DISCERN: an instrument for judging the quality of written consumer health information on treatment choices.
Charnock, D, Shepperd, S, Needham, G et al. · Journal of epidemiology and community health · 1999 · DOI
Quick Summary
This study created DISCERN, a tool that helps patients and healthcare providers evaluate whether written information about medical treatments is accurate and trustworthy. Researchers tested the tool on health information about three conditions, including chronic fatigue syndrome (now called ME/CFS), to see if different people using it would reach similar conclusions about quality. The tool consists of 15 questions and works best when used by people with training or experience in healthcare information.
Why It Matters
ME/CFS patients often encounter conflicting or low-quality information about treatment options. DISCERN provides a standardized method for evaluating the reliability of health information, directly empowering patients and advocates to distinguish trustworthy resources from unreliable ones. This is particularly important for ME/CFS, where misinformation can influence treatment decisions with significant health consequences.
Observed Findings
Weighted kappa for overall quality rating: 0.53 among expert panel, 0.40 among information providers, and 0.23 among self-help group members.
Higher agreement levels were associated with user experience and professional knowledge of consumer health information.
Reliability varied across individual instrument items, reflecting subjectivity in rating certain criteria.
The final instrument consisted of 15 questions plus an overall quality rating.
Respondents reported good face and content validity of the instrument in questionnaire data.
Inferred Conclusions
DISCERN is a reliable and valid instrument for assessing written consumer health information quality among experienced users.
The instrument can discriminate between high and low-quality health information publications when applied by trained providers.
Professional experience and training improve inter-rater reliability and consistent application of the tool.
DESCERN is generally applicable across different health conditions and organizations.
Remaining Questions
Does DISCERN rating correlate with clinical accuracy when assessed against systematic reviews or clinical guidelines?
What This Study Does Not Prove
This study does not prove that DISCERN assessment correlates with actual clinical outcomes or patient benefit. It also does not establish that using DISCERN will change patient decision-making or improve health outcomes. The moderate-to-fair inter-rater reliability suggests that subjective judgment plays a significant role, and the instrument's effectiveness may depend heavily on user experience and training.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →