A systematic critique of diabetes on the world wide web for patients and their physicians.

Purpose: The web, a widely accessed medium for patients to obtain health information, has special relevance for patients with diabetes. This paper critiques the publicly available web sites for diabetes, and it establishes criteria for excellence in these sites.

Methods: A web search for diabetes mellitus based on Google, Yahoo, and the directory Mendosa provided the basis for the study. We defined and evaluated three major categories for each site: usability, content, and reliability. Usability was defined by design, ease of navigation, interactivity, and internal search capability. Content was based on the quality of general information about diabetes, discussions about monitoring blood glucose, meal planning, exercise, complications, medications, alternative therapies, resources, and support systems. Reliability was defined by the presence of the HON code, identification of an author, and the availability of experts.

Results: The focused Mendosa search produced 47 web sites. The majority were published by commercial organizations. Five sites were found to have the best usability. Other sites were cluttered or inundated with distracting information from advertisements. Content was generally excellent but limited by an absence of specific advice and information about controlling associated risk factors for cardiovascular disease. Only 17% of sites met all criteria for reliability. The sites that best met the criteria for quality were the American Diabetes Association (www.diabetes.org) and the Joslin Diabetes Center (www.joslin.org).

Conclusions: Despite the large numbers of publicly available web sites for diabetes, only a few met criteria for quality. The physician's input and ongoing evaluation of these quality measures are essential to assure that patients get meaningful and relevant information from the web about managing diabetes.