websites was far higher than standard recommendations and the online information was questionable in many cases. These findings suggest a need for improved online resources in order to better educate patients about ureteral stents and also should inform physicians that popular websites may have incomplete information.