Introduction: Increasingly, patients and their families turn to the internet to learn more about their diagnosis and potential treatment. This study seeks to provide simple criteria for critically evaluating internet resources, allowing a physician to understand what their patients see when they use the internet.

Methods: A general assessment criteria was established and the top ten web sites (by Google page rank) were assessed for the five most common operative diagnoses in neurosurgery. Assessment includes Accuracy (factual correctness and appropriate context), Readability, Usability (ability to retrieve information) and Accessibility. Procedures studied included lumbar disc herniation, cervical disc herniation, glioma, meningioma, and lumbar stenosis.

Results: The majority of top sites were not peer-reviewed. For spine diagnoses, the majority of sites had a commercial bias manifest as decreased Accuracy scores due to context, second most-common were sites with academic affiliation, and third most common were general information sites (such as Wikipedia). For cranial diagnoses, most commonly sites had an academic affiliation or were general information sites. Overall assessment varied by diagnosis.

Conclusions: A general assessment criteria of web-based resources is useful to evaluate educational material encountered by patients and their families. Commercial bias increases accessibility and decreases accuracy, which is more common in spine diagnoses

Patient Care: Improve communication between patient and provider. The provider will also have a systematic approach to assessing web-based content.

Learning Objectives: 1. Learn an efficient way to evaluate web-based resources 2. Understand the information encountered by patients and families outside of the medical environment

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