Background: The quality of online health-related information may affect users’ understanding and medical decision-making with dramatic impact, particularly in case of stroke. Objective: The objective of this study was to assess the quality of information about stroke on the Romanian and Hungarian websites in terms of completeness and accuracy. Methods: The research was designed as an observational cross-sectional study. The sample included 25 Romanian and 25 Hungarian websites presenting information about stroke for the general public. General characteristics such as website ownership, main goal, website genre and medical approach were identified by the evaluators using a predetermined set of common instructions. The completeness and accuracy of the information were assessed by two independent assessors against a quality benchmark. Results: Overall, most of the websites were owned by private commercial companies (42%), had educational goal (66%), were designed as medical web-portals (46%) and had a conventional medicine approach (72%). Mean completeness score was 5.6 points (SD± 1.9) for Romanian sites and 4.1 points (SD ± 2.4) for Hungarian sites (p = 0.017). Mean accuracy score was 6.2 points (SD ± 1.1) for Romanian sites and 7.0 points (SD ± 0.7) for Hungarian sites (p = 0.02). Conclusions: The information about stroke on the Romanian and Hungarian websites had poor quality. Although we found statistically significant differences between the quality scores of the two language sub-samples and two site characteristics associated with significantly higher quality, the practical relevance of these findings for online health information seekers should be interpreted with caution.

Background:Finding accurate health-related information on the Internet may be a real challenge for users lacking the critical skills necessary to assess the validity of online content, even if they browse websites that are compliant with credibility criteria. The aim of the study was to check whether an overall high website credibility or compliance to any of the individual criteria for credibility are correlated/associated with a higher quality of health-related information on a sample of Romanian and Hungarian stroke-related websites. Methods: The crosssectional study included a sample of 50 websites presenting stroke for the general population in Romanian and Hungarian language. The websites' compliance with 12 widely recognized credibility criteria, and the completeness and accuracy of the stroke-related articles found on the respective sites were systematically assessed by two independent evaluators applying a common evaluation procedure. Results: The mean value of the credibility score was 4.3 points (95% CI: 3.9-4.8), the mean value of the completeness score was 4.8 points (95% CI: 4.2-5.5), and the mean value of the accuracy score was 6.6 points (95% CI: 6.3-6.8). Correlation coefficients between the credibility score and completeness/accuracy score did not reach statistical significance (Spearman rho = 0.038, p = 0.793 and Spearman rho = 0.156, p = 0.278, respectively). With a few exceptions, the t-tests for independent sample comparison have shown no significant differences between websites that complied and those that did not comply with each individual credibility criterion. Conclusions: The mean credibility score of the Romanian and Hungarian stroke-related websites was poor and it was not correlated with neither completeness nor accuracy of the information displayed on the respective pages. With a few, practically irrelevant exceptions, compliance with individual credibility criteria was not associated with higher content quality on the investigated sample. 540136 Tîrgu Mureș, Romania. Tel +40 265 212 111 Alex Otniel Popescu • Str. Gheorghe Marinescu nr. 38, 540139 Tîrgu Mureș, Romania. Tel +40 265 215 551 David Maior • Str. Gheorghe Marinescu nr. 38, 540139 Tîrgu Mureș, Romania. Tel +40 265 215 551 Mihaela Dănilă • Str. Gheorghe Marinescu nr. 50, 540136 Tîrgu Mureș, Romania, Tel +40 0265 210 900 Mihaela Dobria • Str. Gheorghe Marinescu nr. 38, 540139 Tîrgu Mureș, Romania. Tel +40 265 215 551

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