1. Taxonomy
2. Resource Identification
3. Consideration Criteria for Web site to be included
4. Review Process
5. Geriatric Online Assessment Tool (GO-AT)
6. Exempt from review
7. Criteria for accepting a resource for posting (Acceptance Criteria)
8. Maintenance

TAXONOMY
The objective of developing the taxonomy was to create a hierarchical list of topics (Quest list) that would allow us to identify and categorize geriatric resources. A list of geriatric topics was matched to corresponding headings or heading/subheading combinations from the controlled vocabulary of the National Library of Medicine’s Medical Subject Headings (MeSH). In terms of specificity, the list is restricted to three tiers or indentations (see Taxonomy list). The list encompasses many of the diseases that are specific to the geriatric population; “geriatric syndromes” and organ-specific diseases that are commonly encountered but not specific diseases in this population.

RESOURCE IDENTIFICATION
Resource Identification Methodology:
Geriatric resources were first accumulated by scanning the web sites of national organizations and associations, and reviewing medical meta-lists, and resource directories which specialize in geriatrics and gerontology. A list of over 500 original sources was compiled from these directories and meta-lists. From the 500 sources a short list of 50 superior sources was compiled. By referring to this list as well as using search engines like Google, resources were located for each Quest List term. These resources were limited to a professional scope and were required to fall within one of the four following categories: Practice Guidelines, Clinical Management, Clinical Trials, and Educational Resources.

CONSIDERATION CRITERIA.

To be considered for inclusion at the GeriatricWeb the site/document should:

1. Be targeted for health care professionals
   
2. Be free or public access sites (paid subscription sites will not be reviewed)
   
3. Deal with geriatric-related health issues (Those with general health-related issues will not be included unless information may impact the elderly population but this needs to be decided by the Review Board)

REVIEW PROCESS

Each identified resource passes through multiple levels of review:

Level I – The librarian reviews identified resources for consideration to be included in GeriatricWeb. (See Consideration Criteria)
Level II – A screening process by Editor-in-Chief for relevance, public availability, and criteria. (See Consideration Criteria)
Level III - If the resource satisfies the consideration criteria, then it is forwarded to a reviewer from the ERB. Each reviewer has provided an interest area and this is matched to the extent possible. Reviewers use the Geriatric Online Assessment Tool to evaluate sites and assign a numerical score to each.
Level IV – After the reviewer provides his/her evaluation, it is reviewed by the editor and if it satisfies the Acceptance Criteria it is approved for posting.

GERIATRIC ONLINE ASSESSMENT TOOL (GO-AT)

Introduction

The Geriatric Online Assessment Tool is a tool that was developed based the Health Summit Working Group Criteria for assessing quality of Health Information on the Internet and modified to match the GeritaricWeb Project aims. This document is a companion for reviewers to ensure some standardization in the use of the GOAT tool and the resulting assessments. Please note that some aspects of the review process are subjective.

The GOAT is divided into 2 sections: the resource information and the resource assessment. In addition, the GOAT requests the reviewer name and date of review.

The Resource Information
This section collects data on the resource (web site or PDA resource). It has seven questions:

1. Web site Address: Enter the URL that has been provided to you by GeriatricWeb; eg: www.americangeriatrics.org/products/postionpapers/cga.shtml In most instances, the resource librarian will automatically complete this when you log on to review.

2. Web site Title: Enter the title of the resource. For example: Comprehensive Geriatric Assessment position statement of the AGS. Most of the time, the resource librarian will automatically complete this when you log on to review. Please make sure the title is correct and is self-contained.

3. Author(s) [mark all that apply]: Mark the author for this Web site, please note that the author is the entity that has created the resource not the one who publishes it (Even if the resource has been accessed by the publishing entity please mark the information about the authoring entity). A resource can be authored by many entities or by one entity that can be classified under many categories. Please mark all that apply.

• Health care provider / Physician group (PP): choose this if the author is a healthcare provider, a physician group, hospital, etc.
  
• Academic Institution (AI): choose this if the author is an academic institution e.g. a medical school, a teaching institution, etc.
  
• National/Governmental Organization(NO): choose this if the authoring entity is a national organization such as American Geriatric Society or a federal agency such as National Institute of Health or Federal Drug Administration.
  
• Commercial/Pharmaceutical Company (CC): Choose this if the authoring entity is a pharmaceutical company such as Merck Inc, or a commercial entity.
  
• Others: If none of the above applies please mark this one.

4. Country [optional]: enter country of origination of the resource or that of the author’s country where the document or resource was created. If the author and resource are different, then use the author’s country.

5. Appropriate Audience [mark all that apply]: Mark here your judgement about the appropriate audience, which can be one of the following:

• Medical Students
  
• Residents
  
• Fellows
  
• Faculty

6. Web site/Resource Description [Max: 150 words]: Briefly describe this Web site/resource you are reviewing eg:
This linked document is the American Geriatric Society’s position statement on Comprehensive Geriatric Assessment (CGA). It describes the definition of CGA, the components of CGA and the research methodology for CGA.

The Resource Assessment

The tool for assessment has been developed to be able to incorporate many aspects of geriatric resources in a concise score. Higher scores mean that the resource is more reliable. The resource is evaluated on credibility, accuracy, design, and educational usability, with 25% for each characteristic. Some aspects of this process are subjective.

Resource Credibility
1. Author/Source: [Information on the author is provided including credentials and affiliations]: eg if the author is a single individual what are his credentials. If it is an institution or organization who was involved in creating the documents.
Yes [5] No [0]
2. Currency: [Date of original information and posting date if available] does the resource provide when the document was authored or when it was posted on the web.
Yes [5] No [0]
3-Conflict of interest: [Apparent or hidden conflict of interest] In your judgement, is there any conflict of interest. Eg the authoring entity has interest in providing the positive data but not the negative data, or downplays the negative data, on a certain intervention. If the entity admits to a conflict of interest, please mark yes.
Yes [0] No [5]
4-Disclaimer: [Provide a statement on conflict of interest if present, medical advice, and copyright]: If there is a conflict of interest, is there a disclaimer, how about copyright statement, how about use of the site as medical advice?
Yes [5] No [0]
5-Editorial/peer review and evidence based: [a review process of geriatric medical information is done/provided]: In your judgement, is the information provided evidence based, is there a peer review to that information?
Yes [5] No [0]

Resource Accuracy [1 lowest / 5 highest]

This section uses a 1 to 5 scale on accuracy of the site. After reviewing the site, what was your impression, on overall accuracy, is it up-to-date, are the sources of the information provided eg references, is the information balanced and two sided?

	1	2	3	4	5	Score
1-Overall accuracy/reliability
2-Up-to-date [5=most up-to-date]
3-Information sources stated
4-Limitation of evidence presented
5-Balanced opinion presented

Resource Design [1 lowest / 5 highest]

This section uses a 1 to 5 scale on the site or resource design: did you like the design, how was the flow from one part of the resource to the other, any grammar problems, how about inside and outside linkage, is there a search utility and how good is it?

	1	2	3	4	5	Score
1-Overall aesthetics/Looks
2-Logical organization and flow [navigability]
3-Language and grammar
4-Internal/external links and browsing
5-Quality of Internal search [if none choose 1]

Educational Principles [1 lowest / 5 best]

This section assesses the educational process of the resource on a scale of 1 to 5. In your judgement, this resource has stated the objectives, promoted the learning process, is interactive, uses examples, and how relevant is it to the geriatric field/care of older individuals?

	1	2	3	4	5	Score
1-Learning objective stated
2-Promotes and stimulates learning
3-Interactive (feedback, Q&A)
4-Examples given
5-Geriatric Relevance [5=most relevant]

Confidentiality

The site has a confidentiality statement [for example, the site states whether it collects information on its users or not; if so how information collected is to be handled]: C+ if it does C- if it does not.

EXEMPT FROM REVIEW

The following sites would be exempt from the resource assessment section of the GO-AT, however resource information section of the GO-AT will still be completed (including audience, description, source etc.):
a. Medical Illustrations: pathology slides, radiology images
b. Clinical Trials
c. Guidelines and position statements

ACCEPTANCE CRITERIA

The resource will have to score at least 75 on the total score. If it scores between 50 and 74, then it has to score 18 or greater on the Accuracy domain and 15 or greater on the Credibility domain. The site will be rejected if total score is less than 50 (49 or less) regardless of the accuracy/credibility domain scores.