Reliability of information about the use of antiepileptic drugs during pregnancy from three major web search engines in China

Objectives: The objective of this study was to assess the reliability of online information, as provided by three major search engines in China, about the usage of antiepileptic drugs (AEDs) during pregnancy. Method: Over eight weeks, six physicians conducted a literature search on six computers and six smartphones at a frequency of once per week. During each web search on each computer and smartphone, three major search engines in China were used, namely, Baidu, Sogou and 360. The search terms used were a combination of words, including one AED name (valproate/oxcarbazepine/levetiracetam/lamotrigine) and one Chinese word ("huaiyun" or "renshen", which means pregnancy in Chinese). The top ten websites retrieved from each search were recorded. After the content of each website was evaluated, the sites were categorized into 9 types. Meanwhile, commercial advertisements on each web page were also registered. Results: A total of 16,411 search results were assessed. After excluding the redundant web pages, 4840 search results were included in the data analysis. Only 12.05% of the search results were reliable, 47.75% were partly reliable, and 40.21% were unreliable. A total of 4139 (85.52%) webpages contained commercial advertisements. The results from a multivariate analysis suggested that websites with no advertisements and professional websites have an independent positive impact on reliability. Conclusion: Overall, little information on AED usage during pregnancy provided by major search engines in China was reliable. Practice implications: Accurate and professional online information for female patients with epilepsy should be provided through major efforts by the government, search engine companies, professional websites and epilepsy physicians.