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J Hand Surg Am. 2012 Sep;37(9):1881-7. doi: 10.1016/j.jhsa.2012.05.021. Epub 2012 Aug 1.

The effect of search term on the quality and accuracy of online information regarding distal radius fractures.

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Department of Orthopaedic Surgery, Division of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, NY 10021, USA.



Recent emphasis on shared decision making and patient-centered research has increased the importance of patient education and health literacy. The internet is rapidly growing as a source of self-education for patients. However, concern exists over the quality, accuracy, and readability of the information. Our objective was to determine whether the quality, accuracy, and readability of information online about distal radius fractures vary with the search term.


This was a prospective evaluation of 3 search engines using 3 different search terms of varying sophistication ("distal radius fracture," "wrist fracture," and "broken wrist"). We evaluated 70 unique Web sites for quality, accuracy, and readability. We used comparative statistics to determine whether the search term affected the quality, accuracy, and readability of the Web sites found. Three orthopedic surgeons independently gauged quality and accuracy of information using a set of predetermined scoring criteria. We evaluated the readability of the Web site using the Fleisch-Kincaid score for reading grade level.


There were significant differences in the quality, accuracy, and readability of information found, depending on the search term. We found higher quality and accuracy resulted from the search term "distal radius fracture," particularly compared with Web sites resulting from the term "broken wrist." The reading level was higher than recommended in 65 of the 70 Web sites and was significantly higher when searching with "distal radius fracture" than "wrist fracture" or "broken wrist." There was no correlation between Web site reading level and quality or accuracy.


The readability of information about distal radius fractures in most Web sites was higher than the recommended reading level for the general public. The quality and accuracy of the information found significantly varied with the sophistication of the search term used.


Physicians, professional societies, and search engines should consider efforts to improve internet access to high-quality information at an understandable level.

[Indexed for MEDLINE]

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