The Quality of Non-alcoholic Fatty Liver Disease Information Resources for Patients on the Internet in Korea (Preprint)

BACKGROUND The Internet has a wide range of health information resources, and many patients uses the internet to obtain information about their diseases. However, there is increasing concern regarding the quality of internet information. OBJECTIVE Thus, we aimed to systematically evaluate the quality of websites containing educational information about non-alcoholic fatty liver disease (NAFLD) in Korea. METHODS Naver™, Daum™, and Google™ search engines were searched using the term "Non-alcoholic fatty liver disease" in Korean. Two reviewers independently evaluated website quality using the quality evaluation instrument (QEI), which awarded websites scores for specific information on various aspects of NAFLD, as well as a five-point Likert scale (1-5), the DISCERN instrument, and a global quality scale (GQS). RESULTS Forty-seven websites met the inclusion criteria. We found that the quality of the internet information about NAFLD is generally poor. The mean QEI score with standard deviation was 10.31 ± 5.09 (range 4-22), with only 17% of websites scoring higher than 10 points. The median GQS of the websites was 2.0, with no website achieving a score of 4 or 5. The QEI score was highly associated with the GQS score (r = 0.74, p<0.01). For each DISCERN question from question 1 to question 15, the mean score was less than 3. The intraclass scores, which indicate inter-rater agreement, for the QEI, GQS, and the total DISCERN score were 0.85 (p<0.01), 0.84 (p<0.01), and 0.89 (p<0.01) respectively, indicating an acceptable agreement. CONCLUSIONS Overall, the internet health information for patients regarding NAFLD is poor and in need of much improvement. There is a need for institutional support, qualitative regulation of internet information, and development of an accreditation system to provide patients with internet health information of appropriate quality.