This study shows that colorectal cancer websites were readable but potentially unreliable. Government certified sites were superior to non-certified sites. Improvements are required to provide patients with reliable information to make informed decisions on medical treatments. We propose that national cancer services develop reliable and easily readable information regarding the diagnosis and investigation of colorectal cancer. The site should provide adequate information regarding the treatment options and importantly how each treatment option would affect the patient's quality of life. Clinicians can then provide these websites to the patients before and after their consultations to allow the patient to be fully informed.

Internet information on vascular surgical conditions and procedures is poorly written and unreliable. We suggest that health professionals should recommend Web sites that are easy to read and contain high-quality surgical information. Medical information on the Internet must be readable, accessible, usable, and reliable.

Objectives and settingThe aim of this study was to create a hashtag #SoMe4Surgery on the social network application Twitter, and to examine the natural history of the resulting online community.Design and outcome measuresA prospective, four-stage framework was proposed and used: (1) inception phase (connection): users were actively invited to participate; (2) dissemination phase (contagion): several tweetchats were designed, scheduled and run; (3) adherence phase (feedback): Twitonomy and NodeXL summaries were regularly posted on Twitter; and (4) impact phase (outcomes): abstracts and manuscripts, and related projects on Twitter. Tweets, influencers and interactions were analysed, and a brief survey was shared with participants to assess demographics and motivations of social media use.ParticipantsUsers engaging with the #SoMe4Surgery hashtag.ResultsUsers of the hashtag came from a wide variety of specialties and geographical locations, as well as varying in age and stage of training. The inception of #SoMe4Surgery was followed by an increase in the follower count and impressions of users. A total of 675 tweeters posted 11 855 tweets with 30 122 retweets between 28 July and 27 December inclusive. There were new contributors and activity throughout the period. There were many more retweeters than accounts posting original content. Over a 10-day period ending on 31 December 2018, the number of followers of the 10 most influential accounts was higher than the number of followers of the 10 most engaging accounts (p=0.002). The mean (SD) number of tweetchat participants was 121 (64), who posted 719 (365) tweets and had a potential reach of 3 825 155 (1 887 205) accounts. Spin-off projects included surveys from low and medium-income countries, subspecialised hashtags, presentations and one publication.ConclusionsThe creation of a cohesive online surgical community may allow a flattened hierarchy, with increased engagement between surgeons, other healthcare professionals, researchers and patients.

This study has shown that currently 80 trusts in England provide acute and elective arterial and aortic surgery with 48 centralised complex and arterial vascular services. An integrated vascular service will provide the best quality of care, develop the latest techniques and improve clinical standards.

Surgeons and trusts should be able to provide patients with printed consistent and accurate information regarding their post-operative recovery time, including return to driving and return to work.