Multiple types of grafts: biological and mechanical with guide to who has which (age >65 years biological)

• 0 – Mentions only one graft

• 1 – Mentions all but does not offer guide

• 2 – Mentions all and offers guide

Multiple types of procedure: Thoracotomy, minimally invasive procedure, transcatheter aortic valve replacement

• 0 – Mentions only one method

• 1 – Mentions some

• 2 – Mentions all

Advantages and disadvantages of biological and mechanical (warfarin, clicking, deterioration)

• 0 – No evaluation given

• 1 – Partial evaluation given (for example, advantages of both or advantages and disadvantages of one)

• 2 – Full evaluation given

In op complications

• 0 – Does not mention

• 1 – Mentions some and does not offer evaluation

• 2 – Comprehensive with evaluation

Post op complications (heartblock, thromboembolism, deterioration)

• 0 – Does not mention

• 1 – Mentions some and does not offer evaluation

• 2 – Comprehensive with evaluation

Indications for surgery — symptoms

• 0 – Does not mention

• 1 – Mentions some and does not offer evaluation

• 2 – Comprehensive with evaluation

Recovery (time off work usually 2–3 months, valve noise)

• 0 – Does not mention

• 1 – Mentions some and does not offer evaluation

• 2 – Comprehensive with evaluation

Misleading in terms of main procedure (for example, transcatheter procedure, minithoracotomy as mainstay)

• 0 – Not evident

• 1 – Unclear

• 2 – Clearly supporting one form of procedure

Bias towards type/make of graft

• 0 – Not evident

• 1 – Partially supports one or a few type(s)/make(s) of valve

• 2 – Clearly supporting one type/make of valve

Provides false information of any sort

• 0 – Not evident

• 1 – Occurs once

• 2 – Occurs more than once

Information known to be important and likely to be of interest to a patient

Previously published test for reliability of internet information¹²

Aspects of HON guideline criteria¹¹