Who provides the best orthodontic information on the internet: Dentists or specialists?
I have based this post on a new study that looked at the quality of orthodontic information on the internet.
We know that a high proportion of our patients spend time on the internet getting orthodontic information from various websites. While they may find these sources useful, it is important to recognise that there are are no controls over the quality of this information. This means that there is potential for people to provide misinformation and make unsubstantiated claims. Furthermore, our professional ethical codes recommend that any material we post on websites is honest and truthful. As a result, this study is timely and important.
A team based in East London, the Beautiful South of England, did this study.
Madahar Arun , Qureshi Usman & Ama Johal
Journal of Orthodontics, 44:2, 82-89, DOI: 10.1080/14653125.2017.1313546
They set out to look at the quality, accuracy, usability and readability of orthodontic information on the internet.
What did they do?
They did this study in several main stages.
- Firstly, they identified the most popular search terms used by the public in orthodontic searches.
- They used these terms to identify 544 websites
- Then they excluded discussion groups and scientific articles etc
- In this final stage, they analysed the websites using five validated assessment tools.
- Discern: This evaluates the quality of information about clinical choices.
- LIDA: This looks at the accessibility, usability and reliability of the sites.
- JAMA: These are benchmarks on the quality of authorship etc
- HONseal: This focuses on the honesty of healthcare information
- Flesch Reading score: This is the readability rating.
What did they find?
They analysed a total of 119 websites and found the following:
- The keywords “cosmetic braces” and ‘Fixed braces” accounted for 55% of the websites.
- The most commonly appearing treatment modalities were conventional fixed, removable braces and Invisalign, this accounted for 50% of the “mentions”.
- Orthodontists and general dentists published 71% of the sites.
- The specialist orthodontists provided information on the more complicated treatment options. Whereas, general dentists mainly provided short term treatment options, for example, Six Month Smiles, Inman and other alignment methods.
- Specialist orthodontists produced the highest quality websites in terms of general information, accuracy etc. General practitioner’s sites were some of the lowest scoring sites.
- The highest ranked websites did not correlate with the highest quality.
What did I think?
This was a paper that looked at an important question. I am not an expert in the methods that they used but I thought that they looked reasonable. Importantly, they collected, and analysed the data in a systematic way. I was a little confused by the use of the validated tools. For example, it was not clear how they measured the accuracy of the information.
Nevertheless, I thought that it was very interesting to find that there was a difference in the quality of the information between the websites of specialists and general practitioners. When I thought about reasons for this finding, I tended to agree with a suggestion made by the authors. This was that general dentists provided and promoted simple alignment treatments and these methods have a limited evidence base. Therefore, this reflects their quality and is an important finding. I think that this is particularly true when we consider some of the claims that are made for “speedy treatment” with “new” braces that are claimed to be much better than conventional ones.
When I started reading this paper I thought I would see information on whether some of the websites made claims that were were misleading. Unfortunately, I could not find any evidence of this in the paper. I am aware of several websites that I feel “cross this line”. I cannot help thinking that this is a big problem and we need to address this issue.
In summary, I think this was an interesting paper that provided an insight into the quality of websites. It was a good first step in identifying an important issue that must be relevant to both our patients and those who support advertising ethics.
Emeritus Professor of Orthodontics, University of Manchester, UK.