“My knee is cracking” – What information is available on the internet about it? A systematic appraisal of the credibility, readability and accuracy of online information about knee crepitus

Abstract

Objectives: To summarise and systematically appraise the credibility, readability, and accuracy of the online information about knee crepitus. Design: Systematic appraisal of online information. Method: The top 20 URLs of two search engines (Google and Bing) for the following terms were screened for eligibility ‘knee crepitus’, ‘knee sound’, and ‘knee crackling’ (N ​= ​120 websites). Two reviewers assessed the websites for credibility (JAMA benchmark) and readability (Flesch Reading Ease and Flesch-Kincaid Grade Level tests). For accuracy, we performed a qualitative analysis creating thematic units based on the website's content and explored whether they were supported by evidence. Results: Fifty-one websites were included. There was a large variation in the overall credibility of websites, with more than half of the websites lacking credible information. The median Flesch reading ease was 62 (range ​= ​42–88) and Flesch–Kincaid grade level was 8 (range ​= ​3–12). Six key thematic units emerged from our qualitative analysis all with sub-themes within them. The main topics covered by websites were: (i) What is knee crepitus? (ii) Is knee crepitus a problem? (iii) What is the cause of knee crepitus? (iv) How to manage knee crepitus? (v) What are the health consequences of having knee crepitus? (vi) Who should I seek if I have knee crepitus? Conclusion: Patients and clinicians should take caution when seeking web-based information about knee crepitus. Websites about knee crepitus lack credibility, present a large variation in readability outcomes, and there was no research evidence available to support most of their information.

Keywords

• Knee
• Health information management
• Health communication
• Internet
• Cartilage
• Patellofemoral pain syndrome