Honolulu patients are among the happiest with their doctors as compared to others nationwide, a study by Denver-based Vanguard Communications showed.

The health care marketing and public relations firm said it used software to analyze Internet reviews of 46,300 health-care providers on Google+ and Yelp.com.

It found the best patient reviews in San Francisco and Oakland, Calif. and Honolulu, and the harshest critics in Bakersfield and Modesto, Calif. and North Hempstead, New York.

The company collected ratings of individual doctors, group medical practices, clinics and hospitals in the 100 largest U.S. cities.

The so-called Happy Patient Index ranked each city according to its average patient rating on the five-star scale used by both websites.

Online doctor reviews have caused controversy over their accuracy and fairness, particularly among the medical profession, though a recent study in the Journal of the American Medical Association reports that 35 percent of people select providers based on good reviews, while 37 percent avoid them based on bad reviews, the company said.

For more information, including rankings of all 100 cities, please visit VanguardCommunications.net/hpi-100-rankings/.