# Evaluating the Quality of Online Information on Percutaneous Endoscopic Lumbar Discectomy (PELD) Using the DISCERN Instrument

## TL;DR

This study assesses the quality of Italian online information about a minimally invasive back surgery called PELD and finds it to be moderate-to-low, with poor coverage of risks and evidence sources.

## Contribution

The study evaluates the quality of Italian-language online resources on PELD using the DISCERN instrument, revealing gaps in critical information.

## Key findings

- The mean DISCERN score for 20 websites was 39.5 out of 80, indicating moderate-to-low quality.
- High clarity in explaining the procedure was offset by poor citation of sources and discussion of uncertainties.
- Strong inter-rater reliability (Cohen’s kappa = 0.82) was achieved between the two reviewers.

## Abstract

Introduction: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgical procedure increasingly referenced in patient-oriented websites. However, the quality of such online health information is inconsistent. This study evaluates the quality of Italian-language web content on PELD using the DISCERN tool.

Methods: A systematic search was conducted on 25 May 2025 using the Italian-language interface of Google (Google LLC, Mountain View, California, United States) with the keywords "PELD," "discectomia endoscopica percutanea," and "ernia del disco PELD." Twenty websites targeted at the general public were selected. Each was independently assessed using the 16-item DISCERN instrument by two trained reviewers. Inter-rater reliability was calculated using Cohen’s kappa coefficient.

Results: The mean overall DISCERN score across the 20 websites was 39.5 (SD = 8.7) out of 80, indicating moderate-to-low quality. High-scoring domains included clarity of procedural explanation (mean = 4.2/5), while critical aspects such as citation of sources (mean = 2.1/5) and discussion of uncertainties (mean = 1.7/5) were underrepresented. Cohen’s kappa was 0.82, indicating strong agreement between reviewers.

Conclusion: Online Italian-language resources on PELD exhibit moderate quality and frequently omit essential components such as treatment risks and alternative options. Enhancing transparency and evidence citation is essential to improve the quality of patient education materials.