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In our study&#44; we aimed to use the DISCERN score to &#40;a&#41; determine the average quality of online information on p-IBD and &#40;b&#41; assess whether the quality depended on the source of the information&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We performed a Google search on the October 28th&#44; 2019 with the keywords&#58; &#8220;Crohn&#8217;s disease&#8221;&#44; &#8220;ulcerative colitis&#8221;&#44; &#8220;Inflammatory Bowel Disease&#8221;&#44; &#8220;colonoscopy&#8221; and &#8220;endoscopy&#8221;&#44; all of them combined with the terms &#8220;pediatric&#8221; and &#8220;children&#8221;&#46; We recorded the first 10 results for each search and excluded scientific papers&#44; advertisements&#44; videos and subscription-only sites&#46; We classified websites by type of source as hospital&#44; professional society&#44; government agency&#44; health press or patient organization&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We assessed the quality of the written information using the DISCERN instrument &#40;possible total score&#44; 16&#8211;80&#41;&#46; Evaluators rated each item by assigning 1&#8211;5 points &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; in addition to providing a detailed explanation for each&#44; including examples&#46; We categorized DISCERN total scores as excellent &#40;68&#8211;80&#41;&#44; good &#40;55&#8211;67&#41;&#44; fair &#40;42&#8211;54&#41;&#44; poor &#40;29&#8211;41&#41; or very poor &#40;16&#8211;28&#41;&#46; In order to minimize subjectivity&#44; four evaluators assessed the quality of the content&#44; after which the mean total score was calculated for each selected website&#46; We compared the proportion of websites with a rating of excellent or good in each category using the Fisher exact test&#46; We performed the statistical analyses with the software SPSS version 20&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The search yielded 100 websites&#44; of which 65 met all the inclusion criteria&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the distribution by type of authorship and the DISCERN scores&#46; The median DISCERN score for the total sample was 40&#46;8 &#40;interquartile range&#44; IQR 10&#46;5&#41;&#46; Only 5 websites had an excellent or good score&#46; The proportion of websites with excellent or good scores was significantly higher in websites from government agencies and professional societies compared to those from hospitals or the health press &#40;33&#46;3&#37; and 30&#37; vs 2&#37; and 0&#37;&#59; <span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;05&#41;&#46; None of the health press websites received an excellent or good score&#46; Surprisingly&#44; the search did not yield any websites from patient organizations&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The quality of online information on pIBD is highly variable&#46; Most of the easily found websites are from hospitals&#44; but professional societies and government agencies provide information of higher quality&#46; Despite a rapid growth in the provision of health information&#44; the overall quality remains poor and valuable resources may not be easy to find&#46; However&#44; it is time to face this fact&#58; patients with pIBD and their families are consulting or even following the advice available online&#46; One of our responsibilities is to inform about and protect against unreliable sources of information about treatment choices&#44; and the DISCERN instrument can be used as a guide to the standard that users are entitled to expect&#46; Facilitating patient-engaged care in a safe and reasonable way does more than just empower patients&#44; it also leads to better outcomes&#46;</p></span>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46; Is it relevant&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46; Is it clear what sources of information were used to compile the publication &#40;other than the author or producer&#41;&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46; Is it clear when the information used or reported in the publication was produced&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46; Is it balanced and unbiased&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46; Does it provide details of additional sources of support and information&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46; Does it refer to areas of uncertainty&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46; Does it describe how each treatment works&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46; Does it describe the benefits of each treatment&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46; Does it describe the risks of each treatment&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46; Does it describe what would happen if no treatment is used&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">13&#46; Does it describe how the treatment choices affect overall quality of life&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46; Is it clear that there may be more than one possible treatment choice&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46; Does it provide support for shared decision-making&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46; Based on the answers to all of the above questions&#44; rate the overall quality of the publication as a source of information about treatment choices&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Health press &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patient organizations &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Median DISCERN scores &#91;IQR&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">40&#46;1 &#91;7&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">45&#46;9 &#91;26&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">46&#46;3 &#91;33&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">49 &#91;-&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">- &#91;-&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Excellent or good&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;33&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Fair&#44; poor or very poor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">49 &#40;98&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;70&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;66&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                      "doi" => "10.9734/BJMMR/2016/21884"
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Scientific Letter
Is Dr. Google® trustworthy? Reliability of the online medical information on pediatric inflammatory bowel diseases
¿Se puede confiar en el doctor Google®? Fiabilidad de la información médica online sobre la enfermedad inflamatoria intestinal pediátrica
Marta Velasco Rodríguez-Belvísa,
Corresponding author
martavrb@gmail.es

Corresponding author.
, Laura María Palomino Péreza, Carmen Sánchez Fernández-Bravoa, Ana Sanchiz Pereab, Rosa Ana Muñoz Codoceoa
a Sección de Gastroenterología y Nutrición, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
b Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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In our study&#44; we aimed to use the DISCERN score to &#40;a&#41; determine the average quality of online information on p-IBD and &#40;b&#41; assess whether the quality depended on the source of the information&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We performed a Google search on the October 28th&#44; 2019 with the keywords&#58; &#8220;Crohn&#8217;s disease&#8221;&#44; &#8220;ulcerative colitis&#8221;&#44; &#8220;Inflammatory Bowel Disease&#8221;&#44; &#8220;colonoscopy&#8221; and &#8220;endoscopy&#8221;&#44; all of them combined with the terms &#8220;pediatric&#8221; and &#8220;children&#8221;&#46; We recorded the first 10 results for each search and excluded scientific papers&#44; advertisements&#44; videos and subscription-only sites&#46; We classified websites by type of source as hospital&#44; professional society&#44; government agency&#44; health press or patient organization&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We assessed the quality of the written information using the DISCERN instrument &#40;possible total score&#44; 16&#8211;80&#41;&#46; Evaluators rated each item by assigning 1&#8211;5 points &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; in addition to providing a detailed explanation for each&#44; including examples&#46; We categorized DISCERN total scores as excellent &#40;68&#8211;80&#41;&#44; good &#40;55&#8211;67&#41;&#44; fair &#40;42&#8211;54&#41;&#44; poor &#40;29&#8211;41&#41; or very poor &#40;16&#8211;28&#41;&#46; In order to minimize subjectivity&#44; four evaluators assessed the quality of the content&#44; after which the mean total score was calculated for each selected website&#46; We compared the proportion of websites with a rating of excellent or good in each category using the Fisher exact test&#46; We performed the statistical analyses with the software SPSS version 20&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The search yielded 100 websites&#44; of which 65 met all the inclusion criteria&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the distribution by type of authorship and the DISCERN scores&#46; The median DISCERN score for the total sample was 40&#46;8 &#40;interquartile range&#44; IQR 10&#46;5&#41;&#46; Only 5 websites had an excellent or good score&#46; The proportion of websites with excellent or good scores was significantly higher in websites from government agencies and professional societies compared to those from hospitals or the health press &#40;33&#46;3&#37; and 30&#37; vs 2&#37; and 0&#37;&#59; <span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;05&#41;&#46; None of the health press websites received an excellent or good score&#46; Surprisingly&#44; the search did not yield any websites from patient organizations&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The quality of online information on pIBD is highly variable&#46; Most of the easily found websites are from hospitals&#44; but professional societies and government agencies provide information of higher quality&#46; Despite a rapid growth in the provision of health information&#44; the overall quality remains poor and valuable resources may not be easy to find&#46; However&#44; it is time to face this fact&#58; patients with pIBD and their families are consulting or even following the advice available online&#46; One of our responsibilities is to inform about and protect against unreliable sources of information about treatment choices&#44; and the DISCERN instrument can be used as a guide to the standard that users are entitled to expect&#46; Facilitating patient-engaged care in a safe and reasonable way does more than just empower patients&#44; it also leads to better outcomes&#46;</p></span>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">DISCERN items&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">1&#46; Are the aims clear&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46; Does it achieve its aims&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">3&#46; Is it relevant&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">4&#46; Is it clear what sources of information were used to compile the publication &#40;other than the author or producer&#41;&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">5&#46; Is it clear when the information used or reported in the publication was produced&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46; Is it balanced and unbiased&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46; Does it provide details of additional sources of support and information&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46; Does it refer to areas of uncertainty&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46; Does it describe how each treatment works&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46; Does it describe the benefits of each treatment&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46; Does it describe the risks of each treatment&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46; Does it describe what would happen if no treatment is used&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46; Does it describe how the treatment choices affect overall quality of life&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46; Is it clear that there may be more than one possible treatment choice&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46; Does it provide support for shared decision-making&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46; Based on the answers to all of the above questions&#44; rate the overall quality of the publication as a source of information about treatment choices&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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      1 => array:8 [
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DISCERN&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Hospitals &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;50&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Professional societies &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Government agencies &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Health press &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patient organizations &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median DISCERN scores &#91;IQR&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">40&#46;1 &#91;7&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#46;9 &#91;26&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;3 &#91;33&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#91;-&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- &#91;-&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Excellent or good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;33&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Fair&#44; poor or very poor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">49 &#40;98&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7 &#40;70&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;66&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Patients&#8217; preferences regarding shared decision-making in the treatment of inflammatory bowel disease&#58; results from a patient-empowerment study"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                      "titulo" => "Unmet communication and information needs for patients with IBD&#58; implications for mobile health technology"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Khan"
                            1 => "D&#46; Dasrath"
                            2 => "S&#46; Farghaly"
                            3 => "E&#46; Otobo"
                            4 => "M&#46; Safwan Riaz"
                            5 => "J&#46; Rogers"
                          ]
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                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.9734/BJMMR/2016/21884"
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                        "tituloSerie" => "Br J Med Med Res&#46;"
                        "fecha" => "2016"
                        "volumen" => "12"
                        "paginaInicial" => "12119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28217532"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Consumer evaluation of the quality of online health information&#58; systematic literature review of relevant criteria and indicators"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Sun"
                            1 => "Y&#46; Zhang"
                            2 => "J&#46; Gwizdka"
                            3 => "C&#46;B&#46; Trace"
                          ]
                        ]
                      ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2196/12522"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Med Internet Res&#46;"
                        "fecha" => "2019"
                        "volumen" => "21"
                        "paginaInicial" => "e12522"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31045507"
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                      "titulo" => "How adolescents use technology for health information&#58; implications for health professionals from focus group studies"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Skinner"
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                            2 => "B&#46; Poland"
                            3 => "E&#46; Goldberg"
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                      "doi" => "10.2196/jmir.5.4.e32"
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                        "tituloSerie" => "J Med Internet Res&#46;"
                        "fecha" => "2003"
                        "volumen" => "5"
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                          0 => array:2 [
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                      "titulo" => "Adolescents&#8217; use of the Internet&#58; a controversial&#44; coming-of-age resource"
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                          "etal" => false
                          "autores" => array:1 [
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Article information
ISSN: 23412879
Original language: English
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