Evaluating the quality of websites providing complementary and alternative medicine patient information for neck pain

Abstract

Abstract Background In 2017, there were 288.7 million global cases of neck pain. A growing treatment option for neck pain is complementary and alternative medicine (CAM), with approximately 50% of Americans seeking these therapies. Despite the popularity of CAM, patients hesitate to disclose their use to professionals, likely contributing to greater reliance on the Internet for information. The present study evaluates the quality of online CAM consumer health information for neck pain. Methods We used Google to search six unique terms across four English-speaking countries. Eligible websites discussed CAM use for neck pain. Websites were assessed in duplicate with the DISCERN instrument, which assesses publication reliability (questions 1-8), quality of treatment information (questions 9-15), and overall publication quality (question 16). Scores were summed (questions 1-15), and means and standard deviations were calculated. Results Overall, 473 webpages were identified, of which 104 were unique; thirty-seven eligible websites were assessed with the DISCERN instrument. The mean summed DISCERN score across all websites was 46.04/75.00 (SD=9.79), and the mean overall quality rating was 3.05/5.00 (SD=0.76). Websites discussed treatment benefits, treatment options, and shared decision-making, but inadequately described treatment risks, the effect of no treatment, and treatment impact on quality of life. Conclusion Variable website quality suggests that healthcare providers should inquire about any online health information accessed by their patients. Commercial websites in particular should be cautiously navigated given their low DISCERN scores and lack of HONcode certification. Useful tools to assess website quality include health-related seals of approval and conflict-of-interest declarations.