Health Information on the Internet

Consumers have access to medical information like never before. The Internet and its sophisticated search tools have resulted in:

  • A greater number of patients accessing information on the Internet
  • A greater number of people creating health-related websites
  • A number of research studies evaluating search skills, information gained and quality of health information on the Internet. These studies show that the quality of health information on the web varies tremendously.
  • There are valuable nuggets of information amid masses of JUNK.
  • Patients believe that the Internet is a reliable source of information

In the results of one study published in JAMA, the investigators searched the Internet for information on obesity, depression, breast cancer and childhood asthma. The results showed that less than ¼ of the first page of "hits" led to relevant content and the results showed that "Accessing health information using search engines and simple search terms is not efficient. Coverage of key information on English- and Spanish-language Web sites is poor and inconsistent, although the accuracy of the information provided is generally good. High reading levels are required to comprehend Web-based health information." [JAMA. 2001 May 23-30;285(20):2612-21.]

The Problem:

Content on the Internet is unregulated, and therefore, anyone can publish anything on the Internet. There is sound information on the Internet along with dangerous information. You need to be able to tell the difference!

Ask yourself the following:

  • Why did the person create the page?
  • What is the purpose of the web site?
  • What is in it for author?
  • Are they trying to sell me something?

There are 5 basic criteria for website evaluation: Accuracy, Authority, Bias, Currency, Coverage. Each of these alone is meaningless, but together they create solid guidelines for evaluation.

1. Accuracy

  • Is the information based on sound research?
  • Can the information on the web page be verified by another source?
  • Are the cited sources reliable?
  • Is the information consistent with other sources?
  • Are there grammatical or spelling errors?
  • Are there footnotes, bibliographies, or references so you can verify the information?
  • Are the references reliable? (a citation to Parade magazine does not have the same weight as an article from Health Affairs)

2. Authority

  • Who published the page? Is the author an authority on the subject? What are the person’s credentials?
  • Is the person or web site backed by a known organization?
  • Is the person affiliated with a university? If so, is the person a student or a faculty member?
  • Can you easily find contact information on the web page?
  • What is the domain name? (.edu, .gov ) Is it a personal page or supported by an organization?
  • Ads and pop ups – Scholarly and authoritative sites generally do not have ads or pop-up boxes.
  • Is the information consistent with other sources?
  • Contact information. The more information an author provides about him or herself, the better. Be skeptical about names of organizations that sound prestigious; the "National Alliance for Cancer Treatment Analysis" may sound like a reputable organization, but it could be out of someone’s basement.

Examples:
DHMO – United States Environmental Access Center (EAC)--No such thing exists
http://www.dhmo.org (click on - Editorial: Truth about DHMO http://www.dhmo.org/truth/Dihydrogen-Monoxide.html) Note statement at bottom of website = "Note: content veracity not implied"

Look at the URL

  • The tilde. Information that has the backing of an organization has better quality control than an individual, who has no one to answer to. Use of the tilde generally means that the information is from an individual and is not necessarily endorsed by the organization hosting the site. Example: http://members.tripod.com/~tourette13/
  • The domain. "Dot coms" are not necessarily bad, "dot orgs" are not necessarily good. Look at the content. Also, beware of domains that indicate that the health site originates outside the U.S. This may suggest treatment options that are not generally available in the US (Check the URL for .uk, .de, etc.)

3. Bias/Objectivity

  • Is the information showing just one point of view?
  • What kind of institution sponsored the webpage? A pharmaceutical company? A non-profit organization?
  • Is advertising clearly marked?
  • Can you tell if the information you are reading is an advertisement?

4. Currency/Timeliness

  • Is there a date on the page?
  • When was the page last updated
  • Do the links work?
  • Has there been more recent research on the subject?

    • Questions to ask:

  • Is the information dated or can you tell from the content when it was written?
  • Is the information likely to change?
  • Is the information recent enough to be useful?

Visit: Hormone Replacement
When was this page written?

5. Coverage

Many health sites are not comprehensive. The information they give may be accurate, but important information may be left out. Don’t stop with a single site unless you can answer these questions to your satisfaction.

  • How does this information compare with other sources (including published print sources) on the same topic?
  • Is a better source available? (Consider varying your approach to searching for relevant information.)
  • Does the site have a disclaimer that describes any limitations, purpose, scope, currency, or authority of the information?
  • Is the information complete?
  • Are there sources given for additional information?
  • Does the site have a disclaimer that describes any limitations, purpose, scope, currency, or authority of the information?