Assessing the Quality of Online Resources for Vascular Neurosurgery and Skull Base Surgery: A Bilingual Evaluation Using DISCERN and JAMA Benchmarks

Introduction Patients increasingly seek information about complex neurosurgical conditions online. The quality of such resources has not been systematically studied for vascular neurosurgery and skull base surgery. Research question How do German- and English-language online resources for eight vascular and skull base neurosurgical conditions compare in reliability and transparency, and is search rank associated with quality? Material and Methods A simulated Google search was performed for nine search terms covering eight conditions in German and English. The first 20 results per search were rated by two independent raters using the modified DISCERN Plus score (16–80) and JAMA benchmarks (0–4). Non-parametric tests, effect sizes and intraclass correlation coefficients were calculated. Results In total, 355 websites were included (177 English, 178 German). Mean DISCERN score was 41.1 ± 9.7 and mean JAMA score 2.61 ± 0.94 (fair quality). English-language sites scored higher than German sites on both instruments, with small effect sizes (r = 0.12–0.13). Host type was strongly associated with JAMA scores (ε 2 = 0.25); educational and governmental sites scored highest. Among English-language results, top-ranked websites were of higher quality (rho = -0.315; positions 1–5: median DISCERN 49.8 vs. 40.0–42.0 thereafter), whereas rank was unrelated to quality in German-language results. Interrater agreement was good to excellent (ICC 0.79–0.82). Discussion and Conclusion Online resources for these conditions are generally of fair quality. Top-ranked English-language results tended to be of higher quality, whereas search rank was not informative for German-language results. Guiding patients, particularly German-speaking patients, towards reliable resources remains essential.