Quality of online sports medicine information “highly variable”

PainSci » bibliography » Starman et al 2010
updated Apr 16, 2025

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Ten pages on PainSci cite Starman 2010: 1. Extraordinary Health Claims 2. The Complete Guide to IT Band Syndrome 3. The Complete Guide to Low Back Pain 4. The Complete Guide to Patellofemoral Pain Syndrome 5. Complete Guide to Plantar Fasciitis 6. Shin Splints Treatment, The Complete Guide 7. The Complete Guide to Neck Pain & Cricks 8. How to Simplify Chronic Pain Puzzles 9. Complete Guide to Frozen Shoulder 10. Content quality on the Internet

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, reporting 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.

As of 2023, this remains the most recent paper about the quality of online sports medicine content, and obviously the Internet has changed a lot since 2023 … but not generally for the better!

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!

~ Paul Ingraham

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.

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.

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