JMIR Publications

ABSTRACT

Background:

The Internet has revolutionized the visibility and accessibility of data. Over half of today’s world population used the Internet in 2021. Searching the Internet for web-based health information (WBHI) was the third most frequent Internet activity, and 6.75 million searches are done daily for health information. Often, WBHI are considered a “first aid” resource for health information, and WBHI is used to compare diagnoses and/or treatment options or to supplement insufficient time with a healthcare provider. More seriously, some patients believe that WBHI are trustworthy and might defer or replace medical consultation or treatment from healthcare providers. As such, ensuring the availability, accessibility, and quality of WBHI is essential for the well-being of individuals and populations. The format and quality of WBHI vary substantially. The format ranges from health blogs/forums based on personal experiences offering unregulated information to peer-reviewed journal articles that provide complex data addressed to medical professionals. Therefore, the quality of WBHI could vary considerably between the resources of WBHI. Some global research indicates that the quality of some WBHI targeting the public could be of low-quality. Evidence that examined Arabic WBHI often found that a considerable proportion of the WBHI had low quality. The evaluation of context-specific WBHI (i.e., language) emerges as a public health priority that might address some health literacy inequality. Oral lichen planus (OLP) is a prevalent chronic inflammatory mucocutaneous disease that frequently affects the oral mucosa. Between 0.5-2% of the world's population is affected by OLP. In a review of studies conducted in Arab countries, OLP had a potential malignant transformation rate ranging from 0.4% to 6.5%. Although there is no gold standard measure of the quality of WBHI, some international tools like JAMA benchmarks and Health On the Net (HON) are frequently utilized to examine the WBHI in different languages. Literature that evaluated the English content of WBHI regarding OLP, using the aforementioned tools, reported moderate accuracy and reliability. A comprehensive evaluation of 122 Arabic health websites revealed that these websites varied substantially in meeting some of the industry benchmarks, like the HON code. Though accessing high-quality WBHI can effectively increase the public’s knowledge, support health-related decision-making, and improve health-seeking behaviors and/or outcomes no studies focused on evaluating OLP-related WBHI in Arabic. As such, the need arises to scrutinize the content and accuracy of Arabic WBHI related to OLP accessible to the public.

Objective:

To explore and assess the quality of the Web-Based Health Information (WBHI) available and accessible to the public on Oral Lichen Planus (OLP) in Arabic language.

Methods:

The Arabic translation of the term OLP and its derivatives were searched in three general search platforms, and each platform's first few hundred results were reviewed for inclusion. We excluded content related to cutaneous LP, content not readily accessible to the public (e.g., requiring subscription fees, directed to healthcare providers), and content not created by healthcare providers or organizations (i.e., community forums, blogs, and social media). We assessed the quality of the Arabic WBHI with three standardized and validated tools: DISCERN, JAMA benchmarks, and Health on the Net (HON).

Results:

Out of 911 resources of WBHI reviewed for eligibility, 49 were included in this study. Most WBHI resources were provided by commercial affiliations (57.1%), with the remainder coming from academic or not-for-profit affiliations. WBHI were often presented with visual aids (i.e., images) (66%). DISCERN scores were highest for explicitly stating the aims of the WBHI resource, while the lowest scores were for providing the effect of OLP (or OLP treatment) on the quality of life. Less than one-quarter of the resources (22.4%) met all four JAMA benchmarks, indicating high quality of the WBHI, while the remainder WBHI failed to meet one or more of JAMA benchmarks. HON scores showed that one-third of WBHI sources had scores above 75% indicating higher reliability and credibility of the source, while one-fifth of the sources scored below 50%. Only one in every seven WBHI resources scored high on all the 3 quality instruments simultaneously. Generally, WBHI from academic affiliation had higher scores quality instruments compared to content provided by commercial affiliations.

Conclusions:

There are considerable variations in the quality of WBHI on OLP in Arabic language. Most WBHI were deemed to be of moderate quality at best. Providers of WBHI could benefit from integrating guidance from international quality assessment tools to improve the quality and, hopefully, the utility of these valuable WBHI resources.