• David E Winchester, Diana Baxter, Merry J Markham, and Rebecca J Beyth.
• Cardiology Section, Medical Service, Malcom Randall VA Medical Center, Gainesville, FL, United States.
• Interact J Med Res. 2017 May 4; 6 (1): e6.

BackgroundThe World Wide Web and social media provide the public with access to medical information unlike any other time in human history. However, the quality of content related to cardiac stress testing is not well understood.ObjectiveThe aim of our study was to evaluate the quality of content on the Internet relating to the use of cardiac nuclear stress testing and the Choosing Wisely campaign.MethodsWe searched the World Wide Web, Google Video (including YouTube), and Twitter for information relating to these two topics. Searches were performed using English language terms from a computer in the United States not logged into any personal user accounts. Search results were reviewed for discussion of specific topics including radiation risk, accuracy of testing, alternative testing options, and discouragement of inappropriate test use.ResultsWe evaluated a total of 348 items of content from our searches. Relevant search results for Choosing Wisely were fewer than for other search terms (45 vs 303). We did not find any content which encouraged inappropriate testing (ie, screening in low risk individuals or testing prior to low risk operations). Content related to Choosing Wisely was more likely to discourage inappropriate testing than search results for other terms (29/45, 64% vs 12/303, 4.0%, odds ratio 43.95, 95% CI 17.6-112.2, P<.001).ConclusionsThe Internet content on nuclear stress tests consistently discouraged inappropriate testing. The Choosing Wisely content was more likely to discourage inappropriate testing, less relevant content was available. Generating authoritative content on the Internet relating to judicious use of medical interventions may be an important role for the Choosing Wisely campaign.©David E Winchester, Diana Baxter, Merry J Markham, Rebecca J Beyth. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 04.05.2017.

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