Inflammatory bowel disease: An evaluation of health information on the internet

Table 1 Summarizes general information about websites on inflammatory bowel disease included in the study

No.	Website title, Organisation	URL	Authority/ownership, state, country	Year created	Last updated	Number of pages	Number of tables	Number of images	Number of illustrations
1	Inflammatory Bowel Disease (IBD), Mayo Clinic	http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/definition/con-20034908	Mayo Foundation for Medical Education and Research, Arizona, United States	1997	04 Feb 2014	11	0	0	0
2	Inflammatory Bowel Disease Health Center, WebMd	http://www.webmd.com/ibd-crohns-disease/	WebMD, Inc., Georgia, United States.	1998	06 Sep 2013	2	0	3	0
3	Inflammatory Bowel Disease (IBD), Center for Disease Control and Prevention (CDC)	http://www.cdc.gov/ibd/	Centers for Disease Control and Prevention (CDC), Georgia, United States.	1999	04 Sep 2014	3	0	1	1
4	Inflammatory Bowel Disease, NHS Choices	http://www.nhs.uk/conditions/inflammatory-bowel-disease/pages/introduction.aspx	NHS England, Wakefield, United Kingdom.	1996	29 Apr 2013	2	0	0	0
5	What are Crohn's and Colitis? Crohn's and Colitis Foundation	http://www.ccfa.org/what-are-crohns-and-colitis/	Crohns and Colitis Foundation of America, New York, United States.	1996	14 Apr 2014	1	0	1	0
6	Inflammatory Bowel Disease, KidsHealth	http://kidshealth.org/parent/medical/digestive/ibd.html	Kids Health Organisaion, The Nemours Foundation, Orlando, United States.	1995	27 Jan 2015	4	0	1	0
7	Inflammatory Bowel Disease (IBD). FamilyDoctor	http://familydoctor.org/familydoctor/en/diseases-conditions/inflammatory-bowel-disease.html	American Academy of Family Physicians, New Jersey, United States.	1998	22 Jan 2015	7	0	0	0
8	Inflammatory Bowel Disease, Healthline	http://www.healthline.com/health/inflammatory-bowel-disease#Overview1	Healthline, California, United States.	2004	29 Nov 2011	6	0	0	0
9	Crohn's and Colitis, Australia	https://www.crohnsandcolitis.com.au/about-crohns-colitis/inflammatory-bowel-disease/	Crohn's and Colitis Australia, Victoria, Australia.	2009	24 Jul 2014	3	0	1	0
10	Crohn's and Colitis UK	http://www.crohnsandcolitis.org.uk/information-and-support/information-about-ibd/what-is-IBD	Crohn's and Colitis UK, United Kingdom.	2010	13 Nov 2014	2	0	1	0
11	Inflammatory Bowel Disease (IBD) (Intestinal Problems of IBD), MedicineNet	http://www.medicinenet.com/inflammatory_bowel_disease_intestinal_problems/article.htm	Medicine.Net.com, WebMed Network, New York, United States.	1995	6 Sep 2013	12	0	27	0
12	Inflammatory Bowel Disease Center, Cedars-Sinai	http://www.cedars-sinai.edu/Patients/Programs-and-Services/Inflammatory-Bowel-Disease-Center/	Cedars-Sinai Medical Center, California, United States.	1992	5 Jul 2013	2	0	0	0
13	Inflammatory Bowel Diseases Symptoms and Treatment: Livescience	http://www.livescience.com/39880-inflammatory-bowel-disease.html	Tanya Lewis, LiveScience Contributor, New York, United States.	2001	10 Apr 2014	11	0	1	0
14	Inflammatory Bowel Diseases Program, Penn Medicine.org	http://www.pennmedicine.org/gastroenterology/patient-care/gi-diseases/inflammatory-bowel-disease-ibd/	Penn Medicine, Pennsylvania, United Stats.	2003	6 Nov 2014	4	0	0	0
15	Inflammatory Bowel Diseases Support Groups, IBDsupport.org	http://www.ibdsupport.org/	IBD support.org, Utah, United States.	2011	30 May 2014	2	0	0	0
16	Inflammatory Bowel Disease (IBD), ABC Health and wellbeing	http://www.abc.net.au/health/library/stories/2012/02/22/3435688.htm	Australian Broadcasting Corporation, NSW, Australia.	2001	3 Dec 2014	4	0	1	0
17	Inflammatory Bowel Disease (IBD), GIKids	http://www.gikids.org/content/7/en/IBD	GIKids and The NASPGHAN Foundation, Pennsylvania, United States.	2009	11 Jun 2013	2	0	1	0
18	Inflammatory Bowel Disease, Vitamin D Council	https://www.vitamindcouncil.org/health-conditions/inflammatory-bowel-disease/	The Vitamin D Council, California, United States.	2007	17 Jun 2011	6	0	0	0
19	Inflammatory Bowel Disease Symptoms and Diagnosis, Seattle children's	http://www.seattlechildrens.org/medical-conditions/digestive-gastrointestinal-conditions/ibd-symptoms/	Children's Hospital and Regional Med. Ctr, Washington, United States.	1993	23 Apr 2014	2	0	0	0
20	Crohn's Disease, Patient.co.uk	http://www.patient.co.uk/health/crohns-disease-leaflet	Patient, Patient information Publications, Leeds, United Kingdom.	1997	05 Mar 2013	8	0	0	1
21	Patient Information Crohn Disease (Beyond and the Basics), Uptodate	http://www.uptodate.com/contents/crohn-disease-beyond-the-basics	UpToDate, Wolters Kluwer Health, Illinois, United States.	1998	29 Jul 2014	5	0	0	0
22	Crohn's Disease, Centre for digestive diseases	http://www.cdd.com.au/pages/disease_info/crohns_disease.html	The Centre for Digestive Diseases, NSW, Australia.		08 Jul 2013	4	0	0	0
23	Crohn's Disease, Patients: British Society for Gastroenterology	http://www.bsg.org.uk/patients/general/crohn-s-disease.html	British Society of Gastroenterology, London, United Kingdom.	1996	05 Aug 2014	6	0	0	0
24	Crohn's Disease, Bupa	http://www.bupa.co.uk/health-information/directory/c/crohns-disease	The British United Provident Association Ltd, London, United Kingdom	1996	16 Jun 2014	6	0	0	1
25	Crohn's Disease, University of Maryland Medical Center	http://umm.edu/health/medical/reports/articles/crohns-disease	University of Maryland Medical Center, Maryland, United States	1996	19 Sep 2013	20	0	0	0
26	Crohn's Disease, Symptoms, Diagnosis, Treatment, Southern Cross	https://www.southerncross.co.nz/AboutTheGroup/HealthResources/MedicalLibrary/tabid/178/vw/1/ItemID/523/Crohns-disease-symptoms-diagnosis-treatment.aspx	Southern Cross Healthcare Group; Auckland, New Zealand.	1998	01 Feb 2015	5	0	0	0
27	Crohn's Disease, American family physician	http://www.aafp.org/afp/2011/1215/p1379.html	American Academy of Family Physicians, Kansas, United States	1995	02 Jul 2014	2	0	0	0
28	What is Crohn's Disease? What Causes Crohn's Disease? MNT	http://www.medicalnewstoday.com/articles/151620.php	Christian Nordquist, MNT, Sussex, United Kingdom.	2003	02 Jan 2014	7	0	0	0
29	Crohn's Disease, Netdoctor	http://www.netdoctor.co.uk/diseases/facts/crohnsdisease.htm	NetDoctor.co. Ltd, London, United Kingdom.	1998	24 Aug 2014	7	0	1	0
30	Crohn's Disease, UCSF medical center	http://www.ucsfhealth.org/conditions/crohns_disease/	University of California San Francisco Medical Center, California, United States.	2000	04 Jan 2012	2	0	0	0
31	Crohn's Disease Symptoms and Treatment, US.news Wellness	http://health.usnews.com/health-news/health-wellness/articles/2013/08/03/crohns-disease-symptoms-and-treatment	Guido Zanni, US News, New York, United States,	1995	22 Jan 2015	3	0	0	0
32	What are the treatments for Crohn's disease? Beth Israel Deaconess Medical Center	http://www.bidmc.org/Centers-and-Departments/Departments/Digestive-Disease-Center/Inflammatory-Bowel-Disease-Program/Crohns-Disease/What-are-the-treatments-for-Crohns-disease.aspx	Beth Israel Deaconess Medical Center, Massachusetts, United States.	2002	16 Mar 2006	15	0	4	1
33	Diagnosing Crohn's, Crohn's and Me.	http://www.crohnsandme.com/crohns-information/crohns-disease-diagnosis.aspx	UCB Multinational Biopharmaceutical Company, Brussels, Belgium	2005	29 Apr 2014	9	1	1	1
34	Understanding Crohn's Disease, Crohn's and Colitis.	http://www.crohnsandcolitisinfo.com/Crohns/What-is-Crohns-Disease	Crohn's and Colitis, Illinois, United States	2011	02 Oct 2014	8	0	1	1
35	Learning About Crohn's Disease, National Human Genome Research Institute	http://www.genome.gov/25521854	National Human Genome Research Institute, Massachusetts, United States		27 Sep 2011	2	0	0	0
36	Crohn's Disease, UPMC Life Changing Medicine	http://www.upmc.com/services/digestive-disorders-center/services/ibd/conditions/pages/crohns-disease.aspx	UPMC Digestive Disorders Center, UPMC Presbyterian, Pennsylvania, United States	1999	04 Mar 2014	3	0	0	0
37	Crohn's Disease, Cincinnati Children's	http://www.cincinnatichildrens.org/health/c/crohns/	Cincinnati Children's Hospital Medical Center, Ohio, United States	1998	15 may 2012	4	0	1	0
38	Crohn's Disease, Cleveland clinic	http://my.clevelandclinic.org/health/diseases_conditions/hic_Inflammatory_Bowel_Disease_IBD_QandA/hic_Crohns_Disease	The Cleveland Clinic Foundation, Ohio, United States	1998	02 Jan 2015	2	0	0	0
39	Treatment of Crohn's Disease, UNC Multidisciplinary Center for IBD Research and Treatment	http://www.med.unc.edu/gi/specialties/ibd/about-ibd/treatment-of-ibd-1/treatment-of-crohns-disease	UNC, School of Medicine, North Carolina, United States	1986	07 Mar 2013	9	0	9	10
40	Crohn's Disease, Emedicine health	http://www.emedicinehealth.com/crohn_disease/article_em.htm	EMedicine.com Inc, WebMD Network, Georgia, United States	2003	06 Sep 2013	10	0	0	1
41	Understanding Crohn's Disease and Ulcerative Colitis. Australian Gastroenterology Institute.	http://www.nevdgp.org.au/info/gastro/crohns.htm	Australian Gastroenterology Institute, Digestive Health Foundation, New South Wales, Australia		02 Jun 2014	3	0	0	0
42	Crohn's Disease, Health Centers	http://www.drweil.com/drw/u/ART00339/Crohns-Disease.html	Weil's Foundation, Arizona, United States	1999	16 Jan 2012	3	0	1	0
43	Crohn's Disease- An Overview, the Royal Children's Hospital Melbourne	http://www.rch.org.au/kidsinfo/fact_sheets/Crohns_Disease_an_overview/	The Royal Children's Hospital Melbourne, Victoria, Australia		19 Jun 2014	3	0	0	0
44	Fighting Inflammatory Bowel Disease Together, the Irish Society for Colitis and Crohn's Disease	http://www.iscc.ie/page.php?id=18&title=What%20is%20IBD	The Irish Society for Colitis and Crohn's Disease, Dublin, United Kingdom	2000	05 Jan 2014	4	0	10	1
45	Crohn's Disease Diagnosis, New health guide	http://www.newhealthguide.org/Crohn%27s-Disease-Diagnosis.html	New Health Guide, United States	2013	10 Feb 15.	3	0	1	0
46	Crohn's Disease, HealthDay.	http://consumer.healthday.com/encyclopedia/digestive-health-14/digestion-health-news-200/crohn-s-disease-644392.html	HealthDay, New York, United States	2002	15 Apr 2014	4	0	0	0
47	Ulcerative Colitis, Wikipedia	http://en.wikipedia.org/wiki/Ulcerative_colitis	Wikimedia Foundation, Inc, California, United States	2001	08 May 2012	14	6	6	1
48	Living with UC, Do You Know Your Treatment Options?	http://www.livingwithuc.ca/	Janssen Inc., Canada	2010,	May 2014	8	4	0	2
49	What Is Ulcerative Colitis? Everyday Health	http://www.everydayhealth.com/conditions/ulcerative-colitis	Everyday Health Media, LLC, New York, United States	2004	10 Feb 2014	14	0	0	0
50	What Is Ulcerative Colitis? News Medical	http://www.news-medical.net/health/What-is-Ulcerative-Colitis.aspx	The AZO Network, New South Wales, Australia	2004	26 Feb 2015	2	0	0	0
51	Crohn's Disease and Ulcerative Colitis, Better Health Channel	http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Crohn%27s_disease_and_ulcerative_colitis	Crohn's and Colitis, The State Government of Victoria, Victoria, Australia	2007	28 Sep 2014	4	0	0	0
52	Ulcerative Colitis, Jackson Siegelbaum Gastroenterology	http://gicare.com/diseases/ulcerative-colitis/	Jackson Gastroenterology Ltd, Central Pennsylvania, Pennsylvania, United States	1997	07 April 2014	3	0	0	3
53	Ulcerative Colitis, Crohn's and Colitis Canada	http://www.crohnsandcolitis.ca/site/c.dtJRL9NUJmL4H/b.9012449/k.C223/Ulcerative_Colitis.htm	Crohn's and Colitis, Canada	2008	19 Dec 2013	12	0	0	1
54	Ulcerative Colitis, Healthgrades	http://www.healthgrades.com/conditions/ulcerative-colitis	HealthGrades, Inc, Colorado, United States	1999	08 May 2014	4	0	0	0
55	Information for Those with Ulcerative Colitis, Colitis UK	http://www.ulcerativecolitis.org.uk/	Colitis UK, Buckinghamshire, United Kingdom	2005	20 Oct 2013	10	0	0	0
56	Colitis and Chronic Ulcerative Colitis, Virginia Mason	https://www.virginiamason.org/ColitisandChronicUlcerativeColitis	Virginia Mason Medical Center, Washington, United States	1998	07 May 2008	3	0	0	0
57	Ulcerative Colitis, GastroNet	http://www.gastro.net.au/diseases/ulcerativecolitis.html	GastroNet Australia Pty Ltd, Canberra, Australia	2009	12 May 2014	5	2	4	5
58	Ulcerative Colitis, Ulcerative Colitis Net.	http://www.ulcerativecolitis.net/	Serovera, Florida, United States	2000	28 Feb 2014	9	3	1	0
59	Inflammatory Bowel Disease, Lab Tests Online	http://labtestsonline.org/understanding/conditions/inflammatory-bowel	American Association for Clinical Chemistry (AACC), Washington, DC, United States	2001	08 Nov 2010	3	3	0	2
60	Inflammatory Bowel Disease Fact Sheet, Womenshealth.gov	http://www.womenshealth.gov/publications/our-publications/fact-sheet/inflammatory-bowel-disease.html	Womenshealth.gov, the US Department of Health and Human Services	1995	29 Nov 2014	3	0	0	3
61	Inflammatory Bowel Disease (IBD), Innerbody	http://www.innerbody.com/diseases-conditions/ibd	InnerBody, California, United States	1996	02 Oct 2012	5	2	3	4
62	Inflammatory Bowel Disease (IBD), Rightdiagnosis	http://www.rightdiagnosis.com/i/inflammatory_bowel_disease/intro.htm	Rightdiagnosis. com, United States	2005	11 Jul 2013	2	1	5	0
63	Inflammatory Bowel Disease, Lifescript.com	http://www.lifescript.com/health/centers/digestive/related_conditions/inflammatory_bowel_disease.aspx	LifeScript, California, United States	1999	05 May 2014	1	5	2	1
64	Inflammatory Bowel Disease (IBD), MUSC Health	http://www.ddc.musc.edu/public/symptomsDiseases/diseases/smallBowel/IBD.html	Digestive Disease Center, The Medical University of South Carolina, South Carolina, United States	1990	21 May 2013	1	1	1	0
65	Inflammatory Bowel Disease (IBD): Ulcerative Colitis, Crohn's Disease, New York-Presbyterian Digestive Diseases.	http://nyp.org/services/digestive/ibd.html	NewYork-Presbyterian Hospital, New York, United States	1998	24 Aug 2007	1	2	0	0
66	Inflammatory Bowel Disease, Human Diseases and Conditions Forum.	http://www.humanillnesses.com/original/Her-Kid/Inflammatory-Bowel-Disease.html	Human Diseases and Conditions Forum, United States	2006	16 Oct 2013	2	3	1	0
67	Facts About Crohn's Disease, US. Food and Drug Administration	http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107358.htm	US Food and Drug Administration, The US Department of Health and Human Services, Maryland, United States	1997	14 Oct 2014	1	3	2	1
68	Crohn's Disease Symptoms and warning Signs, SymptomFind	http://www.symptomfind.com/diseases-conditions/crohns-disease-symptoms-warning-signs/	Symptom.Find.Com. United States	2008	21 Jun 2014	3	2	1	2
69	Crohn's Disease-At a Glance, SixPartsWater.Org	http://www.sixpartswater.org/knowledge-centre/crohns-disease/glance	SixPartsWater.Org, United Kingdom	2007	02 Oct 2012	2	1	3	0
70	Ulcerative Colitis, eMedTV	http://colitis.emedtv.com/ulcerative-colitis/ulcerative-colitis.html	eMedTV, Washington, United States	2005	07 May 2014	3	0	5	2
71	Crohn's Disease, Department of Surgery, University of California.	http://colorectal.surgery.ucsf.edu/conditions--procedures/crohns-disease.aspx	Department of Surgery, University of California, California, United States	1986	10 Oct 2013	1	1	4	1
72	Crohn's Disease, the National Institute of Diabetes and Digestive and Kidney Diseases	http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/crohns-disease/Pages/facts.aspx	The National Institutes of Diabetes and Digestive and Kidney Diseases, NIDDK, Maryland, United States	2002	20 Jul 2014	1	1	2	0
73	Crohn's Disease, Patient Education Center	http://www.patienteducationcenter.org/articles/crohns-disease/	Patient Education Center, Harvard Medical School, Harvard Medical Publications, Massachusetts, United States	2003	20 Jun 2014	2	0	3	0
74	Crohn's Disease Information, alot health	http://health.alot.com/conditions/crohns-disease-information--163	Alot Health.Com, Arkansas, United States	1994	15 Aug 2014	3	1	1	1
75	Crohn's Disease, Diagnose-me.Com	http://www.diagnose-me.com/symptoms-of/crohns-disease.html	Diagnose-me.Com, Hawaii, United States	2002	21 Jan 2014	1	3	4	1
76	Crohns Disease Information: Is Colon Cleansing the Answer, Colon Cleanse Information	http://www.colon-cleanse-information.com/crohns-disease-information.html	Colon-Cleanse-Information.Com, MKR Concepts, Oregon, United States	2007	11 Nov 2014	3	0	5	0
77	Crohn's Disease or Regional Enteritis, MD India.	http://www.medindia.net/patients/patientinfo/Crohns-Disease.htm	Medindia4u.com Pvt. Ltd, Chennai, India	2000	21 Nov 2014	5	0	1	0
78	Crohn's Disease Information, Digestive Disorders	http://www.articleinsider.com/health-and-fitness/digestive-disorders/crohns-disease-information	Digestive Disorders, United States	2003	03 Sep 2014	2	1	2	1
79	Inflammatory Bowel Disease, Patient Center, American College of Gastroenterology	http://patients.gi.org/topics/inflammatory-bowel-disease/	Patient Center, American College of Gastroenterology, Maryland, United States	1996	16 May 2013	4	3	1	2
80	Crohn's Disease:Symptoms, Diagnosis and Treatment, Disabled World.Com	http://www.disabled-world.com/health/digestive/crohns-disease/	Disabled World.Com, New York, United States	2004	29 Oct 2012	1	3	4	1
81	Crohn's Disease, Nutritionist Resource	http://www.nutritionist-resource.org.uk/articles/crohns-disease.html	Nutritionist Resource, Surrey, United Kingdom	2010	9 Feb 15	3	1	3	0
82	Crohn's Disease: Symptoms, Diagnosis and Treatment, verywell.com	http://seniorhealth.about.com/cs/digestivetract/a/crohns_2.htm	Verywell.com part of about.com, Inc., United States	1999	10 Feb 14	6	0	4	0
83	Ulcerative Colitis, Halyard Surgical.	http://www.ulcerative-colitis.org/	Halyard Surgical, New South Wales, Australia	2003	7 Nov 14	2	0	6	1
84	Ulcerative Colitis Overview, Health Communities.com	http://www.healthcommunities.com/colitis/ulcerative-colitis-overview.shtml	Healthcommunities.com, New York, United States	1998	10 May 13	3	2	0	0

IBD: Inflammatory bowel disease; NHS: National Health Service; UNC: University of North Carolina.

Table 2 Summarizes websites included in the study on inflammatory bowel disease included in the study: The accuracy scores (calculated using the DISCERN score and the HONcode score) and the readability scores

No.	Website title, Organisation	URL	Accuracy scores		Readability scores
			The DISCERN Score (mean ± SD)	The HONcode score (Out of 100)*	The Flesch-Kincaid Grade Level Index	The Coleman-Liau Readability Index
1	Inflammatory Bowel Disease (IBD), Mayo Clinic	http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/definition/con-20034908	65.0 ± 1.0	0.86*	13.1 ± 0.0	15.0 ± 0.0
2	Inflammatory Bowel Disease Health Center, WebMd	http://www.webmd.com/ibd-crohns-disease/	41.3 ± 1.1	0.70*	10.5 ± 3.2	13.3 ± 2.5
3	Inflammatory Bowel Disease (IBD), Center for Disease Control and Prevention (CDC)	http://www.cdc.gov/ibd/	28.7 ± 0.6	0.90	10.9 ± 2.7	13.3 ± 0.6
4	Inflammatory Bowel Disease, NHS Choices	http://www.nhs.uk/conditions/inflammatory-bowel-disease/pages/introduction.aspx	53.7 ± 0.6	0.63	12.2 ± 1.6	12.3 ± 1.5
5	What are Crohn's and Colitis? Crohn's and Colitis Foundation	http://www.ccfa.org/what-are-crohns-and-colitis/	50.3 ± 0.6	0.81	16.2 ± 9.3	13.7 ± 0.6
6	Inflammatory Bowel Disease, KidsHealth	http://kidshealth.org/parent/medical/digestive/ibd.html	50.7 ± 0.6	0.45	12.0 ± 0.7	11.7 ± 0.6
7	Inflammatory Bowel Disease (IBD). FamilyDoctor	http://familydoctor.org/familydoctor/en/diseases-conditions/inflammatory-bowel-disease.html	45.0 ± 1.0	0.63*	9.6 ± 1.4	10.7 ± 0.6
8	Inflammatory Bowel Disease, Healthline	http://www.healthline.com/health/inflammatory-bowel-disease#Overview1	41.0 ± 1.0	0.59*	8.7 ± 0.6	11.7 ± 0.6
9	Crohn's and Colitis, Australia	https://www.crohnsandcolitis.com.au/about-crohns-colitis/inflammatory-bowel-disease/	41.7 ± 0.6	0.34	13.6 ± 3.2	13.0 ± 1.0
10	Crohn's and Colitis UK	http://www.crohnsandcolitis.org.uk/information-and-support/information-about-ibd/what-is-IBD	60.7 ± 0.6	0.45	10.4 ± 1.6	10.3 ± 3.1
11	Inflammatory Bowel Disease (IBD) (Intestinal Problems of IBD), MedicineNet	http://www.medicinenet.com/inflammatory_bowel_disease_intestinal_problems/article.htm	57.3 ± 1.5	0.75*	13.3 ± 1.5	14.3 ± 1.5
12	Inflammatory Bowel Disease Center, Cedars-Sinai	http://www.cedars-sinai.edu/Patients/Programs-and-Services/Inflammatory-Bowel-Disease-Center/	25.7 ± 1.1	0.27	13.1 ± 2.9	14.0 ± 3.6
13	Inflammatory Bowel Diseases Symptoms and Treatment: Livescience	http://www.livescience.com/39880-inflammatory-bowel-disease.html	39.3 ± 0.6	0.27	11.1 ± 1.4	11.3 ± 1.5
14	Inflammatory Bowel Diseases Program, Penn Medicine.org	http://www.pennmedicine.org/gastroenterology/patient-care/gi-diseases/inflammatory-bowel-disease-ibd/	38.0 ± 0.0	0.54	15.1 ± 2.6	13.0 ± 2.0
15	Inflammatory Bowel Diseases Support Groups, IBDsupport.org	http://www.ibdsupport.org/	52.0 ± 1.7	0.61*	12.8 ± 3.7	13.0 ± 3.6
16	Inflammatory Bowel Disease (IBD), ABC Health and wellbeing	http://www.abc.net.au/health/library/stories/2012/02/22/3435688.htm	34.0 ± 0.0	0.45	11.1 ± 0.3	11.3 ± 0.6
17	Inflammatory Bowel Disease (IBD), GIKids	http://www.gikids.org/content/7/en/IBD	31.0 ± 0.0	0.52	12.5 ± 0.3	12.7 ± 0.6
18	Inflammatory Bowel Disease, Vitamin D Council	https://www.vitamindcouncil.org/health-conditions/inflammatory-bowel-disease/	31.3 ± 1.1	0.43	11.0 ± 10.4	10.7 ± 1.5
19	Inflammatory Bowel Disease Symptoms and Diagnosis, Seattle children's	http://www.seattlechildrens.org/medical-conditions/digestive-gastrointestinal-conditions/ibd-symptoms/	37.3 ± 0.6	0.43	8.9 ± 1.0	11.0 ± 1.0
20	Crohn's Disease, Patient.co.uk	http://www.patient.co.uk/health/crohns-disease-leaflet	55.7 ± 1.5	0.59*	8.5 ± 2.0	10.0 ± 1.7
21	Patient Information Crohn's Disease (Beyond and the Basics), Uptodate	http://www.uptodate.com/contents/crohn-disease-beyond-the-basics	36.7 ± 1.1	0.70	11.2 ± 1.9	12.3 ± 0.6
22	Crohn's Disease, Centre for digestive diseases	http://www.cdd.com.au/pages/disease_info/crohns_disease.html	34.7 ± 0.6	0.52	12.0 ± 0.6	14.3 ± 1.1
23	Crohn's Disease, Patients: British Society for Gastroenterology	http://www.bsg.org.uk/patients/general/crohn-s-disease.html	49.7 ± 0.6	0.56	11.3 ± 1.7	10.7 ± 1.1
24	Crohn's Disease, Bupa	http://www.bupa.co.uk/health-information/directory/c/crohns-disease	52.0 ± 0.0	0.77*	8.2 ± 0.5	9.0 ± 1.7
25	Crohn's Disease, University of Maryland Medical Center	http://umm.edu/health/medical/reports/articles/crohns-disease	64.7 ± 1.5	0.81	15.3 ± 4.8	15.0 ± 1.0
26	Crohn's Disease, Symptoms, Diagnosis, Treatment, Southern Cross	https://www.southerncross.co.nz/AboutTheGroup/HealthResources/MedicalLibrary/tabid/178/vw/1/ItemID/523/Crohns-disease-symptoms-diagnosis-treatment.aspx	42.7 ± 0.6	0.40	13.8 ± 0.3	13.7 ± 0.6
27	Crohn's Disease, American family physician	http://www.aafp.org/afp/2011/1215/p1379.html	42.3 ± 1.1	0.18	9.0 ± 2.9	12.3 ± 4.2
28	What is Crohn's Disease? What Causes Crohn's Disease? MNT	http://www.medicalnewstoday.com/articles/151620.php	45.7 ± 1.5	0.50*	11.2 ± 2.1	10.7 ± 1.5
29	Crohn's Disease, Netdoctor	http://www.netdoctor.co.uk/diseases/facts/crohnsdisease.htm	43.0 ± 0.0	0.59	10.0 ± 1.6	12.3 ± 1.5
30	Crohn's Disease, UCSF medical center	http://www.ucsfhealth.org/conditions/crohns_disease/	41.0 ± 1.0	0.40	11.4 ± 0.5	11.3 ± 0.6
31	Crohn's Disease Symptoms and Treatment, US.news Wellness	http://health.usnews.com/health-news/health-wellness/articles/2013/08/03/crohns-disease-symptoms-and-treatment	48.3 ± 0.6	0.50	6.7 ± 0.8	12.3 ± 2.5
32	What are the treatments for Crohn's disease? Beth Israel Deaconess Medical Center	http://www.bidmc.org/Centers-and-Departments/Departments/Digestive-Disease-Center/Inflammatory-Bowel-Disease-Program/Crohns-Disease/What-are-the-treatments-for-Crohns-disease.aspx	41.7 ± 1.5	0.59	14.3 ± 2.2	14.3 ± 1.1
33	Diagnosing Crohn's, Crohn's and Me.	http://www.crohnsandme.com/crohns-information/crohns-disease-diagnosis.aspx	43.3 ± 1.1	0.27	13.6 ± 1.1	12.7 ± 2.5
34	Understanding Crohn's Disease, Crohn' and Colitis.	http://www.crohnsandcolitisinfo.com/Crohns/What-is-Crohns-Disease	41.7 ± 0.6	0.45	12.4 ± 2.0	12.0 ± 2.6
35	Learning About Crohn's Disease, National Human Genome Research Institute	http://www.genome.gov/25521854	29.0 ± 0.0	0.40	10.8 ± 0.5	12.3 ± 1.5
36	Crohn's Disease, UPMC Life Changing Medicine	http://www.upmc.com/services/digestive-disorders-center/services/ibd/conditions/pages/crohns-disease.aspx	44.3 ± 0.6	0.27	20.3 ± 9.5	15.0 ± 2.0
37	Crohn's Disease, Cincinnati Children's	http://www.cincinnatichildrens.org/health/c/crohns/	44.7 ± 0.6	0.40	9.3 ± 1.1	10.7 ± 0.6
38	Crohn's Disease, Cleveland clinic	http://my.clevelandclinic.org/health/diseases_conditions/hic_Inflammatory_Bowel_Disease_IBD_QandA/hic_Crohns_Disease	26.3 ± 1.1	0.50*	12.9 ± 1.2	12.3 ± 2.3
39	Treatment of Crohn's Disease, UNC Multidisciplinary Center for IBD Research and Treatment	http://www.med.unc.edu/gi/specialties/ibd/about-ibd/treatment-of-ibd-1/treatment-of-crohns-disease	42.3 ± 0.6	0.45	12.3 ± 0.5	13.3 ± 0.6
40	Crohn's Disease, Emedicine health	http://www.emedicinehealth.com/crohn_disease/article_em.htm	59.3 ± 1.2	0.86*	13.0 ± 1.2	13.0 ± 1.7
41	Understanding Crohn's Disease and Ulcerative Colitis. Australian Gastroenterology Institute.	http://www.nevdgp.org.au/info/gastro/crohns.htm	42.3 ± 1.1	0.27	10.4 ± 0.7	11.3 ± 0.6
42	Crohn's Disease, Health Centers	http://www.drweil.com/drw/u/ART00339/Crohns-Disease.html	37.0 ± 0.0	0.50	11.9 ± 1.1	12.7 ± 1.5
43	Crohn's Disease- An Overview, the Royal Children's Hospital Melbourne	http://www.rch.org.au/kidsinfo/fact_sheets/Crohns_Disease_an_overview/	33.7 ± 1.1	0.50	7.7 ± 2.0	11.3 ± 1.5
44	Fighting Inflammatory Bowel Disease Together, the Irish Society for Colitis and Crohn's Disease	http://www.iscc.ie/page.php?id=18&title=What%20is%20IBD	37.7 ± 0.6	0.40	11.6 ± 1.4	10.7 ± 0.6
45	Crohn's Disease Diagnosis, New health guide	http://www.newhealthguide.org/Crohn%27s-Disease-Diagnosis.html	18.3 ± 0.6	0.65	13.5 ± 0.7	13.7 ± 1.1
46	Crohn's Disease, HealthDay.	http://consumer.healthday.com/encyclopedia/digestive-health-14/digestion-health-news-200/crohn-s-disease-644392.html	61.0 ± 1.0	0.86*	10.9 ± 1.4	12.0 ± 0.0
47	Ulcerative Colitis, Wikipedia	http://en.wikipedia.org/wiki/Ulcerative_colitis	54.0 ± 0.0	0.63	15.2 ± 2.1	14.0 ± 2.6
48	Living with UC, Do You Know Your Treatment Options?	http://www.livingwithuc.ca/	44.3 ± 1.1	0.68	12.2 ± 1.6	11.3 ± 2.3
49	What Is Ulcerative Colitis? Everyday Health	http://www.everydayhealth.com/conditions/ulcerative-colitis	40.0 ± 0.0	0.54*	14.1 ± 0.7	13.0 ± 1.0
50	What Is Ulcerative Colitis? News Medical	http://www.news-medical.net/health/What-is-Ulcerative-Colitis.aspx	46.0 ± 1.0	0.59	11.9 ± 0.2	13.0 ± 1.0
51	Crohn's Disease and Ulcerative Colitis, Better Health Channel	http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Crohn%27s_disease_and_ulcerative_colitis	34.3 ± 1.1	0.31	9.8 ± 2.4	11.3 ± 1.5
52	Ulcerative Colitis, Jackson Siegelbaum Gastroenterology	http://gicare.com/diseases/ulcerative-colitis/	52.3 ± 0.6	0.36	10.6 ± 1.4	11.7 ± 2.1
53	Ulcerative Colitis, Crohn's and Colitis Canada	http://www.crohnsandcolitis.ca/site/c.dtJRL9NUJmL4H/b.9012449/k.C223/Ulcerative_Colitis.htm	19.7 ± 0.6	0.31	9.2 ± 1.8	10.0 ± 1.0
54	Ulcerative Colitis, Healthgrades	http://www.healthgrades.com/conditions/ulcerative-colitis	52.7 ± 1.1	0.68	14.5 ± 3.5	14.0 ± 1.0
55	Information for Those with Ulcerative Colitis, Colitis UK	http://www.ulcerativecolitis.org.uk/	49.0 ± 1.7	0.45	14.5 ± 2.0	11.7 ± 1.1
56	Colitis and Chronic Ulcerative Colitis, Virginia Mason	https://www.virginiamason.org/ColitisandChronicUlcerativeColitis	40.7 ± 0.6	0.31	16.7 ± 3.9	15.0 ± 2.0
57	Ulcerative Colitis, GastroNet	http://www.gastro.net.au/diseases/ulcerativecolitis.html	26.7 ± 0.6	0.60	13.1 ± 1.1	13.3 ± 2.3
58	Ulcerative Colitis, Ulcerative Colitis Net.	http://www.ulcerativecolitis.net/	41.3 ± 0.6	0.30	11.4 ± 3.3	12.0 ± 2.0
59	Inflammatory Bowel Disease, Lab Tests Online	http://labtestsonline.org/understanding/conditions/inflammatory-bowel	38.3 ± 0.6	0.32*	13.0 ± 0.7	12.0 ± 1.0
60	Inflammatory Bowel Disease Fact Sheet, Womenshealth.gov	http://www.womenshealth.gov/publications/our-publications/fact-sheet/inflammatory-bowel-disease.html	55.7 ± 1.5	0.40	8.8 ± 0.7	10.0 ± 1.0
61	Inflammatory Bowel Disease (IBD), Innerbody	http://www.innerbody.com/diseases-conditions/ibd	39.0 ± 1.0	0.25	17.2 ± 5.7	16.7 ± 1.5
62	Inflammatory Bowel Disease (IBD), Rightdiagnosis	http://www.rightdiagnosis.com/i/inflammatory_bowel_disease/intro.htm	38.0 ± 1.0	0.33	15.9 ± 4.1	15.7 ± 2.1
63	Inflammatory Bowel Disease, Lifescript.com	http://www.lifescript.com/health/centers/digestive/related_conditions/inflammatory_bowel_disease.aspx	32.0 ± 1.0	0.50	15.1 ± 2.8	12.7 ± 1.5
64	Inflammatory Bowel Disease (IBD), MUSC Health	http://www.ddc.musc.edu/public/symptomsDiseases/diseases/smallBowel/IBD.html	22.7 ± 1.1	0.27	14.2 ± 2.2	15.7 ± 2.9
65	Inflammatory Bowel Disease (IBD): Ulcerative Colitis, Crohn's Disease, New York-Presbyterian Digestive Diseases	http://nyp.org/services/digestive/ibd.html	32.3 ± 0.6	0.27	13.2 ± 0.5	12.7 ± 0.6
66	Inflammatory Bowel Disease, Human Diseases and Conditions Forum.	http://www.humanillnesses.com/original/Her-Kid/Inflammatory-Bowel-Disease.html	35.3 ± 1.5	0.14	10.7 ± 0.9	13.3 ± 2.3
67	Facts About Crohn's Disease, US. Food and Drug Administration	http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107358.htm	34.7 ± 2.1	0.36	10.6 ± 2.6	13.7 ± 2.1
68	Crohn's Disease Symptoms and warning Signs, SymptomFind	http://www.symptomfind.com/diseases-conditions/crohns-disease-symptoms-warning-signs/	26.0 ± 1.0	0.26*	10.0 ± 1.9	13.7 ± 2.3
69	Crohn's Disease-At a Glance, SixPartsWater.Org	http://www.sixpartswater.org/knowledge-centre/crohns-disease/glance	39.7 ± 0.6	0.15	18.3 ± 3.4	12.7 ± 0.6
70	Ulcerative Colitis, eMedTV	http://colitis.emedtv.com/ulcerative-colitis/ulcerative-colitis.html	55.3 ± 0.6	0.32*	12.1 ± 0.8	11.0 ± 2.0
71	Crohn's Disease, Department of Surgery, University of California.	http://colorectal.surgery.ucsf.edu/conditions--procedures/ulcerative-colitis.aspx	51.0 ± 1.0	0.73	12.4 ± 0.8	12.3 ± 2.5
72	Crohn's Disease, the National Institute of Diabetes and Digestive and Kidney Diseases	http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/crohns-disease/Pages/facts.aspx	68.3 ± 1.2	0.95	13.6 ± 3.9	13.7 ± 5.5
73	Crohn's Disease, Patient Education Center	http://www.patienteducationcenter.org/articles/crohns-disease/	38.0 ± 1.0	0.30	8.9 ± 0.8	12.3 ± 1.5
74	Crohn's Disease Information, alot health	http://health.alot.com/conditions/crohns-disease-information--163	32.3 ± 0.6	0.22	10.4 ± 1.5	12.0 ± 2.6
75	Crohn's Disease, Diagnose-me.Com	http://www.diagnose-me.com/symptoms-of/crohns-disease.html	32.0 ± 1.0	0.28	12.5 ± 1.6	14.3 ± 1.1
76	Crohns Disease Information: Is Colon Cleansing the Answer, Colon Cleanse Information	http://www.colon-cleanse-information.com/crohns-disease-information.html	35.7 ± 2.5	0.36	13.2 ± 0.5	14.7 ± 1.5
77	Crohn's Disease or Regional Enteritis, MD India.	http://www.medindia.net/patients/patientinfo/Crohns-Disease.htm	46.3 ± 1.1	0.54	11.8 ± 1.3	14.0 ± 2.6
78	Crohn's Disease Information, Digestive Disorders	http://www.articleinsider.com/health-and-fitness/digestive-disorders/crohns-disease-information	33.3 ± 0.6	0.60	10.2 ± 0.6	12.3 ± 0.6
79	Inflammatory Bowel Disease, Patient Center, American College of Gastroenterology	http://patients.gi.org/topics/inflammatory-bowel-disease/	58.3 ± 1.2	0.80	12.7 ± 1.3	13.0 ± 1.0
80	Crohn's Disease:Symptoms, Diagnosis and Treatment, Disabled World.Com	http://www.disabled-world.com/health/digestive/crohns-disease/	26.3 ± 2.3	0.19	8.6 ± 0.6	12.00 ± 1.73
81	Crohn's Disease, Nutritionist Resource	http://www.nutritionist-resource.org.uk/articles/crohns-disease.html	39.3 ± 0.6	0.57	10.2 ± 2.6	11.3 ± 1.1
82	Crohn's Disease: Symptoms, Diagnosis and Treatment, verywell.com	http://seniorhealth.about.com/cs/digestivetract/a/crohns_2.htm	44.3 ± 1.5	0.37	12.6 ± 0.7	11.0 ± 1.0
83	Ulcerative Colitis, Halyard Surgical.	http://www.ulcerative-colitis.org/	51.7 ± 1.5	0.25	12.1 ± 0.6	12.7 ± 2.5
84	Ulcerative Colitis Overview, Health Communities.com	http://www.healthcommunities.com/colitis/ulcerative-colitis-overview.shtml	52.7 ± 1.5	0.23*	12.6 ± 1.2	12.7 ± 1.1

^*Websites that received HONCode certificates. IBD: Inflammatory bowel disease; NHS: National Health Service; UNC: University of North Carolina.

Table 3 Grouping the websites on inflammatory bowel disease included in the study under five categories

Category	Number	DISCERN score		HONcode score
		mean ± SD6	95%CI for means	mean ± SD7	95%CI for means
Universities and Research Centers1	25	41.3 ± 11.3	36.6-45.9	0.46 ± 0.20	0.37-0.54
Foundations and Associations2	15	44.5 ± 10.5	38.6-50.2	0.53 ± 0.16	0.44-0.62
Commercial and Pharmaceutical Companies3	25	40.4 ± 10.1	36.3-44.6	0.44 ± 0.18	0.36-0.52
Charities and Volunteer work4	9	40.2 ± 11.9	31.0-49.4	0.39 ± 0.17	0.26-0.52
Non-university Educational Bodies5	10	46.7 ± 9.7	39.7-53-6	0.63 ± 0.20	0.48-0.76
Total	84	42.1 ± 10.7	39.8-44.5	0.48 ± 0.19	0.44-0.52

¹This category includes university-affiliated centers, state hospitals, national or state research centers;

²This category includes gastroenterological societies, foundations, and associations- most were on inflammatory bowel disease, Crohn's disease or ulcerative colitis;

³This category includes industrial bodies, commercial and pharmaceutical companies aiming at serving the community and patients with inflammatory bowel disease;

⁴This category includes charities and websites created by individuals, or groups;

⁵This category includes all other non-university educational bodies including colleges, academies, councils, WebMed, etc.;

⁶The DISCERN scores were not significantly different between the groups as per ANOVA (combined, P = 0.472) or (linear term, P = 0.475);

⁷The HONcode scores were significantly different between the groups as per ANOVA (combined, P = 0.041). The linear term, P = 0.228.

Table 4 Examples of assessment of the content of some websites on inflammatory bowel disease

Website Number	Title	Areas of deficiencies	Suggestions for improvement
45	Crohn's Disease Diagnosis, New health guide	Symptoms of Crohn's disease are briefly mentioned. Some details are needed to explain the common presenting symptoms. No mention of differential diagnosis. No mention of investigations needed to confirm the diagnosis. Nothing is mentioned about treatment of Crohn's disease.	Symptoms may include abdominal pain, typically in the right lower quadrant, diarrhoea, some blood may be present in stools, fatigue. In more severe disease fever, and weight loss may be present. Some patients may have nausea, and abdominal distention together with abdominal pain. It is worth to mention that Crohn's disease is a lifelong illness (chronic disease). People who have Crohn's will experience periods of flare-ups, when their symptoms are active, and other times when their symptoms go into remission. Up to 30% of patients may have changes in the area around the anus including anal fistulas (internal tracts connecting the anal lumen with the skin around the anus), abscess, skin tags, and anal fissures. About 10%-20% of patients also have joint pains, lower back pain, skin rash known as erythema nodosum, and eye changes. (images showing some of these changes will enhance this part). A section discussing investigations should be added. In addition to detailed medical history, the treating doctor will initiate the evaluation by testing for infectious conditions that can cause inflammation of the colon, screen for endocrine-metabolic disorders such as excessive activity of the thyroid gland. Therefore biochemical tests and stool tests are needed. Endoscopic evaluation (colonoscopy) should be carried out in patients who have symptoms suggestive of inflammatory bowel disease and no evidence for an infection to explain symptoms. Small bowel images, computed tomography (CT) enterography may also be needed. Nutritional changes, medical and surgical treatment should be briefly discussed.
53	Ulcerative Colitis, Crohn's and Colitis Canada	Symptoms are briefly stated. No mention of differential diagnosis, investigations and no discussion of medical and surgical treatment.
64	Inflammatory Bowel Disease (IBD), MUSC Health	Symptoms of inflammatory bowel disease are not clearly written. One would wonder, are "bowel sores" and "intestinal bleeding" symptoms? Differential diagnosis is not mentioned. The approach for diagnosing inflammatory bowel disease is not mentioned and the treatment of IBD is not explained.	As discussed earlier.
68	Crohn's Disease Symptoms and Warning Signs, SymptomsFind	Although symptoms of Crohn's disease are mentioned briefly, they are not explained. Mild, moderate and severe inflammatory bowel disease are stated but not explained. This should be explained in a simple language. Complications are mentioned but there was no mention how the disease is diagnosed, and what investigations are needed. Nothing is mentioned about nutritional changes, medical and surgical treatment of inflammatory bowel disease.	Patients are described to have mild ulcerative colitis when they have: -Fewer than four bowel motions (stools) per day. -No bleeding or small amounts of bleeding in their stools. -Normal erythrocyte sedimentation rate (ESR) -No fever, no anaemia and no increases in their heart rate, Patients are described to have moderate ulcerative colitis when they have: -More than four stools per day. -Mild elevation in ESR. Patients are described to have severe ulcerative colitis when they have: -More than six stools a day (loose stools). -Fever, rapid heartbeat, and anaemia. -Elevated ESR. The website may also mention changes that necessitate hospital admission and medical attention. Websites may provide key questions that patients may use when they review their treating doctors. Examples of these questions: •I wonder what's causing these symptoms? •What type of tests do I need? Do these tests require any special preparation? •What treatments are available, and which do you recommend? •Are there any medications that I should avoid? •Do I need to follow any dietary restrictions? •Are there any risks if I become pregnant? The MayoClinic website has listed a number of useful questions that patients can use.
12	Inflammatory Bowel Disease Center, cedars-Sinai.	Under symptoms of Crohn's disease, it is written, "The most common signs are pain in the stomach area (usually on the right side) and diarrhea", it is not clear what is meant by pain in the stomach area on the right side? Complications are provided but no signs are stated. No mention of differential diagnosis, no mention of investigations and possible findings. Nutritional changes, medical and surgical treatment are not explained.	The authors should differentiate between symptoms and signs. Scientific errors are noted in the website and common presenting symptoms should be stated. It may be useful to explain the symptoms under two main headings: symptoms in children, and symptoms in adults. Investigations needed to diagnose the disease should be discussed. Patients are usually interested to know more detail about these investigations. Information provided should answer questions such as -Name of the test -Why the test is need? -What is the test about? -Nature of the investigation (invasive vs non-invasive) -Are there special preparations needed prior to the test? -Any possible complications related to the investigation? -What can the results of the test tell the patient and the treating doctor? It is also important to state that IBD is an ongoing condition (chronic disease), so some of the tests may need to be repeated from time to time, or extra tests may be needed. These investigations may include: (1) Blood tests including full blood count, inflammatory markers tests including erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), liver function tests, urea and electrolytes, and other biochemical tests, (2) stool tests including stool microscopy, stool culture and sensitivity, fecal markers such as fecal calprotectin, fecal lactoferrin, (3) Endoscopy including colonoscopy, sigmoidoscopy, proctoscopy, with biopsies for histological studies (4) radiological studies such as barium studies, CT scans, MRI scans and PET scans.

Table 5 Summarizes the inter-rater agreement between evaluators calculated using Cohen kappa coefficient scores

DISCERN items	Mean score (95%CI of the difference)			Reviewer variability (κrange)
	Evaluator 1	Evaluator 2	Evaluator3
1. Are the aims clear?	1.7 (1.5-2.0)	1.7 (1.5-2.0)	1.8 (1.5-2.0)	0.885-0.953
2. Does it achieve its aims?	1.4 (0.9-1.8)	1.5 (1.0-1.9)	1.5 (1.0-1.9)	0.790-0.904
3. Is it relevant?	3.8 (3.6-4.0)	3.8 (3.6-4.0)	3.8 (3.6-4.0)	0.792-0.887
4. Is it clear what sources of information were used to compile the publication (other than the author or producer)?	2.5 (2.2-2.9)	2.5 (2.2-2.8)	2.5 (2.2-2.8)	0.879-0.880
5. Is it clear when the information used or reported in the publication was produced?	2.7 (2.4-3.1)	2.7 (2.3-3.0)	2.7 (2.3-3.0)	0.793-0.875
6. Is it balanced and unbiased?	3.7 (3.5-4.0)	3.8 (3.6-4.0)	3.7 (3.5-3.9)	0.796-0.890
7. Does it provide details of additional sources of support and information?	2.2 (1.9-2.5)	2.2 (1.9-2.5)	2.2 (1.9-2.5)	0.792-0.827
8. Does it refer to areas of uncertainty?	3.2 (3.0-3.4)	3.1 (3.0-3.3)	3.2 (3.0-3.3)	0.764-0.832
9. Does it describe how each treatment works?	3.1 (2.8-3.4)	3.1 (2.8-3.4)	3.1 (2.8-3.4)	0.859-0.874
10. Does it describe the benefits of each treatment?	2.4 (2.2-2.7)	2.4 (2.2-2.7)	2.5 (2.2-2.8)	0.782-0.841
11. Does it describe the risks of each treatment?	2.3 (2.0-2.6)	2.3 (2.0-2.6)	2.3 (2.0-2.7)	0.772-0.902
12. Does it describe what would happen if no treatment is used?	1.5 (1.3-1.7)	1.5 (1.3-1.7)	1.5 (1.3-1.8)	0.870-0.923
13. Does it describe how the treatment choices affect overall quality of life?	2.0 (1.8-2.2)	2.0 (1.8-2.2)	2.1 (1.9-2.3)	0.859-0.906
14. Is it clear that there may be more than one possible treatment choice?	3.6 (3.4-3.9)	3.6 (3.4-3.9)	3.6 (3.4-3.8)	0.773-0.849
15. Does it provide support for shared decision-making?	2.7 (2.4-2.9)	2.8 (2.6-3.0)	2.8 (2.5-3.0)	0.767-0.854
16. Based on the answers to all of the above questions, rate the overall quality of the publication as a source of information about treatment choices?	2.9 (2.7-3.2)	3.0 (2.7-3.2)	2.9 (2.6-3.2)	0.900-0.959