Don't believe everything you read on the net about vertebroplasty

Most websites with information on vertebroplasty – a procedure in which a special medical-grade cement mixture is injected into a fractured vertebra – do not paint the full picture about the pros, cons and alternatives of the treatment. Therefore patients should always sit down with their physicians to thoroughly discuss their options, rather than take everything they read on the Internet as the full gospel. This new information appears in a new study by Barrett Sullivan of Case Western Reserve University in the US, who looked into the quality and accuracy of information available on the internet about vertebroplasty. The findings appear in Springer's journal Clinical Orthopaedics and Related Research.

Sullivan and his colleagues studied the contents of 105 websites that all carry information about vertobroplasty, one of two approved minimally invasive cement augmentation procedures used to relieve pain caused by osteoporosis-related vertebrate compression fractures. The sites were evaluated as "excellent", "high", "moderate", "low" or "unacceptable." These ratings were based on the source of each site's authorship or sponsorship, its content, the references cited, the contact detail provided to set up an appointment and their certification status.

Only seven percent of the sites received an "excellent" recommendation from the researchers based on the quality and accuracy of the information they provided. A further six percent received a "high quality" rating and 11 percent of sites were of "moderate quality." What causes alarm is that 57 percent of all sites were deemed as carrying "unacceptable" information.

In general, the websites were more likely to highlight indications and benefits of than to discuss contraindications or risks of the procedure. All 105 sites highlighted the procedure's benefits, while only 53 percent outlined any risks. In all, 74 percent of the sites referenced appropriate indications, with only 45 percent discussing any contraindication. Only 51 percent of the sites mentioned alternative treatments. When it came to the sources on which the information is based, only 27 percent of sites cited peer-reviewed literature. Forty-one percent offered experiential or non-cited data based on American populations, while seven percent also included data from international populations.

"The information available on the Internet clearly is not an acceptable substitute for the physician-patient relationship, with a majority of sites presenting information that we believe is of unacceptable quality for patient education," adds Sullivan. "Appropriate discussion of a patient's understanding of a procedure is critical, and physicians should make efforts to inquire about internet research, taking time to counsel patients regarding the limitations of Internet ."

More information: Sullivan, T.B. et al (2014). Can Internet Information on Vertebroplasty be a Reliable Means of Patient Self-education? Clinical Orthopaedics and Related Research. DOI: 10.1007/s11999-013-3425-5

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