133 dianahealth.com: a useful tool that promotes appropriateness in healthcare

Objective DianaHealth.com (www.dianahealth.com) is an on-line database that seeks to improve the appropriateness of care and clinical practice by identifying recommendations of low and high value clinical practices around the world. It was developed in 2013 by the Department of Clinical Epidemiology and Public Health of the Hospital de Sant Pau in Barcelona. The website is open access, independent and regularly updated. It is available in English and Spanish, and has a search engine to retrieve appraisals using one or more search criteria. The aim of this work is to describe the behaviour of DianaHealth visitors during the last 2 years. Methods The information for analysis was gathered through a web-server programme (AWStats 6.9) and included number of visits per day, month and year; unique visits per month and year; annual mean length of the visits (minutes); number of pages and hits (files requested from the server) per visit; device used (desktop or mobile device), and user country. Data were tracked throughout a period of 24 months (2016–2017). The statistical analysis included the medians of the analysed metrics. Data were collected as information aggregates, considering absolute anonymity. Results The total number of recommendations included in DianaHealth.com until May 2018 was 4019. Between 2016 and 2017 there was an increase of 3 times of the total visits and 2 times of the unique visits. In 2016 there were 17 332 total visits and 8703 unique visits; and in 2017 46 490 and 16,980, respectively. The mean length of visit for both periods was similar (2016: 4 mins 50secs; 2017: 4 mins 17secs). The mean pages per visit was 7.09 in 2016 and 3.66 in 2017. The mean hits per visit was 24.02 in 2016 and 11.45 in 2017. In 2016 the 86.6% of them were done from a desktop, 12.7% came from mobile devices and 0.7% from other devices. In 2017 an increase in the use of mobiles was noted (82.7% desktop; 16.8% mobile, and 0.5% others). Both years, most of the hits were from Spain (79,9%); among European countries, most visits came from France (2.5%), and the United Kingdom (0.8%). Conclusions DianaHealth is a helpful and increasingly used tool, fact that is proven by the increase of 3 times of visits in one year, with more than 46 000 visits in 2017. Despite this important growth, more efforts must be made to promote and disseminate this website in order to improve knowledge and easy access of general public, professionals and stakeholders to low value recommendations.