User preference as quality markers of paediatric web sites

Objective: Little is known about the ability of internet users to distinguish the best medical resources online, and how their preferences, measured by usage and popularity indexes, correlate with established quality criteria. Our objective was to analyse whether the number of inbound links and/or daily visits to a sample of paediatric web pages are reliable quality markers of the pages. Design: Two-year follow-up study of 363 web pages with paediatric information. Measurements: The number of inbound links and the average number of daily visits to the pages were calculated on a yearly basis. In addition, their rates of compliance with the codes of conduct, guidelines and/or principles of three international organizations were evaluated. Results: The quality code most widely met by the sample web pages was the Health on the Net Foundation Code of Conduct (overall rate, 60.2%). Sample pages showed a low degree of compliance with principles related to privacy, confidentiality and electronic commerce (overall rate less than 45%). Most importantly, we observed a moderate, significant correlation between compliance with quality criteria and the number of inbound links (p < 50.001). However, no correlation was found between the number of daily visits to a page and its degree of compliance with the principles. Conclusions: Some indexes derived from the analysis of webmasters' hyperlinks could be reliable quality markers of medical web resources.