Instruments to assess the quality of health information on the World Wide Web: what can our patients actually use?

To find and assess quality-rating instruments that can be used by health care consumers to assess websites displaying health information. Searches of PubMed, the World Wide Web (using five different search engines), reference tracing from identified articles, and a review of the of the American Medical Informatics Association's annual symposium proceedings. Sources were examined for availability, number of elements, objectivity, and readability. A total of 273 distinct instruments were found and analyzed. Of these, 80 (29%) made evaluation criteria publicly available and 24 (8.7%) had 10 or fewer elements (items that a user has to assess to evaluate a website). Seven instruments consisted of elements that could all be evaluated objectively. Of these seven, one instrument consisted entirely of criteria with acceptable interobserver reliability (kappa ≥ 0.6); another instrument met readability standards. There are many quality-rating instruments, but few are likely to be practically usable by the intended audience.