The Internet is a powerful resource can may help patients make informed treatment decisions but the quality of the content on health-related Web sites is not rigorously monitored and studies have shown that some Web sites present inaccurate information.

More than 110 million adults in the United States have searched online for health information, and two-thirds of these patients seek information through a search engine rather than directly accessing a specific Web site, so helping people to gain an understanding of which types of sites will be most reliable has a great deal of benefit.

New research published in the Journal of the American College of Surgeons says unsponsored and professional society Web sites provide significantly higher quality information about common elective surgical procedures compared with commercially sponsored Web sites. In addition, the study authors say that providing patients with technical search terms may increase the likelihood of obtaining reliable surgical information on the Web.

A panel of surgeons evaluated 145 Web sites using a validated, qualitative rating system. The evaluation was based on 16 clinical and nonclinical criteria specific to patients undergoing elective surgical procedures, including risks of the operation and the amount of advertising present on the Web site. Searches were conducted for 10 common elective general surgical procedures using technical, descriptive and layperson search terms (for example, "Roux-en-Y gastric bypass," "gastric bypass," and "stomach stapling").

Univariate analyses showed unsponsored sites had higher mean composite scores, indicating higher quality, than sites sponsored by commercial organizations such as law firms and representing advertisements (50.6 percent versus 25.0 percent, p<0.0001). In particular, composite scores of professional society Web sites were significantly higher than those of the remaining Web site types (66.3 percent versus 38.3 percent, p<0.0001). In addition, 8.3 percent of the evaluated Web sites were determined to have poor quality information, with sponsored Web sites more likely to contain false statements and conflicts of interest.

Searches performed with a technical search term had significantly higher mean composite scores than searches using a layperson term (47.5 percent versus 36.9 percent, p<0.02).

Researchers concluded that although the quality of health-related information varies on the Internet, surgeons can give their patients suggested search terms for procedure-related Internet browsing to increase their investment in their own care. The authors added that surgeons should continue to ask their patients about Web sites they use in order to correct potential inaccuracies in the information available on those sites.

"Empowering patients with a trusted source of information will lead to better informed patients and, in turn, improved expectations of surgery outcomes," said Clifford Ko, MD, FACS, Professor of Surgery at the University of California, Los Angeles. "Surgeons should steer patients to high-quality medical Web sites until an accepted, widely used seal of credibility is established."