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01.12.2012 | Correspondence | Ausgabe 1/2012 Open Access

BMC Medical Informatics and Decision Making 1/2012

An evaluation of the content and quality of tinnitus information on websites preferred by General Practitioners

BMC Medical Informatics and Decision Making > Ausgabe 1/2012
Kathryn Fackrell, Derek J Hoare, Sandra Smith, Abby McCormack, Deborah A Hall
Wichtige Hinweise
Kathryn Fackrell, Derek J Hoare contributed equally to this work.

Competing interests

DJH and DAH are serving members of the British Tinnitus Association, on the Professional Advisory Committee and the Board of Trustees, respectively. KF received a student bursary from Action on Hearing Loss to take part in this project.

Authors’ contributions

KF acquired, analysed and interpreted data, coordinated the study, and drafted the manuscript, DJH conceived of the study, participated in the design, acquired, analysed and interpreted data, and helped draft the manuscript, SS and AM acquired, analysed and interpreted data, DAH participated in design, acquired, analysed and interpreted data, and edited the manuscript. All authors approved the final manuscript. DJH (DipN, PhD) and DAH (PhD) have substantial expertise in tinnitus and have published several recent studies using qualitative research methods and evaluations of the GPG in primary and secondary care. DJH has 10 years clinical experience working in NHS. KF is a final-year psychology student with training in qualitative research methods. SS (BSc) is experienced in tinnitus research and qualitative analysis. AM (PhD) has experience in tinnitus research and significant expertise in qualitative website analysis. All authors read and approved the final manuscript.



Tinnitus is a prevalent and complex medical complaint often co-morbid with stress, anxiety, insomnia, depression, and cognitive or communication difficulties. Its chronicity places a major burden on primary and secondary healthcare services. In our recent national survey of General Practitioners (GPs) from across England, many reported that their awareness of tinnitus was limited and as a result were dissatisfied with the service they currently provide. GPs identified 10 online sources of information they currently use in clinical practice, but welcomed further concise and accurate information on tinnitus assessment and management. The purpose of this study was to assess the content, reliability, and quality of the information related to primary care tinnitus assessment and management on these 10 websites.


Tinnitus related content on each website was assessed using a summative content analysis approach. Reliability and quality of the information was assessed using the DISCERN questionnaire.


Quality of information was rated using the validated DISCERN questionnaire. Significant inter-rater reliability was confirmed by Kendall’s coefficient of concordance (Wt) which ranged from 0.48 to 0.92 across websites. The website Map of Medicine achieved the highest overall DISCERN score. However, for information on treatment choice, the British Tinnitus Association was rated best. Content analysis revealed that all websites lacked a number of details relating to either tinnitus assessment or management options.


No single website provides comprehensive information for GPs on tinnitus assessment and management and so GPs may need to refer to more than one if they want to maximise their coverage of the topic. From those preferred by GPs we recommend several specific websites as the current ‘best’ sources. Our findings should guide healthcare website providers to improve the quality and inclusiveness of the information they publish on tinnitus. In the case of one website, our preliminary findings are already doing so. Such developments will in turn help facilitate best practice in primary care.
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