DISCERN
DISCERN is a brief questionnaire that provides users with a valid and reliable way of assessing the quality of written information on treatment choices for a health problem. DISCERN can also be used by authors and publishers of information on treatment choices as a guide to the standard that users are entitled to expect.
Weil et al. evaluated the quality of information available on the Internet to patients with a cervical pathology undergoing elective cervical spine surgery.
Six key words (“cervical discectomy,” “cervical foraminotomy,” “cervical fusion,” “cervical disc replacement,” “cervical arthroplasty,” “cervical artificial disc”) were entered into two different search engines (Google, Yahoo!). For each keyword, the first 50 websites were evaluated for accessibility, comprehensibility, and website quality using the DISCERN tool, transparency and honesty criteria, and an accuracy and exhaustivity scale.
Of 5,098,500 evaluable websites, 600 were visited; 97 (16%) of these websites were evaluated for quality and comprehensiveness. Overall, 3% of sites obtained an excellent global quality score, 7% obtained a good score, 25% obtained an above average score, 15% obtained an average score, 37% obtained a poor score, and 13% obtained a very poor score. High-quality websites were affiliated with a professional society (P = 0.021), had bibliographical references (P = 0.030), and had a recent update within 6 months (r = 0.277, P < 0.001). No correlation between global quality score and other variables was observed.
This study shows that the search for medical information on the Internet is time-consuming and often disappointing. The Internet is a potentially misleading source of information. Surgeons and professional societies must use the Internet as an ally in providing optimal information to patients 1).
1. Are the aims clear? No Partially Yes 1 23 4 5 Hint: Look for a clear indication at the beginning of the publication of * what it is about * what it is meant to cover (and what topics are meant to be excluded) * who might find it useful If the answer to Question 1 is ‘No’, go directly to Question 3 2. Does it achieve its aims? No Partially Yes 1 23 4 5 Hint: Consider whether the publication provides the information it aimed to as outlined in Question 1 3. Is it relevant? No Partially Yes 12 3 4 5 Hint: Consider whether * the publication addresses the questions that readers might ask * recommendations and suggestions concerning treatment choices are realistic or appropriate 4. Is it clear what sources of information were used to compile the publication (other than the author or producer)? No Partially Yes 1 23 4 5 Hint: * Check whether the main claims or statements made about treatment choices are accompanied by a reference to the sources used as evidence (e.g. a research study or expert opinion) * Look for a means of checking the sources used such as a bibliography/reference list or the addresses of the experts or organisations quoted Rating note: In order to score a full ‘5’ the publication should fulfil both hints. Lists of additional sources of support and information (Q.7) are not necessarily sources of evidence for the current publication 5. Is it clear when the information used or reported in the publication was produced? No Partially Yes 1 23 4 5 Hint: Look for * dates of the main sources of information used to compile the publication * date of any revisions of the publication (but not dates of reprinting) * date of publication (copyright date) Rating note: The hints are placed in order of importance - in order to score a full ‘5’ the dates relating to the first hint should be found 6. Is it balanced and unbiased? No Partially Yes 1 23 4 5 Hint: Look for * a clear indication of whether the publication is written from a personal or objective point of view * evidence that a range of sources of information was used to compile the publication (e.g. more than one research study or expert)* evidence of an external assessment of the publication Be wary if * the publication focuses on the advantages or disadvantages of one particular treatment choice without reference to other possible choices * the publication relies primarily on evidence from single cases (which may not be typical of people with this condition or of responses to a particular treatment) * the information is presented in a sensational, emotive or alarmist way 7. Does it provide details of additional sources of support and information? No Partially Yes 1 23 4 5 Hint: Look for suggestions for further reading or for details of other organisations providing advice and information about the condition and treatment choices 8. Does it refer to areas of uncertainty? No Partially Yes 12 3 4 5 Hint: * Look for discussion of the gaps in knowledge or diVerences in expert opinion concerning treatment choices * Be wary if the publication implies that a treatment choice aVects everyone in the same way (e.g. 100% success rate with a particular treatment) Section 2 HOW GOOD IS THE QUALITY OF INFORMATION ON TREATMENT CHOICES? N.B. The questions apply to the treatment (or treatments) described in the publication. Self-care is considered a form of treatment throughout this section. 9. Does it describe how each treatment works? No Partially Yes 1 23 4 5 Hint: Look for a description of how a treatment acts on the body to achieve its eVect 10. Does it describe the benefits of each treatment? No Partially Yes 12 3 4 5 Hint: Benefits can include controlling or getting rid of symptoms, preventing recurrence of the condition and eliminating the condition - both short-term and long-term 11. Does it describe the risks of each treatment? No Partially Yes 1 23 4 5 Hint: Risks can include side eVects, complications and adverse reactions to treatment - both short-term and long-term 12. Does it describe what would happen if no treatment is used? No Partially Yes 1 23 4 5 Hint: Look for a description of the risks and benefits of postponing treatment, of watchful waiting (i.e. monitoring how the condition progresses without treatment) or of permanently forgoing treatment 13. Does it describe how the treatment choices aVect overall quality of life? No Partially Yes 12 3 4 5 Hint: Look for * description of the eVects of the treatment choices on day-to-day activity* description of the eVects of the treatment choices on relationships with family, friends and carers 14. Is it clear that there may be more than one possible treatment choice? No Partially Yes 123 4 5 Hint: Look for * a description of who is most likely to benefit from each treatment choice mentioned, and under what circumstances * suggestions of alternatives to consider or investigate further (including choices not fully described in the publication) before deciding whether to select or reject a particular treatment choice 15. Does it provide support for shared decision-making? No Partially Yes 12 3 4 5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1756830/pdf/v053p00105.pdf