Introduction: The internet is used frequently to acquire information about pediatric neurosurgical conditions. The sources, nature, accuracy, and usefulness of this information have not been examined recently. The results from Google and Bing searches of 10 common pediatric neurosurgical terms were analyzed using a relevant scoring system.

Methods: Google and Bing searches were performed for 10 common pediatric neurosurgical topics (spina bifida, concussion, hydrocephalus, pediatric Chiari malformation, pediatric brain tumor, plagiocephaly, craniosynostosis, tethered spinal cord, pediatric neurosurgery, and pediatric epilepsy surgery). The first 10 "hits" in both search engines were analyzed using the Currency, Relevancy, Authority, Accuracy, and Purpose [CRAAP] Tool, which assigns a numerical score in each of 5 domains: currency, relevance, authority, accuracy, and purpose. Agreement between results was assessed between Google and Bing, Google and Google over time (6 months apart), and using privacy settings in both native browsers. Readability was assessed with an online analytical tool (readable.io).

Results: The majority of Google and Bing searches yielded information with good CRAAP scores (mean 71% and 75%, respectively), with good concordance (58%) between search engines. There was high agreement (72%) over time and very high agreement with privacy settings (92%). Government sources scored the best in both CRAAP score and readability. Hospitals and universities were the most prevalent sources. A high correlation in inter-rater reliability for CRAAP scoring was also observed.

Conclusions: Overall, Google and Bing searches yielded similar, with generally relevant and accurate information; however, depth and breadth of information was highly variable. Pediatric neurosurgery practices and neurosurgical professional organization websites, were inferior to governmental and encyclopedic- type resources such as Wikipedia. This presents an opportunity for pediatric neurosurgeons to participate in the creation of better online patient/parent educational material.

Patient Care: This assessment of the currently available patient-parent educational material reveals the present "go-to" resources and identifies significant opportunities for neurosurgeons to improve the quality of online material.

Learning Objectives: 1. Understand the sources and usefulfulness of pediatric neurosurgery patient-parent information currently available on the internet via Google and Bing searches. 2. Identify opporunities for improving the available patient-parent educational information acquired via internet searches.

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