Quality of online sports medicine information “highly variable”
Four articles on PainSci cite Starman 2010: 1. The Complete Guide to IT Band Syndrome 2. The Complete Guide to Low Back Pain 3. The Complete Guide to Patellofemoral Pain Syndrome 4. The Complete Guide to Neck Pain & Cricks

PainSci commentary on Starman 2010: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Researchers evaluated the accuracy of top Internet sources of information about common orthopedic conditions, such as knee injuries and low back pain. Given how they selected websites to review, it’s almost likely that they reviewed this one! What I wouldn’t give to know.
They found that “the quality and content of health information on the internet is highly variable for common sports medicine topics.” Brought to you by the Department of Duh! That conclusion is just a bit of an understatement: there are lots of prominent sites peddling the most astonishing nonsense.
Dr. Steven Novella wrote about this study, commenting specifically on privately run health information sites like PainScience.com:
It is also not surprising that individual sites also scored relatively low on average. An individually run site is only as good as the individual running it, so there is bound to be a great deal of variability. Also, individuals are more likely to make mistakes or have missing information than groups.
Amen!
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: Although the use of the Internet to access health information has grown quickly, the emergence of quality controls for health information web sites has been considerably slower. The primary objective of this study was to assess the quality and content of Internet-based information for commonly encountered diagnoses within orthopaedic sports medicine.
METHODS: Ten common diagnoses within the scope of orthopaedic sports medicine were chosen. Custom grading templates were developed for each condition, and they included an assessment of web-site type, the accountability and transparency of the information (Health On the Net Foundation [HON] score), and the information content. Information content was divided into five subcategories: disease summary, pathogenesis, diagnostics, treatment and complications, and outcomes and prognosis. Two popular search engines were used, and the top ten sites from each were independently reviewed by three authors. Data were evaluated for interobserver variability, HON scores, information content scores, and subgroup score comparisons.
RESULTS: After eliminating duplicate sites, a total of 154 unique sites were reviewed. The most common web-site types were commercial (seventy-four sites) and academic (thirty-two sites). Average HON scores, on a 16-point scale, were 9.8, 9.5, and 8.5, for reviewers 1, 2, and 3, respectively. Average information content scores, on a 100-point scale, were 56.8, 56.0, and 54.8 for reviewers 1, 2, and 3, respectively. Average content scores in each subgroup ranged between 45% and 61% of the maximum possible score. The presence of the HONcode seal was associated with significantly higher HON (p = 0.0001) and content scores (p = 0.002).
CONCLUSIONS: The quality and content of health information on the Internet is highly variable for common sports medicine topics. Patients should be encouraged to exercise caution and to utilize only well-known sites and those that display the HONcode seal of compliance with transparency and accountability practices.
related content
Specifically regarding Starman 2010:
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.