Assessing the quality of internet resources on pediatric neurosurgery for caregivers

Purpose Parents increasingly seek online information about pediatric neurosurgical conditions. We assessed the quality and transparency of German- and English-language pages on seven common conditions. Methods A simulated lay Google search (30 December 2025) used one German and one English term per condition. The first 20 results per query were screened; the condition-website record was the unit of analysis. Two raters independently scored each page with the 16-item DISCERN Plus instrument, an adapted DISCERN version with condition-specific content items (range 16–80), and the four JAMA benchmarks. Analyses used non-parametric tests and mixed models accounting for domain clustering. Results After five exclusions, 275 records remained (139 English, 136 German). The mean DISCERN Plus score was 39.9 ± 12.3 of 80; 46.9% fell into the exploratory “poor” or “very poor” bands. The mean JAMA score was 2.6 ± 1.0, and 54 pages (19.6%) met all four benchmarks. English pages scored higher (DISCERN Plus median 41.0 vs 35.8, p < 0.001; JAMA 3.0 vs 2.0, p = 0.002), also after adjustment for host type and domain clustering (+ 4.6 points, p = 0.010). Scores differed by host type in the overall test, with descriptively the highest medians for governmental sites; no differences between conditions were detected. Search rank was weakly associated with DISCERN Plus scores and not significantly with JAMA scores. Conclusions Information for caregivers is of moderate-to-low quality with marked transparency deficits, and Google ranking is only weakly related to quality. Institutions should pilot a pre-publication checklist for family-facing pages, and clinicians should recommend vetted resources.