Mapping the quality of information on osteoporosis: A cross-sectional analysis of online health information

Background Osteoporosis is a complex disease with multiple causes and treatments, making access to accurate online health information (OHI) critical for informed decision-making amid rising digitization and misinformation. This study aimed to evaluate whether current OHI on osteoporosis meets the criteria for evidence-based health information (EBHI) to support informed decisions. Methods We conducted a descriptive cross-sectional study to evaluate the quality of OHI in German and English. Google searches were independently screened by two reviewers. Websites were included if they targeted laypeople, offered decision-making options, and were presented in a coherent way. Quality was assessed using the validated “Mapping the Quality of Health Information” (MAPPinfo) checklist. A subset was independently assessed by two raters to ensure interrater agreement, with the remaining assessments conducted individually. Data analysis included the calculation of mean scores (0 - 100%), which represent the fulfilment of the EBHI criteria. Results 146 websites met the inclusion criteria (81 German, 65 English) and came from various sources, including pharmaceutical companies (30%), hospitals (35%), government agencies (16%), specialist organisations (10 %), non-profit organisations (8%), patient organisations (4%), health insurances (3 %), and other providers (4 %). Websites covered OHI on diagnostics (n = 120), treatment (n = 136), prevention (n = 102), and rehabilitation (n = 1), with 92% addressing multiple areas. Overall quality was unsatisfactory, with diagnostics, treatment and prevention scoring means (SD) of 15.3% (5.2), 16.7% (5.7), and 17.4% (5.6), respectively. Conclusions Current OHI on osteoporosis often fails to meet basic standards of EBHI, highlighting the urgent need to improve the quality to support informed decision-making. As the use of OHI increases, ensuring that these resources are reliable and evidence-based is critical to improving patient outcomes. Clinical trial number: not applicable