• Steven G Rothrock, Ava N Rothrock, Sarah B Swetland, Maria Pagane, Shira A Isaak, Jake Romney, Valeria Chavez, and Silvio H Chavez.
• Department of Emergency Medicine, Dr. P. Phillips Hospital, Orlando Health, Orlando, Florida.
• J Emerg Med. 2019 Oct 1; 57 (4): 469-477.

BackgroundThe Internet is a universal source of information for parents of children with acute complaints.ObjectivesWe sought to analyze information directed at parents regarding common acute pediatric complaints.MethodsAuthors searched three search engines for four complaints (child + fever, vomiting, cough, stomach pain), assessing the first 20 results for each query. Readability was evaluated using: Flesch-Kincaid Grade Level, Gunning Fog, Simple Measure of Gobbledygook, and the Coleman-Liau Index. Two reviewers independently evaluated Journal of the American Medical Association (JAMA) Benchmark Criteria and National Library of Medicine (NLM) Trustworthy scores. Two physicians (emergency medicine/EM, pediatric EM) analyzed text accuracy (number correct divided by total number of facts). Disagreements were settled by a third physician. Accuracy was defined as ≥ 95% correct, readability as an 8th-grade reading level, high quality as at least three JAMA criteria, and trustworthiness as an NLM score ≥ 3. Accurate and inaccurate websites were compared using chi-squared analysis and Mann-Whitney U test.ResultsEighty-seven websites (60%) were accurate (k = 0.94). Sixty (42%) of 144 evaluable websites were readable, 38 (26%) had high-quality JAMA criteria (kappa/k = 0.68), and 44 (31%) had reliable NLM trustworthy scores (k = 0.66). Accurate websites were more frequently published by professional medical organizations (hospitals, academic societies, governments) compared with inaccurate websites (63% vs. 33%, p < 0.01). There was no association between accuracy and physician authorship, search rank, quality, trustworthiness, or readability.ConclusionMany studied websites had inadequate accuracy, quality, trustworthiness, and readability. Measures should be taken to improve web-based information related to acute pediatric complaints.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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