Quality of French-language online information on low back and radicular pain: A systematic evaluation of noncommercial websites.

Abstract

Low back pain (LBP) and associated radicular leg pain are among the most prevalent musculoskeletal conditions worldwide. Despite clinical guidelines promoting evidence-based management strategies, online health information remains of inconsistent quality, with potential implications for care outcomes. To conduct a systematic evaluation of the credibility, information presentation, accuracy, and comprehensiveness of French-language, noncommercial websites providing treatment information on LBP and radicular pain. We conducted in August 2022 systematic Google searches across country-specific domains in France, Belgium, Switzerland, and Canada. We included freely accessible, French-language webpages that provided at least one treatment recommendation for LBP or radicular pain. Commercial webpages and those requiring registration were excluded. Two independent reviewers assessed each webpage using the Journal of the American Medical Association benchmark criteria for credibility and a modified Netscoring framework, a tool designed to evaluate the quality and presentation of online health information. Treatment recommendations were coded against a synthesis of clinical guidelines to evaluate accuracy and comprehensiveness. Overall, 88 webpages were included, 41% having been updated since 2020. Comprehensiveness varied widely: only 41% of LBP recommendations and 26% of radicular pain recommendations were addressed. Absolute accuracy of webpage recommendations was 22%, with institutional webpages showing greater accuracy than mainstream sources (28% versus 15%, p < 0.001). Pharmacological therapies were often inappropriately promoted. Concerning credibility, only a small minority of the webpages (19%) disclosed potential conflicts of interest, and 60% presented bibliographic references. Most French-language noncommercial websites provide incomplete and frequently inaccurate treatment information on LBP and radicular pain. Institutional websites generally offer better quality content, but significant gaps remain - particularly for radicular pain. Health professionals should be aware of the poor quality of online French-language information on LBP and guide patients toward trustworthy resources. Developing validated, user-friendly platforms could help reduce misinformation and support evidence-based self-management.